bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiovascular risk factors and social determinants in a population study in Rio de Janeiro, Brazil
Authors: Ferreira L , Flumignan V , Marinho B , Sampaio F , Morais J , Botelho B , Mello T , Silva R , Fernandes A , Muxfeldt E 
Published: October 2020

Abstract

Background
The association of cardiovascular (CV) diseases and their risk factors with socioeconomic status has been well described, but its influence is often underestimated in epidemiological studies in Brazil.

Objective
To evaluate the relationship between the main CV risk factors and socioeconomic indicators in a population of adults registered in a Family Health Care (FHC) unit in a great urban center - Rio de Janeiro, Brazil.

Methods
Cross-sectional population study that included adults aged between 20 and 50 years living in the area covered by the FHC unit in Rio de Janeiro. Demographic data (gender and age), socioeconomic data (education level, profession, employment), CV risk factors (smoking, sedentary lifestyle, obesity, hypertension, diabetes, dyslipidemia) were recorded. The metabolic profile is evaluated through laboratory tests. Those who studied up to high school were considered poorly educated.

Results
604 individuals were enrolled [39% male, mean age: 38.8 ± 8,9 years] The median of schooling was 12 years. 288 individuals had high schooling, 44.5% were male. A total of 130 individuals did not study or work. Women with low education had a higher risk of smoking, obesity and hypertension with no difference regarding labor or study activities. Otherwise, men with low education had a higher risk of sedentary lifestyle and hypertension. Among men, not working or studying increased the risk of smoking and hypertension.

Conclusions
We found an inverse association between socioeconomic conditions and the prevalence of CV risk factors. Women are more affected by low schooling, while men are more affected by their working occupation. The study suggests that socioeconomic factors influence the CV risk, affecting men and women differently, pointing to the need for more comprehensive public health policies that effectively reverse this situation.

Key messages
We found an inverse association between socioeconomic conditions and the prevalence of CV risk factors. Socioeconomic factors influence cardiovascular risk differently according to gender.
Hydration status and hypertension in University workers
Authors: Padrão P , Moreira P , Silva-Santos T , Abreu S , Pinho O , Gonçalves C 
Published: October 2020

Abstract

Background
Vascular function and blood pressure regulation may be impaired by acute hypohydration but data on the association between hypertension and hydration status is scarce. The objectives of this study were to evaluate the hydration status in a sample of university workers and to assess the association between hypertension and hydration status.

Methods
A cross-sectional evaluation of a sample of 60 university workers (32 women) was conducted in 2019/2020 in Portugal. A 24-hour urine sample was collected; urinary volume, creatinine and osmolality were quantified. Free water reserve (FWR) was used to assess hydration status and subjects were classified as hypohydrated (FWR&lt;0) or euhydrated (FWR &gt; =0). Arterial blood pressure was evaluated [average of 2 blood pressure (BP) measurements] by researchers using standard methodology and participants with systolic and diastolic blood pressure ≥130 mm Hg and/or ≥80 mm Hg, respectively, were classified as hypertensive. A binary logistic regression model was used to estimate the association between hypohydration and hypertension, adjusting for sex, age and use of anti-hypertensive drugs. Odds Ratios (OR) and respective 95% Confidence Intervals (95%CI) were calculated.

Results
Hypertension was observed in 40.6% of women and 67.9% of men whereas hypohydration affected 31.3% of women and 32.1% of men. After adjusting for confounders, hypertension was associated with a 7-fold increased risk of hypohydration (OR = 7.56; 95% CI: 1.81-31.59).

Conclusions
These results stress the positive association between hypohydration and hypertension and highlight the need for implementing strategies for the promotion of water intake, particularly in the hypertensive patients.
This project was granted by Fundação para a Ciência e Tecnologia - Grant POCI-01-0145-FEDER-029269.

Key messages
Hypohydration affect nearly one third of this sample of university workers. Hypertension was associated with a 7-fold increased risk of hypohydration.
Barriers in access to cancer treatment in Europe: a systematic review of the European Literature
Authors: Jachmann A , Klingberg K , Zapata-Garcia M C , Srivastava D S , Exadaktylos A , Martin-Moreno J M 
Published: October 2020

Abstract

Background
Within NCD`s, Cancer accounts for the 2nd most frequent cause after Cardiovascular diseases and in some European countries it´s the leading cause of premature deaths. One of the challenges within cancer therapy can be found in inequity in access to cancer treatment, because this causes worse health outcomes, which are attributable to the accessibility of health care and thus avoidable. The objective of the systematic review was to identify barriers in access to cancer treatment in Europe (inter-country) and within 6 European countries (intra-country): Spain, Germany, Switzerland, Finland, Bulgaria, UK.

Methods
To obtain data scientific (PubMed, CINAHL, Embase) and grey literature were searched using keywords relating to inequity in access to cancer therapy in Europe. Collected Abstracts of published articles in English between 01/2013 and 05/2018 were reviewed independently. Identified barriers in access to cancer therapy were grouped into 2 categories: patient and health system/provider factors, followed by thematic analysis for each category.

Results
Out of 786 unique articles, 14 were included in the systematic review. The most frequent cited barriers within Europe were patient socioeconomic status (n = 7, 50%), age (n = 4, 28.6%) and reimbursement and availability of cancer medicine (n = 4, 28.6%).

Conclusions
This review showed that different barriers in access to cancer therapy still exist in Europe and therefore demonstrated an urgent need for actions to reduce these disparities across all Europe. Additional to the known equity stratifiers the role of health system factors concerning different reimbursement processes and shortages in widely used cancer drugs was emphasized. The amount of available studies with main focus on barriers in access to cancer therapy in Europe varies by equity stratifier, cancer site and type of treatment and seems to be very limited, showing a need for future investigations upon this topic with possibly uniform scales.

Key messages
This review showed that different barriers in access to cancer therapy still exist in Europe and therefore demonstrated an urgent need for actions to reduce these disparities across all Europe. Additional to the known equity stratifiers the role of health system factors concerning different reimbursement processes and shortages in widely used cancer drugs was emphasized.
The brand narratives of Philip Morris International: developing methods to identify corporate voices
Authors: Fitzpatrick I , Gilmore A , Cranwell J , Byrne D 
Published: October 2020

Abstract

Background
Existing research into marketing and advertising of tobacco companies shows the industry continues to spend huge sums of money promoting harmful products. In the face of increasing controls on the advertising of these products, and restrictions on their participation in policy development enshrined in a global treaty, tobacco companies must adapt to remain competitive in an unfavourable climate. Although there has been much engagement with the development of corporate messages by the 4 big tobacco brands, no systematic review of textual and visual corporate messaging used by these companies exists. This research presents the case of Philip Morris International (PMI), and maps out its key messages to investors and public audiences.

Methods
This research combines corpus linguistics with inductive coding to illustrate key topics, themes and the linguistic habits of PMI. A linguistic comparison with the messaging of 40 other transnational corporations provides a reference from which the unique characteristics of PMI's language can be identified.

Results
Thematic analysis of written and visual content highlights several dominant themes, namely Science, Transformation, Sustainability and Permissibility. Redemptive tropes were common in the sample, apparent in repeated reference to a desire to be and do better and to improve the lives of smokers around the world. Similarly, a strong emphasis on science was apparent in both the use of imagery and language, including scientific notation, laboratories and individual scientists.
The identification of linguistic and visual brand strategies will facilitate the education of advocates and consumers about the approach of the tobacco industry in their pursuit of continued business. Identifying the core values PMI is actively promoting could help to identify emerging corporate strategies in influencing public health policy, including the promotion of corporate goodwill in markets where product-specific advertising is banned.

Key messages
Big tobacco using new platforms to influence policy making. Corporate narratives impact perception of tobacco harm.
Qualitative appraisal of stakeholders’ perspective on diabetes mellitus policy in Jakarta, Indonesia
Authors: Bachtiar A , Edward A , Candi C , Sarena A 
Published: October 2020

Abstract

Background
Diabetes prevalence in Indonesia increased from 6.9% to 8.5% between 2013 and 2017.1 It was the third-leading cause of death in 2017. The government responded by introducing the Health Minimum Service Standard Policy (HMSS) in 2016. This study aims to perform a rapid qualitative appraisal of strategic stakeholders and capture their perspective on policy implementation.

Methods
We used a qualitative approach by interviewing stakeholders from the Ministry of Health, provincial and district-level governments, and 12 primary healthcare providers in Jakarta. The interview was performed from December 2019 to January 2020. Policy dissemination, implementation, and evaluation were also assessed during the interview. Triangulation was done with direct observation and routine data review at primary healthcare.

Results
The policy was disseminated from the MoH to state and district-level governments through workshops. It improved the coverage of screening, from 7.13% to 26.92% between 2017 and 2019 in Jakarta. Most stakeholders concerned about the problem with people's awareness and multisectoral collaboration to improve the coverage of diabetes services. PHC managers expressed internal threats (limited health workers, ineffective teamwork, and limited budget) and external threats (poor care-seeking, people's awareness, and commitment from across stakeholders) in implementing the policy.

Conclusions
Diabetes screening coverage in PHC has increased since the implementation of the policy, but below far from reaching a universal target. The government should collaborate with PHC to address the issues of internal and external threats.

Key messages
The 'SPM' policy introduced in 2016 has provided guidance for state and district-level government to assist the efforts on improving diabetes screening by PHCs in Indonesia. Coverage for diabetes screening in Jakarta, the capital city of Indonesia, has not reached the target. Further exploration of external and internal threats at PHC level is needed.
Cancer cluster and citizen alarms: epidemiological and statistical approaches
Authors: Miligi L , Stoppa G , Piro S , Caldarella A , Intrieri T , Mannesci G , Ferrari C , Biggeri A , Catelan D 
Published: October 2020

Abstract

Background
Respond to alarms for possible cancer cluster is a public health problem, but the management of these alarms is difficult and sometime conflictual.

Methods
We reviewed the guidelines on the management of disease clusters developed in various countries and the approaches used in previous disease cluster episodes in Tuscany. Statistical approaches for cluster detection were also reviewed. We performed a clustering analysis (spatio or spatio-temporal when appropriate) on childhood leukemia using data from Tuscany Cancer Registry (RTT). We used spatial hierarchical Bayesian model on aggregate data at municipality level. We performed test for general clustering and cluster detection on individual data.

Results
More than 100 tests for clustering analysis has been identified in the literature. Bayesian analysis on aggregate data did not show areas at higher risk with the exception of the city of Florence for childhood cancer among males. We did not found clusters for leukemia. In previous studies on disease clusters in Tuscany, most investigations have been started from community concerns and in the majority of situations a multidisciplinary approach was used. In some case an increase of incidence rate was observed, but rarely specific cluster cancer tests were used.

Conclusions
Hierarchical Bayesian models to aggregate data provided useful to identify long range geographical patterns while clustering analysis on individual data is a useful tool for small scale patterns. Both represent important tools for epidemiological surveillance studies particularly on childhood cancer. The best test for all situations doesn't exist, but the choice is determined by the type of question being asked from the data, by different situations and by different approaches. The Tuscany cancer clusters survey and the review of the guidelines on the management of clusters developed in different countries, give us the opportunity to formulate some suggestions for the health agencies.

Key messages
Respond to alarms for cluster of cancer and suggest recommendations for epidemiological and statistical standardized approaches is a public health issue. Tuscany cancer clusters survey and the review of the guidelines on the management of clusters developed in different countries, give the opportunity to formulate some suggestions for health agencies.
Prostate cancer incidence and predictions: Observational Study (Monastir, Tunisia: 2002-2030)
Authors: Bannour R , Zemni I , Ben Nasrallah C , Aroua N , Kacem M , ben Fradj M , Dhouib W , Abroug H , Sriha A 
Published: October 2020

Abstract

Introduction
Cancer is an eminent public health issue in the developing countries. The risk factors incriminated in cancer higher incidence are multiple such as the growing population rates, increasing tobacco consumption, the changes of diet and lifestyle. In Tunisia, there are three population-based cancer registries at the present time providing data on cancer incidence and survival. According to the data published by WHO International Agency for Research on Cancer (IACR) (GLOBOCAN 2018), prostate cancer in Tunisia ranks fifth among cancers with almost 819 new cases per year. The aim of this study was to we report trends in the cancer incidence during the span of time between 2002 and 2013 from the population-based cancer registry of the centre of Tunisia, and to predict the future number of cancer cases by 2030.

Methods
The cancer incidence data were collected from the Center cancer registries from 2003 to 2012.The data were stratified by cancer site, sex and age. We used SPSS software in order to calculate the crude incidence rates and age-standardized incidence rates. SPSS software was used in order to estimate the future number of cancer cases by 2030.

Results
A total of 725 cases of prostate cancer were enregistrated. The mean age of patients was 71.6 ±10.61years. The crude incidence rates were estimated 23.537. The standardized incidence rate was 33.92. A significant positive trend was noted with a b = 0133 and p &lt; 10-3. 1033 new cases are predicted by 2030

Conclusions
The data of the cancer register of the center shows that the incidence of cancer is rising, and it is consistent with the National cancer intelligence, but some cancer incidence showed slightly higher, such as thyroid cancer and prostate cancer. In order to face this alarming situation, many preventive steps should be done such as strengthening early screening and diagnosis of cancer, improving clinical research in order to better control the risks factors.

Key messages
Prediction of the future number of cancer cases is of great interest to society. Prostate cancer in Tunisia ranks fifth among cancers.
Addressing oral health-related quality of life of the elderly – A Oral health promotion approach
Authors: James A 
Published: October 2020

Abstract

Background
Older people are representative of the vulnerable population. According to census 2011, the proportion of elderly in India is 8.6%. Owing to social transformation and evolving lifestyles, the number of old age homes is increasing rapidly with institutionalized elderly having poorer oral health status. This study was conducted to assess the situation among the sample of institutions meant for the elderly and to plan relevant intervention, policy development aligning with principles of health promotion to improve the oral health quality of life.

Methods
A mixed-method study was adopted after approval from the institutional ethical board. To plan an appropriate intervention, situation analysis was done by conducting in-depth interviews, administrating questionnaires and direct observation. The intervention was planned based on the data obtained by building healthy public policy by a memorandum of understanding (MoU) between institutions, distribution of oral hygiene aids, oral health education, and demonstration of oral hygiene techniques. Institutionalized elderly selected for intervention in an old age home were 82. At baseline, oral health quality of life was assessed using the Geriatric Oral Health Assessment Index (GOHAI). After 3 months follow-up, Paired t-tests were used to compare baseline and follow-up data.

Results
Qualitative data on thematic analysis revealed that administrators highlighted on fiscal, economic, administrative, personnel, ethical aspects of policy instrument and type of oral health care services to be provided. Quantitative results showed that mean and SD for the pre and post GOHAI score was 1.6 ± 0.41 and 3.06 ± 0.80 (P &lt; 0.001)

Conclusions
Oral health promotion approach to address challenges and issues at the community level appears a more promising approach as it facilitates a systematic process and more comprehensive. Policy initiatives with stakeholders brought a sustainable improvement of oral health quality of life.

Key messages
Ottawa charter model oral health promotion based intervention with the coordination of stakeholders helps in improving functional ability and intrinsic capacity of institutionalized elderly. To improve the quality of life among institutionalized elderly there is a need for transformation of health systems away from disease based curative models to comprehensive health care models.
Trends in cardiovascular disease in the region of Monastir (Tunisia) over 12 years
Authors: Abroug H , Ben Fredj M , Zemni I , Kacem M , Bennasrallah C , Dhouib W , Sriha A 
Published: October 2020

Abstract

Background
Cardiovascular diseases (CVDs) are the major cause of morbidity and mortality worldwide. However, CVD prevalence trends is still weakly documented in Tunisia. The objective of this study is to examine trends in the prevalence of CVDs in the Monastir region between 2002 and 2013.

Methods
Data were collected from the regional register of hospital morbidity. The register refers to the WHO International Classification of Diseases, 10th revision (ICD-10). Data were verified and analyzed using IBM SPSS Statistics version 22.0 software. Linear regression was used to calculate the slope 'b' of the least-squares line to estimate admission trends for each CVD category according to sex and age group. A p-value of 5% was considered statically significant.

Results
From 2002 to 2013, cardiovascular diseases accounted for 21,240 hospital admission in the region of Monastir, representing more than a quarter (28.7%; CI 95%: 28.1-29.3%) of all Non Communicable Disease admissions in adults. Males represented 55.9%. The median age at admission was 64 years (IQR 54-71 years). The CVD crude prevalence rate (CPR) was 3.60 /1,000 inh. The age-standardised CVD rate (ASR) was 4.56 per 1000 PY and it was higher in men than in women (5.41 vs. 3.72, respectively, p &lt; 0.001). CVD prevalence rate increased over time (b = 17.78; p&lt;.001). This increase was significant in men (b = 33.69; p &lt; 0.001) and in age groups over 40-years-old (b = 15.30; p &lt; 0.001). However, it declined significantly in women (b= -16.32; p &lt; 0.001). Coronary heart diseases (CHD) were the most prevalent CVD categories (47.7%).

Conclusions
Hospital admissions for CVD increased over the study period, in particular in men and in age groups over 40-years-old. CHDs were the prevalent disease. A comprehensive prevention strategies focused on lifestyle habits such as unhealthy diets, physical inactivity and tobacco consumption are greatly recommended to improve this prevalence trends.

Key messages
Over a 12-year period, CVD prevalence increased in men but not in women at the university hospital of Monastir. A comprehensive prevention strategies focused on lifestyle habits such as unhealthy diets, physical inactivity and tobacco consumption are greatly recommended to improve this prevalence trends.
DICA endoscopic classification: 2-year analysis from an international, multicenter prospective study
Authors: Nasi G , Tursi A , Di Mario F , Elisei W , Picchio M , Bafutto M , Dumitrascu D , Regula J , Mastromatteo A M , Brandimarte G 
Published: October 2020

Abstract

Background
Diverticulosis of the colon is the most frequent anatomical alteration detected during colonoscopy. The endoscopic classification “DICA”(Diverticular Inflammation and Complication Assessment) has been recently developed in order to have an objective endoscopic description of the colon harbouring diverticula. Aim of this multicentre, international, prospective study was to assess the predictive value of this classification in term of acute diverticulitis and surgery occurrence on a 2-year observational follow-up period.

Methods
2215 prospective patients at the first diagnosis of diverticular disease were enrolled after exclusion of radiological signs of acute diverticulitis; inflammatory bowel diseases; ischemic colitis; prior colonic resection; patients with severe liver failure (Child-Pugh C) or severe kidney failure; pregnant women; patients who are currently using or who have received any laxative agents or mesalazine or probiotics or antibiotics &lt; 2 weeks prior to the enrollment; inability to comply with study protocol; patients with or history of cancer, of any origin, within 5 years before enrollment; history of alcohol, drug, or chemical abuse.

Results
1377(62.15%) patients were classified as DICA 1, 599(27,04%) as DICA 2 and 239(10.80%) as DICA 3. The risk of acute diverticulitis occurrence/recurrence, as well as the risk of surgery, were significantly linked to the severity of DICA score at entry. Overall, acute diverticulitis occurred in 123 (5,5%) patients: it occurred in 32 (2,3%) DICA 1, 53 (8,9%) DICA 2 and 32 (16.4%) DICA 3 patients respectively (p &lt; 0,0001). Overall, surgery occurred in 35 (1,6%) patients: it occurred in 2 (0.1%) DICA1, 15 (2,5%) DICA 2 and 18 (7,6%) DICA 3 patients respectively (p &lt; 0,0001).

Conclusions
The 2-year results of this prospective study seems to confirm that DICA endoscopic classification has a significant prognostic role on the risk of acute diverticulitis occurrence/recurrence and surgery in these patients.

Key messages
DICA is the first endoscopic classification of diverticular disease. The risk of occurrence/recurrence of acute diverticulitis and the risk of surgery are strictly linked to the severity of DICA score.