bluuebunny/crossref_metadata_2025_split huggingface dataset:
Noise at school: any implications for teachers’ health? Findings from the French CONSTANCES study
Authors: Temam S , Billaudeau N , Kab S , Zins M , Vercambre M-N 
Published: October 2023

Abstract

Background
While noise at school is a well-known issue concerning students’ well-being, data on its potential effect on teachers’ health are limited.

Methods
Among teachers (n = 13,843) and a sample of non-education employees (n = 34,338) participating in the French CONSTANCES cohort (enrollment phase 2012-2020), we evaluated self-reported noise exposure at inclusion with the question “do you work in an environment where you sometimes have to raise your voice to talk to people 2 or 3 meters away?”(yes/no). First, we compared proportions of teachers who reported noise exposure to different groups of non-education employees. Second, among teachers, we cross-sectionally assessed, using logistic regressions adjusted for potential confounders, how combined exposure to occupational noise and work-related stress (defined alternately as effort-reward imbalance or tension with the public) was associated with two health indicators: self-perceived health (poor vs. good) and depressive symptoms (Centre of Epidemiologic Studies Depression scale, sex-specific cut-points, high vs. low to moderate), respectively.

Results
Thirty-two percent of teachers declared working in a noisy environment compared to 14% among non-education employees included. Primary school teachers were particularly exposed (42.6%), in comparable proportions to manual workers (43.3%). Among teachers, noise alone was not significantly related to self-perceived health but slightly associated with higher odds of depressive symptoms. We further observed evidence of an interaction effect on depressive symptoms between noise and tension with the public.

Conclusions
This large study highlights that noise is a common occupational exposure among teachers in France. As it may interact with sense of physical insecurity to weight particularly on mental health, our results advocate for a better considering of such every day and long-term exposure on teachers’ health.

Key messages
• Noise is a common occupational exposure for French teachers.
• As it may interact with work-related stress to affect mental health, noise at school should not be overlooked as an occupational hazard.
Combating Weight Stigma in Healthcare: A Cross-Country Analysis and Intervention Initiative
Authors: Forray A , Johnson K , Cherecheș R M 
Published: October 2023

Abstract

Background
Rising global obesity rates coincide with increasing weight stigmatization, affecting various life aspects, including healthcare. Discrimination impacts patient well-being and care quality, leading to suboptimal treatment. This research compares weight stigma among healthcare professionals in Romania, UK, and Greece, addressing personal and second-hand weight bias.

Methods
The study used cross-sectional data from the Breaking Weight Bias survey, including 125 healthcare professionals from Romania, Greece, and the UK. Data collection occurred between June and August 2021 via an online survey. Measures included the Universal Measure of Bias-FAT (UMF-FAT) questionnaire, personal experience with weight bias, and experiences of weight bias in medical settings.

Results
More women participated in the study across all countries. The mean age was 37.12 years (SD = 10.92). Bachelor's degrees were most common (43.4%), with Greece having the highest percentage of Master's (41.7%). Romania had the highest Doctoral degrees (32.4%). Private healthcare settings were the most common (51.3%). UMB-FAT results showed varying bias between countries. Romania had the highest rates (M = 3.08, SD = 0.768). Statements indicating more bias included poor hygiene (M = 2.40, SD = 1.832) and lacking consideration for others (M = 1.74, SD = 1.459). Over half of the participants (53.3%) experienced personal weight-related teasing. Greece had the highest rate (62.9%). Regarding second-hand weight bias experiences in medical settings, a high level of agreement (30-50%) was observed.

Conclusions
This study confirms weight bias in healthcare professionals across multiple countries, revealing moderate bias levels. Despite limitations, the findings contribute to understanding weight bias across different regions and fields. There is a need for weight-bias education among healthcare professionals, as it can harm patient-provider relationships and care quality.

Key messages
• Research confirms moderate weight bias in healthcare professionals across Romania, UK, and Greece.
• Study highlights the need for weight-bias education in medical training to improve patient-provider relationships.
Adherence to the EAT-Lancet reference diet and risk of type 2 diabetes, mediation by body mass index
Authors: Berthy F , Allès B , Fezeu L K , Lairon D , Pointereau P , Touvier M , Hercberg S , Galan P , Baudry J , Kesse-Guyot E 
Published: October 2023

Abstract

Background
Prevalence of diabetes has more than tripled since 1980. Urbanization, more sedentary lifestyles, and modern diets high in fat, sugar and salt are among the main causes of this increased incidence. A diet rich in healthy plant-based products is a way to prevent T2D (4) but has also impact on the natural resources and environment. In 2019 the EAT-Lancet Commission proposed a planetary, healthy, and reference diet, designed to reduce the global health-environmental double burden of current dietary patterns. The objective of this study was to investigate the association between the EAT-Lancet reference diet and type 2 diabetes (T2D) risk.

Methods
The study was conducted using data from 88,964 adults participating to the French NutriNet-Santé cohort 2009-2022 (78.8 % female; mean (SD) baseline age of participants was 43.8 (14.5) y). The endpoint was incident T2D. The main exposure was the EAT-Lancet Diet Index (ELD-I) modelled as sex-specific quintiles (Qs). Hazard Ratios (HRs) and Confidence Intervals (CIs) were assessed by Cox proportional hazards models adjusted for potential confounders. A mediation analysis was also implemented. The role of body mass index (BMI) as a potential mediating factor in the relationship was investigated.

Findings
During follow-up (median = 6.79 y), 812 incident T2D cases occurred. The ELD-I ranged from −192 to 429 points with a mean (SD) score of 43.4 (25.7) points. Compared with the participants who had lower adherence to the EAT-Lancet reference diet, those with higher had a 29 % lower risk of T2D (HRQ5vs.Q1: 0.71; 95% CI: 0.56, 0.89; Ptrend = 0.0024). The association studied was mediated up to 58 % by BMI.

Interpretation
In this large cohort study, higher adherence to the EAT-Lancet reference diet was associated with a decreased risk of T2D beyond body weight change. These results support previous findings and highlights the interest of the EAT-Lancet reference diet as a healthy and sustainable diet.

Key messages
• Higher adherence level to the EAT-Lancet reference diet was associated with a decreased of type 2 diabetes risk.
• The association between the EAT-Lancet reference diet and the occurrence of type 2 diabetes is partially mediated by BMI.
The Influence of immigration on breastfeeding: Results from the FinChildren survey
Authors: Muhumed I , Meinilä J , Klemetti R , Adebayo F , Virtanen S , Erkkola M 
Published: October 2023

Abstract

Background
Breastfeeding (BF) is essential to health promotion, disease prevention, and diminishing health inequalities. Recent studies in the Nordic countries revealed suboptimal BF practices among immigrants. Our aim is, first time in Finland, to quantitatively examine breastfeeding practices and sociodemographic characteristics of immigrants in comparison with natives.

Methods
We use a nationwide FinChildren (2020) survey on parents with infants, focusing on Somali- (n = 29), Arabic- (n = 81) and Russian speaking (n = 181) parents and their infants. We compared them with native Finnish speakers (n = 7508) using logistic regression and adjusting for confounders.

Results
Somali/Arab mothers had lower educational level, had higher BMI, were younger in age, and had more often C-sections. Proportions of both exclusive and any breastfeeding at 4-5 months were lower among Somali/Arabic speaking mothers (14% and 97%, respectively) compared to native Finnish (39% and 99%, respectively) and to Russian speaking mothers (41% and 98%, respectively). The difference in proportions of any BF between groups was not statistically significant. In the regression models fitted, being a Somali/Arabic speaking mother alone increased the odds of non-exclusive BF at 4-5 months fourfold (aOR 0.23, 95% CI 0.07, 0.72). Over 30% of Somali/Arab mothers had planned to mix feed their infants during antenatal period. This was inversely associated with exclusive BF at 4-5 months (aOR 0.14, 95% CI 0.11, 0.18) in the adjusted model.

Conclusions
Both exclusive and any BF were more common amongst native Finnish and Russian speaking mothers compared with Somali/Arabic speaking mothers. This study suggests the need for culturally sensitive interventions to promote BF amongst immigrants from outside Europe and to minimise any health inequality resulted from it.

Key messages
• This study found suboptimal breastfeeding practices amongst immigrant groups from outside Europe. Hence, it emphasizes the need for future research to further examine this pattern.
• Results of the present study emphasize the need for culturally sensitive breastfeeding interventions to prevent health inequalities in early nutrition.
Local responses to migration crises: ASL Roma 2’s experience with the Afghani and Ukrainian crises
Authors: Rosso A , Rinaldi A , Coluzzi D , Perrelli F , Pavone R , Napoli P A , De Angelis G 
Published: October 2023

Abstract

Issue/problem
In August 2021 and March 2022, Roma 2 Local Health Authority (ASL) was confronted with the prompt arrival of migrants from Afghanistan and Ukraine, following the humanitarian crises occurring in the two countries. The Migrants and Vulnerable Populations’ Health Unit (MVPH) needed to promptly develop interventions to respond to the health needs of newly arrived migrants.

Description of the problem
A multidisciplinary team was established in both emergencies, coordinated by the MVPH Unit, composed of nurses, medical doctors, vaccination staff, administrative staff, cultural mediators, responsible for outreach activities in the hotels were migrants were hosted. A basic assessment of health needs, COVID-19 tests and vaccination, TB screening were offered on-site. People were also granted access to health services through release of an STP (temporarily present foreigner) code. For the Ukrainian population, a dedicated Hub was also set up to respond to the health needs of people not hosted in hotels, with the full-time presence of cultural mediators. Collaboration with Non-Governmental Organizations working in support to the humanitarian crisis was activated.

Results
From August 21 to September 2 2021, 469 people from Afghanistan arrived in three facilities located in ASL Roma 2 area who were all assessed for their needs, were offered COVID-19 vaccine and received STP codes. From 1 April to 30 June 2022, 626 people accessed the dedicated Ukraine Hub. Forty-five site visits were carried out in the six hotels hosting Ukrainan refugees, with 343 people receiving a clinical examination.

Lessons
The presence of a dedicated service has allowed a rapid reorganization of ASL Roma 2 services to deal with humanitarian emergencies and the prompt activation of already established collaborative networks. Preparedness, good governance mechanisms and networking are key elements to develop effective responses to humanitarian crises.

Key messages
• A dedicated service for the health needs of migrants and vulnerable populations allowed the prompt developemt of effective local responses to global migration crises.
• Preparedness, a clear governane mechanism and networking with partner organizations were key elements of the local response to migrant emergencies.
A latent transition analysis of a Danish smoking reduction intervention trial
Authors: Lund L 
Published: October 2023

Abstract

Background
Distinct use patterns of tobacco and nicotine products are evolving among young people, notably after the market expansion of today's products. This study aims to identify and characterize subgroups of distinct tobacco and nicotine use patterns and to determine how a smoking reduction intervention and sociodemographic factors affected the transition patterns.

Methods
Data were from a Danish smoking reduction intervention targeting vocational school students. A latent transition analysis (LTA) was applied to identify patterns in latent classes of tobacco and nicotine use (use of cigarettes, smokeless tobacco, e-cigarettes, and hookah) from baseline to follow-up and to evaluate intervention effects on these patterns.

Results
A total of 2,158 students completed baseline and/or follow-up (FU) surveys (mean age = 20.8 years, 49.5% female). Three classes were identified: non-users (baseline: 31.3%, FU:33.9%), cigarette users (baseline: 36.0%, FU: 38.2%), and poly-users (baseline:33.7%, FU:27.9%). Students at intervention schools had 36% lower odds of transitioning from cigarette use at baseline to poly-use at follow-up (OR = 0.64; 0.41-0.99, p = 0.047) than control school students. Male and younger students were more likely to transition from cigarette use to poly-use. In contrast, students with origins other than Danish were more likely to transition from poly-use to non-use.

Conclusions
Intervention efforts must address tobacco and nicotine use progression towards high-risk use patterns, targeting those at greater risk of these progressions, such as males and younger students. Future research could benefit from using the LTA approach when evaluating intervention effects.

Key messages
• Three distinct latent nicotine and tobacco use classes emerged among Danish young adults attending vocational schools: non-use, mainly smoking, and poly-use.
• Students at intervention schools had lower odds of transitioning from cigarette use at baseline to poly-use at follow-up than control school students.
School exposure to air pollution in the UK and Ireland: Indoor-Outdoor air quality assessment
Authors: Parra M , Knowlton T 
Published: October 2023

Abstract

Background
Globally, 93% of children under the age of 15 (1.8 billion) are exposed to fine particulate matter (PM2.5) levels that might cause respiratory/cardiovascular disorders, impaired neuro/cognitive development, and cancer. Air pollution causes 1/10 deaths in children under the age of 5.

Methods
The purpose of this observational study was to collect data on indoor and outdoor air quality in 24 schools over 10 school days and compare it with city-wide average air quality levels reported in rural/urban areas in the UK and Northern Ireland. Nitrogen dioxide, volatile organic compounds (VOCs) and PM10,2.5,1 were monitored inside the classrooms and school surroundings with personal pollution monitors. City-wide averages were taken from local reference air quality and ground-source monitoring stations. Data was expressed using the Plume Labs Air Quality Index (PAQI) thresholds [low (0-20), moderate (21-50), high (51-100), very high (101+) pollution level] aligned with WHO's exposure recommendations.

Results
Despite both AQIs being in the moderate threshold, the school's average indoor AQI was ∼44% higher than the city-wide average. Only 27% of schools’ indoor air quality indexes matched the city-wide average, 59% were higher and 14% were lower. Rural schools had a marginally higher average indoor AQI than urban schools. The primary classroom pollutants observed were VOCs, followed by PM10. The average walk-exposure AQI of 33% of total schools was higher than the city's average. The school reporting the highest average walk AQI was seven times higher than the lowest.

Conclusions
Poor indoor air quality and higher levels of pollutants were found inside the majority of the schools across the regions. There is a need for mitigation strategies to identify responsible factors for indoor air pollution. A regulatory framework for school ventilation and behavior interventions like nasal washes may reduce pollution exposure and its impact on children's health outcomes and mortality.

Key messages
• Poor indoor air quality (∼44% higher than the city-wide average) and higher levels of pollutants (volatile organic compounds and PM10) were found inside the majority of the schools across the regions.
• A regulatory framework for school ventilation and behavior interventions like nasal washes may reduce air pollution exposure and its impact on children’s health outcomes and mortality.
Sickness absence and/or disability pension and future work income after age 65 and 70 in Sweden
Authors: Martikainen A , Alexanderson K , Svedberg P , Farrants K 
Published: October 2023

Abstract

Background
As retirement ages are increasing in Europe, more knowledge is needed on factors that are associated with extended working life. Our aim was to explore if prior sickness absence (SA) and/or disability pension (DP) due to mental and/or somatic diagnoses were associated with income from work after age 65 and 70, respectively.

Methods
A 4-year prospective population-based cohort study using microdata from nationwide registers. We included all who in 2014 were aged 65-69 (cohort A; n = 201,263) and ≥70 (cohort B; n = 93,751), respectively, had income from work in 2014 (baseline), and lived in Sweden in 2010-2015. Cox proportional hazard regression was used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for associations between prior SA (in spells &gt;14 days) and/or DP due to mental and/or somatic diagnoses, overall and stratified by the number of net days (2010-2014), and future years with income from work (2015-2018), censored for death and emigration, adjusted for sociodemographic and work-related factors, and stratified by sex.

Results
The majority had no SA or DP during the exposure interval (cohort A 66.3% women, 75.8% men; cohort B 96.8% women, 97% men). Many had income from work at some point during follow-up (cohort A 77.8% women, 81.6% men, cohort B 81.9% women, 83.4% men). Prior somatic SA/DP was associated with a marginally but significantly higher HR for earlier exit from paid work in cohort A (women 1.08; 95% CI: 1.06-1.10; men 1.10; 1.08-1.12), lower HR for men in cohort B (0.93; 0.86-0.99), and non-significant HR for women in cohort B. The corresponding association for mental SA/DP was significant only for women in cohort A (1.09; 1.06-1.13).

Conclusions
The likelihood of earlier exit from paid work was slightly higher for those aged 65-69 at baseline with prior somatic SA/DP, but lower for men aged ≥70 at baseline with prior somatic SA/DP. Prior mental SA/DP was associated with earlier exit only for women aged 65-69 at baseline.

Key messages
• Prior SA/DP was in many cases marginally but significantly associated with future income from work. The direction of association differed depending on the diagnosis of the spell, cohort and sex.
• More knowledge is needed on how older workers with different types of morbidities and functional limitations can extend their working life in Sweden as well as in other European countries.
Effects of the COVID-19 pandemic on the wellbeing of LGBTQ+ individuals in Moldova
Authors: Holliday N , Mulear V 
Published: October 2023

Abstract

Background
Sexual and gender minority (LGBTQ+) individuals often face physical and mental health disparities. In Moldova, a lower-middle-income, former Soviet state, there are few legal protections or social rights for LGBTQ+ people. The COVID-19 pandemic exacerbated health disparities for many communities that have historically been marginalized, including LGBTQ+ people. The impact of the pandemic on LGBTQ+ people in Moldova was previously unstudied.

Methods
We conducted a mixed-methods analysis of the effects of the COVID-19 pandemic on the mental and physical wellbeing of LGBTQ+ individuals in Moldova. We recruited self-identified LGBTQ+ people in Moldova to participate in an online survey or in-depth interviews. We analyzed interviews with a grounded theory methodology and survey data with descriptive statistics and we interpreted the data sets concurrently to identify emergent themes.

Results
From June to July 2022, we collected 86 online surveys and 12 interviews. Regarding mental wellbeing, our findings suggest LGBTQ+ people experienced both negative and positive effects due to the COVID-19 pandemic. Participants described an inability to be their authentic selves, especially when sheltering with unaccepting family members, as well as feelings of depression, anxiety, and loneliness. At the same time, participants described social support from the LGBTQ+ community and time and circumstances in which to explore their identities. Relating to physical wellbeing, participants reported interruptions to transgender medical care and some concerns about housing affordability.

Conclusions
This research contributes to a limited set of health studies on the experiences of LGBTQ+ individuals in Moldova. Our results highlight some unique impacts of the pandemic on LGBTQ+ people and underscore the importance of further research in this area and on the necessity for response plans that can address the needs of LGTBQ+ people in future health crises.

Key messages
• Many LGBTQ+ people in Moldova cited the pandemic as an opportunity to explore their identities, especially away from the public eye.
• During the pandemic, many LGBTQ+ individuals in Moldova needed to conceal their authentic selves from household members, exacerbating feelings of depression and loneliness.
The association between Planetary Health Diet, body mass index and polygenic risk score for obesity
Authors: Suikki T , Maukonen M , Kaartinen N E , Marjonen H , Pajari A M , Männistö S 
Published: October 2023

Abstract

Background
The way we eat and produce food are threatening our health and environmental sustainability. The EAT-Lancet Planetary Health Diet (PHD) was launched to consider both aspects. The association between PHD and body mass index (BMI) has barely been studied, and especially the role of inheritance in this context is unclear. Therefore, we examined the association between PHD and BMI and further evaluated whether the association differs by the level of genetic susceptibility for obesity.

Methods
In total, 4377 participants (≥18 years, female 56%) from the Finnish FinHealth 2017 Study were included. A validated food frequency questionnaire was used to assess the habitual diet. We developed an energy-standardized dietary index based on the PHD adapted for the Finnish food culture (score range 0 − 13 points). Genetic susceptibility for obesity was evaluated with a polygenic risk score (PRS) based on one million obesity associated single nucleotide polymorphisms. Linear regression was used for the statistical analyses.

Results
The mean PHD score for all participants was 4,0 (SD 1,5). There was a borderline negative association between PHD and BMI (β -0.01 95% CI -0.02, 0.00). When the genetic background was considered, this negative association reached statistical significancy in two lowest quartiles of PRS (lower susceptibility for obesity) (p &lt; 0.05). Whereas no association was observed among those with higher PRS for obesity.

Conclusions
Although, the adherence to PHD was relatively, our findings suggested that individuals with lower genetic susceptibility for obesity may benefit from the better adherence to a healthy and sustainable diet in terms of weight maintenance.

Key messages
• Genetic susceptibility for obesity may play a role in the association between diet and obesity.
• Healthy and environmentally friendly diet may be beneficial for weight maintenance even with the low adherence to the diet.