bluuebunny/crossref_metadata_2025 huggingface dataset:
People with diabetes have a substantial lower life expectancty
Authors: Hilderink H , Poos R , Leemrijse C , Heins M
Published: October 2022

Background

People with diabetes live shorter lives on average than people without diabetes. This is not only because they have diabetes, but also more often other chronic diseases. This causes a greater risk of death. It makes a difference what kind of diabetes someone has. In type 1 diabetes, the natural immune system does not work properly. In type 2, an unhealthy lifestyle plays a role. An unhealthy lifestyle increases the chance that someone will get type 2 diabetes and the chance that that person will die of another disease, such as cardiovascular disease.

Methods

RIVM has linked general practitioners’ data from 2012-2019 to the vital statistics of the Dutch National Statistical Office. The population of people registered with and without diabetes were coupled with the mortality data. Making use of life tables, associated life expectancies were calculated. For people under the age of 45, no robust analysis could be made.

Results

People aged 45 with type 1 diabetes live on average 13 years shorter than people without diabetes. For a 45-year-old with type 2 diabetes, that is on average 4 years shorter. The chance of dying is about 5 times greater for people aged 45 to 60 with type 1 diabetes than for people without diabetes of this age. This difference becomes smaller as they get older, because people without diabetes also get one or more diseases more often. In type 2 diabetes, the mortality rate for people aged 45 to 60 years is about 2 times greater than for people without diabetes. Again, the difference decreases as they age.

Conclusions

A substantial lower life expectancy of 13 years for type 1 and 4 years for type 2 diabetes has different societal and policy consequences. Since type diabetes 1 is unavoidable, more attention should be given to living with this condition, while for type 2 prevention of for example overweight should get attention.

Key messages

• People with for type 1 and type 2 diabetes have 13 and 4 years lower life expectancy.

• More attention should be given to prevention and to living with diabetes.
Association of HDL subfractions with cardiovascular risk in Hungarian general and Roma populations
Authors: Pikó P , Werissa NA , Kosa Z , Sandor J , Seres I , Paragh G , Adany R
Published: October 2022

Background

High-density lipoprotein (HDL) cholesterol levels are inversely associated with cardiovascular risk (CVR). However, HDL cholesterol is not a homogeneous lipid and can be subdivided into subfractions, which are not uniformly associated with CVR. Among Roma populations, the prevalence of reduced HDL cholesterol levels and, consequently, that of cardiovascular diseases is very high. However, it is not known how this reduction affects the different HDL subfractions and whether changes in their representation are associated with changes in CVR.

Methods

The study aimed to investigate whether there is a difference in the HDL subfraction profile between the Hungarian general (HG) and Roma populations and to determine the association of the different subfractions with the CVR estimated by the Framingham Risk Score (FRS) and the Systematic COronary Risk Evaluation (SCORE) algorithms. HDL cholesterol was separated using the Lipoprint system, which separates 10 subfractions into three classes: large HDL (HDL-L), medium HDL (HDL-I), and small HDL (HDL-S). Analyses were carried out on samples of 100 control subjects (50 Hungarian general and 50 Roma individuals with normal lipid profiles) and 277 individuals with reduced HDL-C levels.

Results

Our results show that Roma has reduced levels of the overall HDL subfraction profile, with significant decreases in HDL-6, and -7. Regardless of the estimation method, elevated levels (in mmol/L) of HDL-1 to 3 and HDL-L were significantly associated with reduced risk. A higher representation (in %) of HDL-1 to 3 subfractions have a significant risk-reducing, while HDL-8 to 10 have a risk-increasing effect estimated by FRS.

Conclusions

The results of our study show that levels of CVR protective HDL subfractions are significantly lower in Roma individuals and their reduced levels are associated with increased CVR, suggesting that the distribution of HDL subfractions contributes to the overall unfavourable CVR profile of Roma.

Key messages

• Levels of HDL-6 and -7 subfractions were significantly lower in the Roma population than in the Hungarian general one.

• The HDL subfraction profile of the Roma population is associated with a higher cardiovascular risk among them.
Anticipating the unimaginable: Heat Health Warning Systems in Europe and Australia
Authors: Parkes M , Bone A , Csutoros D
Published: October 2022

Background

It has long been a maxim of climate and health research that heatwaves kill more people than all other natural disasters combined. Heatwave frequency, severity and duration have increased as climate change intensifies, and recorded temperatures during recent heat events now regularly surpass previous worst-case projections. Temperate zones, between 40°-60° north or south of the Equator, are particularly vulnerable, as small variations in mean temperature can trigger large-scale increases in morbidity, mortality and concomitant health service strain. Heat Health Warning Systems (HHWSs) combine temperature forecasts with public health actions to mitigate these impacts. However, in the absence of a consensus definition of heatwaves multiple systems have developed, and comparative analysis of the effectiveness of different HHWS and their interventions are hindered by lack of a common threshold metric for defining and predicting heatwave severity.

Methods

This paper provides a comprehensive review of current HHWS and their evidence base in temperate zones in Europe, the United Kingdom and Australia - contiguous landmasses containing multiple jurisdictions with high heterogeneity in local HHWSs, in which single heatwave events trigger vastly different public health responses. A systematic review of available published and grey literature was undertaken to generate a schema of HHWSs in these zones. Results were then narrowed to review and synthesise evidence for each, with a focus on threshold effectiveness in predicting health impacts.

Results and conclusions

Over twenty distinct HHWS are reviewed, with substantial variation in the evidence for their effectiveness. We make the case for a unified threshold metric for defining heatwaves, to facilitate research and identify warning systems which accurately predict health impacts and effectively communicate risk.

Key messages

• Lack of definitional consensus and heterogeneity in threshold metrics hinders comparison of Heat Health Warning Systems.

• Accurate prediction and rapid communication of heat risk is crucial to prevent health impacts of heatwaves.
Use of Hashtags related to Covid-19 infodemics by bot accounts
Authors: Suarez-Lledo V , Ramos-Fiol B , Ortega-Martin ME , Carretero-Bravo J , Alvarez-Galvez J
Published: October 2022

Background

Along with the Covid-19 pandemic we need to fight an ‘infodemic'. Some of the most widespread social media platforms such as Facebook, Instagram and Twitter have implemented policies to combat the spread of misinformation about Covid. However, the online ecosystem is still full of health myths, hoaxes, and fake news that-either consciously or unconsciously-is propagated by social media users with different purposes, messages that can lead to attitudinal and behavioral changes which might result in inadequate health decision making

Methods

We use Twitter Stream API to collect tweets about Covid-19 during the early outbreak. Then we filtered those tweets with hashtags related to three infodemic topics: 5g, bill gates, UV and hydroxychloroquine. Then, we use Botometer to obtain the probability that each account is a bot or not. We use bot classification along with network analysis (Louvain community detection) to delve into the subtopics and the use of hashtags.

Results

The resulting data collection contains ∼14M tweets from ∼285K of different Twitter accounts. We selected only tweets written in English. Regarding 5G, the most important communities link China with the virus, are about “democratshateamerica” or conspiracy theories. Tweets about Bill Gates contain hashtags about Trump, America, or mention the batflu. Communities related with UV are about Trump disinfectant, or pointing out that tv channels spread fake news. Those tweets that mention hydroxychloroquine mostly contain hashtags that mention qanon or maga content.

Conclusions

In this paper, we analyze the use of hashtags by accounts classified as bots. Using Louvain community detection we identify co-occurring hashtags. Using social network analysis we identify which hashtags are the most important within the conversation.

Key messages

• We identify several communities around most important infodemic topics. Bots activity in most of the cases is about political content than spreading health misinformation.

• This method allows to find subtopics based on the use of hashtags. Which allow public health policies to prevent the spread of infodemics.
How to design information strategies on e-mental health services for prospective healthcare providers
Authors: Braun P , Schwientek A-K , Loerbroks A , Apolinário-Hagen J
Published: October 2022

Background

Among prospective healthcare providers (HCPs) such as medical students, mental health problems are prevalent, but they seem reluctant to seek help. Barriers include fear of stigmatization or limited resources of counseling centers. Electronic mental health services (eMHSs) seem to be promising low-threshold and evidence-based tools for increasing treatment availability. However, uptake rates remain low. Reasons include skepticism and lacking awareness, which can be addressed through acceptance-facilitating interventions (AFIs) such as multi-attributes information strategies. To date little is known about how to design AFIs to meet prospect HCPs’ information needs and preferences.

Methods

Between August 2021 and June 2022, n = 21 semi-structured online interviews and n = 3 co-design workshops were conducted with medical and psychology students across Germany to define attributes and levels of information strategies. Interviews were recorded, transcribed and content-analyzed using MAXQDA.

Results

Most students reported having little knowledge about eMHSs but would have liked to be informed at the beginning of their studies or as an integral part of their study program. We identified 5 attributes that information strategies should consist of: information source (e.g., student counseling center), information path (e.g., flyer), timing (e.g., during freshman week), recommendation (e.g., from HCPs), and quality criterion (e.g., evidence-base). Attributes included 4 to 6 levels. Concerning design preferences, students favored green or blue as colors, and short texts with images.

Conclusions

For a comprehensive dissemination of eMHSs into the healthcare system, prospective HCPs need to be educated on eMHSs. This study gives first insight into how AFIs should be designed to inform prospective HCPs. Future research should focus on systematic variations of AFIs’ attributes and their levels mimicking real-world decision scenarios through discrete choice experiments.

Key messages

• Through tailored AFIs, prospective HCPs can be informed about eMHSs for both personal and professional needs.

• Our results give student counseling centers with limited resources clear guidelines on how to inform prospective HCPs on low-threshold eMHSs.
Use and barriers to the use of telehealth services among the Arab population in Israel
Authors: Laron M , Penn N
Published: October 2022

Background

Telehealth services tends to be used relatively infrequently by minority populations, thereby exacerbating health inequalities. This study examines the individual, circumstantial and environmental factors that facilitate or hinder usage of telehealth among Israeli Arabs, who constitute 21% of the Israeli population.

Methods

Data was collected through a telephone survey among the adult Arab population in October 2020 with 501 respondents (42% response rate). Analysis included logistic regression.

Results

Most of the Arab population use the internet several times a week (93%) and have a smartphone (96%). The most popular telehealth service was telephone appointments with a doctor (66%). Two thirds have never used the health plan’s mobile application, though most have no objection to using chat (75%) or video conversation (51%) with a medical professional. The most significant barrier to using telehealth is lack of awareness of services such as ordering medicines (23%). Conversely, factors that facilitate the use of telehealth include previous acquaintance with the doctor (91%); Arabic services (82%); and recommendation by health professionals (79%). Multivariate analyses indicate a strong positive correlation between education and the use of telehealth for written correspondence with a known health professional (p = 0.001).

Conclusions

Telehealth services (e.g., phone appointments) which are already used widely by the Israeli-Arab population, should be retained and developed further. In parallel, digital health literacy and linguistically and culturally adaptation of digital services should be promoted. Awareness of those services should be enhanced through culturally adapted marketing and via recommendations from the family doctor.

Key messages

• Identification of the barriers to the use of telehealth services among minority populations can help service providers reduce usage gaps between minority and majority population.

• The use of telehealth services should be simplified to suit people with a low digital health literacy.
Patient expectations do matter - experimental evidence on antibiotic prescribing decisions
Authors: Wang S , Cantarelli P , Groene O , Belle N
Published: October 2022

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

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

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

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

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

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 < 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

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

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 <5 ppm (lower LOD), and in 2.4% (112) it was between 5 ppm and <20 ppm. In the remaining 0.6% (28), the gluten concentration was ≥20 ppm. Of these, 0.32% (15) were between 20 and <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 <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

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

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.
A novel technology for disinfecting surfaces infested with Candida auris: the UVC chip
Authors: Frongillo E , Amodeo D , Nante N , Cevenini G , Messina G
Published: October 2022

Background

The fungal pathogen Candida Auris is increasingly associated with multidrug-resistant infections that are highly expensive for the Health Care System. The spreading of this pathogen can occur, among others, through contact with infected surfaces or medical instruments. This study evaluated the efficacy of a novel UVC chip, novel alternative to UVC LEDs and lamps, in inactivating Candida auris strain.

Methods

This experimental study was carried out between July and September 2020 at the University of Siena. Candida auris (ATCC 12372) at two known concentrations (1.5X107 and 1.5x106 CFU/ml) at a fixed distance (7,5 cm) from the chip (5.1mW radiant power) was tested, in triplicates, with three exposure times (5, 10 and 15 minutes). Potato Dextrose Agar (PDA) plates without the plate lid and containing Candida auris were exposed to UVC light. Subsequently, the plates were incubated at 36 °C for 48 h. Log reduction between treated and positive control (not exposed to UVC light) samples was calculated.

Results

At 15 minutes, we had the highest inactivation result, mean 4.43 log10, starting from a 1.5x106 CFU/mL concentration. At a higher concentration, 1.5X107 CFU/mL, the reduction had a mean of 3.51 log10.

Conclusions

The results of the experiments showed a significant microbial reduction in relation to the exposure time. The highest level of reduction was reached after 15 minutes of exposure. UVC chip had a relevant biocidal effect on Candida auris and may represent a valuable tool in the prevention of infections caused by this pathogen, which is becoming increasingly prevalent and persistent globally.

Key messages

• The use of UVC Chip decreases surface contamination.

• New technology against healthcare-associated infections.
Health absenteeism due to dementia in Slovenia and its costs in the period from 2015-2018
Authors: Jelenc M , Sedlak S
Published: October 2022

Background

The number of employed people with certain mental or chronic illnesses is increasing. Given the fact that these are mainly diseases of the elderly and the fact that working life is increasing and populations are aging, we are already facing a public health problem that can increase without appropriate measures. Dementia mainly affects the elderly, but may occur in employed persons as well. This impairs their ability to work and is associated with costs. For the first time in Slovenia we performed a study to assess health absenteeism due to the diagnosis of dementia in the period from 2015 to 2018, to show its economic consequences and to plan the measures.

Methods

The method of direct and indirect costs was used. We showed the indirect costs, which represent a loss, ie goods and services not produced on the market, namely, absenteeism due to dementia, and its economic impact. The costs of temporary absence from work were calculated on the basis of data obtained from the national health databases. The estimated cost of compensation for absence from work is based on the average gross salary. International Classification of Diseases-10 edition was used for the diagnoses of dementia; the Health Insurance Institute of Slovenia was the source of financial data.

Results

Temporary absence from work due to the diagnosis of dementia in the period 2015-2018 in Slovenia amounted to around 0.6% of all calculated direct and indirect costs for this period, amounting to 11,037,275.00 EUR. The cost has been rising over the years.

Conclusions

The results are underestimated, as rare cases of dementia are diagnosed before the age of 65 and due to data limitations. The employers should keep affected persons as long as possible active by adjusting the labour environment, working hours, providing an ergonomically designed workplace or by implementing preventive measures. These will reflect in positive financial effects on the economy, companies and the individuals.

Key messages

• It is fundamental to encourage employers of persons with dementia to keep them in the initial phase of dementia active for as long as possible by adopting proper measures.

• Awareness of dementia is extremely important, as rapid recognition of signs of dementia and subsequent diagnosis, allow early and appropriate treatment.
Night work and sustainable working life - a prospective trajectory analysis of Swedish Twins
Authors: Ropponen A , Wang M , Raza A , Narusyte J
Published: October 2022

Objectives

Night work has been widely studied for the associations with diseases, sickness absence (SA) and disability pension (DP), but less for sustainable working life. We aimed to investigate the longitudinal changes in sustainable working life among those with or without baseline night work.

Methods

Using data from Swedish national registers, sustainable working life was defined as employment during follow-up without interruptions due to SA/DP, unemployment, and old-age pension. Survey data for two cohorts (i.e., born before or after 1959) were utilized to assess night work at baseline (yes/no) in 1998-2003 and 2004-2006, respectively. The final samples for the two cohorts were 34680 and 19637, respectively. Group-based trajectory models were applied.

Results

Among those born before 1959 (mean age 59 years, 13 years follow-up), a five-trajectory solution was best for those with and without night work. The trajectory groups were stable sustainable working life (38-42%), stable unsustainable working life (24-25%), early (13%) or later (13%) decreasing sustainable working life, and between sustainable and unsustainable working life (7%). Among those born after 1958 (mean age 37 years, follow-up 10 years), four trajectories were detected for those with night work: stable sustainable working life (81%), stable unsustainable working life (6%) and increasing (7%) and decreasing (5%) sustainable working life. For those without nightwork, a three-trajectory solution was best: stable sustainable working life (83%), stable unsustainable working life (6%) and between sustainable and unsustainable working life (11%).

Conclusions

Sustainable working life was similar across baseline night work statuses of older cohort but differed in younger cohort. The findings suggest that at least night work at one time point does not affect sustainable working life. However, night work at early stages of working life could be accompanied with lifestyle counselling for sleep and recovery.

Key messages

• Trajectories of sustainable working life seem similar for those with or without night work adding to the understanding of effects of such work to health.

• From public health perspective, counselling employees with night work already at early stages of working life for health behaviours including sleep and recovery could support sustainable working life.
Work-related stress predicted future sick leave in primary health care patients
Authors: Hultén A-M , Bjerkeli P , Holmgren K
Published: October 2022

Background

Studying the relationship between work-related stress and sick leave is valuable in taking actions for workers’ health. This study aimed to analyse the association between work-related stress, measured with the Work Stress Questionnaire (WSQ), and registered sick leave among primary health care patients in Sweden.

Methods

The prospective longitudinal study included 232 patients who were non-sick-listed, employed, aged 18-64 years and sought care for mental and/or physical health complaints. Logistic regression analysis was performed with questionnaire data on work-related stress from baseline together with sick leave data from a national register for the following 12 months.

Results

High stress due to indistinct organization and conflicts was reported by 21% (n = 49), while 45% (n = 105) reported high stress due to individual demands and commitment. During 12 months 36% (n = 83) were on sick leave for 15 days or more. The odds of being on sick leave was twice as high for patients perceiving high stress due to indistinct organization and conflicts, high stress due to individual demands and commitment, low influence at work, or high interference between work and leisure time. Perceiving high stress due to both indistinct organization and conflicts as well as individual demands and commitment quadrupled the odds of sick leave, OR 4.15 (95% CI 1.84; 9.38).

Conclusions

Work-related stress and sick leave were prevalent among the patients. Primary health care can therefore be a suitable arena for addressing these issues. Perceiving work-related stressors and stress within one or multiple areas increased the odds of registered sick leave by two to four times. Hence, a wide spectrum of factors needs to be considered, to capture the dynamic interaction between the individual and the work environment.

Key messages

• Work-related stress is associated with future sick leave for primary health care patients.

• Early identification of patients with work-related stress is important for the primary health care.