bluuebunny/crossref_metadata_2025 huggingface dataset:
Defining neighborhood walkability for children in the ELFE cohort study
Authors: Parker D , Chazelas E , Melchior M
Published: October 2024

Background

Although walkability is known to be associated with obesity in adults, there is a paucity of data evaluating the association of walkability and health outcomes in children. In particular, little is known regarding the possible association with children’s mental health.

Methods

We used data from the Etude Longitudinale Française depuis l’Enfance (ELFE) cohort study. Participating mothers gave birth in 2011 in a representative sample of 320 maternity hospitals in mainland France. This pilot study is limited to participants in Paris and children at 5.5 years old. Walkability is defined by three parameters: population density (defined by census data), street connectivity (defined by intersection density), and land-use mix (entropy index). To approximate walkable areas, 500-meter street-network buffer zones were created around each participants address using a geographic information system. Children’s mental health was assessed using parent-reported Strengths and Difficulties Questionnaire at age 5.5 years.

Results

There was a total of 280 children in this pilot study. On measures of land-use mix, we found a mean of 0.79 (SD: 0.12), representing high accessibility. Residential and intersection density were highly correlated (p < 0.01). The walkability index demonstrated high variability among participants (mean: 10.6; SD: 10.44; range: -1.67 - 30.59).

Conclusions

Developing a walkability index is a multifactorial measure to describe a children’s neighborhood environment. Future work includes determining the association with children’s mental health disorders, while accounting for individual and neighborhood variables. This ecological model can inform social epidemiology and contextual disparities in children’s health.

Key messages

• Little is known about neighborhood walkability and the association with children’s mental health.

• Using objective measures to calculate neighborhood composition and help elucidate this relationship.
Unveiling loneliness: health determinants of feeling alone in the older urban residents
Authors: Kozela M , Ciochoń A , Pająk A
Published: October 2024

In older people health condition contributes to the feeling of being alone (loneliness). We aimed to assess which chronic health conditions are the strongest determinants of loneliness in older urban residents. Participants of the Polish part of the HAPIEE Study (Health Alcohol and Psychosocial Factors in Eastern Europe) examined in 2019-20 were included to the analysis. Trained nurses interviewed respondents in their homes. Loneliness was assessed using 3-item UCLA scale (range: 3-9, cuf-off≥ 6 points). Socioeconomic data, self-rated health (SRH) and the history of 18 diseases diagnosed by the doctor was assessed using standardized questionnaire. Multivariable logistic regression was used; odds ratios and 95% confidence intervals are presented (OR (95%CI)). There were 461 participants (48% males) of mean age 72 years (SD = 6.3). In 34 participants (7%) UCLA score was 6 or more. The majority (63%) of respondents were married or cohabiting. Nearly 90% declared having children. After adjustment for marital status and having children, poor distance vision 3.84 (1.31-6.12), hearing problems 2.20 (1.07-4.53), acute back pain syndrome 2.21 (1.06-4.59) and cancer 2.36 (1.03-5.41) were determinants of loneliness. Further adjustment for age weakened the association with distance vision 2.74 (1.26-5.94) and waved the relationship with hearing problems 2.06 (0.99-4.29). The estimates for remaining health conditions remained almost unchanged. The strongest predictor of loneliness was SRH. After adjustment for age, marital status, having children and objective burden of chronic diseases, compared to good SRH, participants with moderate and poor SRH were more likely to report loneliness by over 3 and 6 times: 3.41 (1.29-9.05) and 6.60 (2.16-20.18), respectively. The perception of poor health and diagnosis of cancer strongly determined loneliness in older people, but other important predictors of loneliness were conditions that objectively hinder maintaining social contacts.

Key messages

• In older people health condition is related to the feeling of being alone, and the strongest objective health determinant of loneliness was diagnosis of cancer.

• Independently of objective burden of chronic diseases, self-rated health was a significant predictor of loneliness in older urban residents.
Narrowing socioeconomic inequalities in coronary heart disease: insight from Mendelian randomization
Authors: Xu X , Fu J , Wu F , Xu W
Published: October 2024

Background

Socioeconomic inequalities in coronary heart disease (CHD) represent a pressing global public health concern. However, which dimensions of socioeconomic status (SES) affect CHD and the potential modifiable mediators remain elusive.

Methods

We performed two-sample Mendelian randomization (MR) analyses based on summary data from large-scale genome-wide association studies in populations of European ancestry. Specifically, by applying bidirectional univariable MR (UVMR) and multivariable MR (MVMR), we investigated the causal relationships of education, occupation, income, Townsend deprivation index (TDI) with CHD and the independent effects of these SES indicators. We further employed a two-step MR to comprehensively profile the mediating effects of 23 behavioral, 3 psychological and 5 biological factors in the relationships.

Results

An independent causal association was observed between genetically predicated education and CHD, with a 30% lower risk of CHD (OR: 0.70; 95% CI: 0.53-0.93) for each 4.2-year of schooling. Each one-s.d. higher household income was causally, but not independently, associated with a 39% lower risk of CHD (OR: 0.61; 95% CI: 0.49-0.77). No significant causal association was suggested for occupation and TDI with CHD, and no reverse causal effect was observed for CHD on the SES indicators. Of 31 candidate mediators, nine factors mediated the effect of education on CHD significantly, with an individual mediation proportion of 33.5% for smoking, 29.2% for sedentary behaviour, 14.4% for blood lipids, 13.4% for BMI, 11.7% for systolic blood pressure, 9.5% for diastolic blood pressure, 7.8% for well-being spectrum, 6.4% for depression and 2.8% for blood glucose.

Conclusions

This study highlights that education was the primary SES indicator affecting CHD with considerable mediation by a number of modifiable risk factors. These findings inform policies to mitigate disparities of CHD risk attributable to socioeconomic inequalities.

Key messages

• Education can be prioritized over other common SES indicators as an essential strategy to reduce the burden of CHD.

• Interventions for narrowing socioeconomic inequalities in CHD could focus on more easily modifiable mediating factors.
Excess all-cause mortality in 21 countries during 2022: COVID-19 impact by C-MOR project
Authors: Pallari C T , Achilleos S , Quattrocchi A , Bennett C M , Ambrosio G , Polemitis A , Charalambous A , Demetriou C A
Published: October 2024

National published COVID-19 mortality estimates do not fully encompass the extent of the pandemic’s impact on mortality. To address this challenge, calculating excess all-cause mortality at the national level is important. Our focus was on understanding total weekly excess mortality for 2022, by analysing mortality data across 2020-2022, from 21 countries participating in the international consortium (C-MOR), which provided data for examination. Excess mortality was calculated by comparing the weekly 2022 age-standardized mortality rates per 100,000 population against a baseline mortality, estimated using historical data from 2015-2019. Excess cumulative mortality for 2022 was found in all 21 countries. The excess mortality for the total population varied between 8.6 and 116.2, with the minimum excess belonging to Peru and the maximum to Georgia. Australia, Austria, Cyprus, Denmark, Estonia, Georgia, Greece, Israel, and Norway showed a higher excess in 2022 than in 2020, while Australia, Austria, Cyprus, Denmark, Israel, Italy, Norway, Spain, and Sweden also showed a higher excess in 2022 than in 2021. Mauritius showed a significant excess mortality for the first time in 2022. For all countries, but Australia, the % of COVID-19 deaths out of all deaths decreased in 2022 compared to 2021. Contrary to the ‘harvesting effect’, which would expect a decline in mortality rates post-pandemic, our results underscore a sustained excess mortality throughout 2022. The 2022 excess deaths are mainly non-COVID-related, stemming from broader pandemic impacts on healthcare systems and other factors. Conversely, in Australia, international boarders reopened in 2022, resulting in the first community-wide transmission and a substantial rise in excess deaths. Our study reveals nuanced excess mortality dynamics post-vaccination, providing crucial insights for policymakers and stressing the necessity of continued vigilance and adaptive strategies against COVID-19’s diverse impacts.

Key messages

• All countries investigated experienced continued all-cause excess mortality during 2022, compared to pre-pandemic years. For most, excess mortality in 2022 was higher than in 2021 and 2020.

• For all countries, except Australia, the contribution of COVID-19 deaths to the mortality estimates in 2022 is decreased, highlighting the impact of indirect pandemic related effects on mortality.
Epidemiology of Dementia in the Campania Region (Italy): A 2015-2020 population-based study
Authors: Affinito G , Triassi M , Brescia Morra V , Palladino R , Salvatore E , Moccia M
Published: October 2024

As the global population ages, dementia poses a significant health challenge, ranking seventh among leading causes of death worldwide. Considering the high societal and financial burden of dementia, our study aims to provide estimates of prevalence and incidence for any dementia and Alzheimer’s dementia (AD) in the Campania Region (South Italy). It is Population-based study, using routinely collected healthcare data of individuals living in the Campania Region (South Italy) from 2015 to 2020. We included individuals aged ≥65 years who had at least one administrative record for dementia and/or AD. Prevalence rates adjusted for age and sex used 2020 European population as reference. To estimate incidence, we tested three possible algorithms, which differed for the duration of the time interval between study baseline (Jan 1, 2015) and index date (first record for dementia and/or AD in administrative databases). We employed a clinical database for the validation of our algorithms towards neuropsychological test results. Among individuals, 80,392 had dementia, of which 35,748 had AD. The age- and sex-standardized prevalence rates per 1,000 individuals for any dementia and AD were 77.64 (95%CI=77.57; 77.68) and 34.05 (95%CI=34.01; 34.09), respectively. There were 82.10 incident cases of any dementia per 100,000 per year (0.79 sensitivity and 0.62 specificity), and 59.89 incident cases of AD per 100,000 per year (0.80 sensitivity and 0.59 specificity). The capture-recapture method showed low number of undetected cases (1.7% for any dementia and 3.0% for AD). Our algorithms showed acceptable performance with AUC ranging from 0.59 to 0.72, and double likelihood ratio of correctly identifying individuals above and below MMSE standard cut-offs (24 and 26). Our algorithm, integrating administrative and clinical data, holds potential for assessing dementia’s epidemiological burden, identifying risk factors, planning healthcare access, and developing prevention strategies.

Key messages

• Providing comprehensive estimates of dementia burden aids public health planning and resource allocation.

• Integrated administrative and clinical data provide robust tools for epidemiological analysis and preventive strategies.
SINAVE’s quality: completeness for Meningococcal Disease – Northern Portugal, 2020-2022
Authors: Rodrigues A , Mouta F , Vieira M , Vidal-Castro J , Mendes A , Cruz-Alves G
Published: October 2024

Due to Meningococcal’s Disease (MD) severity and impact in public health, in Portugal it is mandatory to notify the suspicious cases to implement effective control measures. MD cases are notified in the National Surveillance System (SINAVE), which triggers epidemiological investigation, risk assessment and community intervention. The quality of SINAVE is defined by various attributes, being their evaluation crucial to improve and guarantee quality standards. Our goal is to evaluate the external and internal completeness of SINAVE for MD in northern Portugal from 2020 to 2022. We have conducted a cross-sectional study, using MD cases from 2020 to 2022. External Completeness was estimated using a two-source capture-recapture method, with data from SINAVE and Diagnostic-Related Group (DRG) cases. Hospital readmissions’, duplicates and cases from other regions were excluded. Internal completeness of SINAVE was accessed for each case and for each non-mandatory variable. For external completeness (EC) analysis, 21 of the 23 DRG cases were eligible for matching. Out of 31 SINAVE confirmed cases, 20 were eligible for matching. EC of SINAVE was 66,7%. For internal completeness (IC) analysis, we excluded 7 cases that did not meet the criteria for inclusion. The mean IC was 73,5% (min 38,5%, max 85,7%) when analysing by case. When assessing each of the 30 non-mandatory variables of the reports, 7 (23,3%) had an IC of 100% and 13 (43,3%) had an IC of 0%, the mean value was 49,7%. SINAVE assessment, as a routine, is crucial to identify the need for improvement. Completeness is fundamental to ensure an effective public health response. Our results confirm under-reporting and incomplete report of MD. There is a need to strengthen the improvement of data quality of SINAVE. Future studies may be important to estimate true incidence of MD and compare the results for other diseases in order to improve public health actions.

Key messages

• Meningococcal disease requires timely public health intervention.

• valuation of the surveillance system is crucial, with completeness playing an important role for data quality and prompt response.
Molecular surveillance of A. baumannii in intensive care units: exploration of transmission chains
Authors: Ceparano M , Capitani V , Rondòn S , Migliara G , Baccolini V , Marzuillo C , Villari P
Published: October 2024

Background

Multidrug-resistant Acinetobacter baumannii (MDR-Ab) is one of the main causes of healthcare associated infections (HAIs). During the SARS-CoV-2 pandemic there was an increase in MDR-Ab infections, especially in intensive care units (ICUs). This study aimed to assess the potential spread or emergence of specific clusters of MDR-Ab across four different ICUs at the Umberto I teaching hospital of Rome.

Methods

From January 2020 to January 2022 microbiological surveillance was conducted in four ICUs: two dedicated to COVID-19 patients (ICU-1C, ICU-2C) and two to non-COVID-19 patients (ICU-1R, ICU-2R). The genetic relatedness between A. baumannii isolates was assessed using pulsed-field gel electrophoresis (PFGE). Illumina whole genome sequencing was conducted on 26 representative isolates.

Results

In total, 178 A. baumannii isolates were obtained from 129 COVID-19 patients and 49 non-COVID-19 patients. The isolates were classified into 17 PFGE pulsotypes, being two major (A, B) and five intermediate (C, D, E, H, Q). Clone A was present in all ICUs, while Clone B was present only in ICU-1C and ICU-2R. Overall, 117 isolates belonged to clone A and exhibited a MDR phenotype; all of them were placed within the international clonal lineage II. All isolates showed carbapenems resistance primarily attributed to the presence of the blaOXA-23 gene, while aminoglycosides resistance observed in almost all isolates was attributed to the presence of the armA gene. Small outbreaks involving intermediate pulsotypes were detected between ICU-1R and ICU-2R, ICU-1C and ICU-2R, ICU-1C and ICU-2C, ICU-1C and ICU-1R.

Conclusions

The observed outbreaks could be attributed to a decline in attention to normal care practices for the prevention of HAIs during the COVID-19 pandemic, favouring the spread of MDR-Ab. Therefore, it is recommended the strengthen of control measures and the implementation of long-term strategies targeting MDR microorganisms in the ICUs.

Key messages

• Acinetobacter baumannii was frequently found infecting patients across four different ICUs at the Umberto I teaching hospital of Rome.

• Acinetobacter baumanni outbreaks and multidrug resistance were observed. Therefore, the implementation of long-term strategies targeting MDR microorganisms in the ICUs is highly recommended.
Factors associated with actinic keratoses in people with albinism in the Albivoire program
Authors: Coulibaly F D , Dassi Tchoupa Revegue M H , Amani KLWG , Lauressergues E , Lenaud S , Garette B , Przybylsky C , Kouamé K
Published: October 2024

Background

People with albinism (PWA) face health inequalities partly due to barriers in accessing health care, consequently delaying the diagnosis of skin precancerous and cancerous lesions. Actinic keratoses (AK), are common precancerous lesions, indicating a high risk of skin cancer. Given the scarcity of research on skin cancer prevention among PWA in Africa, this study aimed to determine the prevalence and factors associated with AK in PWA followed in the Albivoire program.

Methods

This cross-sectional analytical study was conducted within the ongoing Albivoire program in Ivory Cost. Initiated in Ivory Coast in 2021, Albivoire is the largest comprehensive preventive and care initiative with and for PWA, offering medical consultation campaigns in dermatology, ophthalmology, and psychology. Dermatological records of consenting patients were analyzed. The prevalence (95%CI) of AK was estimated, and the associated factors assessed using logistic model.

Results

To date, a total of 1978 PWA received care across four regions (Abidjan, Bouaké, Korhogo and Man). Available data from 475 PWA were analyzed, among whom 247 (52%) were women. The median age was 14 years (interquartile range [IQR]: 7-25). Of these, 181 individuals (38.1%, 95% CI [33.7 - 42.6]) presented with actinic keratoses (AK). The median age of PWA with AK was 22 years (vs 11 years for without AK (p < 0.001). Among PWA with AK, 87.8% were daily exposed to sun (vs 12.2% for those exposed occasionally, p = 0.026). In the multivariate analysis, factors significantly associated with AK included age 22 years or older (vs age < 22 years, aOR=4.83, p < 0.001), the presence of ephelides (vs absence; aOR=2.08, p = 0.003) and presence of xerosis (vs absence aOR=4.88, p < 0.001).

Conclusions

This study highlights the high prevalence of AK in PWA in Ivory Cost, and identifies specific modifiable associated factors which should be targeted in global health strategies to prevent skin cancer among this vulnerable population.

Key messages

• Prevalence of skin precancerous lesions (actinic keratoses) in people with albinism in Ivory Cost is high (38%) and associated with modifiable risk factors.

• Tailored public health interventions needed to prevent skin cancers in vulnerable populations, targeting lesions like xerosis, ephelides, and actinic keratoses through skin protection.
Comparing statistical forecasting methods for modelling respiratory virus healthcare demand
Authors: Earl R , Baguelin M , Van Leeuwen E , Lopez-Bernal J , Ferguson N
Published: October 2024

Background

Emergency departments in the United Kingdom are under sustained pressure with rising demand for healthcare, gradually decreasing the functionality of the NHS. Forecasts can aid management in the allocation of appropriate healthcare supplies and staffing needs in advance of an expected surge, as well as allow stakeholders to assess most likely outcomes and potential worst-case scenarios. This is especially valuable during the seasonal waves of respiratory infections. Respiratory viruses are usually concentrated in a 6-8 week seasonal surge during the winter period, creating large pressure on the health system. Current forecast models’ performance depreciates significantly after 1 week. This analysis will forecast 6 weeks of respiratory health admissions, comparing traditional and newly emerging forecasting methods.

Methods

Using 20 years of English hospital admissions data, we evaluated both within season training models (2-20 weeks) and longer term seasonal models (1-10 years), to forecast 6 weeks of hospital admissions. Respiratory admissions were defined according to ARI/ILI ICD10 codes assigned in hospital, stratified by age and region. Models were iteratively constructed, trained and probabilistic forecasts were evaluated across the respiratory season of September to April using Weighted Interval Score. Averages of each model across iterations were generated for comparison.

Results

For non-seasonal models, shorter model training lengths created better forecast models for 6 weeks. For seasonal models, optimal training length varied across model complexity. Simple models performed best at forecasting 1 week, however performance deteriorated the most as the forecast window increased. Overall, the Prophet model performed best on average at forecasting 6 weeks across all scenarios.

Conclusions

Applying our framework for optimal model selection in forecasting analysis will help to inform better practice for future health demand modelling.

Key messages

• This analysis will inform better practice for future health demand forecasting 6 weeks in advance, allowing for preparation of resources for seasonal surges in healthcare demand.

• This analysis suggests using models with modest levels of increased complexity over simpler models could significantly improve forecast performance in the short-medium term.
Memory impairment after one year of the acute episode of Covid-19 infection
Authors: Zemni I , Kacem M , Bennasrallah C , Dhouib W , Ben Fredj M , Abroug H , Ben Rached N , Mhalla A , Bouanene I , Sriha A
Published: October 2024

Introduction

Memory impairment is one of the most frequently reported sequelae of COVID-19 infection. The aim of our study was to estimate the risk of memory disorders one year after the acute episode of COVID-19 infection in the Tunisian population of Monastir.

Methods

This is a cohort study conducted in Monastir University Hospital. The study included two groups: Exposed subjects were randomly selected among those with a positive diagnosis of COVID-19 between September 2021 and January 2022. The non exposed group was selectd among subjects with a negative COVID-19 diagnosis during the same period and who had no COVID infection during the following year. The Mac Nair scale was used to assess memory impairment after one year of follow up.

Results

Our study included 140 subjects diagnosed with Covid-19 and 139 subjects who had never been in contact with this virus. The incidence rate of memory impairment at one year post-Covid-19 infection was 17.9% (IC95% [11.5 - 24.2%]), whereas in the non exposed group it was 9.4% (IC95% [4.45% -14.5%]). Multivariate analysis revealed that the group exposed to Covid-19 had a significantly higher Mac-Nair Total score after one year of the acute episode of infection compared with the non exposed group (exp β = 1.25, IC95% [1.10; 1.42]). The other main predictors of memory impairment in the study population were age (exp β = 1.006, IC95% [1.001; 1.01]), diabetes (exp β = 1.67, IC95% [1.44; 1.95]), history of anxiety and depression ((exp β = 1.71, IC95% [1.35; 2.17]) and obesity (exp β = 1.25, IC95% [1.10; 1.42]), whereas vaccination with two or more doses prior to COVID-19 infection (exp β = 0.84, IC95% [0.74; 0.96]) and male gender (exp β = 0.65, IC95% [ 0.57; 0.73]) were found to be protective against these disorders.

Conclusions

Our study allowed us to estimate the risk of long-term memory disorders following Covid-19 infection. This could help better guide preventive measures to reduce the incidence of these disorders.

Key messages

• The incidence rate of memory impairment at one year post-Covid-19 infection was 17.9%.

• The main other predictors of memory impairment were age, female gender, diabetes, history of anxiety and depression and obesity whereas vaccination prior to COVID-19 infection was a protective factor.
Trends in diabetes morbi-mortality and its association with abdominal obesity among Tunisian adults
Authors: Zribi M , Zoghlami N , Elati J , Traissac P , Aounallah-Skhiri H
Published: October 2024

Introduction

Tunisia is undergoing rapid nutritional transition, with increasing rates of abdominal obesity. Coupled with rising diabetes prevalence, it poses significant challenges to public health. This study aimed to estimate the morbi-mortality prevalence and trends of diabetes among Tunisian adults, particularly examining its association with abdominal obesity.

Methods

We conducted a secondary data analysis on adults aged 35 to 70 from three national surveys in Tunisia, in 1996 (n = 3513), 2005 (n = 7700), and 2016 (n = 6007) respectively. Mortality data was sourced from the Tunisian National Information System on Causes of Death in 2020. The underlying cause of death was determined using the IRIS software, following WHO guidelines for tabulating mortality statistics. Diabetes was defined according to the American Association of Diabetes criteria. Abdominal obesity was defined as a waist-to-height ratio ≥ 0.6. We performed chi-squared test for trend analysis.

Results

A total of 17220 participants were analyzed. We found a significant upwards trend in diabetes prevalence (p < 10-3): it increased from 13.1%[11.9-14.3] in 1996 to 15.1% [12.5-17.4] in 2005, then to 20.5%[18.9-22.1] in 2016. Linear trend test concluded to significant increase in diabetes prevalence estimated at 56.6% in two decades. Diabetes was significantly associated with abdominal obesity (Odds ratio (OR)=2.17[2.11-2.21]). Diabetes was the leading cause of death among Tunisian adults in 2020 (n = 22715). The proportional mortality due to diabetes was estimated at 6.2% (n = 1407) (6.4% for men and 6% for women). The age group with the highest proportional mortality due to diabetes was 65-70 years old (44.6%).

Conclusions

Our findings highlight the burden of diabetes on public health in Tunisia and its association with abdominal obesity. Hence the urgency to strengthen comprehensive preventive and control measures to alleviate its repercussions among the Tunisian population.

Key messages

• The prevalence of diabetes increased significantly amongTunisian adults in the past two decades.

• Immediate implementation of targeted interventions and policy measures is imperative to effectively address this issue.
Resistance Profiles of the ESKAPEE Complex at Veracruz’ s Children Hospital, 2023
Authors: Ceballos Vela M , Marín Vargas J A , Castillo Ceballos C E , Villegas-Dominguez J E , Sosa Gonzalez Y R , Bravo Sarmiento E , Alba Aburto D E
Published: October 2024

Introduction

ESPAKEE complex bacteria are well known as a Multidrug Resistance Organisms that cause difficult mange infections. Management of these infections should be based on the monitoring of resistance profiles to provide appropriate therapy to reduce hospitalization costs and patient improvement.

Materials and methods

A cross-sectional, retrospective, descriptive study analyzed 179 ESKAPEE bacteria isolated from pediatric patients (0-18 years) between January 1 and December 31, 2023. Laboratory tests utilized VITEK 2.0 technology, reporting Minimal Inhibitory Concentration (MIC) and classifying them as resistant or non-resistant. Descriptive statistics were generated using SPSS v22.

Results

The study included 179 antibiograms. Among Enterobacter species, E. aerogenes (3) and E. cloacae (17) showed 100% resistance to cefalotin. S. aureus (22) exhibited the highest resistance to Oxacillin (36.4%). Klebsiella pneumoniae (40) demonstrated 97.5% resistance to Ampicillin, followed by resistance to first-generation cephalosporins: cefalotin 62.5%, and third-generation cephalosporins: ceftriaxone and ceftazidime both at 60%. Acinetobacter baumannii (9) showed 100% resistance to Fosfomycin. Pseudomonas aeruginosa (30) displayed 100% resistance to Ceftriaxone, Cefotaxime, and Cefuroxime. Enterococcus faecium (2) exhibited 100% resistance to ciprofloxacin, erythromycin, ampicillin, and levofloxacin, while Enterococcus faecalis (16) showed 50% resistance to tetracycline. E. coli (39) exhibited the highest resistance to Ampicillin (87.2%), while in first-generation cephalosporins: cefalotin 66.7%, third generation: cefotaxime 66.7%, ceftazidime 64.1%, and ceftriaxone 66.7%.

Conclusions

The ESKAPEE complex species isolated in the hospital displayed diverse resistance profiles against various antibiotic families.

Key messages

• Monitoring ESKAPEE bacteria’s resistance profiles enables physicians to select appropriate antibiotics at optimal dosages and timings.

• Physician should know the rate of resistance of the antibiotics that they use for treatment of ESKAPEE bacteria.
Long-Term Impact of Infertility and Assisted Reproductive Technology on Cardio-Renal Health in Sweden
Authors: Mezzoiuso A G , Ye M , Noto M E , Henriksson P , Rodriguez-Wallberg K , Rado M , Öberg A S
Published: October 2024

Background

The use of Assisted Reproductive Technology (ART), such as in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI), is rising in Europe. These treatments involve high doses of hormones to increase oocyte collection. While most safety studies in women have focused on cancer risks, the association with cardio-renal diseases remains under-explored. This study examines whether the use of ART is linked to coronary ischemic disease (CHD), stroke, brain hemorrhage, other cerebrovascular diseases, chronic kidney disease, and aortic aneurysm/dissection, while also exploring the association between infertility and these conditions.

Methods

A nationwide cohort study was conducted using Swedish national registries, following all nulliparous women who gave birth between 1982 and 2002 until the end of 2017. Descriptive statistics and inverse probability weighted Kaplan-Meier curves to adjust for body mass index, maternal age, country of origin, smoking, and year of delivery, were used to compare 1) women who conceived with or without ART, 2) women who used IVF or ICSI respectively to women with known infertility that conceived without ART, and 3) women with and without known infertility.

Results

Compared to all other women, women undergoing ART were at elevated risk for CHD, stroke, and other cerebrovascular diseases, but after adjustment for underlying risk factors, including infertility, no substantial differences were seen. As a group, women with known infertility were at elevated risk of CHD and stroke, also after adjustment for known background factors.

Conclusions

Data suggest that the use of ART does not increase the long-term risk of cardio-renal diseases. Nonetheless, infertility itself is associated with a higher risk of CHD and stroke.

Key messages

• Infertility, more so than the use of ART, is linked to elevated risks of CHD and stroke.

• Preventive measures for these conditions should be considered for women with infertility.
Health symptoms in individuals with and without post-covid in the Dutch general population
Authors: Gerbecks J , Yzermans C J , Duckers M , Baliatsas C
Published: October 2024

Background

Health symptoms, often non-specific in nature such as headache and sleep problems, are more prevalent in the aftermath of disasters. Relatively little research focused on non-specific symptoms in the context of the COVID-19 pandemic, including those with post-covid conditions. The aim of this study was to assess the symptomatic profile of people with post-covid conditions, and to assess differences in health symptoms between non-infected individuals, infected individuals, and individuals with post-covid.

Methods

A nation-wide cross-sectional health survey performed in 2022 was combined with routine primary care electronic health records (EHRs). Prevalence of individual symptoms was analyzed, as well as symptom scores for number, duration, and severity of symptoms. The total survey sample consisted of 315,586 individuals. The EHR sample consisted of 29,797 individuals with matched survey data. Both samples were divided into three groups: non-infected, infected, and post-covid.

Results

Survey participants with post-covid experienced significantly (CI 99%) more (incidence risk ratio (IRR) 1.55), longer lasting (IRR 1.87), and more severe self-reported symptoms (IRR 1.95) compared to non-infected individuals. For infected compared to non-infected survey participants, there were hardly differences in symptom scores. The most distinct differences in individual symptoms were observed for loss of smell or taste, fatigue, and respiratory problems. Based on EHR data, the post-covid group is at significantly higher risk of experiencing fatigue, shortness of breath, headache, sleep problems, and dizziness.

Conclusions

Individuals suffering from post-covid are at the highest risk of experiencing health symptoms, both based on self-reported symptoms as well as based on EHRs. The infected group generally experienced more self-reported symptoms than the non-infected, but on average, they experienced them at a shorter duration, and they also reported them to be less severe.

Key messages

• Health symptom prevalence is higher in individuals with post-covid in the Netherlands.

• This effect is confirmed in self-reported health surveys as well as in primary care registries.
Human Rights System Guidelines on the Benefit from Scientific Progress in Access to Medicines
Authors: Ventura da Silva M
Published: October 2024

Health innovation and research has become an economic and profitable activity. Market practices have exposed inequalities, scarcities and inequities in access to treatments and have significantly reduced the decision-making power of governments in the field of public health. Documentary research on the human right (HR) to health (Art. 12) and its interrelationship with the right to benefit from scientific progress (Art. 15, b) of the International Covenant on Economic, Social and Cultural Rights (CESCR) on access to medicines in three bodies of the UN system - the ICESCR Monitoring Committee (CESCR), the Human Rights Council (HRC) and World Health Organisation - over the last 10 years. The documents address three main topics. Market: marketing restrictions, price controls and using flexibility in pharmaceutical patents to reduce costs and produce generics. Innovation: patent protection without barriers to access to medicines for people in need. Health system interventions: giving priority to economic efficiency and sustainability by institutionalising health technology assessment, selecting essential medicines, developing clinical guidelines and integrating and linking regulatory agencies. These normative guidelines minimise the ethical, political and legal dimensions of the human right to enjoy scientific progress in access to medicines as a priority value that should guide public and private action, and emphasise technocratic and financial measures that seek to reconcile the liberal and social logic of the ICESCR.

Key messages

• In order to maximise the guarantee of human rights in access to medicines, economic and financial considerations should play only a residual role in human rights.

• To give countries greater decision-making power at the global health, the scope of the right to benefit from scientific progress and its applications in health care needs to be expanded.
Ethics in social listening in infodemic management in health emergencies
Authors: Machiri S , Purnat T , Ishizumi A , Nguyen T , Von Harbou K , White B , Emiroglu N , Germani F , Spitali G , Reis A
Published: October 2024

Issue

During the COVID-19 pandemic and subsequent outbreaks, health organizations have increased the use of social listening to inform infodemic management and outbreak response activities. This demonstrated the need to provide ethical guidance to organizations, and individuals engaging in social listening practices before, during and after public health emergencies, whilst protecting human rights.

Description of the problem

Social listening as a public health activity draws on analysis of conversations in social media, internet platforms, and feedback from geographically localized communities. Infodemic insights are generated rapidly, to support agile action by health organizations that improves outbreak response, health information delivery, community engagement, or reduction of unintended harm experiences by communities. Social listening involves use of social media and internet trace data, which were traditionally not used in public health for understanding community expressions, WHO convened a panel of experts to develop a framework on ethical considerations for social listening in infodemic management to provide recommendations for health authorities and researchers on practical tools that support setting up new data analysis and use of insights hereto not used in routine.

Results

The guidance framework has been structured into segments that vary from ethical principles and challenges in social listening and generation of infodemic insights, alignment with human rights, substantive principles, procedural principles, and practical guidance for translating these principles into real-world practice.

Lessons

This guidance aims to illuminate the intricate ethical dimensions of social listening and stress the urgent need for ethical guidance in this realm. The framework is a comprehensive inquiry of the ethical scope in social listening, providing valuable insights, practical guidance, and case studies to enhance understanding of this critical global health issue.

Key messages

• While essential, social listening and infodemic insights come with ethical risks, including potential harm to populations in vulnerable situations, erosion of trust, and misuse of data.

• This ethical framework will govern social listening practices and ensure responsible and ethical social listening.
Reviewing and assessing emerging trends and needs for research, development and innovation (RDI) and capacity building in a short, medium and long-term perspective
Authors: Baron R , Hansen J
Published: October 2024

An important aim of the Partnership is to identify current and future health services and systems priorities and to identify capacity building and training needs to support RDI activities in health and care systems in the Partnership countries and the EU as a whole. This is being done by means of periodical reviews, among others building on scientific research literature, strategic and policy documents and consultations of stakeholders. At the conference workshop, results of the mapping are presented, with a special focus on priority areas that can contribute to health systems transformation towards sustainable and people-centred health and care systems accessible to all. The session will allow participants provide reflections on and refinements to potential common priorities across national RDI agendas. This will provide direction for future research calls, based on an inventory of priorities that are considered by both policy audiences, research and wider stakeholder communities that should be addressed at EU and national levels.
The corporate political activity of the food industry in Ireland: an analysis and proposed solutions
Authors: Campbell N , Finucane F , Walsh M , Reilly K
Published: October 2024

Background

The study consisted of mapping the corporate political activity (CPA) of the food industry in Ireland. Following that study, we plan to benchmark the efforts made by the Irish government to address any undue corporate influence on public health policy.

Methods

We followed the INFORMAS methods for studying the food industry’s CPA (document analysis) and analysed the key commercial actors in Ireland and their activities over a 24-month period. We also conducted nine semi-structured interviews with key informants.

Results

We found a total of 147 CPA occurrences during the period of analysis. That data was triangulated and completed with information shared by our participants. We found examples of the food industry lobbying the government, shaping scientific evidence, and framing the problems and solutions on diet in ways that would not harm the industry. IBEC, a trade association, and the dairy sector were particularly active in trying to influence public health in Ireland.

Conclusions

Our study shows that the food industry uses its CPA to influence public policy, research, and practice in Ireland. The next step for our project will be to benchmark the Irish government against international standards for its efforts to limit the negative effects of the CPA on public health policy.

Key messages

• In Ireland, as in other countries, the food industry uses its CPA to interfere with public health policy, research and practice.

• There is a need to address that influence, and we will benchmark the efforts of the Irish government in trying to limit the CPA, against international standards.
Revealing the influence of food industry actors in relation to nutritional policies in Belgium
Authors: Cnockaert S , Vandevijvere S
Published: October 2024

Unhealthy food is one of the prevailing risk factors of NCDs and cancers, making the food industry a key player in their prevention. However, evidence-based public health policies aimed at reducing consumption of unhealthy food, may threaten industry sales. In response, food industry actors try to influence the development and implementation of these nutritional policies by engaging in corporate political activities (CPA). As part of the Joint Action PreventNCD, the CPA of relevant food industry actors in relation to public health nutritional policies will be assessed. In Belgium, strategies of Fevia, the umbrella organization of the food industry, are examined. This study analyses publicly available information collected from Fevia’s website, social media accounts (i.e. X and LinkedIn), newsletters and newspapers. A thematic qualitative analysis is conducted using established frameworks to categorize both framing and action strategies used by the industry. The categorization of framing strategies reveals how the food industry presents the actors, problems, and solutions. The framework of action strategies categorizes the CPA of the food industry under the following six strategies: information and messaging; financial incentives; constituency building; legal action; policy substitution; opposition fragmentation and destabilization. Preliminary results indicate that the industry often frames itself as ‘the good actor’ and primarily uses strategies such as ‘information and messaging’, ‘constituency building’ and ‘policy substitution’ to influence policies in Belgium in their favor. In the next phase, interviews with stakeholders (e.g. policymakers, politicians,...) will be performed to collect undocumented information. Overall, this research sheds light on the ongoing CPA of the food industry and will increase transparency in their influence on the development and implementation of effective nutritional policies aimed at reducing the burden of NCDs and cancers.

Key messages

• This study reveals how the umbrella organization of the food industry in Belgium influences public health nutritional policies through various corporate political action and framing strategies.

• Identifying these CPA increases awareness of the industry’s influence, but also promotes their transparency and accountability, which is crucial for reliable and effective nutritional policy.
Enhancing policy impact: Bridging evidence to action
Authors: Fragny C , Delattre V , Samoila M , Stefan A , Da-Cruz L , Cucu I , Lazar S , Rus A , Ungureanu M
Published: October 2024

The aim of the THCS partnership, regarding bridging evidence to policy, is to develop evidence-based cooperation strategies that enable policymakers in partner countries to base their decisions on validated and reliable knowledge. This approach aims to drive meaningful transformation in our health and care systems collectively. Facilitating knowledge exchange and mutual learning among policymakers is key to achieving this goal. THCS seeks to foster the sharing of experiences, best practices, and lessons learned, and ultimately design tailored tools to ensure policymakers are aware of existing resources and opportunities for effective policy development. During the workshop, the presentation, discussions, and activities will focus on two main issues: identifying who should be considered a policymaker and determining the necessary tools to develop evidence-based strategies. Participants are encouraged to explore how evidence-based strategies can be translated into policy actions and integrated into practice at various levels of the health system, from local to national and European levels.
Avoiding hedonic contrast to increase acceptance of healthy sustainable school meals
Authors: Kokkorou M , Dinnella C , Spinelli S , Wollgast J , Maragkoudakis P , Monteleone E
Published: October 2024

To promote sustainable eating in schools, new approaches for embracing plant-based (PB) meals are needed. Hedonic contrast (HC) describes how liking for one item is influenced by the recent experience of other items of different hedonic valence. Despite its established impact on liking, HC’s effect on intake, particularly in repeated exposure experiments, is limited. Moreover, its effect on food-related emotions remains largely unexplored. Hence, this study investigated how HC influences liking, emotions and intake of an innovative co-created PB dish, served as part of a course meal, at school in a repeated exposure study. Two groups of students (N (HC) =71, mean age=14.5 and N (control) =57, mean age=15.3) were served the same neutrally liked main PB dish (pumpkin stuffed lentils balls (LPA)) after a starter dish (rice with vegetables) which was altered in taste through seasoning and cooking methods to be more (HC) or less (control) tasty. The exposure was repeated once/week for 5 consecutive weeks. Liking and emotional responses for the dishes were recorded through a questionnaire and food consumption by weighting plate waste. HC led to lower liking (p = 0.037) and lower positive emotions (cheerful, pleasure) with high arousal (surprise) for LPA, while increasing negative valence emotions (disappointed). Moreover, LPA consumption was significantly lower in the HC group vs the control (45% vs 60% respectively, p = 0.040), resulting in lower protein intake in the HC group (p = 0.029). The effects of HC remained stable with time. This study, for the first time, reveals a sustained rise in food-related positive high arousal emotions, when foods are presented following less liked food. Since new foods evoking positive valence and high arousal emotions have higher chances to be appreciated than foods evoking positive valence and low arousal emotions, this work opens new perspectives on how to propose new, healthier and more sustainable PB dishes in school canteens.

Key messages

• Avoiding negative contrast between school meals is a promising strategy to ensure higher liking, intake and increased positive emotions over repeated exposure for innovative plant-based dishes.

• To enhance adolescent’s acceptance and uptake of new plant-based dishes in school canteens, it is better to serve them after less tasty options.