bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors associated with objectively-derived physical activity and sedentary behavior in older adults
Authors: Chen Mrs , van Hees Mr , Yerramalla Mrs , Dugravot Mrs , Landré Mr , Fayosse Mrs , Benadjaoud Mr , Sabia Mrs 
Published: October 2021

Abstract

Background
Identification of factors associated with older adults' physical activity (PA) and sedentary behavior (SB) is essential to inform effective targeted prevention strategies to prevent the impact of lack of PA and high sedentary time on health in older adults. While most previous studies examined factors associated activity levels separately, this study investigated factors associated with the activity distribution using the continuum of acceleration, avoiding loss of information that could arise from categorization of activity levels.

Methods
This study included 3896 participants (25.3% women, mean [range] age: 69.4 [60-83] years) from the Whitehall II accelerometer sub-study. The association of socio-demographic, lifestyle and cardiometabolic factors with the whole activity intensity distribution and time in SB, light PA and moderate-to-vigorous PA was examined using functional data analysis and linear regressions, respectively. The consistency of the associated factors over time was examined using factors assessed at the time of the activity measure, and 9 and 18 years prior this measure.

Results
Cross-sectional analyses showed participants who were older, current smokers, obese, with chronic conditions, and those reporting poor SF36 physical component score spent more time in the lowest acceleration intensities at the expense of less time in higher intensities. Occupational position in men and SF36-mental component score in women were additionally associated with activity distribution. In both men and women, the pattern of factors associated with PA and SB were generally similar in prospective and cross-sectional analyses.

Conclusions
This study confirms socio-demographic disparities in PA and SB and identify several modifiable factors which are eligible to health promotion interventions. Factors associated with activity intensity distribution at older age were consistent in the 20 years before physical activity measure.

Key messages
Factors associated with activity intensity distribution at older age slightly differ between men and women. Factors associated with activity intensity distribution at older age were consistent whether they were assessed in mid-life or at older age suggesting promotion of PA shall start as early as possible.
eHealth for elderly people with balance disorders and risk of falling. A mixed methods study
Authors: Gaspar A , Escada P , Lapão L 
Published: October 2021

Abstract

Background
The increasing life expectancy in Europe has not always been accompanied by an increase in healthy life expectancy. The burden of chronic diseases including balance disorders with risk of falling, and insufficient access to clinical data have led to a misuse of healthcare provision. Portuguese government have invested in digital heath, including electronic health record and eHealth services, as a strategy to relieve this pressure. However, the clinical applicability of eHealth devices in screening, assessing, and treating elderly people with balance disorders and risk of falling in Portugal is unknown.

Objective
This study aims at knowing how can the health systems use eHealth for more effective provision of care for elderly people with balance disorders and risk of falling.

Methods
An explanatory sequential mixed methods study was performed. From June to August 2019, an open questionnaire with 18 multiple choice questions was made available on the website of Portuguese General Medical Council. Subsequently, from December 2019 to April 2020, a qualitative study was conducted with semi-structured interviews. The eligible participants were physicians who provide healthcare to the elderly.

Results
118 physicians responded to the questionnaire. 55% of the participants were dissatisfied or very dissatisfied with digital clinical availability and 61% with the time spent to access and to fill data. The eHealth was considered pertinent or very pertinent by 76% of the participants. Eight senior physicians discussed the constraints of data availability and pointed out strategies to improve clinical data and eHealth devices.

Conclusions
Despite the investments in digital health, there are still constraints contributing to the current misuse of care provision for elderly people with balance disorders. The use of eHealth was considered beneficial, but it should be improved further, and it should be considered for a more effective care delivery.

Key messages
In Portugal, there are still constraints contributing to the current misuse of care provision for elderly people with balance disorders. and risk of falling. The use of eHealth should be improved for a more effective provision of care.
Digital health literacy and its association with anxiety among students in Pakistan
Authors: Zakar R , Zakar MZ , Dadaczynski K , Okan O 
Published: October 2021

Abstract

Background
The public health importance of digital health literacy has significantly increased during COVID-19 pandemic all over the world. Health literacy enables individuals in informed and timely decision making. Anxiety particularly during difficult situations may hinders the decision making ability of individuals. The aim of this study was to assess the digital health literacy seeking and its association with anxiety level among university students during the wake of COVID-19 pandemic in Pakistan.

Methods
This study was conducted as a member of COVID digital Health literacy network between 49 countries through an online-based cross-sectional survey. Data were collected with 1747 students from randomly selected four public sector universities in Punjab province of Pakistan. Digital health literacy instrument was used to assess students' skills in digital health information seeking regarding COVID-19. Sense of coherence (SOC) was evaluated through 9-item scale and anxiety was assessed using 9-items Dark Future Scale. Simple bivariate and multivariate linear regression was performed to assess the association of key characteristics with DHL and anxiety level among students.

Results
The study found that about 54% of the students had high DHL and 51.9% had low or no anxiety. The results of multivariate analysis show that gender (p value=0.005), sense of coherence (p value&lt;0.001) and importance of information (p value&lt;0.001) were significantly associated with DHL. Additionally, Age (p &lt; 0.001), subject group of study (p = 0.03), university of study (p &lt; 0.000) and financial satisfaction (p &lt; 0.001) were significantly associated with anxiety among students. However, there was no significant relationship of DHL, SOC, and wellbeing with anxiety.

Conclusions
Concerted and focused interventions are needed to address anxiety related issues among university students.

Key messages
Future research should focus on health literacy environment and its relationship with the broader social, economic, and psychosocial contexts of anxiety among students. Concerted and focused interventions are needed to address anxiety related issues among university students.
Quality of life in adult patients with open-angle glaucoma:a systematic review
Authors: Dhouib W , Abdallah S , Bannour R , Ben Cheikh A , Bhiri S , Ghali H , Khefacha S , SAID Latiri H , Ben Rejeb M 
Published: October 2021

Abstract

Background
Assessment of the quality of life of glaucoma is an essential basis for their management in order to prevent deterioration of the disease. The aim of the study was to describe through a systematic review the quality of life of patients with open angle glaucoma and identify its associated factors.

Methods
It was a systematic review conducted based on the preferred reporting items for Systematic Reviews and Meta-analyses (PRISMA).Criteria for eligibility were all published population-based primary literature in Pubmed and Embase interface, written in English, since January 2014 to 31 December 2019. Electronic research was done through the following documentary query ((((‘glaucoma'[MeSH Terms]) AND (‘quality of life'[MeSH Terms])) AND (‘open angle glaucoma'[Title/Abstract])) AND (‘adult'[MeSH Terms])) AND (‘risk factors'[MeSH Terms]).Level of evidence and grades of recommendation was assessed according to the Scottish Intercollegiate Guidelines Network (SIGN).

Results
Among 139 articles, 15 were selected. Most of them were descriptive cross-sectional studies using different measuring instruments. We found that the quality of life of glaucoma patients varies according to the regions in Asia, Europe, America and Africa. The highest scores were recorded in Asia, followed by North America and Europe, which have very close scores. The risk factors associated with the quality of life of glaucoma patients were: Age, sex, level of education, professional status, marital status, visual acuity and disability, anxiety and depression.

Conclusions
The level of quality of life in this type of patient varies considerably between regions and countries and even in the same country. Associated factors are predominantly socio-demographic.

Key messages
The level of quality of life in patients with glaucoma varies considerably between regions and countries. Associated factors are predominantly socio-demographic.
Not really a smoker? Prevalence and attitudes to social occasional smoking in Trinity College Dublin
Authors: Hayes CB , Murray SR , Lyne SJ , Cryan MC , Mullin M , McGrath D 
Published: October 2021

Abstract

Background
Occasional smoking is defined as any smoking which occurs on a less than daily basis. Social smoking is a sub-group of occasional smoking which is smoking primarily carried out in social contexts. Data on occasional cigarette smoking and the subset of social smoking among third-level students are limited. This study assessed the prevalence of and attitudes to occasional/social smoking among undergraduates and postgraduates in an Irish university

Aims
(1) To determine the prevalence of occasional/social smoking among third-level students; (2) To evaluate students' attitudes to occasional/social smoking, including perceived benefits and harm; (3) To explore when students commenced occasional/social smoking, their reasons and their continued smoking habits; and (4) To determine any influence of other factors e.g. alcohol consumption on occasional/social smoking.

Methods
Anonymous online survey of undergraduates and postgraduates, via email and social media using Survey Monkey. Data were analysed in Microsoft Excel.

Results
1,310/18,407 (7.1%) of students responded. 1,267/1,310 (96.7%) provided adequate data for analysis. 423/1267 (33.4%) self-reported as current smokers of whom 106/1267 (8.4%) classified themselves as daily and 317/1267 (25%) as occasional smokers. The occasional smokers comprised 266/1267 (21%) social smokers and 51/1267 (4%) non-social smokers. Occasional smokers tended to start smoking later and think less about quitting than daily smokers. 386/423 (97.2%) of all current smokers reported that alcohol increased their smoking habits.

Conclusions
Prevalence of self-reported occasional smoking among university students was higher than daily smoking. Most occasional smokers primarily smoked in social contexts. All current smokers reported that alcohol increased cigarette intake. Effective intervention campaigns tailored to determinants of occasional/social smoking are needed as part of induction to third level.

Key messages
Prevalence of self-reported occasional smoking among university students is higher than daily smoking. Most occasional smokers smoke primarily in a social environment. Campaigns tailored to determinants of occasional/social smoking are needed for university entrants as part of induction to third level.
Cut-off values for anthropometric indices in predicting morbidity and mortality in Turkey: a cohort
Authors: Erkoyun E , Boncukçu Eren E , Ünal B , Sakarya S , Sözmen K , Dinç Horasan G , Ekinci B , Ergör G 
Published: October 2021

Abstract

Background
Anthropometric measurements are associated with cardiovascular outcomes and mortality and the association varies by community. This study aims to estimate the incidence of cardiovascular outcomes and all cause mortality and determines their association with the anthropometric measurements.

Methods
The data from Turkey Chronic Diseases and Risk Factors Survey were used for the cohort which recruited two 15 years and older adults from each family physicians' list in 2011 in Turkey using simple random sampling (n = 18,477). Family physicians collected the medical history and performed anthropometric measurements. Initially healthy participants for cardiovascular morbidity (coronary heart disease (ICD-10 codes I20.0-I25.0) and stroke (ICD-10 codes I60.0-I69.0) and all participants for all-cause and cardiovascular mortality were followed-up through electronic health records by 2017. Area under the curves (AUCs) were estimated and the adiposity risk was defined as cut-off points determined using Youden Index. The sample was stratified by age-groups (&lt;65, ≥65). Poisson and Cox models were fitted for morbidity and mortality outcomes, respectively.

Results
Over six years of follow-up, 5.7% of 15,877 and 1.3% of 16,062 participants developed CHD and stroke respectively. In total, 664 all-cause deaths (4.0%) were observed with 155 caused by CVDs (0.9%). A body shape index (i.e. 0.658 for all-cause mortality among younger men), waist-to-height ratio (i.e. 0.743 for CHD incidence among younger women), and BMI had higher AUCs for the outcomes. Higher anthropometric measurement groups had almost always higher CHD incidence risk in all groups but lower all-cause mortality in older men. Higher body-mass index was associated with lower mortality in younger men.

Conclusions
This cohort study in Turkey showed that having higher anthropometric measurements is mostly associated with higher CHD incidence and mostly lower mortality among older men. This association deserves further studies.

Key messages
In Turkey, higher anthropometric measurements are associated with higher coronary heart disease incidence in among participants. In Turkey, higher anthropometric measurements are mostly associated with lower all-cause mortality in older age-groups.
The Impact of Health Sector Reforms on Health System in Bangladesh: A Scoping Review
Authors: Udechukwu T , Carnapete L , Matin M , Haider S , Clech L , Ridde V 
Published: October 2021

Abstract

Background
Climate-induced environmental changes, and their potential impact on population health, are among the most pressing challenges affecting health systems. These health impacts put additional strain on health systems, putting their resilience and capacity to deal with increased shocks and stresses to the test. Implementing reforms to address the vulnerabilities in the health system can help build its capacity to cope with these shocks. We conducted a scoping review to explore the literature on health sector reforms in Bangladesh and understand their impact on health systems.

Methods
A scoping review was conducted by searching through academic (MEDLINE, SCOPUS, Web of Science and Google Scholar) and grey literature published in English and French between 1991 and 2021 that addressed national health sector reforms impacting the health system and access to care.

Results
Our search yielded 2688 articles for screening and 22 were included in our scoping review. One of the major health sector reforms was the shift from a project-based approach to a sector-wide approach (SWAp) in health. Studies found that implementing initiatives such as community clinics, a voucher scheme for pregnant women, increase in hospital beds at public facilities improved health care access and delivery of care, especially for rural districts. Despite government efforts, the health system continues to be vulnerable to shocks due to a significant shortage of formally qualified health professionals especially nurses and technologists and relatively low public financing.

Conclusions
Evidence suggests that health sector reforms implemented as part of SWAp have had a limited improvement on the health system. More emphasis should be placed in the future on implementing reforms to address critical issues such as human resources for health and health financing, which may contribute to building their capacity to cope with emerging threats due to climate change and improving access to care.

Key messages
Building a resilient health system may involve assessing the system's vulnerabilities, strengths and limitations through the perspective of health sector reforms. Current health sector reforms have had limited impact in addressing the vulnerabilities of the health system.
Substitution of processed meat for fish or poultry and the impact on hypertension in the E3N cohort
Authors: Thao U , Madika A L , Boutron-Ruault MC , MacDonald CJ 
Published: October 2021

Abstract

Objectives
Processed meat has been associated with an increased risk of hypertension (1). This study aimed to determine the possible effect of substituting processed meat (PM) with fish using specified food substitution models (2), in the French E3N cohort study.

Methods
This study included 46843 women from the prospective E3N study who had no hypertension at 1993, and completed a first food frequency questionnaire (FFQ) sent in 1993 which was used to estimate dietary intakes of various foods including PM, and fish, considering serving sizes of 150 g. Estimates of the hazard ratio for incident hypertension were obtained using Cox Proportional Hazard Models, and the substitution method (2) was used to obtain estimates for substitution of PM for fish. Boot-strapping with 50 samples was used to estimate 95% confidence intervals for the substitution. Models were sequentially adjusted for age and risk-factors for hypertension, then dietary variables, and finally energy.

Results
During follow-up, 12,465 cases of hypertension were reported over 712,703 personyears. Mean consumption of processed meat was 1.3 servings/week, 1.3 servings/week for fish and 2.3 servings/week for poultry. Substitution of one serving of processed meat for fish per week was associated with a slightly reduced risk of hypertension in all models, regardless of the underlying restrictions placed on diet, or energy (HR = 0.95(0.91: 0.98)). The association was weaker for poultry (HR = 0.98 (0.96, 1.01)).

Conclusions
Substitution one serving of PM for fish per week could be associated with a small reduction in the risk of hypertension amongst French women.
References: (1) Lajous M, et al. Processed and unprocessed red meat consumption and hypertension in women. Am J Clin Nutr. 2014 Sep;100(3):948-52. (2) Ibsen D, et al, Food substitution models for nutritional epidemiology, Am J Clin Nutr, 2021 Feb;113(2):294-303

Key messages
Processed meat is associated with an increased risk of hypertension. Substitution of processed meat for fish may reduce this risk.
Report on the presence of Salmonella and Campylobacter spp. in fresh meat marketed in Italy
Authors: Corradini C , Russini V , Migliore G , Varcasia BM , De Marchis ML , De Santis P , Lovari S , Bogdanova T , Bossù T , Bilei S 
Published: October 2021

Abstract

Introduction
Salmonella (S.) and Campylobacter (C.) are the most common agents of foodborne infections and a risk for immunocompromised patients. The present study reports the prevalence and characterization of S. spp. in imported poultry, beef and pork meat marketed in Italy over six years. Furthermore, we present data of prevalence and species identification for C. spp. isolated from poultry samples collected in the years 2016 and 2018.

Methods
Poultry (chicken and turkey), beef and pork meat samples were collected by Health Local Authorities all over Italy. The presence of C. was tested according to the ISO 10272 and the species identification was assessed using Multiplex PCR (C. coli e C. jejuni). S. was tested according ISO 6579 and serovars were identified through serum agglutination using S. antisera.

Results
The prevalence of S. in chicken and turkey was respectively 1.31% (4/306) and 0% in 2016, 7.89% (24/304) and 2.33% (7/300) in 2018, 14.4% (37/257) and 3.59% (9/251) in 2020; S. was never detected in beef meat but it was found in 1.05% (3/287) of pork samples in 2015, 1.98% (5/253) in 2017, 1.74% (5/287) in 2019. Among all the available samples, the most common serotypes identified were S. Infantis and S. Bredeney. The presence of C. was detected in 4.25% (13/306) of chicken samples and in 0.74% (2/272) of turkey samples in 2016, increasing respectively to 17% (17/100) and 1.06% (1/94) in 2018. Similar frequencies were found for coli and jejuni species.

Conclusions
The results show that poultry meat is the most relevant source of C. and S. Uncooked or not well-cooked meat can still be a risk for the consumers, despite the adoption of biosecurity measures suited to prevent S. to enter in farms. Source attribution and prevalence studies like this can be a useful tool to set up monitoring plans, identify priorities for food safety interventions and risk communication.

Key messages
The crucial role of source attribution studies to help Authorities to plan further controls. Public agencies and stakeholders should give clear communication about the risk of not well-cooked meat.
Evaluation of the stress and eating behaviors of medical students after university entrance exam
Authors: Kara SA , Demir M T , Sengelen M 
Published: October 2021

Abstract

Emotions are important on eating behaviours but the direction of the effect is unknown. The aim of this study is to evaluate eating behaviours and some related factors of first grade medical students after the university entrance exam. This study was performed in a medical faculty from Ankara, Turkey in October 2019. Researchers used a questionnaire comprising of 56 questions; 23 questions about students' sociodemographical characteristics and 33-item Dutch Eating Behavior Questionnaire (DEBQ). DEBQ is a self-report questionnaire and Turkish validity and reliability was tested in 2011. Written permission from Faculty Executive Committee was obtained prior to the study and informed consent were obtained from the participants. The significance level was taken as p &lt; 0.05. SPSS 25.0 package program was used in data analysis. Three hundred and ninety one students (80.6%) out of a total of 485 participated in the study. Of all 319 students participating in this study, the mean age was 18.53±0.71 and 52.4% were men (n = 205). Forty point two percent of the students claimed that their eating habits were healthless, while 33.8% of the students stated that they ate more when they were stressed and 50.9% of the students stated that their body weight was increased during their university entrance exam period. Mean DEBQ total points were higher in women and in students who stated that their body weight was increased during their university entrance exam period than the others (student t test, p &lt; 0,001; ANOVA test, p &lt; 0,001, respectively). Multiple Linear regression analysis pointed out that being women increased DEBQ total point by 9,091 point (p &lt; 0,001, 95% CI: 5,595-12,587). This study demonstrated that nutrition and eating habits are critical issues for young people's life and their future. Therefore many students need more help and guidance about stress management and healthy eating habits especially when they are preparing for important exams and also right after the exams.

Key messages
This study demonstrated that nutrition and eating habits are critical issues for young people’s life and their future. Many students need more help and guidance about stress management and healthy eating habits especially when they are preparing for important exams and also right after the exams.