bluuebunny/crossref_metadata_2025_split huggingface dataset:
What regional living conditions affect hypertension in Russia?
Authors: Maksimov S , Zelenina A , Balanova Yu , Shalnova S , Muromtseva G , Kapustina A , Drapkina O 
Published: October 2021

Abstract

Background
The area of residence and its characteristics affect cardiovascular disease indicators at different spatial scales. Our study evaluated the impact of a wide range of characteristics of large administrative regions (socio-economic, etc.) on individual probability of the prevalence, awareness, treatment, and control of hypertension among the Russian adult population.

Methods
We used data from the cross-sectional phase of the epidemiological study “Epidemiology of Cardiovascular Diseases in the Regions of the Russian Federation” (ESSE-RF) conducted in 2013-2014. A total of 19,791 individuals aged 25-64 years were examined. To calculate regional indices, 64 indicators were obtained from the official website of the Federal State Statistics Service of Russia.

Results
There were no associations between the territorial characteristics and the prevalence of hypertension in the general population. However, the Socio-Geographical Index has a direct impact on men (OR = 1.18; 95% CI: 1.05-1.32), people with low education (OR = 1.14; 95% CI: 1.02-1.27) and older people (OR = 1.16; 95% CI: 1.02-1.32). Hypertension awareness is directly associated with the Demographic (OR = 1.13; 95% CI: 1.02-1.25) and Industrial Territory Index (OR = 1.15; 95% CI: 1.01-1.33). The deterioration of the social situation (Socio-Geographic Index) related to poor adherence to treatment (OR = 0.76; 95% CI: 0.64-0.90) and poor control of hypertension (OR = 0.79; 95% CI: 0.69-0.90). The influence of territorial characteristics on the awareness, treatment, and control of hypertension is less pronounced than the individual characteristics of the population and differs when stratified by gender, age and educational level.

Conclusions
The analysis made it possible to assess the influence of the characteristics of the population living in large areas on the prevalence, awareness, treatment, and control of hypertension. These patterns reflect an empirical approach to the territorial characteristics.

Key messages
The first attempt to understand why there are such significant differences in the prevalence, awareness, treatment and control of hypertension in the Russian regions. New knowledge about the impact of living conditions on the health status.
Moderate partially skimmed milk consumption is associated with reduced mortality risk
Authors: Ruggiero E , Di Castelnuovo A , Costanzo S , Esposito S , Persichillo M , Cerletti C , Donati MB , de Gaetano G , Iacoviello L , Bonaccio M 
Published: October 2021

Abstract

Background
Data on milk and other dairy products intake with health outcomes are inconsistent. We investigated the association of milk and total dairy consumption with the risk of all-cause and cause-specific mortality in a Mediterranean population.

Methods
We performed a longitudinal analysis on 22,889 men and women (mean age 55.4±11.7 y; 52.3% women), from the Moli-sani Study cohort (enrollment 2005-2010) followed-up for a median of 11 years. Dietary data were collected through a 188-item food frequency questionnaire. Total dairy consumption (g/d) was calculated as the sum of milk (whole and partially-skimmed, g/d), yogurt (whole and partially skimmed, g/d) and cheese (fresh and hard, g/d). Hazard ratio (HRs) with 95% confidence interval (CI) were calculated by multivariable Cox regression, modelled by spline curves.

Results
In multivariable-adjusted analysis controlled for sociodemographic, clinical and dietary factors, cheese, yogurt or whole milk intake were not associated with either all-cause or cause-specific mortality (p for overall association &gt;0.38), as well as was total diary intake (p &gt; 0.18). On the contrary, non-linear J-shaped curves were observed for the association of partially skimmed milk intake with all-cause and cancer mortality (p value for total and non-linear association=0.0072 and 0.035, and 0.097 and 0.049, respectively; magnitude of the relative reduction =16% and 18% at nadir of 128 and 114 g/d, respectively). A linear association between partially skimmed milk intake and CVD mortality was observed (p for association =0.047; p for non-linearity= 0.41), with HR = 0.82 (95%CI: 0.68-0.98) at 125 g/d and a window of statistically significant protection ranging from 100 to 250 g/d.

Conclusions
In a large Mediterranean population of adults, consumption of 1 standard cup of partially skimmed milk was associated with lower all-cause, cancer and CVD mortality. Other dairy sources were not associated with mortality.

Key messages
In a large Mediterranean population, total dairy intake did not predict mortality. Daily consumption of 1 standard cup of partially skimmed milk lowers the risk of all-cause, cardiovascular and cancer mortality.
Public Health Services during the COVID-19 pandemic in 3 European countries: PT, EN and DE
Authors: Vareda R , Garcia T , Rachadell J 
Published: October 2021

Abstract

Background
Monitoring and responding to health hazards and emergencies is an Essential Public Health Operation delivered by public health services (PHS) (2). In the European Region, there is a wide range of organizational and financial models for PHS delivery to the populations, but the best approach is still largely unknown (3). This work aims to analyze PHS organization and financing and compare their health results during the COVID-19 pandemic in 3 countries: Portugal, England and Germany.

Methods
We searched The European Observatory on Health Systems and Policies database; GoogleScholar® for the terms “organization” and “financing” associated with PHS and Europe; OurWorldInData® for COVID-19 data.

Results
PHS Organization: PT has national, regional and local units with a top-down decision-making hierarchy, though information flows both ways. EN has the national health system and Public Health England (that supports autonomous local elected health authorities), with independence and little overlapping between them. DE has Federal, State, County and Municipal health actors with self-government and administrative autonomy to a certain degree. Spending on ‘preventing care' as a share of total health expenditure: PT (1,7%), DR (3,2%) and EN (5,1%). COVID-19 cases: DE showed best results while PT and EN were similar.

Conclusions
WHO states the most effective and efficient method of delivering PHS is through an integrated approach, rather than through vertical programmes (2), but PT vertical organization with information flowing both ways and a network of horizontal supporting PH institutions may favor needed coordinated responses during a pandemic. In geographically larger countries, exerting autonomous decisions at different levels may improve preventive measures' efficacy. This analysis adds to the previous literature that suggests the most efficient PHS are adapted to local contexts.

Key messages
The best PHS organization is still unknown, though adaptation to regional and local contexts seems key for better results. Greater spending on “preventive care” does not necessarily guarantee better results, suggesting PHS organization may have a more important role.
Practice surrounding adverse events in residential care facilities in Ireland
Authors: McGrane N , Dunbar P , Dunnion M , O'Connor L 
Published: October 2021

Abstract

Background
Part of regulation of residential care facilities (RCFs) is the statutory responsibility of RCFs to notify the regulator about adverse events (AEs). Notifications typically include a description of practice in the aftermath of AEs and are an information source that can inform quality and safety improvements. The herein aim therefore was to analyse narratives in notifications received by the Health Information and Quality Authority (HIQA) in Ireland, to identify practice surrounding AE management and reporting.

Methods
A sample (n = 447) of notifications received by HIQA in 2018 was drawn from the Database of Statutory Notifications from Social Care in Ireland, 2013-2019. Inductive thematic analysis was conducted. Analysis was structured using the a priori agreed themes of: practice in the aftermath of an AE, system vulnerabilities and reporting practices.

Results
Two overarching themes were identified. The first, a chronological theme contained three sub-themes: pre event, including existing measures and situations, response to the event and continued response. Measures that are resident focused and follow policies and protocols in RCFs to prevent or mitigate the seriousness of AEs, were evident in the response and continued response. From this chronological order emerged the cyclical theory where short and longer term actions become part of the pre-event of future similar or repeated AEs. The second overarching theme, regulatory input, encapsulated procedural notes, requests for further information and notes on repetitive patterns.

Conclusions
RCFs respond to AEs with short and longer term actions with resident health and wellbeing as the focus. These actions in turn become part of the pre-event of future AEs. This cycle can be leveraged for quality improvement initiatives. Input from inspectors was positive and constructive but highlighted some regulatory burden. Dissemination of these results as good practice guides may improve management and reporting of AEs.

Key messages
Residential care facilities respond to adverse events with short and long term measures which feed into the management of future AEs. This cycle can be leveraged for quality improvement initiatives. Improvement opportunities in reporting practices were found. The development of good practice guides for residential care facilities and inspectors could reduce regulatory burden.
Evidence and recommendations for a value-based decision making on vaccinations
Authors: de Waure C , Calabrò GE , Tognetto A , Carini E , Giacchetta I , Bonanno E , Mariani M , Ricciardi W , de Waure C 
Published: October 2021

Abstract

Issue/problem
Vaccinations are one of the most successful public health measures and contribute to the achievement of Sustainable Development Goals. Despite this, there are still several challenges, such as poor resources, unequal access, and vaccine hesitancy. An exploitation of the full value of vaccinations could help contrasting them.

Description of the problem
A dual approach was followed to exploit full value of vaccinations. First, the four pillars of value pinpointed by the Expert Panel on Effective Ways of Investing in Health of the European Commission, namely personal, societal, allocative, and technical value, were considered to carry out a systematic review of available papers addressing the value of vaccinations. The synthesis of data was the submitted to a panel of international experts in vaccinations who gave inputs on recommendations to drive a value-based decision-making.

Results
Overall, 54 papers published from 2010 onwards addressed at least one pillar of value with most of them (83.3%) assessing a single one. Two-thirds of papers addressed the technical pillar, namely the economic value, in most cases without catching the broad economic implications. Very few studies addressed allocative and societal value highlighting the need to generate evidence to support the application of these pillars. Furthermore, some aspects of the allocative pillar, such as equity, accessibility, and appropriate use, were not addressed so far. Recommendations on research on full value of vaccinations, decision-making process and public engagement were eventually issued.

Lessons
The project allowed to apply for the first the value-based approach to vaccinations. This led to the identification of current gaps in the assessment of full value of vaccinations and to recommendations to foster a value-based decision-making. These results have international relevance because of the growing attention to the value-based approach for sustainable health systems.

Key messages
The full value of vaccinations need to be further investigated according to the four pillars pinpointed by the Expert Panel on Effective Ways of Investing in Health. Different actions could be promoted with respect to research, decision-making process and public engagement in order to exploit the full value of vaccination and drive a value-based decision-making.
Hepatitis C infection among primary health care patients: prevalence and risk factors
Authors: Ciupkeviciene E , Dragunas G , Dabravalskis S , Petkeviciene J , Kupcinskas L 
Published: October 2021

Abstract

Background
Many people chronically infected with the hepatitis C virus (HCV) are not aware of their infection. The benefit of screening for HCV is earlier treatment with antiviral medications, which are highly effective and can prevent long-term complications of chronic HCV such as cirrhosis, liver cancer, and death. This study aimed to examine the prevalence of HCV infection and its risk factors among primary health care patients.

Methods
The study was carried out in the primary health care centre of seaport Klaipeda, Lithuania. Patients were invited to participate in the screening by family doctors, regional media, social networking sites, and leaflets. Screening for HCV involved a blood test for the presence of an antibody to HCV (TOYO rapid test). Those with positive test results and a randomly selected control group of patients with negative test results were invited to participate in a telephone interview about possible risk factors of infection. In total, 1720 patients were screened. The HCV infected group consisted of 32 patients (56.3% men, mean age 55.4±9.4 years) and a control group of 96 patients (55.2% men, mean age 54.8±9.5 years).

Results
The prevalence of HCV infection among screened patients was 1.9%. The odds ratio (OR) of HCV infection in patients who reported blood transfusions before 1993 was 7.7 (95% CI 2.1-27.6) compared to those who did not have a blood transfusion or had later. HCV infection was diagnosed more often among patients who were blood donors before 1993 compared to those who were not donors or were later (OR 5.6; 95% CI 2.3-13.1). Having a tattoo increased the likelihood of HCV infection by 5.6 times (95% CI 2.1-14.4). Injection of illegal drugs was reported by 8.4% of HCV positive patients, 34.9% of them was in a prison for more than 3 months.

Conclusions
Primary health care institutions should consider screening people who are at high risk of HCV infection.

Key messages
Risky behaviours are associated with higher risk of HCV infection. Epidemiologic data on HCV infection is crucial for developing optimal healthcare policies for the prevention and treatment of HCV infection.
Neutrophil-Lymphocyte Ratio as a Prognostic Factor for 15-Day Mortality of Patients infected in ICU
Authors: Tsoumbou-Bakana G , El Fahr K , Tamir M , Traore B , Charra B 
Published: October 2021

Abstract

Introduction
The determination of the groups at risk of death at admission in patients with bacterial infection in the ICU is important. Several prognostic factors have already been identified, however the neutrophil/lymphocyte ratio (NLR) has the advantage of being common and inexpensive.

Objective
To determine the threshold value of NLR to determine the group at risk of 15-day mortality and the overall survival of patients according to this threshold.

Methods
This was a retrospective cohort conducted in the intensive care unit of the Ibn Rochd University Hospital in Casablanca over a period of 2 years (January 2019 - January 2021), among hospitalized patients with bacterial infection, acquired or nosocomial. The sample size was calculated a priori and multivariate statistical analyses (multiple logistic regression, Youden index and Kaplan Meier survival estimation and Log Rank) were performed using Rstudio software. The significance level was less than 5%.

Results
A total of 200 patients were included in the study, 136 patients were alive at 15 days, there were no differences in age between the two groups. Factors associated with patient mortality at 15 days were: gender, use of vasoactive drugs, use of mechanical ventilation, type of sepsis, site of infection, SOFA score (p &lt; 0.000), Apache score (p = 0.009) and NLR at admission (p = 0.001). The cut-off value for NLR was 15.07 with a mean discriminant value of 64.1%. The difference in median overall survival of patients in the two groups according to the threshold value was statistically significant 22 +/- 1.9 days and 11 +/-1.12 days (p = 0.042).

Conclusions
The NLR appears to be a prognostic factor for 15-day mortality. The knowledge of prognostic factors and threshold values of these indicators allow the prediction of at-risk groups in order to best adapt their management.

Key messages
The use of common and inexpensive biological prognostic markers are a reliable alternative to identify at-risk patients to optimize their management in developing countries. The RNL is a good biological prognostic markers of mortality of patients infected in ICU.
Young scientists: facing arboviruses and youth participation in the Ceilândia territory, Brazil
Authors: Cavaca A , Padrão MR , Rocha F , Mourão C , Garcez L , Silva M , Köptcke L 
Published: October 2021

Abstract

Background
Arboviruses currently represent a growing public health problem in the world. There is a set of structural and historical issues involved in the health-disease process and arboviruses prevention, among which are the need for critical and problematizing health education, with real participation of the school community and commitment of young students in the territories. Therefore, the study aims to analyze a training experience in scientific initiation on arboviruses, from the youth perception, as protagonists in the territory of Ceilândia-Distrito Federal-Brazil.

Methods
This study is characterized as a qualitative research-action, which was structured in 3 stages: 1) document analysis of the essays written by the students; 2) realization of the Training Course for Scientific Initiation in Basic Education and Arboviruses; 3) focus group with 12 students, after having participated in the training activity, in order to understand their pe rceptions about the educational process and its repercussion in the protagonism and responsibility of acting in the territories.

Results
The results of the Content Analysis showed the students' perception centered on eight analytical categories: students' motivation for scientific initiation; process of knowledge formation; importance of the scientific dissemination; training of young scientists; relationship of arboviruses with waste accumulation; health and environment; arboviruses prevention and control; youth participation and empowerment.

Conclusions
Facing arboviruses requires broad-spectrum policies and interventions, with interdisciplinary actions in society, both in the health and education scenarios. It is understood that youth are social protagonists in facing the vulnerabilities to which they are subjected. Therefore, scientific education strengthened the Ceilândia's youth as subjects of rights, stimulating the innovation in preventive ac tions to combat arboviruses in the territory.

Key messages
Facing arboviruses requires interdisciplinary broad-spectrum policies and interventions. Scientific education stimulates youth leadership in combating arboviruses in the territory.
Protector factors for use of non-prescribed hormones among transwomen in São Paulo, Brazil, 2020
Authors: Bassichetto K , Maschião LF , Paiatto BNM , Paula LG , Gomez Junior JL , Rocha F , Spíndola C , Barros C , Veras MA 
Published: October 2021

Abstract

Despite the Brazilian universal and free of charge public health system, transwomen (TGW) still face barriers to their right to access healthcare, especially transition-related. One of the most common gender- affirmative need is the use of hormones, which is available for free in the health national system. In spite of that, the use of non-prescribed hormones is a reality - rising the risk of complications. The aim of this analysis is to describe the frequency of non-prescribed hormones and assess risk factors among TGW. TransOdara is a cross-sectional study, conducted in São Paulo, Brazil, from December 2019-October 2020, which included TGW&gt;18 years. Participants were recruited from an ongoing cohort study, originally assembled using RDS. A questionnaire collected socio-demographic and behavioral information. Predictor variables for non-prescribed hormone use were assessed using multivariable logistic regression. Brazilian MOH and PAHO supported the study. 403 TGW participants were recruited. The mean age was 34.4 years (SD 9.6). The majority (70%) declared themselves black/parda, while 103 (27%) participants self-reported white and 12 (3.0%) yellow/Indigenous. Most (95%) reported ever having taken hormones, from which 48.8% (197/384) reported presently taking hormones. Among those, 53% (104/196) reported non-prescribed hormone use. Among participants that ever took hormones, mean age for starting was 18.6 years (SD 6.7). In our multivariate model, higher education - high school (p &lt; 0.05) and incomplete college or higher (p &lt; 0.005) - and older age (p &lt; 0.005) were protective factors for non-prescribed hormone use, adjusted by income and ethnicity. Non-prescribed hormones use is high among TGW, even though free access in Brazil's health system. High formal education and being older are protection factors for using hormones out of professional supervision. There is an urgency to review the current policy strategies, aiming to reduce this health risk behavior.

Key messages
Use of hormones among TGW is high. Majority reported hormonization out of professional supervision in lifetime. High formal education and being older are protective factors for non-prescribed use.