bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burden of disease due to ambient particulate matter pollution in Germany from 2010 to 2021
Authors: Plass D , Kienzler S , Wintermeyer D 
Published: October 2024

Abstract

Background
Worldwide, according to the global burden of disease (GBD) study, around 118 million disability-adjusted life years (DALYs) were attributable to ambient particulate matter (PM2.5) in 2019. Further, 97% of Europe’s urban population are exposed to annual average levels of PM2.5 above the World Health Organization’s guideline value of 5 µg/m³. In Germany, considerable efforts have been made to reduce PM2.5-emissions, which resulted in a continuous decrease of exposure. We estimated the burden of disease attributable to PM2.5-exposure in Germany for a time series from 2010 to 2021.

Methods
We used the environmental burden of disease (EBD) methodology developed by the WHO. For the exposure assessment we combined annual average measured and modelled PM2.5-concentrations with information on population density at a 2-by-2 km² grid. Using the exposure-response functions from GBD 2019, we estimated the EBD for chronic obstructive pulmonary diseases, type 2 diabetes mellitus, lung cancer, stroke and ischemic heart diseases (IHD). National surveys and register data were used to estimate the baseline burden of disease.

Results
In total, we estimated 232,863 (95%-CI: 153,716-314,882) DALYs attributable to PM2.5 in 2021. We observed a reduction of about 50% compared to 2010. The highest attributable burden was estimated for IHD with 70,197 (95%-CI: 42,609-101,785) DALYs, which is about 8% of the overall IHD-burden. The mortality-to-morbidity ratio revealed that years lost due to death (YLLs) had a higher share (69.9%) of overall DALYs with 162,561 (95%-CI: 106,918-222,567) YLLs.

Discussion
Despite a decreasing trend of the EBD for PM2.5 in Germany since 2010, our results show that there is still a long way to a pollutant free environment as envisaged by the EU’s zero pollution ambition. Using EBD as a standardized methodology and the DALYs as the core measure allows to have a comprehensive and comparable overview of the impact of PM2.5 on population health.

Key messages
• Ambient particulate matter pollution is an important environmental risk factor in Germany.
• The decreasing trends is encouraging but there is still a long way to go to meet the objectives of the EU’s zero pollution ambition.
How was the impact of heatwaves on daily hospital admissions in Portugal (2000-2018)?
Authors: Alho A , Oliveira A P , Viegas S , Nogueira P 
Published: October 2024

Abstract

Background
Climate change has increased the frequency, intensity, and duration of heatwaves, posing a serious threat to public health. While the link between high temperatures and premature mortality has been extensively studied, the comprehensive quantification of heatwave impacts on morbidity remains understudied.

Methods
We assessed the relationship between heatwaves and daily hospital admissions at a county level in Portugal, considering all major diagnostic categories and age groups, over a 19-year period from 2000 to 2018. Our nationwide study included a comprehensive geospatial analysis, integrating over 12 million hospital admission records with heatwave events indexed by the Excess Heat Factor (EHF), covering all 278 mainland counties. To estimate the impact of heatwaves on hospital admissions, we applied negative binomial regression models at both national and county levels.

Results
A statistically significant overall 18·9% increase in daily hospital admissions was found during heatwave days (IRR=1·189, 95% CI: 1·179-1·198). This impact affected all age groups, with pediatric ages being the most affected (21·7%), followed by the working-age (19·7%) and elderly individuals (17·2%). All 25 Major Disease Diagnostic Categories experienced significant increases, particularly Burns (34·3%), Multiple Significant Trauma (26·8%), and Infectious and Parasitic Diseases (25·4%). Notable rises were also observed in Endocrine, Nutritional, and Metabolic (25·1%), Mental (23%), Respiratory (22·4%), and Circulatory (15·8%) diseases.

Conclusions
Our results provide statistically significant evidence of the association between heatwaves and increased hospitalizations across all age groups and for all major causes of disease. This is the first study to estimate the full extent of heatwaves’ impact on hospitalizations using the EHF index over a comprehensive 19-year period, encompassing an entire country, and spanning 25 disease categories during multiple heatwave events.

Key messages
• There is a clear association between heatwaves and increased hospital admissions across all age groups and Major Diagnostic Categories.
• Our data offer crucial information to guide policymakers in effectively and efficiently allocating resources to address the profound healthcare consequences resulting from climate change.
High-resolution modeling and projection of heat-related mortality in Germany under climate change
Authors: Wang J Y , Nikolaou N , an der Heiden M , Irrgang C 
Published: October 2024

Abstract

Heat is a leading cause of premature deaths during summer months. Understanding the relationship between high temperatures and excess mortality is crucial for designing effective prevention and adaptation plans. Traditional statistical methods have been repeatedly applied to analyze heat-related mortality. However, spatially and temporally high-resolution analyses are challenging due to fragmented data archives across different agglomeration levels, especially for mortality data. We propose a neural network-based model to estimate heat-related mortality. This approach allows for high temporal and spatial resolution estimations, such as regional heat risk during specific heatwaves. Using Germany as a case study, we calculated heat-related excess mortality rates at the district level and visualized the dynamics of local health risks within a heatwave. Overall, we estimated a total of 48,000 heat-related deaths in Germany over the last decade (2014-2023), with most occurring during specific heatwave events. For example, in 2023, the heatwave from July 7-14 contributed approximately 28% (1100 deaths) to the total of about 3,900 heat-related deaths for the entire year. This estimation is consistent with previously published reports from the Robert Koch Institute (RKI), considering the resolution differences in the input data. In addition, we combined our model with shared socio-economic pathways (SSPs) of future climate change, assuming a static population and baseline mortality rate. The results suggest that heat-related risk in Germany could further increase by a factor of 2.5 (SSP245) to 9 (SSP370) without adaptation to extreme heat. Our approach is a valuable tool for the monitoring of regional heat-related risks as well as scenario-based risks projections for the future. The results of the model can help develop climate-driven public health strategies, aiding in the identification of local risks during heatwaves and in long-term resilience planning.

Key messages
• High-resolution modeling of heat-related mortality helps us to develop targeted adaptation and prevention plans.
• The majority of heat-related mortality occurs during heatwaves in summer.
The future of nutrition education for health systems capacity building
Authors: Grosso G , Ray S 
Published: October 2024

Abstract
In the ever-evolving landscape of global health, nutrition education plays a pivotal role in shaping the well-being of populations. The future of nutrition education encompasses a holistic understanding of health, considering not nutritional adequacy in health and disease, but also cultural, social, and environmental factors. Tomorrow’s health professionals must also be equipped to address the interconnectedness of nutrition with mental health, sustainability, and community dynamics. Nutrition education will increasingly involve collaboration across disciplines. Health professionals, educators, policymakers, and community leaders must work together to create a comprehensive ecosystem that fosters nutrition literacy. This collaboration extends beyond traditional healthcare settings to schools, workplaces, and local communities. Furthermore, digital transformation will also revolutionise nutrition education. Online platforms, mobile apps, and virtual simulations will enhance learning experiences whilst interactive modules, webinars, and gamified content will engage learners and facilitate continuous professional development. Moreover, telehealth and tele-nutrition will bridge geographical gaps, ensuring access to quality education globally. Cultural sensitivity in nutrition education is also needed across geo-demographic boundaries to appreciate diverse dietary practices, food taboos, and traditional knowledge. Nutrition education should also empower health professionals to advocate for policy change across food systems, promote sustainable practices, and address food insecurity and therefore understanding policy frameworks and participating in advocacy efforts will be key. Finally, embracing the future requires a commitment to lifelong learning to remain at the forefront of nutrition science and its cutting edge as the questions may remain the same but the answers vary significantly as we garner new evidence to navigate evolving global challenges.
An analysis into the rise of private healthcare in England by geographical location and time period
Authors: McCannn L , Holdroyd I , Emberson R , Painter H , Ford J 
Published: October 2024

Abstract

Background
Private healthcare is a rapidly growing industry in the UK, particularly for surgical procedures. Across the pandemic period, waiting lists for elective surgical and consultant-led care increased from 4.4 to 7.5 million patients. This study aimed to analyse the trends and geographical variations in privately funded and NHS-funded orthopaedic private procedures across England compared to NHS waiting times.

Methods
We conducted a longitudinal study using quarterly national data between 2019 and 2023 in England. Descriptive analysis of quarterly orthopaedic surgical volumes per 10,000 people, and quarterly orthopaedic surgery wait times stratified by geographical location and time period was conducted.

Results
Between 2019 and 2023 there were a total of 1,469,450 procedures across the private sector, comprising 1,030,095 NHS-commissioned private orthopaedic procedures and 439,355 private orthopaedic procedures. The South of England performed a higher total number of private procedures per year compared to the North (63 vs 57/10,000 people); whilst there was almost double the number of privately funded procedures (23 vs 12/10,000), the difference was less amongst NHS-funded procedures (45 vs 40/10,000 respectively). There was a large variation in the number of NHS-funded procedures per 10,000 between regions. The North has consistently shorter waiting times than the South.

Conclusions
Our findings indicate considerable geographical variation in the use of private healthcare between regions, suggesting a two-tier healthcare system. The founding principles of the NHS, healthcare free at the point of use based on clinical need irrespective of ability to pay, continue to be eroded. Policy makers and politicians urgently need to find solutions to ensure all members of society can access the same high quality health care.

Key messages
• Private healthcare utilization in the UK for orthopaedic procedures, has increased significantly, contributing to an emerging two-tier healthcare system.
• There are large geographical disparities in access to healthcare services, with he South of England performing more private proceeds with longer NHS waiting times compared to the North.
Vaccine conspiracy beliefs are the main determinant of adult vaccine hesitancy
Authors: Smola P , Zwierczyk U , Kowalska-Duplaga K , Duplaga M 
Published: October 2024

Abstract

Background
Many factors influence the level of vaccine hesitancy. The COVID-19 pandemic demonstrated that conspiracy beliefs are an important element of overwhelming misinformation. The main aim of the study was to assess the relationship between vaccine hesitancy (VH) and vaccine conspiracy beliefs (VCB) in Polish society.

Methods
The analysis was conducted using data from an online survey of 2189 Internet users conducted in November 2021. Uni- (ULRM) and multivariable linear regression (MLRM) models were developed for vaccine hesitancy as a dependent variable. The independent variables included VCB score (VCBS), health (HL) and e-health literacy (eHL), Internet (IU) and social media use (SMU), political views (PV), and sociodemographic variables.

Results
The VCBS, eHL, HL, age, income, vocational and marital status, place of residence, PV, IU, and SMU were significant predictors of VH in ULRMs. A significant relationship with VH was maintained in MLRM for all independent variables enlisted earlier, apart from age, income, and vocational status. Respondents with higher VCBS were more likely to have higher VH (B, 95%CI: 0.38, 0.37-0.40). Those with undetermined HL had higher VH than persons with sufficient HL (B, 95%CI: 0.13, 0.06-0.20). A higher level of eHL predicted a lower level of VH (B, 95%CI: -0.01, -0.012 - -0.03). Lower IU and higher SMU were associated with higher VH (B, 95%CI: 0.16, 0.02-0.30, and 0.10, 0.03-0.17, respectively). Supporters of far right-wing party showed higher HV than supporters of the governmental party (B, 95%CI: 0.16, 0.07-0.27). Finally, singles showed higher HV than married (B, 95%CI: 0.07, 0.01-0.13), and residents of small cities had higher HV than residents of rural areas (B, 95%CI: 0.08, 0.004-0.15).

Conclusions
The vaccine conspiracy beliefs play a major role in the development of VH. The interventions aimed at the change of antivaccination attitudes should address the problem of widespread conspiracy beliefs.

Key messages
• Conspiracy beliefs are an important determinant of attitudes toward vaccination.
• The development of adequate digital health literacy may be a protective factor against vaccine hesitancy.
Mother-to-child Transmission using the National HBV Perinatal Prevention Data in Korea, 2002-2021
Authors: Ki M , Kim B W , Baik D , Kim J H 
Published: October 2024

Abstract

Aims
To define risk factors associated with mother-to-child transmission (MTCT) and to create supporting evidence for the National Hepatitis B Perinatal Prevention Program (HBPPP) in Korea.

Methods
We analyzed HBPPP mother-infant pair data enrolled from 2002 to 2021. The major outcome was the HBsAg status of the infant resulting from post-vaccination serological testing. Additionally, we used prescription records of antivirals against the hepatitis B virus (telbivudine, tenofovir disoproxil fumarate) from 2010 to 2021 by data linkage with the National Health Insurance claims data. To select significant risk factors by maternal HBeAg status based on the data from 34 to 42 weeks of pregnancy, multivariate logistic regression analysis was used.

Results
Data from 232,242 mother-infant pairs were analyzed. Among 154,331 (66.5%) infants with post-vaccination serological testing results, 3,620 (2.3%) were HBsAg-positive. The incidence of MTCT has shown a decreasing trend, from 4.1% in 2002 to 1.0% in 2021. However, the rate was high at 5.5% (1822/32986) for infants of HBeAg-positive mothers. Maternal antiviral prescription during the pregnancy period, old age, HBeAg negative, delivery type (C-section), and breastfeeding were significant factors in decreasing the risk of MTCT. Among the HBeAg-positive, there was a significant difference in the antiviral prescription 0.7% (11/1692) compared to the non-prescription 4.9% (789/16264) [aOR, 7.71; 95% CI, 4.24-14.02]. The result was similar for the HBeAg-negative group, 0.7% (302/44888).

Conclusions
To eradicate the hepatitis B virus on a national level, MTCT must be further reduced. To achieve this, it is necessary to introduce strong additional preventive measures, including quantitative HBV DNA testing for mothers with chronic hepatitis B and administering antiviral prophylaxis at the third trimester of pregnancy with HBV-DNA ≥200,000 IU/mL into the HBPPP.

Key messages
• The incidence of mother-to-child transmission has shown a decreasing trend, from 4.1% in 2002 to 1.0% in 2021.
• Maternal antiviral prescription, old age, HBeAg negative, delivery type (C-section), and breastfeeding were significantly decrease the risk of mother-to-child transmission.
Involving children in health literacy research
Authors: Jenkins C 
Published: October 2024

Abstract

Background
The range of health literacy research related to children has not normalised children’s involvement as advisors in health literacy research about them. While research with children can be difficult to facilitate, the principles of involvement and engagement should guide all health literacy work. This presentation shares learning from convening a Children’s Advisory Group to consult children about health literacy research priorities, ethics and methods.

Methods
Children (n-8) aged 7-11, referred by adults whose networks included children, joined a Children’s Advisory Group as Child Advisors. Consultations focused on a proposed study of how children’s critical health literacy could be supported in a community setting. Child Advisors piloted methods for rapport-building and data collection to be adapted for use with child participants later. Child rights-informed evaluation forms captured children’s reflections on their involvement.

Results
Consulting with a Children’s Advisory Group has challenges and benefits. Despite equity-focused strategies, e.g. introductory phonecalls and postcard updates, seldom-heard children remained less involved and the extent of parent/caregiver support varied. Child Advisors valued independent consultations led by their interests. Contributions included child-friendly consent documents, livestreamed draw-and-describe inspired by favourite influencers, and a novel Interview to the Alien protocol designed to appeal to middle childhood.

Conclusions
Taking an equity-focused approach is relevant for research with children focused on critical health literacy. Consulting with Child Advisors provides a way to involve children in health literacy research that holds adult researchers accountable for acting on children’s contributions. It is important to offer Child Advisors more than one option to get involved in research so that their insights can be foregrounded in future health literacy research with children.
Challenges and possibilities in adolescent loneliness interventions
Authors: Lasgaard M , Friis Bo A , Christiansen J 
Published: October 2024

Abstract
Researchers typically associate the high prevalence of loneliness during adolescence with evolving dynamics and changes in relationships, both familial and peer-related. Consequently, transient feelings of loneliness are anticipated and considered part of the normative developmental process. While many adolescents naturally navigate through periods of loneliness by reconnecting with peers, a subset experiences prolonged feelings of loneliness. This group faces an increased risk of additional mental health issues and potential adverse health consequences. Such findings underscore the importance of effective and scalable interventions. This presentation draws upon a comprehensive meta-analytical review of loneliness interventions and a dedicated chapter in the upcoming Cambridge Handbook of Loneliness. focusing on interventions for adolescents. It will offer a brief overview of contemporary loneliness interventions and intervention strategies. Furthermore, it will discuss the unique considerations required when addressing loneliness in adolescents compared to other age groups. This includes the critical importance of loneliness prevention for adolescents, particularly within the school environment. Furthermore, the presentation will discuss the potential of community-based interventions aimed at tackling adolescent loneliness, showcasing the ongoing Danish community-based intervention ‘More Together.’ ‘More Together’ is a large-scale, complex, multi-component and multi-level intervention for community change that aims to reduce loneliness among young and elderly people. The intervention is rooted in an extensive cross-sector partnership. The presentation will highlight potentials and pitfalls encountered when addressing adolescent loneliness within a community setting.
Interventions to reduce loneliness in children and adolescents: A systematic review and meta-analysis
Authors: Burke L 
Published: October 2024

Abstract
Despite the growing focus on adolescent loneliness and loneliness interventions, our understanding of successful approaches for tackling loneliness in childhood and adolescence remains limited. While recent reviews have made advances in exploring loneliness interventions for this age group, our understanding of successful approaches remains limited. Key knowledge gaps persist, particularly concerning potential moderators - specifically, the characteristics that may determine the effectiveness of an intervention is sparse, leaving a significant gap in our understanding of which interventions are most effective and for whom. This presentation aims to fill this gap by presenting the findings of a systematic review and meta-analysis on interventions to reduce loneliness in children and adolescents. The presentation will provide a brief overview of the methodology employed and provide insights into the characteristics of the interventions reviewed, including an assessment of their overall effectiveness in alleviating loneliness. The primary focus, however, will be on presenting findings regarding the effectiveness of interventions across different participant groups, including variations based on socio-economic status, age group, pre-existing mental and physical health conditions, as well as baseline levels of loneliness. Additionally, the presentation will explore the impact of different intervention strategies on the effectiveness of loneliness interventions for children and adolescents. Lastly, the presentation will offer reflections on avenues for future research and practice based on the findings.