bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and biological profile of newly diagnosed HIV-infected patients in Casablanca
Authors: Lyazidi S , Marih L , Marhoum El Filai K , Hassoune S , Nani S , Sodqi M 
Published: October 2021

Abstract

Background
HIV infection continues to be a major global public health issue. UNAIDS estimates that 690 000 HIV-related deaths occurred in 2019. In Morocco The number of people living with HIV was estimated at 21,000 in 2018. HIV prevalence in Morocco remains low (around 0.1%) in the general population. It is much higher among female sex workers, men who have sex with men (MSM), people who inject drugs and migrants. In Casablanca the epidemic is concentrated among MSM. The aim of this study was to describe the epidemiologic, clinical and immuno-virological characteristics of people newly diagnosed with HIV infection managed in the Ibn Rochd teaching Hospital of Casablanca.

Methods
A cross-sectional study was performed including patients newly diagnosed with HIV infection and managed in the infectious diseases department from January 1st, 2017 to June 30, 2018. Data were collected from patient's medical records and were analyzed using SPSS 16. Main outcomes were presented as mean and pourcentages.

Results
525 patients newly diagnosed with HIV infection were managed during the 18 months period in the Infectious Diseases Department. The mean age was 36.1 years, with a sex ratio of 1.1. Among them, 43% were single and 61.7% were unemployed. Heterosexual transmission mode represented 65.5% and MSM represented 23%. The seropositivity was discovered through an evocative symptom in 47.8% of all cases. The main clinical symptoms were: weight loss (16.6%) and oral candidiasis (11.2%). The main opportunistic infection was tuberculosis (23%). 36.1% of cases were diagnosed at acquired immunodeficiency syndrome (AIDS) stage. Medians of the first CD4 count and viral load performed were respectively 248/mm3 and 88 174 copies/ml.

Conclusions
Despite a good antiretroviral coverage, HIV infection is still diagnosed late in our country. The emphasis must be on the promotion of voluntary testing mainly among groups at high risk of infection.

Key messages
More active offer of HIV testing, by general practitioners, should play a crucial role in the early identification of HIV infections. Strategies such as use of preexposure prophylaxis should be developed to prevent HIV transmission among MSM.
Impact of sociodemographic factors on children’s immunization in Bulgaria
Authors: Hadzhieva S , Pancheva R , Usheva N 
Published: October 2021

Abstract

Introduction
Vaccinations have been touted as one of the “greatest public health achievements”, but the rate of under-vaccination in child population is steadily declining, especially in low-income groups. Many studies show, that country-specific parental socio-demographic factors may influence on children's immunization coverage.

Aim
To assess which family socio-demographic factors influence parental vaccine hesitancy.

Methods
A survey was conducted among 1195 parents of children under the age of 7y., between 2015-2017, mean age of 30.9±6.4y., of Bulgarian or other ethnic groups, living in Eastern Bulgaria. Questions about family socio-demographic factors, attitude, beliefs and fears were included.

Results
The share of parents who state that they would not have vaccinated their children if the vaccination program was not compulsory is 20.9%. They are mainly in the age range 30-39(42,4%;Spearman's ρ = 0,13;р&lt;0,0001), with higher education(57.6%; Pearson's r=- 0,13;р&lt;0,001), of Bulgarian ethnicity (73,7%;Pearson's r=-0,12;р&lt;0,0001%), living in a larger town, mainly gathering information about vaccines from the Internet(29.9%), mass media(30%) and/or relatives and friends(25.5%). Even of compulsory vaccination programs, these parents tend to have children with missed or postponed vaccinations. Insufficient knowledge and/or shortcomings of the health system are the leading factors for parents with lower education and Roma ethnic group living in relatively smaller settlements, who do not to have a full-scale vaccination program of their children.

Conclusions
Socio-demographic differences in parental attitudes towards compulsory vaccination require a differentiated approach. Preventive health care work is needed to overcome the growing anti-vaccine attitudes. Education and proper evidence-based proofs about vaccines and their benefits is needed for one types of a population group while increased knowledge and improved access to medical services for another population group.

Key messages
A large-scale study, characterized as a representative to the country, about the parents' attitudes towards immunization as a whole in the Republic of Bulgaria was carried out. Some socio-demographic factors that might have affected the readiness of parents to vaccinate their children have been analyzed.
Falls in older people at home and leisure time during the COVID-19 pandemic in Portugal
Authors: Alves T , Rodrigues E , Neto M , Mexia R , Matias-Dias C 
Published: October 2021

Abstract

Falls are one of the most common mechanisms of injury namely at home and in leisure time reaching one of the most vulnerable groups of the population such as the older ones, with expression in morbidity and mortality. The pandemic context we are experiencing it has had effects on the physical, mental and social wellbeing of populations but also on the use of health care whose magnitude and reasons are subject of discussion. The aim of this study is to understand the evolution of falls episodes in victims aged 65 and over, which needed attendance in the emergency room of the Health National Service Hospitals in Portugal based on hospital records, through EVITA system, between 2017 and 2020. A descriptive analysis of the data was performed, with the determination of absolute and relative frequencies (percentages). Bivariate comparisons were performed using Pearson's chi-square test with a significance level of 5%. In this analysis, the statistical program SPSS V.24 was used. In the four years between 2017 and 2020 the older people aged 65 and over represented 27% of the total of attendances in the emergency room. Considering the total of ED attendances in this age group 10% occurred due to fall at home or during leisure time. In the last four years there were 462 953 falls in people victims aged 65+, constituting 46% of hospital ED attendances by fall. From march to december 2020, falls episodes have remained below the values of similar periods in the previous four years (p &lt; 0,01). The largest percentage decrease in falls in 2020 compared to the same period in 2019 occurred in april, with a decrease of 41%. Most of this falls in the study population occurred at home (61%), followed by falls in outdoor spaces (11%). Globally, this reality regarding to the decrease of the ED attendances during this pandemic context is not exclusive to Portugal.

Key messages
The older people represented 27% of the total of attendances in the emergency room in the four years in analysis. 10% of ED attendances occurred due to fall at home or during leisure time. From march to december 2020, was observed a significant decrease of falls episodes compared with the previous four years.
Driving Behaviour in Depressed Patients vs Healthy Controls
Authors: Tsoutsi V , Dikeos D , Basta M , Papadakaki M 
Published: October 2021

Abstract

Introduction
Depression is characterized by mental, emotional and executive dysfunction, and it may have an impact on driving behaviour. The aim of the study was to evaluate driving performance in depression.

Methods
Participants (39 depressed patients vs 30 controls) completed questionnaires and scales on demographics, driving experience and habits, mental and physical health. They also completed two specific questionnaires on driving behaviour and attitude: the Driver Behaviour Questionnaire (DBQ) with three sub-scales (driving errors, traffic violations and attention lapses) and the Driver Stress Inventory (DSI) which assesses drivers' vulnerability to stress reactions while driving and consists of five sub-scales (aggression, dislike of driving, hazard monitoring, thrill seeking and proneness to fatigue).

Results
All driving sub-scales did not differ between cases and controls. For both the total population of participants and for depressed patients separately aggression and hazard monitoring (HM) were found to be positively correlated to fatigue severity scale total score (FSS), HM was correlated with male sex, and proneness to fatigue (PF) was negatively correlated with the total score of STOP-BANG, a questionnaire for probable sleep apnea. Only among depressed patients there was a positive correlation of PF with the total score of Athens Insomnia Scale (AIS), of traffic violations with AIS and body mass index, and of both dislike of driving and HM with the anxiety sub-scale of the Hospital Anxiety and Depression Scale. Only when all subjects were considered together, age was negatively correlated to thrill seeking and traffic violations.

Conclusions
While there are no significant differences between depressed patients and controls, there are parameters which influence driving behaviour and attitude similarly for both groups (especially fatigue and sex) and specific parameters only for depressed patients (anxiety, insomnia symptoms and BMI).

Key messages
Driving behaviour and attitude of depressed patients and healthy controls are influenced by specific parameters. Depression per se and its consequences, such as sleep disorders and anxiety, affect driving performance and attitude.
Long-term outcomes of in utero Ramadan exposure: a systematic review
Authors: Mahanani MR , Abderbwih E , Wendt AS , Deckert A , Antia K , Horstick O , Dambach P , Kohler S , Winkler V 
Published: October 2021

Abstract

Background
Previous systematic reviews have documented perinatal health effects of in utero Ramadan exposure on children. Our study aims to review possible long-term consequences.

Methods
Following PRISMA guideline, we searched PubMed, PsycINFO, EconLit, Index Islamicus, Web of Science, Cochrane Library, WHO Global Index Medicus, WHO Virtual Health Library and Google Scholar for original research articles analysing any long-term outcome of in utero Ramadan exposure, excluding maternal and perinatal outcomes.

Results
Fourteen studies from 4874 non-duplicate search results were included. Most studies suggest negative consequences from in utero Ramadan exposure on health as well as on economic outcomes later in adulthood. Higher under-five mortality rate, higher mortality under three months and under one year, shorter stature, lower body mass index, increased incidence of vision, hearing and learning disabilities, lower math, writing and reading scores, as well as lower probability to own a home were associated with Ramadan exposure during conception or first trimester of pregnancy. Further, age and sex of the child seem to play a pivotal role on the association.

Conclusions
Existing studies suggest that in utero Ramadan exposure may adversely impact long-term health and economic well-being. However, evidence is limited. Meanwhile, increasing awareness of the potential risks of Ramadan fasting during pregnancy should be raised among pregnant women and clinicians and other antenatal care workers should promote better maternal healthcare.

Key messages
In utero Ramadan exposure may adversely impact long-term health and economic well-being. Some negative effects are observed particularly when Ramadan occurred during the first trimester of pregnancy.
Relation between depression and chronic physical disease and healthcare utilisation in the Portuguese
Authors: Pedrosa B , Neto M , Namorado S , Leite A 
Published: October 2021

Abstract

Background
Previous studies show high chronic physical disease/depression comorbidity and higher healthcare use in these patients. Most studies focus on a single physical disease and do not consider number of diseases or depression severity. We aimed to characterise the chronic physical disease/depression relation in the Portuguese and analyse its association with healthcare use.

Methods
We undertook a cross-sectional study, using data (2019/2020) from an existing family panel (Em Casa Observamos Saúde), with “chronic physical disease” as exposure and “depression” and “healthcare use need” as outcomes. The sociodemographic characteristics of the sample were described. Logistic and multinomial regression analysis between depression (presence/severity) and chronic physical disease (presence/type/number) and between this comorbidity and healthcare use need were conducted. Adjusted odds ratio (OR) and 95% confidence intervals (CI95%) were calculated for each analysis. Analyses were weighted to account for complex sample design.

Results
1068 individuals were included. In the population, 8.9% had depression and 72.1% had chronic physical disease. There was no statistically significant relation between general physical disease and depression (OR = 1.68 [CI95%:0.55;5.15]), but there was between allergy (OR = 2.08 [CI95%:1.02;4.25]) and COPD (OR = 3.04 [CI95%:1.21;7.61]). The risk of depression was smaller in those with two physical diseases (vs. three or more, OR = 0.32 [CI95%:0.15;0.68]). A relation between chronic physical disease and depression with healthcare use need was not observed with wide confidence intervals.

Conclusions
This study suggests a relation between COPD, allergy and a higher number of physical diseases and depression in the Portuguese. No evidence of an increased need for healthcare services was identified. Clinicians should be aware of this relation and more research needs to be conducted after the pandemic context.

Key messages
Depression is common in patients with physical diseases and should be treated. Improving coordination between services should be prioritised. No evidence of an increased need for healthcare services was identified but research outside the pandemic context should be pursued.
Social support and health-related quality of life among patients with chronic heart failure
Authors: Bannour R , Harzali Z , Dhouib W , Ben Cheikh A , Bhiri S , Ghali H , Khefacha S , Said Latiri H , Ben Rejeb M 
Published: October 2021

Abstract

Introduction
Heart failure (HF) represents a major public health issue in Tunisia due to its frequency and its consequences in terms of morbidity and mortality. Despite improved treatment, HF is still associated with high mortality and impaired quality of life. Therefore, improvement or maintenance of health-related quality of life (HRQoL) is important when caring for these patients. The aim of this study was to evaluate the health-related quality of life (HRQoL) and explore its associated factors and its relationship with social support.

Material and methods
A cross sectional study was conducted over a period of two months in the cardiology departments in the following university hospitals: Sahloul and Farhat Hached in Sousse, Fattouma Bourguiba in Monastir and Taher Sfar in Mandia. Overall, 92 participants were included. Data was collected using an interview administrated questionnaire in the Tunisian dialect. This questionnaire used the Tunisian version of the SF-36 and MSPSS.

Results
The mean age of the participants was 63.1 ± 10.4 with female predominance (53.3%). The overall score of the SF-36 was 45.1 ± 26.5. The physical component was more impaired than the mental component ((41.2 ± 29.1 VS51.3 ± 27). The two dimensions mental health and social functioning had obtained the highest averages (63.6 ± 22.4 and 51.4 ± 33.1; respectively). The MSPSS score was 52.5 ± 21. The ‘family' subscale had the highest mean (21 ± 8). HRQoL was positively associated with social support (p = 0.013; r = 0.257). The predictors of good HRQoL were: young age, university level of education, cohabitation with family, high socioeconomic level and one-sided HF.

Conclusions
Therapeutic education sessions should be implemented in order to improve the functional symptoms of HF, reduce the rate of readmissions and subsequently improve HRQOL. We also stress the importance of giving priority to strengthening social ties between the patient and their social circles.

Key messages
Heart failure is still associated with high mortality and impaired quality of life. Therapeutic education sessions should be implemented in order to improve the Quality of life of HF patients.
Gender (in)equality in the labor market: a case study of Environmental Health Officers
Authors: Paixão S , Suzano C , Ferreira A , Figueiredo JP 
Published: October 2021

Abstract

The female gender has been discriminated, as it is considered inferior, in relation to the male. In the health sector, although the proportion of women has increased, the occupational segregation still persist. The mortality rate reduction, is largely due to the unrecognized contribution of women. Segregation manifests itself in a variety of ways, ranging from a limited set of opportunities to wage disparities. It's paradox since, even in “mostly female” jobs, like Environmental Health (EH), the minority of men usually have an “escalator”, reaching leadership quickly. This abstract addresses the gaps in the challenges of gender inequality in EH, since the fact that women are a health driver is been ignored. We seek to know the attitudes and opinions of the Environmental Health Officers (EHO), about: identity centralities; discrimination in society, profession and organization. This study is observational, descriptive, cross-sectional and level of knowledge II. The target population comprises by EHO (women and men). The sample design adopted was non-probabilistic and technical for convenience. The information was collected through a digital questionnaire. On average, men presented a more conservative view, compared to the female, associating women to mother's role and housewives, revealing a certain conservatism. There was, therefore, a prevalence of gender stereotypes. A correlation was found, about the organizational discrimination, since who revelead a minor difference between genders, were also those who presented a lower index of stereotypes. In other words, an organization that provides a life balance, leads its workers to desconstruct social and professional stereotypes. In conclusion, a gender diagnosis is essential to identify asymmetries and to start the change. This study identifies and analyzes inequalities in the EH area. Most of the results found follow the literature and are relevant to define future strategies.

Key messages
Global health organizations are starting to recognize the importance of gender challenges as a way to achieve universal health coverage which facilitates a new narrative. Recent data from the International Labor Organization estimate that gender pay gaps in the health sector are higher compared to other sectors, although women hold a large number of health jobs.
Hand hygiene compliance: the experience of three Italian tertiary care hospitals
Authors: Canta I , Bordino V , Libero G , Zotti CM 
Published: October 2021

Abstract

Introduction
Hand hygiene is an important measure in infection prevention to decrease transmission of microbial pathogens. Especially in these last two years, COVID-19 pandemic brought focus on the importance of a correct and frequent hand hygiene. Currently, direct observation is considered the gold standard for hand hygiene surveillance. The purpose of this observational study is to assess healthcare professionals hand hygiene compliance during the World Health Organization's ‘Five Moments for hand hygiene'.

Methods
In this study we examined perceptions, compliance, techniques, and contextual issues of hand hygiene practices among healthcare workers, in three different hospitals. Twelve different wards were observed, including ICU, surgical wards and medical wards. At least 200 hand hygiene opportunities (based on the WHO's ‘Five Moments') were recorded for each ward, using a mobile application called SpeedyAudit™.

Results
The results showed highly variable levels of adherence to the hygiene practices, with compliance rates ranging from 20% to 84%. There was also a wide variability of compliance between the different moments, with compliance rates ranging from 75% after touching patient surroundings to 59% before touching a patient. Overall, physicians had the worst score among the healthcare workers, resulting in 55% of compliance, while social health operators performed best with 70%.

Conclusions
There is still a huge variability in hand hygiene among healthcare workers. Despite the conceivable Hawthorne Effect influence, general compliance was not optimal. Overall hand hygiene adherence and knowledge should be achieved by implementing hand sanitizer distribution, offering further education and raising awareness on the importance of a correct hand hygiene, for the sake of both patients and healthcare workers.

Key messages
Hand hygiene adherence and knowledge should be achieved by implementing hand sanitizer distribution, offering further education and raising awareness on the importance of a correct hand hygiene. There is still a huge variability in hand hygiene among healthcare workers.
Antibiotic resistance in wastewater from socio-spatially different communities
Authors: Schmiege D , Zacharias N , Sib E , Falkenberg T , Moebus S , Evers ME , Kistemann T 
Published: October 2021

Abstract

Antibiotic resistance (ABR) and the spread of multidrug-resistant organisms (MDRO) via wastewater are of global health concern. Simultaneously, wastewater-based surveillance is a promising approach to gain an overview of the local ABR situation providing complementary public health data at lower costs. Research on the general community as one of the biggest dischargers is rather scarce. The objective of this study was to explore spatial and temporal differences in the occurrence of MDRO in community wastewater from socio-spatially different districts. Wastewater from three socio-spatially different districts in the Ruhr Metropolis, Germany, was sampled monthly over a year and analysed for extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli via culture-based methods. Isolates were validated with matrix assisted laser desorption ionization time of flight mass spectrometry. Antibiotic resistance profiles were analysed via microdilution. Phenotypic ESBL-producing E. coli could be isolated from every wastewater sample. The socio-spatially disadvantaged area displayed higher ESBL-producing E. coli loads adjusted for domestic discharge and inhabitants (median: 3.8e+8 CFU/d/inh.) compared to the other two areas (socio-spatially advantaged: 1.5e+8 CFU/d/inh. and socio-spatial average: 2.0e+8 CFU/d/inh.). Aggregated into seasons, values were highest for the winter season. Resistance profiles varied only for those antibiotics, which can be administered in outpatient care, showing lower resistance levels in the socio-spatially advantaged area. The general community is an important contributor of ESBL-producing E. coli in wastewater. Spatial and seasonal influences of ESBL-producing E. coli in wastewater between different communities, depicting the human outpatient sector, are identifiable and suggest a higher ABR burden in a socio-spatially disadvantaged area and during the winter season, as well as lower resistance levels in a socio-spatially advantaged area.

Key messages
The general community is a relevant source of multidrug-resistant bacteria in wastewater with observable spatial and seasonal influences between socio-spatially different communities. Findings suggest small-scale differences with a higher antibiotic resistance burden in a socio-spatially disadvantaged area and lower resistance levels in a socio-spatially advantaged area.