bluuebunny/crossref_metadata_2025_split huggingface dataset:
The burden of executive dysfunction after ischemic stroke (Bulgaria, 2019-2021)
Authors: Veleva I , Valkova M , Chumpalova-Tumbeva P 
Published: October 2024

Abstract

Background
Executive dysfunctions have great impact on behavior and quality of life in elderly. They also play important role for post-stroke functional outcome. The aim of our study was to examine the frequency, severity and types of executive dysfunctions at the third month after the ischemic stroke.

Methods
We examined 108 patients 3 months after ischemic stroke (66.67±9.03 years old, 66 males and 42 females) via 128-Wisconsin Card Sorting Test (WCST). WCST is a standardized instrument for detecting various executive dysfunctions. It is applicable for patients after stroke, because the test doesn’t require preserved arm motor functions. It measures global executive functioning (GEF), inhibitory control system (ICS), executive attention (EA), cognitive flexibility (CF) and working memory (WM). Our patients’ results were compared to the normal population test results. SPSS 24 was used for statistical analysis.

Results
Impaired GEF were found in 46% of our patients, most of them had mild or moderate impairment. One fourth of them showed impaired ICS, although the impairment in most of the cases was mild. EA deficits were found in 43% of our cases (17% had mild, 15% mild to moderate, 7% moderate and 4% severe impairment). WM dysfunction was found in 1/3 of them (the average result was about 27 percentiles; 29% had mild and 5% had mild to moderate deficits) and about ¼ of our patients had borderline results. CF was impaired in 68% of our patients (11% had mild, 28% mild to moderate, 16% moderate and 13% severe impairment).

Conclusions
GEF impairment is frequent after stroke. Patients had problems in ICS, EA, CF and WM. However, in most of the cases the dysfunction is mild or moderate and can be found only if it is actively searched and accessed. The most impaired functions were CF and EA. Patients with executive dysfunction require cognitive rehabilitation and specific social support.

Key messages
• Executive dysfunctions are frequent after ischemic stroke. The impairment is mild or moderate, but however it impacts the quality of life, behavior, prognosis and outcome of post-stroke survivors.
• Patients with executive dysfunctions require specific cognitive rehabilitation and social support.
Functioning in Older Adults: Prevalence and Implications for Policy and Digital Services
Authors: Sääksjärvi K , Holm M , Koskinen S , Aalto A , Pennanen M , Ilmarinen K , Hammar T , Sainio P 
Published: October 2024

Abstract

Background
Actions maintaining and promoting functioning, and proactively preparing for the surge in demand for services in near future, are needed as the population is aging. Policy actions need to base on up-to-date picture of the situation. We examined the prevalence of limitations in different dimensions of functioning in the older population.

Methods
Data consisted of participants aged 75 years or older (n = 9,686) in the nationally representative Healthy Finland Survey in 2022. The questionnaire included questions on various aspects of functioning (physical, cognitive, psychosocial, need and use of help), quality of life, internet use and digital competence. Weighted prevalence of functional limitations by age (75-79, 80-84, 85-89, ≥90 years) was analyzed for men and women using logistic regression, sampling design and non-response acknowledged.

Results
Difficulties in most aspects of functioning increased rapidly with age. In ≥ 90-year-olds, one third experienced major difficulties in activities of daily living (vs. 4% in 75-79-year-olds), and 30% of men and 45% women aged 90 or over experienced major difficulties in getting out of their home (vs. 4% in 75-79-year-olds). The prevalence of loneliness doubled by age, from 9% in the youngest to 21% in oldest age group. The corresponding increase in psychological distress was from 9% to 15%. Need for help increased dramatically with age, but the unmet need among those needing help did not, being around 20% in all age groups. In ≥ 90-year-olds, 83% of men 92% of women reported little or no internet skills (vs. 40% in 75-79-year-olds), and 55% of men and 75% women did not use digital services at all, i.e. neither independently nor with help from others (vs. 25-28% in 75-79-year-olds).

Conclusions
Difficulties in functioning and need of help were common among the oldest age groups which underlines the urgency to ensure sufficient resources for elderly care.

Key messages
• While developing health and social care services, equal access to services must be ensured even for those not able to use digital services.
• Functioning must be supported not only by measures aimed at the individual, but also by improving the environment so that people with a lower level of functioning can cope with their everyday lives.
Prevalence and accumulation of metabolic risk factors of cardiovascular disease in Finland
Authors: Lehtoranta L , Santalahti A , Ikonen J , Parikka S , Jääskeläinen T , Sääksjärvi K , Lahti J , Männistö S , Jousilahti P , Lundqvist A 
Published: October 2024

Abstract

Background
Cardiovascular disease (CVD) remains the leading cause of death and disability in the world. We aimed to examine the prevalence of metabolic risk factors of CVD and their accumulation in the Finnish working-age population.

Materials and methods
The data consisted of individuals aged 20 to 69 who participated in the population-based Healthy Finland health examination survey in 2023 (n = 4375; participation rate 56%). We studied the accumulation of four risk factors: hypertension, hypercholesterolemia, diabetes and central obesity. The information was collected using health examination measurements and blood samples. Information on medical conditions and medication use was collected using questionnaires and national register data. All analyses utilized weighting coefficients. Adjusted results (age, sex) were calculated via logistic regression.

Results
The most common CVD risk factor was hypercholesterolemia (male= 69%, female= 63%), followed by central obesity (m = 41%, f = 44%), hypertension (m = 44%, f = 34%) and diabetes (m = 11%, f = 6%). At least three risk factors were present in 26% in male and 23% in female participants, while 17% of males and 22% of females had no risk factors. The prevalence and accumulation of metabolic risk factors became more common with age. Of those aged 60-69, more than 10% had all four risk factors and almost half had at least three. Central obesity increased the risk of hypertension (OR 3.11; 95% CI 2.61-3.71), diabetes (OR 3.97; 95% CI 2.86-5.52) and hypercholesterolemia (OR 1.75; 95% CI 1.48-2.07) compared to those without central obesity.

Conclusions
81% of all participants had at least one metabolic risk factor for CVD and 50% had at least two. High prevalence and accumulation of CVD risk factors remains a major threat to future morbidity, mortality, and increased healthcare costs in the Finnish working-age population. It is particularly important to identify those individuals with several simultaneous risk factors.

Key messages
• Metabolic risk factors for CVD are common in the Finnish working-age population, with high prevalence especially hypercholesterolemia and central obesity.
• If the increasing prevalence of risk factors is not addressed, morbidity, mortality and health care costs can be expected to increase in the future as the population ages.
Exploring non-smokers’ attitudes toward e-smoking: results from the Minerva Project Europe
Authors: Gregori D , Khan N M , Ocagli H , Azzolina D , Martinato M , Lorenzoni G 
Published: October 2024

Abstract

Background
In the shifting paradigm of tobacco use, the attitudes of non-smokers toward e-cigarettes are crucial for public health planning, as in the literature it has been suggested that non-smokers who use e-cigarettes could be more prone to switch to tobacco. This multi-center study investigates the interplay between traditional smoking and the potential benefits of transitioning to e-smoking, through a comprehensive examination of smoking behaviors, dietary, and lifestyle practices.

Methods
MINERVA (My changINg lifEstyles, our Research, and eVeryone’s heAlth) is an ongoing prospective international cohort study aimed at investigating the association between smoking habits and dietary and lifestyle habits among the study participants. The secondary objective pertains to the assessment of subjects’ willingness to try e-cigarettes. We implemented an univariable logistic regression analysis on a dataset comprising 2367 nonsmokers to identify factors influencing their willingness to smoke e-cigarettes.

Results
Employment significantly predicted willingness, with employed non-smokers showing a higher likelihood to consider e-smoking (OR 2.5, p = 0.002). Household dynamics, specifically the presence of children, also affected the decision, indicating a protective effect against adopting e-smoking (OR 1.26, p &lt; 0.001). Lifestyle choices, particularly fitness and dietary habits, played a discernible role. Surprisingly, age inversely correlated with the willingness to try e-smoking, as younger non-smokers were more likely to consider it (OR 0.97 per year increase, p &lt; 0.001), suggesting that this openness could increase their risk of future tobacco use, which carries important public health consequences.

Conclusions
The study’s outcomes underscore the impact of socio-economic and lifestyle factors on non-smokers’ openness to e-cigarettes. These insights are pivotal for devising culturally competent educational campaigns and regulatory policies.

Key messages
• In the shifting paradigm of tobacco use, the attitudes of non-smokers toward e-cigarettes are crucial for public health planning.
• By thoroughly analyzing smoking habits, diet, and lifestyle choices, the Minerva Project research aims to shed light on the complex dynamics between health behaviors and smoking.
Lifestyle habits and openness to alternative tobacco products: insights from the Minerva Project
Authors: Gregori D , Khan N M , Ocagli H , Azzolina D , Martinato M , Lorenzoni G 
Published: October 2024

Abstract

Background
Recent studies have suggested that the use of alternative tobacco products (ATPs) is a significant predictor of cigarette smoking, particularly among young individuals. The present study evaluates the association between dietary patterns, specifically junk food consumption, and the willingness to try ATPs among non-smokers.

Methods
MINERVA (My changINg lifEstyles, our Research, and eVeryone’s heAlth) is an ongoing prospective international cohort study primarily focused on investigating the link between smoking habits and the dietary and lifestyle habits of participants. Subjects are given a web-based survey to report socio-demographic characteristics, dietary and lifestyle habits, smoking habits, and attitudes towards ATPs. This analysis concentrates on respondents from Italy who do not smoke traditional tobacco products.

Results
The survey included 7,535 respondents from Italy; of these, 40% (2,992 subjects) were non-smokers. Among the non-smokers, 219 (7%) were identified as fast-food consumers (defined as consuming fast-food at least once a week). Fast-food consumers were significantly more likely to consume junk food as snacks (87% vs. 62%) and were less likely to report daily consumption of fruits and vegetables. Notably, fast-food consumers were 2.5 times more likely to be willing to try ATPs compared to those who do not consume junk food (Odds Ratio [OR] 2.55, 95% Confidence Interval [CI] 1.68-3.88).

Conclusions
Junk food consumption has been identified as being associated with an increased willingness to use ATPs among non-smokers. This finding is significant from a public health standpoint, highlighting the crucial influence of unhealthy eating habits in fostering an interest in ATP use.

Key messages
• The Minerva study evaluates the association between dietary patterns, specifically junk food consumption, and the willingness to try alternative tobacco products among non-smokers.
• The study underscores the public health importance of addressing dietary patterns alongside smoking habits.
Foregone care in the Italian elderly population: a new challenge for the National Health System
Authors: Contoli B , Asta F , Possenti V , Gallo R , Marotta D , Pettinicchio V , Minardi V , Masocco M 
Published: October 2024

Abstract

Background
The avoidance of medical care among the elderly in Italy has been exacerbated during the COVID-19 pandemic and today, according to data from the Passi d’Argento surveillance, it involves over 3 million elders. The study analyzes the medical care avoidance among the elderly in Italy, the motivations behind it and the changes over time.

Methods
Passi d’Argento surveillance system, coordinated by the Italian National Institute of Health and conducted by Local Health Units, continuously collects information on health and lifestyles, as well as care and assistance needs, of the population aged over 65 residing in Italy, through interviews with representative samples by gender and age.

Results
Between 2021 and 2022, 1 in 4 individuals over the age of 65 (24%) reported avoiding, in the 12 months before the interview, a medical visit or diagnostic test they needed. The phenomenon is higher among those reporting significant economic difficulties (37%). Among those who have waived, 31% said they did so for fear of Sarsv-Cov-2 infection; 22% due to suspension of service and/or closure of the practice because of the restrictions imposed by the COVID-19 pandemic; 36% declared that the avoidance reason was due to long waiting lists; 7% due to difficulty reaching the facility. With the end of the pandemic, this phenomenon has decreased overall (from 34% in 2020 to 23% in 2022), however, there is an increase of individuals who report renouncing due to long waiting lists or difficulties accessing services.

Conclusions
Data clearly highlights the difficulties of National Health System in meeting the health needs of elderly citizens, which persist even after the pandemic. It is important to preserve the right and the access to prevention and care for the elderly, for which timeliness is crucial. In this perspective, these data can provide important guidance for action at both national and regional levels.

Key messages
• Having national data on foregone care allows to see the burden of the phenomenon.
• Even after the pandemic, the phenomenon of medical care avoidance among the elderly continues to be observed.
Assessing progress towards viral hepatitis B and C elimination in prisons in the European region
Authors: Fondelli S , Pisetta R , Mazzilli S , Montanari M L , Seyler T , Azevedo e Silva F , Tavoschi L 
Published: October 2024

Abstract

Background
In 2016 the WHO launched the global health sector strategy for the elimination of viral hepatitis, alongside a dedicated monitoring&evaluation (M&E) framework to assess progress at national, regional and global levels. Despite being a priority setting for viral hepatitis elimination in Europe, prisons are rarely integrated into national monitoring efforts. Besides, prisons are particular contexts with a high viral hepatitis prevalence, where it is possible to utilize adequate micro-elimination strategies.

Objectives
We aimed to assess available metrics of viral hepatitis burden and coverage of prevention and control interventions in prison settings in Europe using routine sources of data.

Methods
We adapted the WHO M&E framework for viral hepatitis elimination to the prison context. The resulting M&E framework has 49 indicators of which 10 are defined as core. Data were sourced from available European prison surveillance systems at European level, namely: European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and WHO Health in Prisons European Database (HIPED).

Results
In total 38 countries in the European region provided data to either data sources for 2020. For WHO-HIPED, among core indicators, 3 out of 10 could be calculated for HCV, and covered prevalence, HCV treatment availability and treatment outcome. Concerning HBV, 3 core indicators out of 10 could be calculated and covered prevalence, screening availability and treatment coverage in prison. With EMCDDA surveillance system we could calculate 4 HCV core indicators and 6 HBV core indicators.

Lessons
Availability of health data from prison settings is scarce, hampering the current capacity to monitor the progress in the viral hepatitis elimination within prisons contexts strategies and its relative contribution to global health goals achievement. A coordinated and standardised M&E framework tailored to this specific setting is needed to foster data collection and systematic monitoring.

Key messages
• Micro-elimination strategies in prison context contribute to the global health goals achievement.
• A coordinated and standardized M&V framework, adapted to the prison context, is needed to foster data collection and monitoring of the viral hepatitis elimination strategy.
Passing the hot potato: a multinational study on public trust in the health policy process
Authors: Zavattaro F , Gille F , von Wyl V 
Published: October 2024

Abstract

Background
Health data-sharing initiatives are central to European and national e-health strategies, aiming to improve healthcare quality, inform policymaking, and drive research. Public trust is crucial for their success, influencing public participation and policymakers’ legitimacy. This study investigates the role of public trust in the health policy process at both the European level and in Italy, France, and Switzerland to determine 1) if a common conceptual understanding of public trust across different countries and policy stages exists, and 2) if policymakers explicitly discuss and implement trust-building measures in their legislative work

Methods
A total of 60 interviews were conducted with 16 European, 15 Italian, 14 French, and 15 Swiss policymakers from the World Health Organization, the Council, Parliament, and Commission at the European level, along with representatives from the Ministry of Health, Parliament, regional councils, local health authorities, frontline staff, and relevant agencies at the national levels

Results
Preliminary results reveal that a common definition of public trust in health data sharing is missing. Associations to public trust are observed at the European level with citizens’ reassurance about their sensitive data being shared, and in Switzerland with data security. In France, public trust is connected to public engagement, while no distinct patterns were identified in Italy. Findings also reveal a consensus among interviewees on the central role public trust plays in health data-sharing initiatives; yet public trust is perceived as a vague concept, often addressed implicitly without a clear strategy

Conclusions
The study reveals widespread ambiguity among policymakers regarding the definition of public trust and its translation into policy. Practical guidance is crucial to effectively integrate elements of public trust into policymaking, thereby actively reinforcing trust in health data sharing through legislative efforts

Key messages
• While policymakers recognize the importance of public trust for data-driven health initiatives, they lack a common conceptual understanding on what trust is and how to build it.
• Guidance is needed to help policymakers actively contributing building trust in health data sharing through their legislative work.
Reception of health data using the Australian Burden of Disease study as an example
Authors: Anton A , Gourley M , Kirkland L , Chapman A M 
Published: October 2024

Abstract

Background
Health data, especially on Burden of Disease (BoD), are vital for evidence-based health promotion and effective dissemination is crucial due to resource intensiveness. Germany’s national BoD study is currently transitioning to permanence. Analysing the Australian Institute of Health and Welfare’s (AIHW) well-established collaboration with stakeholders and their reception of health data at national and regional level offers insights for improved knowledge translation.

Methods
To follow the path of stakeholder engagement, this 3-month project involved scientific exchanges with the AIHW and Department of Health, Western Australia. It compiled communication strategy examples and documents stating examples of BoD data use. A quantitative online survey accompanied by a series of 18 qualitative 45-minute interviews was conducted. The survey implemented via Swift Digital has been running for 20+ days. Interview partners originated from the fields of health research, politics, planning and advocacy for patients or population groups. Results were analysed, illustrated digitally as a booklet and refined in a participatory workshop.

Results
Communication strategies such as embargoed press and stakeholder releases as well as regular online formats were identified. The survey and interviews displayed the required technical and content-detail level from key facts to raw data and visualisation needs. Noteworthy are the demand to link data to economic aspects like disease expenditure, trends and future scenarios. It elucidated how diverse target groups utilize data to place disease significance and preventive public health measures, aiding dissemination. Alongside, it shows examples of knowledge translation by emphasizing impact over indicators when targeting communities.

Conclusions
Prioritizing target group identification and employing tailored communication strategies regarding data format and detail level are essential when utilizing new data.

Key messages
• Analyzing a well-established collaboration with stakeholders offers insights for improved knowledge translation and reveals leveraging engagement strategies for others.
• Understanding stakeholder needs is essential for promoting broader health data use in policy and practice, fostering evidence-based decision-making, and enhancing public health outcomes.
Mapping the Public Health and Health Promotion Capacity in Oman
Authors: Al Riyami H 
Published: October 2024

Abstract

Background
An essential condition to enabling people to increase control over their health is to have sufficient capacity for public health (PH) and health promotion (HP). Despite the recognition of its importance, a comprehensive view of the PH and HP capacity in the sultanate of Oman is not yet available. This study provides a mapping of the country’s PH and HP capacity at national, governorate and district levels.

Methods
An online quantitative survey was performed amongst 70 health policy maker and experts in PH and HP using a questionnaire based on the PH capacity framework of Aluttis et al., yielding data on the country specific context with relevance for PH and 6 PH capacity domains, each divided in subdomains: leadership and governance; organizational structures, workforce, financial resources, partnerships, and knowledge development. Internal consistencies of the scales measuring the capacity subdomains ranged from .75 to .99.

Results
The survey revealed relatively low scores, representing partial development of capacities, for most of the public health capacity domains. The highest levels of capacity were observed for knowledge development (health information and monitoring systems, reporting systems and knowledge infrastructure), organizational structures (institutional capacity, program delivery structures, PH within health services, and response emergencies) and partnerships (formal consortia, informal partnerships and multisectoral coordination). In contrast, leadership and governance, workforce development, and financial resources score lower.

Conclusions
Mapping the strengths and weaknesses of PH and HP capacity in Oman allows to make recommendations for improving population health. Whereas all domains of PH and HP capacity are partially developed, there is a need to further improve capacity in all domains.

Key messages
• PH and HP capacities are partially developed in Oman.
• Mapping the PH and HP capacity allows to identify strengths and weaknesses and make recommendations for improving public health.