bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cervical cancer screening in pregnancy: a review of specific indications in the Italian regions
Authors: Catalini A , Acuti Martellucci C , Morettini M , Fraboni S , Massetti L , Giacomini G , Pasqualini F 
Published: October 2021

Abstract

Introduction
Cervical cancer represents the second most frequently diagnosed cancer during pregnancy. Screening programmes have allowed earlier diagnosis and greater treatment options. Many studies have confirmed that Pap smear testing is safe during pregnancy, but some healthcare workers are still reluctant to perform them in fear of adverse pregnancy outcomes. This work aims to systematically evaluate the presence of specific indications on Pap smear during pregnancy in the protocols of organized screening programmes across all Italian regions. These would reassure the healthcare professionals when screening pregnant women.

Methods
We carried out a research on Google and also on the official websites of all 21 Italian regions/autonomous provinces, gathering all cervical screening related documents. If the organized screening protocols did not include indications on Pap smear during pregnancy, clinical or technical documents with detailed descriptions of the cervical screening pathway were selected. Subsequently, we summarized the collected evidence for all regions: presence of a comprehensive protocol for cervical screening, the provision of indications for pregnant women, and their consistency with national guidelines.

Results
20 out of 21 regions had comprehensive protocols for the standardised provision of cervical screening within the organised, publicly funded, programmes. Only five out of these 20 included indications specific for pregnant women, and all these were consistent with the guidelines provided by national scientific societies.

Conclusions
Our comprehensive analysis of cervical screening documents provided by Italian regions showed an alarming lack of specific indications on the execution of screening Pap smears in pregnant women. Clear indications should instead be widely available to screening staff, in order to appropriately perform cervical screening of pregnant women.

Key messages
Only a minority of the Italian regions explicitly included indications for Pap smear execution during pregnancy. The presence of these indications is strongly warranted as it would allow timely, safe, and appropriate cervical screening also for pregnant women.
Apparent life-threatening events in infants
Authors: Ameayou S , Salimi S , Hassoune S , Nani S , Alaoui-inboui F 
Published: October 2021

Abstract

Background
The incidence of infant apparent life-threatening event (ALTE) was reported as 0.6-2.4 per 1000 live birth. The difficulty of the diagnosis lies in the delicate interpretation of the results of the clinical examination and the complementary examinations. The objectives of this study were to describe epidemiological, clinical and paraclinical characteristics of infants hospitalized for ALTE and to determine the most common diagnosis.

Methods
We conducted a case serie from January 2013 to April 2018 in the pediatric ward 2 at Abderrahim Harrouchi Children's Hospital, Casablanca of all infants aged less than 2 years hospitalized for malaise (newborn excluded). We obtained our data using a standardized form of service. We described our data by mean, frequency and percentages using SPSS 16.

Results
The mean age of onset of symptomatology is 4.8 months. Recurrence of discomfort was present in 30% of cases. The socio-economic conditions were unfavorable in more than half of the cases (63.3%). Clinical examination was abnormal in 6.6% of cases. Complementary examinations performed systematically in all patients were Blood cell count, blood ionogram, CRP, blood glucose and chest x-ray. Other examinations were performed according to the history and the clinic data. The most common diagnosis was gastroesophageal reflux (36.7%), cardiac problems (16.7%), lower respiratory tract infection (13.3%), and ‘'unknown'' (26.6%).

Conclusions
Few complementary examinations are systematically needed and their performance is increased if they are oriented by a careful history and physical examination which then allows to advance in the diagnostic procedure.

Key messages
Complementary examinations are largely inconclusive and only a history and complete clinical examination can make it possible to advance in the diagnostic procedure. Infants who demonstrate historical or physical examination elements suggestive of a specific etiology of their event, such as gastroesophageal reflux, should be evaluated and treated accordingly.
Chronological trends and causes of deaths among reproductive-age-women in Southern Tunisia
Authors: Maamri H , Ben Ayed H , Ketata N , Yaich S , Baklouti M , Karray R , Feki H , Damak J 
Published: October 2021

Abstract

Introduction
Mortality data of women with reproductive age (WRA) data are important indicators of the health system performance. This study aimed to determine the magnitude, trends and main causes of WRA deaths.

Methods
The study used longitudinal hospital-based surveillance design for the period 2014-2020 in Southern Tunisia including all WRA (15- 49 years) who died in public health facilities in this region.

Results
During the 7-year-period, there were 331 WRA deaths, and this number increased sharply with age (χ2= 21.7;p&lt;0.001). Non-communicable diseases were the leading causes of deaths (41.7%) and were statistically more frequent in older women (52% vs 37.5%;p&lt;0.001) and urban regions (48.9% vs 36.6%;p=0.025). Concerning communicable diseases and maternal deaths, they were statistically more common in rural regions (12.4% vs 5%;p=0.026 and 17% vs 8.8%;p=0.031,respectively). There were 45 maternal deaths, with an average maternal mortality ratio (MMR) of 51.39/100,000 Live births(LB)/year. There was a slowly declining trend in the MMR during the reference period, without significant change (χ2=0.7;p=0.4), with a peak of 97.37/100,000LB in 2016. Direct obstetric deaths constituted 73.9% of all maternal deaths, among which the leading causes were obstetric haemorrhage (66.7%) and eclampsia (14.3%). Among the indirect causes, cardiovascular diseases (37.5%) and infections (16.6%) were the most common.

Conclusions
Mortality indicators among WRA remained sustainably high in Southern Tunisia, despite the declining curve. The causes of death varied according to age groups and access to health facility. Strengthening community-based initiatives to promote the goal of ending preventable maternal deaths is urgently recommended.

Key messages
High mortality indicators among WRA remained sustainably in Southern Tunisia. Stregthening community-based initiatives to promote the goal of ending preventable maternal deaths is urgently recommended.
Feasibility of youth empowerment initiative for identifying never- and under-immunized children
Authors: Bengali R , Siddiqi DA , Mehmood M , Khan AA , Baig Q , Khan AJ , Chandir S 
Published: October 2021

Abstract

Background
One-in-every 5 children globally remains deprived of life-saving vaccines. We developed and implemented the Adolescent Health and Leadership Program (AHLP) among school girls from grades 8-10 (Kiran Sitaras (KSs); Shining Stars) to provide them with soft skills and community mobilization skills and equipping them to become community advocates for immunization. We evaluated the feasibility of KS community mobilization through validating KSs' ability to accurately identify and link never- and under-immunized children with immunization services.

Methods
We implemented a mixed-methods study in six public schools located in peri-urban areas of Karachi, Pakistan. After the development and roll-out of AHLP in schools, KSs conducted door-to-door visits in their neighborhoods to identify never-and under-immunized children. This was followed by verification visits by field staff to establish accuracy and immunization camps to vaccinate never- and under-immunized children identified by KSs.

Results
From January 28 to February 22, 2020, 591 KSs visited 10,330 households, screened 3,295 under-2 children and identified 7.5% (247/3,295) never- and 27.0% (889/3,295) under-immunized children, with an accuracy of 90.4% and 49.6%, respectively. In January 2021, 291 never- and under-immunized children were invited to immunization camps, of which 28.9% (84/291) received vaccinations, while 57.0% (166/291) did not respond to the invite and 14.1% (41/291) were deemed ineligible (illness, overage, etc.).

Conclusions
We demonstrated the feasibility of empowering adolescent girls to boost immunization uptake in LMIC settings. Engaging young women from within the community provides an organic and sustainable solution for promoting immunization coverage and equity today and ensuring they will continue to champion the cause in their capacity as tomorrow's mothers. We are actively scaling-up our solution across the country to create a force of 100,000+ KSs to magnify our efforts.

Key messages
The Kiran Sitara initiative, via its community-centered approach, leverages the force of adolescent school girls to boost demand and referrals for immunization in unreached geographical pockets. The Kiran Sitara initiative utilizes the power of youth engagement to identify never- and under-immunized children, and subsequently increase vaccine-uptake.
Attitudes towards vaccination among Croatian high school students
Authors: Miskulin I , Hac D , Domacinovic T , Kovacevic J , Pavlovic N , Miskulin M 
Published: October 2021

Abstract

Background
Due to the success of immunization, most of young people have little experience with vaccine preventable diseases. This inexperience may increase vaccine hesitancy in this population subgroup which can potentially jeopardize population vaccination coverage. Understanding young peoples' attitudes towards vaccination is important for vaccination uptake. The aim of this study was to evaluate attitudes towards vaccination among Croatian high school students.

Methods
This online cross-sectional questionnaire study was conducted during the January 2021 to April 2021 in convenient sample of high school students from north-western part of Croatia. Vaccination Attitudes Examination scale (VAX) was used to assess antivaccination attitudes in study population.

Results
The study included 1012 high school students; 29.2% males and 70.8% females; median age 17.0 (interquartile range (IQR) 17.0 - 18.0) years. Overall value of the VAX score in study sample was 50.4±11.1. Female students had more negative attitudes towards vaccination in comparison to male students (P = 0.001). When analysing differences between female and male students according to the VAX scale subcategories the study revealed that female students demonstrated more worries over unforeseen future effects of the vaccination (P &lt; 0.001) while there were no differences between females and males according to the mistrust of vaccine benefits, concerns about commercial profit and preference for natural immunity (P = 0.155, P = 0.157 and P = 0.142, respectively).

Conclusions
The study revealed rather high antivaccination attitudes among Croatian high school students as measured by VAX score. Further studies are needed to better understand factors that influence such attitudes in study population because programs directed towards changing antivaccination attitudes in order to be efficient need to successfully tackle all of those factors.

Key messages
Public health interventions directed towards suppression of antivaccination movement should more involve younger population subgroups, such as elementary and high school students. Positive attitudes towards vaccination in younger population subgroups are one of the crucial preconditions for adequate vaccination coverage.
Prevalence of Tobacco use among Tunisian adolescents: a cross-sectional national survey
Authors: Ayedi Y , Harizi C , Skhiri A , Fahfakh R 
Published: October 2021

Abstract

Introduction
Tobacco use initiation mostly begins before the age of 18 years old. Being concerned by the increasing prevalence of smoking among adolescents, WHO developed the Global Youth Tobacco Survey. It focuses on youth addiction to tobacco products. This survey was carried out 4 times in Tunisia. GYTS 2017 is the most recent among them.

Aim
Describe the different tobacco products prevalence and access of smokers to tobacco products and to smoke cessation.

Methods
It is a school-based survey uses a two stages cluster sample design to produce a representative samples of students aged from 13 to 15 years old. It was conducted in April and May 2017 in 67 secondary school all over the country. The investigation tool was an anonymously answered questionnaire, which contained core questions about six majors tobacco related topics.

Results
One out of four students had ever tried to smoke a cigarette; 37.4% of boys vs. 10% of girls (p &lt; 0.001). Lifetime cigarettes prevalence was 7.8%; 14.4% of boys vs. 1.6% of girls (p &lt; 0.001). As for water pipe, 12.7% had ever tried to smoke, even for one or two snuffs. Lifetime water pipe use prevalence was 7.2% (13% of boys vs. 2.8% of girls, p &lt; 0.001). Among cigarettes smokers, 62.5% were able to buy their own cigarettes. Therefore, 23.5% of cigarettes smokers and 41.5% of water pipe smokers were not able to buy their products because of their age. Sixty percent of smokers want to quit and 56.4% had already tried to stop during the year prior to the survey. Seventy-two percent had asked help to quit smoking. Eighteen percent had requested advice from a professional.

Conclusions
Cigarette and water pipe use prevalence among youth is alarming in Tunisia. Selling tobacco products to minors is not prohibited. Implementing such a law is necessary to reduce adolescents' access to cigarettes, and consequently, reduce tobacco use prevalence. Teenagers should benefit from smoke cessation programs, as well as adults.

Key messages
Tobacco prevalence among youth is alarming in Tunisia. Prohibiting tobacco sale to minors is necessary.
Analisys facial emotional expressions in attendees the recreovía program in Bogotá - Colombia
Authors: Rubiano Espinosa OF , Morales Eraso NS , Alvarado Melo JE , Riveros Medina MA , Rubiano Espinosa JF , Sarmiento Dueñas OL , Rubio Rojas MA , Galvis Leal P , Morales Garcia LY 
Published: October 2021

Abstract

Background
The Recreovía (PR) program promotes healthy habits and lifestyles through the practice of physical activity (PA) directed and musicalized in public spaces in Bogotá Colombia, with an average annual attendance of 800,000 participants. The objective of this study was to evaluate the changes in Emotional Facial Expression (EFE) during a PA session of the PR. The emotions evaluated were happiness, sadness, surprise, scare, disgust, and contempt, in addition, the neutral emotional state described by Ekman (1972).

Methods
Descriptive cross-sectional study, with 566 subjects aged 15 to 85 years (72.1% women and 27.9% men). The sample was estimated with a 95% confidence interval and a 5% margin of error. The facial expression analysis was performed with the FaceReader® facial recognition software and equipment. The data were analyzed through the techniques of Mann-Whitney U and Kruskal-Wallis with SPSS version 24 software.

Results
The age ranges were distributed as follows: 15-30 (22.8%), 31-45 (49.6%), 46-60 (26.9%) and 61-85 (0.7%). Users placed their emotions like this, neutral 47%, happiness 20%, sadness 7%, angry 6%, surprise 3%, scare 4%, disgust 8% and contempt 1%. The differences by gender were found, sadness (women 8%, men 5%, p = 0.007) and angry (women 5%, men 7%, p = 0.040). In the comparison by age, differences were found between 15-30 years and 46-60 years (neutral 35%, 47%, p = 0.000; happiness 27%, 13% p = 0.001; scare 2%, 6% p = 0.016).

Conclusions
Neutrality is an emotional state that does not show happiness or sadness, it is hypothesized that during this time the learning processes predominate. The most evoked emotion during the AF session was happiness followed by far by sadness, emotion related to the ambiguities of the movements in the process of learning motor gestures and happiness corresponds to the achievement in the execution that generates adherence to the program Recreovía that contributes to the mental and social health of the participants.

Key messages
Reduced levels of physical activity have a great impact on health. A sedentary lifestyle and emotional expressions is a more common risk factor that affects people's mental health. Mental disorders are a multifactorial condition that affects health, and in this case, physical activity for Bogotanos becomes a vehicle that transforms people's health and quality of life.
Long time psychological distress affected by the Great East Japan Earthquake after four years
Authors: Tsuchiya Y , Tsujiuchi T , Iwagami T , Ogiwara A , Tanaka Y 
Published: October 2021

Abstract

Background
On March 11th, 2011, the Great East Japan Earthquake hit the Tohoku area, and more than 15,000 people lost their lives by the tsunami and earthquake. People who survived natural disasters, terrors, or serious diseases reported long-time psychological distress such as PTSD (Post Traumatic Stress Syndrome) or depression. This study aims to elaborate on factors associated with PTSD post the Great East Japan Earthquake after four years.

Methods
Quantitative and qualitative analysis from a questionnaire survey conducted after four years of the earthquake in 2015. The questionnaires included participants' attributes, IES-R scale to evaluate PTSD, loss of their families by tsunami and earthquake, their own tsunami experience, many relocations after the earthquake, lost job after the earthquake. The open-ended question asked them to write about their challenges in their lives and others.

Results
We received 3465 responses. Among those who responded, the IES-R scale was significantly larger in women (n = 1397) (aOR=1.55, p = 0.001) than men (n = 1966). Higher in those with more their own tsunami experience (aOR=1.35, p = 0.014), in those with lost loved ones (aOR=2.1, p &lt; 0.01), and in those with more economic difficulties (aOR=1.6, p &lt; 0.001). In addition, those with less social connectedness (aOR=1.34, p = 0.017) and forced to live separately with family members after the earthquake(aOR=1.36, p = 0.014) were significantly higher in the scale. From a quality analysis, we observed much psychological distress from participants.

Discussion and Conclusions
In this study, more than half in the PTSD risk group reported that they had never cared for mental pain after the earth quake. We overlook PTSD frequently. However, long-range monitoring and care are necessary for those affected by a significant disaster.

Key messages
PTSD after disasters have been overlooked frequently. A long-range monitoring and care are necessary after a significant disaster.
Mobility and migration of health care workers
Authors: Corvo E , De Caro W 
Published: October 2021

Abstract

Introduction
The estimated shortage of about 15 million health and social care professionals, including over 6 million nurses, together with the significant phenomenon of international migration of such professionals, emerged, during COVID-19, with even more evidence. During the pandemic the danger of a collapse of health systems in many areas due to a shortage of staff was manifest. In addition to this, low-income countries are witnessing a decrease in their health and social care workforce resulting in further inability to ensure essential levels of professional coverage to deal with populations' needs.

Methods
An integrative review analysis, in 4 languages (English, Italian, Spanish, French) of trend in terms of legislation and policy documents were conducted using health and social database and gray literature. 29 different document were include in this review.

Results
A number of initiatives have been developed in order to establish international and/or bilateral obligations among countries; however, this showed to be insufficient. There is therefore the need to set up a joint effort/actions among different stakeholders such as Government, Higher Education institution, International Labor health market actors, and NGOs in the field of migration, labor and training of health and social care professionals in order to better meet health and social care needs worldwide.

Conclusions
It is timely to develop specific actions aimed at setting up a passport for health and social care professionals which allows to guarantee prior certification and accreditation of skills by independent agencies; countries should work together to improve retention of health care professionals in their job. Moreover, every effort should be done to enhance younger generation interest in health and social carrier, as opportunity to really makes difference in other lives and to play an active role in the development of society.

Key messages
Without health and social care professionals, there is no health. Migration is a serious issues and opportunity.
The future of the drug phenomenon and drug monitoring in Europe until 2030
Authors: Palczak K , Moreira M , Griffiths P 
Published: October 2021

Abstract

We are living in an era of fast and fundamental changes with an uneven impact on geographies and generations. The pace of the social transformations and technology innovations is accelerating and outpacing policies and responses in place. Also, the European drug situation and drug markets are becoming more complex and dynamic, with important implications for the EU drug monitoring system and research. Therefore the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) conducted the first ‘futures exercise' to inform the agency's strategic reflection on how to improve the response of the EU monitoring system in the context of rapid changes in the information environment and new information needs. The EMCDDA piloted the usefulness of the foresight approach for transforming the agency and its monitoring activities into a more sensitive and agile system, which could, in turn, help increase Europe's preparedness for future challenges in health and security areas. The ‘futures exercise' applied the horizon-scanning method to study events, issues, and trends affecting the drug area and went far beyond the drugs or the addiction field and the European region. It analysed global drivers of change that may have in the future implications for the drugs situation, drug monitoring and related responses. The methods applied ranged from literature review, thematic analysis, workshops and expert panels. It had a robust participatory component to enable stakeholders representing different disciplines and countries to contribute to and benefit from the process. Out of 14 Megatrends, five were selected as most significant for the drugs field, and the future EMCDDA work: technological change, climate change and environmental degradation, diversified inequalities, shifts in health challenges and population. Moreover, four categories of emerging changes in the drugs field were identified: shifts in drug policy, the discourse of addictions, drug markets and drug services.

Key messages
Foresight is a valuable tool for analysis going beyond specific areas of expertise and recognising that a single-issue focus is often insufficient in dealing with emerging threats and opportunities. A participatory approach contributes to building a shared vision of the major drivers of change impacting the drugs field, information needs and future developments in the EU drug monitoring system.