bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of childhood adversity on addictive behaviours through impulsivity among adolescents
Authors: Mlouki I , Elomma Mrabet H , Bouanene I , Sioud I , Bchir A , Omri N , Ben Youssef F , Sfar H , El Absi M , El Mhamdi S 
Published: October 2021

Abstract

Background
Little is known about the mechanism by which Adverse childhood experience (ACE) affects adolescent's engagement in addictive behaviours in the African context. We investigated the role of impulsivity in the link between ACE and behavioural addiction among schooled youth in Tunisia.

Methods
We performed a cross sectional study among 1940 schooled adolescents in the region of Mahdia (Tunisia) from January to February 2020. We used the validated Arabic version of the World Health Organization ACE questionnaire. The Barratt Impulsivity Scale as well as the Internet Addiction Test were used as screening tools for impulsivity and internet addiction.

Results
A total of 1940 adolescents returned the questionnaires. About 97.5% reported experiencing at least one ACE. We found that ACEs score predict addictive behaviours through impulsiveness (p &lt; 0.001; % mediated = 16.7%). Particularly, intra-familial ACEs (p &lt; 0.001; % mediation = 27.8%) demonstrated the most mediation by impulsivity followed by exposure to extra-familial ACEs (p &lt; 0.001; % mediation = 10.5%). There were interactions between ACE and impulsivity in terms of their impact on internet addiction (p &lt; 0.001; % mediation = 37.5%).

Conclusions
The mediation part of impulsivity in the association between ACE and cyberaddiction is alarming.

Key messages
Impulsive behaviors mediates the effect of childhood adversity on addictive behaviors. Great mediation part of impulsivity (37.5%) for internet addiction among Tunisian youth.
COVID-19 impact on the health and emotional well-being of the general population
Authors: Cabrera-Léon A , Sánchez-Cantalejo C , Rueda MM , Saez M , Enrique I , Ferri R , Castro L , Barceló MA , Villegas R , Daponte A 
Published: October 2021

Abstract

A tremendous number of studies describe results on the evolution of the COVID-19 impact on infected patients, hospital admissions, deaths, mental health and well-being of the population. However, there are hardly any reports on its impact and evolution since the beginning of the pandemic with clinical, contextual and individual perception information. Our work describes the research project called Health Care and Social Survey (ESSOC, Encuesta Sanitaria y SOCial). It arises from the need to provide specific, reliable, early, and timely data on the impact of COVID-19 that can be considered when making decisions to prepare and provide an effective Public Health response in the different affected populations. It is linked to official statistical operations included in the Andalusian Regional Government and has also been granted a favorable opinion by the Research Ethics Committee. The ESSOC is based on a Real-World Data design. It integrates observational data extracted from multiple sources including information based on surveys and clinical, epidemiological, population, and environmental registries. The surveys have an overlapping panel design with a total of over 22,000 effective interviews being carried out over three years from the beginning of the state of alarm in Spain. Their geographical scope is the Autonomous Region of Andalusia (8.4MM people, the fifth most populated region in Europe), and the population scopes are general population, population residing in disadvantaged areas, and population over the age of 55. The conceptual approach of this study encompasses all aspects affecting health that will contribute to an extraordinary increase in the current knowledge of the impact of the COVID-19 pandemic. Its results will be very useful for cross-disciplinary comparisons in population-based studies, and the methodology developed will serve as a model to be applied in other epidemiological studies.

Key messages
It is needed to provide specific, reliable, early, and timely data on the impact of COVID-19 that can be considered when making decisions to prepare and provide an effective Public Health response. Our research project integrates observational data extracted from multiple sources including information based on surveys and clinical, epidemiological, population, and environmental registries.
Incidence rate of Healthcare Associated Infections in a COVID-19 Intensive Care Unit
Authors: Marte M , Marotta D , Giannini D , Mazzalai E , Barone LC , Baccolini V , Migliara G , Marzuillo C , De Giusti M , Villari P 
Published: October 2021

Abstract

Background
Intensive Care Units (ICU) faced a high pressure under the COVID-19 pandemic. It is recognized that patients admitted in these wards are more susceptible to Healthcare Associated Infections (HAIs). This study aims at comparing the incidence of HAIs in a COVID-19 ICU to a No-COVID ward.

Methods
A retrospective cohort study including patients admitted to the ICU of the Teaching Hospital Policlinico Umberto I in Rome from April 2020 to March 2021 was performed. Data on age, gender, hospitalization, different types of devices (ventilation, central venous and urinary catheter), number and type of device-related HAI were collected. Statistical analyses were performed with Episheet and STATA 13.

Results
Out of 347 patients admitted in the ICUs, 329 were included in the study (217 had COVID-19 and 112 had not). In the COVID-19 group, patients were mainly male (69.58%) with a mean age of 62.5±13.5 years, whereas the other group was slightly older (63.2±16.2 years) and more balanced between the two sexes (52.68% male). A total of 133 patients developed at least one HAI, 94 of which were SARS-CoV-2 positive. Globally, 246 HAIs were diagnosed: 163 occurred in the COVID group and 83 in the No-COVID one. The cumulative days of hospitalization were 3233 for the COVID group and 2134 for the No-COVID. The incidence of HAI considered for 1000 days of hospitalization among COVID patients was 50.42 (IC 95%: 42.97-58.78), compared to 38.89 (IC 95%: 30.98-48.22) for the No-COVID one, for an incidence rate ratio of 1.30 (IC 95%: 0.99-1.71).

Conclusions
Even though the confidence interval contains the value 1, the results point out that there is an increase in the incidence rate of HAI among COVID-19 patients. Further investigations are needed to better understand the reasons behind the present findings.

Key messages
Patients admitted to Intensive Care Units are more susceptible to Healthcare Associated Infections. Our study aims at describing the impact of COVID-19 on the risk of developing such conditions. Being infected with COVID-19 leads to an increase in the incidence rate of Healthcare Associated Infections. Further studies are needed to understand the underlying reasons.
Use of antidepressants during COVID19 outbreak: a real-world drug-utilization study
Authors: Fornari C , Antonazzo IC , Paoletti O , Cei E , Bartolini C , Conti S , Ferrara P , Mantovani LG , Gini R , Mazzaglia G 
Published: October 2021

Abstract

Background
Lockdown measures implementation (LMI) to prevent COVID19 disease diffusion was associated to increased depression and anxiety cases. The main aim was to evaluate whether LMI affected prevalence and incidence of antidepressants (ADs) use, and ADs treatment interruption (TI) in the general population.

Methods
Adults (≥18 years) with at least 1 dispensing of ADs between 01/01/2019-26/09/2020 were selected from a regional Italian healthcare administrative database. Patients presenting an AD dispensing in the year preceding the first observation were considered as prevalent otherwise as incident users. We divided the studied period into 3 parts: pre-lockdown (01/01/2019-08/03/2020), lockdown (09/03/2020-14/06/2020) and post-lockdown (15/06/2020-27/09/2020). The weekly prevalence (WP) and incidence (WI) per 10,000 inhabitants were compared among periods. Incidence of TI (no dispensing refill within 30 days of the end of its validity) was computed among prevalent AD users.

Results
The WP (mean of 552.3 per 10,000 pre-lockdown vs 505.5 lockdown phase; relative change: -9%) and WI (5.2 vs 3.7; -29%) of ADs use decreased after LMI. During the post-lockdown phase WP (505.5 vs 495.9; -2%) decreased whereas the WI (3.7 vs 4.3; 16%) slightly increased in relation to the lockdown period, although differences were not statistically significant. Conversely, the incidence of TI increased during lockdown (344.7 vs 384.3; 12%) and post-lockdown (384.3 vs 394.2; 3%) periods, even not always statistically significant.

Conclusions
Our analysis showed a reduction of ADs use during the early phase of lockdown. Several factors might have impacted on the observed phenomenon (i.e, patient reluctance to start new AD treatment). Considering the mutation of the virus and the potential waves that might occur in the next months, a continuous monitoring of the impact of COVID19 on mental diseases onset and treatment adherence are suggested.

Key messages
In Italy, the implementation of lockdown measures was followed by a reduction in antidepressants use, even though evidences are that diagnoses of psychiatric disorders increased. Future studies should monitor if these phenomena led to an increase in adverse events potentially correlated with inappropriate treatment of depression.
Using machine learning to analyse large volume of public health data to drive service improvement
Authors: Papakonstantinou T , Bondaronek P , Stefanidou C , Gold N , Chadborn T 
Published: October 2021

Abstract

Background
The UK government's approach to the pandemic relies on a test, trace and isolate strategy, mainly implemented via the digital Contact Tracing and Advice Service (CTAS). Feedback on user experience is central to the successful development of public-facing services. As the situation dynamically changes and data accumulate, interpretation of feedback by humans becomes time-consuming and unreliable. The aim was to evaluate the use of Machine Learning (ML) techniques as tools to understand the issues with the Service as expressed in the free-text responses of the users. The specific objectives were to 1) conduct an analysis of supervised and unsupervised techniques to develop the most optimal model, 2) generate actionable themes that can be used to increase user satisfaction of the CTAS.

Methods
We evaluated and compared 5 supervised classification algorithms in terms of serviceability and accuracy. We proceeded by evaluating an unsupervised Topic Modelling approach, testing models with 5-40 topics and differing covariates in terms of coherence, residuals and interpretability by human coders. Two human coders conducted thematic analysis to interpret the topics.

Results
Due to the low accuracy, the degree of human involvement and broadness of themes we found that a supervised ML approach was not well suited to our objective. We identified a Structural Topic Model with 25 topics and metadata as covariates as the most appropriate for acquiring insights. Preliminary results from analysis of the feedback by 16,262 users from May 2020 to March 2021 highlighted issues with the Service falling within three major themes: lack of data coordination, ineffective communication, and technical issues.

Conclusions
Structural Topic Modelling was found to be the most effective technique to rapidly acquire user insights. The 25 topics provided highly specific insights of issues that can be utilized towards improving the CTAS.

Key messages
A ML approach can be a quick and cost-effective method to provide high quality, actionable insights from free-text feedback in order to optimize public health services. Topic models can rapidly provide highly specific user insights with minimal human involvement and low maintenance requirements, making them ideal evaluation tools for pandemic response services.
The COVID-19 policy and strategic documents storm: a heartfelt request from the battlefield
Authors: Boned-Ombuena A , Merino-Egea C , Orenga-Damigo I , Taberner Cuevas A , Canós-Cerdá M , Orrit-Ferrer G , Grau Darás MT , Recuenco Díez L , Monteagudo-Giménez A , Boned Fustel P 
Published: October 2021

Abstract

Issue
The COVID-19 pandemic declared by WHO on 11 March 2020 brought not only a big threat to the global population but also a huge number of technical, policy and strategic documents with a very varied level of quality and accessibility. It has been a great challenge for frontline public health workers to surf the information wave, in order to effectively apply it in the context of crisis management.

Description
COVID-19 related policy, strategic and operational documents analysed and implemented by our team -at a public health centre at health department level, in the Valencian Region (Spain)- during the pandemic were reviewed. Key elements considered were: length, quality of structure and content, validity period, as well as dissemination channel.

Results
From February 2020 to date, the European Centre for Disease Prevention and Control (ECDC) alone has published 90 guidance and technical reports, representing 1,503 pages (mean length 16,7 pages, SD 14,0, range 3-92). As regards the Spain national COVID-19 strategy, i.e., a total of 26 versions have been issued so far, between 24 January 2020 and 26 February 2021. Mean length was 19,8 pages (SD 6,8, range 8-31) and average validity period of versions was 15,7 days (SD 16,4, range 1-70). They did not include a summary of recent changes. They were made publicly available through the official Ministry of Health website. As for regional-level documents, 5,3% (21) did not have a date, and their main channel of dissemination was via email.

Lessons
We strongly recommend that policy and strategic documents at all levels comply with a minimum set of quality standards -including essential elements such as organization, title, publication date, page numbers, table of contents, key messages, and summary of changes in comparison with previous versions- and are disseminated through internet or intranet knowledge management systems. This would efficiently save a large number of hours and headaches to frontline professionals.

Key messages
In the context of public health crisis management, timely and appropriate access of frontline public health professionals to updated and concise information is crucial. COVID19 policy and strategic documents at all levels were reviewed. They should comply with a minimum set of quality standards, including a summary of recent changes, and be adequately disseminated.
Mental health during the COVID-19 pandemic in Portugal
Authors: Santos O , Virgolino A , Heitor MJ , Fialho M , Costa A , Rasga C , Martiniano H , Costa J , Vicente A , Caldas de Almeida T 
Published: October 2021

Abstract

Background
Mental health is being impacted by COVID-19, as a result of both the globalized perception of health risk and the massive social and economic measures, required to control the pandemic. A main goal of this study, the SM-COVID19, was to characterize the mental health of the general population and to identify vulnerable groups, during the first lockdown in Portugal.

Methods
Cross-sectional online survey, conducted between May 22 and July 20, 2020, with a nationwide non-probabilistic sample of adults residing in Portugal (≥18 years old). Data were collected with sound psychometric scales for symptoms of anxiety, depression and post-traumatic stress disorder (PTSD), work-life balance, resilience, work-related variables, and sociodemographics. Logistic regression models were used to assess risk and protective factors for mental health suffering.

Results
Overall, 3982 individuals participated in the study (female, 79.1%; mean age, 45.15±12.31 years; 71.0% completed higher education studies). The prevalence of symptoms of moderate to severe anxiety was 26.5% (95% Confidence Interval (CI): 24.0-29.1), of depression symptoms was 26.0% (95%CI, 23.6-28.7), and of PTSD symptoms was 26.5% (95%CI, 24.0-29.2). Moreover, more than one third of the respondents (41.2%; 95%CI: 38.3-44.1) reported symptomatology for at least one of these three psychiatric disorders. Women, individuals who suspended their professional activity (or in layoff or unemployed) during the lockdown, and those with difficulties in managing work and family demands had higher odds for psychological suffering.

Conclusions
The COVID-19 pandemic is a public health crisis with major interpersonal, social and economic impacts at the individual level. Mental health and wellbeing are being severely affected, as confirmed by the high prevalence of symptoms of psychological suffering herein. Mental health protection measures need to be defined and implemented, mainly targeting the most vulnerable groups.

Key messages
COVID-19 pandemic is associated with high prevalence of anxiety, depression and PTSD. Observed mental health inequities imply effective vulnerable-groups-focused mental health promotion programs.
Sex differences and trends of self-rated health in population aged 25-64 years from 1988 to 2017
Authors: Gafarov V , Panov D , Gromova E , Krymov E , Gagulin I , Gafarova A 
Published: October 2021

Abstract

Aim
To determine gender differences in the dynamic of self-rated health in an open population of 25-64 years over 29 years in Russia.

Methods
Within the framework of the screening in 1988-89 under the WHO MONICA-psychosocial (MOPSY) program (n = 1676, 49.5% males, mean age 44.1±0.4y), MOPSY screening in 1994-95 (n = 1527, 43% males, 44.85 ± 0.4y), in 2003-2005 under the international project HAPIEE (n = 1650, 34.9% males, 54.25±0.2y), in 2013-2016 (n = 975, 43.8% males, 34.5±0.4y) and 2016-2017 (n = 663, 41.3% males, 51.95±0.32y) within the framework of the budgetary theme No. AAAA-A17-117112850280-2, random representative samples of men and women in one of districts in Novosibirsk were examined. Self-rated health was assessed using the questionnaire ‘Knowledge and attitude towards own's health'.

Results
Rates of negative self-reported health in open population was extremely high in 1988. The share of women who consider themselves healthy was 13.7%, men - 37.9%. Gender differences increased with age. Only 10.5% of women and 29.7% of men had no complaints about their health. In 2013, there was an increase in positive health estimation among males and females and a decrease in the frequency of complaints, especially in female part of the population - by 2-2.5 times. The favorable trend which began in 2013 continued in 2017, when men and women more often self-esteemed own health status as “good” compared to earlier periods of observation. The proportion of women believed that taking comprehensive care of their health rose to 15% by 2017, equaling that of men. With the exception of 2013, women were more likely than men to report that “taking care of their health is not enough”, although by 2017 this proportion had dropped to 20%.

Conclusions
Sex differences in self-rated health increase with age, but the frequency of health complaints increases proportionally in men and women. There were found favorable tendencies in assessments of health, especially in female population.

Key messages
Rates of negative self-reported health in open population was extremely high in 1988 but subsequently favorable tendencies in assessments of health was found by 2017. Sex differences in self-rated health increase with age, but the frequency of health complaints increases proportionally in men and women.
An investigation protocol to manage a foodborne outbreak in a disaster event
Authors: Mandato D , Fraulo P , Romano A , Mazzone P , Colarusso G , Noschese R , Peruzy MF , Ambrosio RL , Galiero G , Baldi L 
Published: October 2021

Abstract

Background
During disaster events, the displaced populations living in tent camps are at high risk from foodborne illness outbreaks (FBO) as in these circumstances it is difficult to follow proper hygienic procedures during food handling and storage. When an outbreak occurs, an epidemiological investigation able to identify the source(s) of the exposure is essential to rapidly establish control measures to prevent continuing episodes of illness. This work aimed to evaluate the effectiveness and the applicability under simulated field conditions of an investigation protocol to be used during a FBO. Moreover, the application of the software ‘TOSSINFO' for data analysis was evaluated.

Methods
In May 2018, a FBO associated with the consumption of a tuna affecting 46 out of 75 people present in a tent camp in southern Italy was simulated. During the simulation, two teams of doctors and veterinarians participated in the investigation. The investigation protocol involved three steps: environmental inspection, epidemiological investigation, and data analysis through TOSSINFO. This software allows calculating different epidemiological indicators, several measures of association, and the visualization of the progression of the outbreak through epidemic curves.

Results
At the end of the exercise, both teams were able to trace the source of the infection. After data collection and data analysis, the groups demonstrated a strong association between illness people and tuna consumption. Furthermore, the teams achieved similar

Results
RR (7.50 vs 7.01), OR (27 vs 28), and Chi-square (12.1 vs 10.1).

Conclusions
The results demonstrated the validity of the procedure and the simple execution of the software analysis. These guidelines represent an opportunity for the implementation of foodborne disease management strategies and could be used throughout the community, leading to an improvement of the Public Health surveillance system.

Key messages
These guidelines allow for effective management of a food toxinfection episode. The original software TOSSINFO used in this procedure enables quick and easy identification of infected food.
Clinical Practice Guide and risk population ID card for monitoring and controlling leptospirosis
Authors: Gómez Martín MC , Rodriguez Benjumeda LM , Lozano Dominguez MC , De Eguilior Mestre C , Luque Marquez R , Aznar Martín J , Jodar Sanchez F , Luque Romero LG 
Published: October 2021

Abstract

Issue/problem
Leptospirosis is an endemic disease which is mandatorily notifiable in Spain. It is associated with occupational activities in which workers come into contact with rat urine. In our region, this disease's rates of prevalence and incidence are highest among red swamp crayfish collectors (Procambarus clarkii) (RSCC). The increase in outbreaks of leptospirosis over the last 7 years has motivated us to design and implement a Clinical Practice Guide (CPG) for health workers, informational material for the general population, and ID cards and specific information aimed at RSCCs, as a means of reducing the incidence rate. The guide may also serve as a useful tool in other regions and countries with activities associated with Leptospira-infected wetlands.

Description of the problem
The material we have designed is the result of a research project funded by the Consejería de Salud de Andalucía to identify leptospirosis incidence, prevalence, and risk factors among wetland RSCCs. Hardly any CPGs or informational material exist about this disease. The GPC and the educational material designed may be very useful in other environments with a high risk of leptospirosis.

Results
Prevalence of the disease was higher among RSCCs than among the general population (9.8% vs 3.1%) (OR: 3.4; CI 95%: 1.1-12.7) and accumulated incidence was 17.4%. Less than half of the workers adopted appropriate individual preventive measures.

Lessons
The risk of contracting leptospirosis is 3.4 times greater for the RSCC population than it is for the general population. Early detection and antibiotic therapy prevent aggravation of the disease in serious cases and may even prevent deaths. Education and the promotion of preventive measures among RSCCs reduces the risk of infection. The training of health professionals and the design of decision algorithms shorten and improve the quality of treatment for leptospirosis patients.

Key messages
Early detection and antibiotic therapy reduce the incidence of severe forms of leptospirosis. The material designed will help the risk population to adopt preventive measures and seek medical attention.