bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social gradient in quality of life according to microscale neighbourhood features, Limassol, Cyprus
Authors: Middleton N , Kleopa D , Kouta C , Panayiotou A 
Published: October 2023

Abstract

Background
Beyond indices of socio-economic disadvantage (SED), not standard practice in Cyprus, neighbourhood audits provide information about environmental inequity not captured by other methods. Lack of spatial thinking often leads to attributing geographical differences to socio-demographic composition.

Methods
A random sample of 45 neighbourhoods along the SED continuum were audited using the Cyprus Neighborhood Observational Tool (CyNOTes). SED was defined according to a purposefully developed postcode level index (N = 124), by factor analyzing a set of census indicators. A sample of 10 residents aged 45-64 per neighborhood responded to a door-to-door SF-36 quality of life (QoL) survey (N = 450). Associations of QoL with SED and audit scores, organized in 9 domains, were explored in random-effect regression models adjusting for gender, age, education and income.

Results
The SED index captured a stepwise decrease across tertiles with increasing disadvantage in both Physical (-1.79 95% CI -2.84, -0.73; p &lt; 0.001) and Mental (-1.42 95%CI -2.46, -0.59; p = 0.008) SF-36 Component Scores. Associations attenuated but remained statistically significant after adjusting for person-based social position. Re-classifying neighbourhoods according to audit ratings also revealed a social gradient for most CyNOTes domains. The domain with the strongest association with both Physical (-1.84 95%CI -2.88, -0.80; p &lt; 0.001) and Mental SF-36 Scores (-1.88 95%CI -2.83, -0.93; p &lt; 0.001) was “Pedestrian and Cycling Environment”. Associations persisted in adjusted models and appeared similar, if not stronger, to associations with the SED index.

Conclusions
The study depicted the social gradient in quality of life among late working-life residents across Limassol neighbourhoods. Other than the expected patterning according to SED, audit indicators of environmental inequity also captured a social gradient, linking micro-scale neighborhood features to the residents’ quality of life.

Key messages
• A social gradient in quality of life was demonstrated along the socio-economic and environmental disadvantage in Limassol.
• Depicting neighborhood microenvironment inequity can trigger and contextualize conversations about health and place among the local Public Health research and policy community.
Diet-related greenhouse gases emissions according to individual readiness to reduce meat consumption
Authors: Reuze A , Baudry J , Méjean C , Brunin J , Péneau S , Touvier M , Kesse-Guyot E , Allès B 
Published: October 2023

Abstract

Background
Reducing greenhouse gases emissions (GHGe) requires drastic changes in dietary patterns, notably reducing meat consumption. As the process of change can be experienced as stages, we might wonder what actual changes in diet-related GHGe result from each stage of meat reduction. We therefore aimed to describe levels of diet-related GHGe and their change over time according to the individual readiness to reduce meat consumption.

Methods
Food consumptions of 13,635 non-vegetarian French adults participating in the NutriNet-Santé Cohort were assessed using a food frequency questionnaire at two time points, in 2014 and 2018. Diet-related GHGe were assessed using life cycle assessment. A questionnaire in 2018 allowed us to characterize participants by their level of readiness to reduce meat consumption, using the stages of change from the transtheoretical model: precontemplation, contemplation/preparation, action, maintenance. Energy-adjusted diet-related GHGe were compared according to stages in 2014 and 2018 using ANCOVA and compared over time using Student test. Dietary intakes and their contribution to diet-related GHGe were also described.

Results
Individuals in the maintenance stage had the lowest diet-related GHGe, with an average of 3.73 kg CO2eq/day (SEM=0.02) in 2018, representing a difference of -26% compared to the precontemplation stage. Only participants in the action and the maintenance stages decreased their diet-related GHGe over time (both p &lt; 0.0001). Specifically, GHGe from ruminant and monogastric meat (e.g. pork, chicken) decreased over time for the last two stages (all p &lt; 0.0001), while their GHGe from cheese increased.

Conclusions
The last two stages of meat reduction resulted in a reduction of diet-related GHGe. As this reduction is not sufficient to meet GHGe reduction objectives, further efforts are needed and new levers, combined with public health guidelines must emerge to enhance the transition.

Key messages
• Individuals with higher readiness to reduce meat consumption actually reduce their overall GHGe, mostly due to reduced consumption of ruminant meat, but also pork and poultry.
• Observed reduction in diet-related GHGe is not yet sufficient to meet GHGe reduction objectives and further efforts are required.
Life-course socioeconomic status and its impact on functional health of Portuguese older adults
Authors: Henriques A , Ruano L , Fraga S , Soares S , Barros H , Talih M 
Published: October 2023

Abstract

Background
Functional health is arguably one of the most important health indicators for older adults, because it assesses physical, cognitive, and social functions in combination. However, life-course circumstances may impact this multidimensional construct. The aim of the present study was to assess the relationship between life-course socioeconomic status (SES) and different dimensions of functional health in older adults.

Methods
Data on 821 Portuguese adults aged 50 and over in 2013-2015 were analyzed. Life-course SES was computed using participants’ paternal occupation (non-manual (nm); manual (m)) and own occupation (nm; m), resulting in four patterns: stable high (nm+nm), upward (m+nm), downward (nm+m), stable low (m+m). Functional health included physical and mental functioning, cognitive function, handgrip strength, and walking speed. Linear (beta coefficients) and logistic regressions (odds ratios) were used to estimate the association between life-course SES and functional health.

Results
Overall, those who accumulated social disadvantage during life-course presented worse functional health than those with stable high SES (stable low - SF-36 physical functioning: β=−9.75; 95%CI: -14.34;-5.15; SF-36 mental health: β=−7.33; 95%CI: -11.55;-3.11; handgrip strength: β=−1.60; 95%CI: -2.86;-0.35; walking time, highest tertile: OR = 5.28; 95%CI: 3.07;9.09). Those with an upward SES were not statistically different from those in the stable high SES for most of the health outcomes however, those with an upward SES trajectory tended to have higher odds of cognitive impairment (OR = 1.75; 95%CI: 0.96;3.19). A downward SES trajectory increased the odds of slower walking speed (OR = 4.62; 95%CI: 1.78;11.95).

Conclusions
A disadvantaged life-course SES impacts older adults’ physical and mental functioning. For some outcomes, this was attenuated by a favourable adulthood SES but those with a stable low SES consistently presented worse functional health.

Key messages
• Overall, stable high SES leads to better functional health, but for mental health functioning, handgrip strength and walking speed, it is possible to overcome the initial social disadvantage.
• These results reinforce that even though health disparities may start early in life, they are mutable and capable of changing through the improvement of socioeconomic conditions.
Transferable lessons learned from improving health literacy responsiveness in Dutch rheumatology care
Authors: Bakker M M , Putrik P , Boonen A 
Published: October 2023

Abstract

Background
Health literacy difficulties among (groups of) individuals represent a significant public health challenge. Improving health literacy responsiveness of systems and services could reduce health inequalities in communities and patient populations.

Methods
We conducted a mixed-methods study to improve health literacy responsiveness in three Dutch rheumatology centres, using the OPtimising HEalth LIteracy and Access (Ophelia) approach. Patients and health professionals were involved in an inclusive needs assessment (n = 895 and 39, respectively) and co-design consultations to identify local solutions (n = 14 and 38, respectively). Based on all steps, we formulated transferable lessons learned (outcome-related or process-related) for public health and health care.

Results
Outcome-related lessons: a mixed-methods Ophelia approach was successful in identifying health literacy challenges and 175 potential solutions. Challenges are similar between disease groups and centres, but require solutions specific to the local context. Recognising challenges at the point of care is difficult. For a healthcare service to be responsive to health literacy needs, increased awareness alone is not enough; it will require a conscious actions and systemic change at multiple levels, including training. Process-related lessons: prerequisites for a successful health literacy responsiveness project include using multidimensional measurements, an inclusive participatory approach with all stakeholders, collaboration with experts in a community of practice, and strong project governance.

Conclusions
The Ophelia project in rheumatology care was successful in its aims of finding solutions to improve health literacy responsiveness. Public health and healthcare organisations should consider improving their health literacy responsiveness using a grassroots co-design approach. However, project success will depend on the quality of its governance; future programmes should follow a systematic approach.

Key messages
• Using a grassroots co-design approach such as Ophelia can help identify locally relevant solutions to health literacy challenges and support organisational efforts to reduce health inequalities.
• Successfully improving health literacy responsiveness requires, at minimum, inclusion of people with most complex health literacy challenges, strong project governance, and stakeholder engagement.
The association between maternal prenatal vitamin B12 intake and child cognitive development
Authors: Hrezova E , Ksinan Jiskrova G , Pikhart H 
Published: October 2023

Abstract

Background
Nutrient deficiencies in diet during pregnancy may have an adverse effect on the development of offspring. The association between prenatal vitamin B12 intake and cognitive functioning in children is unclear. Therefore, we examined such association in Czech children.

Methods
Czech part of European Longitudinal Study of Pregnancy and Childhood is a population-based prospective longitudinal birth cohort study of pregnant women and their children enrolled in 1991-1992. Dietary data was measured at 32 weeks of gestation using 145 items self-reported food frequency questionnaire. Parents reported on their child's speech and language development at 18 months, 3, 5, and 7 years of age (outcomes ranging from n = 1891 to n = 2362), from which single scores for vocabulary, language, early communication, understanding, and intelligibility were calculated. Higher scores indicate better speech and language development. Data were analysed using multiple ordinal and logistic regression models.

Results
Higher prenatal vitamin B12 intake was associated with higher speech and language test scores in fully adjusted models. Children of mothers with higher B12 intake had increased likelihood of higher scores in vocabulary (OR = 1.06, 95% CI: 1.01; 1.11), language (OR = 1.05, 95% CI: 1.01; 1.10), early communication (OR = 1.06, 95% CI: 1.01; 1.11) and understanding (OR = 1.09, 95% CI: 1.04; 1.14) at 18 months of age. Furthermore, they were more likely to get maximum points in the intelligibility test at age 3 (OR = 1.08, 95% CI: 1.02; 1.14) opposed to children of mothers with lower B12 intake. There were no associations at 5 and 7 years.

Conclusions
We found consistent and significant associations between prenatal vitamin B12 intake and early speech and language development. The results suggest that a diet during pregnancy low in vitamin B12 may negatively affect children's cognitive development. Thus, a healthy pregnancy diet with sufficient vitamin B12 should be promoted.

Key messages
• A diet low in vitamin B12 during pregnancy may have negative effects on the cognitive development of offspring, according to a longitudinal birth cohort study.
• Adequate prenatal vitamin B12 intake is important for cognitive development, particularly speech and language development.
Unintended perinatal health consequences of a Swedish family policy: A population-based study
Authors: Juárez S , Debiasi E , Honkaniemi H , Aradhya S , Hjern A , Duvander A-Z 
Published: October 2023

Abstract

Background
Family policies can influence parents’ fertility behaviors, with consequences for perinatal health. The 1980 and 1986 Swedish speed premium policies aimed to protect parents’ income-based parental leave benefits within birth intervals shorter than 24 and 30 months, respectively, but additionally encouraged shorter birth spacing and childbearing at older ages - both risk factors for several perinatal health outcomes. This study evaluates the association of the 1980 and 1986 speed premium policies with perinatal health outcomes.

Methods
We used information on all singleton births in Sweden from 1974 to 1991 (n = 1,762,784) to calculate rates of preterm birth, low birthweight (LBW), small for gestational age (SGA) at preterm and stillbirth, by month and year of birth. Changes in outcomes at reform periods were evaluated with interrupted time series analyses.

Results
The 1980 speed premium policy was linked to a monthly rate increase in preterm births relative to the pre-reform period (0.013 [95% CI 0.0061-0.0200] percentage points), equivalent to a 24% increase from 1980 to 1986. After the 1986 relaxation of the policy, the trend in monthly rates reversed (-0.025 [95% CI -0.033--0.018] percentage points). LBW displayed a similar pattern over both reform periods, which was attenuated when considering LBW at term. Rates of SGA at preterm and stillbirths did not change following either reform. Further analyses suggested that changes in perinatal health were restricted to births among native- and Nordic-born mothers, i.e., the primary groups to adjust their fertility behaviors to the reforms.

Conclusions
Despite its economic advantages for couples, especially mothers, the introduction of the speed premium policy had adverse perinatal health consequences particularly for preterm births. Family policies should be carefully designed with a ‘Health in All Policies’ lens to avoid possible unintended adverse repercussions for perinatal health.

Key messages
• Family policies can have unintended, adverse perinatal health effects if their eligibility requirements encourage individuals to make fertility decisions that are associated with health risks.
• Policymakers should adopt a ‘Health in All Policies’ approach for developing and evaluating family policies to avoid unintended public health harms.
Hypertensive disorders of pregnancy and long-term risk of maternal stroke - a systematic review
Authors: Brohan M , Daly F P , Kelly L , McCarthy F P , Khashan A S , Kublickiene K , Barrett P M 
Published: October 2023

Abstract

Hypertensive disorders of pregnancy (HDP) are associated with a long-term risk for cardiovascular disease among parous patients later in life. However, relatively little is known about whether HDP are associated with an increased risk for ischaemic stroke (IS) or haemorrhagic stroke (HS) in later life. This systematic review aimed to synthesize the available literature on the association between HDP and the long-term risk for maternal stroke. PubMed, Web of Science, and CINAHL were searched from inception to December 19, 2022. Studies included were case-control or cohort studies, conducted with human participants, available in English, measuring the exposure of a history of HDP (preeclampsia (PE), gestational hypertension (GH), chronic hypertension (CH), or superimposed preeclampsia) and the outcome of maternal IS or HS. Three reviewers extracted the data and appraised the study quality following the Meta-analyses of Observational Studies in Epidemiology guidelines and using the Newcastle-Ottawa scale. The primary outcome was any undifferentiated stroke (AS) and secondary outcomes included IS and HS. The protocol for this systematic review was registered on PROSPERO (CRD42021254660). 24 studies were included (10,632,808 study participants). HDP were significantly associated with AS (aRR, 1.74; 95% CI, 1.45-2.10). PE was significantly associated with AS (aRR, 1.75; 95% CI, 1.56-1.97), IS (aRR, 1.74; 95% CI, 1.46-2.06), and HS (aRR, 2.77; 95% CI, 2.04-3.75). GH was significantly associated with AS (aRR, 1.23; 95% CI, 1.20-1.26), IS (aRR, 1.35; 95% CI, 1.19-1.53), and HS (aRR, 2.66; 95% CI, 1.02-6.98). CH was associated with IS (aRR, 1.49; 95% CI, 1.01-2.19). In conclusion, exposure to HDP, including PE and GH, seems to be associated with an increased risk for AS and IS among parous patients in later life. Preventive interventions may be warranted for patients who experience HDP to reduce their long-term risk for stroke.

Key messages
• Hypertensive disorders of pregnancy appear to be associated with an increased risk of maternal stroke in later life.
• The strength of association between exposures and outcomes varies by hypertensive disorder of pregnancy subtype and stroke subtype.
The Solution-focused Intervention for Mental health to promote adolescent mental well-being
Authors: Söderqvist F , Norling U 
Published: October 2023

Abstract
With its compensatory mandate, the school is essential for health-promoting interventions. There are evaluated programs available that prevent mental problems, mental illnesses and various risk behaviours. However, there is a dearth of evaluated interventions designed to promote mental well-being in adolescents, which are adapted for upper secondary school. It was against this background that the development and evaluation of the Solution-focused Intervention for Mental health (SIM) began in 2018. This presentation will briefly overview the intervention, its components, design and results from feasibility studies. As an intervention programme, SIM consists of group-based coaching that starts from the core components and indicators of mental well-being and enjoying school. Thus, the intervention is based on a normative model of mental well-being; however, the dialogue conducted during the nine two-hour weekly group sessions is based on the solution-focused approach and its techniques. Specially trained teachers facilitating the content and process during group sessions lead SIM. The SIM programme is manual-based and designed to help students discover, explore, practice and develop existing personal resources in order to strengthen hedonic and eudemonic well-being. The teacher uses solution-focused coaching techniques to encourage the students to practise and discover how to utilise their existing resources. By focusing on what works small steps can be taken towards a desired future using indicators of well-being and solution-focused techniques. SIM has so far been tested in feasibility studies in 2019 (n∼140), 2021 (n∼200) and 2023 (n∼50). Results from focus group interviews, session scales ratings and pairwise testing of changes in well-being after compared to before interventions show promising results with increased well-being and total effect sizes ranging from Coheńs d of 0.19 to 0.59. SIM is now ready to be properly evaluated in a randomised controlled trial.
Anti-discriminatory language in public health research and practice in Germany
Authors: Kajikhina K , Sarma N , Koschollek C 
Published: October 2023

Abstract
Anti-discriminatory language has long been an important topic in the education and media sector, and has also been discussed in international public health research since the 1980s. However, the topic has so far had little presence in public health in Germany. Therefore, a guideline on discrimination-sensitive language around migration and health was developed at the Robert Koch Institute within the Improving Health Monitoring in Migrant Populations project. The 5 basic principles together with an overview of relevant terms and concepts are an orientation for responsible communication in public health research and invites people to critically examine and reflect on their own use of language. Expertise from the education and media sector, as well as from our anti-racist network played a crucial role the creation of the guideline. We will present and discuss the guideline with the international public health community to continue the learning process initiated during the creation process.
Which policies have been implemented to achieve healthy diets from sustainable food systems at the local level across East and West Africa? Results from a policy mapping across 8 African countries
Authors: Burgaz C , Van Dam I , Vandevijvere S 
Published: October 2023

Abstract

Introduction
Policymakers make decisions that shape food systems (from production, to consumption, to waste). According to the United Nations a quarter of the global population by 2050 will be African, agriculture is the source of livelihood for 70% of the African population, and the continent faces multiple forms of malnutrition simultaneously. After having compiled an evidence-based list of 44 good practice policies with double- and triple-duty potential to address food systems, based on a scoping review and workshops with international experts, we aimed to identify the implementation level of those good practice policies at national and local levels across 8 African countries.

Methods
In October 2022, a detailed policy mapping started at national and local levels across two African regions, in 8 countries (Benin, Burkina Faso, Ivory Coast, Kenya, Senegal, Tanzania, Togo and Uganda). Evidence of policy development and/or implementation was gathered across those 44 good practice policies, including, among others, information on jurisdiction, responsible government departments and agencies, overarching strategies, regulatory objectives of the policies, and whether policies address nutrition inequalities and/or women's empowerment. The results from the mapping will be analysed using Excel and NVivo12 software program.

Results
The final results will be available by June 2023. Our results will provide information on the role and potential of local governments to address food systems across African countries. In particular, the results will offer insight on the policy stakeholders involved, on ongoing national, regional or local plans and priorities, and on best examples of local public policies that have positively impacted human or planetary health across different domains of the food system.

Conclusions
The results from the mapping could inform similar studies across European countries, or inspiration for actions by local policymakers across Europe.