bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitudes towards COVID-19 preventive measures: an Italian cross-sectional study
Authors: Scampoli P , Di Giovanni P , Cedrone F , D'Addezio M , Di Martino G , Meo F , Staniscia T 
Published: October 2021

Abstract

Background
The outbreak of COVID-19 was declared Public Health Emergency of International Concern on the January 2020. During an infectious disease outbreak, non-pharmaceutical interventions are essential to delay an epidemic peak and to flatten the epidemic curve, in order to wait for vaccine development. Perception or beliefs may be essential in determining adherence to official recommendations. The aim of this study was to assess whether perceptions of COVID-19 and awareness of preventive strategies effectiveness were associated to behavioural changes.

Methods
Web-based survey was performed in Italy between the 9 and the 15 March 2020. The survey contained six sections: subject's demographics, subject's behaviours during the latest three weeks, subject's behaviours during the latest 24 hours, perceived efficacy of behaviours, awareness raised by the government-led prevention campaign for COVID-19 and co-occurring anxiety.

Results
1912 participants were enrolled in the study. 48.1% of the participants (n = 919) reported to perform at least 7 preventive behaviours. Most people reported a change in the frequency of their hand-washing (94.7%), an increment in the frequency of surface cleaning and disinfecting (58.9%), and a reduction in the use of public transport (92.5%). Behavioural changes were related to an increase in the anxiety level (OR 1.47; 95%CI 1.16-1.87). After adjusting for personal characteristics and anxiety, an association resulted between clear perception of COVID-19 high infectiousness (OR 1.25; 95%CI 1.00-1.59) and of its severe consequences (OR 1.29; 95%CI 1.05-1.59), clearness of communication about the virus (OR 1.41; 95%CI 1.17-1.71), and increased likelihood of performing the recommended behavioural changes.

Conclusions
To better protect people against future epidemics, health-promotion efforts should be aimed at increasing the level of awareness towards infectious diseases and at implementing and encouraging non-pharmaceutical interventions.

Key messages
Clear perception of COVID-19 high infectiousness and of its severe consequences are associated with an increased likelihood of performing the recommended behavioural changes. Health promotion strategies should be a critical part of infection prevention and control program.
COVID-19, Mental health and intervention-priorities among Northern Italian University students
Authors: Patrono A , Placidi D , Calza S , Brunelli P , Cagna G , Manco A , Renzetti S , Rota M , Moncada S , Lucchini R 
Published: October 2021

Abstract

During the first wave of COVID-19 pandemic, the most affected area in Italy was the southeast part of the Lombardy region. The University of Brescia is one of the largest in Northern Italy. The aim of this study is to investigate the psychological and somatic symptoms driven by lifestyle changes due to the lockdown among the students of the University of Brescia.15261 University students were enrolled through institutional email;14302 were Master's and Bachelor's Degreestudents,724 were Residents and 235 doctorates.3553 students (23.28% of total),aged on average 22 years, completed the survey. Physical health, dietary and sleep habits, physical activities, economic and social issues were investigated through an anonymous, online ad hoc form, available until July 2020 and approved by the local Ethic Committee. Five psychosomatic outcomes were assessed: digestive disorders, headache, panic-anxiety crises, depression-sadness, fear od COVID-19.Factor analysis was applied to reduce the number of variables while logistic and ordinal logistic regression models were used to test the association between the latent variables and each outcome. Female gender, medium-intensive use of telephone, worsening of sleep quality, mnemonic difficulties and performance reduction were associated with all the outcomes. Low physical activity, increased time spent watching television and the worsening of dietary habits represented a significant risk factor for at least three of the outcomes. Despite the relatively low compliance, the survey clearly identified few priorities of intervention to prevent psychological and somatic effects of pandemic in the next future: circadian rhythm, nutritional habits, physical activity, use of media, gender issues. The results of this study show the psychosomatic effects of social isolation and the pandemic on a population at risk of young adults and can promote interventions to minimize the occurrence of psychosomatic consequences on young adults.

Key messages
Analysis of the main risk and protection factors in a population of young adults in the development of psycho-physical symptoms during the period of isolation due to the covid-19 pandemic. Support the need to implement public health services also to reduce health costs with possible methods of intervention, in harmony with the findings.
Impact of COVID-19 on women's life: their health, quality of life and lifestyle
Authors: Zembala-John J 
Published: October 2021

Abstract

COVID-19 has affected all aspects of life of men and women. However, women are considered to be hit the hardest by the pandemic. The aim of the study was to determine the impact of COVID-19 on women's lifestyle and quality of life (QoL). A questionnaire was developed consisting of sociodemographic data, health condition (presence of chronic condition, BMI, COVID-19 status), selected lifestyle components, stress level (Perceived Stress Scales, PSS-10) and QoL (sense of security/social relationships/mental and physical wellbeing/health care access/financial situation/work satisfaction) in comparison to pre-COVID times. The questionnaire was distributed via social media from April 2-9th, 2021 (peak of 3. COVID wave in our country). 195 women (mean age 40.1, range: 20-71 years) were enrolled in the study. 63.6% were married, 10.3% single, 60% were parents. Mean BMI was 24.8 (range: 16.7-45.7). 57.4% women had a correct BMI, 26.2% were overweight, 12.8% obese. 30.3% had a chronic condition. 36.9% had COVID-19, 23.8% not sure about undergoing SARS-CoV-2. 41.5% women declared gaining weight during COVID-19, 23.6% - eating healthier than before pandemic. 46.7% reported lower physical activity, 12.9% greater alcohol intake and 7.2% smoking more in comparison to pre-COVID. 33.8% have worked more; 44.6% have had additional everyday tasks related to taking care of a family member. 51.8% experienced high stress, 30.8% - moderate. 63.1% declared their overall QoL has deteriorated, 76.4% - their mental wellbeing, 55.9% - physical. 30.2% declared their family relations has worsen and 40.5% - relationship with friends in comparison to pre-COVID times 53.3% believed their work satisfaction worsen, 22.6% - financial situation. In 78.5% cases sense of security was worse comparing to before pandemic. COVID-19 has had a great impact on women's life. It has affected their health and wellbeing; changed their health behaviors. It has also led to increased stress level and decreases QoL.

Key messages
Although COVID-19 has affected both sexes, women are hit the hardest by the pandemic. Special attention should be paid aftermath to the long-term impact of coronavirus on this group. We may not be able to control all aspects of pandemic; what we can and should do, is to take our health in hand, care more about health, pay greater attention to prevention and healthy lifestyle.
Trends in alcohol consumption during COVID-19 lockdowns: systematic review
Authors: Acuti Martellucci C , Martellucci M , Flacco ME , Manzoli L 
Published: October 2021

Abstract

Background
The spread of SARS-CoV-2 required virtually all governments to employ non-pharmaceutical infection containment measures such as quarantine and generalised lockdowns. Several authors raised warnings about potential negative changes in alcohol-related behaviours due to the lockdowns. The objective of the present systematic review was to summarise available evidence on trends of alcohol consumption temporally associated with COVID-19 lockdowns.

Methods
We performed a systematic review in PubMed, Scopus, Web of Science and EMBASE, using the search terms ‘coronavirus', with either ‘alcohol drinking', ‘alcoholism', ‘alcoholic beverages', and ‘alcohol intoxication'. Studies were included if they evaluated the change in alcohol consumption prevalence or frequency both before and during the lockdowns, or if they assessed changes in alcohol use retrospectively. The outcomes were changes in prevalence of alcohol consumption, or in its frequency.

Results
A total of 128 records were retrieved, and 24 studies met eligibility criteria. Most samples were drawn from either the general population (e.g. social media users), university students, or regular drinkers. The outcomes measurements varied widely, and multiple scales were also used for the assessment of harmful alcohol use. The majority of the studies found that alcohol consumption prevalence increased during lockdowns (e.g. +25.7% in UK). Also, increased frequencies were reported by 14.0% in Poland and 32.1% in China. Finally, one study from Australia observed no overall changes, while one from Cyprus reported decreased alcohol consumption frequency.

Conclusions
Understanding the impact of lockdowns on alcohol consumption is essential for countering possible increases in harmful use, and a consensus should be reached for performing standardised and comparable assessments.

Key messages
Alcohol consumption increased in many countries during the COVID-19 lockdowns, with local variations. Assessments used a great variety of outcomes, hindering a comprehensive assessment of this phenomena.
How can tobacco policy models quality be assessed: a systematic review
Authors: Huang V , Head A , Hysen L , O’Flaherty M , Buchan I , Capewell S , Kypridemos C 
Published: October 2021

Abstract

Policy simulation models (PSMs) have been used extensively, both to shape health policies before real-world implementation and to evaluate post-implementation impact. However, an accepted quality assessment framework for simulation models is lacking. This systematic review aimed to develop a novel quality assessment framework for tobacco control PSMs. We searched five databases to identify peer-reviewed tobacco control PSMs that projected tobacco-use and tobacco-related outcomes from smoking policy scenarios. We extracted information on modelling inputs, structure and outputs. Using our proposed quality assessment framework, we scored models on nine dimensions: representativeness of population, policy effectiveness evidence, simulated smoking histories, simulated smoking-related diseases, exposure-outcome lag time, transparency, sensitivity analysis, validation and equity. We then compared the model score with the number of cited papers using each model. The results were narratively presented. After screening 5046 candidate papers; 145 papers were included and categorised into 25 PSMs. After scoring the models using our proposed framework, we observed that seven models were given seven and more points. The higher-scored models were generally those with a higher number of publications. While all included models had been subject to sensitivity analysis, other best practices were often lacking. Nine models did not explicitly consider smoking-related diseases. Smoking histories were commonly collapsed into crude smoking status categories rather than reflecting smoking intensity or quitting history. Furthermore, only four models estimated policy equity impact. Our systematic review revealed a variety of modelling techniques used in tobacco control. Our novel quality assessment framework offers a potential quality measure for tobacco control policy simulation models. It may guide health decision modellers and inform health policymaking.

Key messages
All nine framework dimensions were observed in two tobacco control PSM, suggesting the framework relevance and feasibility. However, few models achieved high scores in all dimensions. This novel quality assessment framework aims to support the development and sharing of good modelling practice and thus promote better health policy decision-making.
Factors associated with PSA testing in men ≥ 50 years in Ireland
Authors: O'Donovan R , Fitzpatrick P 
Published: October 2021

Abstract

Background
Ireland has among the highest rates of prostate cancer in the EU, primarily due to widespread PSA screening. PSA screening is not recommended for asymptomatic men. Due to the potential for harm to the patient, and the economic and clinical repercussions for the healthcare system caused by inappropriate screening, this study aimed to investigate associations between PSA screening and sociodemographic, lifestyle, and health-related factors in men ≥50 years in Ireland.

Methods
A cross-sectional study was completed using data from Wave 4 of The Irish Longitudinal Study on Aging (TILDA), a nationally representative sample of community dwellers ≥ 50 years in Ireland. Participants self-reported having or not having a PSA test to screen for prostate cancer in the previous two years. Variables were entered into a multivariable logistic regression to estimate adjusted odds ratios (OR) for associations between PSA testing and the factors of interest.

Results
There were 2,426 male participants, with 68% reporting a PSA test in the previous two years. In adjusted analysis, older age (OR 1.78, 95%CI 1.32-2.31), third level education (OR 1.34, 95%CI 1.07-1.69) and a higher household net income (OR 2.14, 95% CI 1.52-3.02) increased the likelihood of PSA testing. Health-related factors positively associated with PSA testing screening were private health insurance (OR 1.89, 95%CI 1.52-2.35), blood pressure measurement in the previous year (OR 8.80, 95%CI 6.06-12.77) and a positive family history of cancer (OR 1.42, 95%CI 1.13-1.78).

Conclusions
High rates of prostate cancer screening are taking place in Ireland, despite the absence of a population-based screening programme. Men of older age, higher socioeconomic status and who demonstrate health-protective-behaviours have an increased risk of PSA screening. This subgroup of the population should be targeted to increase awareness of the potential benefits and harms of PSA testing.

Key messages
Rates of PSA screening remain high in Ireland, despite the absence of a population-based screening programme. Increased awareness of the potential harms and benefits of PSA screening is needed.
e-Health Literacy among medical students
Authors: Moretti V , Valdi G , Brunelli L , Arnoldo L , Conte A , Masoni M , Guelfi MR , Anelli F 
Published: October 2021

Abstract

Background
The struggle against fake medical news, nowadays widely spread by web sources, is a main issue in public health especially in a pandemic period. Even among medical students, there is a lack of eHealth literacy (eHL) skills to solve medical problems. The Italian Medical Doctors Federation (FNOMCeO) promoted a Web source as a first-aid communication kit for basic notions in health hot-topics named “dottoremaeveroche” (DMVEC). This study aims to evaluate its effectiveness in improving eHL.

Methods
Between April and November 2019, medical students from the University of Firenze (Italy) joined a cross-sectional web-based survey before and after accessing the DMVEC Web source. The 8-item self-assessment tool (IT-eHEALS) was used to examine subject's eHL, in addition to questions on source's features and its quality. All responses were rated on a 5-points Likert scale. Changing of abilities' perception was assessed using Wilcoxon test.

Results
A total of 329 joined the survey, 42% male, mean age of 20.6±2.1. Participants felt moderately confident in eHL, in fact the initial eHEALS overall mean score was 3.6± 0.7. Students had a good perception on how to find helpful health resources (mean score 3.9±0.8) and how to use the Internet to answer health questions (mean score 3.8±0.9), but their ability in using this information to make health decisions was low (mean score 2.9±1.1). All items improved after the use of DMVEC, with overall mean score of IT-eHEALS increasing to 4.3±0.6 (p &lt; 0.0001). Regarding source's quality, mean score related to transparency of sources, an aspect underestimated at first, increased from 3.5±1.2 to 4.7±0.7 (p &lt; 0.0001).

Conclusions
Low levels of eHL can damage public health efforts, as seen during COVID19 pandemic. DMVEC effectiveness in medical students demonstrated that the scaling up to the general population of online educational interventions, with further implementation, could help in tackling infodemic and fake news spreading.

Key messages
Moderate levels of eHL among medical students could reflect lower levels in general population, highlighting this as critical issue in public health. Educational programs addressed to Health professionals could be adapted and empowered considering general population as target.
A study of commercially available complementary foods for infants and young children under 36 months
Authors: Santos M , Matias F , Vaz R , Castanheira I , Rito A , Loureiro I , Assunção R 
Published: October 2021

Abstract

Background
Commercially available complementary foods (CACFs) have been assuming an important proportion of infants and toddlers' diets in high-income countries, despite the concerns regarding their nutritional content and potential problematic marketing strategies used to promote these products. In 2016, the WHO guidance on ending the inappropriate promotion of foods for infants and young children (IYC) was approved (1) to support countries to take action on this issue. To implement this Guidance, a draft Nutrient Profile Model (NPM) (2) was developed to drive decisions regarding the identification of foods which are inappropriate for promotion.

Aim
To support the implementation of the NPM at National Level, studying the availability, composition, and marketing of CACFs for IYC in Portugal.

Methods
Three phases were considered: 1) collect data on CACFs products targeted at IYC (0-36 months); 2) compare composition of these products with WHO guidance; 3) compare methods used to promote these products with WHO Guidance.

Results
A total of 209 products were sampled. The most common products were soft-wet spoonable, ready-to-eat foods (n = 129), dry, powdered and instant cereal/starchy foods (n = 61) and dry finger foods and snacks (n = 16). Twenty-five products (11%) were marketed as being suitable for infants under the age of 6 months. For infants between 6-8 months 78% of the products were marketed as being suitable. For the age group 12 months and over, 11% of the products were marketed as being suitable.

Conclusions
This study provides valuable insights into the CACFs at the national level and reinforces that action is needed to improve the implementation and operationalization of WHO guidance on ending the inappropriate promotion of foods for IYC.

Key messages
NPM can support countries identifying products that can/cannot be promoted for IYC. It is a key opportunity to build policy measures, ensuring children healthy growth and development.
Trans fatty acids policy analysis to prevent non-communicable diseases in Tunisia
Authors: Rejaibi S , Cherif I , Chemli H , Ati J El , Buse K , Hawkes S , Aounallah-Skhiri H 
Published: October 2021

Abstract

Background
Despite the widely published international guidelines for a better implementation of health policies promoting healthy eating habits; the epidemiological situation regarding most weighing heavily non-communicable diseases (NCDs) on global health, is still alarming. We aimed to analyze Tunisian health policies targeting trans fatty acids (TFA) consumption to prevent and control NCDs.

Methods
Based on in-depth policy content analysis and stakeholder interviews, Tunisian policies related to promoting healthy diets and restricting unhealthy consumption of TFA, were identified. Four sub-components of WHO best-buys were assessed: goal to eliminate industrially-produced TFA, legislation to ban their use in food chain, TFA labeling and fiscal policies, and mass media campaign to promote healthy diet and reduce TFA intake. Findings were analyzed based on three main axes of the “policy cube approach”: comprehensiveness of policy content, policy effectiveness and respect of equity principles. For each axis, final assessment was performed based on a Likert scale: low, moderate and high.

Results
Although (3/4) WHO best-buys are covered by the national strategies for NCDs and obesity prevention for 2018-2025 and 2013-2017 respectively. This analysis has revealed moderate level for comprehensiveness of policy content, because ofthe absence of specific mention regarding legislation. A moderate level in policy salience and effectiveness was also highlighted (weak accountability mechanisms and no budget line for effective implementation for all WHO best-buys). A very low respect to equity principles was also underlined with no specific attention regarding vulnerable populations.

Conclusions
Main weaknesses in TFA policies concerned legislation, budget allocation and accountability mechanisms. “Legislation measures” to ban trans-fats use in the food chain and resource mobilization for “nutrition labeling and mass-media campaigns” effective implementation, are recommended.

Key messages
Several weaknesses in TFA policies have been highlighted, mainly related to: legislation, budget allocation, accountability mechanisms and low respect to equity principles. Legislation reinforcement and efficient resource mobilization for “nutrition labeling and mass-media campaigns” effective implementation, are strongly recommended.
Scanning 2d barcodes on vaccine vials to link vials to immunized child, a pilot study
Authors: Ali Khan A , Siddique M , Abdo M , Pearman J , Prusik T , Chandir S 
Published: October 2021

Abstract

Background
Vaccine stockouts contribute to millions of children missing their routine immunizations globally. This is often due to inadequate forecasting and management of vaccine stocks, especially in low and middle-income countries, such as Pakistan, already characterized by suboptimal coverage. Tracking vaccines via 2D barcodes on each vial, could improve management of vaccine stocks. Vial level data can then be linked to Electronic Immunisation Registry (EIR) data (2D Bar codes already used), facilitating data quality improvements which could unlock programmatic gains. Our aim was to test feasibility and acceptability of scanning vaccine vials in a “live” setting.

Methods
We conducted a pilot in 12 vaccination sites in Karachi/Pakistan. Vaccinators were divided into 3 groups and allocated to use one of the following: their existing android phone (government of Sindh's Zindagi Mehfooz [Safe life; ZM-EIR]); a Zebra touch computer; a handheld scanner. The box of dummy vaccine vials of pneumococcal conjugate vaccine (PCV) and oral polio vaccine (OPV) each with a 2D barcode on it, was scanned by the stockroom manager prior to deployment. Vaccinators were required to scan the corresponding dummy vial and immunization cards while working. We integrated the OneScanTM API on the ZM-EIR to link vial to child data and evaluated the vaccinator's experience through thematic analysis of interviews.

Results
2,310 vaccine vials were scanned and linked to immunized children (Zebra Touch Computer 72.6%, Android phone 19%, Handheld device 8.4%). Overall, vaccinators gave positive feedback and highlighted that scanning vials would simplify their work and save time, contingent on the program going paperless. Likewise, managers outlined digitally tracked vials would greatly reduce stock mismanagement.

Conclusions
Linking vaccine vial to child is a feasible and effective solution for vaccine stock management, acceptable by both vaccinators and stock managers.

Key messages
Linking vial to child is an acceptable method for accurate vaccine stock management and usage, improving forecasting and reducing stock outs. Linking vial to child will better facilitate rapid tracking of reported adverse events from vaccinated child back to the exact vaccine vial.