bluuebunny/crossref_metadata_2025_split huggingface dataset:
Communication on analgesia and sedation: parents’ opinions in six pediatric ICU in northern Italy
Authors: Martinato M , Fazio PC , Sagredini R , Pagano G , Ferrario S , Conio A , Monaco E , Gregori D , Amigoni A , Mondardini MC 
Published: October 2022

Abstract

Introduction
Communication between healthcare professionals and parents regarding analgesic and sedative treatments for seriously ill children is challenging. Although appropriate information may help parents during admission to the pediatric intensive care unit (PICU), some areas of communication may be missed.

Objectives
To explore and describe the opinions of parents of children admitted to PICU about analgosedation, information received about it and its potential adverse effects, and suggestions for improving the comfort of hospitalized children.

Methods
Parents’ opinions were collected in six PICUs in northern Italy. Parents of children who were hospitalized for more than 48 hours and required analgesia and sedation were asked to provide opinions on the quality of information with respect to the treatments used, possible short- and long-term sequelae, satisfaction with efficacy, environmental factors perceived as disturbing, and suggestions for improving children’s comfort.

Results
Forty-eight parents participated. Information about analgosedation was rated, as was its effectiveness. Parents pointed out some interesting suggestions to improve their children’s comfort during their hospitalization in PICU. On the other hand, it was found that information about possible complications, withdrawal syndrome, delirium, or difficulties in obtaining the desired level of sedation was often provided poorly or inadequately. In addition, wide differences were found between centres, particularly with regard to analgosedation side effects and withdrawal syndrome.

Conclusions
Parents should receive early explanations of these potential complications. Even considering the limited number of participating PICUs, distributed exclusively in northern Italy, and the small number of participants, this is the first data collection focused on communication between health professionals and parents of children undergoing analgosedation treatment in pediatric intensive care units.

Key messages
• This is the first data collection focused on communication between health professionals and parents of children undergoing analgosedation treatment in pediatric intensive care units.
• Information about possible complications, withdrawal syndrome, delirium, or difficulties in obtaining the desired level of sedation was often provided poorly or inadequately.
Can YouTube be used as a credible source of information for COVID-19 vaccination in Italy?
Authors: Ancona A , Godoy M , Bertuccio P , Gentile L , Odone A , Signorelli C 
Published: October 2022

Abstract

Background
The COVID-19 pandemic led to an ‘infodemic', as defined by the WHO, which made it difficult to be accurately informed on public health topics. For this purpose, many people use social media as a source of information, mainly YouTube. Given the great resonance of this platform, our study aims at assessing quality and reliability of its content regarding the COVID-19 vaccination.

Methods
During March 2022, six searches were performed on the Italian YouTube platform using the following terms: “Covid vaccination”, “Covid vaccine”, “Coronavirus vaccination”, “Coronavirus vaccine”, “Sars-Cov-2 vaccination” and “Sars-Cov-2 vaccine”. A total of 329 videos were analysed, after removing 271 duplicated videos, and classified in seven types of channel. The reliability of the content was evaluated through the HoNCode score, while quality was tested using the validated DISCERN tool.

Results
The most frequent category was ‘Internet Media’ (33%), while the less frequent one was ‘Educational Medical’ (7%). The content reliability (i.e. HoNCode score) resulted higher for videos produced by medical healthcare workers than non-medical ones. Concerning the quality, the DISCERN score resulted significantly higher for the Educational channels (median 46.0 for medical and 41.3 non-medical ones) as compared to Internet Media (26.5) and New Agencies (24.3).

Conclusions
Although YouTube has implemented a policy against misinformation related to the COVID-19 vaccination, the study highlights that there is extreme heterogeneity in reliability and quality of videos. Content produced by non-medical users, especially “Internet Media” and “News Agencies” categories should be evaluated with attention by users, as their quality is not appropriate to the importance of the topic.

Key messages
• Because of to the heterogeneity of its content, YouTube should be evaluated carefully when used as a source of information for Covid-19 vaccination.
• Content produced by non-medical users, is generally of poor quality, not appropriate to the importance of the topic.
Socioeconomic Inequalities in pediatric Metabolic Syndrome: mediation by parental health literacy
Authors: Lepe A , de Kroon MLA , Reijneveld SA , de Winter AF 
Published: October 2022

Abstract

Background
Parental health literacy may explain the relationship between parental socioeconomic status (SES) and pediatric metabolic syndrome (MetS). For this reason, we assessed to what extent parental health literacy mediates the relationships between parental SES and pediatric MetS.

Methods
We used data from the prospective multigenerational Dutch Lifelines Cohort Study. Our sample consisted of 6,683 children with an average follow-up of 36.2 months (SD 9.3) and a mean baseline age of 12.8 years (SD 2.6). We used natural effects models to assess the natural direct, natural indirect, and total effects of parental SES on MetS.

Results
On average, an additional four years of parental education, e.g. university instead of secondary school, would lead to cMetS scores that were 0.499 (95% confidence interval (CI) 0.364; 0.635) units lower, which is a small effect (d 0.18). If parental income and occupational level were one standard deviation higher, on average cMetS scores were 0.136 (95%CI 0.052; 0.219) and 0.196 (95%CI 0.108; 0.284) units lower, respectively; these are both small effects (d 0.05 and 0.07, respectively). Parental health literacy partially mediated these pathways; it accounted for 6.7% (education), 11.8% (income), and 8.3% (occupation) of the total effect of parental SES on pediatric MetS.

Conclusions
Socioeconomic differences in pediatric MetS are relatively small, the largest being by parental education. Improving parental health literacy may reduce these inequalities. Further research is needed into the mediating role of parental health literacy on other socioeconomic health inequalities in children.

Key messages
• Parental socioeconomic status (SES) has a small inverse relationship with pediatric metabolic syndrome (MetS), which is partially mediated by parental health literacy.
• Targeting parental health literacy may reduce inequalities in pediatric MetS. It may also influence other pediatric socioeconomic health inequalities, but further research is needed.
The impact of the SARS-CoV-2 pandemic on cause-specific- mortality: a systematic literature review
Authors: Sanmarchi F , Esposito F , Adorno E , Fantini MP , Golinelli D 
Published: October 2022

Abstract

Background
Although investigating the patterns of COVID-19 excess mortality (EM) is relevant, understanding the effects of the pandemic on cause-specific mortality is even crucial and should also be assessed, as this metric allows for a more detailed analysis of the true impact of the pandemic. The aim of this systematic literature review is to estimate the impact of the pandemic on different causes of death, providing a quantitative and qualitative analysis of the phenomenon.

Methods
We searched MEDLINE to identify studies that reported cause-specific mortality during the COVID-19 pandemic. We adopted several inclusion criteria: original article; assessed at least one cause-specific mortality during the pandemic; assessed causes of deaths using the ICD-10 classification; reporting of at least one of the following outcomes: cause-specific mortality estimates or cause-specific EM; full-length articles. Several relevant data were extracted (e.g. publication year, data stratification, territory, country income level, all-cause EM, and cause-specific mortality, etc.).

Results
The search identified 548 articles. After title, abstract and full-text screening, we extracted relevant data from the final set of 14 articles. Cause-specific mortality was reported using different units of measurement. Only 9 studies reported the statistical significance and/or confidence intervals. The most frequently analyzed causes of death were cardiovascular diseases (n = 11), cancer (n = 7), diabetes (n = 6), and suicide (n = 5). We found very heterogeneous patterns of cause-specific mortality, for all the specific causes of deaths, except for suicide and road accident.

Conclusions
The impact of the pandemic on cause-specific deaths has been very heterogeneous and the analyses conducted so far are not exhaustive. We advocate for the urgent need to find a consensus to define uniform methodological approaches to establish the true burden of the COVID-19 pandemic on non-COVID-19 mortality.

Key messages
• We reviewed the body of literature to estimate the impact of the COVID-19 pandemic on different causes of death, and to provide a quantitative and qualitative analysis of the phenomenon.
• We did not identify unique patterns of cause-specific mortality due to too varied approaches in terms of disease classification and coding, and methodologies used for estimating mortality.
Acute Alcohol intoxication in Belgian adolescents: a retrospective hospital chart study
Authors: van Roozendaal HE , Van Hal G , van der Lely N 
Published: October 2022

Abstract

Background
Binge drinking by adolescents in Belgium is an increasing problem, according to emergency physicians who have recently alerted society about the increasing numbers of adolescents admitted to hospital due to acute alcohol intoxication (AAI). Until now, only estimations of the prevalence of AAI in adolescents are known and research about potential risk factors has not yet been conducted in Belgium.

Methods
To gain more insight into the prevalence, medical characteristics, and context of AAI, a retrospective study in hospitals in the city of Antwerp was conducted. Medical charts of 10 to 18-year-old patients admitted with AAI between 2015 and 2021 were investigated and analysed.

Results
Between 2016 and 2021, 547 adolescents with AAI were admitted to 5 of the 8 hospitals in Antwerp. In the University Hospital of Antwerp (n = 177) mean age at admittance was 15.9 years. Older patients had a significantly higher BAC than younger patients (U:2357, 1, p-value: &lt;0.001). In 10% of the patients combined drug use was proven and in this group, BAC was significantly lower (U:209, 1, p-value: &lt;0.001). 60% of the patients were transmitted to the hospital by ambulance and in 31% the ambulance was assisted by specialised medical care. In 18% of the cases, the police were involved. The results of the other hospitals are not yet known at the time of submission but will be presented at the EPH conference.

Conclusions
According to the data so far, younger patients and patients with comorbid drug use are admitted with a lower BAC, which could be seen as a potential risk factor. This should be considered in developing preventive measures like sensitization. Moreover, in a noteworthy percentage, ambulances, specialized care, and police are involved, which contributes to high medical and social costs. However, data addressing demographics and the context of AAI were mostly missing. Therefore, prospective research is required to further investigate potential risk factors for AAI.

Key messages
• A significant amount of adolescents with AAI are admitted in the city of Antwerp every year, with a mean age of 15.9 years old, which is below the legal alcohol age.
• Considering the high prevalence of AAI and the major impact it has on adolescents health and medical and social costs, it is necessary to decrease the prevalence of binge drinking in adolescents.
Impact of BMI on breast screening participation: a data linkage study
Authors: McBride K , Munasinghe S , Sperendei S , Page A 
Published: October 2022

Abstract

Background
Regular mammographic screening can reduce breast cancer morbidity and mortality. Participation rates are suboptimal in Australia’s fully funded biennial breastscreening program (BreastScreen) for women aged 50-74. Despite obesity being a well-established risk factor for post-menopausal breast cancer, cross sectional data suggests obesity may be a risk factor for non-participation in recommended screening, due to adverse screening experiences. This research aimed to ascertain the link obesity and non-participation by using data linkage of routinely collected data.

Methods
Data for women age eligible for breast screening were linked between the NSW Cancer Registry and the Australian Longitudinal Study of Women’s Health (ALSWH) to create a cohort of women who either participated in screening as recommended or not. Women from the 1946-1951 ALSWH birth cohort were included in the study. These women reported BMI via 8 survey waves. The primary outcome was adherence to breast screening measured by frequency of screening over the follow-up period (1998-2016). Unadjusted risk ratios were calculated using mixed-effects logistic regression for the association between BMI and screening participation.

Results
The study included 2804 linked records of age eligible women (mean age of 52.37[SD 5.47]). 22.8% of the cohort were obese (BMI&gt;30kg/m2). Obesity was significantly associated with non-recommended screening participation (screening within 3 years of last breast screen); odds ratio 1.63 (95% confidence interval 1.32 to 2.00, p &lt; 0.0001).

Conclusions
Obesity has a significantly impact on recommended participation in a nationally provided breast screening program, despite obesity being a risk factor for post- menopausal breast cancer. Optimising participation among higher risk and under-screened women in under utilised breast cancer screening programs is warranted. Development of targeted interventions to increase screening participation among these higher risk women is needed.

Key messages
• Women living with obesity and less likely to participate in recommended breast screening.
• Targeted interventions are needed to optimise participation in breast screening to ensure these higher risk women are not at higher risk of adverse outcomes due to breast cancer.
Nonmedical use of anxiolytics among Tunisian students: Connecting the dots from 2013 to 2021
Authors: Silini A , Rejaibi S , Zid M , Zoghlami N , Ben Slema I , Mallekh R , Zribi M , Ben Youssef S , Ben Salah N , Aounallah-Skhiri H 
Published: October 2022

Abstract

Background
Nonmedical use of prescription drugs such as sedatives and anxiolytics is a fast growing public health threat in several countries. In Tunisia, although several studies have investigated the prevalence of nonmedical use of anxiolytics among school-age students, there is a gap in knowledge regarding trends in anxiolytics misuse. We aimed to determine the prevalence of nonmedical use of anxiolytics and examine trends between 2013 and 2021.

Methods
Pooled data from three Mediterranean school surveys on alcohol and other drugs (MedSPAD I-2013, MedSPAD II-2017, MedSPAD III-2021) were used. Based on three-stage stratification sampling method, teenagers in first and second grades of secondary education, were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Data collection was performed using a self-administered standardized questionnaire. We studied weighted lifetime nonmedical use of
prescription anxiolytics and performed global and by gender trend analysis. Epi data software was used for data entry and all statistical analysis, were performed with STATA software.

Results
A total of 14.723 students were enrolled with sex ratio (Male/Female) equal to 0.61 and mean age of 16.2±0.8 years. The prevalence of nonmedical anxiolytics’ use increased from 2.1% to 3% then to 8.4% for 2013, 2017 and 2021, respectively. Global and by gender trends analysis concluded to significant increase from 2017 to 2021 (p &lt; 10-3). However, a non-significant increase was revealed from 2013 to 2017.

Conclusions
Our study is the first to confirm a significant increasing trend in non-medical use of anxiolytics among Tunisian adolescents. These findings emphasize the urgent need for early detection of psychological vulnerability among adolescents in order to prevent their engagement in such risky behaviors.

Key messages
• Decision makers should be sensitized regarding the alarming increasing trend in non-medical use of anxiolytics, among Tunisian adolescents.
• The state control of these substances accessibility and early detection of psychological vulnerability, are highly required.
Cannabis use in Tunisian adolescents: Alarming trends from 2013 to 2021
Authors: Rejaibi S , Zribi M , Silini A , Zid M , Zoghlami N , Mallekh R , Ben Slama I , Ben Youssef S , Ben Salah N , Aounallah-Skhiri H 
Published: October 2022

Abstract

Background
Cannabis is the most widely used illicit psychoactive substance worldwide. In Tunisia, the prevalence of cannabis use and its association with other risky behaviours were reported in several publications interesting mainly early adolescence. However, no publications exploring trends based on national epidemiological data are available yet. Our purpose was to determine cannabis prevalence in Tunisian high school adolescents and assess significant trends from 2013 to 2021.

Methods
Pooled data from Mediterranean school surveys on alcohol and other drugs conducted in 2013, 2017, and 2021, were used. Based on three-stage stratification sampling method, first and second grade secondary education students were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Self-administered standardized questionnaire was used in data collection. We studied weighted lifetime prevalence of cannabis use and chi square test for trend was used for global, by gender and by sector (private/public) trends assessement. STATA software was used for statistical analysis.

Results
A total of 14.723 students were enrolled with sex ratio (M/F) equal to 0.61 and mean age of 16.2±0.8 years. The prevalence of cannabis use increased from 1.4%, to 3.8% then to 7.9% for 2013, 2017 and 2021 respectively. Trend assessement concludes to significant increase in overall cannabis use (p &lt; 10-3). Besides, there was a significant increase in both public and private schools, and among both boys and girls. However, the greatest increase was among male students (3.5% in 2013, 9.2% in 2017 and 16.1% in 2021) (p &lt; 10-3).

Conclusions
Despite the reinforcement of restrictive legislative measures, the prevalence of cannabis use among Tunisian high school adolescents is significantly increasing. Moreover, it’s important to further investigate problematic cannabis use and its effects on adolescents’ physical and mental health.

Key messages
• Trend assessement confirmed the significant increase in lifetime cannabis use in high school adolescents in Tunisia, for both sexes and for both private and public sector.
• This alarming public health issue requires urgent legislation review and close multisectoral collaboration to control supply and demand.
Letters from Mars. Soft law under scrutiny of ethics during crisis. Responsibility and accountability
Authors: Morard S , Guinoiseau S 
Published: October 2022

Abstract

Like most of western countries France has been severely hit by the first wave of covid during Spring 2020. France managed to get through it thanks to a confinement, full dedication of health and &lt;&lt; first line &gt;&gt; workers and of course the excellency of its bureaucracy. France is now famous for its digitalized self-made one-hour-walk certificate. It is however less-known for its MARSes, acronym for &lt;&lt; message d'alerte rapide sanitaire &gt;&gt; or quick sanitary warning messages that got usually sent to hospitals and nursing homes... on Friday nights or weekends. Some lawyers saluted the method as an innovative and modern process that adapted quickly the response to the evolution of the situation shifting from hard rules written in the due process of law to an era of properly crafted regulations. Professionnals were less enthusiastic regarding this matter. It was less an issue of professional curtesy expected form a central state towards civil servants than one related to the content of the messages. Quality varied depending on the news. Some messages imposed very clear and strict rules such as: &lt;&lt; no visit under any circumstances in nursing homes &gt;&gt; or later when tests were available, &lt;&lt; should any cluster appear, all residents must be tested. &gt;&gt; However, all messages ended the same and ritual way: &lt;&lt; Provisions included in this message must be performed and adapted under direction supervision and adapted to the context of the institution &gt;&gt;. Interestingly enough the way the text was written rose questions: If the rule is clear, why should it be adapted? The rule enters in conflict with other preexisting rules. Which one should apply? Classical legal and political theory are of great help sorting formal issues. Hume’s non ethical cognitivism and Kant’s categorical imperative were used redesigning the working frame. Since accountability was for direction to bear, so was it for it to draw fair and acceptable solutions in due respect of democratic principles.

Key messages
• Limit cases prove that rules are unsufficient in decision making.
• Balanced decisions require collegiality to overstep limited rationality.