bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of tobacco retailers density reduction on smoking status of Belgian adults
Authors: Croes S , Guariguata L , Devleesschauwer B , Gorasso V 
Published: October 2024

Abstract

Background
Smoking being one of most impactful risk factors for causing non-communicable diseases (NCD) and consequently attributable death, represents an enormous public health issue. New policy interventions aimed at reducing smoking prevalence are planned in the Belgian Tobacco Free Generation plan. Within the plan, it is aimed to reduce the number of outlets that sell tobacco products, as a higher tobacco retail density (TRD) is believed to be linked to higher smoking prevalence. Using health impact assessment (HIA), this study aims to evaluate the policy before it is set in place.

Methods
For this intervention a 17% reduction in density was estimated according to the scoping review would be associated with an 0.39 percentage point reduction in prevalence. The Potential Impact Fraction (PIF) was calculated to assess the change in proportion of current smokers. Time series and projections of the Belgium Health Interview Survey provided data on the smoking status from 1997 untill 2040. The relative risk were retrived from the Global Burden of Disease 2021 study. Using data from the Belgian Burden of Disease Study, the avoidable burden was estimated.

Results
The policy is expected to reduce the density by 17 % by 2025, which results in a PIF for lung cancer of 0.92%, decreasing to 0.82% in 2040. The smoking prevalence would decrease from 12.62% to 12.23%. We estimated that this intervention would avoid the burden of more than 300 lung cancer cases and around 100 deaths in 2040.

Conclusions
The HIA in this study suggests that reducing TRD has a potential to contribute to achieving the objectives in Tobacco Free Generation plan. However, it should be noted that the impact is rather small, lower than 1% for most diseases. In addition, the actual impact may vary depending on the specific implementation of the policy and future smoking trends. Further research is needed to refine the effect size estimate based on the actual policy intervention details.

Key messages
• Reducing tobacco retail density can reduce the burden of smoking.
• Modeling limitations need further research to refine HIA results.
Heterogeneous courses of cardiovascular disease incidence in Europe 2000-2019 – what are the causes?
Authors: Stolpe S , Stolpe S 
Published: October 2024

Abstract

Background
Data from the Global Burden of Disease (GBD) project distributed by the Institute for health metrics and evaluation (IHME) include incidence and prevalence data for almost all countries in the world. In course of own research, the data on cardiovascular disease (CVD) incidence in Western European countries were analysed and revealed great variation in the course of CVD incidence, that is difficult to interpret. We want to present the different courses of CVD incidence for selected countries and discuss possible reasons for this diversity with the audience.

Methods
GBD data on CVD incidence and mortality for 25 European countries from 2000-2019 for men and women were to graphically display courses of CVD incidence for visual analysis.

Results
The course of CVD incidence in Western Europe is country-specific - and, within a country, even sex-specific. Yet, in many countries besides the Baltic states and Czechia, CVD incidence reaches a minimum in 2010, increasing afterwards again. Different patterns of incident courses were visible:
a) wave-shaped courses which increase e.g. in Austria, Belgium, France and in males in Finland only, but decrease for both sexes Germany, Norway, Portugal and Poland, and in males in Denmark
b) u-shaped courses in Spain, Great Britain, France, Italy, and for Finnish and Dutch females
c) linearly increasing for both sexes in Czechia, the Baltic states and in Swiss males
d) linearly decreasing for women Norway, Belgium, Denmark and Austria.

Conclusions
The patterns of CVD incidence in Europe are multitude and country-specific even between sexes, reaching a minimum in 2010 in most countries. The validity of analyses combining these different patterns for regional analyses of CVD incidence such as in GBD reports do not take account for this diversity. Unless these differences can be explained by country-specific prevention or risk factor profile, the validity of data on CVD incidence seems to be limited.

Key messages
• CVD incidence in Europe between 2000 and 2019 is country-specific changing and very heterogeneous.
• Analyses summarizing data for (Western/Eastern) Europe will miss this heterogeneity and might come to invalid conclusions regarding the development of CVD incidence.
A Delphi method approach to consensus - based translation of ‘Second Victim’ definition into German
Authors: Roesner H , Klemm V , Strametz R 
Published: October 2024

Abstract

Background
Healthcare providers involved in unanticipated adverse patient events, unintentional healthcare errors, or patient injuries, and who become negatively impacted, are defined as ‘Second Victims’. The term Second Victim has gained substantial attention since its inception around 2000, yet lacks a standardized definition in the German context. This study addresses this gap by proposing a consensus-based translation of the term into German, aiming to foster understanding and facilitate research comparability.

Methods
A Delphi method approach was employed, engaging a panel of German-speaking, clinically and scientifically active Second Victim experts. The study was conducted using an online survey and commenced with the reference of the consensus- and evidence-based definition from the European Researchers’ Network Working on Second Victim (ERNST) published in 2022.

Results
Nine out of eleven invited experts participated in the study, contributing to a robust consensus-building process. Through three Delphi rounds, a consensus rate of 90% was attained for the translation of the international definition of a Second Victim. The resulting definition provides a comprehensive understanding of the term within the German context.

Conclusions
This Delphi study establishes a formal consensus among recognized experts, delivering a German-language, evidence-based definition of the term Second Victim. It serves as a crucial foundation for understanding and further researching the Second Victim phenomenon within the German-speaking healthcare community.

Key messages
• Consensus-based German translation of Second Victim enhances clarity in healthcare discourse.
• Delphi method with German experts yields unified definition, promoting the coherence of patient safety research.
Effect of sustainable food habits on gut microbiota diversity: A pilot study
Authors: Tillander A , Halling Ullberg O , Toivanen S , Bälter K 
Published: October 2024

Abstract

Background
To reach climate goals, sustainable food habits are needed and a plant-based diet is more climate-friendly. However, analyses of food products show that the highest levels of pesticide residues have been found in vegetables, fruits and cereal. Further, pesticide residues have been seen to decrease microbiota diversity. Since microbiota diversity is linked to human health, understanding these dynamics is crucial. This study aimed to evaluate the effect of sustainable food habits on gut microbiota diversity.

Methods
An 8-week intervention study on sustainable food habits with participants randomized into three groups and assigned to different diets; climate friendly (n = 8), organic (n = 9) and control group (n = 9). Data was collected at baseline, at 4 weeks, and at 8 weeks and included a comprehensive meal questionnaire (Meal-Q), urine samples for pesticide analysis, and fecal samples for gut microbiota diversity. As intervention the groups attended four educational sessions about their specific diet. Linear mixed-effects models were used for data analyses.

Results
There was no indication of adverse effects of a climate friendly diet (p = 0.79) or an organic diet (p = 0.32) on gut microbiota diversity compared to the control group. Pesticide residues that showed negative effects on gut microbiota diversity were mepiquat (p &lt; 0.05) and chlormequat (p &lt; 0.05). The single food items that had adverse effects on gut microbiota diversity was Lemonade (p &lt; 0.05), Juice (p &lt; 0.05), and Brie cheese (p &lt; 0.05).

Conclusions
Despite its small sample size, this study provides valuable insights, supported by an 8-week longitudinal design and comprehensive monitoring of dietary habits. Notably, both climate-friendly and organic diets showed trends toward increased gut microbiota diversity over time. These findings need to be confirmed in future studies with longer durations and larger sample size.

Key messages
• A climate-friendly diet not only benefits planetary health but also holds potential for individual health improvements.
• Increased intake of plant-based items did not reduce gut microbiota diversity.
Mental health problems identified in early school age and later mental health problems and disorders
Authors: Pant S W , Pommerencke L M , Jørgensen S E , Skovgaard A M , Pedersen T R , Madsen K R 
Published: October 2024

Abstract

Background
Poor mental health in childhood and adolescence youth is an important public health challenge. We aimed to examine the prospective association between mental health problems among primary school children and later diagnosed mental disorders and mental health problems in youth.

Methods
A prospective cohort study of children participating in school health nurse examination during first years of primary school (approx. 6 years) in 17 municipalities in the capital region of Copenhagen, Denmark, with follow-up until their 16th birthday. Baseline data included information from national population registers and school health nurse records. Outcome variables: mental disorders diagnosed at hospital from approx. age 6 until 16 years (N = 6,930) and school health nurse records of mental health problems at approx. age 16 (N = 11,250).

Results
Problematic relations to peers in early primary school was associated with later neurodevelopmental disorders, including intellectual disability, autism-spectrum disorder and disorders of hyperactivity and inattention (AOR=4.14, 95% CI 2.15-7.97), and poor home related well-being in youth (AOR=1.67, 95% CI 1.02-2.74). Poor school well-being in early primary school was associated with poor school well-being ten years later (AOR=1.67, 95% CI 1.19-2.34) as well as problematic relations to peers (AOR=1.83, 95% CI 1.08-3.10). Further poor general well-being in early primary school was associated with problematic relations to peers in youth (AOR=2.21, 95% CI 1.17-4.18).

Conclusions
School health nurses identify a group of children in the early years of primary school with mental health problems and an increased risk of later mental health problems and disorders, and therefore they play an important role in the early identification of children at risk.

Key messages
• Children with problematic relations to peers have up to a fourfold increased risk of later mental disorders.
• The school health nurses play an important role in the early identification of children at risk of later mental health problems.
Risk Profiles of Avoidable and Unavoidable Hospitalizations: a Swedish population-based study
Authors: Gentili S , Locatelli G , Bellocco R , Calderón-Larrañaga A , Rizzuto D , Lennartsson C , Hedberg Rundgren Å , Fratiglioni L , Vetrano D L 
Published: October 2024

Abstract

Background
Older adults frequently experience multiple hospitalizations, owing to their complex health and social needs. This study aims to comprehensively characterize the risk factors associated with avoidable and unavoidable hospitalization among older adults. Specific emphasis is placed on avoidable/unavoidable hospitalization originating from chronic or acute causes.

Methods
Data on 3,166 individuals aged ≥60 years were obtained from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), linked to the Swedish National Patient Register. Multistate models were used to investigate the risk profiles of participants experiencing their first and recurrent hospitalizations over 15 years. The Swedish National Board of Health and Welfare criteria were used to define avoidable/unavoidable hospitalizations.

Results
Women had a lower hazard of avoidable hospitalizations for chronic conditions as well as unavoidable hospitalizations (HR range 0.46-0.84). However, receiving informal care was associated with 88% increased hazard of avoidable hospitalizations due to chronic causes (95%CI 1.18-2.99), while receiving formal care was associated with 44% increasing hazard of avoidable hospitalization due to acute causes (95%CI1.04-1.98). Factors such as slow walking speed, multimorbidity, and polypharmacy were associated with a high risk of avoidable hospitalizations due to both acute (HR range1.27-3.03) and chronic (HR range1.63-2.54) causes.

Conclusions
Both clinical and functional factors have emerged as key predictors of avoidable hospitalization, underscoring the importance of comprehensive risk assessment and proactive healthcare management strategies to reduce the burden of hospital utilization in older adults.

Key messages
• Targeted interventions are essential to improve healthcare outcomes among older adults at risk of avoidable hospitalizations due to chronic and acute conditions.
• The study identified predictors such as slow walking speed, multimorbidity, and polypharmacy, underscoring the need for comprehensive risk assessment to prevent avoidable hospitalization.
Mortality related to different circulatory diseases: a multiple causes of death analysis, 2008-2022
Authors: Fedeli U , Casotto V 
Published: October 2024

Abstract

Background
Mortality from circulatory diseases significantly increased in 2020 compared to pre-pandemic years in many countries. However, data were mostly limited to the underlying cause of death and to the first phases of the pandemic. Analyses of any mention of a disease in death certificates (multiple causes of death approach, MCOD) are more robust to changes in coding rules/practices and to the role of COVID-19 as a competing cause of death.

Methods
Mortality records were extracted from 2008 to 2022 among residents of the Veneto Region (Northeastern Italy, 4.9 million population). Based on MCOD, age-standardized mortality rates (2013 European standard) were computed for ischemic heart diseases (IHD), cerebrovascular diseases (CVD), atrial fibrillation (AF), and hypertensive diseases (HD). The annual percent change (APC) was estimated through the pre-pandemic period (2008-2019), and change in rates during pandemic years were computed compared to 2019.

Results
Before the pandemic, rates were steeply declining for IHD (APC -5.1%; 95%CI -5.5, -4.6) and CVD (-4.0%; -4.4, -3.5); mortality related to HD reduced at a slower pace (-1.9%; -2.3, -1.4), whereas AF-related mortality was increasing (+1.0%; 0.1, 1.8). During the first year of the pandemic, the growth in mortality compared to 2019 was +26% for HD, +18% for AF, +13% for CVD and +12% for IHD. In 2021-2022, rates for CVD and IHD returned to pre-pandemic levels; rates for HD reduced with respect to 2020 but remained above the baseline; AF-related mortality was still increasing.

Conclusions
The pandemic differentially impacted mortality associated to different circulatory diseases, depending on pre-existing long-term trends (increasing for AF) and on susceptibility to severe COVID-19 disease (higher for HD). Continuous surveillance based on MCOD is warranted to properly assess changes in mortality associated to specific circulatory diseases after the end of the pandemic.

Key messages
• Multiple causes of death analyses are warranted to assess how the pandemic affected pre-existing long term trends in cause-specific mortality.
• Mortality related to different circulatory diseases increased in 2020, but pre-pandemic trends, the extent of the increase in 2020, and further changes observed in 2021-2022 largely diverged.
Association of Altitude with Mortality among Patients with Hypertension - A Cohort Study
Authors: Lu J , Pang L , Xia Y , Guo Z , Yang W , Duo L , Zhu Q , Wang T 
Published: October 2024

Abstract

Background
Available evidence falls short in assessing the risk of all-cause mortality and cardiovascular disease (CVD) mortality among individuals with hypertension residing at various altitudes. This study’s objective was to investigate the correlation between residential altitude and the rates of all-cause mortality and CVD mortality among hypertensive patients.

Methods
This prospective cohort study encompassed 67,275 hypertensive individuals aged 35 years and above in the year 2018. Participants were categorized into four distinct groups based on their residence altitude: those living below 500 meters, between 500 and 1499 meters, 1500 to 2500 meters, and above 2500 meters. The study spanned a mean follow-up duration of 4.78 years. The associations between residential altitude and the risks of all-cause and CVD mortality were analyzed using Cox proportional hazards regression models.

Results
Among the 67,275 hypertensive patients included in the study (mean age of 63.9 years, with 45.3% being male), 8,768 deaths were recorded, of which 5,666 were attributed to CVD. Following multivariate adjustment, when compared to the group residing at altitudes below 500 meters, the groups living at altitudes of 500-1499 meters, 1500-2500 meters, and above 2500 meters exhibited significantly elevated risks of all-cause mortality [hazard ratio, HR = 1.45 (95% CI: 1.36-1.54), 1.35 (95% CI: 1.36), and 1.41 (95% CI: 1.28-1.54), respectively] and CVD mortality [HR = 1.47 (95% CI: 1.35-1.58), 1.42 (95% CI: 1.33-1.52), and 1.46 (95% CI: 1.31-1.62), respectively]. For each 500-meter increment in altitude, the risk of all-cause and CVD mortality increased by 10% and 11%, respectively. Subgroup analyses and sensitivity assessments consistently supported this association.

Conclusions
This study’s findings indicate a substantial connection between long-term residential high-altitude exposure and increased risks of all-cause mortality and CVD mortality among individuals with hypertension.

Key messages
• Increased altitude of residence increases the risk of subsequent all-cause and CVD mortality in hypertensive patients.
• This study highlights that relevant guidelines and healthcare providers should consider altitude as an important factor in reducing the burden of hypertension and CVD.
Patient referral pathways to leisure providers: impacts on physical activity and falls risk
Authors: Cuddihy C , Jopling H 
Published: October 2024

Abstract

Background
Physical activity aids prevention and management of noncommunicable diseases. Yet many UK adults, particularly those with long-term health conditions, do not meet recommended activity levels. In 2021, West Suffolk Foundation Trust commissioned local leisure provider Abbeycroft to offer 24 week tailored physical activity programs as part of respiratory and frailty patient pathways.

Objectives
Evaluation of activity and outcome data for all 1670 individuals referred between January - December 2023 to determine future commissioning decisions.

Results
256 participants had completed a 24 week pathway by the time of analysis. Compared to baseline, they demonstrated statistically significant (p &lt; 0.05) self-reported improvements on the Short Warwick Edinburgh Mental Well-being Scale (median 25 to 27) amongst 68.9% of participants; and on the self-reported International Physical Activity Questionnaire 62.1% reduced time spent sitting (average 436 to 300 minutes/ week), 75% increased metabolically active minutes (average 955 to 2632 minutes/week) and the proportion of participants with a low (inactive) score decreased by 61%. Of 40 frailty patients, 87.5% lowered their self-reported Short Falls Efficacy Scale Score (14.6 to 10.4) and observed Timed Get up and Go (13.55 to 9.53 seconds), indicative of moving from a higher risk to lower falls risk (p &lt; 0.05). 24 week retention exceeded 80% for all ages except 16-20 years. 17.8% of participants were &gt;75 years.

Lessons
Both pathways have been recommissioned and new tailored pathways for Parkinson’s disease, COPD and cancer are planned. This partnership working is a sustainable, integrated way to embed prevention in the community but needs time to build relationships and streamline data sharing.

Key messages
• Hospital and community referral pathways to leisure providers significantly improve patient well-being, physical activity and falls risk.
• These pathways are affordable, adaptable across conditions and show high retention.
Advancing transdisciplinarity as an epistemology for more ethical engagements with fishing communities
Authors: Strand Mia 
Published: October 2024

Abstract
Celebrated as one of the necessary solutions to more sustainable ocean governance by the UN Ocean Decade for Sustainable Development, transdisciplinarity, co-design, co-production, and co-creation of knowledge continue to be praised by a variety of scholars for their opportunities for impactful and socially significant research. However, despite increased recognition as necessary to respond to complex sustainability challenges, including transformative ocean governance, there are sustained differences in how people and scholars define and conceptualize transdisciplinarity and how people operationalize and apply transdisciplinary research. This perspective is not about what transdisciplinary research entails but is rather asking whether transdisciplinary research is always the appropriate approach. Without a clear understanding of what ethical and equitable transdisciplinarity entails, how do we ensure this does not negatively impact non-academic collaborators such as fishing communities? How do we make sure transdisciplinarity does not become yet another extractive research practice? The paper discusses the difference between partial and comprehensive transdisciplinarity, addresses coloniality of co-design, and reflects on who we cite and why as researchers. Finally, the paper considers how we can advance transdisciplinarity as an epistemology for more ethical engagements with fishing communities and invite fellow marine researchers to ask critical questions.