bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multi-centric assessment of COVID-19 immunization access and demand among undocumented migrants
Authors: Genovese E , Fiorini G , Corrao G , Page K , Cailhol J , Franchi M , Tlili R , Cella SG , Jackson Y L 
Published: October 2021

Abstract

Background
Marginalization of undocumented migrants raises concerns about equitable access to COVID-19 immunization. This study describes their self-perceived accessibility of and demand for COVID-19 immunization.

Methods
A multi-centric cross-sectional survey was conducted in 4 health facilities providing care to undocumented immigrants in the USA, Switzerland, Italy, and France in February-April 2021. A convenience sample of minimum 100 patients per study site was recruited. Data was collected using an anonymous structured questionnaire including demographic variables, health status, and drivers/barriers for COVID-19 immunization. Descriptive statistics were used to characterize the primary and secondary outcomes: self-perceived accessibility of and demand for COVID-19 immunization.

Results
812 migrants completed the survey (54.3% Geneva, 17.5% Baltimore, 15.5% Milan, and 12.7% Paris). 60.9% were women, the median age was 40 years old (range 17-76), and 19 nationalities were represented: 55.9% Latin America, 12.7% Africa, 11.2% Western Pacific, 7.9% Eastern Mediterranean, 7.6% Europe, 4.7% Asia. Among participants, 14.1% and 26.2% reported prior COVID-19 infection and fear of developing severe COVID-19, respectively. Underlying co-morbidities were common (29.5%). Self-perceived accessibility of COVID-19 immunization was high (86.4%), yet demand was low (41.1%) correlating with age, co-morbidity, and views on immunization which were better for immunization in general (77.3%) than immunization against COVID-19 (56.5%). Hesitancy was mostly due to fear of adverse reactions (39.2%).

Conclusions
In this multi-centric study, undocumented migrants generally believed they would access local COVID-19 immunization programs. Yet, despite positive views about immunization in general, they reported limited confidence in COVID-19 immunization and willingness to be immunized.

Key messages
Self-perceived accessibility of COVID-19 immunization is high, yet demand is limited. COVID-19 immunization campaigns may engage communities and leverage confidence in immunization in general to address concerns about COVID-19 immunization.
Prevalence of SARS-CoV-2 and associated risk factors among asylum seekers living in centres
Authors: Morisod K , Grazioli V , Schlüter V , Bochud M , Gonseth Nusslé S , D'Acremont V , Felappi A , Bühler N , Bodenmann P 
Published: October 2021

Abstract

Background
Understanding the factors influencing SARS-CoV-2 transmission in asylum seekers and refugees living in centres is crucial to determine targeted public health policies protecting these populations. We explored the pandemic's spread into asylum centres during the first wave of the pandemic (May-June 2020) in Switzerland and factors associated with the presence of SARS-CoV-2 antibodies.

Methods
This research is part of SérocoVID, a seroepidemiologic study of SARS-CoV-2 infection conducted in Canton of Vaud, Switzerland. All migrants living in two asylum centres were invited to participate. Anti-Spike IgG and IgA antibodies were measured in all participants. Each participant completed a questionnaire measuring socio-demographic characteristics, medical history, health literacy, public health recommendations, behaviours and exposures. The association of independent variables with serologic test result were estimated using a multivariable logistic regression model.

Results
The mean (SD) age of the 124 participants (23% women) was 33.7 (11.6) years (Centre 1, n = 82; Centre 2, n = 42). The mean participation rate was 37%. The seroprevalence in Centres 1 and 2 were 13% [95% CI 3-14%] and 50 [34-65%], respectively. Next, 41% of SARS-CoV-2 positive people never developed symptoms, and no one had developed severe Covid-19 disease. After adjusting for individual characteristics and centre, seropositivity was higher among people with low health literacy (aOR 6.2, p = 0.010 [1.6, 24.8]) and non-smokers (aOR 5.4, p = 0.013 [1.4- 20.3]). No other significant associations were found.

Conclusions
Findings suggest that developing targeted public health measures, especially for low health literacy people, would be necessary to limit the risk of outbreaks in asylum centres and improve this population's safety. Further investigations are required to understand better the negative association between tobacco consumption and SARS-CoV-2 infection.

Key messages
Asylum centres require specific public health measures to guarantee their population's safety and limit the virus spread. Asylum seekers and refugees with low health literacy seem particularly vulnerable during the Covid-19 pandemic.
Prospective association between dietary pesticide exposure profiles and Type 2 Diabetes risk
Authors: Rebouillat P , Vidal R , Taupier-Letage B , Debrauwer L , Gamet-Payrastre L , Touvier M , Fézeu LK , Lairon D , Baudry J , Kesse-Guyot E 
Published: October 2021

Abstract

Background
Many modifiable risk factors have been identified for type 2 diabetes. However, emerging risk factors such as food contaminants could also play a role and studies are lacking on the subject. We aimed to assess the prospective associations between dietary pesticide exposure profiles and Type 2 Diabetes (T2D) risk among NutriNet-Santé cohort participants.

Methods
In 2014, participants completed a Food Frequency Questionnaire, assessing conventional and organic food consumption. Exposures to 25 active substances were estimated using a residue database accounting for farming practices from Chemisches und Veterinäruntersuchungsamt Stuttgart, Germany. Exposure profiles were established using Non-Negative Matrix Factorization (NMF), adapted for sparse data. Cox models adjusted for confounding factors were used to estimate hazard ratios (HR) and 95% confidence interval (95% CI), for the association between the four obtained NMF components and T2D risk.

Results
The sample comprised 33,013 participants aged 53 years old on average, among which 76% of women. During follow-up (median: 5.95 years), 340 incident T2D cases were diagnosed. Positive associations were detected between NMF component 1 (reflecting high exposure to azoxystrobin, chlorpyriphos, imazalil, malathion, profenofos, thiabendazole) and T2D risk: HRQ5 vs Q1=1.47, 95% CI(1.00, 2.18). NMF Component 3 (reflecting low exposure to several synthetic pesticides) was associated with a decrease in T2D risk, among those with high dietary quality only (high adherence to French dietary guidelines): HRQ5vsQ1=0.31, 95%CI(0.10, 0.94). No associations were found for NMF Components 2 and 4.

Conclusions
These associations between some pesticide mixtures and T2D diabetes risk need to be confirmed in other types of studies and settings. These results could have important implications for developing prevention strategies, through regulations or dietary guidelines.

Key messages
Specific pesticide mixtures could play a role in increased type 2 Diabetes risk. Organic eaters were less exposed to most synthetic pesticides.
Prevalence of Major Depressive Episode in 27 European Countries
Authors: Arias de la Torre J , Ronaldson A , Vilagut G , Peters M , Valderas JM , Serrano-Blanco A , Martín V , Dregan A , Alonso J 
Published: October 2021

Abstract

Background
Information about the prevalence of current Major Depressive Episode (MDE) across European countries is essential for its monitoring and for the development of evidence- based mental health policies. The aims were to: 1) estimate the prevalence of MDE by country in Europe; and 2) assess variations in prevalence between countries.

Methods
Data from participants of 27 countries that completed the questionnaire of the second wave of the European Health Interview Survey (EHIS-2) were analysed (n = 258,888). The prevalence of MDE was quantified using the Patient Health Questionnaire-8 (PHQ-8) with a cut-off score of ≥ 10. Prevalence and 95% Confidence Intervals (CI) were estimated for each country. Variation in prevalence (country vs the rest) was evaluated using bivariable and multivariable negative binomial regression models considering the specific country as the main explanatory variable. From these models, crude Prevalence Ratios (PR) and adjusted Prevalence Ratios (aPR) were obtained.

Results
The overall prevalence of current MDE in Europe was 6.38% (6.24%-6.52%). The country with the lowest prevalence was the Czech Republic (2.58%, 2.14%-3.02%) and the country with highest prevalence Iceland (10.33%, 9.33%-11.32%). In all the countries (except for Finland and Croatia) prevalence was higher in women than in men. The countries with the highest aPR were Germany (aPR: 1.80, 95% CI: 1.71-1.89) and Luxembourg (aPR: 1.50, 95% CI: 1.35-1.66), while Slovakia (aPR: 0.28, 95% CI: 0.24-0.33) and the Czech Republic (aPR: 0.32, 95% CI: 0.27-0.38) exhibited the lowest aPR.

Conclusions
Considerable variability in the prevalence of MDE by country in Europe was observed without a clear pattern. These results serve as baseline for monitoring the prevalence of MDE at a European level and suggest a need for developing preventive strategies against depression, particularly in those countries identified with the highest prevalence.

Key messages
The results of this study show that the overall prevalence of MDE is high (6.38%), with important variation across countries (ranging from 2.58% in the Czech Republic to 10.33% in Iceland). The results found could serve as a reference for the monitoring of MDE in Europe and for the development of screening and preventive strategies both at European level as well as at a country level.
Knowledge, perceptions and attitudes of university students regarding COVID-19, Cyprus
Authors: Middleton N , Tsioutis C , Kolokotroni O , Heraclides A , Nobelos PT , Mamais I , Pantelidou M , Christaki I , Nikolopoulos G , Dietis N 
Published: October 2021

Abstract

Background
University students represent an active group with important implications in the novel coronavirus transmission. Elucidating their knowledge, attitudes and perceptions was important for customizing communication material and other information activities.

Methods
The cross-sectional online INTERACT survey targeted students in conventional programs in the five main Universities in the Cyprus Republic between 17-31 March 2020, a week either side of the first national lockdown (24 March).

Results
A total of 3641 students completed the survey (19% response rate): 65.5% female, 80.9% Bachelor, 41% Health/Life sciences. Amongst participants, 68.8% and 20.6% responded correctly to at least six and eight of 10 knowledge-related questions. Objective knowledge did not vary substantially according to self-evaluation of knowledge. Misconceptions were identified in 25-30%. Only 29.1% expressed positive attitude towards a hypothetical person with COVID-19 without also projecting judgement or blame. Odds of expressing positive attitude increased by 18% (95%CI 13-24%) per unit increase in knowledge. Studying at postgraduate level was predictive of better knowledge (OR of ≥score8 1.81; 95%CI 1.34-2.46) and positive attitude (OR 1.35; 95%CI 1.01-1.80). With average knowledge score 6.4 (SD 1.6) vs 6.1 (SD 1.6), Health/Life Sciences students performed marginally better, but were not any more likely to express positive attitude.

Conclusions
Although Cypriot University students appeared relatively knowledgeable, there were specific gaps and misconceptions, some of which may be attributed to changes in information provided to the public. Attitudes should also be interpreted in the local context where reporting, though seemingly neutral, was not characterised by empathy towards people affected. Findings highlight the importance of continuous and good communication, especially as guidance changes, both in terms of content as well as effect.

Key messages
Misconceptions and negative attitudes related to COVID19 were identified among Cypriot University students, including those in Health Sciences. Good quality communication is important both in terms of content as well as its effect on shaping attitudes.
A self-help app for Syrian refugees with posttraumatic stress (Sanadak): results of a randomized controlled trial
Authors: Roehr S , Jung FU , Pabst A , Grochtdreis T , Nagl M , Renner A , Hoffmann R , Koenig H-H , Kersting A , Riedel-Heller S G 
Published: October 2021

Abstract

Background
Syrian refugees often develop posttraumatic stress as a result of the Syrian civil war and migration stressors. However, there is a lack of adequate treatments. The smartphone app Sanadak was developed and evaluated to provide cognitive behavioral therapy-based self-help in the Arabic language for Syrian refugees with posttraumatic stress.

Methods
In a randomized controlled trial, eligible individuals were allocated to the intervention group (IG; app) or control group (CG; psychoeducational reading material). Data were collected during structured face-to-face interviews at 3 assessments (preintervention/baseline, postintervention/after 4 weeks, follow-up/after 4 months). Using adjusted mixed-effects models, changes in posttraumatic stress and secondary outcomes were investigated as intention-to-treat (ITT) and per-protocol (PP) analysis.

Results
Of 170 screened individuals (aged 18-65 years), 133 were eligible and randomized to the IG (n = 65) or CG (n = 68). Although there was a pre-post reduction in posttraumatic stress, ITT showed no significant differences between IG and CG after 4 weeks (Posttraumatic Diagnostic Scale for DSM-5, Diff -0.90, 95%CI -0.24 to 0.47; P=.52) and after 4 months (Diff -0.39, 95%CI -3.24 to 2.46; P=.79). The same was true for PP. Regarding secondary outcomes, ITT indicated a treatment effect for self-stigma after 4 weeks (Self-Stigma of Mental Illness Scale/SSMIS-stereotype agreement: d = 0.86, 95%CI 0.46 to 1.25; stereotype application: d = 0.60, 95%CI 0.22 to 0.99) and after 4 months (d = 0.52, 95%CI 0.12 to 0.92; d = 0.50, 95%CI 0.10 to 0.90).

Conclusions
Sanadak reduced mild to moderate posttraumatic stress in Syrian refugees, but not superior to the control condition. Therefore, Sanadak may not be suitable as a standalone treatment. However, as the app usability was very good, no harms detected, and stigma significantly reduced, Sanadak has potential as a bridging aid within a stepped and collaborative care approach.
Impact of COVID-19 epidemic on Lombardy’s prisons (Italy): transmission and measure of prevention
Authors: Mazzilli S , Giuliani R , Arzilli G , Cairone C , Sebastiani T , Scardina G , Cocca G , Tavoschi L , Ranieri R 
Published: October 2021

Abstract

Background
Early on in the COVID-19 pandemic, scientific community highlighted the potential risk of epidemics occurring inside prisons. Consequently, specific operational guidelines were promptly released and stringent containment measures quickly implemented, including access restriction to essential staff only. During the 2nd epidemic wave prevention strategies were gradually relaxed, visitors were readmitted and people in prison (PiP) activities were repristinated. Here, we describe the spread of COVID-19 in 18 detention facilities in Lombardy region, Italy, during the 1st(Mar-Jul 2020) and 2nd(Oct 2020-Feb 2021) waves and the impact of prevention and control measures implemented in prison.

Methods
We conducted a descriptive retrospective analysis of cases' distribution. Moreover, a comparison among the epidemic burden affecting POs and PiP and a correlation analysis between the number of cases occurred and prevention measures implemented were carried out.

Results
Our population consists of a monthly average of 2269 prison officers (POs) and 7604 PiP. POs were at higher risk of contracting COVID-19 during both waves. Occurrence of cases among PiP was temporally associated with cases among POs. There was heterogeneity in the size of outbreaks across different prison facilities. During the second wave, COVID-19 spread more widely in prison both among POs (2ndwave attack rate (AR) per 1000 individuals: 27.2; monthly range (MR): 0.9-64.5 vs 1stwave AR 2.4; MR: 0.0-12.1) and PiP (2ndwave AR: 23.5; MR: 11.6-50.8 vs 1stwave AR 1.6; MR: 0-5.2).

Conclusions
Prevention and control measures adopted timely during the first wave were effective to limit Sars-CoV-2 spread within prison facilities. According to our findings, POs and PiP are population groups at high risk for acquiring and transmitting COVID-19 and should be prioritized for testing, active case finding and vaccination. This study highlights the importance of including prison settings within emergency preparedness plans.

Key messages
Stringent prevention and control measures when adopted timely were effective to protect detention facilities from Sars-CoV-2 spread. Our study, reporting the burden of COVID-19 epidemic experienced by prison of Lombardy, Italy, highlights the importance of including prison settings within emergency preparedness plans.
Preliminary assessment of COVID-19 serological situation in a high-risk cohort
Authors: Cornio AR , Bordino V , Meddis D , Garlasco J , Marengo N , Vicentini C , Di Tommaso S , Giacomuzzi M , Memoli G , Zotti CM 
Published: October 2021

Abstract

Introduction
Studies on the duration of immune response in subjects with COVID-19 could facilitate understanding of how immunity develops and persists during the natural course of infection, as well as providing epidemiological information useful in public health decisions on the use of vaccines. The study aims to analyse antibody response in a cohort of subjects with high-risk of exposure to SARS-CoV-2 due to the long-term care facility environment.

Methods
We recruited 657 subjects between guests and healthcare workers from Piedmontese nursing homes. IgG directed against the S1 domain of SARS-CoV-2 spike protein were assayed on serum. We used EUROIMMUN kit, which exploits ELISA method. Reference values are (RU/mL): positive ≥ 11; borderline 8 ≤ value &lt; 11; negative &lt; 8.

Results
Among the 657 subjects, we examined 494 health workers and 163 guests. The average age was 56.2. In relation to COVID-19, 402 subjects had a previous infection, 255 had not. About serology: positive 369; negative 261; borderline 27. The mean of the IgG values was 35.68 RU/mL. Swabs/serology: 77.36% with previous infection were positive to serology, 18.66% negative; of all subjects who were always negative to swabs, 72.94% were negative, 22.74% positive. Moreover, the mean time elapsed from positive swab to serology test was 144.08 days.

Conclusions
Preliminary results show that the antibody response is present and persistent in the study population, even a long time after the infection. According to literature, antibody persistence has great variability in our population, as no statistically significant correlations were found between antibody titer and other variables such as time elapsed since infection. The examined sample, belonging to high-risk category (long-term care facilities), is most likely to present repeated exposure to SARS-CoV-2, highlighted by the seropositivity of never infected subjects. These findings might help policy makers better address resources regarding vaccines.

Key messages
Antibody response is present and persistent in the study population, even a long time after the infection. Antibody persistence has great variability in our population, as no statistically significant correlations were found between antibody titer and other variables such as time elapsed since infection.
The Indirect Impact of Covid-19 Pandemic on Hospitalizations for Cardiovascular Diseases in Abruzzo
Authors: D'Addezio M , Di Giovanni P , Cedrone F , Di Martino G , Meo F , Scampoli P , Staniscia T 
Published: October 2021

Abstract

Background
In 2020 the Covid-19 pandemic influenced the organization of all health systems, imposing new rules for accessing the hospitals and delaying or reducing the ability to cope with all the population needs. In addition, people with life-threatening conditions deferred care for their fear of contagion. The study aimed to evaluate the indirect impact of Covid-19 on hospitalization rates for cardiovascular diseases in 2020 in Abruzzo.

Methods
Data were obtained from the hospital discharge records of all Abruzzo. We analyzed all the hospitalizations included in Major Diagnostic Categories 5 (cardiovascular diseases). First, we distinguished both between public or private hospitalizations and ordinary or day-hospital admissions. Second, we compared the first nine months of 2020 with a mean of the same months in the two previous years. Finally, we calculated the variable percentage.

Results
A huge reduction in hospitalization in MCD 5 contest was observed in each subgroup. Specifically, ordinary regimen had a peak of -56,4% in April. Day-hospital admissions were the most affected by Covid-19 with a peak of -84% in April. The largest reduction in hospitalizations occurred in private hospitals, in both ordinary (-81% in April) and DH admissions (-100% in April). A rebound in admissions was reported only for ordinary private regime between June and September, with a peak of + 24% in August.

Conclusions
Covid-19 had a severe impact on Abruzzo hospitalizations. The medical conditions that we examined needed effective hospital treatment to avoid adverse outcomes or death. Subsequently, fewer hospitalizations for such medical conditions were almost certainly associated with patient harm. Despite the pandemic, health system leaders should manage to provide subjects with hospital care, when necessary.

Key messages
Covid-19 had a significant indirect impact on the rate of hospitalizations for cardiovascular disease in Abruzzo. Despite the pandemic, regional health systems should manage to provide effective hospital care for patients with cardiovascular conditions that require hospitalization.