bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic And Mental Health Challenges: Lessons From The COVID-19 Era
Authors: Melchior M , Hecker I , Roversi A 
Published: October 2024

Abstract
The relationship between work arrangements, financial difficulties, compliance with COVID-19 sanitary measures, and preexisting mental health issues amidst the ongoing pandemic is multifaceted. By merging data from the TEMPO cohort and other European cohort studies during the RESPOND European project, we seek to provide comprehensive about these dynamics for developing targeted interventions and policies aimed at mitigating the adverse impact of pandemics on mental well-being. Our analyses reveal significant associations between unemployment, financial strain, and elevated levels of symptoms of anxiety and depression during the COVID-19 pandemic. Even after controlling for pre-pandemic socioeconomic and mental health factors, individuals experiencing unemployment or financial difficulties were more likely to report heightened mental distress. Additionally, our findings highlight gender-specific patterns in compliance with COVID-19 sanitary measures, with women exhibiting increased compliance amidst mental health difficulties, while men, particularly those with lower educational attainment, demonstrated decreased compliance. These preliminary results underscore the complex interplay between socioeconomic factors, mental health, and public health behaviours during pandemics. In conclusion, our study underscores the urgent need for targeted interventions and strategies to address the intersecting challenges of mental health, employment, financial strain, and compliance with public health measures during the COVID-19 pandemic. The findings emphasize the importance of considering socioeconomic disparities in designing effective interventions aimed at promoting public well-being and resilience in the face of future pandemics. By leveraging these insights, public health practitioners and policymakers can develop evidence-based approaches to support individuals and communities experiencing heightened vulnerabilities during times of crisis.
The association between electronic media use and quality of life (QoL) in Norwegian adolescents
Authors: Kleppang A L , Stea T H , Bonsaksen T , Leonhardt M , Lien L , Steigen A M 
Published: October 2024

Abstract

Background
The use of screens, especially mobile devices like tablets and smartphones have increased over the last years and have become an integrated part of modern life. Adolescents today spend a lot of their time using screens both at school and outside school. Identifying how screen use are related to QoL is necessary to plan effective policies and interventions in adolescence since it is the period where different behaviours are adopted. The purpose of this study is to examine the association between electronic media use and quality of life (QoL) among adolescents.

Methods
This study was based on self-reported cross-sectional data from the Young-Hunt4 study, conducted in 2017-2019. The target group comprised 8066 13-19 years old adolescents. QoL was measured with the Norwegian version of the Inventory of Life Quality (ILC). The ILC scale consists of seven items with four response alternatives. Electronic media use was measured using the two variables Social media use and Gaming. Multiple linear regression was used to analyse the association between gaming, social media use and QoL.

Results
Preliminary results showed an inverse association between gaming (&gt;3 hours per day) after school and quality of life (β: -.07, p &lt; 0.001) and social media use (&gt;3 hours per day) after school and quality of life (β = -.06, p &lt; 0.001). Similar inverse associations were observed between gaming (&gt;3 hours per day) in the weekend and quality of life (β: -.09, p &lt; 0.001) and social media use (&gt;3 hours per day) in the weekend and quality of life (β = -.04, p = 0.002). These associations remained significant after controlling for gender, age, family economy, psychological distress and having friends.

Conclusions
More than three hours on screens per day after school was negatively associated with QoL. Hence, public health policy and practice should pay attention to consequences of screen time use in adolescence. Additional research is needed to further explore these associations.

Key messages
• More frequent use of electronic media is negatively associated with QoL.
• Public health policy and practice should pay attention to screen time in adolescence and its association with QoL.
‘We do not include tests and treatment for those [STI] conditions’: the trouble in navigating access and care for STIs among gay, bisexual men and transgender and other MSM in Kenya and Rwanda
Authors: Igonya E , Muga W , Azubuike P , Stojanovski K 
Published: October 2024

Abstract

Background
Lesbian, gay, bisexual men, and transgender persons (LGBT) in Kenya and Rwanda have a hard time accessing healthcare, in particular sexual health screening. We used a social norms and values framework to examine determinants of access to healthcare, with specific attention to sexual healthcare.

Methods
We draw on cross-sectional mixed methods research in Kenya and Rwanda that examined the lived experiences of sexual and gender minorities in access to health services. A cross-sectional quantitative survey in Rwanda (n = 499) and Kenya (n = 1,550) was conducted with LGBT people. We conducted key informant interviews (n = 81), in-depth interviews (n = 48), digital storytelling (n = 3), and focus group discussions (n = 30). We used a mixed-methods thematic and content analysis to integrate quantitative and qualitative findings.

Findings
Accessibility and quality of care were the main barriers to healthcare services. The results indicate widespread discrimination and stigma toward LGBT people in service provision. Approximately half of the survey participants, 47%, reported challenges accessing health services, and 25% indicated they experienced discrimination in healthcare. Qualitative results link low quality of care to stigma and discrimination. “Mostly at the hospitals, there are times people take too much time discussing who we are instead of giving us the treatment we seek, and send us to mental health to first deal with our sexuality issues since they think it is a ‘sickness.’” (Focus group, Muhanga, Rwanda). Our study highlights challenges in navigating sexual healthcare in government, faith-based, and donor-funded health facilities.

Conclusions
Access to healthcare services, particularly sexual health screening and prevention, is a growing issue for LGBT people in Kenya and Rwanda. Stigma acts as a significant barrier to high-quality healthcare. Sensitivity training and educational opportunities for healthcare professionals are urgently needed to address stigma.
Informing healthy urban policy making through quantitative health impact appraisal – a co-designed approach
Authors: Hunt A , Eaton E 
Published: October 2024

Abstract

Quantitative health impact appraisal for land use development is currently challenging. We show how a co-designed process between urban decision makers and academics can help to improve ways of deriving evidence for creating healthier cities. The Health Appraisal of Urban Systems (HAUS) economic valuation model was developed with local partners to inform a strategic framework for a UK urban regeneration site. HAUS is a comparative risk assessment model which allows the user to understand mechanisms for change through applying an impact-pathway approach to quantify changes in health. It is informed by systematic reviews of epidemiology and societal costs of 85 individual health end-points. Scenarios combined a range of characteristics including air and noise pollution, green space, crime, walkability, food environment and transport. Health outcomes include morbidity and mortality impacts. Results show the value of a holistic approach to comparing health risks in designing urban living. By monetising outcomes, practitioners were able to understand the relative magnitude of risk within a specific area and compare alternate urban development scenarios. Compared to an unmanaged development, the Strategic Framework can mitigate health risks by improving safety and quality of the public realm and add health benefits by encouraging activity and active commuting. Flood risks are managed, and green infrastructure improved and extended. These benefits extend to communities outside the site boundaries. Over 25 years, the PV benefits are £60 - 80 million in averted health costs. Strategic planning for urban areas can unlock the potential of the public realm to tackle health inequalities and mitigate serious risks to public health. Timely access to quantitative information on health can help inform understanding of unhealthy environments, strengthen arguments for good design, reinforce capacity of planning teams and so improve the quality of urban developments.

Speakers/Panelists
Odile Mekel
NRW Centre for Health, Bochum, Germany
eHealth profile and care coordination of primary care physicians
Authors: Jendly M , Santschi V , Tancredi S , Chiolero A 
Published: October 2024

Abstract

Background
Digital health or eHealth is a vast field encompassing mobile health (mHealth), health information technology, wearable devices, telehealth, and telemedicine, and is changing the practice of medicine. While it holds promise for enhancing care coordination, its adoption is hindered by various barriers, including at the healthcare professional level. We assessed the eHealth profile of primary care physicians and its relationship with care coordination.

Methods
As part of the Commonwealth Fund 2022 IHP survey of primary care physicians, 1114 physicians in Switzerland completed a questionnaire on their digital health use, and care coordination practices. Based on their responses, we built a digital health score, summarizing physicians’ use of digital health tools, and a care coordination score. Associations between both scores were assessed using stratified analyses and multiple linear regression.

Results
Among 1114 participants (46% women, mean age 52), 83% used electronic patient records, 96% used teleconsultations for less than 5% of consultations, and 63% never used connected health tools for the monitoring of patients with chronic diseases. A total of 16% allowed for online appointments, 20% for online medical prescriptions, 52% for communicating electronically lists of medications with other healthcare professionals, and 89% the possibility of e-mail or web communications with the patient. The eHealth score was positively associated with the number of weekly working hours, being an internal medicine specialist or practicing physician, the number of full-time equivalents in the practice, and with being in a group practice setting. The higher the eHealth profile score, the higher was the care coordination score.

Conclusions
Physicians’ use of digital health tools was positively associated with care coordination. This could underscore the potential benefits of digital health in enhancing collaborative and interprofessional care practices.

Key messages
• In a large survey of primary care physicians, the use of digital health tools and care coordination were correlated.
• Digital health could enhance collaborative and interprofessional care practices.
Machine Learning powered Patient Records Analysis for Injury Monitoring in Children and Adolescents
Authors: Zysset A , Feer S , Saaro F M , Bächli M , Niemann S , Meier D , Seiler M , Bogojeska J , Dratva J 
Published: October 2024

Abstract

Background
Injuries to children and adolescents are common and are associated with individual suffering and costs. Switzerland lacks data of injuries in children and adolescents. This study investigates the feasibility of utilizing machine learning (ML) methodology to automatically extract relevant data from electronic pediatric patient records needed for monitoring and prevention purposes.

Methods
The feasibility study follows three steps. 1. Utility evaluation of text data from electronic pediatric patient records regarding ML, injury monitoring and prevention requirements in a test-sample. 2. The development of an ML-based approach to extract relevant information based on electronic pediatric patient records (N = 30’884) of children treated for injuries at the University Children’s Hospital Zurich emergency department between 2018-2022. 3. The performance of the ML methodology is evaluated.

Results
Qualitative and ML expert assessment of the sample showed that the desired data on injuries is contained in the test-sample and necessary requirements are met. Data records differ in detail with severe injuries providing especially rich information records. The international IDB code-tree was proved to be too elaborate and adult-orientated and was adapted. Preliminary data analyses indicate that the number of accidents is highest in the age group from 0 to 4 years (36%). More male (58%) children were treated. Majority of accidents were classified as less severe (73%), few (&lt;1%) as very severe. Further lessons learned, along with more detailed prevalence data on injuries in children and adolescents, will be available by August 2024.

Conclusions
Extraction of injury information from electronic patient record by means of ML may provide valuable information for injury monitoring and prevention, so far missing in Switzerland. Prerequisites for the successful application of ML are digital record access, usable coding-tree, and detailed text input by the emergency departments.

Key messages
• An ML-based approach has the potential to improve the data basis by extracting valuable accidents information from existing texts of patient records.
• To successfully apply this method, digital record access and detailed text data are needed.
Noise inequalities and cardiovascular diseases in Bulgaria
Authors: Tsanova D , Vitkova T S , Bankova E M , Ivanova B , Dimitrov D 
Published: October 2024

Abstract

Background
Social determinants of health in the physical environment are among the social determinants that greatly impact population health. At very high levels, noise can cause permanent changes in a person’s psyche but, even at lower levels, it can cause stress and disorders. Global burden of diseases studies arrange noise on the second position among the environmental risk factors, related to sleep disturbance, cardiovascular effects etc. The study aims to analyse noise pollution in Bulgaria and measure its association with cardiovascular diseases.

Methods
National Statistical Institute and Eurostat data were used to analyse the noise pollution in Bulgaria. The 28 regions were compared according to the proportion of surveyed points above permissible limits and the death rates due to CVD, /2022/. Data were statistically processed with SPSS v.26. To establish the correlation, the Pearson coefficient was used.

Results
Data provided by Eurostat reveal that 9% of the total population suffers from noise but there is a very positive trend - from 17.7% /in 2005/ to 8.7% /in 2023/. The share of surveyed points above permissible limits shows a continuing trend of maintaining a high percentage - 71.80% /2011/ and 68.62%/2022/. The district comparison shows significant variations - Blagoevgrad -17.65% and Silistra, Kyustendil and Razgrad with shares above 80%. The study found that almost all districts with the highest share of surveyed points above permissible limits have higher levels of death rate due to CVD. The results of statistical data analysis show that there is a positive moderate linear correlation between the share of surveyed points above permissible limits and the death rate due to CVD - Pearson coefficient 0.423 (p = 0.025).

Conclusions
The study found a moderate correlation between noise pollution and the death rate due to cardiovascular disease. CVD have a multifactorial genesis, but reducing noise in urban areas would help prevent these diseases.

Key messages
• As a result of the performed analysis, it can be concluded that the investigated indicators determining the degree of discomfort during the daily period remained high in Bulgaria.
• The established health inequalities between regions and the increasing mortality from CVD are one of the factors for the deteriorating level of public health in Bulgaria.
Burden and economic impact of PM2.5 exposure on Acute Myocardial Infarction in Portugal, 2011-2021
Authors: Madeira F , Corda M , Martins C , Perelman J 
Published: October 2024

Abstract

Background
Air pollution, specifically particulate matter with a diameter of 2.5 micrometers (PM2.5), is the primary environmental health risk in Europe. Exposure to PM2.5 increases the risk of cardiovascular diseases, including AMI, resulting in high direct costs associated with in-patient treatment. This study aims to estimate the avoidable and attributable disease and economic burden of AMI due to ambient PM2.5 exposure in Portugal between 2011 and 2021.

Methods
National databases were used to assess the annual number of hospitalisations and deaths due to AMI between 2011 and 2021. The annual mean costs were calculated using a direct cost analysis (bottom-up micro-costing) to assess the direct economic burden of AMI. In turn, these cases and associated costs were multiplied by the respective morbidity and mortality population attributable fraction (PAF) to estimate the number of hospital admissions and deaths, and their associated costs attributable to ambient PM2.5 exposure. For 2019 and 2021, an alternative scenario of exposure was considered (2021 WHO Air Quality Guidelines), and the avoidable morbidity and mortality costs were determined using the potential impact fraction (PIF).

Results
Between 2011 and 2021, there were 130,447 hospitalisations and 47,968 deaths due to AMI, with 4.79% and 28.90%, respectively, attributable to ambient PM2.5 exposure. This translates to a direct economic burden of morbidity of more than 44 million euros and mortality of almost 195 million euros. If the proposed scenario guidelines were met, 279 cases and 448 deaths would have been avoided in 2019, resulting in a savings of almost 9.7 million euros. In 2021, 93 cases and 355 deaths would have been avoided, with approximately 4 million euros saved.

Conclusions
Exposure to ambient PM2.5 significantly contributes to AMI cases and deaths in Portugal, imposing a significant economic burden. These findings highlight the urgent need for measures to improve air quality.

Key messages
• PM2.5 pollution in Portugal drives AMI cases and fatalities, entailing significant economic costs.
• Adhering to WHO air quality guidelines promises substantial reductions in AMI incidence and save millions annually in healthcare expenditure.
Urban Exposome and Health
Authors: Jeong A , Kyriakou K , Kasdagli M I , Janc M , Vlaanderen J , Huss A , Katsouyanni K , Tonne C , Polanska K , Probst-Hensch N 
Published: October 2024

Abstract

Background
The environment in which we live is thought to explain 70% of the non-communicable disease burden. The aim of EXPANSE project (funded from the European Union Horizon 2020 research and innovation programme under grant agreement No 874627) is to evaluate the optimal strategies for maintaining health in the context of contemporary urban environments. As a component of the project, Urban Labs allow deep phenotyping of the urban exposome and assessing its use and perception. The Urban Labs aim to improve exposure assessment, identify mediating and modifying lifestyle factors, and link the urban exposome to intermediate endpoints relevant for cardiometabolic and pulmonary health.

Methods
By monitoring the activities of 4,000 individuals in five distinct urban areas, Urban Labs provide a comprehensive understanding of the urban exposome, which can be compared with residential address-based model estimates. The participants complete a baseline questionnaire, repeated bi-monthly questionnaires and exposure-specific questionnaires over a period of 2 years using mobile phone application (ExpanSeeker). Two-week personalized measurements including spatial-temporal activity patterns, sensor-based environmental and behavioral measurements, and minimally invasive biological sample collection are performed covering different seasons.

Results
The Baseline Questionnaire (BQ) and two-weeks measurement campaigns (MC) were completed in European cities as follows: Athens BQ = 379, MC = 232; Barcelona BQ = 1040, MC = 303; Basel BQ = 731, MC = 655; Lodz BQ = 634, MC = 100; The Netherlands (multicity) BQ = 1033, MC = 326. Data collection process is ongoing.

Conclusions
The collection of novel data on individuals activities and perceptions within temporal and geographical contexts in Urban Labs will contribute to a more comprehensive understanding of how the urban dwellers are exposed to and interact with their environment, thereby supporting healthier urban engineering and policy making.

Key messages
• Urban Labs will provide a more comprehensive understanding of the impact of the urban environment on individual’s behavior, their exposome, enabling more accurate prediction of non-communicable risk.
• Urban Labs will provide a base to support healthier urban engineering and policy making.
Dietary trajectory profiles of French adults over time: Multicriteria analysis of sustainability
Authors: Toujgani H , Berlivet J , Berthy F , Allès B , Fouillet H , Touvier M , Lairon D , Mariotti F , Baudry J , Kesse-Guyot E 
Published: October 2024

Abstract

Despite the urgent need for sustainable dietary transitions, few studies have examined current dietary trajectories using longitudinal data. This study aimed to identify dietary consumption trajectory profiles over an 8-year period (2014-2022) while assessing their sustainability in a multicriteria approach. Consumption data from NutriNet-Santé cohort participants were collected using FFQs in 2014, 2018 and 2022. Dietary trajectory profiles were modeled using group-based multi-trajectory based on factors from Principal Component Analysis on energy-adjusted consumption data (n = 17,187). Profiles were analyzed for sustainability (environmental and nutritional dimensions) using multi-adjusted mixed-effects models. Six trajectory profiles (P) were identified. P0 (considered as reference) had average consumption for all food groups, with increased plant-based intake over time. In comparison, P1 had the highest baseline alcohol (+301%) and offal intake, increasing processed meat (+74%) and decreasing offal over time. P2 had higher milk (+187%) and sweet drinks intake, increasing animal substitutes (+1737%) and whole-grain products. P3 had higher nuts (+680%) and legumes intake, increasing egg (+166%) and reducing fruit juice. P4 had high fish (+39%) and fruit intake, increasing butter (+53%) and reducing alcohol. P5 had higher pork (+143%) and red meat intake, increasing fish (+31%) and reducing dairy. Initially, P3 and P4 had the lowest GHG emissions (-18%, -49% vs. P0), best nutritional profiles, and higher organic food consumption. P5 had the greatest environmental impact (+51%) and the lowest nutritional scores. Over time, P0 reduced GHG emissions and improved nutritional scores. P3 and P4 showed minimal changes, while P5 had the greatest GHG emissions decrease (-14%) and nutritional quality improvements. Identifying ongoing dietary transition trajectories, our findings contribute to optimizing targeted actions aimed at promoting sustainable dietary consumption habits.

Key messages
• Regardless of initial dietary preferences, French adults exhibit an overall trend over time towards increased intake of plant-based foods and decreased intake of red meats, at varying scales.
• French adults exhibit varying degrees of transition towards more sustainable diets, with an overall decrease in GHG emissions from food consumption and an improvement in their nutritional profiles.