bluuebunny/crossref_metadata_2025_split huggingface dataset:
Local solutions by slum communities to deal with summer water scarcity: Learning from Indore, India
Authors: Agarwal S , Verma S , Kothiwal K , Verma N , Vishvakarma K 
Published: October 2020

Abstract

Issue
Government of India's, NITI Aayog reports that 600 million people in India face extreme water stress. Slums and similarly vulnerable urban populations face huge challenges in accessing water for basic needs, increasing in summers. Indore is an extreme water stressed city in India.

Methods
During Urban Health Resource Centre's (UHRC) program work in slums, including women's groups UHRC forms and trains in 2018 we learnt of acute water scarcity in summers. Women in 16 slums were motivated to evolve and implement possible solutions. Most slum dwellers provide services on low wages to the city. With public bore-wells drying-up, in Feb.- May 2019 UHRC helped women's groups' submit community requests, reminders to elected ward representatives and Municipal offices for free water tankers. UHRC motivated slum families to collectively negotiate with private providers to reduce cost, systematise water supply for more families. In 4 peri-urban slums we strengthened water access relationship between farmers and slum dwellers.

Results
During Feb.-May 2019 10 of the 16 slums received free water tankers from Municipal Corporation. More population of 4 peri-urban slums accessed water from farmer's tube-well. Slum families evolved coping mechanisms of storing more general use water in underground tanks or many cans. Families with larger storage shared water with needy families demonstrating social cooperation.

Lessons
Trained and mentored slum women's groups gently negotiating with elected ward-level politicians and municipal officials helps in provision of free water tankers in summers. This strategy to get govt. water supply in slums is adaptable in fast growing Indian cities. Owing to geographical proximity, rural-urban cooperation can help slums in city's fringes obtain water from farmer tube-wells used for irrigation. Fostering community cooperation helps more needy families get water.

Key messages
Slum communities develop local mechanisms to access and store water which need to be understood by civil society organisations and Government to improve solutions for water supply in summer months. Slum women emerge as dynamic actors to improve the lives of both women and men (Sen, 2000). In this case women help negotiate for and foster community cooperation for water, store more water.
What is the healthcare carbon footprint? A collaborative analysis of current literature
Authors: Di Fonzo D , Rivolta S , Mazzolai E , Turatto F , Mammana L , Righini M 
Published: October 2020

Abstract

Background
Climate change (CC) is a public health (PH) issue of growing concern. Health care systems in every country have a significant impact in terms of greenhouse gas emissions (GHGE) causing global warming, but there seems to be a general lack of knowledge about this. As members of the junior study group on CC and PH of the Italian Society of Hygiene (SItI), we launched a project of shared education and literature research about the carbon footprint of healthcare (HCCF). We believe such an effort to be useful in spreading awareness and promoting change both in clinical practice, health care management and at policymaking level.

Objectives
To answer these questions: What is the estimated national and global HCCF?
Which activities contribute to HCCF?
What are the possible actions and policies to reduce HCCF while providing universal health care of good quality in all countries?
From Dec 2019 to Feb 2020 we used databases and backward citation searching to retrieve references which we split among individuals to process, then we shared summaries of the material with the group.

Results
HCCF makes about 4.4% of all GHGE, with important variations among countries. We found estimates on emissions for various activities (e.g. operating theatres) and items (e.g. inhalers), as well as proposed solutions for practitioners, managers, manufacturers and policymakers (e.g. low-impact technologies, advocacy, health promotion to reduce healthcare volumes).

Conclusions
HCCF is complex, attributable to many components and amenable to mitigation through actions at all levels, with additional benefits for efficiency and public health. These conclusions are relevant for all countries as they imply joint international and transversal efforts throughout the world's health care sector.

Key messages
Current data and analysis, available for several services and in many countries, show healthcare carbon footprint is significant. Emissions from health sector can be reduced while granting universal healthcare globally.
Perception of the risk of contamination through feeding in pregnant and breastfeeding women
Authors: Company-Morales M , Fontalba-Navas A , Rubio-Jimenez M F , Gil-Aguilar V , Arrebola J P 
Published: October 2020

Abstract

Introduction
Persistent Toxic Substances (PTS) are substances that are characterized by the cumulative effect at low doses inside the body. Exposure to PTS in pregnant and breastfeeding women, through food consumption, shows various harmful effects on the health of the mother, the fetus and the baby. The objective of this article is to analyze how pregnant and breastfeeding women perceive the presence of chemical substances in food and reflect on the accumulation, transmission and elimination of these substances.

Methodology
Descriptive and interpretive study under the qualitative research paradigm following a phenomenological and ethnographic perspective. As instruments to obtain the primary data we rely on 111 semi-structured interviews with pregnant and breastfeeding women, 4 focused ethnographies, 8 focus groups (63 women), 71 feeding diaries, 71 free listings. To encode the content of the speeches of pregnant and nursing women we rely on the N-Vivo 12 software.

Results
Pregnant and breastfeeding women are concerned about food quality controls. Women trust on local and seasonal foods such as fresh fruits and vegetables from non-extensive crops and close to their home. Foods that produce distrust in women are processed, packaged foods, red meat and large fish. The latter foods promote in women a perception of risk of contamination by chemical substances, manifesting a defenseless situation to maintain a diet without contaminants.

Conclusions
Pregnant and breastfeeding women in Spain have no information on the risk and danger of synthetic chemicals or PTS, with the exception of certain toxic substances such as mercury present in large fish. Women maintain a duality in their own care and that of the fetus or child. This circumstance implies that the women interviewed believe that PTS and synthetic chemicals may have different harmful effects on the mother and the degree of growth of the fetus and, subsequently, of the baby.

Key messages
Future mothers are worried about the type of product they eat, knowing that food influences healthy growth and development of the fetus. Pregnant and breastfeeding women often distrust “processed” or “industrial” foods, which they tend to associate with low quality and large amounts of additives and chemical substances.
Influence of tobacco and e-cig smoke on intestinal microbiota: a systematic review
Authors: Giffi M , Antinozzi M , Sini N , Valeriani F , Gallè F , Romano Spica V , Liguori G , De Vito C , Cattaruzza M S 
Published: October 2020

Abstract

Background
Intestinal microbiota (IM) plays a crucial role in maintaining human body homeostasis, yet it is highly susceptible to lifestyle changes and environmental factors, such as tobacco and e-cig smoking.
This systematic review aims to investigate the relationship between smoking and IM in healthy humans, by assessing abundance of Phyla and species' variability.

Methods
PubMed, Scopus and Web of Science were searched until April 2019. Studies assessing IM of healthy adult tobacco/e-cig smokers, collected on faecal samples and analysed with genome sequencing of rRNA 16 S, were included. Any type of study design, described in English, was considered. Quality assessment was performed with Methodological index for non-randomized studies and Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies.

Results
Eight out of 1,838 studies (one controlled prospective and seven cross-sectional studies) were included. The only controlled prospective study found a signiﬁcant increase in α and β-diversity, an increase in Firmicutes (p = 0.014) and a decrease in Bacteroidetes (p = 0.019) after a smoking cessation intervention. In cross- sectional studies, ﬁve out of seven studies found a statistically signiﬁcant decrease in α-diversity among tobacco/e-cig smokers, while results on β-diversity were more contradictory. One out of two studies evaluating Firmicutes found a signiﬁcant decrease in smokers (p = 0.047). The only study assessing Bacteroidetes found a signiﬁcant increase among smokers (p = 0.015). Five studies analysed genera, three of them found a decrease in Bacteroides and two an increase in Prevotella.

Conclusions
What seems to emerge is a decreasing species’ variability in smokers, yet it is difficult to proﬁle IM in smokers in terms of phyla’s abundance, because of few studies available and some further limitations, such as small sample sizes and lack of adjusted analysis to cope with confounding factors like gender, diet and other lifestyles.

Key messages
There is a decrease in species’ variability among smokers. Further studies are needed to assess abundance of phyla in healthy smokers, taking into account confounding factors.
Depression and lack of physical activity as factors leading to higher health care utilisation
Authors: Dorner T E , Haider S , Grabovac I , Rieder A 
Published: October 2020

Abstract

Background
Depressive symptoms and lack of physical activity (PA) often occur simultaneously, since depression, associated with listlessness can lead to lack of PA, and lack of PA, associated with poor quality of life and health satisfaction can lead to depressive symptoms. Both factors are independent risk factors for a higher health care utilisation. We aimed to assess the effects of the combination of depressive symptoms and lack of aerobic PA on the probability of using in- and outpatient health care services.

Methods
Data from 15.770 people from the nationally representative Austrian Health Interview Survey from 2014 were used for the analysis.

Results
In analysis, adjusted for socio-demographic, health related, and lifestyle-related factors, the combination of depressive symptoms and lack of PA were associated with higher odds of outpatient health care utilisation (OR: 1.43; 95%CI: 0.99-2.07) in men and (OR: 2.02; 95%CI: 1.50-2.73) in women, and with higher odds of inpatient health care utilisation (OR: 1.52; 95%CI: 1.02-2.26) in men and (OR: 1.75; 95%CI: 1.28-2.40) in women. Being affected by depressive symptoms alone showed slightly lower, and being affected by lack of PA alone showed clearly lower OR for health care utilisation compared to the combination of the two factors

Conclusions
Our results show that the combination of depressive symptoms and lack of PA are associated with a higher health care utilisation. Both factors are often neglected health hazards in the health care system and the attendance of affected people could be regarded as opportunity to address those factors properly.

Key messages
The combination of depressive symtoms and lack of physical activity lead to higher health care utilisation. Addressing those factors in the health care system properly would be a good opportunity to address those important health hazards.
Human Centric Lighting: The impact of light on sleep and attention of factory shift workers
Authors: Kindt S , Van de Putte E , Bracke P , Vandevivere L , Ryckaert W 
Published: October 2020

Abstract

Introduction
Increased blue-enriched morning light is often said to support circadian rhythm synchronization. Through a better sleep quality, one's cognitive and emotional functioning can also be enhanced. However, it is unclear which light characteristics (especially illuminance at eye level) are necessary to obtain a wellbeing effect in employees. This field study investigated different lighting conditions in a truck factory.

Methods
71 shift workers participated in the study during their morning shift (6 am - 2 pm). Measurements of sleep (MotionWatch8), attention (D2 attention task, go no-go computer task) and visual comfort (questionnaire) were administered before and after changing the lighting conditions. A Human Centric Lighting-condition (HCL; vertical melanopic equivalent daylight illuminance (MEDI) = 250 lux, CCT=5000 K; N = 33) was compared with a control LED-condition (MEDI = 44 lux, CCT=4000K; N = 38).

Results
Results show that workers in the HCL-condition showed a larger improvement in sleep efficiency (p=.057) and concentration (p=.01) than the control LED-group. No differences were found in visual comfort between groups.

Discussion
Preliminary results are promising and show that 250 MEDI might be a sufficient cut-off to stimulate workers' sleep and cognition. The high illuminance level was not detrimental in the HCL condition for the perceived visual comfort.

Key messages
Blue-enriched morning light supports sleep and concentration in shift workers. High illuminance levels are not detrimental for the perceived visual comfort.
Evidence-based practice competency and its related factors among healthcare students
Authors: Tlili M , Tarchoune S , Aouicha W , Lamine H , Taghouti E , Dhiab M B e n , Chelbi S , Ajmi T , Mallouli M , Ben Rejeb M 
Published: October 2020

Abstract

Background
Evidence-based practice today is a worldwide approach in optimizing quality of healthcare. This approach remains little known among Tunisian future healthcare professionals. This study aimed to describe health sciences students' competencies in Evidence-based practice (attitudes, skills and knowledge) and to determine factors associated with these competencies.

Methods
A descriptive cross-sectional study was conducted from February to March 2018, at the Higher School of Health Sciences and Techniques of Sousse (Tunisia) among health sciences students. Data were collected using the validated Evidence Based Practice Competencies Questionnaire (EBP-COQ) measuring students' knowledge, attitudes and skills in Evidence-based practice. The Statistical Package for Social Sciences (SPSS.20) software was used to analyze data. Independent-Samples T test and One-way ANOVA test were performed to assess the differences between the different subgroups and their association with the Evidence-based practice components.

Results
Altogether, 365 students participated to the study (response rate: 93.11%). The overall Evidence Based Practice Competencies score was 3.26±0.53 out of 5. The attitude, skills and knowledge subscales received 4.04±0.41; 3.05±0.77 and 2.70±0.74 as mean scores respectively. Students' demographic and academic features were significantly associated with their competencies in Evidence-based practice including age (p &lt; 10-6), gender (p &lt; 10-3), academic degree (p &lt; 10-6), English-language reading skills (p &lt; 10-6), students' education in research methodology (p &lt; 10-6) and statistics (p &lt; 10-5), and their familiarity with the term “Evidence-based practice”(p &lt; 10-6).

Conclusions
The reported knowledge and attitudes among the future caregivers is considered below the required competency standards. These findings highlight the urgent need for changes in the current educational strategies to ensure successful implementation of Evidence-based practice in Tunisia.

Key messages
The transition from studentship to a professional health-caring role requires that students are well equipped with EBP competencies to increase their likelihood of utilizing EBP in their future. Understanding the underlying factors that may influence Evidence based practice competencies is useful in developing teaching strategies for effective EBP.
Changing students' knowledge and attitudes towards intimate partner violence
Authors: Papadakaki M , Apostolidou A , Giakoumaki E , Taraktsi S , Chliaoutakis J 
Published: October 2020

Abstract
The need for effective awareness raising interventions for the prevention of intimate partner violence (IPV) has been widely acknowledged, given its frequency among dating relationships. The current intervention study aimed to improve IPV knowledge, attitudes and practices of university students. A pre/post-test design with a control group was employed to compare changes in baseline measures of IPV at post intervention stage. A total of 80 higher education students participated in the study and provided full data; 40 students (intervention group) and 40 students (control group). The awareness raising intervention included: a) a one-day intensive educational seminar, b) reminder and email messages over a 4-week period, and c) demonstration of informational material in public places. Students in the intervention group performed better than those in the control group regarding IPV attitudes (p=.174 and p=.011). No statistically significant improvements were shown in terms of IPV knowledge and self-reported IPV victimization/perpetration. Further studies are necessary to decide on the structure and content of awareness raising interventions that could serve as an IPV prevention measure for young people.

Key messages
Higher education curricula need to incorporate lessons on intimate partner violence management. Longer, practice-based interventions may have a greater effect in changing students' behaviours towards intimate partner violence.
Dental caries among refugees in Europe: A systematic Literature Review
Authors: Bhusari S , Ilechukwu C , Elwishahy A , Horstick O , Winkler V , Antia K 
Published: October 2020

Abstract

Background
Oral health is one of the most neglected aspects of refugee health. Conflict, violence, loss and unfamiliarity faced by refugees and the reliance on the host country make it difficult to achieve good oral health. The aim of the study was to systematically review the evidence on the prevalence of dental caries among refugees and to evaluate the provided dental care services in the European region.

Methods
Following the PRISMA guidelines, we searched PubMed, Cochrane, WHOLIS, Web of Science, Medline Ovid, and Google Scholar identifying studies on dental caries among refugees in Europe focusing on articles published after 2015 till September 2019. The words caries, decay, DMF, and dental health, refugee and asylum seeker were used.

Results
We obtained 3004 records and included 11 studies in the analysis. The 6 studies primarily focusing on oral health showed a prevalence of caries between 55.8% and 100%, while it ranged from 3% to 65% in the remaining 5 studies investigating the general health of refugees. Caries prevalence was proportional to age and inversely associated with education, whereas gender and country of origin showed no significant association. Oral health is nowhere part of the general health assessment done on arrival and is mainly complain based. Treatment is available at an emergency basis and in equivalence as that of local populations only after the acceptance of refugee status. Lack of orientation, primary focus on resettlement, lack of uniformity, language, cultural and economic barriers emerged as explanatory models for the limited access to oral health care.

Conclusions
Our study identified a high prevalence of caries and limited access to dental health services as the main challenges. The necessity of oral health check-ups will help to shift from curative to preventive oral health care. Further research is urgently needed to better understand the dental health needs of refugees in Europe.

Key messages
Necessity of oral health check-up irrespective of need will help make shift from curative to preventive oral health care. Further research is urgently needed to better understand dental health needs of refugees in Europe.
Association between same-sex marriage introduction and attitudes towards homosexuality in Europe
Authors: Hagen D , Goldmann E 
Published: October 2020

Abstract

Background
Existing research suggests a positive relationship between the introduction of same-sex marriage and country-level acceptance of homosexuality across Europe in the first decade of the 21st century. Between 2010 and 2018, another 8 countries in Europe introduced same-sex marriage. Given the well-established association between greater social acceptance of sexual minorities and LGBT health, it is important to continue to monitor the effect of same-sex marriage policies on public attitudes.

Methods
Using data from waves 1 through 9 of the European Social Survey (ESS), the lagged association between same-sex marriage and acceptance of homosexuality in the subsequent wave was analysed for 12 European countries that introduced same-sex marriage between 2002 and 2018. Acceptance of sexual minorities was assessed using the statement, “Gay men and lesbians should be free to live their own life as they wish”, which was dichotomised into two groups: “agree strongly” or “agree” vs. “neither agree nor disagree”, “disagree”, or “disagree strongly”. The association between same-sex marriage laws and acceptance was analysed in mixed-effects logistic regression models adjusting for country-level and individual-level confounders and survey year.

Results
On the country level, acceptance of homosexuality ranged from 61% in Portugal in 2006 to 96% in Iceland in 2016. Based on the total sample of 171,683 observations, acceptance increased from 77% in 2002 to 88% in 2018. Preliminary analyses indicate that existence of same-sex marriage at the time of data collection was associated with 24% increased odds of acceptance of homosexuality in fully adjusted models (95% CI: 1.05-1.48).

Conclusions
This study provides further evidence of an association between same-sex marriage laws and public acceptance of homosexuality. Additional research will be needed in order to further investigate this relationship beyond Western Europe and in relation to sexual minority health and well-being.

Key messages
For 12 European countries, evidence of an association between the introduction of same-sex marriage between 2002 and 2018, and subsequent accepting public attitudes towards homosexuality was found. Given their role as a key social determinant of health, further research on the association between social norms accepting of sexual minority populations and inclusive social policies is warranted.