bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mortality trends for multiple sclerosis in Italy
Authors: Gori F , Kundisova L , Bezzini D , Martini A , Giovannetti L , Chellini E , Nante N , Messina G , Battaglia M A 
Published: November 2019

Abstract

Background
Multiple sclerosis (MS) is the immune-mediated inflammatory disease affecting myelinated axons of the central nervous system with enormous socio-economic impact. The aim of this study was to analyze mortality trends for MS in Italy.

Methods
The mortality data relative to period 1980-2015 were provided by Italian Institute of Statistics, data were aggregated in 5 intervals (1980-1986; 1987-1993; 1994-2000; 2001-2008; 2008-2015). The Age-Standardized mortality Rates (SR) with respective 95% confidence intervals (95%CI) were calculated (using the European standard 2013) in order to evaluate the mortality trends (in confrontation to the initial period) and Standardized Mortality Ratios (SMR), in order to confront mortality in 5 major geographic areas: North-East (NE), North-West (NW), Central Italy (CI), South Italy (SI) and Islands (I).

Results
During the study period 4959 deaths for males and 7433 for females were observed. The SRs were significantly higher for females (0.71;95%CI:0.70-0.73 vs. 0.56; 95%CI:0.54-0.57).
Significantly higher SMR were observed for both sexes in I (M:123.3 vs F:112.7), for females also in NE (106.5) and NW (115.8). Significantly lower SMR for both sexes were observed in SI (M:88.8; F:71.4) and for males in CI (90.9).
The observed SRs during the five intervals for males were: 0.65(95%CI 0.60-0.69); 0.52 (95%CI 0.49-0.56); 0.46 (95%CI 0.43-0.49); 0.53 (95%CI 0.49-0.56); 0.59 (95%CI 0.56-0.62); and for females: 0.69 (0.65-0.73); 0.69 (0.65-0.73); 0.61 (0.58-0.65); 0.68 (0.65-0.72); 0.81(0.77-0.84); respectively. An initial decrease of SRs was observed for males until 2001-2007 in confrontation to the initial period (p &lt; 0.05). For females significant increase of SRs was observed in 2008-2015 (p &lt; 0.05).

Conclusions
An increase of mortality for MS, observed for females, especially after 2000 may reflect the raising prevalence of MS in Italy. Important geographical differences were observed for five main areas.

Key messages
During the study period an increase of mortality for MS was observed for females. Important differences were observed between five main Italian geographic areas.
Mortality inequalities from major causes of death in Lithuania by education during 2001-2014
Authors: Meščeriakova-Veliulienė O , Kalėdienė R , Sauliūnė S , Kaselienė S 
Published: November 2019

Abstract

Background
The aim of the study was to evaluate mortality inequalities from major causes of death by education in Lithuania during 2001-2014.

Methods
Information on deaths (aged 30+) from cardiovascular diseases (ICD-10 codes I00-I99), cancer (ICD-10 codes C00-C97), external causes (ICD-10 codes V01-Y98), and digestive system diseases (ICD-10 codes K00-K93) was obtained from Statistics Lithuania. Mortality rates from these causes were calculated by the level of education (high (post-secondary non-tertiary, tertiary) and low (unknown, preprimary or no education, primary, lower secondary, upper secondary)) per 100,000 person-years. For the assessment of mortality trends during 2001-2014, the Joinpoint regression analysis was applied.

Results
During the analyzed period, mortality from all major causes was higher in the lower educational group (p &lt; 0.05). The most prominent differences in mortality rates between educational groups were found from external causes and cardiovascular diseases. Mortality from cardiovascular diseases (by 2.22% per year), cancer (by 1.87% per year) and particularly from external causes (by 5.2% per year) declined in higher educational group (p &lt; 0.05). In the lower educational groups mortality declined only from cardiovascular diseases (by 0.73% per year), however mortality increased from cancer (by 0.64% per year) and digestion system diseases (by 5.20% per year) (p &lt; 0.05).

Conclusions
Mortality from major causes of death in both educational groups changed unevenly during 2001-2014. In higher educational group mortality declined from cardiovascular diseases, cancer, and especially from external causes, while in lower educational group - just from cardiovascular diseases.

Key messages
In Lithuania, there are still significant inequalities in mortality from the major causes of death by education. Therefore, more attention should be paid for the improvement of the health of the population with lower education.
Improving participation of detained men in organised screening of colorectal cancer in Toulon
Authors: Porte M , Harmel M D , Pernice L , Misserey M , Adam C , Sondey J , Pallier L 
Published: November 2019

Abstract

In France, organised screening for colorectal cancer was set up in 2008. Participation rate was assessed in March 2014 at the prison of Toulon / La Farlède. On the 100 detained men aged 50-74 years old concerned by screening, only 3.9 % were screened. A project aiming at improving participation in screening while addressing specific difficulties related to prison settings (lack of privacy in cells, low socioeconomic and education status of the population, stronger exposition to risk factors for colorectal cancer) was launched in 2015 and has been yearly conducted since then.
How to improve colorectal cancer screening in a prison setting? How to organise a sustainable screening program? What proximity guidance should be provided to foster participation?
The program that was developed mainly consisted in awareness sessions and proximity guidance to testing. Among the 330 detained men targeted between 2015 and 2018, 165 men performed an immunologic test (57.9%) and 45 were excluded for medical reasons. Colonoscopy was performed for 10 of the 13 men with a positive result and lesions were detected for 9 men. Among them, one cancer, 6 high-risk polyps and 2 low-risk polyps were found. Those findings exceeded expected numbers.
Despite a small population sample, data revealed the benefit of the project in comparison with other participation rates: only 33.5% in France and 29.3% in the Var department (estimates for 2016-17 by Santé Publique France). Furthermore, we achieved a participation rate compliant with European recommendations establishing 45% as a minimum target.
The success of our program relied on the synergy between health prevention professionals screening organisers and prison medical staff. Strong involvement of each team constituted a real leverage for project to ensure effective proximity guidance for detained persons leading them to get screened.

Key messages
Awareness program adapted to prison improved participation in colorectal cancer organised screening. Proximity guidance helped to detect cancer and to improve medical care of detained persons.
Geographic disparities in bladder cancer incidence among men in the department of Bouches-du-Rhône
Authors: Mantey K , Cortaredona S , Grisoni V , De Fromont M , Albert P , Karsenty G , Pascal L 
Published: November 2019

Abstract

Bladder cancer incidence is investigated in the department of Bouches-du-Rhône to provide answers to the population reporting an excess of cancer cases in industrial areas. The study aimed to describe the geographical variations of bladder cancer incidence among men and detect potential spatial clusters without point source specification.
Incident cases diagnosed between 2013 and 2016 were extracted from the departmental observatory of cancers REVELA13. Age-standardized incidence ratios (SIRs) were calculated for each commune and bayesian smoothed risk estimate based on the Besag, York and Mollie model were computed for incidence mapping. Morans’I, Potthoff-Whittinghill and Tango statistic tests were used to investigate global clustering and the spatial scan statistic of Kulldorf (SaTScan) was used to investigate local clustering. Analyses were adjusted on a French deprivation index, access to health-care services and population density.
During the study period, 1 735 cases of bladder cancers were diagnosed among men. The study found a spatial heterogeneity (p &lt; 0.01) and aggregation (p &lt; 0.01) but no spatial autocorrelation (p = 0.09). Bayesian smoothed SIRs were not related to the confounding factors studied. An over-incidence was observed in the communes located in the South East of the department including Marseille, the biggest city of the study area. SaTScan algorithms detected two significant high-risk clusters in the same area (RR = 1.50 and 1.38). Introduction of each confounding factors in spatial scan detection, changed slightly the shape of clusters and/or the value of the relative risk but not the location. None high-risk cluster was detected in the communes of the industrial area.
Spatial analysis provides a first answer to the population concerning an excess of risk of bladder cancer at commune level. However, more analysis should be led to identify etiological factors or common environmental exposure.

Key messages
Geographic disparities exist in bladder cancer incidence among men at a commune level in the department of Bouches-du-Rhône. Spatial analysis show excess of risk of bladder cancer in the south-east of the department including the urban area of Marseille.
Health Literacy Profile and educational intervention as a prevention action for Type2 Diabetes
Authors: Dowlut S D , Balcou Debussche M B D , Debussche X D 
Published: November 2019

Abstract

Diabetes Type 2 is being categorized as a health crisis in Mauritius where 22.8% of the population suffers from it coupled with a 19.5% who are pre-diabetic. Government is already spending a huge proportion of the national budget in care of diabetic patients. Since one of the known means to better control diabetes is structured diabetes education, we tested the “learning nests” as a prevention measure for Type2 Diabetes. The “learning nests” is a structured health education programme which takes into account both biomedical and psychosocial dimensions which has already proved its effectiveness in other countries and it is theoretically based on socio-constructivism, social contextualization, empowerment and action planning.
Health literacy refers to the capacity to access, understand and use health related information to make appropriate health decisions. A concept which is highly correlated to the health outcomes of a population since it addresses necessary competencies to maintain oneself in good health.
The objectives of the educational sessions were to educate people on the risk factors of diabetes and at the same time these people can disseminate the knowledge acquired in their social environment. Six educational sessions were organized for 30 participants whereby the main eligibility criteria was age &gt; =18 years. A qualitative study was conducted with the participants to analyse the learning process as well as their health literacy competencies in terms of access, comprehension and evaluation of health information. The study was conducted before and after three structured educational sessions based on cardiovascular risks, Physical Activities and managing fat intake.
The findings show that these learning situations when contextualized can prove to be promising, in terms of health actions being undertaken by participants and improvement in health literacy competences in a middle-income country like Mauritius.

Key messages
Improvement of Health Literacy level can decrease the prevalence of Diabetes. Structured Health Education can help in improving health literacy.
Prognostic value of the Diverticular Inflammation and Complication Assessment (DICA) classification
Authors: Nasi G , Mastromatteo A M , Cambiè G , Di Mario F , Elisei W , Franceschi M , Nouvenne A , Tursi A , Violi A , Brandimarte G 
Published: November 2019

Abstract

Colonic Diverticulosis is one of the most common anatomic alterations found in the clinical practice. This condition has 60% incidence in the population over 60 years old. About 20% of patients with this condition will develop Diverticular Disease, and 5% of them will evolve into Diverticulitis. The aim of the study is to analyse the validation of the classification considering the distribution of the severity DICA score between the patients with diagnosis of colonic Diverticulosis.
We analysed and classified with DICA 5635 colonoscopies in the period between January 2012 and April 2018 and we obtained the Hospital Discharge Form from all the patients that had been admitted to the hospital in the same time period. The results showed that 69.9% of the patients were assigned to the score DICA1, 21% to DICA2 and 9.1% to DICA3. Ageing increased both the diagnosis of Diverticular Disease and the severity score. The severity was higher in female patients (DICA1=44.6%,DICA2=50.8%,DICA3=57.8%). The occurrence of complications overall was 5.4% and specifically: not complicated Diverticular Disease (DICA1=1%, DICA2=1.8%, DICA3=3.5%); not complicated Diverticulitis (DICA1=2.1%, DICA2=4.7%, DICA3=6.4%); Bleeding in Diverticulitis (DICA1=0.4%, DICA2=1.2%, DICA3=4.5%); Diverticular Perforation (DICA1=0.0%, DICA2=0.1%, DICA3=0.4%). The complications that needed a surgical procedure were for DICA1 about 0.2%, for DICA2 0.8% and for DICA3 2.5%. As well the average of the occupant days in the hospital and the cost, respectively, was for DICA1:8.5 days and 2300 €; for DICA2:9.5 days and 3080 €; for DICA 3:13 days and 4090 €.
The majority of the patients with Diverticular Disease belonged to the severity score DICA1 and the patients classified with DICA3 were mainly female and older than 69 years old. The study confirmed the prognostic value of the endoscopic classification DICA since the occurrence of complication resulted in a statistically significant relation with the score DICA3.

Key messages
DICA classification was able to discriminate, based on endoscopic records, the patients that could develop complications for Diverticular Disease. DICA classification is a valid parameter to predict the outcome of the disease, with great impact on public health improving the effectiveness of treatment.
Leadership and chronic diseases: a bibliometric review
Authors: Cabral M , Daminani G 
Published: November 2019

Abstract

Background
Leadership and chronic diseases are two frequent topics in current public health discussions. We performed a bibliometric analysis to study what interactions exist between these two themes. This study allows an insight on what is being published and also identifies potential gaps that need to be addressed.

Methods
We have reviewed all the titles and abstracts of articles available at PUBMED with the MESH terms ’Leadership’ and ’Chronic Disease’. We collected information about the authors, year, journal and type of publication and country where the study was done. We have also done a qualitative analysis on the themes addressed.

Results
We have found 171 entries, of witch 85 (49,7%) referred to apparent peer reviewed studies in English. All other publications referred to editorials, commentaries or the PUBMED entry did not allow for greater clarification. From 1998 the publication of articles became regular, with a peak of 14 articles published in 2014. The average of authors per publication was 3,19. The most frequent country involved was the USA (62), follow by the UK (14), Canada (11) and Australia (10). 128 publications were identified, of which BMC Health Serv Res was the one with the highest number of articles included (5). There was some form of a call for greater leadership from nurses in 22 articles. We also highlight 5 articles that called for a greater role of pastors and religious communities in this field.

Conclusions
Despite the perception of being common topics, there is still a low rate of publication of studies in the field of leadership and chronic diseases. There is a predominance of articles from the USA. There was not a predominant publication in this field. Despite doctors being typically seen as the leaders within the health field, the articles included seem to point to a trend in calling for a bigger leadership role of other actors, such as nurses.

Key messages
There is a need for more research in the field of leadership in chronic diseases. There seems to be a trend calling for greater leadership in the field from non-physician actors.
Metabolic complications of obesity
Authors: Mizouri R , Khiari M , Boukhayatia F , Ben Naceur K , Ben Othman R , Mahjoub F , Berriche O , Jamoussi H 
Published: November 2019

Abstract

Background
Obesity, through its numerous complications, influences the functional and vital prognosis, especially in situations of massive or morbid obesity. The aim of our study was to study the metabolic complications associated with obesity.

Methods
This was a descriptive cross-sectional study carried out in the first half of 2018 involving 100 obese patients attending the Obesity Unit of the National Institute of Nutrition in Tunis. Each patient received a complete clinical examination with a standard biological assessment. Obesity is defined by a body mass index ≥ 30 Kg / m2.

Results
The average age of our patients was 45.08 ± 13.9 years with a female predominance of 88%. The average weight was 103.76 ± 17.9 Kg. The average BMI was 38.95 ± 5.72 Kg / m2. The average waist circumference was 123.88 ± 13.13 cm and the average fat mass was 45.98 ± 12.22 kg. Twenty percent of our population was diabetic with an average duration of progression of 6.6. ± 4.04 years. The prevalence of dyslipidemia was high in morbidly obese patients with a rate of 18.6% compared to moderate to severe obesity at 6.4%. Arterial hypertension was noted in 33% of our population. The presence of moderate sleep apnea syndrome was noted in 31.3% of cases. Hyperuricemia was found in 8.6% of cases. Rheumatologic complications were marked by gonalgia in 26% of cases and low back pain in 6.8% of our patients.

Conclusions
Screening for complications related to obesity is necessary and essential for the comprehensive care of the obese person. Their treatment must be specific and it should not be limited to weight loss.

Key messages
Obesity. Metabolic complications.
Environment and Health: Official knowledge and lay response
Authors: Elliott P , Payne N 
Published: November 2019

Abstract

Due to its history, Halton, United Kingdom, provides a natural experiment to investigate the divide between lay and official knowledge about environment and deprivation, and how these may influence health choices and outcomes. 55 semi-structured interviews were carried out to assess a cross-section of residents’ perceptions and experiences of health, environment and lifestyle, taking a life history approach to examine health over time, and how choices were constructed. These were analysed for themes using a structuration theory approach. Residents’ viewpoints were then presented to twenty local public organisation officials, with their own perceptions also discussed. The overall standpoints were very different to those expressed by residents, being based on quantifiable knowledge such as that gained by officially collected statistics. Residents were not only sceptical about the knowledge presented by public health organisations, but valued lay knowledge gained through observation and experience. Official knowledge was interpreted primarily via an analysis of why this knowledge was created rather than an assessment of the knowledge itself. The interpretation was formed by a perception amongst residents that lay fears about pollution were being, at best, downplayed or, at worst, discounted by ’the powers that be’ who, in turn, placed faith in checks carried out by other official bodies. Official knowledge represented an expression of vested interests, presented by superordinate and external agents. A feeling of disempowerment co-existed alongside a perception that there was access to a form of truth via observation and experience rather than empirical knowledge. Whereas scientific information was discredited, lay knowledge was seen to be a more reliable guide as it remained free from a perceived bias. A degree of agency could be exercised perhaps only in this perception of ’pure’, if unprovable, knowledge.

Key messages
Formulation of official knowledge and reception of issued messages by lay residents in an area of high deprivation and compromised environment. Factors influencing perception, and adoption, of health messages which may impact on health and well-being in a local population.
Associations of environmental variables with different types of stroke
Authors: Vaiciulis V , Vencloviene J , Radisauskas R , Kranciukaite-Butylkiniene D , Tamosiunas A , Rastenyte D 
Published: November 2019

Abstract

Background
Air temperature (T) and atmospheric pressure (AP) are among the most closely studied weather variables; increases, decreases, and fluctuations in both have been significantly linked to numerous stroke subtypes. We decided to detect the association between daily numbers of ischaemic stroke (IS) and haemorrhagic stroke (HS) and daily North Atlantic Oscillation (NAO) and Arctic Oscillation (AO) indices and monthly indices of Quasi-Biennal Oscillation (QBO).

Methods
The study was conducted in Kaunas city from 2000 to 2010. Kaunas stroke register presented daily numbers of IS, subarachnoid haemorrhages (SAH), and intracerebral haemorrhages (ICH). We evaluated the association between these types of stroke and NAO, AO, and QBO indices (NAOI, AOI, and QBOI) by applying Poisson regression, adjusting for month and other weather variables.

Results
During the study period, we analysed 3,992 cases (2,205 men and 1,787 women) with stroke. IS composed 3,199 (80.1%), ICH 533 (13.4%), and SAH - 260 (6.5%). A change in mean daily atmospheric pressure (AP) of &gt; 3.9 hPa and QBOI &lt;-27 were associated with the risk of SAH (RRs with 95% CI were, respectively, 1.54 (1.18-2.03), and 1.68 (1.06-2.66)). The risk of HS was associated with daily increases in AP and QBOI &lt;8.37 (p &lt; 0.05). The risk of IS was negatively associated with AOI (RR = 0.97 (0.94-0.99). During November-March, NAOI &gt;0 was associated with HS (RR = 1.29 (1.03-1.62)), and a negative association between NAOI and IS (RR = 0.91 (0.84-0.98)) was found.

Conclusions
The results of our study provided new evidence that the NAO, AO, and QBO pattern may affect the risk of stroke. The impact of these teleconnection indices is not identical for different types of stroke.

Key messages
This abstract is part of publication, which will be published later on. In some cases, environmental impact is not essential, but quite often determines the course of various diseases, especially of the circulatory system.