bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic use and resistance: knowledge, attitudes and practices in Italian healthcare workers
Authors: Panattoni N , Renzi E , Di Simone E , Costantino S , Baccolini V , Migliara G , Marzuillo C , De Vito C , Villari P , Massimi A 
Published: October 2024

Abstract

Background
Antimicrobial resistance (AMR) is one of the most significant public health challenges globally. The misuse or incorrect use of antibiotics has led to the emergence of resistant bacteria, making it increasingly difficult to treat infections. This study aims to identify knowledge, attitudes, and practices among Italian healthcare workers (HWs) - medical doctors (MDs) and nurses - regarding antibiotics, antibiotic use, and antibiotic resistance.

Methods
Cross-sectional study; a validated questionnaire from the European Centre for Disease Prevention and Control was distributed via web survey starting from April 2024 to a voluntary sample of healthcare workers employed in Italy. Descriptive analysis and multivariable logistic regression were performed to investigate predictors of knowledge regarding antibiotic use and AMR. Ethical approval was obtained from the local ethics committee.

Results
So far, 154 HWs were enrolled, of which 132 were nurses (85.7%). The average level of knowledge regarding AMR and antibiotic use was 6.8/7 (± 0.2) for MDs and 6.1/7 (± 0.2) for nurses, with an overall score, among HWs of 6.19 (± 0.99), compared to a European average of 6.35. The multivariable analysis highlighted that the medical profession reported higher knowledge regarding prudent antibiotic use and AMR (aOR 6.90; 95% CI 1.83-26.01, p-value = 0.004), while concerning professional practice, the unavailability and difficulty of access to guidelines seemed to increase the risk of reporting inadequate knowledge (aOR 2.04; 95% CI 1.01-4.13, p-value = 0.046).

Conclusions
Our preliminary results provide an insight into the importance of structuring and actively disseminating procedures/protocols and guidelines to deepen the issues of AMR and prudent antibiotic use. Also, there appears to be a need to enhance the delivery of refresher courses targeting HWs, with particular attention to settings at high infection transmission risk. EU funding: Project no. PE00000007, INF-ACT.

Key messages
• Although a higher knowledge about prudent antibiotic use and AMR, more efforts are needed to increase access to guidelines.
• Constant updating of knowledge and practices is necessary to face the challenges of antibiotic resistance in public health.
European guidelines for the management of tuberculosis screening in migrants: a systematic review
Authors: Pinheiro M , Moreira D , Valente C , Cruz M , Aguiar A , Duarte R 
Published: October 2024

Abstract

Background
This systematic review assesses the current available evidence across the WHO European region on the effectiveness and cost-effectiveness of the different approaches used for TB screening and also explores the facilitators and barriers that migrants face during screening programs.

Methods
We conducted an extensive, comprehensive, and systematic literature search across multiple databases, including MEDLINE, Cochrane, Scopus, and ISI Web of Knowledge, without any restrictions on publication date or language. In addition, we reviewed grey literature and reports from WHO. The data were meticulously analyzed using RStudio, with a focus on screening effectiveness indicators, such as infection and disease detection rates, uptake, coverage, and cost-effectiveness economic analyses.

Results
Our review included 43 studies covering over 8 million migrants from 11 countries. The findings demonstrate that while screening uptake was high, coverage varied, and completion rates for preventive treatments were low. Economic analyses supported the high cost-effectiveness of the screening programs, particularly when integrating both active TB and LTBI screening strategies.

Conclusions
The implementation of uniform screening protocols could potentially streamline efforts, reduce TB transmission, and offer substantial public health and economic benefits, making this research highly relevant for policymakers and healthcare providers.

Key messages
• An important strength of this study lies in its pioneering approach of current recommendations regarding screening for latent tuberculosis infection and active TB within the WHO European region.
• This is the first study that provides a comprehensive overview of screening interventions across 11 countries and incorporates studies with large sample sizes (n &gt; 8 million migrants).
Scoping Review of Pre-Exposure Prophylaxis and Post-Exposure Prophylaxis in HIV Prevention in Türkiye
Authors: Cavdar S 
Published: October 2024

Abstract

Background
Pre-Exposure Prophylaxis (PrEP) is a medical -antiretroviral- prevention method that reduces the risk of HIV transmission during sexual intercourse or injection drug use. Post-exposure prophylaxis (PEP) refers to taking medicine after risky exposure. The European Centre for Disease Prevention and Control (ECDC) has recommended the integration of PrEP into the existing HIV prevention packages since 2015. In Türkiye, first PrEP Guideline was published in 2022. The aim of this study is to evaluate the literature gap on the PrEP and PEP for HIV prevention research in Türkiye.

Methods
This study was conducted in October 2023. Searches were performed using the keywords ‘HIV, AIDS’ and ‘Pre-exposure prophylaxis, PrEP, Post-exposure prophylaxis, PEP’ in PubMed, Web of Science, Scopus, TRDizin, and Dergipark for all years. ‘Türkiye, Turkey, Turkish’ were added into the keywords in international indexes, without using country filters. Inclusion criteria were research on PrEP or PEP for HIV, research conducted in or using data from Türkiye, publications in English/Turkish. Exclusion criteria were non-HIV topics, non-Turkish data, non-English/Turkish publications. Lists were merged, duplicates were removed. Inclusion-exclusion criteria were conducted at title and abstract level. Full texts of the included articles examined for bibliometric characteristics, study types, and key results.

Results
1014 publications yielded, 993 evaluated, and 17 fully reviewed. Four discussed Türkiye’s PrEP practices (2018-2023); three analyzed PEP regimens; three were reviews on PrEP/PEP in Türkiye (2016-2022). Two original research articles explored PrEP awareness among Türkiye’s men having sex with men (2022) and infectious disease physicians’ attitudes toward PrEP (2020). Studies showed gaps in PrEP information and service access.

Conclusions
There are limited studies published on PrEP and PEP in HIV prevention in Türkiye. This study highlights the need for local research on the topic.

Key messages
• Evaluation of Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) publications highlights gaps in HIV prevention research.
• Limited literature on PrEP and PEP in HIV prevention emphasizing the need for further studies and improved access to PrEP information.
Hand hygiene intervention in the prevention of healthcare associated infections
Authors: Ben Cheikh A , Ghali H , Bhiri S , Balhi S , Khefacha S , Ben Rejeb M , Said Laatiri H 
Published: October 2024

Abstract

Background
Healthcare associated infections are a major cause of morbidity and mortality in intensive care units. Observance hand hygiene is singled out as a key element in interruption of these infections. The present study aimed to assess whether hand hygiene intervention program in intensive care unit at the Sahloul University Hospital of Sousse is able to decrease healthcare associated infections.

Methods
We carried out a pre-experimental study among patients hospitalized in seven intensive care units at the Sahloul University Hospital of Sousse during two distinct periods of 3 months, the first in 2019 and the second in 2021. During these two periods, we monitored only patients hospitalized in the ICU for more than 48 hours and incidence of healthcare associated infections was compared. Healthcare associted infections were defined as infections occurred at least 48 hours after admission to the intensive care units. The hand hygiene promotion intervention, done during the year 2020, was based on 3 axes (training sessions, procedures writing and professional practicesevaluation).

Results
Incidence of healthcare associated infections decreased significantly in post-intervention (p = 0.000). The decrease of Ventilator-associated pneumonia was significantly higher than other types of infections(p = 0.042). Extended Spectrum B-Lactamase Producing Enterobacteriaceae infections and Ceftazidim resistant Pseudomonas Aeruginosa infections decreased significantly in after intervention (p = 0.000).

Conclusions
The results of our study showed that improved hand hygiene resulted in a reduction in healthcare associated infections.

Key messages
• Observance hand hygiene is singled out as a key element in interruption of healthcare associated infections.
• Improved hand hygiene resulted in a reduction in healthcare associated infections.
International and intercultural training on the use of Art Therapy for Dementia Care
Authors: Giusti M , Vannini I E , José H , Sousa L , Natzik M H , Persiani N 
Published: October 2024

Abstract

In 2023 more than 55 million people had dementia worldwide, with nearly 10 million new cases every year. Currently art therapy has been widely adopted in the assistance of people with dementia because of the positive outcomes in terms of reducing depressive and behavioural symptoms and of improving the patients’ overall quality of life. In literature there was a knowledge gap on social and health professionals’ training for being able to effectively use art therapy in relation with different origins of people with dementia in a multi-ethnic world. This research aimed to assess the impact of promoting joint international and intercultural training session for social workers and health professionals’ students. The used methodology was a prospective research-intervention study with the conductions of two seasonal schools (Florence - Italy in July and Ankara - Tukey in October 2023) on the use of art therapy in the different stages of dementia disease within the Erasmus+ Project DementiaCare (2021-1-TR01-KA220-HED-000027648). Each seasonal school was attended by 25 students from Italy (5), Portugal (5), Slovenia (5), and Turkey (10) to ensure an international and intercultural approach. Pre- and post- test results showed the increased knowledge of students on the theoretical notions on dementia care and art therapy. Positive opinion on the projects developed by mixed group of students (with representants of the 5 involved universities) manifested the enforcement of their relational competences and skills mutually adapting their way of doing and communication register to the multi-ethnic and multi-cultural group’s needs. Evidence showed how mutual knowledge among social and health professionals with different cultures and their joint training allowed these professionals to be able to provide an integrated and effective assistance to every patient with dementia, personalizing assistance according with their different traditions and historical memories.

Key messages
• Art therapy has been adopted as non-pharmacological approach in dementia care to mitigate progression of symptoms’ severity, serving as alternative tool for self-expression for patients.
• Conducting joint international and intercultural training sessions for social and health professionals in art therapy enabled them to develop a respectful, multi-ethical approach to dementia care.
Factors influencing washing hands during the COVID-19 pandemic in the Ukraine population
Authors: Kim Y J , Lee J W , Kim K B , Noh J W 
Published: October 2024

Abstract

Background
Washing hands is recommended as one of the key preventive measures for reducing the transmission of COVID-19 and other infectious agents. The World Health Organization (WHO) consistently emphasized that handwashing is one of the most effective methods to prevent COVID-19. However, research on Ukraine handwashing has been limited. This study aims to investigate factors influencing the practice of regular handwashing in Ukraine during the COVID-19 pandemic.

Methods
This study analyzed 800 households from the 2020 Ukraine Multi-Sector Needs Assessment (MSNA) survey data. The survey, conducted from January to February 2020, was administered by the REACH Initiative. The data was analyzed using Stata/MP version 16.1.

Results
As the number of household members increases, especially when the head of the household is female, the likelihood in adoption of washing hands more regularly increases significantly. People who take between 30 to 59 minutes to arrive at healthcare facility by walking, compared to those who take less than 15 minutes showed significantly decreased likelihood in washing hands more regularly.

Conclusions
While social distancing measures and travel restrictions have reduced contact possibilities with friends and colleagues, families represent the smallest social unit, making complete isolation within them difficult. Hence, the number of household members increases, there may be a higher tendency to wash hands more frequently due to the virus. Given that women exhibit higher levels of concern and fear regarding the pandemic, it is interpreted that they are more likely to wash their hands more frequently. Also households living more than 5km from the nearest health facility face higher barriers in accessing health care. They are more likely to wash their hands less due to low access to medical information.

Key messages
• The number of household members, the gender of the head of the household, and access to health facilities can affect COVID-19 prevention behaviors, such as hand washing.
• Hand washing can prevent infectious diseases as well as various germs, so it is required to implement policies that can make them a habit.
Experiences of treating people with persisting symptoms after COVID-19: a focus group study
Authors: Goes A , Santos M , Silva J , Moniz M , Soares P , Leite A 
Published: October 2024

Abstract

Background
A proportion of people who had COVID-19 infection continue to suffer with persistent symptoms. The long-term effects of COVID-19 are recognised as heterogeneous and complex, challenging health services. This study aims to explore the experiences of healthcare professionals dealing with patients suffering from persisting symptoms following COVID-19 infection and their views on the healthcare services response.

Methods
We held 4 focus groups (n = 19) with healthcare professionals by video-call. Healthcare professionals were recruited using a snowball strategy, taking level of care, healthcare area, and nature of function as diversification criteria. Participants were invited to tell their experiences regarding the following topics: experiences and challenges in providing care to patients with persisting symptoms following COVID-19 infection; usual care pathways; models of care. Data were recorded, transcribed, and anonymized. The qualitative data were submitted to thematic analysis following an inductive approach. A computer-assisted qualitative data analysis software (MaxQDA) was used.

Results
Based on thematic analysis, 4 core themes emerged: uncertainty; new condition, usual challenges; variable standards implementation; personalized and multilevel care. This new condition challenged health services and health professionals to keep adjusting and updating responses in a context of uncertainty, but at the same time revealed the usual challenges and needs for providing timely and integrated care. Health services burden challenges the implementation of care standards. This heterogeneous condition demands a multi-level response, including general information and advice, enabling self-management, and providing rehabilitation.

Conclusions
Healthcare professionals envision an heterogenous condition, bringing uncertainty to healthcare services. More research, training, and information to the population is required for an appropriate response.

Key messages
• Persisting symptoms following COVID-19 challenged an already overwhelmed health system, bringing barriers to healthcare standards implementation.
• The heterogeneous nature of the condition and the healthcare services burden may leave some people to chance, demanding a diverse set of care.
Investigation of a Norovirus GII outbreak in a primary school in Portugal,2023
Authors: Cristovão F , Marques R , Peixoto V , Ourique M , Rodrigues N , Martins Correia D 
Published: October 2024

Abstract

Background
The onset of acute gastroenteritis cases among students in a primary school class on September 19, 2023, prompted an immediate response from the local Public Health unit. A collaborative effort was initiated to investigate and contain the outbreak.

Methods
Epidemiological questionnaires were distributed to 166 students and 8 staff members, defining cases as individuals exhibiting symptoms including diarrhoea, vomiting, or nausea between September 19th and September 24th, 2023. Additionally, stool samples were collected from three individuals.

Results
Out of 166 students and 8 staff members, 39 individuals met the case definition, resulting in attack rates of 22% (37/166) and 25% (2/8) among students and staff, respectively. Laboratory analysis confirmed two cases of Norovirus GII among the tested specimens, with five students requiring medical attention.

Conclusions
Our investigation underscores the significance of continuous epidemiological surveillance and swift implementation of infection control measures in school settings. The detection of Norovirus transmission emphasizes the necessity for rigorous adherence to infection control best practices. Our findings advocate for sustained technical support from public health authorities to prevent and manage similar outbreaks effectively.

Key messages
• Study on Norovirus outbreak in a primary school highlights the imperative of infection control measures, emphasizing the importance of ongoing support from public health authorities.
• The Norovirus outbreak investigation underscores the vital role of surveillance and swift response in containing infectious diseases within educational settings safeguarding all.
Preventing unintentional injuries in children: the parents’ beliefs matters (CHILD Vigilance)
Authors: Alves T , Papadakaki M , Strukcinskiene B , Silva S , Braz P , Aniceto C , Vagionaki K , Chliaoutakis J , Matias-Dias C 
Published: October 2024

Abstract

The CHILD Vigilance project is a European study supported by the Injury Prevention & Safety Promotion Section of the European Public Health Association (EUPHA INJ) and aims at assessing parenting knowledge and attitudes that are relevant to supervision and risk taking in children. For children the majority of these injuries occur in or around the home when their safety is the responsibility of a parent or other caregiver. The study aims contribute to the epidemiological knowledge of injuries through the study of the perceptions of parents and caregivers of children and adolescents. A descriptive, observational, cross-sectional study was developed under the CHILD Vigilance project, developed at European level within the scope of the Injury Prevention & Safety Promotion Section of the European Public Health Association. The information was collected by survey, from parents’ associations and schools in the EU countries represented in the EUPHA INJ Section. A total of 916 valid responses were obtained, involving 1229 children (51,4% male; mean age 7,8 years). Falls were perceived as the most common type of unintentional injuries in pre-schoolers and school-age children (47,8% in Greece; 63,5% in Portugal; 74,8% in Lithuania). However it was found differences in these countries as to the most common type of injury in adolescents, pointing out road traffic crashes (41.2% in Greece vs 39.5% in Portugal) and poisonings in Lithuania (38,1%). Some differences were also observed between these countries as to the most common causes of death. In Greece and Lithuania diseases were reported the main cause in the pre-schoolers (62,5%; 35,1%) and in primary education (55,1%; 29,7%), being injuries pointed as the most frequent cause only in the oldest. The study emphasizes the need to invest in the identification of appropriate determinants of child unintentional injuries and harmonised injury outcomes across global initiatives.

Key messages
• The lack of data regarding to parents’ knowledge on injury prevention involving children highlight the need to conduct this type of studies.
• The need for adequate epidemiological data on the burden of child injuries and validated tools to accurately measure injuries.
Economic evaluation of Polygenic Risk Scores in healthcare interventions: a systematic review
Authors: Siena L M , Riccio M , Rosso A , Baccolini V , Migliara G , Isonne C , Leone I , Marzuillo C , Villari P 
Published: October 2024

Abstract

Background
Polygenic Risk Scores (PRS) quantify genetic susceptibility to diseases, promising personalized healthcare. This review explores current evidence regarding the economic evaluation of strategies based on PRS or other polygenic risk stratification approaches, scrutinizing their methodologies.

Methods
The study protocol was registered in PROSPERO (CRD42023442780). A systematic search in PubMed, Scopus, and Web of Science identified full economic evaluations of intervention based on polygenic risk stratification strategies. The quality of the included articles was assessed using the Drummond checklist. This study was supported by the EC and MUR under PNRR - M4C2-I1.3 Project PE_00000019 ‘HEAL ITALIA”.

Results
Nineteen articles were included in the analysis, with oncological conditions being the most frequently investigated (13), followed by cardiovascular conditions (3). In nearly 80% of the studies, PRS was employed for screening interventions, with the general population being the primary target in 14 out of the 19 studies. All the economic analysis models investigated cost-utility in terms of QALYs, with Markov models and microsimulations being the most common structures. The majority of these models were based on simulated cohorts derived mostly from North American or European data, with 9 adopting a healthcare system perspective and 6 a societal perspective. Although delivery strategies for PRS testing were rarely addressed, PRS costs were included in nearly all studies. Indirect costs were examined in fewer than half of the studies. In 12 out of 19 studies, the conclusions claimed the cost utility of PRS involving strategies.

Conclusions
Despite the technique’s potential, evaluations of various strategies based on PRS approaches yield heterogeneous conclusions regarding cost-utility. Our study highlights the factors contributing to this heterogeneity and underscores the need for further exploration, ideally prioritizing real-world data.

Key messages
• PRS strategies evaluations vary in cost-utility conclusions, highlighting the need for further investigation.
• Real-world data and practical implications should be prioritised in PRS research.