bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring the Burden of Climate-Related Asthma in Ireland via Microsimulation and Hybrid Costing
Authors: Di Capua G , Hynds P , O'Dwyer J , Priyadarshini A 
Published: October 2023

Abstract

Asthma affects approximately 5.7% of EU citizens, with over 7.7% of Irish residents suffering from the condition. Climate change will significantly affect both the prevalence and severity of asthma via exposure to temporal stressors including fluctuating air quality, changing local vegetation patterns, and increasingly intense precipitation. Resulting asthma cases will result in significant additional costs and pressures on the healthcare sector, the magnitude of which however remains, to date, unclear. The current project will provide an econometric analysis of the public healthcare burden generated by climate-related asthma via a national longitudinal survey (n = 1,695) of asthma sufferers and semi-structured interviews with healthcare professionals. Current and future likely healthcare expenditures will be quantified using time-driven activity-based costing and microsimulation as a function of future demographic shifts and climate change scenarios. The indirect burden of climate-related effects will be calculated utilizing a hybrid set of physical, psychological, and economic burden-of-disease measures. Preliminary results indicate that asthma-related limitations on daily activities significantly impair males more than females (t = 2.937, p =.005), with decreases in quality of life significantly differing across age groups (F = 4.234, p =.003). The asthma-related toll on quality of life is further associated with presentation of adverse mental health effects including depression (r = -.301, p&lt;.001) and anxiety (r = -.340, p&lt;.001), indicating compounded physical and psychological health and economic susceptibilities within households with younger, male asthma patients. Findings will increase the current evidence-base for specific demographic groups across Ireland, enabling future budget allocation, surveillance, and healthcare management and providing a replicable model for surveillance of the economic burden of climate-related asthma across Europe.

Key messages
• The study will increase the evidence-base for budgetary allocation based on simulated health vulnerabilities and develop a baseline for research on climate-associated health outcomes.
• The study will translate cross-sectoral health impacts into monetary “bottom lines” for elucidating health-related costs associated with specific climate change scenarios via hybrid costing.
Vaccine-preventable diseases: evaluating immune response in a sample of Italian healthcare students
Authors: Paladini A , Amantea C , Rossi M F , Fortunato C , Cadeddu C , Gualano M R , Laurenti P , Borrelli I , Santoro P E , Moscato U 
Published: October 2023

Abstract

Background
Healthcare university students are exposed to a range of risk factors during their hospital practical training, particularly in relation to biological hazards. Despite being students, they must be paid the same attention as health professionals in relation to the same possibility of transmitting infections to fellow colleagues, patients, and the wider community.The primary aim of this study is to investigate the seroprevalence characteristics of IgG antibodies against main infectious diseases in students enrolled in medical and health-related degree programs in an Italian university.

Methods
We conducted a retrospective epidemiological study of health professions students of a university hospital in Rome, collecting sociodemographic information and serology of antibody titers under study (hepatitis B, measles, mumps, rubella and varicella) from 2013 to 2023. After initial description of the study population, bivariate and multivariate analyses were performed to study the association between presence of antibodies with relevant variables.

Results
Our study sample included 2523 students (68.5% females; mean age 22.2, SD 3.8), of which 44.4% were protected against HBV, 87.3% against measles, 85.5% against mumps, 94.6% rubella and 95.2% against varicella. Differences in antibody coverage between age groups were statistically significant (p &lt; 0.001), with the exception of mumps. Surprisingly, the prevalence of HBV antibody titer below the seropositivity cut-off appeared to have an inverse correlation with older age (1998-99 OR 0.75 CI 0.61-0.93, 2000-01 OR 0.50 CI 0.41-0.62, 2002-04 OR 0.40 CI 0.31-0.52).

Conclusions
Despite several recommendations and campaigns to promote vaccinations, the goal of achieving high immunization rates among healthcare workers still represents a challenge. Public health policies should focus on improving prevention strategies, including serological screening and workplace vaccination for non-immune individuals, especially for Hepatitis B.

Key messages
• Improving prevention strategies, including serological screening and vaccination, is crucial to achieve high immunization rates among healthcare students, especially for Hepatitis B.
• Health profession students are at risk of exposure to infectious diseases during hospital practical training, and the prevalence of immunity varies among different age groups.
EPASCORE: A new indicator for prescriptive appropriateness of antimicrobials: our
experience
Authors: D'Avino A , Grande D , Schiattarella A , Dionisi P , Dolce M , Miraglia B A , Brandimarte G , Carnali M , Nasi G 
Published: October 2023

Abstract

Background
Antibiotic resistance is being a crucial issue in hospitals, and its control, passes through an appropriate use of antibiotics. To evaluate the prescriptive appropriateness, we introduced a new indicator which takes into account the rate of infections together with antimicrobial consumption and the median time of treatment of each event.

Methods
The “Estimated Prescriptive Appropriateness Rate” (EPA-SCORE) “has been calculated for each group of bacteria, as the rate between the observed consumption of an antibiotic (DDD/1000days of hospitalization) and the expected one as if the same antibiotic had been used for 10 days exclusively for the observed infections for which it was indicated, according to the following formula: EPASCORE = (DDD observed/expected)*1/(N.of infections). Data from January 2020 and June 2022 were collected while restrictive and persuasive strategies of Antimicrobial Stewardship were implemented. Changes in EPA-SCORE were evaluated through the years.

Results
In our hospital, in the first semester of 2022 prevalence of ESBL+ Gram negative-infections was 0.90 cases/1000 doh/year. The observed consumption of drugs indicated for those infections was 86.9 DDD/1000 dof, whilst the expected one for the registered number of infections was 9.01 DDD/1000doh, with an EPASCORE of 10.37%. Regarding multi-drug-resistant gram negative-infections, prevalence was 1.48/1000doh/year; observed antibiotic consumption for them (whose prescription was restricted to ID specialists) was 43DDD/1000doh, whilts the expected DDD was 29.6 DDD/1000doh (EPASCORE 67.7%). Comparing data between 2022 and the same period of 2020, a significant increase in EPASCORE was detected (+4.2% and +7.1% for ESBL+ and MDR Gram- infections in 2022 respectively)

Conclusions
Our date demonstrate that the EPASCORE represents a feasible indicator of appropriateness of antimicrobial prescription, and restrictive strategies of antimicrobial stewardship can help to improve its outcome.

Key messages
• Antimicrobial Stewardship has a leading role to face antimicrobial resistance.
• EPA-SCORE is a feasible indicator to measure appropriateness of antimicrobial prescription.
Barriers and enablers to vaccine uptake in the Ultra-Orthodox Jewish population: a systematic review
Authors: Jacobson A , Spitzer S , Gorelik Y , Edelstein M 
Published: October 2023

Abstract

Background
The Jewish Ultra-Orthodox (UO) population is an undervaccinated minority group that has been disproportionally affected by outbreaks of vaccine-preventable diseases (VPD) such as measles and polio. Underlying reasons remain poorly characterized. We aimed to identify vaccination barriers and enablers in this population.

Methods
We systematically reviewed the literature, searching Pub-med, Web of science, Medline, PsychNet and Scopus from 1995 to 2021 for quantitative and qualitative primary research in English. We assessed included publications for quality and extracted relevant data based on the 5As taxonomy: access, awareness, affordability, acceptance and activation.

Results
We included 9 qualitative and 7 quantitative studies from the 125 studies identified. Access barriers included scheduling difficulties, inconvenient opening hours, and logistical difficulties related to having multiple young children. Acceptance barriers included safety concerns. Insufficient knowledge about the importance of vaccines and timely vaccination and the perception of being shielded from infections because of seclusion from wider society were key awareness barriers. Competing priorities, such as work and housework, were the main affordability barriers. Mainstream religious leadership's support for vaccination was an enabler, although recent studies suggest their influence on vaccination behavior is decreasing and the influence of anti-vaccination messages is growing.

Conclusions
Barriers to vaccination among the UO were mainly logistical, with little religious framing. Safety and efficacy concerns were similar to those reported in the wider community. Decreasing influence of the traditionally pro-vaccine mainstream religious leadership and growing influence of anti-vaccination movements targeting the UO community are new phenomena that require close monitoring. Tailored interventions are required to protect the community and wider society against future VPD outbreaks.

Key messages
• Vaccination barriers in Ultra-Orthodox Jewish communities are due mainly to logistical challenges, such as competing priorities in large families with young children.
• Religious leadership is the main enabler of vaccination in Ultra-Orthodox Jewish communities, but their declining authority and exposure to antivaxx materials is causing a shift in attitudes.
Aligning Environmental Sustainability, Health and Affordability in Diet Quality: A Systematic Review
Authors: Leydon C , Leonard U M , McCarthy S N , Harrington J M 
Published: October 2023

Abstract

Background
Improving population health while simultaneously respecting planetary boundaries is of critical interest globally. Despite this shared motivation, research on the dietary changes required continues to operate in silos, focusing on certain pairings (diet-climate), rather than examining sustainable diets in their totality. This review aimed to summarise the literature on adherence to a priori defined dietary patterns in consideration of diet quality, environmental impacts, metabolic risk factors for non-communicable diseases (NCDs), and affordability.

Methods
Following the PRISMA guidelines, the review protocol was registered prospectively with PROSPERO. Seven electronic databases were searched as of October 2022. Two reviewers independently screened abstracts for inclusion, followed by full-text. One reviewer conducted data extraction and a quality assessment of eligible articles.

Results
Twenty-four studies were included with the majority from European countries (n = 22), and two from Australia. Thirteen distinct diet quality scores were identified, with those measuring adherence to national dietary guidelines the most reported. Thirteen distinct environmental impact indicators were identified, with greenhouse gas emissions (GHGE) (n = 23) assessed most. Indicators to assess impact on biodiversity were reported least. All studies reported on Body Mass Index (BMI) and seven on the daily cost of dietary adherence. Higher quality diets assist with maintaining a healthy weight and reducing environmental impacts, however, incongruities between population and planetary health can occur, especially between plant food consumption and water footprint. Further, sustainable diets can increase financial cost.

Conclusions
Higher diet quality can reduce planetary pressures, however lower impact diets are not inherently nutritionally optimal. Higher quality, low environmental impact diets may provide a protective role against risk of obesity, but have affordability implications.

Key messages
• Diets providing synergies between health and multiple environmental concerns requires continued research, with specific focus on the socio-cultural and economic dimensions of sustainable diets.
• Public health strategies to confront the Global Syndemic should greater emphasise the win-win outcomes for population and planetary health through dietary change in higher-income countries.
Evaluation of metabolic parameters among health workers in terms of adherence to Mediterranean diet
Authors: Uğraş Dikmen A , Medeni V , Özkan S , Tonbuloğlu Altıner Ö , Demirbaş O B , İlhan M N 
Published: October 2023

Abstract

Background
The certain occupational risk factors, such as physical and mental stress from working conditions and poor diet, make healthcare workers(HCWs) a vulnerable group for obesity and non-communicable diseases(diabetes, dyslipidemia, etc.). Adopting a healthy and sustainable diet is very important in terms of both health and environmental impacts. The aim of this study was to evaluate metabolic parameters among HCWs in terms of adherence to the Mediterranean diet, which is shown to be a healthy and sustainable dietary model.

Methods
This cross-sectional study included 372 HCWs. The data collection tool consisted of the sociodemographic information of the participants, Mediterranean Diet Adherence Scale(MEDAS) questions, body mass index(BMI) and metabolic parameter information obtained retrospectively from hospital data. BMI≥30 kg/m2 and 25-29.9 kg/m2 were considered obese and overweight, respectively. Descriptive and inferential statistics were performed.

Results
71% of the participants stated that they had not heard of the concept of ‘sustainable nutrition’ before. Of the HCWs who participated in the study, 65.3% were overweight or obese. It was found that 59.7% of the HCWs showed low adherence to the Mediterranean diet and 39.5% showed moderate adherence. Men(p &lt; 0.001), those with high school education or less (p = 0.030) and those who did not think that they ate healthy(p = 0.001) had significantly lower compliance with the Mediterranean diet. BMI(p = 0.022) and HbA1c(p = 0.049) parameters were significantly lower and HDL parameter(p = 0.015) was higher in HCWs with moderate and high adherence to the Mediterranean diet.

Conclusions
It was observed that the frequency of hearing the concept of ‘sustainable nutrition’ and compliance with the Mediterranean diet was low among healthcare professionals. Also, it was found that the frequency of obesity, dyslipidemia, and high diabetes-related parameters were increased in those with low adherence to the Mediterranean diet.

Key messages
• National, EU and global policies should be developed to increase compliance with healthy and sustainable diets among health workers who play a key role in the provision of quality healthcare services.
• Plans and programs to increase adherence to Mediterranean-type dietary patterns will bring significant increased health benefits related to non-communicable diseases and its risk factors.
How are Norwegian municipalities working to promote a healthy and sustainable diet?
Authors: Torheim L E , Totland T H , Lyshol H , Ljøsne I , Helleve A 
Published: October 2023

Abstract

Background
Diet and nutrition are crucial factors for public health. The importance of diet in promoting sustainability is increasingly understood, and there is a large overlap between healthy and sustainable diet. In Norway, municipalities play a key role in public health work including promoting a healthy diet in the population. The aim of this study was to describe Norwegian municipalities’ efforts to improve the diet of the population, and examine whether this was linked to sustainability.

Methods
All 356 municipalities in Norway were invited to answer a digital questionnaire which was filled in by 170 municipalities (48%). The data are presented as proportions.

Results
Most of the municipalities participating in the survey (91%) reported implementing at least one intervention to promote a healthy diet, however, these were mainly limited to a few nationwide activities such as the school milk or school fruit schemes. Only 7-8% were working to promote a sustainable diet through nudging or reducing meat consumption. Reduction of food waste was reported by 38% of the municipalities. In only a third of the municipalities, did employees who work with public health or sustainability have nutrition competencies.
The municipalities that did not answer the questionnaire were to a greater extent small municipalities and municipalities located in northern Norway than the municipalities that participated in the survey.

Conclusions
The work to promote a healthy diet was fragmented and not an integrated part of the public health effort in most municipalities. Very few municipalities worked to promote a more sustainable diet.

Key messages
• Efforts to promote a healthy diet in Norwegian municipalities are fragmented and inadequate.
• Norwegian municipalities’ promotion of a healthy diet is to a limited extent linked to promoting sustainability.
Mitigating and preventing food insecurity: a scoping review of the current EU policies
Authors: Capriolo A , Specchia M L , Zace D , Carini E , La Gatta E , Messina R , Petrella L , Di Pietro M L 
Published: October 2023

Abstract

Background
Food insecurity (FI) is a major public health concern, due to its association with a variety of adverse health outcomes. The aim of this study is to provide a picture of the EU policy response and adherence to the international recommendations in terms of FI mitigation and prevention.

Methods
A scoping review was carried out based on PRISMA Extension for scoping reviews method. By using specific queries/keywords, Pubmed and Scopus were searched and also institutional databases: EUR-Lex, WHO Global Database on the Implementation of Nutrition. The search was supplemented by a review of a list of organizations’ official websites, including Cordis, Food and Agriculture Organization of the United Nations, United Nations International Children's Emergency Fund and World Food Programme.

Results
The search on PubMed and Scopus produced a list of 8 articles, 3 concerning agriculture policies in EU, 4 related to intervention on the school lunch and 1 focused on the introduction of a tax on unhealthy drinks. Based on the search on EUR-Lex and WHO Global Database on the Implementation of Nutrition, 4 EU-wide statutory policies were collected covering school meals, food loss reduction, food waste prevention and food crisis and humanitarian aid operations.
The institutional website's review returned 18 documents in the form of ‘soft law’ measures, including action plans, action tools and projects.

Conclusions
Preliminary findings suggest that currently, at EU level, a coherent specific policy framework on FI is lacking. The policy fragmentation is mainly due to the multidimensional nature of FI, which has interconnections with multiple and different areas of food system-food availability, food accessibility, food safety and food quality and healthiness. The outputs also show that to date EU has failed to adhere to the international recommendations (above all, WHO recommendations) on FI mitigation and prevention. This has significant implications in terms of public health.

Key messages
• Policies design and implementation have the potential to create living environments conducive to good health and to lead to concrete health gains.
• Health gains resulting from strategies and policies implementation against FI reduce healthcare costs associated with the treatment of the FI-related diseases.
Inequalities in availability and compliance of school food programs in Canadian elementary schools
Authors: Maximova K , Tran T , Marshall K , Veugelers P J 
Published: October 2023

Abstract

Background
School food programs (SFP) are essential to promoting healthy eating in children. Canada lacks a federally funded and standardized SFP, resulting in a patchwork of SFP offerings. We examined SFP availability and compliance with Alberta Nutrition Guidelines for Children and Youth (ANGCY) in elementary schools from different socioeconomic settings.

Methods
Data were collected from 2 repeat cross-sectional surveys between 2008-2021: (1) REAL Kids Alberta (Raising healthy Eating and Active Living Kids in Alberta), a provincially representative population-based survey; and (2) APPLE Schools (A Project Promoting healthy Living for Everyone in Schools), a health promotion intervention targeting elementary schools in socioeconomically disadvantaged settings. School principals reported on availability and compliance of breakfast/snack and lunch programs with ANGCY. School-level socioeconomic characteristics included: Pampalon index (from Census data) and rural/small vs. large population centre (PC).

Results
Provincially, less than 50% schools offered breakfast/snack program. Lunch program was offered in over 85% schools. Over half of SFP complied with ANGCY by including 3-4 food groups (breakfast/snack: 62%, lunch: 52%). SFP availability in more vs. less deprived schools increased over time (2008: 25% vs. 26%, 2014: 58% vs. 40%). More schools located in rural/small vs. large PC offered SFP and availability increased over time (2008: 29 % vs. 18%, 2014: 56% vs. 46%). There were no consistent trends in compliance of SFP by socioeconomic characteristics. SPF availability and compliance in APPLE Schools improved from 68% to 73% and 53% to 68%, respectively. SPF availability was higher in more vs. less deprived APPLE schools (Y1: 85% vs. 54%, Y6+: 78% vs. 69%).

Conclusions
Higher availability and compliance of SFPs with nutrition guidelines in deprived and rural settings emphasize the critical role of SFPs in mitigating socioeconomic inequalities in healthy eating.

Key messages
• School food programs are essential to promoting healthy eating in children.
• School food programs may play a critical role in mitigating socioeconomic inequalities in healthy eating.