bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety culture in COVID-19 wards during 2020 SARS-COV-2 pandemic
Authors: Bianchet B , Doimo A , Moretti V , Bellomo F , Degan S , Farneti F , Cocconi R 
Published: October 2021

Abstract

Background
Safety of care is an essential aim of a healthcare system, even during a pandemic. Incident reporting (IR) is an important safety tool to identify system failures. This study evaluates the impact of SARS-COV-2 pandemic on IR trend in the COVID-19 wards of an Italian Academic Hospital (AH) in Italy.

Methods
The study analyzed the IR submitted by the wards of Infectious Diseases (ID), Intensive Care Unit (ICU), Pneumology (P) and Emergency Room (ER) of the AH of Udine from 2016 to 2020. For each ward, IR of 2020 were compared to IR of 2016-2019 period, expressed as the mean value. The IR's topics of ER unit, classified according to the International Standards of Patient Safety, were compared between 2019 and 2020. Variation in reporting was assessed using Chi-square tests.

Results
During 2020, 180 incidents were reported, 81.7% of which submitted by ER unit. Three wards showed a decrease in reporting compared to 2016-2019 period: -18% (7vs8,5) for ID unit, -26% (16v21,7) for ICU and -44% (10vs18) for P unit. ER unit, instead, showed a great IR increase (147vs49; +200%). Considering the reporting from 2016 to 2019, 196 out of 389 (50.4%) of IR came from ER unit. Analyzing the difference in reporting in ER unit between 2019 and 2020, the IR topics regarding “Delay in execution and reporting exams” increase from 2 to 21 (p &lt; 0,05), “Lack of human and/or instrumental resources” from 4 to 29 (p &lt; 0,05) and “Prevention and Control of Hospital Infectious” from 0 to 13 (p &lt; 0,05).

Conclusions
ER unit showed a higher attitude in reporting than the other considered wards, especially during the COVID-19 period, recognizing IR as an important tool to highlight critical issues. This aspect may reflect the stronger safety culture already present in this unit. SARS-COV-2 pandemic stressed in ER needs of human resources to cope with reorganization determined by COVID-19, rapid covid-test results for the patient's care path definition, implementation of infection control procedures.

Key messages
A solid safety culture may contribute to maintain high levels of IR even while during challenging times for healthcare systems. Difference in reporting among Covid wards could be explained by a different level of Safety Culture.
Public health as common goal or individual constraint in winter tourism of Tyrol and Vorarlberg
Authors: Kerschbaumer L , Walch S , Sahling F , Reisberger M , Mevenkamp N , Mantel C , Lackner N , Luttinger P , Pejkovic E 
Published: October 2021

Abstract

Background
In February 2020 the alpine village Ischgl, located in the Austrian province Tyrol, reached prominence as a COVID-19 hotspot and starting point for the virus diffusion in Europe. Since then, local authorities, winter tourism and its key stakeholders where under close supervision. The here presented study focusses on how they align their personal and corporate interests with collective interests of mitigating the spread of the virus.

Methods
In summer 2020 a convergent parallel-mixed methods' approach was adopted. It includes 3 focus groups in skiing resorts of Tyrol and Vorarlberg, a quantitative complete online survey, with mayors of municipalities, managing directors of all cable cars companies as tourism associations and 22 qualitative expert interviews with this target groups.

Results
There were 105 out of 375 mayors of municipalities, 57 out of 140 managing directors of all cable cars companies and 37 out of 41 tourism associations of Tyrol and Vorarlberg participating in the online survey. The demand for a standardized risk management in tourism was high, the willingness to compromise low. Inconsistent legal regulations, economic losses, acknowledging risks and taking responsibility for the own area of influence were conflicting topics.

Conclusions
Uncertainty about legal requirements was widespread and therefore mitigating strategies and measures were often classified as a disturbance. Economic concerns where far more prevalent than concerns about public health, blaming other decision-makers was a common strategy. According to the results authorities where advised to:
-reduce complexity and increase transparency within the communication
-demonstrate uniformity without exceptions -show solidarity to facilitate willingness to compromise -provide future perspectives

Key messages
Although demanded a uniform risk management was only possible at a late stage in November 2020 and only in selected fields. COVID-19 promotes reluctance in making decisions.
Social media influencer marketing to build a counter-narrative for promoting sexuality education
Authors: Ahmed F , Ahmad G , Schumacher J , Brand T 
Published: October 2021

Abstract

Background
A recent cross sectional community readiness assessment carried out in Islamabad, Pakistan indicated that the community is at the denial or resistant stage for implementing school-based sexuality education in Pakistan. The resistance was attributed to lack of awareness and prevalent misconceptions regarding sexuality education. This study aims at qualitatively exploring strategies for targeting misconceptions and increase awareness regarding sexuality education with stakeholder involvement.

Methods
35 in-depth interviews and a focus group discussion was conducted to discuss the results of the readiness assessment comprising of community members, researchers, NGO representatives, and social media influencers. Discussion guide included topics on engagement strategies, intervention modes of delivery, target audience, misconceptions, community support, and optimizing sexuality education in local context. Qualitative content analysis was conducted for analyzing the data.

Results
Results indicate that current community support is usually passive in nature and digital or social media platforms are mostly used to talk about sexuality education. Participants believed social media can be used as a platform for disseminating information by involving social media influencers with careful narrative building around sexuality for rebranding the topic, as talking about sexuality is seen as a taboo in the society. Targeting misconceptions through counter narratives and scientific evidence was considered as a way forward for increasing community acceptability and readiness. Violence, staying safe, and age appropriateness were identified as some of the key features of sexuality education that need to be highlighted for garnering community support.

Conclusions
For promoting sexuality education in Pakistan, it is essential to tackle resistance by sensitizing the community and digital social media platforms offer an opportunity to do this through influencer marketing.

Key messages
Digital and social media offer an opportunity for promoting sexuality education in conservative settings like Pakistan. Social media influencer marketing might be useful in building counter narrative and for community engagement.
The impact of Covid-19 on symptomatic back pain – A new surging epidemic?
Authors: Cuschieri S , Grech S 
Published: October 2021

Abstract

Background
The Covid-19 pandemic led to global public health advocacy for a population behavioural and daily routine change. Remote work and social distancing were advocated to curb the community spread. A consequential effect on the physical health of the population is expected. The study aimed to explore whether since the onset of Covid-19 back pain complaints have increased while identifying potential reasons, among the Malta adult population.

Methods
An anonymous online survey was distributed on social media (6th to 20th April 2021). The survey enquired about changes in employment, daily routine, physical activity (PA) patterns and for the presence of back pain before (&gt;6 months duration) and during Covid-19. Data on the socio-demographic status was noted. Descriptive, comparative and multivariant regression analyses were performed.

Results
A total of 388 responded with 30% (CI 95%: 25.55-34.64) reporting chronic back pain pre-Covid-19 while 49% (CI 95%:44.28-54.18) reported back pain since the onset of Covid-19. A significant change in daily routine and physical activity (p &lt; 0.01 respectively) to a more sedentary pattern was observed. Out of those reporting back pain since Covid-19, 51.83% (CI 95%:44.78-58.81) reported a shift to remote working/learning. Indeed, continuously sitting down (OR: 15.53 p = &lt;0.01), no PA (OR:4.22 p = &lt;0.01), once a week PA (OR:5.74 p = &lt;0.01), 2-3 times PA a week (OR:2.58 p = 0.05) and 4-5 PA a week (OR:3.46 p = 0.02) were associated with experiencing back pain since onset of Covid-19, when adjusted for sex, age, education and employment status.

Conclusions
The pandemic led to behavioural changes that have enhanced a sedentary lifestyle with a consequential negative impact on back pain. Those working/learning remotely may be experiencing non-optimal ergonomic conditions intensifying musculoskeletal strain with back pain complaints. Such occurrence is anticipated to increase the burden on the healthcare systems and the disability adjusted-life years.

Key messages
Covid-19 has impacted on behavioural attitudes and daily routines resulting in enhanced sedentary lifestyles with anticipated consequential effects including back pain. Covid-19 is anticipated to increase the burden on healthcare systems with enhanced chronic diseases occurrences including back pain.
Heath literacy, illness perception and NAFLD/NASH awareness in primary care patients in Crete, Greece
Authors: Gergianaki I , Anastasaki M , Papadaki S , Anastasiou F , Koek G , Leen H , Mendive J , Muris J , Lionis C 
Published: October 2021

Abstract

Background and Aims
Patient health literacy (HL), illness perception and awareness are key factors driving health behaviour. This observational study aims to assess the level of HL, illness perception and awareness about non-alcoholic fatty liver disease (NAFLD)/steatohepatitis (NASH) in high-risk primary care (PC) patients in Greece, Spain and the Netherlands.

Methods
Eligibility criteria included: 1) aged ≥50 years, and 2) obesity, and/or metabolic syndrome, and/or diabetes. Patients consecutively visiting PC practices completed a questionnaire assessing socio-demographic characteristics and health habits. HL, illness perception and NAFLD/NASH awareness were assessed using the European Health Literacy Survey Questionnaire, the Brief Illness Perception Questionnaire and the Public Awareness of NAFLD Questionnaire respectively.

Results
Data are available at this moment from the Greek setting. Among the Greek participants (N = 141, 53.2% females, mean age 66 years) 66.7% had diabetes, 78% obesity and 71.6% metabolic syndrome, with 22.7% reporting active smoking. Most (71.6%) had heard about NAFLD by their personal physician. Obesity (78%), excess alcohol intake (45.8%), lack of exercise (38.7%) and diabetes (32.4%) were recognized as the commonest determinants of fatty liver disease, while 78% were aware of ultrasound as the main diagnostic modality and 47% did not know whether there is an available treatment. Only 39% of the participants find information of their treatments easily.

Conclusions
Our preliminary results show that the majority of patients seem to be aware about NAFLD/NASH and their determinants. It's alarming that a lot do not know about treatment, although they are high-risk.

Key messages
Our preliminary results show that the majority of patients seem to be aware about NAFLD/NASH and their determinants. It’s alarming that a lot of patients do not know about their treatment, although they are high-risk.
The effect of pre-ESRD care program on potentially inappropriate medication in advanced CKD patients
Authors: Lai CP , Chen YY , Deng CY , Wu CK 
Published: October 2021

Abstract

Background
Due to the multiple comorbidities and the associated complications among advanced CKD population, assessing potentially inappropriate medications (PIM) in these patients is an important task for physicians and multidisciplinary care team members. This study aimed to investigate the impact of the national pre-ESRD pay-for-performance (P4P) program on prescribing quality in Taiwan.

Methods
We conducted a retrospective cohort study using data from National Health Insurance Research Database (NHIRD) maintained by the Health and Welfare Data Science Center, Ministry of Health and Welfare (HWDC, MOHW). The incidents of CKD in year 2010 were observed until the end of 2017. Adult patients who initiated maintenance dialysis therapy were enrolled. To identify the use of PIM that should be avoided in advanced CKD patients, the Beers 2019 criteria and latest Taiwan Manual of Renal Injury Prevention and Drug Safety were applied. We measured PIM use in one year before starting long-term dialysis.

Results
Among 7,828 participants underwent continuous dialysis treatment, 2,119 (27.1%) were P4P patients. Most (90.4%) participants were prescribed one or more PIMs before ESRD initiation. After adjusted age, sex, Charlson Comorbidity Index (CCI) and the number of nephrologist visits, the logistic regression showed lower probability of PIM use in the P4P enrollees (OR = 0.56, 95% CI = 0.47-0.66). The effect of P4P on PIM was more prominent in the subgroups of patients who were female and CCI≤3.

Conclusions
The implementation of the pre-ESRD P4P program might reduce PIM use among CKD patients. Our results underline the strategy of financial incentives in the payment design to improve prescribing patterns.

Key messages
Prescribing potentially inappropriate medications is common among patients who were approaching ESRD. The study highlights the importance of implementing the pre-ESRD P4P program to reduce PIM use in advanced CKD patients.
Associations between space weather events and the Incidence of cardiovascular diseases
Authors: Vaičiulis V , Venclovienė J , Tamošiūnas A , Kiznys D , Lukšienė D , Krančiukaitė-Butylkinienė D , Radišauskas R 
Published: October 2021

Abstract

Introduction
Different studies have shown that solar and geomagnetic activities (GMAs) affect human health outcomes, especially cardiovascular systems being the most clearly impacted.

Aim
To analyse the associations of geomagnetic storms (GSs) and other space weather events with morbidity from acute myocardial infarction (AMI) during the period 2000–2015.

Methods
To evaluate the influence of space weather variables, we used adjusted rate ratios (RRs), their 95% confidence intervals, and p-value of coefficients in the Poisson regression model.

Results
12330 AMI cases (men and women n = 6942 and 5388, respectively) were registered. The study revealed that a higher risk of AMI and were related to the period of 3 days before GS—a day after GS, and a stronger effect was observed during the spring-autumn period. The strongest effect of high-speed solar wind (HSSW) was observed on the day of the event. We found significant associations between the risk of AMI and the occurrence of Solar flares (SFs) during GSs. We also found a statistically significant increase in rate ratios for all AMIs between the second and fourth days of the period of interplanetary coronal mass ejections (ICMEs).

Key messages
This Abstract is a part of PostDoc project. One of the goal of this project is to determine and evaluate heliogeophysical factors that have an effect on morbidity and mortality from CVD.
Environmental substances associated with Alzheimer's disease – A scoping review
Authors: Elonheimo H , Katsonouri A , Andersen HR 
Published: October 2021

Abstract

Background
Dementia is an overarching term for memory-affecting and progressive diseases interfering with cognitive abilities, behaviour and daily living of persons affected. Deterioration of cognitive function influences the processes of memory, thinking, orientation, comprehension, learning and language capacity as well as judgement. Alzheimer's disease (AD) is the most common form of dementia, prevalent in approximately 50-70% of the dementia cases. In 2015, there were 47 million people affected by dementia worldwide, and the figure was estimated to increase to 75 million by 2030 and to 132 million by 2050. Genetics, environmental factors and lifestyle patterns are risk factors for developing AD.

Methods
In the framework of the “European Human Biomonitoring Initiative” (HBM4EU, https://www.hbm4eu.eu/), a set of 18 substances or substance groups were prioritized for investigation. For each of these, a scoping document was developed, summarizing current knowledge and policy-related knowledge gaps. This work presents a scoping review of chemical substances, which may be associated with AD, based on the HBM4EU scoping documents and relevant recent scientific literature.

Results
Exposure to pesticides is possibly a risk factor for AD. Exposure to mercury is possibly associated with AD development, but results are inconsistent. Though results on cadmium and arsenic and AD are conflicting, they are possibly associated with the risk of disease. The evidence regarding lead is weak. Harmful exposures to these substances in Europe were mostly connected to occupational settings.

Conclusions
Although there is tentative evidence on exposure to environmental substances and risk for AD, more research is needed. Some evidence is inconsistent and there is a lack of extensive human studies. Attention should be paid to certain occupations, such as farmers exposed to pesticides and workers exposed to heavy metals, since these substances may be linked to increased disease rates of AD.

Key messages
Exposure to pesticides, mercury, cadmium and arsenic may adversely affect cognitive abilities and contribute to risk of AD. High-quality epidemiological research is needed to confirm the findings. Because adverse environmental chemical exposures affect both workers in certain occupations and general public, protecting humans from the chemical hazards is an essential public health issue.
Distribution of Salmonella spp. serotypes in poultry flocks in Abruzzo and Molise, Italy (2015-2020)
Authors: Perilli M , Telera GC , Sericola M , Di Marcantonio L , Marotta F , Romantini R , Del Matto I , Pomilio F , De Massis F 
Published: October 2021

Abstract

Issue/problem
The Italian National Health System has implemented a National Control Program for Salmonella in poultry populations in order to reduce the prevalence of infection. Starting from 2019, the control program has introduced health measures against Salmonella breeding flocks of Gallus gallus, positive to Salmonella Infantis, an emerging serotype at European level, and widespread along the entire poultry primary production chain.

Description of the problem
Recent data from the European Union One Health 2019 Zoonoses Report published by EFSA, highlighted that most of the Salmonella isolates (70%) originated from broilers. Interestingly, Salmonella Infantis accounted for 29.7% of the total.

Results
In the framework of the Italian Salmonella National Control Program the isolation of Salmonella spp. is carried out according to ISO 6579-1: 2017 from faeces, dust and boot socks. During the 2015-2020 period, testing in the Italian Regions Abruzzo and Molise was performed on 2,791 samples and 5,039 sample units. The percentage of samples positive to Salmonella spp. in Abruzzo and Molise was 16,9% and 10,1%, respectively. Out of 395 Salmonella spp. strains isolated, Salmonella Infantis was the most prevalent, representing the 54,9% and 61,9% for Abruzzo and Molise, respectively, followed by Salmonella Livingstone (18,4%) for Abruzzo and (14,4%) for Molise.

Lessons
The record of Salmonella Infantis in the areas under study reflects the European trend highlighted by the EFSA 2019 Report and justifies the decision to increase the biosecurity measures in farms where this serotype is isolated and to proceed with destruction of positive animals according to the Regulation 1069/2009/EC.

Key messages
Salmonella Infantis represents a risk for human health due to the presence of antimicrobial resistance genes that confer resistance to relevant antibiotics used in the treatment of human infections. Biosafety guidelines and disinfection practices on poultry farms should be improved in order to reduce the spread of this serotype, also considering its capability to form biofilm.
Evaluation of COVID-19 case investigators’ interviewing skills in a portuguese public health unit
Authors: Durão J , Souto A , Hernández LM , Simões JD , Teixeira V 
Published: October 2021

Abstract

An effective control of the COVID-19 pandemic requires a thorough epidemiological interview of reported cases. The interviewer's skills and preparation directly affect the outcome of the investigation. This study applied a self-assessment survey of the COVID-19 patient interviewing skills on a local public health department workforce. The findings may be used to improve the quality of the interview process and the overall response to the pandemic at a community level. A 50-item questionnaire using a four-point Likert scale was adapted from the COVID-19 Patient Interview Skills Assessment Form created by the Centers for Disease Control and Prevention (CDC) and applied to 50 healthcare workers involved in epidemiological investigation of COVID-19 cases in Almada and Seixal, two municipalities of the Lisbon Metropolitan Area, from January to April of 2021. The most frequently executed steps concern checking patient data in advance (92%), questioning symptoms (97.2%), contact tracing (100%) and determining isolation periods for high risk contacts (100%). Least performed tasks include confirming the testing technique used (50%), asking about hospitalization (44.4%), assessing conditions for home isolation (44%), explaining how to self-monitor symptoms (61%) and checking if the patient understood the instructions (47%). In addition, 8% admitted to not always keeping patient information confidential. While caution is necessary as the data was limited to a single public health local department, our findings show that a majority of healthcare workers fulfill the essential steps of an epidemiological investigation. Areas in need of improvement include inquiring about infection severity, assessing social conditions for quarantine and confirming instructions for self-monitoring and follow-up. In line with CDC recommendations, we believe regular evaluation and feedback of case investigators' skills are crucial to quality assurance of a public health department.

Key messages
A detailed interview provides critical data for monitoring infected individuals and quickly trace, test and isolate those who might have been exposed, thus breaking chains of transmission. The results of this assessment can be used to introduce training measures such as shadowing and role-playing to ensure continued improvement in epidemiological investigations.