bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public health effectiveness of cooling centres in adverse hot weather events: a systematic review
Authors: Dearman C , Adams N , Sousa A , Pearce-Smith N , Petrokofsky C 
Published: October 2024

Abstract

Background
The 2022 heatwave in England highlighted the need for effective public health interventions like cooling centres in temperate climates where built-in air conditioning is uncommon.

Aim
To determine the impacts of cooling centres on heat-related health outcomes for users in temperate climates, assessing their effectiveness and identifying barriers to usage.

Methods
This systematic review analysed literature sourced from MEDLINE, Embase, Web of Science, CENTRAL, and Google Scholar from January 2010 to February 2023. Criteria for inclusion focused on studies evaluating health outcomes related to cooling centre use. Screening and quality assessments were independently conducted using the Mixed Methods Appraisal Tool.

Results
The review included six studies: three quantitative, three qualitative. Two were evidence synthesis of prior studies. No studies conclusively measured health and wellbeing outcomes directly after cooling centre use; instead, research emphasised user demographics, barriers, and facilitators. Common barriers included accessibility, operational hours, and public perceptions, which often misalign with user needs. Successful implementations were noted in centres integrated within community facilities like libraries or community centres. One modelling study suggested a number needed to treat to avoid one heat-related death of 1 million. The relevance of this is unclear as it was in a hotter climate with greater prevalence of air conditioning than in England.

Conclusions
While direct health benefits in cooler climates like England are poorly documented, cooling centres play an essential role in comprehensive heat response strategies. They offer potential social benefits and provide a cost-effective alternative to urban redesign. Future studies should aim to directly measure health outcomes and refine operational strategies to maximise benefits.

Key messages
• Cooling centres are crucial in comprehensive heat response strategies, yet direct evidence in cooler climates like England remains limited.
• Integration with existing community services may significantly enhance cooling centre utilisation and effectiveness.
Extreme Heat and Specific-Cause Mortality during Summer 2018 in Mainland Portugal
Authors: Subtil I , Silva S P , Leite A 
Published: October 2024

Abstract

Climate change has led to increased frequency and duration of extreme heat periods, impacting human health and mortality. During the 2003 heatwave, it was estimated that there were between 25,000 and 70,000 excess deaths in Western Europe. Specific-cause mortality analysis was conducted in Portugal that year and has not been assessed since. The goal of this study is to estimate the impact of an extreme heat period in 2018 on specific-cause mortality in mainland Portugal. An ecological study was conducted comparing observed and expected deaths, from August 2 to 9, 2018, in Portugal. Two comparison periods were chosen: from July 19 to 26, 2018 (C1) and the average deaths from August 2 to 9 in 2017 and 2019 (C2). Excesses, ratios, and respective 95% confidence intervals were calculated in R. Analyses were stratified by sex, age group, and district. Consistent excess deaths were observed between comparators, showing a greater impact in circulatory diseases (C1: 283, 95% CI: 210; 356 and C2: 239, 95% CI: 164; 314) and respiratory diseases (C1: 98, 95% CI: 55; 141 and C2: 95, 95% CI: 52; 138). Regarding death ratios, with C1, the highest death ratios were observed for exposure to excessive natural heat (50.00, 95% CI: 37.11; 65.92) and ischemic stroke (4.00, 95% CI: 2.07; 6.99). With C2, the highest death ratios were observed for exposure to excessive natural heat (50.00, 95% CI 37.11; 65.92) and atherosclerosis (2.71, 95% CI 1.63; 4.24). The excesses and ratios of deaths were higher in more urbanized districts, females, and age groups above 75 years. The results suggest that the extreme heat in 2018 had an impact on mortality. Elevated death ratios and excesses were observed for various causes of death with considerable statistical magnitude and significance. These findings align with other national and international studies. Public health action is increasingly critical to mitigate the observed rise in mortality during periods of extreme heat.

Key messages
• Specific-cause mortality analysis during extreme heat suggests a greater impact in circulatory and respiratory diseases, in residents of urbanized districts, females, and individuals of 75+ years.
• Understanding these specific causes can better inform public health actions and planning, thereby mitigating the adverse effects of extreme heat.
Why greenhouse agricultural workers do not use pesticide protection methods? A case study
Authors: Ilgaz A , Karabiyik I H 
Published: October 2024

Abstract

Background
Exposure to pesticides in individuals working in greenhouse agriculture is an important public health problem that threatens their health more than individuals working in other agricultural jobs for the same period of time, causing an increase in mortality and morbidity rates. Applying protection methods plays an important role in reducing/preventing exposure-related health risks. It is aimed to explore the reasons why greenhouse agricultural workers do not use pesticide protection methods.

Methods
This case study was adopted the descriptive qualitative approach between February-March 2024. Individual in-depth face-to-face interviews were conducted with semi-structured interviews, resulting in 20 participants. The inclusion criteria for participants include being a greenhouse agricultural worker (at least 1 year), being 18 years of age or older, using pesticides, not using any personal protective equipment, and not engaging in protective behavior. Braun and Clark’s (2021) reflexive thematic analysis methodology was used to analyze the data.

Results
In this study generated three main themes and fourteen subthemes. The main themes identified were a) personal attitudes/ characteristics b) negative features of the physical environment, c) negative features of personal protective equipment.

Conclusions
The reasons why greenhouse agricultural workers do not use pesticide protection methods are individual attitudes/characteristics such as laziness and not to care about, negative characteristics of the environment such as temperature, humidity and wetness, and negative characteristics of personal protective equipment such as being heavy and inflexibility. Health institutions and health professionals serving in regions where agricultural workers should develop interventional studies, intervention programs and strategies to protect and improve the health of these individuals.

Key messages
• Greenhouse agriculture workers do not use any of the pesticide protection methods due to individual attitudes/characteristics, negative characteristics of environment and personal protective equipment.
• Health professionals can ensure that greenhouse agricultural workers use pesticide protection methods by increasing their awareness of health risks and planning interventional studies.
Antibiotic resistant Pseudomonas aeruginosa in dental unit waterline: a case study in Milan (Italy)
Authors: Tesauro M , Consonni M , Lodi G , Mattina R , Bergna A , Zehender G , Lai A 
Published: October 2024

Abstract

P.aeruginosa (Pa) is one of the most serious cause of healthcare-associated bacteremia, well-known for its antibiotic resistance (AR). Pa has often been found in dental unit water representing a great risk in public health. Aims are to evaluate the presence of Pa in dental unit (DU) water and its phenotypic and genotypic properties. Pa isolates derive from a monitoring of DU water in an Italian hospital (Milan). Samples were collected on Monday and on Friday, before the beginning and after the end of activities. Resistant PA strains were characterized by phenotypic method using E-test for 6 different classes of antibiotics, and by genotypic method with Whole-genome sequencing (WGS). Resistance genes were annotated with ResFinder v. 4.5 and Sequence Type (ST) was determined using the PA MLST database. 70/272 strains were identified as Pa and 21 of them were AR to one or more antibiotics. They were detected in 10/44 (22.7%) DUs and 2/4 (50%) control sinks (1-2000UFC/100mL). WGS was obtained for 18 strains. 17 belonged to serogroup O11 and ST667 was prevalent (8/18) followed by ST395 (4/18). At the ground floor ST395 was the most prevalent, followed by ST667 and 260, while, at the first floor, ST309 and 667 were in the two controls and ST667, 3245 and 260 in the other DUs. Resistant genes blaPAO, aph(3’)-IIb, catB7 conferring resistance to β-lactams, aminoglycosides and amphenicol, respectively, were observed in all isolates. Only ST3245 strain did not show resistance to Fosfomycin. Genotypic and phenotypic analyses present some discrepancies with the presence of AR genes and no antibiotic resistance detection (4/18) or resistance to other different classes of antibiotics (6/18). The MLST analyses showed a high diversity, with the presence of strains sharing different antibiotic resistance mechanisms in DU water. Detection and analyses by WGS can help to track dissemination of genetic resistance determinants and potential emergence of high-risk clones.

Key messages
• Phenotypic and genotypic analyses in DU water are needed to evaluate risk for human health, in addition to routine microbial monitoring.
• WGS can help to track dissemination of genetic resistance determinants and potential emergence of high-risk clones.
Digital Health Literacy Enhancement Strategies Across Diverse Groups: A Scoping Review
Authors: Ahmed F , Bernal B , Cervera P , Brenner H , Saletti S , Krini M , Fonseca C , Yared W , Zeeb H , Brand T 
Published: October 2024

Abstract

Background
The COVID-19 pandemic has accelerated the use of digital health technologies. Digital health literacy (DHL) is essential for effectively understanding and applying electronic health information. However, unequal access and use of these technologies require interventions to improve DHL for fair healthcare access.

Objectives
This scoping review aimed to identify strategies to enhance DHL in patients and the general population.

Methods
The review used the Joanna Briggs Institute Scoping Review Methodology and PRISMA-ScR guidelines. Eligibility criteria included a wide population, interventions aimed at improving DHL, with no restrictions on outcomes. The search strategy included electronic databases (MEDLINE, PsycINFO, Web of Science), and AI-based software, AS Review, was used for screening.

Results
The review found 5149 articles, 44 met the eligibility criteria. Studies focused on different demographic groups and health conditions. Most interventions were in North America and Europe. The study designs varied. Interventions via mobile apps, online platforms, and in-person sessions aimed at various conditions yielded positive results, including increases in DHL, self-management skills, and health-related behaviors. These interventions involved either independent interventions that focused on DHL or integrated interventions that were part of another intervention that aimed at a health outcome and had an element of DHL enhancement.

Conclusions
The review highlights the importance of DHL in informed decision-making and navigating digital health environments. While many interventions had positive outcomes, methodological limitations challenge the findings, emphasizing the need for more rigorous study designs. Future research should address sustainability, scalability, and the impact of DHL on health disparities, considering cultural sensitivity when developing interventions.

Key messages
• Scoping review identifies strategies to enhance Digital Health Literacy (DHL), crucial for effective use of health technology.
• Despite positive outcomes, methodological limitations exist. Future research should focus on sustainability and scalability.
Facilitating the transfer and implementation of practices across health and care systems
Authors: Koivisto J , Muurinen H 
Published: October 2024

Abstract
The THCS partnership has developed the initial draft of a framework designed to facilitate the transfer and implementation of solutions across health and care systems. During the workshop, we will present this framework along with the preliminary results of its real-world testing in transfer and implementation activities. The goal of this presentation is to gather feedback on the framework and generate ideas for its further development. Choosing to transfer existing solutions rather than developing new ones can offer several advantages in terms of efficiency, reliability, and cost-effectiveness. Adopting existing solutions can save time and reduce development costs significantly. The THCS framework aims to support, promote, and accelerate the transfer and implementation of solutions across health and care systems. The THCS framework is primarily targeted at individuals involved in planning, coordinating, and executing development activities within health and care organizations. This framework includes: 1) Paradigmatic commitments that underpin its understanding of development activities, transferability, and implementation; 2) Principles for conducting the activities of transferring and adapting solutions developed elsewhere; 3) Guidelines for describing original solutions; and 4) Key development tasks that outline the necessary steps for transferring, adapting, and implementing solutions developed elsewhere.
Diets, ergogenic supplements, and microbiota in professional and non-professional athletes
Authors: Ghaffar T , Ubaldi F , Romano Spica V , Valeriani F 
Published: October 2024

Abstract

Background
Regular physical activity has significant health benefits and can help prevent and manage non-communicable diseases. Intense exercise during training requires diet modulation to support health and performance. Anaerobic sports require high-protein diets, while aerobic sports prefer high-carbohydrate diets. Two-thirds of adult athletes take dietary supplements, and non-professional athletes also use supplements to enhance their appearance. However, dietary stress and imbalanced use of supplements leads the body to different diseases like gastrointestinal diseases and even multifactorial diseases e.g. cancer, cardiovascular diseases, and neurodegenerative diseases. Depending on the specific nutritional intake, supplementations, types of exercises the microbiota can be influenced positively or negatively. A systematic review meta-analysis and a pilot study were conducted to investigate the role of diet and supplementation about the microbial composition of the gut, under different types and intensities of physical activities.

Methods
The systematic review and meta-analysis were conducted according to the PRISMA guidelines, and the protocol was registered in PROSPERO (Number CRD42024500826). In a pilot study gut microbiota (16S amplicon sequencing), anthropometric data, and information on diet and supplementation, physical activity and sport habits were collected in a sample including professional and non-professional athletes.

Results
Out of 1318 studies, only 9 met the criteria for inclusion in the meta-analysis. The pilot study’s meta-regression analysis and microbiota analysis highlight the role of physical activity type in changing the Bacillota/Bacteroidota ratio (p = 0.001).

Conclusions
As gut training becomes more popular among athletes, it is necessary to map interactions between microbiota and different personalized diets, physical activities, and the most popular ergogenic supplements to enhance performance and athletic wellness

Key messages
• The microbiome can be inﬂuenced positively or negatively by the specific dietary intake, types of physical activities and ergogenic supplementations.
• To map interactions between microbiota and different diets, physical activities, and popular ergogenic supplements is needed to design new strategies to enhance performance and athletic wellness.
Developing a community engagement toolkit for health impact assessment in Ireland
Authors: Nash K , Kenny T , O’Mullane M , Harris-Roxas B 
Published: October 2024

Abstract

Background
Community involvement is a core principle of Health Impact Assessment (HIA). However, current guidance for HIA published by Ireland’s Institute for Public Health does not include guidelines on community engagement in HIA. As part of the project HIA-IM - ‘Development of a Health Impact Assessment Implementation Model: Enhancing Intersectoral Approaches in Tackling Health Inequalities,’ a Community Engagement Toolkit was created, with the aim of providing guidance for those carrying out HIAs and engaging with community in the process. The project will implement two HIAs, on the Cork City Development Plan (2022-2028) and the national Climate Action Plan (2024). Incorporating the learnings from the first HIA, the Toolkit will be employed in the second HIA of the project.

Methods
To develop the toolkit, a literature review of community engagement in HIA was conducted, with benefits and challenges, key approaches, and case studies of HIA’s gathered from grey literature and peer reviewed articles. In line with the participatory nature of HIA, a public consultation event was held, which was presented as a case study within the Toolkit.

Results
Findings from the literature review contend that engaging with community in HIA captures the lived experiences and local circumstances of the community, fostering empowerment and greater health awareness. However, many practitioners find community engagement to be practically challenging, citing factors such as time and resource constraints; with risks of consultation fatigue and raising expectations.

Conclusions
The review identified tools that have been used to mitigate these challenges and risks to facilitate meaningful community participation. These findings, along with learnings from conducting the first HIA, has informed the content of the Toolkit. Therefore, this Toolkit aims to complement national HIA guidance to centre the community voice in future HIA practice.

Key messages
• Developing a toolkit to strengthen participatory approaches and community engagement in health impact assessment in Ireland.
• Centering the community voice in health impact assessment: the inclusion of lived experiences and local circumstances in health impact assessment practice in Ireland.
Oncofertility in primary health care: the role of the Portuguese family doctor
Authors: Monteiro G P , Carvalhinho M , Amorim H 
Published: October 2024

Abstract

Background
The increasing number of cancer cases diagnosed at young ages and the impact of the disease and treatments on reproductive function have led to the development of Oncofertility. While oncologists typically lead these discussions, family doctors, as primary care providers, also play a crucial role. This study aims to assess family doctors’ knowledge, attitudes, and practices regarding fertility preservation in cancer patients.

Methods
This cross-sectional study, conducted between April 2023 and March 2024, surveyed 351 General and Family Medicine doctors from the Portuguese Northern Regional Health Administration. The questionnaire, consisting of 15 questions, assessed sociodemographic profiles, knowledge, attitudes, and practices. Data were analyzed using descriptive statistics and multivariate logistic regression.

Results
Most participants were female (80.5%) and under 40 years old. The majority (91.5%) had treated fewer than 10 cancer patients under 40 in the past two years. Key barriers included lack of knowledge (63.3%), time constraints (57.0%), and patient age (18.5%). Male physicians were more likely to address specific fertility concerns (OR 2.239) and less likely to view patient age as a barrier (OR 0.459). Physicians aged 31-35 were less likely to discuss fertility preservation (OR 0.553) but more likely to address it in the first consultation (OR 2.969). Urban-based physicians were less likely to discuss fertility preservation (OR 2.099). Only 9.1% always discussed fertility preservation before treatment, 27.6% did so sometimes, and 63.3% never discussed it.

Conclusions
There are significant gaps in the knowledge and practices of family doctors regarding fertility preservation for cancer patients. Targeted training and resources are urgently needed to support family doctors in effectively discussing fertility preservation, crucial for improving the quality of life of young cancer patients wishing to preserve their fertility.

Key messages
• Empowering Portuguese family doctors to address fertility concerns in cancer patients contributes to comprehensive oncofertility care, improving patient outcomes and quality of life.
• Integrating oncofertility support with Portuguese family doctors strengthens primary care, ensuring discussion of fertility preservation is considered as part of cancer treatment planning.
Hospital policies as a tool to reduce gaps between ethnic groups of employees and patients
Authors: Gur A , Inchi L 
Published: October 2024

Abstract

Background
As diverse organizations, hospitals require an inclusive culture that respects and promotes ethnic diversity. Violence, a threat to this diversity, hampers effective organizational functioning. Our study delves into the positive influence of cultural diversity policies and communication about violence on the perception of the hospital’s atmosphere regarding ethnic differences among health employees. It enhances hospital labor relations and mitigates the risk of workplace violence.

Methods
372 hospital employees with an average tenure of 6.5 and an average age of 38 filled out an online close-ended questionnaire (83% are Israeli Jews, 68% are female). 91% report working closely with people from different ethnic origins. Respondents ranked the atmosphere in the hospital regarding ethnic differences between employees and patients, the hospital’s cultural diversity policy, and organizational communication about violence. Data were analyzed by SPSS 28.

Results
Positive correlations were found between variables. A positive atmosphere was significantly related to the hospital’s cultural diversity policy (r=.14, p=.002) and to organizational communication about violence (r=.22, p&lt; .001). However, the regression analysis (with control variables age, sex, and managerial role) revealed that despite employees acknowledging the hospital’s efforts to address diversity and violence, these factors only predict 10% of the variance of the hospital atmosphere [F(5, 366) = 8.346, p &lt; .001; R²=.10].

Conclusions
The hospital should increase actions that will improve the ethnic atmosphere in the hospital. Understanding how the encounter, where employees and patients from diverse ethnic backgrounds interact, influences the hospital’s atmosphere is crucial. These interactions can lead to tensions and offensive behaviors toward employees if not managed well. Hospitals can create an inclusive and harmonious work environment by addressing these tensions.

Key messages
• A cultural diversity policy and communication are necessary to maintain harmonious working relationships. It is essential, particularly in health organizations characterized by ethnic diversity.
• Reducing the perception of ethnic differences may increase well-being and decrease violence. While hospitals often don’t prioritize these issues, this study forefront their influence and importance.