bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toothbrushing habits are associated with self perceived stress
Authors: Vinder N 
Published: October 2024

Abstract

Background
Personal self-care is one of the most important factors in maintaining and improving oral health. Public health guidelines are recommending tooth brushing at least twice daily, once before bed time and at least on one occasion. On the other hand, our regular routines and caring for our own health is influenced by different factors including stress. We wanted to research how much does daily stress influencing tooth brushing habits.

Methods
We analyzed data from 2020 CINDI nationwide cross-sectional survey in Slovenia. Tooth brushing once a day or less was assessed as inadequate. Stress was assessed with question &gt;&gt;How often in the last 14 days have you felt tense, stressed or under a lot of pressure? &lt;&lt; Participants who chose often or always as an answer were assessed as persons under stress. Method of binary logistic regression was used for statistical analysis of association between tooth brushing frequency and self-perceived stress, modified for some socioeconomic factors.

Results
Prevalence of inadequate frequency of tooth brushing was present in 31,6 % of sample, 31,5% in participants who were not feeling tense and 31,8% in participants who often felt tense or stressed. At first it seemed stress is not associated with tooth brushing habits. We adjusted this association for gender, education level and age and this association became clearer. Participants who felt stress and/or under pressure had higher odds for poor tooth brushing habits, their odds ratio was 1,283 (p &lt; 0,001; 95% CI 1,124; 1,464) when adjusted for aforementioned factors.

Conclusions
Oral health is integral part of general health. Association between oral and mental health is often overlooked even though psycho-social aspects are part of modern oral health definition. As personal self-care is cornerstone of maintaining and improving oral health, implementation of mental health aspects should be incorporated in public health advises and programmes for promoting oral health.

Key messages
• Self-perceived stress is associated with toothbrushing habits.
• People who are under stress less regularly brush their teeth.
Living with a chronic disease: tertiary prevention tools in asbestos-exposed patients
Authors: Guerreschi E M , Dragoni L , Sisinni A G , Fabrizi S , Miceli G B , Nante N 
Published: October 2024

Abstract

Background
The main asbestos-related pathology is asbestosis, frequently associated with pleural plaques. The spirometric pattern is mainly restrictive, with reduction in all lung volumes (FEV1, FVC, TLC). Also a reduction in alveolus-capillary diffusion of carbon monoxide (DLCO) may be added, related to the fibrotic process. The aim of the study is to analyze the health surveillance data, correlating the spirometric finding and its variation over time with the clinical and radiological picture.

Methods
The study is conducted on 372 patients with asbestosis from occupational exposure diagnosed in the period 2017-2023, as part of the Tuscany Region’s program for former asbestos exposures (DGR 396/2016). The investigation is at the second level of surveillance, which includes chest CT and Respiratory Functionality Testing (RFT). Data are obtained from patients’ medical records and processed through a database.

Results
Out of 372 patients with asbestosis, 213 had pleural plaques (57.25%). Out of those, there is a progressive worsening of RFTs in a restrictive direction (TLC &lt;80%, FEV1/FVC &gt;70%) in 71 patients (33.3%), with a mean TLC loss of 8.7 ± 5.9 mL over subsequent follow-ups on a yearly basis. The FEV1/FVC ratio also declines, with a mean reduction of 5 ± 2.4%. Out of those 71 patients, 14 (19.7%) also show a mean reduction in DLCO of 6.7 ± 5 mL/min/mmHg. The negative trend in RFTs correlates with the worsening clinical and radiological picture attributable to the occurrence of plaques on a fibrotic framework.

Conclusions
The health surveillance protocol that we adopted has as objective the ascertainment of pulmonary pleura-parenchymal alterations correlated with occupational exposure, investigating their evolution over time through the analysis of spirometric data, and to optimize the management of the functional disability, with a view to the tertiary prevention of patients with asbestos-related disease.

Key messages
• The negative trend in asbestosis PFRs correlates with the worsening of the clinical and radiological picture attributable to the appearance of pleural plaques on an interstitial fibrosis.
• Health surveillance is essential in order to optimize the management of functional disability, with a view to tertiary prevention of patients with asbestos-related disease.
Expanding access to non-communicable disease screening in war-affected communities in Ukraine
Authors: Darahan H , Rodyna R , Karpiuk K , Bogdanov A , Shcherbak-Verlan B , Zaika N , Gamazina K , Dravniece G 
Published: October 2024

Abstract

Background
Non-communicable diseases (NCDs) account for 91% of premature deaths in Ukraine. However, NCD screening lags among young people and across the entire population. The ongoing war has exacerbated barriers to NCD screening due to damaged infrastructure, understaffed medical facilities, and health system deterioration.

Intervention/response
To improve screening, diagnosis, and care, in March 2023 the PATH-led, USAID-funded Support TB Control Efforts in Ukraine (STBCEU) project established community level health access points (HAPs) in five conflict-affected communities. STBCEU procured screening tools (tannometers, glucometers, portable ECGs) for common NCDs, printed informational materials, trained 143 specialists, designed a reporting system, and facilitated monitoring visits to 77 HAPs.

Results
By the end of 2023, the project equipped 113 HAPs in the five communities, and 102 of them initiated NCD screening. From January-March 2024, 1,694 people under 40 years old were screened for NCDs. Among 1,488 blood pressure measurements, 143 cases had high readings (9.6 ±1.5%), 90 (62.9%) of which were first-time diagnoses, and 53 (37.1%) treatment monitoring. Glucose levels were measured 809 times, with elevated levels in 44 cases (5.4 ±1.5%), 30 (68.2%) of which were first-time diagnoses, and 14 (31.8%) treatment monitoring. Additionally, 1,144 mental health consultations were provided.

Conclusions
This initiative represented a first in Ukraine: per national requirements, young people have not historically been screened for NCDs. Expanding NCD screening in war-affected communities has demonstrated substantial early success, with significant detection of high blood pressure and elevated glucose levels among people under 40. This proactive, cost-effective intervention underscores the need for accessible, community-level health interventions in crisis settings and showcases a scalable model for integrating NCD screening into emergency health response frameworks.

Key messages
• The implementation of community-level NCD screening has shown early success in detecting high blood pressure and elevated glucose levels among people under 40.
• Cost-effective NCD screening underscores the need for accessible, community health interventions, providing a scalable model for integrating NCD screening into emergency health response.
A long journey from telemedicine to digital (public) health: the vision of different stakeholders
Authors: Duplaga M 
Published: October 2024

Abstract
The healthcare system willingly adopts new innovative means of communication and solutions offered by computer science. Telemedicine was one of the first terms used in this context. It was initially associated with providing medical services but quickly extended to other areas of health-related activities, including public health. The growth of the global web yielded new prospects for the provision of health services, also resulting in new terms to name the use of information and telecommunication technologies in healthcare. E-health, stemming from the end of 90ies in the 20th century, was initially defined as a new domain strongly associated with public health, especially in the context of access to health information. Quickly, its understanding was extended to all health-related interventions based on innovative digital technologies. Today, digital health and digital public health have emerged as the key terms, signifying the next phase of emerging applications that leverage the advancements made on the technical front. The medical community is probably more inclined to use the former term, while public health professionals are dedicated to the latter. But do these terms carry distinct meanings? Or is it merely a matter of the professional group’s background? Is the focus on individual or population health a differentiating factor? In the meantime, business and technical communities have developed the concept of Health 4.0. This concept emphasizes using technologies like the Internet of Things, cloud computing, big data, and artificial intelligence. However, digital (public) health benefits hugely from these solutions. One can ask whether every professional community needs other concepts and new terms for naming fields, resulting from the multidisciplinary effort. And where are the plain people in this landscape? Do they have sufficient digital and health literacies to accept new modes of health service delivery?
Mortality due to ischemic stroke in Serbia after redistribution of the inaccurately coded deaths
Authors: Todorovic J , Santric-Milicevic M , Stamenkovic Z , Rosic N , Tamburkovski G , Brankovic B , Miltenovic S , Jankovic Mladenovic S 
Published: October 2024

Abstract

Background
Ischemic stroke is a major common cause of death not only in Serbia but worldwide. Mortality statistics commonly include ill-defined, impossible and insufficiently specified causes of death among the underlying causes of death (CoDs). In the activities of the Laboratory for Strengthening the Capacity and Performance of the Health System and Workforce for Health Equity, we examined mortality due to ischemic stroke either as well-defined underlying CoDs or garbage codes (GCs - including the ill-defined, unspecified or impossible CoDs) in Belgrade in 2015 and 2020.

Methods
Anonymous mortality data of the City Institute of Public Health Belgrade were analyzed, and the GCs were redistributed to ischemic stroke as underlying CoDs (ICD-10 codes I63-I63.9), based on the principles of the Global Burden of Disease study, using the three-step approach: 1) exploration and analysis of GCs; 2) modelling of the underlying, antecedent and immediate causes of death; 3) proportionate redistribution.

Results
17% of the total of all deaths in Belgrade in 2015 and 20.9% in 2020 were GCs. Before the redistribution, the share of ischemic stroke as the well-coded CoDs of total mortality was 7.3% (1443/19641) in 2015 and 4.6% (1022/21957) in 2020. A total of GCs - 309 deaths in 2015 and 322 in 2020 were identified for redistribution to ischemic stroke. Based on the type of GCs, in 2015, a total of 139 cases were redistributed in type 1 GCs, 83 in type 2 GCs and 87 in type 3 GCs. In 2020, 141 cases were redistributed due to type 1 GCs, 62 type 2 GCs and 119 type 3 GCs.

Conclusions
This study underscores the significant proportion of all ischemic deaths in Belgrade that were coded with the GCs. After the redistribution, almost one-fifth of the ischemic strokes, previously known as GCs, were added, emphasizing the crucial role of accurate coding in understanding mortality patterns. Improving the coding of deaths is necessary to have reliable information for health policymaking.

Key messages
• One-fifth of the ischemic strokes in Belgrade were previously GCs.
• Accurate coding is essential for understanding mortality patterns and developing valid health policies.
Adult Individuals Applicable to the Family Health Center Knowledge and Awareness About Osteoporosis
Authors: Özkoç H , Erol S , Ergün A 
Published: October 2024

Abstract

Background
The aim of this study is to determine the knowledge and awareness of adult individuals applying to the Family Health Center (FHC) about osteoporosis.

Methods
A descriptive design study was conducted at a FHC in Turkey/Istanbul between January and May 2022. The sample of the research consisted of 320 adults selected by purposeful sampling method. Ethical approval and necessary permissions were obtained from the the conduct of the study. Data were collected through a socio-demographic characteristics form, a 20-item single-subscale Osteoporosis Knowledge Assessment Questionnaire (OKAQ), and a 27-item Osteoporosis Awareness Scale (OAS). Descriptive statistics, normality tests, analysis of variance, Kruskal-Wallis analysis of variance, t-test, and Mann-Whitney U test were used for data analysis. Statistical significance was accepted at p &lt; 0.05.

Results
T The average age of adults is 60.47±13.17 and 55.9% are female and 44.1% are male. 34.7% had completed middle school. Participants’ highest correct response rate in the osteoporosis knowledge assessment questionnaire was for the item ‘Osteoporosis increases the risk of bone fracture’ (81.6%), while the lowest correct response rate was for the item ‘Osteoporosis generally causes symptoms (such as pain) before fractures occur’ (26.3%). According to the Osteoporosis Awareness Scale, adults’ awareness levels were above average. They scored the highest in the preventive behaviors subscale and the lowest in the risk factors subscale. Adults with university-level education scored significantly higher in all subscales of the OAS compared to other education levels (p &lt; 0.05). Individuals with knowledge about osteoporosis and those who consumed milk regularly scored significantly higher in all subscales of the OAS (p &lt; 0.05).

Conclusions
Although adults’ awareness of osteoporosis is above average, their correct knowledge about osteoporosis is inadequate.

Key messages
• An individual’s education level affects osteoporosis knowledge and awareness.
• It is recommended to plan educational initiatives to increase osteoporosis knowledge and awareness.
Burden of inflammatory bowel disease in Belgium, 2020
Authors: Claerman R , Devleesschauwer B , Nayani S , De Pauw R 
Published: October 2024

Abstract

Inflammatory bowel disease (IBD) comprises digestive disorders resulting from non-infectious inflammation of the colon and gastrointestinal tract. With its global prevalence on the rise, IBD poses significant challenges to healthcare systems. There is a need for more accurate disease burden estimates to guide decision-making processes within the health sector. As a part of the Belgian national burden of disease study (BeBOD), this study aims to estimate the burden of IBD in Belgium based on locally available data. We estimated the Belgian IBD burden in 2020 in terms of mortality, prevalence, years of life lost (YLLs) due to premature death, years lived with disability (YLDs), and disability-adjusted life years (DALYs). As there is no single comprehensive data source on prevalence of IBD in Belgium, a critical appraisal of existing local and national data sources was conducted. Prevalence data were combined with disability weights to yield YLDs. YLLs were calculated using the most recent Global Burden of Disease (GBD) 2019 reference life table and the number of deaths caused by non-infective IBD (ICD-10 K50-52). Cause of death data were extracted from Statbel, the Belgian statistical office. The best available data source to estimate the IBD prevalence in Belgium was a widespread network of general practitioners. The prevalence of IBD was 1.5% in 2020. The prevalence-based YLD for IBD was 220 YLDs per 100 000, while the YLL rate was 11.5 per 100 000. We estimated 26 276 DALYs caused by IBD in 2020. Of the total DALYs caused by IBD, 5% were due to YLLs and 95% were due to YLDs. Our burden estimates for IBD in Belgium were however higher than those of the GBD study. IBD imposes a low fatal burden, whereas the burden of morbidity is more prominent. Our findings could be useful for policy makers to justify and prioritize resource allocation. Integrating the current research in BeBOD will allow monitoring the burden of IBD over time.

Key messages
• Inflammatory bowel disease is characterized by a substantial non-fatal burden due to chronic relapsing and persistent symptoms.
• National inflammatory bowel disease burden estimates are useful to guide decision-making within the health sector.
Spatial disparities in cancer incidence and mortality, indicating gaps in prevention and/or care
Authors: Ádány R , Juhász A , Nagy C , Pikó P , Oroszi B 
Published: October 2024

Abstract

Background
There is a rich literature on the distribution of cancer incidence and mortality in socioeconomically different regions of the world, but none of the studies has compared the spatial distribution of mortality and morbidity to see if they are consistent with each other.

Methods
All malignant neoplasms and separately by cervical, colorectal, breast, pancreatic, lung and oral cancers were studied in the Hungarian population aged 25-64 years for the period 2007-2018 at the municipality level by sex. In each case, the spatial distribution of morbidity and mortality and their clusters were compared with each other and with the level of deprivation using disease mapping, spatial regression, risk analysis and spatial scan statistics.

Results
All-cause cancer morbidity and mortality showed a significant association with deprivation. However, the slope of the increase in mortality with increasing deprivation was much steeper than for morbidity in both sexes. The association between deprivation and morbidity was not consistent across all cancers. No significant association was found for male colorectal cancer (RR: 1.003; 95%CI 0.986-1.019), pancreatic cancer (1.014; 95%CI 0.983-1.045) and female colorectal cancer morbidity (RR: 0.977; 95%CI 0.991-1.029), whereas a negative association was found for breast cancer morbidity (RR: 0.977; 95%CI 0.963-0.991). In contrast, a positive association between deprivation and mortality was found for each type of cancer, although with different RRs. However, disease mapping analyses showed only partial overlap between high-risk morbidity and mortality areas, often independent of deprivation.

Conclusions
Our results highlight not only the diverse relationship between the epidemiological situation and deprivation, but also the disproportionate relationship between cancer morbidity and mortality, thus identifying geographical regions and sub-regions with populations that require special public health attention.

Key messages
• Comparative spatial analysis of cancer morbidity and mortality at the municipality level is strongly recommended to identify populations in need of targeted cancer prevention and/or care.
• The usefulness of comparative spatial analysis of cancer morbidity and mortality is demonstrated in Hungary, one of the countries with the most unfavourable cancer burden in international comparison.
A review of the risk factors for Autism
Authors: McGrevey S , Farr W , Male I , Memon A 
Published: October 2024

Abstract

Background
Autism Spectrum Disorder (or Autism) is a neurodevelopmental and neurological condition, with prevalence of 1 in 100 children globally. This review examines the most common factors associated with Autism.

Methods
We conducted a scoping review of factors associated with an increased risk of developing Autism. These included genetic predisposition, parental age, gender, birth complications and morbidities due to other medical conditions.

Results
Evidence from twin studies shows a 90% genetic predisposition towards Autism - with 102 genes strongly associated with Autism, including SCN1A and SLC6A1. There are also genetic syndromes and chromosomal disorders associated with Autism, including Fragile X syndrome and Tuberous Sclerosis complex (TSC). Several studies have demonstrated an increased risk with advanced parental age (&gt;35 years) (e.g., fathers &gt;50 years are 2.2 times more likely to have a child with Autism than those &lt;30 years). Other factors include infections during pregnancy (e.g. immune dysfunction) and gestational diabetes. Prematurity, such as low birth weight (&lt;1500g) and low gestational age (&lt;32 weeks) are also associated with an increased risk of Autism. With regard to gender, boys are more likely to be diagnosed with Autism - gender ratio of 3:1 and 4:1 has been reported in different populations. Abnormalities in brain development during early prenatal or postnatal periods may increase the risk of Autism. These abnormalities can lead to social, communication, and behavioural challenges characteristic of Autism.

Conclusions
Autism is a complex and heterogeneous condition that likely arises from a combination of factors such as genetic susceptibility and pre- and postnatal factors. An understanding of these factors is important for early detection, intervention, and support for children to improve their quality of life and reduce morbidity.

Key messages
• Risk factors associated with an increased risk of developing Autism include genetic predisposition, parental age, gender, birth complications and other comorbidities.
• There is need to increase awareness of the risk factors of Autism to improve quality of life.
Understanding Knowledge and Perception of Hypertension in Rural Zambia: A Population-Based Study
Authors: Tateyama Y , Honda Y , Zulu R 
Published: October 2024

Abstract

Introduction
Hypertension poses a significant challenge in sub-Saharan Africa, with Zambia reporting a 32% prevalence in 2019. However, there is a presumed lack of knowledge among residents due to inadequate preventive education. This study aims to describe the knowledge and perception of hypertension among rural residents in Zambia.

Methods
This cross-sectional study employed rigorous probability sampling. We recruited 690 residents aged 25-64 from the Mumbwa district using a multistage, clustered, household sampling method for surveys and measurements conducted from May to July 2016. Data analysis considered the complex sampling design.

Results
Males accounted for 48.6%, with a mean age of 41.9 (SE 0.6). The prevalence of hypertension was 36.5%, with only 37.1% of those aware of their condition. 98.0% perceived hypertension as common, 71.8% expressed concern, and 62.9% deemed it a more serious health risk than HIV. Stress (85.3%) and dietary habits (excessive oil 51.8%, salt 47.5%, sugar 42.4%, poor diet 31.5%) were recognized as the risks. Perception of smoking and physical inactivity as risk factors was low, at 14.9% and 22.7%, respectively. Regarding hypertension prevention, 73.9% believed it to be preventable, mainly through dietary improvements (69.0%), medication (51.1%), and exercise (36.0%). Perception of smoking cessation and alcohol abstinence was 18.0% and 1.4%, respectively. Only 20.4% had prior hypertension education.

Conclusions
This study reveals residents’ concerns about hypertension and their perception of dietary improvements as preventive measures. However, there was a notable gap in perceiving stress as a preventable risk factor, along with limited awareness of smoking and alcohol as risk factors. Comprehensive health education programs in rural Zambia are necessary to address these gaps, emphasizing lifestyle changes such as stress reduction, smoking cessation, and reducing alcohol consumption to enhance hypertension awareness and prevention.

Key messages
• Participants show a strong awareness of hypertension, perceiving it as a serious health risk and recognizing common factors such as stress and poor dietary habits.
• There is a lack of awareness concerning smoking and physical inactivity as risk factors, emphasizing the necessity for comprehensive education to promote preventive measures.