bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving quality of care for cancer pain: an Italian five-year project
Authors: Greco Maria Teresa , Roberto Anna , Corli Oscar , Apolone Giovanni 
Published: April 2023

Background: cancer pain is still undertreated as for inappropriate use of opioids, as for reason related to other factors. To increase knowledge of cancer pain, the “Mario Negri” Institute promote a series of initiatives to improve the quality of care and patients’ outcomes.
Methods: a series of activities were launched including literature review, clinical studies and training schemes.
Results: literature reviews shown a prevalence of undertreatment ranged from 8% to 82% and a raw prevalence of BTcP (Breakthrough Cancer Pain) of 51%. In the outcome research study mean worst pain at baseline was 6.8, and 38.3% received a strong opioids. Prevalence of BTcP was 40.3%, and 33.9% of the patients were not receiving rescue therapy at the study inclusion. About analgesic effectiveness of oral and transdermal opioids (TD), treatments with TD were associated with a lower probability to switch (OR=0.83) and to drop out from the study (OR=0.68).
Conclusions: the initiative, still ongoing, has allowed a) the creation of a unit for the study and evaluation of cancer pain, b) the production of clinical evidence about the epidemiology, quality and effects of cancer pain management in Italy, c) the design and promotion of a Randomized Controlled Trial to evaluate the effectiveness of four major opioids.
Factors affecting overweight and obesity among urban adults: a cross-sectional study
Authors: Sen Jaydip , Mondal Nitish , Dutta Sweeta 
Published: April 2023

Background: the prevalence of overweight and obesity are increasing at an alarming rate in the developing countries. The present cross-sectional study assesses the prevalence of overweight and obesity along with their associated variables among urban adult individuals belonging to the Bengalee Hindu Caste Population (BHCP).
Methods: the study has been carried out among 600 adult individuals belonging to the BHCP in the age group of 20-60 years and residing in the district of Jalpaiguri, West Bengal, India. Height and weight, along with a number of socio-economic, demographic and lifestyle variables were recorded. International cut off points of the body mass index were used to assess overweight (BMI ≥ 23.00 kg/m2) and obesity (BMI ≥ 25.00 kg/m2). The statistical tests (ANOVA, chi-square and multinomial logistic regression) were done using SPSS (version 15.00).
Results: the prevalence of overweight and obesity were observed to be high among both the male (23.67% and 9.67%) and the female (20.33% and 29.33%) individuals. The sex difference was observed to be significant in case of obesity (p<0.01) and combined overweight-obesity (p<0.01). The multinomial logistic regression indicated that age and monthly income had significant effects on overweight (p<0.05). Sex, age, monthly income, marital status, education and alcohol intake were observed to have significant effects on obesity (p<0.05). Sex, age, monthly income and monthly income and marital status also showed significant effects with combined overweight-obesity (BMI ≥ 23.00 kg/m2) (p<0.05).
Conclusions: the prevalence of overweight and obesity exhibited an increasing trend among urban adults of the BHCP. Sex, age, marital status and monthly income were observed to have more influence on the prevalence of overweight and obesity among them. There appears to be an urgent need for the development of health strategies and intervention programmes for combating the consequences of overweight and obesity.
Surveillance of healthcare acquired infections in hospital and community: a retrospective study in Local Healthcare Organization of Rovigo
Authors: Ronzani Francesca , Scarin Marino , Brusaferro Marco , Intenti Antonia , Marchetto Raffaela , Boldrin Michela , Pierotti Silvia , Marcolongo Adriano 
Published: April 2023

Background: antimicrobial resistance is recognized as one of the greatest threats to human health worldwide. Infections caused by multidrug-resistant bacteria are associated with higher incidences of mortality, morbidity, prolonged hospital stay and increase of costs. Surveillance of alert organism/conditions and bacterial resistance to antimicrobials is a systematic and dynamic system of data collection that analyses and monitors trends of bacterial resistance. This study was conducted to detect antimicrobial susceptibility patterns in order to inform treatment choices and generate hospital-wide baseline data.
Methods: the Local Healtcare Oganization of Rovigo has started a program of surveillance on antimicrobial resistance in hospital and community. In this work some results of the surveillance of microorganism isolated and related antimicrobial resistance are reported, collected in the period 2009-2010 in Rovigo and Trecenta Hospitals, Territorial Nursing Homes (TNH) and community from patients’ blood, urine and respiratory samples.
Results: data show a significant difference in the level of antibiotic resistance between the two Hospitals. High rates of extended-spectrum β-lactamase (ESBL)-producing organisms are detected and carbapenems are the only reliable agents for the treatment of many infections in the Hospital of Trecenta and TNH.
Conclusions: because ESBL producing bacteria are emerging pathogens in the community, the rational use of available antibiotics or the appropriate antimicrobial prescribing are imperative. Local surveillance is a powerful tool to detect and monitor hospital and community infections and provides information useful as a guide to medical practice, including therapeutics and disease-control activities.
Harmful alcohol habits did not explain the social gradient of sickness absence in Swedish women and men
Authors: Mardby Ann-Charlotte M , Holmgren Kristina EM , Hensing Gunnel KE 
Published: April 2023

Background: the aim of this study was to examine the prevalence and socioeconomic distribution of harmful alcohol habits in sick-listed women and men, and whether the social gradient in sickness absence could be explained by the socioeconomic distribution of harmful alcohol habits.
Methods: this cross-sectional questionnaire study included newly sick-listed individuals (n=2 798, 19-64 years, 66% women) from Sweden. The outcome variable, self-reported harmful alcohol habits, was measured with the Alcohol Use Disorder Identification Test. Registered socioeconomic variables (education, income, occupational class) were explanatory variables with age as confounder and selfreported health, symptoms, mental wellbeing, and self-efficacy as mediators. Chi2-tests and logistic regression models were applied.
Results: 9% of sick-listed women and 22% of men had harmful alcohol habits. Women with a low annual income (≤149 000 SEK) had higher odds ratios (OR=2.47; 95% CI=1.43-4.27) of harmful alcohol habits than those with ≥300 000 SEK/year. The significance of low income remained when mediators were introduced into the logistic regression model (OR=2.03, 95% CI=1.13-3.65). In the model including age, income was no longer significant. Men with low income were more likely to have harmful alcohol habits than men with high income (OR=2.59; 95% CI=1.45-4.62). When mediators were included low income remained significant (OR=2.88; 95% CI=1.56-5.31). Income was no longer significant when age was introduced. Education and occupational status were not significant.
Conclusions: harmful alcohol habits were common among sick-listed women and men. The socioeconomic differences in harmful alcohol habits did not explain the social gradient in sickness absence.
Robert J. Levine: a distinguished problem solver
Authors: Bucci Roberto 
Published: April 2023

Robert Levine: a man capable of intelligent and constructive criticism, who could accept with humility the criticisms of others. A man who left a deep mark in the history of research, both inside and outside the United States. Above all, a great problem solver.
A brilliant doctor and refined bioethicist, he was able to deal with the disasters of research on human subjects and to remedy to them. He fought against the application in clinical practice of ethical principles valid only for research, but also against the universalisation of the rules of informed consent, which are applicable only to Western cultures. A researcher who deserves to be known by all, especially by young people.
Countries, national alcohol limits and risk behaviours: results from the TEN D by Night project
Authors: Siliquini Roberta , Bert Fabrizio , Manzoli Lamberto , TEN-D Group  
Published: April 2023

Background: this paper re-analysed data from the international cross-sectional TEN-D survey to investigate the association between country or national alcohol limits and risk behaviours.
Methods: data were collected on subjects aged 16-35 years owning a driving license and attending recreational sites during weekend nights in Belgium/Netherlands, Bulgaria, Italy, Poland and Spain. Each participant was administered a: questionnaire, driving simulation, breath alcohol concentration (BAC) and illegal drugs detection tests. Random-effect regression was used to identify independent predictors of 3 outcomes: high BAC (≥0.5 g/L); negative driving behaviours; self-reported illegal drug consumption.
Results: the survey included 4 534 subjects (mean age 23.1±4.2 years; males 68.3%). Alcohol misuse was highest in Poland (65.1%) and Spain (83.7%), which also showed the highest frequency of negative driving behaviours (39.0%) and illegal drugs consumption (55.6%). Multivariate analysis confirmed country as a predictor of all outcomes, whereas no association was found with national alcohol limits.
Conclusions: the absence of association between national alcohol limits and alcohol misuse or negative driving behaviours suggests that cultural factors might be predominant in explaining the differences across countries. Our findings are preliminary and further research is needed.
A systematic review of the cost-effectiveness of lifestyle modification as primary prevention intervention for type 2 diabetes mellitus
Authors: Radl Katrin , Ianuale Carolina , Boccia Stefania 
Published: April 2023

Background: diabetes is one of the leading causes of death, and has a huge economic impact on the burden of society. Lifestyle interventions such as diet, physical activity and weight reducing are proven to be effective in the prevention of diabetes. To encourage policy actions, data on the costeffectiveness of such strategies of prevention programmes are needed.
Methods: a systematic review of the literature on the cost-effectiveness of prevention strategies focusing on lifestyle interventions for diabetes type 2 patients. A weighted version of Drummond checklist was used to further assess the quality of the included studies.
Results: six studies met the inclusion criteria and were therefore considered in this paper. Intensive lifestyle intervention to prevent diabetes type 2 is cost-effective in comparison to other interventions. All studies were judged of medium-to-high quality.
Conclusions: policy makers should consider the adoption of a prevention strategy focusing on intensive lifestyle changes because they are proven to be either cost-saving or cost-effective.
Cost effectiveness of aortic valve therapies: a systematic review of the literature
Authors: Battaglia Suzanne , Mazzucco Walter , Ricciardi Walter 
Published: April 2023

Background: we performed a systematic review on the cost effectiveness of transcatheter aortic valve implantation (TAVI) to standard aortic valve replacement and medical management in high-risk elderly patients with severe aortic stenosis.
Methods: in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses, a systematic review on current literature for cost-effectiveness of TAVI, standard aortic valve replacement, and medical management for elderly patients with high-risk severe aortic stenosis was performed. Incremental cost effectiveness ratio is used to measure effectiveness through life years gained or quality adjusted life years. Drummond checklist was used to further assess the quality of the included studies.
Results: the systematic literature search identified 4 primary publications (derived from 52 citations) that fulfilled the inclusion criteria. Tremendous discrepancy in incremental cost effectiveness ratio is demonstrated with operable patients similar to Cohort A of the PARTNER trial (€ 749 416 and € 39 577). Inoperable patients similar to Cohort B of the PARTNER trial suggest notable differences in favour for transcatheter aortic valve implantation with an increase in quality adjusted life years (0.06 versus 1.6, respectively). With lifetime horizon to transcatheter aortic valve implantation there is a more comparable incremental cost effectiveness ratio in the literature (€ 38 260 and € 37 432). Lowest incremental cost effectiveness ratio witnessed in the technical inoperable group at € 26 482. Lifetime horizon of 10 years with transcatheter aortic valve implantation differ (€ 39 388 versus € 19 947). Overall, a review of the literature suggests TAVI usage in patients for severe aortic stenosis whom are not eligible for surgery. All the studies were overall judged of medium-high quality.
Conclusions: transcatheter aortic valve replacement is more cost effective with a lifetime horizon for the treatment of patients with high-risk aortic stenosis compared with medical management considering those ineligible for standard aortic valve replacement. Further cost effectiveness research is needed in the stratifications of patient risk and patient co-morbidities for those candidates eligible for surgery.
Anti-asthmatics prescriptions in the paediatric population in the Lazio Region of Italy: association with socio-demographic children’s and physician’s characteristics
Authors: Chini Francesco , Orzella Letizia , Pezzotti Patrizio , Nardelli Marco , Guasticchi Gabriella 
Published: April 2023

Background Asthma is the most common chronic disease in childhood; inItaly its prevalence is estimated to be 9% in children (0-14 years old).
Objective Estimate the use of anti-asthmatics prescriptions in the paediatric population and to evaluate its association with children’s and physician’s characteristics.
Methods The study was conducted in 728,830 children 1-14 years old residing in the Lazio region,Central Italy. Individual data on AA (ATC R03) prescriptions during 2009 were used. Prevalence was calculated according to children’s gender, age and area of residence.
The association, in terms of rate ratio (RR), between AA prescription with children’s and physicians’ characteristics was estimated by multi level Poisson models.
Results Overall, 404,239 AA prescriptions were given to 178,850 (25%) children with the highest frequency in the 1-2 age group (39%). Boys were more likely to receive a prescription than girls. Beclomethasone was the most prescribed active ingredient (34%), followed by salbutamol (24%); 44% of children ³6 years old had only 1 box prescription in the year, 48.9% of these subjects were treated with inhaled corticosteroids alone.
Children’s gender, age and area of residence were the major determinants in drug prescription while, as far as physicians’ level, gender and number of patients in charge were associated to a greater probability of getting an AA prescription.
Conclusion Prescription data provide useful information to measure prevalence use and consumption of AA drugs. Variability between age groups as well as differences in doctors’ characteristics suggests that specific strategies to optimise resource use of AA are needed.
The CONSTANCES cohort, an epidemiological research infrastructure. Methods and results of the pilot phase
Authors: Zins Marie , Berkman Lisa F. , Goldberg Marcel 
Published: April 2023

Background: prospective cohorts represent an essential design for epidemiological studies and allow for the study of the combined effects of lifestyle, environment, genetic predisposition, and other risk factors on a large variety of disease endpoints. The CONSTANCES cohort is intended to provide public health information and to serve as an epidemiological research infrastructure accessible to the epidemiologic research community. Although designed as a “general-purpose” cohort with very broad coverage, it will particularly focus on occupational and social determinants of health, and on chronic diseases and aging.
Methods: the CON STANC ES cohort is designed as a randomly selected representative sample of French adults aged 18-69 years at inception; 200 000 subjects will be included over a five-year period. At inclusion, the selected subjects are invited to fill a questionnaire and to attend a Health Screening Center (HSC) for a comprehensive health examination: weight, height, blood pressure, electrocardiogram, vision, auditory, spirometry, and biological parameters; for those aged 45 years and older, a specific work-up of functional, physical, and cognitive capacities is performed. A biobank will be set up. The follow-up includes a yearly self-administered questionnaire, and a periodic visit to an HSC. Social and work-related events and health data are collected from the French national retirement, health and death databases. The data include social and demographic characteristics, socioeconomic status, life events, behaviors, and occupational factors. The health data cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalizations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare utilization and services provided, and causes of death. To take into account non-participation at inclusion and attrition throughout the longitudinal follow-up, a cohort of non-participants was set up and will be followed through the same national databases as participants.
Results: a field-pilot was performed in 2010 in seven HSCs, which included about 3 500 subjects; it showed a satisfactory structure of the sample and a good validity of the collected data.
Conclusions: the constitution of the full eligible sample begun in 2012 and the cohort will be completed by the end of 2017. A public call for ancillary research projects will be launched in 2014.
Perception of pregnant women towards midwives: attitude and practice during child delivery in health institutions in Ogbomoso, South-West, Nigeria
Authors: Oluyemisi Adeyemo F. , Oyadiran Gifty O. , Ijedimma Margaret O. , Akinlabi Bosede O. , Adewale Akinoso J. 
Published: April 2023

Background: This study aims to ascertain pregnant women’s perceptions of the attitudes and practice of midwives during labour in a mission teaching hospital and a state hospital in Ogbomoso, Southwest Nigeria, and to determine whether or not a relationship exists between patients’perceptions of midwives practice during delivery and the occurrence of neonatal deaths.
Methods: The survey was conducted by administering the questionnaire adapted from Caring Behaviour Inventory (CBI) to a random sample of five hundred and seventy nine respondent mothers who gave birth in either a Mission teaching hospital or a state hospital in Ogbomoso, Southwest Nigeria. This standardised questionnaire collects demographic data and patient perceptions of nursing attitudes and practice, ranking patients’ responses to a series of statements about the midwives on a four point Likert scale. Data was analysed using Pearson product moment correlation analyses and multiple regression analyses.
Results: Our study revealed that there was a positive response on the attitude and practise of midwives during delivery by the respondents. Secondly, there was a positive impression on the influence of the attitude and practice of midwives during delivery by the respondents.
Conclusions: There was no evidence of a relationship between patients’ perceptions of midwives practice during delivery and the occurrence of neonatal deaths.
Priority actions of the different Regional Prevention Plans: common features and innovations
Authors: Russo Francesca , Michieletto Federica , Pettenò Annarosa , Postiglione Chiara , Napoletano Giuseppina 
Published: April 2023

The National Prevention Plan (NPP) 2010-2012, approved by the Agreement between the Government, the Regions and Autonomous Provinces of Trento and Bolzano on 29 April 2010, called for Regions to adopt, by 31/12/2010, the Regional Prevention Plan (RPP) for implementing the interventions provided by the NPP 2010-2012.
This article has considered and compared the different RPP’s. In an attempt to provide an outlook on the future medical prevention plans over the next few years in Italy, a comparison has been made between the RPP from 19 Regions and the Autonomous Province of Trento. This work has been focused on the actions identified in regional plans as a priority concerning the major common and innovative elements.
The analysis of each RPP revealed a common plan to chronic degenerative diseases, because of the aging of the population in every Region of Italy. Other important common targets are: surveillance systems, vaccination programs and screening programs. Toscana and Liguria, more than other Regions, are engaged in the creation of networks involving various social actors. In some Regions there are projects aimed at eliminating social, economic or gender inequities, such as the project “women’s health” in the Region of Puglia. Toscana and Emilia-Romagna Plans pay attention to environment and pollution issues.
Despite social, environmental and economic differences, the various Regions have common principles, concerning: life style, surveillance, vaccination and the screening for cancer.
A study on feeding practice of under 6 months infants attending the Nutrition Clinic of a tertiary care hospital of West Bengal, India
Authors: Shrivastava Prabha , Saha Indranil , Nandy Saswati 
Published: April 2023

Background: while breast feeding is a natural act, it is also a learned behavior. The right technique of feeding in the right position is the key to success of breastfeeding.
Methods: to assess the feeding practice including positioning, attachment and suckling of under 6 months’ infants, a cross-sectional study was undertaken at R. G. Kar Medical College and Hospital, India, among 99 mothers in 2010.
Results: 59.8% mothers completed feeding from one breast before going to the next breast. 77.3% mothers alternated their breasts during subsequent feeds. 41.2% babies were well attached, 47.4% babies were correctly positioned.
Conclusions: there is a need to teach the mothers the techniques of correct positioning and attachment, especially, in the post natal period before discharge from the hospital after delivery.
Reshaping the agenda of the European Commission for the health systems and policy research in Europe within Horizon 2020
Authors: Walshe Kieran , McKee Martin , Groenewegen Peter , Hansen Johan , Figueras Josep , Boccia Stefania , Ricciardi Walter 
Published: April 2023

In 2012 the European Regional Office of WHO published a new health policy strategy, Health 2020, and an accompanying European Action Plan [1, 2], with both documents since being endorsed by the 53 member states. Following consultation with member states, a series of overarching targets have been established in the three areas of Health 2020: i) reducing the burden of disease and risk factors; ii) enhancing health and well- being; and iii) improving governance and systems for health. The WHO is now working with member state governments to develop ‘Regional’ Health 2020 targets [3, 4].
If Health 2020 is to achieve these goals, the actions that flow from it must be based on the best...