bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burden of non-communicable diseases and behavioral risk factors in Albania
Authors: Burazeri G 
Published: October 2020

Abstract
About 85% of the overall burden of disease in Albania is attributable to non-communicable diseases (NCDs) including cardiovascular diseases, cancer, diabetes and chronic respiratory diseases. Furthermore, NCDs account for about 94% of proportional mortality in the Albanian population. The three main risk factors responsible for the disease burden in the Albanian population include arterial hypertension, nutritional-related risks, and smoking. High systolic blood pressure accounts for about one-third of the overall mortality rate in Albania. In turn, dietary risks account for about 30% of the total mortality rate and about 15% of the overall burden of disease in Albania. Conversely, the proportional mortality attributable to smoking is about 16%. Smoking epidemics affects predominantly Albanian males and this trend is likely to increase. The proportion of Albanian females who smoke is still quite small (less than 10%) compared with other countries in the region, but female smoking is considered be steadily increasing.
Differences in smoking prevalence amongst males from different socio-economic strata are not significant, whereas among females significant socio-economic differences are noted. Smoking epidemics in the future are expected to demonstrate large socioeconomic differences with lower social classes in both sexes smoking the most. Similar to other countries, actions and measures for tackling NCDs in Albania should include promotion of healthy nutrition; promotion of physical activity; and antismoking policies starting with school age children and have a gender specific component targeting different settings, enhanced by the intensive use of social media.
Environmental hazards in the preconception period
Authors: Vilcins D 
Published: October 2020

Abstract
Environmental risk factors are ubiquitous, and a growing body of evidence has shown exposure to many environmental hazards is associated with poorer health outcomes. Environmental hazards are linked to human health across the life span, with maternal exposure to a wide range of environmental hazards, such as air pollution, endocrine disrupting chemicals, pesticides and heavy metals, associated with neonatal outcomes and longer-term child health. There is a small body of evidence emerging that suggests maternal and paternal exposure to environmental hazards in the preconception period may be associated with negative health outcomes of resulting children. Understanding the environmental and occupational exposures most pertinent to preconception care allows care givers to provide advice on limiting exposure, which in turn improves the odds of protecting the long-term health of the child. This presentation will provide an overview of the current evidence from the environmental health research. Workshop participants will have the opportunity to discuss pathways of reducing exposure to the environmental health risks most pertinent to the preconception period.
The impact of smoking on deaths and disease in the face of population ageing: the example of Germany
Authors: Mons U 
Published: October 2020

Abstract

Background
Despite weak tobacco control, smoking in Germany has steadily declined over the last 25 years. As policymakers expect that this trend will reflect in a declining associated public health burden, I sought to quantify trends in smoking-attributable mortality (SAM) and smoking-attributable cancer incidence (SACI) and to explore the impact of population ageing.

Methods
Smoking and mortality statistics from 1992 to 2017 were obtained from the German Statistical Office, from which SAM was calculated separately for each cause of death causally associated with smoking. Cancer incidence data from 1999 to 2016 was obtained from the German Cancer Registry, and SACI was calculated separately for each cancer site causally associated with smoking. The impact of population ageing was explored by comparing crude and age-standardized SAM and SACI, respectively. To estimate the impact of population ageing on future SAM and SACI, a forward projection until 2035 was modelled.

Results
Preliminary results suggest that total SAM and SACI only slightly declined over time, while stronger decreases were seen in age-adjusted SAM and SACI. Differences between crude and age-standardized SAM and SACI seem to be particularly striking in men. The forward projection of SAM and SACI suggests that population ageing will lead to further steady increases within the next two decades in both sexes.

Conclusions
Results indicate that past decreases in SAM and SACI due to declines in smoking were largely compensated by population ageing. In the next two decades, population ageing will lead to a steady increase in SAM and SACI. Only by taking determined immediate action with a comprehensive set of evidence-based tobacco control polices could significant inroads into reducing the smoking-associated disease burden be achieved. Also, given still significant smoking rates in middle and old age, there is tremendous potential to curb the associated public health burden by intensifying cessation programs.

Key messages
Contrary to common expectations among policymakers, the smoking-attributable public health burden will strongly increase in the next decades. Determined immediate policy action is required to halt or attenuate these trends.
Resilience factors associated with physical function in vulnerable older adults from four countries
Authors: Pennington J T , Sentell T L , Vafaei A , Camara S M , Belanger E , Pirkle C 
Published: October 2020

Abstract

Background
Adverse childhood experiences (ACEs) include an array of maltreatment and they have been shown to confer higher risks of early mobility loss and ultimately disablement in older ages. This study aims to identify resilience factors associated with physical function in a diverse sample of older adults (65-74 years) from the 2012 International Mobility in Aging Study (IMIAS) who reported ACEs.

Methods
2002 participants were recruited from Kingston, Ontario; St. Hyacinthe, Quebec; Tirana, Albania; Manizales, Colombia; and Natal, Brazil. Economic ACEs were classified by self-report of at least one-poor childhood economic status, childhood hunger, parental unemployment-before the age of 15 years. The Short Physical Performance Battery was used to measure physical function; a score of &lt; 8 was considered poor. Associations between hypothesized resilience factors (education, social support, expressed gender roles) and physical function were identified via bivariate analysis and logistic regression; after adjusting for sex, age, and sample site.

Results
Nearly half (46%) the participants reported economic ACES. High levels of education (OR 0.39; CI: 0.22-0.66) and social support from family (OR: 0.52; CI: 0.36-0.76), partners (OR: 0.47; CI: 0.29-0.74), and friends (OR: 0.59; CI: 0.38-0.92), as well as masculine (OR:0.49; CI: 0.29-0.83) and androgynous (0.48; CI: 0.30-0.77) gender roles, protected against poor physical function for those reporting childhood economic ACEs.

Conclusions
Despite encountering economic ACEs, those who achieved high relative levels of education, greater levels of support, as well as those characterized by masculine or androgynous gender roles, were more likely to maintain good physical performance in older ages compared to those with low education, no social support, and those classified as undifferentiated gender roles. Findings highlight critical points of intervention for those who experienced ACES.

Key messages
These findings imply that the associated negative physical health outcomes of ACEs can be delayed or eliminated via exposure to certain protective factors. Economic ACE exposure may be unavoidable, but there are resilience factors that could be promoted to foster the better health across the life course.
The Impact of early retirement, nation-related and personal characteristics on cognitive decline
Authors: Carmel S , Tur-Sinai A 
Published: October 2020

Abstract

Background
The increasing prevalence of cognitive decline (CD) in old age has become a global challenge. Our study aims to enhance understanding of this phenomenon by evaluating longitudinal effects of personal and national determinants on memory decline (MD) among European retirees.

Methods
We used data from two interviews collected in 12 European (EU) countries and in Israel by SHARE - a multidisciplinary, cross-national bank of survey data. Our sample included 11,930 retirees aged 50+ who were interviewed at baseline (T1) and again four years later (T2). MD was evaluated by the change in the recalled number of words at T2 compared to those remembered at T1. Ten words were presented at each interview and participants were asked to repeat them, first immediately and again after a few minutes (maximum 20 words). The scale for evaluation of change over time ranged from -20 to + 20.

Results
Except for gender, all of our explanatory variables had a significant effect on MD including age, education, health/function status, depressive symptoms, early retirement, active lifestyle and EU-countries divided into four geographical regions. Decline over time in physical and mental health variables had an additional significant negative effect on memory.

Conclusions
These findings lead us to suggest focusing on what we know and are able to change in order to postpone MD. In addition to promotion of national policies to prolong years of education and participation in the workforce, we recommend introducing programs that encourage people to postpone retirement, and adjusting workplace conditions in order to enable older persons to continue contributing to the workforce. We also suggest promoting an active lifestyle among older adults, especially in Mediterranean and eastern European nations by implementing health and active leisure education programs.

Key messages
Declines in health and functioning negatively affect memory, while education and active lifestyle have a protective effect. Moreover, early retirement has a similar negative effect on memory change in each of the studied EU-regions even when controlling for all of the personal and behavioral factors.
Legal and human rights-based approaches to healthy diets and sustainable food systems
Authors: Patterson D W , Buse K , Magnusson R , Toebes B C A 
Published: October 2020

Abstract

Issue
Malnutrition in all its forms poses daunting challenges to global health and development. The agriculture sector is a significant contributor to global warming. COVID-19 has pushed many people into poverty, including food poverty. A radical rethink of business models, food systems, civil society involvement, and national and international governance is required to address the interlinked crises of COVID-19, obesity, undernutrition, and climate change. International human rights law, institutions and mechanisms provide important opportunities for norm setting, advocacy and accountability. Yet these pathways are under-utilised by both governments and civil society.

Description
The global AIDS response demonstrated the power of a human rights-based approach. United Nations' HIV/AIDS and Human Rights Guidelines greatly influenced the global consensus for effective, evidence-based approaches. The Guidelines also informed resolutions of the UN General Assembly and its Human Rights Council, contributing to more affordable medicines, an unprecedented increase in people on treatment, less stigmatising health services, the empowerment of marginalised groups, and the institutionalisation of norms, including “no one left behind.” Human rights-based approaches have also been successfully utilised in tobacco control.

Results
In 2019, 180 experts from 38 countries published an open call on WHO and the UN Office of the High Commissioner for Human Rights (OHCHR) to initiate an inclusive process to develop guidelines on human rights, healthy diets and sustainable food systems. Most signatories were from the health and development sectors, demonstrating the increasingly broad interest in using human rights mechanisms to address global health challenges.

Lessons
Opportunities exist to transform food systems and create healthier food environments and a healthier planet by clarifying existing international obligations to progressively realise the right to food and the right to health.

Key messages
Market forces, alone, are failing to deliver healthy diets and sustainable food systems. International legal frameworks and accountability mechanisms provide opportunities for engagement and action. Human rights guidelines can help mobilize multisectoral action, strengthen State and private sector accountability, and deepen community engagement in the urgent task of achieving Agenda 2030.
Television marketing of food and beverage targeted to children, Italy
Authors: Gianfredi V , Rabica F , Dallagiacoma G , Fatigoni C , Moretti M , Nucci D 
Published: October 2020

Abstract

Aim
According to the World Health Organization (WHO), 40 million children aged &lt; 5 and 131 million of children aged 5-9 are overweight or obese. Growing evidence is focusing on the association between number of hours spent watching television (TV) and children's food behaviour. Our aim was to assess the amount of TV food marketing targeted to Italian children, and to qualitatively analyse the ads.

Methods
The 5 most viewed TV channels were selected and recorded for 20 days (non-consecutive, both week and week-end days) and analysed through the WHO's tool to asses food -beverage multimedia marketing targeted to children. The analysed exposure variables were: type of product, viewing time, channel's target and broadcasting company (for all types of ads), duration of each food ad, type of programme, and target of the advertised product (only for food and beverage). Power of persuasion variables were assessed only for food marketing. Lastly, for each food product showed, the food category and if it was a core vs non-core product was assessed. Differences between groups were assessed using the chi-square test and t-test.

Results
During 320 hours of broadcasting TV, a total of 9,069 ads were identified, (51.7 hours). Food products were the second most frequently advertised (19.4%). On average, 5.4 food ads were displayed during non-peak viewing time/hour (6 during peak). The time slot of 3 pm had the highest rate of food ads (23.8%). Channels targeted to the general public had a higher rate of food ads compared to channels targeted to children (p = 0.000). Private channels transmitted a higher number of food ads compared to public channels (p = 0.000). Humour was the most frequently persuasive technique used in food ads and in ads targeted to whole population (14.3%).

Conclusions
Children usually watch TV programs that have a high rate of food ads, mainly promoting unhealthy products with captivating techniques. Legislators should advocate for a healthier food marketing.

Key messages
Children are exposed to a high amount of TV food commercials daily. Food marketing should be strictly regulated in accordance with the WHO Nutrient Profile model.
The Epidemiology and Burden of Cardiometabolic Risk factors in a Young Emirati Population
Authors: Mezhal F , Ahmed L , Jabari A , Alzaabi T , Alblooshi M , Alhosani A , Ali R 
Published: October 2020

Abstract

Introduction
The United Arab Emirates (UAE) has experienced a rapid growth in economy. This growth was paralleled with a drastic rise in non-communicable diseases (NCDs); primarily cardiovascular disease, which accounts for 40% of mortality in UAE. These NCDs are caused by the accumulation of cardiometabolic risk factors (CRFs) such as obesity, dysglycemia, dyslipidemia, hypertension and central obesity. The CRFs are associated with other factors including sociodemography, physical inactivity, tobacco use, and heredity.

Objective
The objective is to investigate the burden of CRFs and their interrelationship, and to estimate the association with other determinants like sociodemographic status, lifestyle and family history.

Methods
Data was drawn from the UAE Healthy Future Study participants aged 18 to 40. Demographic and health data was collected by questionnaires. Measurements, blood pressure, and blood samples were collected. CRFs were analyzed by age and gender.

Results
A total of 5,126 eligible participants were included in the analysis. The age-adjusted prevalence rates were 26.5% for obesity, 11.7% for dysglycemia, 62.7% for dyslipidemia, 22.4% for hypertension and 22.5% for central obesity. Obesity had the strongest relationship with other metabolic factors. Education, employment, smoking and family history had associations with some metabolic markers. Forty percent had ≥2 risk factors. The burden of ≥ 2 CRFs was affected by age (OR 1.1), having lower education (OR 1.37) and having a family history (OR 1.44).

Conclusions
CRFs are highly prevalent in young adults in the UAE. These risk factors are accumulating and are affected by multiple determinants. Obesity is highly associated with having other CRFs simultaneously. This should be taken into account in the design of target-group-specific prevention of NCD development. Further research is needed to investigate how the clustering manifests in young adults to prevent the early rise of NCDs in the UAE.

Key messages
Cardiovascular disease and associated risk factors are highly prevalent in the young population (18-40) of the UAE. The clustering of cardiometabolic risk factors occurs early in young people in UAE.
Patient-reported outcomes in patients undergoing elective arthroplasty: the PaRIS-IOR study
Authors: Golinelli D , Rosa S , Rucci P , Tedesco D , Grassi A , Amabile M , Cosentino M , Maietti E , Zaffagnini S , Fantini M P 
Published: October 2020

Abstract

Background
The number of hip and knee arthroplasties continues to rise worldwide. The Organization for Economic Cooperation and Development has launched the PaRIS Initiative for the systematic collection of Patient Reported Outcome Measures (PROMs) in patients undergoing elective hip and knee arthroplasty. The Rizzoli Orthopedic Institute (IOR) was selected as a pilot center for the Initiative (PaRIS-IOR study), because it hosts the Registry of Orthopedic Prosthetic Implants (RIPO). The objective of PaRIS-IOR study is to investigate the characteristics and temporal trend of PROMs in relation to the type of surgical intervention and patient profile. Here we report the preliminary results of the first study year.

Methods
The PaRIS-IOR is a prospective, single site, cohort study started on January 1st 2019 that consists of the administration of Euro Quality 5 Dimensions (EQ-5D), Hip disability and Osteoarthritis Outcome Score and Knee injury and Osteoarthritis Outcome Score Physical function Short-form (HOOS-PS, KOOS-PS) questionnaires to patients on the list for elective arthroplasty. Questionnaires data are linked with those routinely collected by the RIPO and regional administrative data, in order to track patients' medical history.

Results
The study population consists of 1,413 patients. Patients undergoing knee arthroplasty (n = 393) were older (68.4 vs 60.2 years; p &lt; 0.001), and had a higher prevalence of obesity (41.6 vs 22.6%; p &lt; 0.001) than patients undergoing hip arthroplasty (n = 1020). Female and obese patients reported a worse perceived health status both in the EQ-5D (p &lt; 0.001) and in the HOOS-PS and KOOS-PS (p &lt; 0.001). Among patients who underwent knee surgery, the younger ones reported a poorer perceived health in the general and the specific questionnaires.

Conclusions
The PaRIS-IOR study has potential important implications in targeting the factors affecting patient-reported functional outcomes and quality of life after joint arthroplasty.

Key messages
The PaRIS-IOR study underscores the poorer perception of health status in female and obese patients undergoing arthroplasty and in younger patients undergoing knee surgery. The routine adoption of PROMs may support surgeons in the management of patients undergoing hip and knee arthroplasty and policy-makers in improving healthcare quality in orthopedics.
Understanding public health providers’ preferences for interventions against informal payment in Tanzania: a discrete choice experiment
Authors: Binyaruka P 
Published: October 2020

Abstract

Background
Informal payments are regressive. They can limit the access to quality healthcare, particularly of the most vulnerable, and are potentially catastrophic. Little is known in terms of providers' preferences for interventions.

Methods
We conducted a cross-sectional discrete choice experiment (DCE) among 432 health providers from 42 public health facilities (hospitals and health centres) in seven districts from Pwani region and five districts from Dar es Salaam region. The DCE attributes were derived from a scoping literature review, qualitative interview from 27 key informants from three districts, and through workshop with health providers, managers and policy makers. The final DCE survey tool included 12 unlabeled choice sets, each describing two hypothetical jobs that varied across six attributes: mode of payment, supervision at facility, opportunity for private practice, awareness and monitoring, measures against informal payment, and incentive payment for lack informal payment in the past 6 months. Multinomial logit and mixed multinomial logit methods were used to estimate preferences for the attributes.

Results
All attribute-levels, apart from supervision at the facility level, were significantly influencing health providers' choice decisions for job type (p &lt; 0.001). The most preferred attributes were measures for awareness creation and monitoring -i.e. preferences were significantly higher for facility with noticeboard (coefficient 0.39, 95% CI 0.29 -0.48 ), followed by provision of receipts (0.34, 0.24 -0.44) and presence of hotline number for reporting corrupt practices (0.26, 0.17 -0.35). Opportunity for private practice was significantly preferred (0.38, 0.31-045) and job preference increases as salary top-up increases (0.06, 0.05-0.7). The less preferred attributes were cash payment for healthcare (-0.27, -0.35- -0.19) and disciplinary measures at the district (-0.15, -0.23 - -0.07) or facility level (-0.10, -0.17- -0.03).