bluuebunny/crossref_metadata_2025_split huggingface dataset:
UbiSeCEF: Ubilab's Secure Cloud Environment Framework for Public Health Research
Authors: Miranda P , Kaur J , Morita P 
Published: October 2023

Abstract

Issue/Problem
The adoption of cloud-based public health research over personal health data in an academic setting in Canada is still in its early stages and lacks the necessary maturity to handle such technologies. This can be attributed to the fact that many public health researchers lack the required IT knowledge to set up and use these environments securely and effectively.

Description of Problem
The lack of expertise among public health researchers in Canada has led to a slow adoption of cloud-based public health research. This has resulted in a significant gap between the potential benefits of cloud-based research and the current state of practice. To address this challenge, we propose Ubilab's Secure Cloud Environment Framework (UbiSeCEF) as guidelines for those interested in conducting similar public research.

Results
UbiSeCEF's components were developed with consideration given to requirements from stakeholders, Ubilab's operations and data objectives, state-of-the-art technologies, and laws and standards that regulate public health research and personal health data sharing. The framework utilizes Azure's data governance framework, virtual private networks (VPN), role-based authentication, and policy-based access to control access to resources and research data. The implementation of UbiSeCEF provides a secure, flexible, and efficient environment for cloud-based public health research.

Lessons
The lack of IT expertise among public health researchers can hinder the adoption of cloud-based public health research. To address this challenge, the development of frameworks like UbiSeCEF can provide guidance for secure and effective implementation. The use of state-of-the-art technologies and compliance with laws and standards that regulate public health research and personal health data sharing can greatly enhance the quality and reliability of research outcomes while ensuring the protection of personal health data.

Key messages
• Framework developed to enhance secure & effective adoption of cloud-based public health research by addressing lack of IT expertise among researchers.
• The research aims to assist other researchers and institutions in navigating the complexities of cloud-based public health research while maintaining the privacy and security of public heath data.
Sexual health communication in public service media: The case of Finland and Sweden
Authors: Abrams R , Nordmyr J , Backholm K , Forsman A K 
Published: October 2023

Abstract

Background
Adolescents spend more time online than ever before and refer to media as their primary source for information on sexual health. Furthermore, studies show that health communication through media is an effective health promotion method, reaching a large scale of the population. Therefore, sexual health promotion through media is a promising public health action. Hence, this study aimed to analyze how and to what extent sexuality and sexual health-related content targeting adolescents is communicated in public service media in Finland and Sweden.

Methods
A critical content analysis will be performed focusing on public service media content highlighting sexuality and sexual health-related topics. Public service media content that has been published in Finnish or Swedish during the last 10 years (2013-2022) and targeting adolescents aged 10-19 years old is included in the study.

Results
The preliminary results shed a light on sexuality and sexual health content in public service media, presenting an overview of what content (themes) is communicated to adolescents, how the communication takes place (channels and formats) and to what extent the theme is prevalent and promoted in Finland and Sweden. The results furthermore highlight the evidence-base informing the production of media content and also illustrate eventual differences in sexuality and sexual health content between the countries.

Conclusions
The findings contribute to the limited knowledge about the media image that is communicated to young people with regard to sexuality and sexual health in Finland and Sweden with regards to both structural and content-related issues, as well as underscoring the opportunities for developing sexual health promotion through public service media.

Key messages
• The findings highlight similarities and differences in sexuality and sexual health content targeting adolescents in public service media in Finland and Sweden.
• The findings highlight how sexuality and sexual health content is prevalent and structured in public service media as well as how it is connected to health promotion.
Improving health outcomes of patients with myocardial infarction with value based methodology
Authors: Vasiljev V , Juraga D , Rukavina T , Bilajac L , Marinović Glavić M , Raat H 
Published: October 2023

Abstract

Digital technologies have the potential to support the implementation of value-based healthcare by enabling personalised patient care and improving health outcomes. The ValueCare project (H2020, No. 875215) aims to deliver personalised integrated (health and social) care services, better outcomes for older people and an improved care experience and is being tested in 7 pilot sites across Europe. The Rijeka pilot site focuses on older patients who have suffered a myocardial infarction (MI), which is a leading cause of morbidity and mortality worldwide. The study will assess the impact of the ValueCare approach on improving health outcomes for older people who have suffered a MI. A total of 240 older people (120 intervention and 120 control subjects) will take part in the study. The intervention group will receive the ValueCare approach, which includes: Consultation between the patient and care provider to discuss the results of the self-reported ICHOM questionnaires; a personalised care plan co-created by the patient and care provider; a digital solution to support the patient's personalised care plan; and monitoring of the personalised care plan by caregivers. ValueCare's digital solution enhances the assessment and monitoring of the personalised care plan through: a mobile application for older people, a wearable, and a web application for caregivers. The mobile application uses a motivation and goal-setting approach, including a Virtual coach who acts as a conversation partner to help participants achieve their personal goals. The impact of the intervention will be evaluated using a self-reported ICHOM Standard Set for Older Persons at three time points: Baseline T0, Follow-up T1 (after 12 months) and T2 (after 18 months). Our results will shed light on the potential of digital technologies to transform the prevention and treatment of MI and ultimately improve patient outcomes and reduce healthcare costs.

Key messages
• Digital health has emerged as a promising approach to transforming healthcare and improving patient's outcomes.
• Value-based healthcare improves outcomes and reduces costs for myocardial infarction treatment, putting patients at the center of care.
The association between self-perceived stuttering and social participation among older adults
Authors: Lindström E , Öhlund Wistbacka G , Eggers K , Lindström M , Lyberg-Åhlander V 
Published: October 2023

Abstract

Aims
Social participation is important for general health and quality of life among older adults. Currently, research concerning the association between stuttering and social participation among older adults with larger data sets is scarce. The aim of this population-based cross-sectional study was to investigate the association between stuttering and social participation among older adults in southern Sweden in 2012.

Methods
Participants were 8518 inhabitants of the Region Skåne in 2012, aged between 55 and 80 years. They were recruited from a larger survey study in which 28029 participated (51.7% average participation rate). The association between stuttering and social participation were conducted with multiple logistic regressions, and adjusted for independent variables (age, gender, country of birth, socioeconomic status, language spoken at home, hearing and self-rated health).

Results
The frequency of self-perceived stuttering was 1.9% among women and 3.3% among men. The statistical analyses showed an association between self-perceived stuttering and low social participation. The associations remained even after multiple adjustments, both among women and men. Each independent variable was significantly associated with low social participation.

Conclusions
In this population-based study, the association between stuttering and low social participation is significant among older adults. Stuttering may thus contribute to low social participation in the age group 55-80 years.

Key messages
• The association of stuttering and social participation in older adults was explored.
• Self-perceived stuttering was associated with lower social participation.
Aging well? Exploring self-reported quality of life in the older Austrian population
Authors: Felsinger R , Mayer S , Haidinger G , Simon J 
Published: October 2023

Abstract

Background
The increase of life expectancy around the world sets an ageing society with all its challenges on the global Public Health agenda. In Austria, the additional years of life gained are not spent in good health, as the healthy life expectation is far below the European average. This study aimed to examine the change in self-reported quality of life (QoL) over time in the Austrian older-aged population and explore associated factors.

Methods
Repeated cross-sectional data was retrieved from three waves of the Austrian Health Interview Survey conducted in 2006, 2014 and 2019, including a total of 10 056 participants aged 65 years and above. To estimate QoL in this age group, domain scores of the WHOQOL-BREF were used. Trends in QoL were descriptively analysed across different age groups, sex and survey years. Adjusted Wald tests were conducted to compare means of older women and men. Linear regression models were estimated to explore the impact of age, sex, family status, education, income, residence and survey year on QoL domains.

Results
While WHOQOL-BREF domain scores increased over time, a steady decrease with age was observable in all survey waves. Mean scores were significantly higher in men than in women in all QoL domains and in each survey year except for the social domain. In the regression analyses, sex differences disappeared in most domains after adjusting for income and education. Factors associated with significantly higher QoL scores in all domains included younger age, higher education, higher income and living in Western Austria.

Conclusions
Observed sex differences in QoL seem to be driven mainly by income and education differences in the older-aged Austrian population. Following the WHO's and UN's 10-year global plan of action - The United Nations Decade of Healthy Ageing 2021-2030 - further efforts towards developing sustainable strategies and policies to reduce socioeconomic inequalities also with attention to sex/gender gap are strongly needed.

Key messages
• This study provides a first in-depth analysis of quality of life in Austrian senior citizens.
• Younger age, higher education, higher income and living in Western Austria are associated with better quality of life.
Care trajectory differences in women and men with end-stage renal disease after dialysis initiation
Authors: Piveteau J , Raffray M , Couchoud C , Chatelet V , Vigneau C , Bayat S 
Published: October 2023

Abstract

Introduction
End-Stage Kidney Disease (ESKD) is a major public health issue with an important burden for patients. Some sex and gender differences related to ESKD are well documented. For example, more men initiate dialysis. However, less is known about the differences in the care that follows dialysis start. The objective of this study was to describe the differences in healthcare utilization in the year following dialysis initiation between men and women.

Methods
Data from the French National Renal Epidemiology and Information Network (REIN) registry linked with the French National Health Data System (SNDS) were used. All adults patients with ESKD who initiated dialysis in France in 2015 were included. Characteristics at dialysis start, including co-morbidities, were compared between men and women. The healthcare utilization, outpatient and inpatient, in the year following dialysis start was examined as frequencies and compared by sex using Chi-2 and Student or Welch test.

Results
We included 8856 patients (36% of women). Women had fewer hospital stays &lt;24 hours than men (53% with &gt; =1 hospitalization &lt;24 hours vs 57% among men, p-value=0.02) and fewer hospital stays for other problems than renal (44% had &gt;2 hospital stays vs 46% in men, p-value=0.04). Hospital stays for vascular access preparation or maintenance were longer in women than men (median duration: 2 days vs 1 day, p-value&lt;0.001). No significant difference was observed between women and men about hospital stays for kidney problems and consultations with a general practitioner.

Conclusions
Taking advantage of the linkage of national clinical and healthcare utilization databases, this study shed light on the care trajectory that follows dialysis initiation between men and women. Similarities were observed, including outpatient follow-up with a GP. Some specific differences, such as longer hospital stays for vascular access preparation or maintenance, calls for further studies to improve the care of women with ESKD.

Key messages
• Few differences exist between men and women in their care trajectory notably an outpatient follow-up with a GP.
• Some differences have been highlighted, especially in some hospital stay duration that could be a subject of futures studies.
Age-period-cohort analysis of mortality and its association with deprivation in Hungary, 2007-2021
Authors: Juhász A , Nagy C , Ádány R , Pikó P , Burkali B , Oroszi B 
Published: October 2023

Abstract

Background
Severe spatial inequalities in health and its determinants are a well-known and long-standing phenomenon in Central-Eastern European countries, including Hungary. The aim of our study was to perform an age-period-cohort (APC) analysis to provide information on mortality trends and their association with deprivation in Hungary using the latest available data for the period 2007-2021.

Methods
The extended APC model, allowing estimation of mortality risk considering deprivation, time, age, and cohort effects and their interactions, was used to analyse the trajectories of several outcome variables along complex dimensions. Model fitting and inference were carried out by using Bayesian computation with INLA methodology.

Results
Mortality risk was the lowest in the 5-9 year age group and increased with age. Between 2007-19, the mortality risk showed a decreasing trend, which returned to the 2007 level by 2020-21 due to the COVID-19 pandemic. Considering the birth cohort effect, the mortality risk peaked in the 1953-57 cohort, then decreased until the 1972-76 cohort, followed by a steady state, and then decreased from the 1988-92 cohort onwards. Deprivation was positively associated with higher mortality risk. The interaction of deprivation and period effect on mortality risk showed a steeper increasing trend for deprived groups for 2020-21. In terms of the interaction of deprivation and cohort effect, the risk of mortality in the most deprived group was higher than the national risk for all birth cohorts. The risk increased until the 1967-71 cohort, then decreased until the 1992-96 cohort, and then again showed an increasing trend. The risk of mortality for the least deprived population was lower than the national average risk, while the opposite difference could be observed for the most deprived group.

Conclusions
Deprivation was associated with higher mortality risk, COVID-related mortality and cohort effect during the study period.

Key messages
• The COVID epidemic-associated increase in mortality affected groups of different deprivation status to varying degree.
• Different cohort effects were found behind the mortality risk in different deprivation groups.
Colonizations and infections due to 3GCR Enterobacteriaceae in a University hospital in Italy
Authors: Stevanin G , Tocco Tussardi I , Palladini F , Montesarchio L , Aprili I , Zandonà E , Tardivo S 
Published: October 2023

Abstract

Background
The spread of third-generation cephalosporin-resistant Enterobacteriaceae (3GCREB) is an increasing issue in terms of antimicrobial resistance and infection prevention and control (IPC), especially in the hospital setting. We aimed to investigate the burden of colonizations and infections caused by 3GCREB in an Italian teaching hospital.

Methods
We performed a retrospective study on cases of 3GCREB isolation from microbiological specimens (from gastrointestinal, urinary, blood, respiratory and cutaneous systems) which were detected over a year period (January-December 2022) at the University Hospital of Verona, Italy. We reviewed the corresponding patients’ charts to retrieve clinical information and classify cases as colonizations vs. infections. Infections counted as hospital-acquired (HAI) when the 3GCREB was detected after the third day following admission, otherwise as community-acquired infection (CAI).

Results
Of 2,451 3GCREB isolates retrieved, 1,815 (74.1%) were from rectal swabs. The monthly detection trend was consistent throughout the year with a minimum in February (n = 159) and a maximum in August (n = 238); monthly average was 204 isolates. The majority of 3GCREB isolates (n = 1,887; 77%) were classified as colonizations. Of the 564 3GCREB isolates which were classified as infections (23% of total isolates), 305 (54.1%) were HAIs and 259 (45.9%) were CAIs. The highest proportion of HAIs (n = 121; 39.7%) was detected in medical units, followed by intensive care areas (n = 100; 32.8%) and surgical units (n = 84; 27.5%).

Conclusions
Comparing the percentages of patients with 3GCREB colonization and infection, we conclude the presence of 3GCREB in our hospital to be about 3 times higher than when only patients with 3GCREB infections are considered. This highlights the importance of surveillance to protect fragile patients. IPC training of staff is essential to counter the intra-hospital spread of these pathogens.

Key messages
• Prevalence of 3GCREB is an increasing healthcare issue in the hospital setting and medical directions should focus on staff IPC training to counter the spread of these pathogens.
• Detection of 3GCREB colonizations is crucial to track the spread of multidrug-resistant organisms, identify cases and protect fragile patients.
Associations between exposure to organochlorine pesticides and diabetes risk: a systematic review
Authors: Vu U , Méjean C 
Published: October 2023

Abstract

Background
The prevalence of diabetes is on the rise worldwide, and recent studies have suggested that exposure to organochlorine pesticides (OCPs) may contribute to this development. However, the evidence remains inconclusive. Our study aimed to consolidate the existing evidence to understand better the association between OCP exposure and the risk of gestational diabetes mellitus (GDM) and type 2 diabetes (T2D).

Methods
We searched for longitudinal and cross-sectional studies in PubMed, Web of Science, and Google Scholar until April 1st, 2023. We included peer-reviewed, English-language studies focused on the general population with clearly stated exposure and outcome measures related to OCP, GDM, and T2D. We collected data on study type, sample size, covariates, and effect measures. The National Toxicology Program's Office of Health Assessment and Translation approach was used to ensure the study quality.

Results
We identified 33 studies, including 8 cohorts, 7 nested case-control, and 18 cross-sectional studies. The focus was mainly on p,p'-DDE, and p,p'-DDT exposures. Findings on the association between OCPs and GDM or T2D risks were mixed, with no conclusive evidence across the studies. For p,p'-DDT, and p,p'-DDE, GDM studies found no significant associations, while T2D studies showed non-significant and positive associations. Other OCP exposures showed mixed results for GDM and T2D. The majority of studies had a probably low risk of bias.

Conclusions
The association between OCP exposure and diabetes risk is inconclusive. Differences in study design, exposure assessment methods, and statistical approaches may contribute to inconsistent findings. Further research, including well-designed prospective studies and meta-analyses, is required. We must prioritize alternative pest control, raise awareness of OCP dangers, enforce regulations, and screen at-risk populations. OCP levels monitoring and healthcare guidance for high-exposure populations are also crucial.

Key messages
• Inconclusive evidence on the association between OCP exposure and the risk of GDM and T2D calls for further research, including prospective studies and meta-analyses.
• Prioritizing OCP risk reduction, raising awareness, and at-risk populations are critical to protect public health.
The impact of the COVID-19 pandemic on delayed care of CVD in Europe: a systematic review
Authors: Khan Y , Verhaghe N , Devleeschauwer B , Cavillot L , Gadeyne S , Pauwels N , Van den Borre L , De Smedt D 
Published: October 2023

Abstract

Aim
Cardiovascular diseases are the leading cause of death worldwide and the COVID-19 pandemic has disrupted healthcare systems, causing delays in essential medical services, including cardiovascular (CV) care. This study aims to estimate the impact of the COVID-19 pandemic on delayed cardiovascular (CV) care in Europe by providing a systematic overview of the available evidence.

Methods and Results
PubMed, Embase, and Web of Science were searched until mid-September 2022. This review included 132 studies. Outcomes of interest were changes in hospital admission, mortality, delays in seeking medical help, delays in treatment initiation, and changes in the number of treatment procedures. Results were presented in five disease groups: Ischemic Heart Disease (IHD), cerebrovascular diseases, Cardiac Arrests (CA), Heart Failure (HF), and others. There was a significant decrease in hospital admissions for IHD, cerebrovascular diseases, and HF, and a significant increase in CA. Mortality rates were higher for IHD and cerebrovascular diseases. Urgent and elective cardiac procedures’ rates also decreased during the pandemic.

Conclusions
The review's limitations include its exclusive focus on European countries, which may not generalize to other regions due to differences in containment and tracing measures. The reviewed studies did not always report consistent outcomes and were primarily conducted during or just after the first wave of the pandemic, limiting our understanding of the long-term impact. Policymakers and healthcare systems should allocate adequate resources, provide clear guidelines for accessing medical care, reduce delays in seeking medical attention, and promote healthy lifestyles to prepare for future pandemics. Future reviews should consider the longer-term impact of pandemics on delayed CV care and evaluate the long-term health and health-economic impact of the COVID-19 pandemic on delayed CV care.

Key messages
• The pandemic has reduced hospital admissions and caused delays in seeking medical attention, while increasing mortality rates for some cardiovascular diseases in Europe.
• Prepare for pandemics: allocate resources, set guidelines for care, reduce delays, promote health, and evaluate impacts on cardiovascular care.