bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lockdown constipation insidence and associated factors among adults during COVID-19 in Turkey
Authors: Yilmazel G 
Published: October 2021

Abstract

Background
The COVID-19 pandemic, by restricting population mobility, may exacerbate the risk factors for new constipation. This study was aimed to determine lock-down constipation incidence and associated factors among adults during COVID-19 pandemic in Çorum city from Turkey.

Methods
A descriptive, cross-sectional study was conducted on adult Turkish population (above 20 years of age), applying an electronic survey between December 2020-February 2021 to evaluate: demographic characteristics, nutrition behaviors, physical activity, weight gain, constipation incidence (according to Rome IV criteria) and coronavirus anxiety with Coronavirus Anxiety Scale Brief Form.

Results
Out of 816 participants evaluated, 301 (36.8%) developed new constipation with a significant decreased in the daily water consumption (p &lt; 0.05) and physical activity, increased consumption of caffeinated beverages, skipped breakfast often, feeding mainly flour and cereal products, and weight gain (p &lt; 0.05) during lock-down. Coronavirus anxiety was detected in 35% of participants and the incidence of constipation was significantly higher in those with coronavirus anxiety (p &lt; 0.001). The multivariate analysis (logistic regression) showed that low water consumption (OR:1.67; p = 0.004), poor fiber diet (OR:1.45; p = 0.000), decreased physical activity (OR:1.34; p = 0.039), weight gain (OR:1.23; p = 0.000) and coronavirus anxiety (OR:1.17; p = 0.000) were associated with “new” constipation.

Conclusions
Lock-down constipation incidence was considerably high among adults and associated with lifestyle behaviors and coronavirus anxiety due to COVID-19 pandemic.

Key messages
Lock-downs may trigger the development of new constipation and anxiety. Risk factors related to the behavior of constipation come to the fore in lock-downs.
11.F. Workshop: Provision of strategic information during the COVID-19 pandemic through a multiple-layers model
Authors:   Organised by: Robert Koch Institute (Germany),   Chair persons: Johanna Hanefeld (Germany), Charbel El Bcheraoui (Germany)
Published: October 2021

Abstract

The response to the COVID-19 pandemic has been random across the world's geographic, economic, social, and political settings, with no one unique approach identified as most successful. The fact is that to respond to a pandemic domestically, public health decision makers need timely and extensive knowledge from international settings, especially about successful practices. Within the Robert Koch Institute, different departments monitor and respond to the epidemic situation domestically. To supplement routine data from domestic settings, the Centre for International Health Protection (ZIG) deployed three additional mechanisms to feed strategic pandemic-related international information into the domestic response. The evidence provided to the appropriate decision makers was collected, evaluated, and synthesized on a daily, bi-weekly, and need-based frequency. Each of the three mechanisms will be presented with a focus on a specific analysis example. The discussion that follows will allow us to share our lessons learned on using international data in domestic epidemic control. Our objective is to inform the public health community on a variety of mechanisms to utilize information from international settings to control their domestic epidemic.

Key messages
Domestic epidemic response should comprise evidence from international settings: a systematic and structured process for data monitoring and analysis is needed to support evidence-informed policies. Departments of international health imbedded within domestic public health agencies can deploy a multiplicity of mechanisms to provide such evidence.
Ethical parameters and guidelines for the introduction of potentially discriminatory measures
Authors: Maeckelberghe Els 
Published: October 2021

Abstract
The last panelist will present key ethical considerations under which the DCC was introduced, determining whether extrapolating such an approach, even given extenuating circumstances sets a precedent serving solely a utilitarian perspective. Different approaches will be discussed on whether the immunised ought to be treated preferentially (granted unrestricted freedoms or a greater degree of freedom for the DCC holders) and whether there are grounds to argue the non-immunised can be justifiably discriminated against (restricted freedom). The basis upon which there can be such discrimination, i.e., healthy, innate biological characteristics, etc., will be further elaborated upon. A key aspect on whether non-contagious, but non-immunised people should experience the same freedoms will also be discussed (given freedom restrictions are normally regarded as a form of punishment). Guidelines for studying the introduction of such measures and ethical parameters to consider when planning research for such public health measures will also be discussed, incl. the assessment of of trade-offs for the individual vs. the broader societal good.
Non–Small-Cell Lung Cancer: Real-World Cost Consequence Analysis
Authors: De Polo A , Buja A , Pasello G , Bortolami A , Zorzi M , Schiavon M , Marchetti M , Baldo V , Rugge M , Conte PF 
Published: October 2021

Abstract

Background
The present work aimed at conducting a real-world data analysis on the management costs and survival analysis comparing data from non-small-cell lung cancer (NSCLC) cases diagnosed in the Veneto region before (2015) and after (2017) the implementation of a regional diagnostic and therapeutic pathway including all new diagnostic and therapeutic strategies.

Methods
This study considered 254 incidental cases of NSCLC in 2015 and 228 in 2017 within the territory of the Padua province (Italy), as recorded by the Veneto Cancer Registry. Tobit regression analysis was performed to verify if total and each item costs (2 years after NSCLC diagnosis) are associated with index year, adjusting by year of diagnosis, sex, age, and stage at diagnosis. Logistic regression models were run to study overall mortality at 2 years, adjusting by the same covariates.

Results
The 2017 cohort had a lower mortality odd (odds ratio, 0.93; P = .02) and a significant increase in the average overall costs (P = .009) than the 2015 cohort. The Tobit regression analysis by cost item showed a very significant increase in the average cost of drugs (coefficient = 5,953, P 5 .008) for the 2017 cohort, as well as a decrease in the average cost of hospice care (coefficient = -1,822.6, P = .022).

Conclusions
Our study showed a survival improvement for patients with NSCLC as well as an economic burden growth. Physicians should therefore be encouraged to follow new clinical care pathways, while the steadily rising related costs underscore the need for policymakers and health professionals to pursue the most rational utilization of public resources.

Key messages
Our work underscores the importance of real-world assessment of costs in oncology, especially in case of a disease like NSCLC, which has such a high impact on treatment costs and patient outcomes. New therapies prolong survival for patients with NSCLC but their sustainability reminds of the importance of prevention: the earlier the diagnosis, the longer the survival and the lower the costs.
The effects of the COVID-19 lockdown and socio-economic factors on stroke hospitalizations in France
Authors: Plat R , Vasile M , Quantin C , Arquizan C , Mercier G 
Published: October 2021

Abstract

Background
Worldwide, the COVID-19 pandemic has been associated with a drop in overall stroke hospitalizations. Additionally, there is a well-known association between stroke and socioeconomic status. This study aims to assess the COVID-19 effect on stroke admissions in France during the first national lockdown and investigate the factors associated with its spatial heterogeneity.

Methods
In this retrospective nationwide study, we used data from the French hospital discharge database (PMSI) to estimate rates of admission for stroke to all public and private hospitals in 2019 and 2020. We used negative binomial regression to test for a nationwide change in stroke admissions during the first lockdown, compared to the same period in 2019 (from week 12 to week 19). We conducted a multivariate analysis to explore the factors associated with the stroke admission incidence rate ratio variation (2020 incidence rate/2019 incidence rate) at the county level.

Results
We found a significant nationwide reduction in stroke admissions during the first wave of COVID-19 (incidence rate ratio 0,91 [0,86 - 0.97]), with notable geographic variations. After adjustment on hospital bed capacity, cumulative in-hospital COVID-19 incidence, standardized death rate at age 65 and unemployment rate, a higher share of labourers at the county level was associated with a higher incidence rate ratio (p &lt; 0.01).

Conclusions
During the first national lockdown, there has been an overall decrease in stroke admission rates. Socio-economic determinants such as low-skilled jobs were independently associated with an increase in the stroke admission incidence rate ratio, while we did not find any independent effect from the local COVID 19 burden and hospital capacities.

Key messages
The first national lockdown led to an overall decrease in stroke admissions in France. This decrease varied between counties according to socio-economic determinants.
Socioeconomic determinants of traditional diet in Eastern Europe: result from the HAPIEE study
Authors: Stefler D , Yi X , Malyutina S , Kubinova R , Pajak A , Hrezova E , Pikhart H , Peasey A , Bobak M 
Published: October 2021

Abstract

Background
Traditional eating habits in Eastern Europe are associated with higher risk of all-cause and cardiovascular disease mortality. However, it is unclear whether this eating pattern is related to socio-economic characteristics of individuals. The aim of this analysis was to examine the socioeconomic determinants of traditional diet in Eastern European populations.

Methods
Data was available from the baseline survey of the Health, Alcohol and Psychosocial Factors in Eastern Europe study, including 21,752 eligible subjects from Russia, Poland and the Czech Republic. Dietary data was collected using food frequency questionnaires, and adherence to the traditional diet was assessed with the Eastern European Diet Score (EEDS). Information on participants` education, parental education and experience of financial difficulties in buying food were used as indicators of participants` socioeconomic position (SEP).

Results
In the multivariable adjusted logistic regression models, high EEDS, indicating higher adherence to the traditional diet, was significantly associated with lower education attainment (university vs. primary or less; OR: 0.85, 95%CI: 0.75-0.96) and lower parental education (0.82, 0.72-0.94). High EEDS was also more common in people who reported financial difficulties in buying food, but this association was weaker (often vs. never; 1.12, 1.00-1.25). Specific components of the EEDS, including intakes of lard, processed meat and preserved fruit and vegetables, were also closely linked to SEP indicators.

Conclusions
Our results suggest that individuals with lower SEP are more likely to follow the traditional eating pattern in Eastern Europe, and education seems to be a particularly important determinant. Public health nutritional interventions should focus on the more disadvantaged groups to improve diet and reduce health inequalities in this region.
Funding: This work was partly funded by the Horizon 2020 CETOCOEN Excellence project (grant no. 857560).

Key messages
This work shows that socioeconomic factors, particularly education, are important determinants of traditional eating habits in Eastern European countries. As traditional diet in this region is linked with poor health, nutritional interventions have the potential to improve population health and reduce socioeconomic inequalities in Eastern Europe.
Dimensions of fruit and vegetable access in the retail food environment; a systematic review
Authors: Turner G , Green R , Alae-Carew C , Dangour AD 
Published: October 2021

Abstract

The consumption of fruit and vegetable (F&V) is important for human health to protect against non-communicable disease and micronutrient deficiency. Increasing consumption of F&V may also benefit planetary health if these foods are substituted for foods with higher environmental footprints such as red meat or dairy. The retail food environment (RFE) is an influential junction between the food system and individual diets as it drives access to F&V through external (physical access) and personal (availability, affordability, acceptability) domains. We performed a systematic search of six literature databases (January 2021) for studies assessing access to F&V in the RFE and its association with F&V consumption in adults in high- and upper-middle income countries. 36 studies were identified and categorised by dimensions of food access - accessibility, affordability, acceptability, availability and accommodation. More than half of the studies (n = 20) were based in the USA. F&V accessibility was the most commonly reported dimension (n = 29); no study reported on accommodation. 6 studies were rated to be high quality. A positive association of increased availability of F&V options in the RFE with intake was identified in 9 of 15 studies. Associations in both acceptability and accessibility dimensions were inconsistent. No association was observed between F&V affordability and consumption although available data were limited. Many challenges exist to building a robust evidence base within food environment research including conceptual, definitional and methodological heterogeneity and measurement standardisation. Future food policies should consider multi-dimensional interventions to promote access to F&V in the RFE across all domains.

Key messages
First systematic review of dimensions of access in the retail food environment (RFE) and fruit and vegetable (F&V) intake suggesting importance of access to available healthy options for F&V intake. The retail food environment is complex but likely predictor of F&V consumption.
Being a parent in Finland: a culturally-tailored psychoeducative parental support programme
Authors: Skogberg N , Laajasalo T 
Published: October 2021

Abstract

Problem
Migrant origin children are overrepresented in child protective services and among cases of suspected maltreatment against children. Language barriers, poor understanding of the child welfare system and differences in perceptions of child rearing and disciplinary practices create additional burden during the assessment process. Authorities struggle to meet the needs of migrant origin families.

Description of the problem
A variety of universal, selective and indicative parenting support programmes are available. While these have been shown to be effective also among persons of migrant origin, cultural adaptation has also been suggested to increase the benefits. Any adaptation to a trial-tested programme may, however, impact its integrity. To avoid this, a separate culturally sensitive Being a Parent in Finland programme was developed to complement other parenting interventions and supporting services offered by the health and social welfare authorities. Intervention was developed as part of the Barnahus project coordinated by the Finnish Institute for Health and Welfare.

Results
The aim of the Being a Parent in Finland psychoeducational group programme is to increase the wellbeing and safety of children through group-based parental support. The programme consists of three two-hour meetings offered to parents of children aged 3 to 12 years. The main themes include the Finnish service system, parenting practices that support the child's development and wellbeing and wellbeing of the family as well as children's rights. Psychoeducational videos were produced as supportive material. Groups of maximum 8-10 participants are led by trained instructors, assisted by professional interpreters.

Lessons
The programme will be piloted by the city of Helsinki, with the first two groups starting in May 2021. Experiences and lessons learned from these groups will be presented. Impact assessment of the programme and will be launched in autumn 2021.

Key messages
While culturally sensitive adaptations may increase positive outcomes of parental programmes, there is a risk for compromising programme integrity, leading to minimized or even adverse consequences. Being a parent in Finland aims at supporting the wellbeing and safety of families through culturally sensitive psychoeducative groups administered as complementary support measure to other services.
Analysis of sexual and reproductive health indicators according sexual orientation young Brazilians’
Authors: Sousa M , Rocha L , Silva F , Felisbino-Mendes M 
Published: October 2021

Abstract

Background
Sexual and reproductive health indicators and behaviors may occur differently between sex and according to sexual orientation. In addition, there is a lack of studies that consider sexual orientation and approach young adults in Brazil.

Objective
To analyze sexual and reproductive health indicators of young Brazilian adults and their differences according to sex and sexual orientation.

Methods
Cross-sectional study with 2,063 young adults, undergraduate students from a public university who responded to the online survey. We estimated the prevalence of sexual and reproductive health indicators, desire or not to have children, report of pregnancy and feeling about the pregnancy state), according to sex (male and female) and sexual orientation (heterosexual, bisexual, homosexual). Differences between prevalence were assessed using Pearson's chi-square test.

Results
Among heterosexuals, condoms were the contraceptive method most used by men (90.6%) and women (75.5%). Women used double protection (53.5%) and had a fixed sexual partner (67.8%) in a greater proportion. Men, on the other hand, maintain the practice of casual relationships more frequently (70.5%) and 43.2% have already had unprotected casual relationships. Among bisexuals, condoms were the method most used by men (97.7%) and women (85.4%). In this group, 51% of women use double protection and have a steady partner (62.2%). Among homosexuals, 99.1% of gays and 46.1% of lesbians used condoms at the last sexual intercourse and 46.1% of lesbians used hormonal methods. Also, 28.8% of gays have already had an STI, a higher rate than among heterosexuals.

Conclusions
There are important differences in sexual and reproductive behaviors between genders and according to the sexual orientation of young people, such as greater vulnerability to STIs among gays and lesbians, and medicalization around the female body, highlighted by the permanence of questionable practices among lesbians.

Key messages
Gender issues could also explain the differences found between men and women. Differences between the sexes are also present when evaluating the use of protection against STIs or unplanned pregnancies.
A systematic review of the association between mental health and tuberculosis disease risk
Authors: Hayward SE , Deal A , Rustage K , Nellums LB , Sweetland AC , Boccia D , Hargreaves S , Friedland JS 
Published: October 2021

Abstract

Background
Tuberculosis (TB) and mental illnesses are highly prevalent globally and often co-exist. Whilst poor mental health is known to modulate immune function, whether mental disorders causally increase TB incidence is unknown. This systematic review examines the association between mental health and TB disease risk to inform clinical and public health measures.

Methods
We carried out a systematic review following PRISMA guidelines (PROSPERO CRD42019158071). We searched MEDLINE, PsycINFO and PsycEXTRA databases alongside reference list and citation searching. Inclusion criteria were original research studies published 01/01/1970-11/05/2020 reporting data on the relationship between mental health and risk of TB disease. CASP and AXIS checklists were used to critically appraise included studies.

Results
We screened 1546 records published over 50 years, resulting in data synthesised from 607,184 individuals. Settings include Asia, South America, and Africa, and both mood (e.g. depression) and psychotic (e.g. schizophrenia) disorders are investigated. Robust evidence from cohort studies in Asia shows that depression and schizophrenia can increase risk of TB disease, with effect estimates ranging from HR = 1.15 [95% CI 1.03-1.28] to HR = 2.63 [95% CI 1.74-3.96] for depression and HR = 1.52 [95% CI 1.29-1.79] to RR = 3.04 for schizophrenia, and a dose-response relationship reported in one study. These data are consistent with data from cross-sectional studies, such as a large survey across low- and middle-income countries (n = 242,952) reporting OR = 3.36 [95% CI 3.01-4.50] for a depressive episode in those with TB versus those without.

Conclusions
Individuals with mental illnesses including depression and schizophrenia experience increased TB incidence and represent a high-risk population to target for screening and treatment. Integrated care for mental health and TB is needed, and interventions tackling mental illnesses and underlying drivers may help reduce TB incidence globally.

Key messages
This systematic review examines data from 607,184 individuals and finds evidence that mental health is a risk factor for TB disease. Those suffering from depression and schizophrenia are an at-risk population that could be identified and targeted for TB screening and treatment.
Stressful life events in pregnancy and sleep problems in childhood: Evidence from the ELSPAC Cohort
Authors: Ksinan Jiskrova G , Stepanikova I 
Published: October 2021

Abstract

Background
Childhood sleep problems have been associated with adjustment difficulties; furthermore, early-onset sleep problems may persist over the life course. Exposure to stress during pregnancy may be a risk factor for developing sleep problems in childhood due to its effect on the stress reactivity in the child. In the current study, we examined the association between prenatal stressful life events (SLE) and childhood sleep problems, paying attention to their trajectory over time.

Methods
Data were obtained from the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ; N = 4,371 mother-child dyads). Mothers reported SLE during pregnancy using an inventory of 42 life events and the number of child sleep problems at the child's age of 18 months and 3, 5, 7, and 11 years. The association between prenatal SLE and the developmental course of sleep problems was examined using a Poisson latent growth model. The model was adjusted for maternal and family demographics, birth characteristics, and maternal depression.

Results
At 18 months, mothers reported on average 2.01 sleep problems (range 0-7, p &lt; 0.001). The rate of sleep problems decreased linearly by 0.89 (p &lt; 0.001) per year. A higher number of prenatal SLE was associated with a higher rate of sleep problems at 18 months (rate ratio [RR]=1.02, 95% confidence interval [CI]=1.01-1.02, p &lt; 0.001), and significantly reduced rate of decrease in sleep problems from 18 months to 11 years (p &lt; 0.001).

Conclusions
Exposure to prenatal SLE was associated with a higher number of sleep problems in early childhood and with their persistence over time. Thus, experiencing prenatal stress may serve as a predisposing factor for the development of sleep problems later in life.

Key messages
Children of mothers who experienced stressful life events in pregnancy had more sleep problems during childhood. Prenatal exposure to stress may predispose individuals to sleep problems later in life.