bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health impact of substituting red meat by fish: addressing variability in risk-benefit assessments
Authors: Thomsen S T , de Boer W , Pires S M , Devleesschauwer B , Fagt S , Andersen R , Poulsen M , van der Voet H 
Published: November 2019

Abstract

Background
Sufficient intake of fish and limited red meat intake is commonly encouraged by national dietary guidelines to prevent various lifestyle diseases. One way to fulfill these guidelines would be to substitute red meat by fish. However, quantitative evidence of the public health gain of such substitution is lacking. Moreover, contaminants in these foods may compromise nutritional benefits. We aimed to estimate the health impact of substituting red meat by fish in the Danish diet in a risk-benefit assessment (RBA). Our study can support policy makers in defining evidence-based public health strategies.

Methods
We quantified the health impact of substituting red meat by fish among Danish adults in terms of Disability-Adjusted Life Years (DALY) using data from a national dietary survey and food monitoring. We investigated the use of probabilistic methods to model variability in individual substitution behaviors and to assess health impact distributions in RBA of food.

Results
Health impact of the substitution varied largely by the type of fish consumed and by age and sex of the consumer. We estimated that 134 (95% uncertainty interval: 102; 169) DALYs/100,000 could be averted per year if a mix of lean and fatty fish is consumed in the Danish recommended amounts and intake of red meat decreased among Danish adults. The highest benefit was estimated for women in the childbearing age and for men above 50 years of age. However, a small fraction of women were assigned an overall health loss due to methylmercury exposure during pregnancy and the associated adverse effects in unborn children.

Conclusions
Our study estimated an overall health gain of substituting red meat by fish in the general Danish adult population, while providing insight in the variability in health impact at the level of individual consumers. Our approach can be applied in other RBAs and the results support the need for targeted public health strategies to ensure consumer health and safety.

Key messages
The health impact of substituting red meat by fish in Danish adults was quantified in terms of disability-adjusted life years (DALYs), while accounting for variability between individuals. We estimated that young women and men above 50 years of age will experience the largest health gain while a small fraction of the women were assigned a health loss due to chemical exposure.
Who, why, when and how do people use urban green spaces? A study of users from 18 parks in France
Authors: Porcherie M , Faure E , le Gall A Roué , Vaillant Z , Thomas M F , Rican S , Héritage Z , Bader C , Simos J , Cantorregi N 
Published: November 2019

Abstract

Introduction
Urban green spaces impact the individual and collective health of populations. At the city level, they act as regulators of environmental hazards and constitute collective protective factors. At the individual level, they constitute social spaces for encounters and rejuvenation. But, these functions depend on the use made of these green spaces which can be inequitable. This paper presents the results of the analysis of the use of green spaces in the 6 French cities selected in the WHO French Healthy City Network conducted as part of the GREENH-City research project.

Methods
Based on park profiles, a qualitative survey was conducted among users of 3 different parks in each of the 6 selected cities with both observations and semi-directive interviews. Thematic analyzes were performed. Observed activities were classified into 8 groups (supervised educational, food, activities i.e. calm, commercial, artistic and cultural, physical non-sport, sports) and related to a specific use (professional/ personal, individual/ collective, authorized/ not and conflictual/ not). The uses described by the individuals interviewed were classified into 4 categories: attendance, utility, opinions and activities.

Results
186 observations and 591 recorded and unrecorded interviews with individuals or groups were conducted in the 18 parks. Overall, calm activities are dominant. However, activities and uses differ between cities and within the city depending on the nature of the parks (ancient, new..), their management, their location (more or less central, located in a deprived area or not) and people expectations.

Conclusions
Park uses are only partially dependent on amenities within the park. The nature of the park itself, its geographical location and its landscape characteristics seem to be decisive for the uses observed. These data are essential to inform public decision-makers and guide the creation and development of green spaces in cities in a vision of social justice.

Key messages
Urban green spaces can improve population health but their uses may be inequitable. Study of population use of urban green spaces may help to shape local policies towards more equity.
Deterioration of housing environment and mental health of asylum seekers – a multi-level analysis
Authors: Mohsenpour A , Biddle L , Bozorgmehr K 
Published: November 2019

Abstract

Background
Asylum seekers arriving in Germany are assigned to a local district and an accommodation centre wherein. We developed and validated a six-item questionnaire for rapid assessment of housing deterioration and investigated its association with inhabitant mental health.

Methods
Using cross-sectional data from a state-wide survey in Germany, we applied a random-effects modelling approach to estimate the exposure effect of housing deterioration on depression and general anxiety among a random sample of asylum seekers, using validated instruments (GAD2/PHQ2) for outcome variables. Housing deterioration was assessed on six items (windows/glass, walls/roof, garbage, graffiti, outside spaces, overall living environment) resulting in a deterioration score as exposure of interest. Additionally, we assessed the instrument’s intra- and inter-rater reliability and internal consistency.

Results
Of the 412 asylum seekers living in 58 accommodation centres, 45.7% reported symptoms of depression and 45.0% suffered general anxiety. Most centres (76.7%) were based in urban municipalities and 45.7% of inhabitants were living in an accommodation centre hosting ≥51 inhabitants. Preliminary adjusted odds ratio for accommodation centres with highest deterioration (Q 4) was 2.07 (0.67-6.40) for generalized anxiety, compared to 1.17 (0.45-3.08) for centres with lowest deterioration (Q 1). For depression, preliminary odds ratio was 1.92 (0.87-4.27) compared to 1.26 (0.63-2.50). The validation study confirmed inter-/intra-rater reliability (Brennan-Prediger coefficient: 0.81 and 0.92, respectively) and internal consistency (Crohnbach’s α: 0.80).

Conclusions
There are higher odds ratios for generalized anxiety disorder and depression among asylum seekers based on higher deterioration of housing environment. A questionnaire for rapid deterioration assessment and identification of accommodations needing further evaluation has been developed and successfully validated.

Key messages
Deterioration of small-scale housing environment is associated with poorer mental health for asylum seekers living in accommodation centres. A highly reliable new tool has been developed for rapid assessment of deterioration status of accommodation centres and identification of those needing further evaluation.
Prevalence of home smoking bans in six European cities: a repeated cross-sectional study (2013-2016)
Authors: Anastasi D , Federico B , Rimpela A , Richter M , Clancy L , Perelman J , Kunst A E , Lorant V 
Published: November 2019

Abstract

Background
Secondhand smoke exposure is responsible for over half a million premature deaths. With regulation now reducing smoking in most public enclosed spaces, one major source of indoor exposure remains the home environment. Home smoking bans (HSBs) are household rules that restrict smoking from certain (partial HSB) or all areas (complete HSB). Recent data suggest growing trends of HSB adoption over time, but it is not known whether time trends vary according to household characteristics.

Objectives
The aim of this study is to examine changes in the prevalence of HSB in six European cities between 2013 and 2016, according to socioeconomic characteristics of the household and smoking behavior of household members.

Methods
Data were collected in all schools participating in both waves of SILNE study in 6 European cities. A self-administered questionnaire was used, targeting students age 14 to 16 (n = 22,326). Students reported their parents’ smoking status and if there was a HSB at their home. Detailed information on socio-economic characteristics were collected as well.

Results
Between 2013 and 2016 the percentage of households with a complete HSB increased from 51.5% to 53.1%, while partial HSB increased from 30.7% to 32.1%. The prevalence of HSB increased in Hannover (G), Latina (I), Amersfoort (N) and Coimbra (P), whereas decreased in Namur (B) and Tampere (F). Socioeconomic differences in HSB were reduced, with larger increases in HSB in households with a lower parental educational level. Increases in HSB were observed among intact households, those without migration background and those with non-smoking parents.

Conclusions
The increase in the prevalence of HSB observed in most cities and throughout a variety of household types and characteristics between 2013 and 2016 may reflect the effect of smoking denormalization in different social contexts. Further actions of the tobacco control community should target the most vulnerable groups.

Key messages
The percentage of households with a complete HSB increased between 2013 and 2016 in 4 out of 6 European cities. Increases in the prevalence of HSB over time were observed across all socio-economic groups.
Sickness absences among young employees in private and public sectors
Authors: Narusyte J , Svedberg P 
Published: November 2019

Abstract

Background
Mental health problems among young adults is a public health problem as well as increasing work incapacity in terms of sickness absence (SA) due to mental diagnoses in Sweden. SA levels among those working in the public sector tend to exceed those working in the private sector. Knowledge is however lacking on whether experiencing mental health problems in young years can contribute to the association. The aim was to examine the association between type of employment and sickness absence among women and men, also adjusting for previously experienced depression and anxiety as well as for familial factors.

Methods
The study included data on 25,496 twins born in Sweden 1959-1990. Information on depression and anxiety as well as on type of employment was obtained from a web-based survey conducted in 2005. Twins were followed prospectively until 2013 through national register data on SA. Logistic regression analyses were run with adjustment for familial factors, such as common genetics and environmental factors related to the family. Odds ratios (OR) with 95% Confidence Intervals (CI) are presented.

Results
Higher rates of SA in the public (59%) as compared to the private (50%) sector were observed among women. There were 29% and 30% of men in public and private sectors, respectively, that have had at least one SA spell during the follow-up. Preliminary results showed that working in the private sector was associated with a higher risk for future SA among women (OR 1.63, 95% CI 1.14-2.33) but not among men (OR 0.66, 95% CI 0.41-1.07). The results changed only slightly after adjusting for previous depression or anxiety as well as for familial factors.

Conclusions
Higher rates of SA among women working in the public as compared to the private sector were not explained by previously experienced depression or anxiety disorders.

Key messages
Higher rates of SA were observed among women working in public as compared to private sector. Previously experienced depression and anxiety were of similar importance for future SA in both public and private sectors.
Levelling the Playing Fields: A Pilot Intervention
Authors: Alexander S , Frohlich K 
Published: November 2019

Abstract

Despite the benefits of outdoor free-play for children (physical activity, well-being, independent mobility), access to urban spaces for play is on the decline in many cities. As such, there are increasing calls from public health officials, city planners and childhood advocates in Canada to promote outdoor play in cities. Responding to these calls, our pilot intervention will examine whether creating urban play spaces through road closures around schools and in neighbourhoods can increase children’s outdoor play, physical activity and social interaction among residents.
The year-long intervention will involve road closures in four Montreal (Canada) neighbourhoods with different socio-economic profiles. After a diagnostic portrait of each site, participatory planning will engage children aged 8-12 and youth aged 13-18 to help redesign their neighbourhood streets for better access and playability. Outdoor play will be measured using a “playability index” to determine if increased outdoor play is due to intervention changes. Children’s physical activity, play and mobility patterns will be captured with GPS loggers and accelerometers, and play duration and location will be recorded through daily diaries. Questionnaires will be given to parents and children regarding changing behaviours and perceptions about outdoor play, risk/safety and independent mobility. While still in a pilot phase, this paper will present the intervention approach and outline how it promises to impact multiple components of urban life for children and adults (physical/mental health, safety, social interaction, environment/equity).
The intervention is innovative by engaging children and families in its design and development, and by involving schools, municipalities and residents in its implementation and assessment. This co-creation and development promises broad impacts on local social practices and policy development, results which may be transferable to other Canadian and international cities.

Key messages
Access to urban outdoor play is critical for children’s well-being. Road closures can increase urban outdoor play, thereby contributing to physical and mental health and promoting social interaction. Child and youth participation in the planning and development of urban play spaces can increase their relevance and broaden their social, environmental, health and policy impacts.
PrEP users among Lisbon MSM Cohort participants – A first look after PrEP implementation in Portugal
Authors: Fernandes F , Meireles P , Rocha M , Rojas J , Barros H 
Published: November 2019

Abstract

Background
Pre-exposure prophylaxis (PrEP) with tenofovir/emtricitabine has shown to be effective in preventing HIV among high-risk HIV-negative men who have sex with men (MSM). Portugal made PrEP available in February 2018, but few MSM reported PrEP use before. We aimed to compare the sociodemographic characteristics of MSM using PrEP and those knowing PrEP but not using and to compare MSM who started PrEP before and after its implementation in Portugal.

Methods
We performed a cross-sectional analysis, using Lisbon MSM Cohort data - an open prospective cohort of HIV-negative MSM testing at a community-based center in Lisbon - regarding the first time PrEP use was reported. Data from March 2015 to April 2019 was used. In this period 2142 MSM participated in the cohort and reported to know PrEP of whom 160 (7.5%) reported to use it. 83 PrEP-users answered a subset of questions about PrEP. Comparisons were performed using t-test, Chi-square or Fisher’s exact test.

Results
Comparing with non-users, PrEP users were significantly older (Mean: 35.7, SD 9.4 vs. 30.8, SD 9.2, p &lt; 0.001), had more frequently a Master or PhD degree (37.2% vs. 27.4%, p = 0.017), and were more frequently born in a foreign country (42.2% vs. 31.8%, p &lt; 0.001). Groups were similar in terms sexual orientation. Among the 83 PrEP users answering more questions about PrEP, 28 (33.7%) reported to have ordered their PrEP medication online, 24 (28.9%) obtained it in a medical appointment in Portugal, 15 (18.1%) in a foreign country, 4 in a clinical trial or demonstration project. Of all PrEP users, 30 (19.4%) started PrEP only after February 2018, and no sociodemographic differences were found comparing with those who started before.

Conclusions
MSM reporting PrEP use were more educated, older and more frequently born in a foreign country than non-PrEP users. MSM starting PrEP before and after February 2018 were similar, which may indicate that making PrEP available did not yet reach a more diverse group of MSM.

Key messages
MSM reporting PrEP use were more educated, older and more frequently born in a foreign country than non-PrEP users. MSM starting PrEP before and after February 2018 were similar, which may indicate that making PrEP available did not yet reach a more diverse group of MSM.
Psychiatric comorbidity and intellectual disability
Authors: Keyes K 
Published: November 2019

Abstract
Most research on the prevalence, distribution, and psychiatric comorbidity of intellectual disability (ID) relies on clinical samples, limiting the generalizability and utility of ID assessment in a legal context. This study assessed ID prevalence in a population-representative sample of U.S. adolescents, and examined associations of ID with socio-demographic factors and mental disorders. Data were drawn from the National Comorbidity Survey Adolescent Supplement (N = 6256). ID was defined as: 1) IQ ≤ 76, measured using the Kaufman Brief Intelligence Test; and 2) an adaptive behavior score ≤76, measured using a validated scale. The Composite International Diagnostic Interview assessed fifteen lifetime mental disorders. The Sheehan disability scale assessed disorder severity. We used logistic regression models to estimate differences in lifetime disorders for adolescents with and without ID. ID prevalence was 3.2%, and was more common among those with specific phobia (OR = 1.66, 95% C.I. 1.02, 2.68), bipolar disorder (OR = 7.24, 95% C.I. 2.10-24.99), after adjusted for demographic and clinical covariates. Among those with Axis I psychiatric disorder, adolescents with ID and mental disorders were significantly more likely to exhibit severe impairment than those without ID, across a broad range of disorders. These findings highlight how sample selection and overlap between ID and psychopathology symptoms might bias understanding of the mental health consequences of ID. For example, associations between ID and behavior disorders widely reported in clinical samples were not observed in a population-representative sample after adjustment for socio-demographic confounders. Valid assessment and understanding of these constructs may prove influential in the legal system by influencing treatment referrals and capital punishment decisions.
The positive effect of workplace accommodations on employment five years after a cancer diagnosis
Authors: Alleaume C , Paraponaris A , Bendiane M-K , Peretti-Watel P , Bouhnik A-D 
Published: November 2019

Abstract

Background
Each year, almost 400,000 new individuals are diagnosed with cancer in France and nearly half of them are in the working age. The disease was found to have a negative impact on professional life, especially for the most vulnerable cancer survivors. Literature reviews have pointed out the lack of studies focusing on the evaluation of interventions. In France, workstation layouts are recommended by the French law, but not mandatory to facilitate return to work. The aim of this study was to explore the effect of having a workstation layout after a cancer diagnosis on maintenance in employment five years after diagnosis.

Methods
We used the French VICAN survey carried out in 2015/2016 on living conditions five years after a cancer diagnosis. Using propensity score matching, we matched two subsamples (with and without workstation layout) to investigate the effect of workstation layout taking into account the characteristics associated with the access to these arrangements.

Results
Among the 1,514 individuals aged between 18 and 54 at diagnosis and employed in a salaried job at this time, three in five (61.2%) had a workstation layout within the five years following the diagnosis: 35.5% had a position type layout, 41.5% had a schedule layout, and 49.2% had a working time layout. Among those who had a workstation layout, 89.7% were still in employment five years after diagnosis against only 77.8% of those who did not so (p.value&lt;0,001). After matching, having a workstation layout increased maintenance in employment from 77.8% to 95.0% (Average workstation layout effect on the treated of 0.172, 95% CI = [0.114; 0.229]).

Conclusions
Having a workstation layout after a cancer diagnosis strongly increases maintenance in employment of five years cancer survivors. More research is needed to better understand the differences in access to these arrangements and the related selection effect.

Key messages
Workstation layout increases maintenance in employment of survivors five years after a cancer diagnosis. Therefore, it should be used more systematically to facilitate work with a chronic disease. Having a workstation layout may constitute a disadvantageous selection bias for more vulnerable workers. It can also lead to discrimination feelings.
How does education affect diet in women? A comparison between Central and Southern Europe cohorts
Authors: Agodi A , Maugeri A , Magnano San Lio R , Favara G , Vinciguerra M , Barchitta M 
Published: November 2019

Abstract

Background
Comparisons among European populations is useful to identify opportunities for planning nutrition strategies to reduce social inequalities in health. Our study aims to identify dietary patterns in adult women and to evaluate their association with educational level in Czech Republic and Italy, which display different health inequalities.

Methods
We performed a cross-sectional analysis of women (aged 25-64 years) with no history of severe diseases, who have been recruited in Brno (Czech Republic; n = 957) and in Catania (Italy; n = 841). Dietary patterns were derived by Food Frequency Questionnaire and Principal Component Analysis. We tested the association between educational level (low vs. high) and adherence to dietary patterns. Logistic regression models were used to assess Odds ratio (OR) and 95% confidence interval (CI), after adjusting for age, employment status, marital status, smoking status, parity, BMI, and menopause.

Results
In both cohorts, we identified the healthy and the unhealthy dietary patterns. We observed that women with high adherence to the healthy dietary pattern were less educated in Czech Republic, and more educated in Italy. After adjusting for covariates, low educational level was positively associated with adherence to the healthy dietary pattern among Czech women (OR = 2.033; 95%CI=1.301-3.176; p = 0.002), and negatively associated among Italian women (OR = 0.166; 95%CI=0.029-0.952; p = 0.044). No association was identified between educational level and the unhealthy dietary pattern.

Conclusions
In the Italian cohort, findings were consistent with the notion that healthy dietary choices are less common among low-educated groups. By contrast, in newly developed countries such as the Czech Republic, the “nutrition transition” from traditional staples to western foods might be more common in highly-educated groups, probably due to the advocacy of Western culture through mass media and commercial marketing.

Key messages
Low educational level has an opposite effect on healthy diet, exhibiting a positive association in Czech women, and a negative association in Italian women. From a broader perspective, the observed effect of education on diet quality helps explain social health inequalities in Central and Southern Europe.