bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community Readiness – are municipalities prepared to prevent obesity in childhood and youth?
Authors: Schröder M , Babitsch B , Hassel H 
Published: October 2021

Abstract

Background
Essential for the success of prevention efforts is the readiness to address a health problem (community readiness). Aim of this study is to analyze the stage of community readiness for the prevention of childhood obesity in municipalities using the Community Readiness Model (CRM). Based on this, strategies will be developed to improve community readiness for the prevention of obesity in childhood and youth.

Methods
A systematic literature review (SLR) was conducted in the databases PubMed, LIVIVO, Cochrane and Google Scholar to identify studies that used the CRM for the prevention of childhood obesity. In order to assess community readiness, the CRM, a structured interview guide and scoring system, was used. Following the CRM protocol, guided interviews were conducted with key informants that were identified in a modified stakeholder analysis. The transcribed interviews were analyzed by two scientists following the CRM scoring system.

Results
The SLR revealed 270 hits. In 28 international studies the CRM has been applied to childhood obesity prevention, predominantly in the Anglo-American language area. In Germany, no studies could be identified using the CRM for the prevention of childhood obesity. Key informant interviews (n = 28) were conducted in five Bavarian municipalities from January to April 2021. The key informant sample comprised administration departments, health and educational facilities.

Conclusions
The CRM enables a multidimensional analysis of a municipality's material and immaterial infrastructure. In workshops with the participating municipalities the results of the community readiness assessment will be reflected. The aim is to develop an action plan with strategies to increase the stage of readiness and support prevention efforts in order to address childhood obesity.

Key messages
The CRM provides a theoretical basis to understand and improve community readiness. It enables the analysis of assets and weaknesses that can influence obesity prevention in municipalities.
Pregnant women and midwives’ perception regarding physical activity recommendation during pregnancy
Authors: Scognamiglio F , Soldà G , Marini S , Masini A , Messina R , Caravita I , Leccese V , Bertini V , Parma D , Dallolio L 
Published: October 2021

Abstract

Introduction
Physical activity (PA) is a modifiable lifestyle factor which contributes to improve pregnancy and perinatal outcomes. Therefore, pregnant women (PW) without contraindications should practice 150 minutes of moderate PA per week, according to the World Health Organization (WHO) guidelines. Nevertheless, a reduction of PA throughout the gestational period appears to be worryingly common. The aim of this survey was to analyse the feasibility of the WHO recommendations, investigating PW and midwives' perceptions towards PA during pregnancy, in a view to enhance future PA interventions.

Methods
A total number of 4 focus groups, involving 10 midwives (aged 43-61) and 10 PW (aged 30-46), recruited at the University Hospital of Bologna, were carried out between July 2020 and April 2021. Due to SARS-CoV-2 restrictions, all meetings were held online, recorded, transcribed and then analysed using the COM-B model.

Results
WHO recommendations were deemed feasible by both midwives and PW when time management skills and capabilities to adapt PA to individual needs were present. Clearly, women with a background in PA practice tend to be highly motivated thereby maintaining the PA routine also during pregnancy. Both groups reported that PA represents a positive element for the mother's and baby's well-being, triggering a virtuous circle and increasing motivation. Being able to access and perform simple, structured, evidence-based activities, family support, and using every opportunity to be less sedentary were reported as key aspects amongst opportunities to improve PA levels.

Conclusions
Positive perception regarding feasibility of the recommendations was similar between groups; nevertheless, midwives perceived pregnancy as an opportunity to change PA routines, while PW considered pregnancy a less dynamic period. Therefore, implementing PA promotion involving midwives might represent a good strategy given their central role during this woman' unique period.

Key messages
WHO physical activity recommendations are overall deemed feasible, but tailored opportunities and strategies tackling everyday obstacles and lack of information need to be provided. Enhancing PA is a key challenge for pregnant women in a view of their own and baby's health. The COM-B model can be used to implement new strategies involving midwives to reach the goal.
Opinion of health professionals about legal issues of surrogacy
Authors: Zubko AV , Borovkova VV , Krasnov GS , Khomanov KE , Shatalina SI , Sabgayda TP 
Published: October 2021

Abstract

The study summarizes opinions of 7504 representatives of the medical community on organizational issues of surrogacy programs, rights, and responsibilities of their participants. Although Russian lawyers are yet to consolidate in developing the surrogacy legal framework, health professionals think that legal aspects are crucial. Almost all health professionals believe that surrogate mothers and contracting parents should be offered a lawyer before making a decision on surrogacy to explain the rights, obligations and responsibilities (92.6%). The majority consider that surrogacy can be used by couples in which a woman cannot give birth for medical reasons (81.0%) and that the surrogate mother should have the right to psychological support after the childbirth and weaning (87.8%). One-fifth of the respondents have no definite opinion on the remaining issues. The majority of the respondents believe that surrogacy should not be funded by the state and genetic parents have to pay for surrogacy; Russia should allow altruistic surrogacy (assistance to friends or relatives); and priority rights for a newborn are held by contracting parents-customers: the contracting parents have the right to request prenatal diagnostics during pregnancy and abortion in case of the detected pathology. Health professionals are hesitant to determine whether the surrogate mother can renegotiate the contract and choose an abortion. Unlike lawyers, health professionals consider it possible for single men to use surrogacy. According to the respondents, during pregnancy and childhood, decisions regarding lifestyle, hospitalization and methods of delivery should be made only in conjunction with specialists from the medical organization that signed the contract. Significant variations by region in the response structure suggest that socio-economic differences, diversities in culture and traditions in these issues have a greater impact on the opinion about surrogacy rather than professional experience.

Key messages
Unlike lawyers, health professionals consider it possible for single men to use surrogacy technology. The majority of the respondents consider that surrogacy can be used by couples in which a woman cannot give birth to a child for medical reasons.
Catering situation at Austrian schools
Authors: Schätzer M , Bhardwaj J , Sommer J , Miskovic R , König J , Hoppichler F 
Published: October 2021

Abstract

Background
Due to the increase in all-day compulsory schools in Austria, it is important that students receive health-promoting meals throughout the day. The aim of the analysis was a nationwide evaluation of the current situation concerning catering at schools.

Methods
Using a nationwide representative sample of schools from the 5th grade upwards, a questionnaire was conducted as a telephone interview with 331 randomly chosen schools. In addition, 56 schools in Vienna from the 5th grade onwards were randomly selected in order to analyze the current offer at school cafeterias in detail.

Results
Lunch was offered at 72% of all schools, a school cafeteria was available at 81%, a cold drink vending machine at 66%, a hot drink vending machine at 41% and a snack vending machine at 23%. With regard to the health promoting composition of the catering offer, 18% of all schools already had a certified lunch menu, 22% a certified school cafeteria, 14% a certified cold drink vending machine and 5% a certified snack vending machine. In 79% of schools there is direct competition for school catering (93% supermarkets, 45% bakeries, 33% snack stands, 8% fast food restaurants). The results of the detailed analysis in Vienna showed that only 35% of all school cafeterias are certified. All of these locations are advised externally.

Conclusions
The majority of the schools offer catering during breaks and at lunchtime. Without external advice, the majority of the offers must be classified as not health promoting.

Key messages
The food offered at schools is an important component in the nutrition of students in Austria. Cafeteria operators in schools often need external advice in order to be able to offer a healthy selection of food and beverages.
Neonatal malformations: organization of information flows in the S. Anna Hospital of Torino
Authors: Bordino V , Musso A , Bert F , Siliquini R 
Published: October 2021

Abstract

Background
Congenital malformations (CMs) represent a serious public health problem, both in terms of size (3% newborns/year) and severity of outcomes. The surveillance activity carried out by the Registers is an important tool for monitoring the frequency of events, to evaluate etiology, support research and public health actions. The aim is to evaluate the organization and the information network related to the diagnosis of malformation in the S. Anna presidium.

Methods
the retrospective study analyzed all newborns with one or more CM and all cases of TOPFA (Termination of Pregnancy for Fetal Anomaly) for CMs in the period 01/2020 - 01/2021. A forward-looking pilot study was then set up to assess the impact on the quality of data collection through the introduction of a MC sheet.

Results
510 cases of CMs were found in live births, 180 in TOPFA for CMs and 4 in stillbirths. The duration of hospitalizations averaged 14.5 days (σ 36.56), with a median of 4 days. In the CMs group, an average maternal age of 33.40 years (σ 9.32), a median of 33 years and a mode of 33 years were calculated, in the TOPFA group an average maternal age of 34 years (σ 6.34), a median of 34 years and a mode of 32 years. In the live births group, 701 maternal diagnoses were detected, categorized and compared with the various national reports. The MC Sheet was compiled for 60 patients, 16 (4.30%) patients before the introduction of the sheet (01/2020 - 09/2020) and 44 (30.43%) after its introduction (10/2020 - 01/2021). Regarding the assessment of the proper use of ICD9CM an adequacy of 78% was observed in the first group vs one of 100% in the second.

Conclusions
Our preliminary data assess the need for a Regional registry, for a comparison with the main national and regional sources available (also with a view to possible participation in the EUROCAT and ICBDSR registers) and for regional health planning.

Key messages
The study underlines the need for a Regional Registry of congenital malformations. The clinical file is not always a complete source for analysing data on congenital malformations.
The impact of obesity on maternal-fetal prognosis through a comparative study
Authors: Bannour I , Frigui R , Bannour R , Khairi H 
Published: October 2021

Abstract

Objectives
To clarify the impact of obesity on the course of pregnancy and childbirth by specifying maternal and fetal complications.

Materials and Methods
This is a comparative case-control study, conducted over a period of two months from February 1 to March 31, 2019, which included patients who gave birth in the Farhat Hached Sousse University Hospital and the Maternity and Neonatology Hospital of Monastir. Patients meeting the inclusion criteria were divided into two groups according to body mass index (BMI) at the end of pregnancy: group I: normal weight 18,5≤ BMI &lt;25 and group II BMI greater than or equal to 30.

Results
Pregnancies of women in Group II were more frequently complicated by gravidic hypertension 8% against 1%, 3% pre-eclampsia against 0% and gestational diabetes 14% against 3%, as well as infections. In obese patients, there were more labor abnormalities with a 17% vs. 3% cesarean section rate and higher instrumental delivery rate 15% vs. 7%. Post-partum follow-up was marked by the occurrence of infectious maternal complications, anemia with breastfeeding difficulties. The newborns of group II women were born with a lower Apgar score and had more neonatal complications such as trauma 6% versus 0% meconium inhalation 6% versus 2% and hypoglycemia 4% versus 0%.

Conclusions
Obesity is a serious problem in obstetrics, with adverse effects on the health of the mother and her baby throughout pregnancy, childbirth and post-partum. The management of obese or overweight pregnant women must be early and adapted to each case with close obstetrical surveillance.

Key messages
Obesity is a serious problem in obstetrics, with adverse effects on the health of the mother and baby. The management of obese or overweight pregnant women must be early.
Evaluation of eating habits and unhealthy eating patterns in high-school girls from Varna, Bulgaria
Authors: Marinov D , Naydenova D 
Published: October 2021

Abstract

Background
Eating habits in children and adolescents are fundamental for their optimal physical and mental health and development. In adolescent girls, adequate nutritional status is paramount for the reproductive system function and reaching peak bone mass. Epidemiological studies have found an increased incidence of unhealthy eating patterns that pose a risk of nutritional deficiencies in adolescents from different European countries. More data is needed on the prevalence of the problem among Bulgarian adolescents, and especially school-aged girls, who are a specific risk group.

Methods
The study included 226 adolescent girls aged 17-19 from Varna, Bulgaria. Data was collected after receiving informed consent. The methods used include:
Anthropometric measurements, including height and weight; Bioelectric impedance analysis using calibrated Tanita BC-420MA (ISSO 9001) and following ESPEN guidelines; Food frequency questionnaire (FFQ).

Results
10% of girls were underweight, 78.5% had normal BMI (18.7-25kg/m2) and 11.5% were overweight/obese. Underweight girls had an average BF%=13.78±4.28, with the lowest BF%=3. Underweight girls had significantly lower consumption of vegetables, whole grains, and dairy products. More than half of the underweight group didn't consume vegetables daily (54.5%). 27.7% of the underweight participants consumed whole grain foods every day compared to 42.9% overweight/obese group. 27,2% of underweight girls met the recommendations for consuming daily dairy consumption, compared to 58.1% in the normal BMI and 65.4% in the overweight/obese group. Fish consumption was low in all groups - 13.6% of underweight girls, 17.7% of the participants with normal BMI, and 3.8% in the overweight/obese group consume fish at least twice per week or more.

Conclusions
Underweight teenage girls have inadequate intake of vegetables, whole grains, and dairy products. The majority of adolescent females do not meet the minimum requirement for fish consumption.

Key messages
The combination of low body weight and inadequate intake of foods rich in bioavailable calcium are risk factors for not achieving peak bone mass in adolescence. Underweight teenage girls are at an increased risk of vitamin and mineral deficiencies due to inadequate intake of vegetables, whole grains, fish, and dairy products.
Mental health during pregnancy and early childhood: recommendations from evidence-based guidelines
Authors: Reinsperger I 
Published: October 2021

Abstract

Background
Mental health problems are common during pregnancy and after birth and are therefore often addressed in the context of antenatal and postnatal care. The project is an update of previous work and aimed at identifying and summarising screening and counselling recommendations from evidence-based guidelines. Mental health was defined broadly and included topics such as substance use and domestic violence.

Methods
Relevant guidelines were identified by searching 2 databases (G-I-N, TRIP Database) and websites of relevant institutions and professional societies. Guidelines, that were published or updated within the last 5 years and fulfilled methodological quality criteria, were included.

Results
A total of 52 guidelines from 16 different institutions fulfilled the inclusion criteria. The guidelines (predominantly) advocate the following mental health screenings: Interviewing about psychosocial stress factors and support needs during pregnancy and after birth; screening for postpartum depression and anxiety disorders; interviewing pregnant women about substance use (smoking, alcohol, drugs) and appropriate counselling. With regard to domestic violence and child welfare risks, some guidelines recommend routine screening and some recommend increased awareness of signs and symptoms by health workers. Routine screening for specific mental and behavioural disorders in children is not recommended by included guidelines; however, if there are indications and symptoms, clarification should take place and attention should be paid to signs and symptoms during preventive examinations.

Conclusions
The included guidelines recommend screening and/or counselling for the majority of the topics addressed. The results of the report can be used as a basis for decision-making for updating national antenatal care and screening programmes.

Key messages
The majority of the included evidence-based guidelines strongly recommend addressing mental health issues during pregnancy and after birth by offering screening and/or counselling. The recommendations from evidence-based guidelines can serve as a decision support for developing national antenatal and postnatal care programmes.
Tobacco use among middle school pupils in Sousse, Tunisia across three years of monitoring
Authors: Zammit N , Ghammem R , Ben Fredj S , Bennasrallah C , Maatoug J , Ghannem H 
Published: October 2021

Abstract

Background
Tobacco use represents a major risk factor for incident disability-adjusted life years among adolescents especially in developing countries. In Tunisia, a national strategy to reduce tobacco use was set up since 2008. However, no surveillance system was implemented to evaluate it.

Objective
To examine trends in tobacco use among middle school children in Sousse, Tunisia between 2014 and 2016 and to determine predictors of its experimentation.

Methods and findings
Three cross-sectional studies were conducted in 2013/2014, 2014/2015 and 2015/2016 school years among middle school-children randomly selected from the governorate of Sousse-Tunisia. The required sample size for each study was 760 participants. Each year, the same procedure was used to recruit pupils from the same middle schools. The same pre-tested questionnaire was self-administered anonymously to participants in their classrooms.

Results
Lifetime tobacco use rose from 11% in 2013/2014 to 17.3% in 2015/2016 (p = 0.001). Across the three years of survey, predictors of lifetime tobacco use were: The male gender (OR, 95% CI: 4.4 [3.2-6.1]), age above 13 (OR, 95% CI:2.3 [1.7-3.1]), lifetime illicit substances use (OR, 95% CI: 3.9 [1.1- 13.8), lifetime inhalant products use (OR, 95% CI:2.2 [1.2-4.3]), tobacco use among the father (OR, 95% CI:2.2 [1.2-4.3]), tobacco use among siblings (OR, 95% CI:1.7 [1.2-2.4]) and current anxiety problem (OR, 95% CI: 1.8 [1.4-2.4]).

Conclusions
Tobacco experimentation is in expansion among the young adolescents of Sousse. Its prevention should integrate a comprehensive substances use prevention program with emphasis on second hand smoking and the associated mental health problems.

Key messages
More attention should be paid to young adolescents in order to prevent tobacco and other substances use among them. Second hand smoking and mental health problems should be considered when planning for prevention programs of tobacco use.
Sexual behavior of Roma women in Romania
Authors: Nanu M , Stativa E , Nanu I , Kozma A , Otelea M , Nanu A , Scantee S , Ciutan M , Popovici G 
Published: October 2021

Abstract

Background
Roma women are considered a vulnerable population with regard to reproductive health. Early pregnancy and childbirth is common among Roma women. Roma women use less preventive services prenatal care, cancer screening and family planning.

Methods
The present study aims to analyze the sexual behavior of Roma women based on the secondary analysis of a subsample of 343 Roma women aged 15-44, as a part of the Romanian Reproductive Health Survey 2016.

Results
The main sexual events of the Roma women start in adolescence: 63.9% of Roma women had their first sexual intercourse at age of 15-19and 26.7% at age of 15 and 9.4% between 20-24 years. Roma with a low educational level start earlier sexual life, 28,8% of Roma women with no education had their sexual intercourse before age 15 and 64.8% between 15-19 years. Roma women are living in couples as adolescents with a higher prevalence of teenager couples in rural area 19.4% of Roma women in rural areas and 13.4% in urban areas are in a couple before the age of 15, (p &lt; o,o5) and 60.5% in rural areas and 58.9% in urban areas between 15-19 years. 2/3 of Roma women had their first pregnancy in adolescence, 66.9% between 15-19 and 8.4% under 15 years of age. Concerning the first delivery 65.4% Roma adolescent girls had their first child at 15-19 years, and 2.8% at ages under 15 years.

Conclusions
The Roma female minorities had in adolescence their main sexual events, the first sexual intercourse, the start of a life in couple, the first pregnancy and the first delivery; Roma women from rural areas and women with a low level of education had all these experiences earlier; In order to prevent unwanted pregnancies, public reproductive health policies in Romania should include measures addressed to the need and specific educational and cultural characteristic of Roma women and their partners.

Key messages
Main sexual events of Roma women begin in adolescence. The reproductive health policies should be adressed with special emphasis to Roma adolescent women.