bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organizing the institutional Public Health response to heat under climate change: A scoping review
Authors: Boeckmann M , Sanchez Martinez G , Kendrovski V 
Published: November 2019

Abstract

Background
Extreme heat events are a major health risk, and their intensity and frequency are expected to increase under climate change. Heat health action plans (HHAP) aim to prevent adverse health effects through measures such as warning systems or communication campaigns. This scoping review asked whether the peer-reviewed Public Health literature suggests evidence for good practice governance of HHAP.

Methods
Databases PubMed and Web of Science were searched using search string combinations of heat, policy, warning system, and related terms. Data was extracted into a pre-defined extraction table based on theory-driven variables related to responsibilities, processes of stakeholder involvement, evaluation and whether good practice advice was provided. Findings were narratively synthesized and gaps in the current knowledge evaluated from a normative standpoint.

Results
Searches resulted in 6681 hits. After title, abstract and full text screening, 20 articles were assessed, 11 from Europe and 9 from other regions. Findings on structure of governance revealed that the Ministry of Health or Ministry for the Environment leads the development of an adaptation plan or HHAP guidance, while locally Departments of Health most often lead coordination of actions. Interagency cooperation was reported as essential, while in the majority of included studies the public are perceived as recipients of advice and warnings rather than as active stakeholders. Tailoring national guidance to local contexts as well as raising awareness of the plan not only among the public but also among all levels of management was one suggested good practice.

Conclusions
Few articles explicitly examine the organization of HHAP and no conclusions about whether a specific approach is superior can be drawn from these studies. To adequately protect human health from extreme heat events, an assessment of whether current governance structures are able to provide effective heat health action could be useful.

Key messages
The peer-reviewed literature does not provide information on which type of HHAP governance is superior. In the absence of a gold standard, it should be assessed what stakeholders and discourses are absent from HHAP governance to ensure vulnerable groups are adequately addressed by HHAP.
“Is anyone walking in our neighborhoods?”: Citizens’ experience of the neighbourhood environment
Authors: Middleton N , Kleopa D , Panayiotou A , Kouta C 
Published: November 2019

Abstract

Background
Several generic or feature-specific neighbourhood audit tools have been developed in recent years. In the context of developing the Cyprus Neighbourhood Observation Tool for auditing urban environments (CyNOTes), a virtual ethnographic study of citizens’ perceptions of their neighbourhood environment was performed.

Methods
The municipality and mayor’s Facebook were reviewed for posts related to neighbourhood environment over a 12-month period (e.g. regeneration projects). Comments were content analysed using a deductive as well as an inductive approach to gain an in-depth understanding of citizens’ perceptions of neighbourhood environment.

Results
348 comments to 27 relevant posts were identified. The unit of analysis was sentences or short phrases and 289 CMU were identified. The central theme was “Citizens’ voice”. Six themes and several sub-themes emerged. “Comparisons” to contrast the differing conditions between high-profile locations versus “left out” residential neighbourhoods (“Yes, the city centre, the waterfront is a jewel, what about the neighborhoods?”) or to compare their experience to “another place-another time”. They express “Mixed feelings” ranging from “hope” to “disbelief” about proposed actions. Citizens are referring to “Consequences” of neighbourhood adverse environment on “Quality of Life” or “Local ecomomy and housing” and identify “Causes” in “Money and Power” or “Lack of vision and planning”. They are placing “Responsibility” in both “Authorities’ inaction” as well as “Everyone’s role”. “Suggestions” included measures related to “Law and Order” as well as “Citizens’ participation”.

Conclusions
Citizens voice their experiences of the neighbourhood environment lack of influence and control and demand for more involvement in decision-making. They blame authorities for neighbourhood problems but also recognize the lack of individual responsibility, suggesting policing and punitive measures and stronger collective action.

Key messages
A virtual ethnographic study of citizens’ comments on social media offers an in-depth understanding of the neighbourhood experience. Citizens want to have a “voice” to express their concerns about neighbourhood problems as well as to participate in decision-making.
Social cohesion as a mechanism behind neighbourhood effects on mental or physical health
Authors: Kress S , Razum O , Zolitschka K A , Breckenkamp J , Sauzet O 
Published: November 2019

Abstract

Background
The neighbourhood where an individual resides have become a relevant element in the study of health inequalities. While there is substantial evidence that environmental factors affect health, far less evidence of the hypothesised role of social mechanisms in the causal chain between neighbourhood characteristics and health is available.

Methods
Using data from the longitudinal German SOEP panel, we built measures of perceived neighbourhood characteristics and a measure of social cohesion for participant living in urban areas. Participants were included in a longitudinal cohort of 4 year observation time starting in 2004. Using linear regression models, we tested the role of social cohesion as a mediator between the neighbourhood characteristics at baseline and a health outcome (mental and physical component of the SF-12) at the end of follow-up adjusted for socio-economic variables.

Results
For the 4 year follow-up 10 665 participants were included. There was no evidence of a mediation effect of our measure of social cohesion between geographical or institutional characteristics and physical health. The effect of social cohesion on mental health was 2.03 ([1.44, 2.59]) and on physical health 1.78 ([1.27, 2.29]). Social cohesion mediated associations between biological (17%, 11%) or built (11%, 14%) characteristics and both physical and mental health and association between institutional characteristics and mental health (7%).

Discussion
We found evidence for a possible role of social cohesion in the pathway between neighbourhood characteristics and health. Only perceived characteristics have been used in this work and the respective role of objective and subjective measures of neighbourhood characteristics should be further investigated. Moreover, validated measures of social cohesion should be developed.

Key messages
The perception of social cohesion mediates the effect of specific perceived characteristics of neighbourhood on mental and physical health. Interventions seeking to improve social cohesion in neighbourhoods might have positive consequences on the health and wellbeing of inhabitants.
An ego-centred approach for the evaluation of health inequalities in urban areas
Authors: Sauzet O , Zolitschka K A , Spallek J , Breckenkamp J , Razum O 
Published: November 2019

Abstract

Background
Neighbourhood possesses attributes, structural, physical and social, for which pathways to health inequalities could be hypothesized. Hence, neighbourhood is a complex mixture of factors which cannot be simply defined by a delineation on a map, making common definitions of neighbourhood (e.g. administrative borders) problematic. We present a new concept for the evaluation of contextual health inequalities in an urban setting.

Methods
An ego-centred approach to neighbourhood effects on health allows to establish to what degree the health outcomes of a person are on average correlated to the health outcomes of his/her neighbours. This approach does not necessitate the definition of what a neighbourhood is, or of its boundaries. Using data from the BaBi birth cohort following up 958 mother-child pairs in Bielefeld/Germany we illustrate how the method provides information about the spatial structure of a possible association between unmeasured neighbourhood factors and birthweight. Spatially correlated birthweight indicates a neighbourhood effect on maternal health.

Results
A parametric model of the correlation structure gives two indicators: a distance after which health outcomes are no longer correlated (practical range), and the strength of correlation (RSV). We modelled birthweight directly and residuals after controlling for (spatially correlated) covariates. After adjusting for the mother’s demographics and neighbourhood characteristics, birthweights remained spatially correlated with RSV of 11% and a practical range of 128 m.

Conclusions
Modelling the spatial correlation of a health outcome provides a measure of the degree of health correlation, thus offering new evidence on the production of health inequalities while incorporating current modelling approaches. Moreover, it measures heterogeneity in a city. This could be used as an indicator for policy makers or town planners to identify areas in need of socioeconomic investment.

Key messages
Modelling the spatial correlation of health outcomes is an approach which enable to assess unmeasured neighbourhood effects. The health correlation neighbourhood approach helps to investigate the production of health inequalities and to identify urban areas in need of socioeconomic investment.
Arsenic metabolism and urothelial cancer risk: a systematic review and meta-analysis
Authors: Di Martino G , Di Giovanni P , Scampoli P , Meo F , Cedrone F , Lucisano G , Staniscia T 
Published: November 2019

Abstract

Background
Arsenic is a toxic metalloid element frequently found in the environment. Chronic arsenic exposure is a critical public health issue in many countries since the identification of arsenic and its compounds as human carcinogens by the World Health Organization. After absorption, inorganic arsenic (iAs) is mainly methylated into monomethylated and dimethylated compounds (MMA, DMA), which are then excreted through the kidney together with unmethylated iAs. Whether the methylation process is to detoxify or potentiate arsenic toxicity, however, remains an ongoing debate. The purpose of this systematic review was to conduct a comprehensive meta-analysis to estimate the association between arsenic exposure and urothelial cancer.

Methods
10 observational studies met the inclusion criteria and were included in the systematic review. IAs%, MMA% and DMA% were extracted from each paper. Weighted Mean Differences with 95% confidence intervals were defined according to Cases minus Controls. Pooled risk estimates from individual studies were assessed using random effects models. Meta-regression analysis was performed to estimate the extent of urothelial cancer risk as a function of iAs%, MMA% and DMA%.

Results
Results showed as patients with urothelial cancer presented higher level of urinary iAs% (WMD 2.70, 95%CI 0.64-4.76), MMA% (WMD 2.81, 95%CI 1.43-4.20) and DMA% (WMD-3.44, 95%CI-6.57–0.30).

Conclusions
These findings suggest that higher level of iAs% and MMA% and lower level of DMA% were associated with an increased risk of urothelial cancer. Additional population based studies are needed to understand the role of arsenic in cancer development. Understanding the meaning of arsenic metabolism could improve the risk assessment of arsenic toxicity and provide a potential tool for disease prediction and prevention.

Key messages
Higher level of iAs%, MMA% and DMA% were associated with an increased risk of urothelial cancer. Understanding the meaning of arsenic metabolism could improve the risk assessment of arsenic toxicity.
Hillwalking and walk leading motivations, perceived benefits and the role of natural environment
Authors: Morocza N , Frankham J , Boddy L M , Mahon E , Stott T A 
Published: November 2019

Abstract

Background
Promoting the link between human and ecosystem health is crucial for building resilient communities. Hillwalking provides health benefits arising from physical activity and exposure to nature. Furthermore, it is likely to influence environmental knowledge and pro-environmental behaviour through connectedness to nature. This project aimed to explore 1) hillwalking and walk leading motivations and perceived benefits, and 2) the role of the environment and nature connectedness among walk leaders and walking holiday guests.

Methods
The first study was completed with seventeen volunteer walk leaders and used a mixed methods design: hillwalking interviews, physical activity measurements, location data and the Nature-relatedness scale. The second study involved five group interviews with the total of twenty-five guests on three different walking holidays. The qualitative data from both studies were analysed using a combined thematic and grounded theory approach and the results were merged with the quantitative data to explore the impacts of environmental factors.

Results
Primary motivations for hillwalking included pleasure, escape from everyday life pressures, to re-charge, being in nature, social inclusion and health. Emerging overarching themes such as balance and adaptation were reported as essential values for walking and were linked to nutritional, physical activity related and environmental aspects of health awareness. The perceived benefits positively impacted on engagement. Connectedness to nature was linked to environmental knowledge and attitudes which manifested in pro-environmental walking behaviour.

Conclusions
The pleasure arising from several aspects of hillwalking or walk leading was the drive for regular engagement, therefore a primary intrinsic motivation. The results imply that attending group walking holidays has the scope to increase environmental awareness and engagement in outdoor physical activity and could be considered as a promotion tool.

Key messages
The findings have the scope to inform future walking promotion programs and encourage long-term engagement by shifting the focus of promotion messages to intrinsic motivational factors. The results support that hillwalking can be used as a tool for combined health and environmental awareness promotion.
Facing climate change challenges: the Italian Public Health Residents response
Authors: Mammana L , Catalani F , Di Fonzo D , Giannico O V , Miceli R S , Righini M , Rivolta S , Sisti L G , Vaccaro F G 
Published: November 2019

Abstract

Background
Climate change (CC) is one of the most important global issues, and exerts a strong impact on public health (PH). Correlation between CC and PH is a matter of concern in the whole scientific community and requires an interdisciplinary approach. Nevertheless, the need to take action on CC sometimes contrasts with national and local policies, involved professionals’ training and citizens’ education. In order to face these challenges, the Italian network of public health residents “Consulta Specializzandi” of the Italian Society of Hygiene, Preventive Medicine and Public Health (SItI) decided to create a specific working group.

Objectives
Main objectives are education of PH residents and practitioners on CC, argument disclosure among the SItI and creation of interdisciplinary networks to promote and extend group activities. Secondary objective is development of a study to identify the gap between scientific evidence, recommendations and guidelines, and the European, national and local policies, with the aim of promoting bottom-up researches and good practices in CC management.

Results
The group was created in January 2019; activities started in March. Firstly we defined priorities and work mode. Then we analyzed scientific evidence and promoted self-training on the link between environment and CC and on the impact of CC on individual and public health. Finally, through attendance at workshops and scientific events, we began to train other PH residents and practitioners and started to create networks with other scientific societies, research centers and foreign academies, in order to promote international research, advocacy and disclosure between different institutions regarding the relationship between CC and PH.

Conclusions
The group has already partially achieved its main objectives, especially increasing awareness and training in CC and related issues. Further activities will permit to strength interdisciplinary networks and to move to secondary objectives.

Key messages
CC severely impacts society. Yet there is no widespread feeling of urgency to act towards its causes and consequences. A change in mindset is mandatory, from individual citizens to decision makers. PH residents and practitioners must be the main actors in training and education, advocacy, disclosure and network creation in CC research and management.
Healthier breath for all and everywhere – Urban air quality monitoring experience
Authors: Gajic J , Dimovski D , Vukajlovic B , Jevtic M 
Published: November 2019

Abstract

Issue/problem
Increasing attention is being paid to air pollution as one of the greatest threats to public and urban health. The WHO’s Urban Health Initiative points out the importance of collecting data and mapping the present state of air quality in urban areas. For citizens, such engagement is enabled by the appearance of personal air quality measurement devices that use crowd-sourcing to make measurement results publicly accessible in real time.

Description of the problem
As a way of contributing to air pollution monitoring in their town, three PhD Public health students conducted over 40 measurements between the start of June and end of August 2018 on various locations in the city of Novi Sad, Serbia. Measurements were performed using AirBeam personal air quality monitoring devices and their results presented as μg/m3 of Particulate Matter 2.5 (PM2.5) and automatically uploaded to the internet using the Air-casting app.

Results
Measurements conducted in public transportation vehicles returned the rather high average value of 40 μg/m3, where coffee shops and restaurants scored an even higher value of 48,67 μg/m3. The lowest average air pollution levels were registered near the Danube river bank (5.67) and in the parks (6), while the sites near crossroads or in the street showed average air pollution of 8.33 μg/m3.
Residential areas where smoking is present during the day reported 2.5 times higher PM2.5 values than those without smokers (33.8 and 12.78 μg/m3).

Lessons
Bearing in mind that the air quality is considered as a serious health risk in urban areas, results of this pilot investigation suggest potential health risk for citizens living in urban areas.
The negative effects of combustion and smoking on air quality are strongly highlighted, as well as the positive impact of green areas and parks near residential areas.

Key messages
Air pollution exposure as a serious health risk in urban areas. Crowdsourcing as a way of air quality monitoring has great potential for contributing to public health.
Integrated veterinary-medical activity on characterization of shigatoxin producing Escherichia coli
Authors: Bertasi B , Finazzi G , Colombo R , Vignati C , Dodaro A , Spelta C , Romanò A , Tel F , Ardissino G L , Luini M V 
Published: November 2019

Abstract

Background
Shiga toxin-producing Escherichia coli (STEC) are an important public health concern as they cause severe conditions (bloody diarrhea and hemolytic uremic syndrome - HUS) and have epidemic potential. Cattle are the main reservoir for the highly virulent STEC O157 strain, and other HUS-associated non-O157 strains. This study aimed to characterize strains from animals and humans and to compare their molecular profiles. Animal isolates were tested for the presence of virulence factors correlated to their pathogenic potential.

Methods
74 STEC human isolates from 43 clinical cases (sporadic or epidemic) and 270 animal isolates from feces from 62 cattle farms were collected. Epidemiological investigation to collect environmental and suspected food samples was carried out for 22 cases. All isolates were typed with PFGE and their serotype was defined by Real-Time PCR. Animal isolates were also tested for the presence of subAB, saa, tia, cfk, adfO, hlyA, efaI1-lifA5’3’, and toxB virulence genes.

Results
O157 was detected in 44% of human cases, other relevant serogroups O26, O111, O103, O145 in 21, 9, 5 and 5% of cases, respectively. The source of infection was identified in one case (cheese contaminated by a O157 strain). Among animal isolates 2, 0.7, 0.7 and 0.3% were identified as O157, O11, O113, and O145, respectively. PFGE highlighted a high heterogeneicity among animal strains, however no pulsotype common to cattle and clinical isolates was found. adfO, cfk, efaI1-lifA5’3’ and toxB were found significantly correlated to eae (intimin).

Conclusions
Human and cattle strains were not correlated, however STEC diversity in cattle was very high and included some strains potentially pathogenic to humans. For this reason, upholding an integrated surveillance is very important.

Key messages
Serotypes relevant to human health were found in cattle in a small but not negligible frequence. No direct correlation was found between animal and clinical isolates.
Customer satisfaction survey in Friuli Venezia Giulia university canteens
Authors: Perri G , Righini M , Tullio A , Del Pin M , Maifreni M , Marino M , Fedele M C , Parpinel M 
Published: November 2019

Abstract

Background
Customer satisfaction represents an innovative approach to measure strengths and weaknesses of an organization and is useful for a customer-focused management and culture development. Our survey’s aim was to investigate perceived quality and needs of customers in the university canteen sector.

Methods
Between April and June 2018, an anonymous online questionnaire was distributed by “agenzia regionale per il diritto agli studi superiori” (ARDISS) among university students in Friuli Venezia Giulia, Italy. The questions covered 3 thematic areas: attendance of the service, quality of services and opinions on new initiatives. Furthermore, there was an open question to collect students’ suggestions or proposals to improve the service. Satisfaction about the service was evaluated through five topics: environments, hygiene, staff, meals, global satisfaction. Collected data were analyzed with descriptive, univariate and multivariate analyses. Statistical analyses were performed using 9.4 SAS software.

Results
Response rate was 20.5% (1933/9404). Multiple logistic regression analyses showed a difference in meal choice (entire vs reduced) between institutional canteen and partner cafeterias users (p &lt; 0.0001) and that male (p &lt; 0.0001) and foreign students (p 0.0003) prefer entire meal instead of reduced. Percentage of students who prefer entire meal is reduced (p &lt; 0.0001) if price range increases. Univariate and multivariate analyses showed that high quality perception is associated with lower price range and no suggestions about food and environments (p &lt; 0.0001); multivariate analyses also showed an association between high quality perception and high canteen attendance (p &lt; 0.05).

Conclusions
The survey showed an association between meal choice and students’ profile and between perceived quality and customer’s features. These data and further analyses may help to select areas where an intervention could improve service quality and, therefore, customer satisfaction.

Key messages
Customer satisfaction is an important tool to measure and improve university canteen service quality. These results helped us to identify services’ strengths and weaknesses according to students’ opinions; this could be useful to select improvement areas.