bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of COVID-19 on migrant populations in high-income countries: a systematic review
Authors: Hayward SE , Deal A , Cheng C , Orcutt M , Norredam M , Veizis A , Campos-Matos I , McKee M , Kumar B , Hargreaves S 
Published: October 2021

Abstract

Background
Migrants in high-income countries (HICs) may have been disproportionately affected by the COVID-19 pandemic, yet the extent to which they are impacted, and their predisposing risk factors, are not clearly understood. We did a systematic review to assess clinical outcomes, indirect health and social impacts, and key risk factors in migrants.

Methods
Our systematic review following PRISMA guidelines (PROSPERO CRD42020222135) identified peer-reviewed and grey literature relating to migrants (foreign-born) and COVID-19 in 82 HICs. Primary outcomes were cases, hospitalisations and deaths from COVID-19 involving migrants; secondary outcomes were indirect health and social impacts and risk factors.

Results
3016 data sources were screened with 158 from 15 countries included in the analysis. We found migrants are at increased risk of SARS-CoV-2 infection and are over-represented among cases (e.g. constituting 42% of cases in Norway [to 27/4/2020], 26% in Denmark [to 7/9/2020], and 32% in Sweden [to 7/5/2020]); some datasets from Europe show migrants may be over-represented in deaths with increased all-cause mortality in migrants in some countries in 2020. Undocumented migrants, migrant health and care workers, and migrants housed in camps have been especially affected, with certain nationality groups disproportionately impacted. Migrants experience a range of risk factors for COVID-19, including high-risk occupations, overcrowded accommodation, and barriers to healthcare including inadequate information, language barriers, and reduced entitlement.

Conclusions
Migrants in HICs are at high risk of COVID-19, with a range of specific risk factors that have not been well-considered in the public health response to date. These data are of immediate relevance to the policy response to the pandemic, with strategies urgently needed to reduce transmission. Migrant populations must also be better considered in national plans for COVID-19 vaccination roll-out.
On behalf of ESGITM

Key messages
Migrants in high-income countries may be disproportionately represented in COVID-19 infections and deaths, with higher levels of many vulnerabilities and risk factors. Migrants must be better included in all aspects of the pandemic response, including vaccination roll-out.
Are 2020’s medical students still suffering from gender stereotypes? An Italian study
Authors: Boietti E , Bert F , Gualano M R , Pompili E , Rousset S , Franzini Tibaldeo E , Tatti R , Siliquini R 
Published: October 2021

Abstract

Background
Gender medicine is crucial to reduce health inequalities in Europe. Knowledge about medical students' attitudes and beliefs regarding sex and gender is important to improve gender medicine courses. The aim of this study is to evaluate gender awareness and its predictors in Italian medical students.

Methods
During 2020, we performed a cross-sectional study among medical students from the University of Turin, Italy. We used the validated Nijmegen Gender Awareness Scale in Medicine (N-GAMS) to investigate gender sensitivity (GS) and gender role ideology towards patients (GRIP) or doctors (GRID). Multivariable logistic regression model was performed to explore potential predictors of gender awareness.

Results
Globally, 430 participants completed the survey (68.4% were females). The 62.5% of male students had a poor knowledge of gender medicine. GRID score significantly differs between males and females (1.64±0.68 vs 1.51±0.49; p = 0.028). Males had lower GS scores (coefB -0.96, p &lt; 0.05), while students who had a better knowledge on gender medicine (coefB 0.14, p &lt; 0.05) and those who have received good example from tutors (coefB 0.14, p &lt; 0.05) were more gender-sensitive. Older age (coefB 0.04, p &lt; 0.05), a better knowledge on gender medicine (coefB 0.12, p &lt; 0.05) and having had a tutor sensitive to gender issues (coefB 0.13, p &lt; 0.05) were predictors of more stereotyped opinions towards patients. Having had a tutor aware of gender medicine (coefB 0.03, p &lt; 0.05), male sex (coefB 0.12, p &lt; 0.05) and older age (coefB 0.03, p &lt; 0.05) were associated with more stereotypes towards doctors.

Conclusions
Gender stereotypes are still common. During university courses and practical training more attention must be paid to explain that stereotyped gender differences are not scientifically proven and they do not contribute to provide better care. Therefore, the implementation of gender specific teaching throughout elective courses should be seriously considered.

Key messages
Receiving more knowledge and more attention about gender medicine during university education was associated with higher gender stereotypes in our sample of medical students. Interventions in European university education are needed to make gender medicine education more effective in order to reduce gender stereotypes and contribute to better care.
Artificial sweeteners and cancer risk in the prospective NutriNet-Santé cohort
Authors: Debras C , Chazelas E , Srour B , Julia C , Kesse-Guyot E , Andreeva VA , Galan P , Hercberg S , Deschasaux-Tanguy M , Touvier M 
Published: October 2021

Abstract

Background
Added sugars' deleterious effects have been established for several chronic diseases, leading food industries to turn towards high-intensity sweeteners. Their safety is debated and findings remain contrasted regarding their role in the etiology of various diseases. In particular, their carcinogenicity has been suggested by several experimental studies but epidemiological data are lacking.
Thus, our objective was to investigate the associations between sweetener intakes (total from all dietary sources, and most frequently consumed: acesulfame-K e950, aspartame e951 and sucralose e955) and cancer risk (overall and by sites).

Methods
Overall, 102,046 adults from the French NutriNet-Santé prospective cohort (2009-2021) were included. Consumption of sweeteners was obtained by repeated 24h-dietary records including brands and commercial names of industrial products. Associations between sweeteners and cancer incidence were assessed by multi-adjusted Cox hazard models.

Results
Compared to non-consumers, high-consumers had higher risk of overall cancer (n = 2527, hazard ratio=1.12, 95% confidence interval=1.00-1.25, P-trend=0.005). In particular, acesulfame-K (HR = 1.18 [1.04-1.34] P = 0.003) and aspartame (HR = 1.20 [1.05-1.38] P = 0.001) were associated with increased cancer risk. Similarly, higher risks were observed for breast (n = 723, HR = 1.25 [1.02-1.53] P = 0.01, HR = 1.39 [1.11-1.74] P = 0.003 and HR = 1.33 [1.05-1.69] P = 0.007 for total sweeteners, e950 and e951, respectively) and obesity-related cancers (n = 1509, HR = 1.16 [1.00-1.33] P = 0.02, HR = 1.23 [1.04-1.45] P = 0.01 and HR = 1.22 [1.02-1.45] P = 0.01 for total sweeteners, e950 and e951, respectively).

Conclusions
These results suggest that artificial sweeteners (especially e950 and e951), which are found in &gt; 12,000 foods and beverage references worldwide, may be associated with increased cancer risk. These findings provide important and novel insights for the ongoing re-evaluation of sweeteners by the European Food Safety Authority.

Key messages
In this large-scale prospective cohort of French adults, intake of high-intensity artificial sweetener intake (especially acesulfame-K and aspartame) was associated with higher risk of cancer. These results provide novel insights to feed EFSA’s expertise for the ongoing risk assessment of artificial sweeteners.
Looking upstream: a framework for analysing the impact of trade on public health
Authors: Koivusalo M , McCallum A 
Published: October 2021

Abstract

Background
Trade has been a commercial and political determinant of health since the Middle Ages. It was the transmission route for increased prosperity and, as the result of mobility, pandemics, such as plague. The importance of trade agreements (TA), their potential to increase inequity and restrict scope for regulating for health are not discussed widely in public health. Comprehensive TAs, emerging impacts of Brexit, global disruption associated with SARS-CoV-2, access to vaccines and climate change require urgent attention. With renewed interest in economy of wellbeing we examine the impact of trade and TAs for public health practice.

Results
We present a six-part framework for analysis of trade-related measures for public health practice:
Trade flows and/or mobility of people, goods, services or capital. Trade can enhance access to fruits, nuts and vegetables, but also tobacco, alcohol and junk food. Tariffs, tax and minimum unit pricing need to be balanced. Scope for regulation and policy measures at national level irrespective of trade flows. Obligations such as intellectual property rights and investment protection that protect corporations against local action. Authority and reference standards. TAs have changed reference agencies (e.g. Codex, ISO) and can include e-health, medical devices and data-related provisions. New provisions can signal a role for trade in improving health or undermine other international agreements. Public health and crisis exemptions so that essential local services and production can take place

Lessons
This framework enables a focus on trade flows and what is negotiated under trade agreements to inform political decision-making and evaluate what negotiated documents imply for population health.

Key messages
Trade impacts on public health depend on trade flows and what is negotiated in trade agreements. The framework for analysis helps in assessing diverse types of public health relevant impact and identifying priorities for action.
Practices towards SARS-CoV-2 transmission prevention among Polish high school students
Authors: Duda-Duma Ł , Nowak K , Harbich M , Bednarek P , Ganczak M 
Published: October 2021

Abstract

Background
Adolescents play a significant role in SARS-CoV-2 spread. The study objective was to assess practices towards COVID-19 among final year Polish high school students.

Methods
Between December 2020-March 2021 an online cross-sectional survey was conducted. Multistage random sampling selected 24 high schools in the Lubuskie region then 51 classes. Students' practices were assessed by an anonymous questionnaire. Significance was tested by Chi-square test.

Results
Response rate was 72.3%; 638 students (360 females) participated (mean age 18.4±0.6 years); 68.7% attended schools in the cities with &lt;100,000 inhabitants; 31.5% were in the science program. Most (81.3%) declared they always used masks in public spaces in the last month (74.3% males vs 86.1% females, p &lt; 0.001; 77.2% of those living in smaller vs 90.5% in larger cities, p &lt; 0.001; 89.6% in the science program vs 77.6% - in the other programs, p &lt; 0.001); 35% always avoided crowded areas (26.9% males vs 39.4% females, p = 0.001; 29.5% living in smaller vs 47% in larger cities, p &lt; 0.001; 43.8% in the science program vs 30.9% - in the other programs, p = 0.002); 24.3% declared always keeping social distance (19.4% males vs 27.2% females, p = 0.02), 29.9% stated they did not touch their faces (25% males vs 33.3% females, p = 0.02; 27.2% living in smaller vs 36% in larger cities, p = 0.02; 37.8% in the science program vs 26.3% - in the other programs, p = 0.003). Among those wearing masks - uncovered noses (64.6%) and masks around the neck (42.3%; 48.1% males vs 38.9% females, p = 0.02) were the most frequent incorrect practices.

Conclusions
Most high school students, in particular males, living in small cities and attending non-science program have inappropriate preventive practices towards COVID-19. Health education programs are urgently needed to better equip students with COVID-19 prevention skills.

Key messages
The study shows data of final year high-school students' practices towards COVID-19 and maybe used by public health experts to better address educational campaigns oriented to Polish adolescents. Health education aimed at high school students would be crucial to improve compliance with SARS-CoV-2 infection control procedures.
Co-production of health: are communities being heard in local health planning in Portugal?
Authors: Nunes AB , Leiras G , Duarte S , Brito DV 
Published: October 2021

Abstract

Background
Health planning is an essential tool to address communities' health needs. Although recommended by portuguese national guidelines, Local Health Plans (LHP) lack adequate community participation, which could improve their implementation and contribute to achieve the SDG agenda and universal health coverage. The aim of this study is to assess the degree of community participation in LHP in Portugal.

Methods
Data was collected from 52 (out of 54) publicly available LHP in April 2021. Each document was reviewed by two independent researchers and analysed considering time frame, participatory approach, stage of the health planning cycle in which the community was involved and methods used to promote community participation. A descriptive analysis was performed.

Results
Although 52 LHP were available, only 37 were valid for 2020. Although community participation was mentioned in all PLH, most did not include a comprehensive community participation approach (88%). Community representatives were particularly involved in the prioritizing health problems stage of the health planning cycle (81%); no LHP mentioned the involvement of the community in the monitoring and evaluation stage. Methods used to promote community participation were clearly stated in 48% of LHP.

Conclusions
Community participation is a key strategy for successful implementation of LHP in Portugal. Most LHP show a clear concern to include community representatives when it comes to prioritizing health problems and highlight the importance of co-production of health between health services and the community, but fail to integrate community participation throughout the health planning cycle. Specific community fora could improve community participation and therefore better implementation of LHP.

Key messages
Most Local Health Plans in Portugal lack a comprehensive community participation approach. A community-centred approach should be prioritized in order to improve LHP implementation.
First assessment of covid-19 vaccine response in a population at risk
Authors: Bordino V , Cornio AR , Garlasco J , Marengo N , Di Tommaso S , Giacomuzzi M , Memoli G , Vicentini C , Zotti CM 
Published: October 2021

Abstract

Introduction
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has led to a global pandemic. Currently, the diagnosis of COVID-19 is confirmed by detecting SARS-CoV-2 via RealTime-RT-PCR in rhino-pharyngeal swab. Serological test is required to evaluate a previous exposure to the virus, as well as antibody response. The aim of this multicentric study is to analyse the antibody response following COVID-19 vaccination in healthcare workers and guests of nursing homes, and to determine differences between subjects with or without a confirmed previous infection.

Methods
Our study included 657 subjects, recruited from guests and healthcare workers of nursing homes in the Piedmont region. 10 days after the completion of the vaccination cycle, a blood sample was taken from the subjects to measure IgG against SARS-CoV-2 spike protein. Serological testing was performed using an enzyme immunoassay kit (EUROIMMUN Anti-SARS-CoV-2 QuantiVac ELISA). We performed statistical analysis with R software.

Results
We recruited 657 subjects aged between 19 to 106. Among them, 404 had a previous infection and 253 didn't have a known previous infection. The serological examination resulted positive in 655 subjects and negative in 2 (X¯ IgG 1095 RU/ml). Samples with titer&gt; 1200 RU/ml will be further diluted to identify the titer and differences from the baseline situation.

Conclusions
This study analyses neutralizing antibodies, which should prevent the virus from binding to target cells via spike protein. According to literature, immunological response to vaccine presents a great variability of antibodies level in the study population. However, no significantly correlations were found between the available variables. Preliminary data show the presence of a very intense antibody response after active vaccine immunization both in subjects with previous infection and in the rest of the study population.

Key messages
Covid-19 vaccine response in a population at risk. Differences between subjects with or without a confirmed previous infection.
Mask reuse during the COVID-19 pandemic: a national survey in Taiwan
Authors: Hu HY , Cheng FS , Yen YF , Lin SY , Weng SH , Chou YC , Chu DC , Chen CC 
Published: October 2021

Abstract

Background
The use of masks is an effective measure to prevent severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection; however, mask reuse is not recommended. Studies examining the factors associated with mask reuse during the coronavirus disease (COVID-19) pandemic are limited. This nationwide survey aimed to determine the prevalence and factors associated with mask reuse among Taiwanese citizens during the pandemic.

Methods
From May 18 through May 31, 2020, a computer-assisted telephone interview system was used to randomly select Taiwanese citizens who were interviewed for COVID-19 preventive behaviors and knowledge on the usage of masks. Multivariate logistic regression was used to identify factors associated with mask reuse during the COVID-19 pandemic. Moreover, generalized estimating equations (GEE) were used to analyze the rate of mask reuse among participants before and during the pandemic.

Results
For a total of 1,075 participants, the overall mean age was 57.4 years, and 82.2% of participants reported mask reuse during the COVID-19 pandemic. After controlling for other covariates, participants who had a greater knowledge on mask usage or had a high supply of masks were less likely to reuse masks during the pandemic. GEE analysis showed that compared with the participants' mask wearing behaviors before the COVID-19 pandemic, they were more likely to reuse masks during the pandemic.

Conclusions
The rate of mask reuse among the general population during the pandemic was significantly higher than that before the pandemic. Individuals were less likely to reuse masks if they had adequate knowledge on mask usage or had a high supply of masks. Since mask reuse is associated with a higher risk of COVID-19 due to the possibility of wearing SAS-CoV-2-contaminated masks, it is imperative to educate people on the correct usage of masks. Further, the government should provide sufficient masks to the general population to decrease the reuse of masks.

Key messages
Mask reuse increased during the COVID-19 pandemic due to the shortage in supply. It is imperative to educate people about the correct usage of masks.
The effect of the COVID-19 pandemic on long-term care managers' intention to quit
Authors: Pförtner T , Pfaff H , Hower K 
Published: October 2021

Abstract

Background
The SARS-CoV-2-pandemic poses major demands for long-term care, which might have impacted the intention to quit the profession among managers of long-term care facilities.

Methods
We used cross-sectional data of an online survey of German long-term care managers from outpatient and inpatient nursing and palliative care facilities surveyed in April 2020 (survey cycle one; n = 532) and between December 2020 and January 2021 (survey cycle two; n = 301).

Results
Results from the multivariate logistic regression analysis, including all variables simultaneously, showed that the pandemic-specific demands [OR = 1.034; CI = 1.011-2.057] and the general demands [OR = 1.023; CI = 1.001-1.045] were significantly associated with the intention to quit the profession. This association was significantly stronger for general demands in survey cycle two compared with survey cycle one. The results highlight the pandemic's immediate impact on long-term care. The interaction term between survey cycle and demands indicated that the association between general demands and the intention to quit the profession significantly rose between survey cycle one and two [OR = 1.036; CI = 1.000-1.072], whereas the association between pandemic specific demands and intention to quit the profession did not significantly vary by survey cycle [OR = 0.975; CI = 0.940-1.012].

Conclusions
In view of the increasing number of people in need of care and the already existing scarcity of specialized nursing staff, the results highlight the need for initiatives to ensure the provision of long-term care, also and especially in such times of crisis.

Key messages
The intention to quit the profession among German managers of long-term care facilities has significantly increased during the SARS-CoV-2-pandemic. During the SARS-CoV-2-pandemic the perceived general demands as well as those directly related to the pandemic have increased significantly.
Wearing masks in public spaces in Poland during SARS-Cov-2 epidemic: an observational study
Authors: Ganczak M , Michalska J , Pasek O , Sikora A 
Published: October 2021

Abstract

Background
Face masks can all be effective means of controlling SARS-CoV-2 transmission. In Poland, obligatory wearing of masks in public spaces was introduced on April 10th, 2020.

Objective
To assess use of masks in public spaces in Poland during the third wave of SARS-Cov-2 epidemic.

Methods
A non-participatory covert observational study was conducted during the 3rd wave, on three dates (20.03/27.03/03.04.2021) at public spaces in 12 provinces with different SARS-Cov-2 infection risks according to the R number. Ten consecutive individuals were observed by each of 91 medical students, using a structured checklist.

Results
Among 3283 observed individuals, the female/male ratios were 1.1/1.1/0.9 on the three dates. Around three quarters were using masks: 76.2% (858/1126) on date 1, 76.3% (867/1137) on date 2; and 79.7% (813/1020) on date 3. Medical masks predominated on all dates (52.4%-50.5%-55.8%), followed by cloth (34.6%-37.6%-33.0%). Location in a closed space (OR = 3.47-2.64-2.84) was associated with higher usage. Participants in sports were about two-three times less likely to use masks (OR = 0.52-0.58-0.34) as compared to other activities. The proportion using masks correctly was as follows: 62.6% (537/858); 63.1% (547/867); 57.7% (469/813) respectively; significant between-gender difference was observed regarding date 1 (date 1: 306/458, 66.8% females vs 231/400, 57.8% males; p = 0.006, date 2: 284/459, 61.9% females vs 263/408, 64.5% males; p = 0.43, and date 3: 232/408, 56.9% females vs 237/405, 58.5% males; p = 0.63). Uncovered noses (55.5%-59.5%) and masks around the neck (18.1%-24.7%) were the most frequent incorrect practices.

Conclusions
The results show an essential difference between governmental regulations and how the general public responds to the SARS-Cov-2 pandemic in the context of mask usage. Medical masks were predominantly used in public spaces, however, almost every third individual wore masks incorrectly.

Key messages
Knowledge translation with the use of adequate communication channels, would be helpful to increase compliance and correct usage. This message can be used to target specific practices when developing public health campaigns which should be then rigorously evaluated for their effectiveness.