bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient expectations do matter - experimental evidence on antibiotic prescribing decisions
Authors: Wang S , Cantarelli P , Groene O , Belle N 
Published: October 2022

Abstract

Inappropriate prescription of antibiotics remains a major contributor to the global antimicrobial resistance crisis despite clear linkages between antibiotic utilization and resistance spread. This study aims to better understand the simultaneous and independent effect of previous prescription behavior, patient expectation, and clinical uncertainty on antibiotic prescribing. This discrete choice experiment was embedded within a routine organizational climate survey administered to all physicians working in the Tuscany healthcare system administered between Nov 11 and Nov 20, 2019 (Qualtrics). Participants were provided with a patient encounter vignette and subsequently asked to in which of two alternatives they were more likely to prescribe antibiotics. The two alternatives varied in levels of clinical uncertainty, patient expectations, and the physician’s past behavior. We fitted a conditional logistic regression model. Respondents included 1,436 hospital-based physicians, of which 52% were female, 78% practiced in a general hospital setting, and 33% were between the ages of 50 and 59. Results show that the odds of prescribing antibiotics decrease when a patient requests it (OR = 0.80, 95%CI [0.72,0.89]) and increase when the physician has prescribed antibiotics to a patient under similar circumstances previously (OR = 1.15, 95%CI [1.03,1.27]). We found no significant effect of clinical uncertainty on the odds of prescribing antibiotics (OR = 0.96, 95%CI [0.87, 1.07]). We show that patient expectation has a significant negative association with antibiotic prescribing among hospital-based physicians. Our findings inform the design of antibiotic stewardship programs in Tuscany and highlight the importance of cultural context in shaping the physician’s disposition when confronted with patient expectations. We suggest shared decision-making to improve prudent prescribing without compromising on patient satisfaction.

Key messages
• Health administrators should address patient expectations when designing hospital antibiotic stewardship programs.
• Physicians’ past prescribing behaviour influences antibiotic prescribing decisions and should be considered during intervention design.
Class inequalities in physical functioning trajectories before and after retirement
Authors: Lahti J , Pietiläinen O , Rahkonen O , Lallukka T 
Published: October 2022

Abstract

Background
Longer work careers are discussed, but inequalities in health trajectories among employees facing retirement remain poorly understood. We examined social class trajectories in physical functioning among ageing female employees ten years before and after transition to old-age or disability retirement.

Methods
We used Helsinki Health Study cohort data. The baseline (2000-02) included 7168 women, aged 40-60, employed by the City of Helsinki, Finland (response 67%). Follow-ups took place in 2007, 2012 and 2017 (response 78-83%). The outcome was RAND-36 Physical Functioning subscale, range 0-100, with higher scores indicating better functioning. Social classes were upper and lower class, and covariates age, work conditions and health behaviours. Mixed-effect growth curve models were used to predict functioning scores and 95% confidence intervals (CI) 10 years before and after mandatory old-age or disability retirement.

Results
Old-age and disability retirees lacked class inequalities in functioning 10 years prior retirement. Towards retirement transition, functioning declined and inequalities emerged. Among old-age retirees, the predicted score was 86.1 (CI 85.2-86.9) for upper class and 82.2 (81.5-83.0) for lower class. Among disability retirees, the score was 70.3 (67.8-72.9) for upper class and 62.2 (60.4-63.9) for lower class. Among old-age retirees, functioning declined and inequalities slightly widened. Among disability retirees, the decline plateaued and inequalities narrowed. Physical work and BMI somewhat attenuated the inequalities.

Conclusions
Among female employees, functioning declined and class inequalities emerged towards retirement transition. Widening inequalities were seen among old-age retirees, but not among disability retirees. Preventing the decline of functioning and related inequalities would help safeguard a healthy and successful ageing among female retirees.

Key messages
• As functioning shows a constant decline before and after old-age retirement, there is a need for slowing down the pace of the decline.
• Class inequalities in functioning tend to widen among old-age retirees; egalitarian measures are needed to turn the development to narrowing inequalities.
Seroprevalence of SARS-CoV-2 before/after case zero
Authors: Bordino V , Vicentini C , Cornio AR , Meddis D , Zotti CM 
Published: October 2022

Abstract

Introduction
Italy was one of the first EU countries hit by the COVID-19 pandemic. Currently, Italy has reported 15.5 million cases of COVID-19 and 161000 deaths. Meanwhile, the vaccination campaign against COVID-19 began in Italy at the end of 2020, using mRNA and viral vector vaccines (immunizing people against Spike protein of SARS-CoV-2. The purpose of this study was to estimate, in a representative sample of the Italian population, the prevalence of antibodies against SARS-CoV2 in 2019 (before case zero, identified in Italy in February 2020) and in 2021, after 3 pandemic waves and a vaccination campaign.

Methods
During October / November 2019: 365 participants were selected in the Piedmontese population among those who went to a hospital for routine blood tests. The population was selected on the basis of age and gender to be representative of the Italian population. The same number of patients was selected in the first quarter of 2021, the inclusion and exclusion criteria remained the same. Sera were searched for spike protein of SARS-CoV-2 and, if positive, tested for anti-nucleocapsid antibodies.

Results
Our preliminary data show that half of the sample for both years is female. In the 2019 sample, i.e. before case zero was identified in Italy (Lombardy), five of the sera (4 males and one female) tested positive for anti-Spike,indicating a previous infection (vaccine didn't exist). In the 2021 sample, 152 males and 139 females tested positive for IgG anti-spike, for a total of 291. The prevalence therefore passed from 1.37% to 79.73%. As regards the search for ANti-Nantibodies, one male and one female tested positive in 2019; in 2021 9 males and 13 females.

Conclusions
The results of our study show that in 2019, before the first official case in Italy was highlighted, coronavirus was already circulating. The prevalence has risen exponentially, going from less than 2% to around 80%.

Key messages
• Covid-19 was circulating in Italy in 2019.
• Seroprevalence of anti-S in 2021 was about 20%.
Contextual effects on health: systematic review of studies using natural experiments among migrants
Authors: Biddle L , Hintermeier M , Costa D , Wasko Z , Bozorgmehr K 
Published: October 2022

Abstract

Background
Many studies on contextual health effects suffer from compositional bias and selective migration into neighbourhoods. Longitudinal natural experiments have the potential to overcome these limitations, and there are several opportunities for this research design in the migration context. We aimed to synthesize evidence from natural experiments among migrants studying the effect of contextual factors on health and healthcare.

Methods
Peer-reviewed literature in English or German was systematically searched in four major databases in December 2021. Following systematic abstract- and fulltext-screening, 32 studies were included for analysis. Evidence on contextual impacts on physical and mental health, mortality, and healthcare was narratively synthesized and quality appraisal conducted.

Results
We found four types of contextual health effects: factors of the place of residence in receiving countries (n = 6), migration-context interactions (n = 10), policy environments (n = 15) and cultural factors (n = 1). Results show the negative impacts of post-migratory contexts on physical health and mortality and the favourable impacts on child health. Impacts on mental health are mixed. Analyses of policy contexts indicate the negative impacts of restrictive migration and social policies on healthcare utilization, mental health and mortality as well as the positive effects when restrictions are lifted.

Conclusions
Natural experiments can serve as powerful tools in disentangling the effect of context on health and reducing bias through self-selection. Results demonstrate the negative impacts for health which lie at the nexus of migration and neighbourhood disadvantage. At the same time, studies uncover the potential of health, welfare and visa programs to counteract such disadvantages and create healthy post-migratory contexts. With careful consideration of causal pathways, results from migration contexts can serve as a magnifying glass for effects of context in other population groups.

Key messages
• Natural experiments can serve as powerful tools in disentangling the effect of context on health and reduce bias through self-selection.
• Results show the negative impacts for health that lie at the nexus of migration and neighborhood disadvantage, as well as the potential of inclusionary policies to counteract them.
Challenges faced by parents of screen-detected children with Cystic Fibrosis: The ICOS study
Authors: Bhatnagar R , Linnane B , Herzig M , Ni Chroinin M , Cox D , Elnazir B , Segurado R , Kirwan L , Southern KW , Fitzpatrick P 
Published: October 2022

Abstract

Background
Informal care is an essential component of overall care for patients, particularly those with chronic illnesses such as Cystic Fibrosis (CF). This study aims to assess the level of caregiving burden faced by parents/caregivers of children with CF (CwCF) recruited to the Irish Comparative Outcomes Study of CF (ICOS), a historical cohort study of CwCF. In July 2011, a new-born screening programme began in Ireland.

Methods
The study population includes the parents of screen-detected CwCF born between July 2011-2021. The Challenge of Living with CF-Short Form is a new, validated 15-item tool that evaluates the caregiving burden faced by parents from the child’s diagnosis until early adolescence. Comparisons based on the age of screen-detected CwCF were conducted. SPSS was used for analysis.

Results
69 parents of screen-detected CwCF responded. Fifty percent of parents of older children (aged 4-12+ years) and 35% of the parents of toddlers (0-3 years) faced moderate-high level difficulties in managing the extra expenses required for the care of their CwCF, despite all children receiving free clinical care, prescriptions and medications. A significantly greater proportion of the parents of older children than younger children experienced constant problems in managing daily oral medication routines (37% vs 13%; P = 0.039), nebulised medication routines (67.5% vs 21.4%; P = 0.003), and physiotherapy routines (57.8% vs 31.8%; P = 0.046)

Conclusions
Using the novel Challenge of living with Cystic Fibrosis-Short Form questionnaire, our findings suggest that the caregiving burden is higher for parents of older CwCF. Expenses incurred by parents of a child with a serious chronic medical condition go beyond medical care and treatment expenses.

Key messages
• The challenge of living with Cystic Fibrosis-Short Form is being used for the first time in a population setting.
• The caregiving burden was more pronounced in the parents of older CwCF.
Alarming trends in Tobacco use in high school Tunisian adolescents: MedSPAD2013-2021
Authors: Silini A , Rejaibi S , Zid M , Zoghlami N , Mallekh R , Ben Slema I , Ben Youssef S , Zribi M , Ben Salah N , Aounallah-Skhiri H 
Published: October 2022

Abstract

Background
Tobacco use is a global health concern, with smoking initiation often beginning in adolescence. In Tunisia, published data assessing trends of tobacco consumption at the national level only concerns middle school students aged 13 to 15 years. No data related to high school students are however published yet. We aimed to determine tobacco smoking prevalence in Tunisian adolescents and assess trends from 2013 to 2021.

Methods
Pooled data from three Mediterranean school surveyson alcohol and other drugs (MedSPAD surveys: 2013, 2017, and 2021) were used. Based on three-stage stratification sampling method, teenagers aged between 15 and 17 years, 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 assessing socio-demographic characteristics and risky behaviours. We studied weighted prevalence estimates of cigarettes and water pipe (WP) smoking. All statistical analysis, including trend analysis, were performed with STATA software.

Results
A total of 14.723 students were enrolled with sex ratio (M/F) equal to 0.6 and mean age of 16.2±0.8 years. The prevalence of cigarette smoking increased from 17.8%, to 20.2% then to 24.7% for 2013, 2017 and 2021, respectively. As for WP smoking, its prevalence increased from 14.8%, to 16.7% then to 19.9% for 2013, 2017 and 2021, respectively. Trends analysis concluded to significant increase over study period for cigarettes and WP smoking (p &lt; 10-3). The increase was most alarming for girls regarding WP smoking (consistent increase over the study period).

Conclusions
Our findings underscore the alarming increasing trend for different forms of tobacco smoking among Tunisian youth. It is therefore crucial to strengthen tobacco control measures among young adolescents in order to counteract the tobacco industry’s expanding marketing of new products primarily targeting this population.

Key messages
• The prevalence of cigarette and water pipe smoking increased significantly among high school Tunisian adolescents from 2013 to 2021.
• A better commitment to the implementation of MPOWER measures for tobacco control is therefore urgent.
Risk analysis of biological hazards in food industry in terms of Public Health
Authors: Vantarakis A , Dimitrakopoulou M 
Published: October 2022

Abstract

Numerous pathogens are transmitted via food and according to recent surveys, there are millions of incidents recorded in Europe in the last decade. More specific, foodborne pathogens such as bacteria, fungi, parasites, and viruses can be detected in different stages of production or distribution of a food product. Examples of predominant symptoms caused by these foodborne pathogens are nausea, vomiting, diarrhea, cramps, fever, headache, cough etc. Therefore, it is essential need to detect, manage, and prevent of foodborne pathogens “from farm to fork” regarding consumers health risks. Europe has established and suggested management systems in food industry that control hazards in food products. However, outbreak incidents by foodborne pathogens existing until now. By using PRISMA guideline, we searched for the most recent publications referring microbiological risk assessments from online databases Scopus, PubMed and Science Direct. From 505 articles initially captured, data was extracted from 84 studies regarding microbiological risk factors in terms of food quality and safety, that are evidenced in European studies. Moreover, information about country of origin, food type, production phase and technology used for detection of pathogens, are also presented. Our results indicated that quality systems should be further developed to control all possible routes of contamination in the supply chain. This work provided information to managers in food industry and scientists for further research regarding microbiological risk assessments. Implementation of effective risk management systems in food industry could contribute to identify and eliminate potential risks and thus, consumer’s health and food quality could be reassured. Therefore, our findings could provide managers in food industry either to build up more effective management systems or even help scientists to better understand ecology of pathogens regarding food matrix and environmental conditions.

Key messages
• Risk analysis of biological hazards in food industry could prevent foodborne diseases.
• Risk analysis of foodborne pathogens is important for public health.
Gluten quantification in gluten-free food for celiac people in Lombardy and Emilia Romagna - Italy
Authors: Pavoni E , Bertasi B , Finazzi G , Filipello V , Losio M-N 
Published: October 2022

Abstract

Background
In recent decades, the celiac disease showed a gradual increase in prevalence. Therefore, there was a raised demand of gluten-free products. EU Reg. 1169/2011 states that 20 mg.kg-1 (ppm) is the maximum gluten content in food for celiac people, and that “gluten-free” labelling must be put on compliant food packages. This work is a study on different food categories, aiming at verifying the safety of analyzed samples.

Methods
Totally, 4615 gluten-free-labelled specimens were collected from January 2019 to April 2022 (pasta, 2944; cured meat, 566; flours/bakery, 489; sweets, 125 and other matrices, 491). A commercially available E.L.I.S.A. kit, according to the AOAC 2012.01-2016 method, was used to quantify gluten.

Results
In 97% of samples (4475) the gluten content was &lt;5 ppm (lower LOD), and in 2.4% (112) it was between 5 ppm and &lt;20 ppm. In the remaining 0.6% (28), the gluten concentration was ≥20 ppm. Of these, 0.32% (15) were between 20 and &lt;80 ppm (upper LOD), and 0.28% (13) ≥80 ppm.

Conclusions
The increased prevalence of celiac disease and the consumers’ perception that a gluten-free diet gives benefits, lead to a greater demand of gluten-free products. In this study, 99.4% of samples were compliant with the gluten-free labelling and safe for celiac consumers. The 0.32% had a gluten content between 20 and 80 ppm, still considered “compliant”, according to the EU Reg. 828/2014 that defines as very low gluten containing (thus edible for some celiac groups), those products with a gluten content &lt;100 ppm. Only 0.28% of samples was non-compliant (≥80 ppm). However, the authors accounted irregular those foods with ≥20 ppm. Considering the importance of these products in the daily diet, and the increasing probability to get sick by individuals, the study of their compliance to the law limits results to be important.

Key messages
• A continuous surveillance of gluten-free-labelled food products is very important to prevent risks for celiac consumers.
• The foodstuffs distributed in the two considered regions are mainly safe for celiac patients.
The Effect of Smartphone Use and Nomophobia on Sleep Quality and Daytime Sleepiness in Turkey
Authors: Erten B , Pehlivan E , Yalcin E 
Published: October 2022

Abstract

Background
Smartphones used unconsciously and in an uncontrolled manner make young people experience sleep problems. This study aimed to investigate the effects of university students’ smartphone addiction and nomophobia levels on sleep quality and excessive daytime sleepiness.

Methods
This study, which had a cross-sectional design, was conducted with 390 people who were first-year and senior students at Inonu University between November and December 2019. The Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Nomophobia Scale, and Smartphone Addiction Scale were used in the present study used. For statistical analysis, the chi-squared test, the Student’s t-test, one-way ANOVA, Spearman’s rank correlation coefficient and binomial logistic regression analysis were used. The research has ethics committee approval.The error level was chosen as p = 0.05.

Results
The smartphone use time of the students was finded to be 5.4±2.6 years, daily online time was 4.3±2.6 hours, and daily sleep time was 7.4±1.5 hours. The students received 78.3±25.8 points from the Nomophobia Scale, 90.3±29.7 from the Smartphone Addiction Scale, 7.2±2.8 from the Pittsburgh Sleep Quality Index, and 5.9±4.1 points from the Epworth Sleepiness Scale. A total of 54.4% of students had moderate, and 22.8% had severe nomophobic symptoms; 83.6% of the group had poor sleep quality, and 14.6% had excessive daytime sleepiness. A positive, moderate and significant relation was detected between the mean Nomophobia score and the mean Smartphone Addiction Scale score. It was also determined that those with less than 30 minutes of smartphone use before sleeping had low nomophobia, smartphone addiction and daytime sleepiness scores, and better sleep quality.

Conclusions
Nomophobic symptoms and smartphone addiction were observed to be high in university students. Most students had poor sleep quality. The awareness of students on healthy sleep, and conscious and controlled smartphone use should be increased.

Key messages
• Smartphone addiction increases the level of nomophobia moderately in university students.
• Those who use a smartphone less than 30 minutes before going to sleep have better sleep quality and lower daytime sleepiness.
The computer-assisted interview In My Shoes – a successful method to capture children’s perspectives
Authors: Fängström K , Dahlberg A , Sarkadi A 
Published: October 2022

Abstract

Background
Child mental health problems are considered the second highest cause of burden of disease in Europe and the Americas. Children’s own opinions and experiences are pivotal in addressing these problems. However, including young children as active informants in health research and practice not only requires a well-trained and highly qualified workforce, but also valid methods that enhance and support children’s self-expression. The aim was to investigate preschool aged children’s experiences in two health and welfare contexts using the interactive computer-assisted interview In My Shoes (IMS).

Methods
Interviews were conducted using IMS in three studies encompassing 43 children aged 3-6 years old. The setting for the first and second study was Child Health Centres and the third setting was families entering the Triple P group parenting programme. Qualitative content analysis was performed.

Results
The IMS interview aided preschool aged children to report on the factual, emotional and physical aspects of their experiences within a health care context. In addition, IMS helped young children verbalise unique information on negative interplay within their families, especially experiences of negative parenting including verbal and physical child abuse. The successes with IMS are likely related to the structured and systematic approach, that it is pictorial-based and emotion-focused, as well as the interactive, collaborative and triadic conversation between the child, the interviewer and the computer.

Conclusions
The interactive computer-assisted interview IMS, is a suitable and valid method for aiding young children to provide unique and extensive information about different aspects of their experiences and lives. We urge professionals and researchers to systematically include the young children’s own perspectives to better tailor and evaluate interventions on all levels to improve children’s health and wellbeing.

Key messages
• Young children’s own perspectives on their health and wellbeing are pivotal to better tailor and evaluate interventions.
• The interactive computer-assisted interview In My Shoes is a suitable and valid method to capture children’s voices.