bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transitions in and out of work across the life course of patient with a NCD diagnosis
Authors: Machado M , Perelman J 
Published: October 2023

Abstract

Background
Coupled with its impact on quality of life, non-communicable Diseases (NCD) may degrade both the quality and quantity of the workforce, and stunt economic growth and productive employment. However, there is limited information about the social costs of NCDs to identify priorities in resource allocation, particularly in regard to retirement policies. In this paper, we investigate if NCDs affect them employment status, i.e., the patients’ ability to work beyond middle age, using longitudinal data.

Methods
We used longitudinal data from employed men and women who responded to the sixth and seventh waves of the SHARE project from several European countries and Israel. We restricted the sample to all people working up to 3 years before the expected retirement age for each country. To achieve a representative sample of employed people from each country we calculated calibrated longitudinal individual weights for participants in these two waves. It was to adjust for non-response, sample selection bias, and attrition (N = 9645). We modelled the probability to change employment status on Wave 7 as function of having a NCD, adjusting for age, gender, marital status, job satisfaction, education level, and country, using multinominal logistic regressions.

Results
Overall, 30.3% of the study population self-reported one NCD and 28.3% mentioned at least two chronic health conditions (multimorbidity). Among multimorbid individuals the risk of unemployment is 1.27 times more (OR = 1.271, 95% CI (1.266-1.276).), while the risk of retirement is multiplied by 1.26 (OR = 1.259, 95%CI (1.255-1.262)).

Conclusions
Having one NCD or multimorbidity is a common phenomenon in the working middle-aged European population. It is associated with unemployment and retirement, controlling for educational level, age, marital status, gender, job satisfaction, and country. This result highlights that early retirement will persist unless health policies are implemented to decrease the burden of NCDs.

Key messages
• This study shows that there is a strong association between having one or more NCD with unemployment and retirement, controlling for educational, age, and occupational type.
• Results reinforce that we need health policies focused on alerting society about real impact of NCD on employment.
Socio-economic burden of cystic fibrosis in Europe: a systematic review of cost of illness evidence
Authors: D'Ambrosio F , Nisticò A , Russo Sanjuanbenito M , Ricciardi R , Calabrò G E 
Published: October 2023

Abstract

Background
Cystic Fibrosis (CF) is one of the most prevalent severe genetic diseases, with a high economic impact on healthcare systems due to its complexity. The life expectancy of CF patients has substantially lengthened due to early diagnosis and improvements in therapeutic regimens with Cystic fibrosis transmembrane conductance regulator (CFTR) modulators. Therefore, strategies to ensure equitable access to these treatments should be optimized. Our study aimed to summarize existing literature regarding the costs of CF in Europe.

Methods
A systematic literature review was performed querying three online database (PubMed, Scopus, Web of Science) from January 2013 to March 2023. Studies carried out in European countries, written in English language, and focused on the socio-economic burden of CF were selected.

Results
Overall, 11 studies were considered. Across countries, the average total annual cost for a CF patient amounted to €14.174,00-53.256,00, higher for children (€15.771-60.412,00) compared to adults (€15.714-€47.217,00). The largest expenditures were recorded for annual direct healthcare costs, which amounted, per patient, to €9861,00-28.827,00, followed by direct non-healthcare costs (€4512,00-18.329,00). For adults, drugs, tests, and hospitalizations represented the primary cost drivers of direct healthcare costs, while for children, direct non-healthcare costs, especially for caregivers, were predominant. Moreover, indirect costs, whose main expenses were related to productivity loss and early retirement, ranged between €1,094-12,443 per patient per year.

Conclusions
The CF management is associated with relevant costs. CFTR modulators represent an important therapeutic opportunity of reducing the clinical and economic burden of CF. Therefore, new evidence and value-based economic evaluations, that also take into account a social perspective, are needed to support the decision-making process.

Key messages
• The use of new health economic models is needed to guide the policy-makers in a value-based evaluation of Cystic Fibrosis treatments that take into account their whole value.
• The assessment of the socio-economic burden of Cystic Fibrosis could guide the identification of the main actions to be implemented to respond adequately to the real health needs of patients.
Self-reported chronic pain: Prevalence and characteristics in the Capital Region of Denmark
Authors: Eliasen M H , Lau C J , Grønkjær M , Jacobsen M H , Elsborg P , Toxværd C G , Andreasen A H , Benthien K S 
Published: October 2023

Abstract

Background
Chronic pain is a burden for both the individual and the society. Primary chronic pain has been included in the International Classification of Disease, 11th version (ICD-11), defined as persistent or recurrent pain for more than three months. The aim of the study was to estimate the prevalence of self-reported chronic pain approximating this definition as well as characteristics of persons with self-reported chronic pain in the Capital Region of Denmark, comprising 1/3 of the citizens in Denmark.

Methods
Self-reported chronic pain, defined to approximate the ICD-11 definition, was assessed in the Danish Capital Region Health Survey 2021, including 56,245 participants from the general population aged ≥16 years (response rate 54.9%). The question was validated using cognitive interviewing. Characteristics of persons with chronic pain were assessed using national registries (socio-demographics) as well as questionnaire data (health status and health-related behavior). Descriptive analyses and multivariate logistic regression models weighted for survey design and non-response were performed.

Results
Preliminary results show that 32% in the Capital Region of Denmark in 2021 had self-reported chronic pain. More women (35%) than men (28%) reported chronic pain. The prevalence of chronic pain increased with age, but still, 20 % of persons aged 16-34 years also reported chronic pain. Chronic pain was inversely associated with education; thus, 45% of persons with short education reported chronic pain. Associations between chronic pain and mental and physical health status as well as health-related behavior, pain interference and pain location will be presented.

Conclusions
Self-reported chronic pain is highly prevalent in the general adult population of the Capital Region of Denmark. Knowledge on prevalence and characteristics of persons with chronic pain is important to create effective prevention and treatment strategies.

Key messages
• Chronic pain is highly prevalent in the general population.
• More focus and research are needed on chronic pain – both concerning prevention and treatment.
Intervention Research in Health Promotion: Policy Issues, the Example of the Ten-Year Cancer Strategy in France
Authors: Foucaud J 
Published: October 2023

Abstract
Prevention research covers a wide range of studies, including the identification of unknown risk factors for certain cancers, or health promotion with approaches by population, by living environment or by territory. This research focuses in particular on identified carcinogenic factors (e.g. tobacco, alcohol, food, certain pesticides) but also on the causes of the prevalence of these factors in certain populations. In addition, surveys on perceptions of cancer and cancer risk factors - such as the 2021 French Cancer Barometer - are needed. They provide a better understanding of behaviour in order to propose targeted and effective interventions. In this context, the PHIR makes it possible to respond to these challenges. In 2010, the French National Cancer Institute was a pioneer in the development of PHIR in France and decided in 2021 to make it one of the spearheads of its ten-year strategy. This presentation aims to report on this policy of developing PHIR as a relevant tool for thinking about health promotion policies and actions, particularly on nutrition, with a focus on health inequalities and on certain populations (young people, vulnerable populations). The presentation will address three challenges for the implementation of this research policy: 1/ the development of the French scientific community in order to be able to respond to priority issues; 2/ the support of research on this topic and the animation of this community; 3/ the use of PHIR as a tool to define health promotion policies and actions. The first part will focus on identifying the modalities of implementation of the PHIR in the framework of a national policy of prevention and health promotion. The second part will focus on the challenges of its deployment among the French scientific community.
Decarbonizing healthcare sector: from a review to a framework of practical solutions
Authors: De Marchi C , Cristiano W , Armocida B , Martuzzi M , Mancini L 
Published: October 2023

Abstract

Background and objectives
Climate change is one of the biggest health threats facing humanity. It can be considered as a syndemic, interacting with social determinants of health and pre-existing chronic conditions, exacerbating their effects on human health. Healthcare sector should play a key role in mitigating the climate crisis considering its mission of protecting and promoting health. Despite this, its climate footprint is equivalent to 4.4% of global net carbon emissions, making it a major contributor to the climate crisis. In this context, healthcare sector needs to lead the way to the net zero carbon emissions. The aim of this paper is to identify key actions for reducing the carbon footprint of the healthcare system and develop a framework for emission reduction actions.

Methods
The study consists of two phases: i) conduction of a rapid review of the literature, through which studies on healthcare carbon footprint published worldwide until April 2022 will be collected, screened by title and abstract and analysed; ii) identification of hubs as main causes for CO2 emissions and development of a framework for adopting practical solutions aimed at carbon reduction actions.

Results
From the rapid review of the literature 747 records have been retrieved. Of this, 21 have been selected after screening by title and abstract.

Conclusions
The climate crisis is increasingly compromising human health, so urgent actions are needed. As the healthcare system contribution to the climate crisis is expected to increase in the next years, efforts must be undertaken to mitigate this and become sustainable and climate-smart. Healthcare system and healthcare professionals should be the ones leading the front by reducing its own pressures to climate. The entire scientific community is called to recognise this issue as a high priority.

Key messages
• Climate crisis as a high priority for healthcare professionals.
• Development of a framework for carbon reduction actions.
Do the pollution related to ozone pose a real health threat to the population in Upper Silesia?
Authors: Kobza J , Geremek M , Grajek M 
Published: October 2023

Abstract

Background
Air pollution is a leading environmental factor, that influences human health. Although Ozone plays crucial role in the screening Earth's surface and lower atmosphere layers from the ultraviolet radiation, the troposphere ozone is proved to have negative effect on human body. Long-term exposure to a higher ozone concentration is related to a decrease in life expectancy.

Objectives
The objective of this study was the measurement-based assessment for determining whether the concentrations of ozone is within admissible limits or exceeded in Silesia province (5 million agglomeration) and therefore pose a threat to the local population together with the levels of PM2.5 and PM10 significantly exceeded at the same time.

Material and methods
The data provided by the Voivodship Inspectorate for Environmental Protection in Katowice for period 2015-2022 was used in the statistical analysis. The received data constitutes the result of 8-hour concentrations of ozone in selected air monitoring stations of Silesian province. The locations of 3 monitoring stations were found useful for the aim of this research; one site is situated in rural background area, another one is located in medium - sized city and the Katowice station is representative for urban background situation.

Results
The alarm level hasn't been exceeded in indicated measurements stations in Silesian Voivodship in period 2015-2022 (averaging time 1 hour: 240 µg/m3 four 3 hours). The target level has been exceeded in 2015-2017, in all three measurements stations and in the following years in one station (in Zloty Potok - 2018 and in Katowice -2019). Each year the largest number of exceedances occurred in August.

Conclusions
The results clearly indicate lack of hazards for general population health in terms of increased concentrations of ozone in the city centres and outside in Upper Silesia agglomeration and the situation even improved in last years. We identified the main sources of ozone.

Key messages
• The troposphere ozone is proved to have negative effect on human body, long-term exposure to a higher ozone concentration is related to a decrease in life expectancy.
• The results clearly indicate lack of hazards for general population health in terms of increased concentrations of ozone in the city centres and outside in Upper Silesia agglomeration.
Anti-racism praxis in an emerging community-academic approach to environmental and climate justice
Authors: LeBron A , Reyes A , Lopez M , Saxon L , Bloom J , Taylor Lucas C 
Published: October 2023

Abstract

Background
Racial injustices, environmental and climate threats, and COVID-19 inequities that disproportionately affect communities of color have contributed to social reckoning with racism. Public health is grappling with how to strengthen collaborative processes, research, and practice to be grounded in an understanding of racism as a public health issue and incorporate a structural racism lens into strategies to promote health equity. We describe a process for strengthening anti-racism praxis for an emerging academic center focused on community-academic collaborative approaches to advancing participatory action research for environmental and climate justice.

Methods
University-based faculty and staff and popular education designers and facilitators collaborated to design an anti-racism process for an emerging environmental and climate justice academic research center. The anti-racism process focused on building leadership and action through deep discussion, reflection, narrative generation, and visioning. This process involved clarifying the Center's purpose, anticipated short- and long-term outcomes, collaborative processes, and theories of change.

Results
The anti-racism process focused on building deep connections and capacity to practice and advance racial justice within the administrative, research, teaching, and practice spheres of academic and community participants identified as active and passive allies on the Spectrum of Allyship. Dialogues illuminated the centrality of storytelling for listening to and learning from a range of lived experiences and envisioning processes and ways of working together. We discuss themes, facilitating factors, and challenges that emerged from our dialogic process.

Conclusions
This case highlights the importance of anti-racism processes as a collective experience to inform racial justice approaches within emerging and sustained public health units - large and small - and in participants’ spheres of influence.

Key messages
• As the field of public health grapples with racism as a driver of health inequities, anti-racism approaches are critical to public health practice and research.
• Anti-racism approaches that engage narratives have potential to inform guiding approaches for public health units committed to health equity.
Exposure to green and blue spaces and depression in older adults: Findings from the EPIPorto cohort
Authors: Behlen M , Henriques A , Severo M , Santos C J , Ribeiro A I 
Published: October 2023

Abstract

Background
Portugal is amongst the European countries with the largest share of older adults and highest prevalence of depression. Natural environments may play an important role promoting population-level mental health. We investigated the associations between the exposure to green and blue spaces and depression among older adults from Porto (Portugal) and the mediation role of social interactions and physical exercise.

Methods
This study included data from the fourth wave (2017) of the EPIPorto cohort, which included only participants aged ≥60. The presence of depressive symptoms was measured using the Geriatric Depression Scale (GDS). Using the residential locations, we computed the Normalized Difference Vegetation Index (NDVI), and the shortest distance to the nearest urban green space and blue space. We fitted crude and adjusted negative binomial regression models. Associations were expressed using relative risks (RR) and 95% intervals (95% CI). We used structural equation modelling to assess mediation.

Results
We included 639 participants, from which 27.2% presented depression (GDS ≥5). In the adjusted models, we found statistically significant associations between having more NDVI within 50 and 100 meters and lower GDS (RR = 0.78 [95%CI 0.65-0.94] and RR = 0.81 [95%CI 0.67-0.97], respectively). Most of the association between NDVI and the GDS was direct, being only slightly mediated by the time spent with family, although both the direct and indirect effects did not reach statistical significance. No significant associations with the remaining variables of exposure were identified.

Conclusions
We observed a direct association between living in areas with more vegetation and less depressive symptoms in older adults in Porto.

Key messages
• Our results suggest that the provision of green space may be an effective strategy to promote mental health in late life.
'I just can't stand being there anymore': Places of contention for older Americans during COVID-19
Authors: Finlay J , Guzman V , Meltzer G , O’Shea B , Yeh J 
Published: October 2023

Abstract

Background
The COVID-19 pandemic has posed new and widespread challenges to experience the health and well-being benefits associated with person-place attachment, particularly among populations identified as vulnerable, such as older people. The aim of this study was to explore how individuals ageing-in-place have perceived and (re)negotiated their sense of place and place identities since the pandemic onset.

Methods
We thematically analysed open-ended responses (n = 1171) collected between April to June 2022 in the COVID-19 Coping Study, a national longitudinal study of the impacts of the pandemic among aging adults living in the US.

Results
Participants were on average 68 years old, with a majority of participants identifying as female (71%), non-Hispanic white (93%), living with others (72%), and retired (66%). We identified five themes, four regarding why particular places were challenging since the pandemic onset: (1) fear of viral exposure, (2) frustrating regulations, (3) uncomfortable and hostile social dynamics, and (4) ‘out of place’ negative emotions; and one regarding how participants addressed pandemic place-based challenges: (5) adjustments made to reframe expectations and behaviours. These findings prompt a critical exploration of how experiences taking place in micro and macro spaces have shifted during the pandemic and the potential wide-ranging and long-term implications they hold for participants’ later-life health and well-being.

Conclusions
Evidence emerging from this analysis highlights the potential of large well-ventilated public spaces that offer diverse opportunities to engage in educational, artistic, and recreational activities as a vehicle to (re)build disrupted place identities for older adults living through increasing social tensions and polarization regarding public health measures.

Key messages
• Changes to built and social environments driven by the COVID-19 pandemic and public health strategies are having lasting impacts on how older people engage with health promoting and enabling places.
• Older people have addressed place-based challenges through antimicrobial precautions, daily routine adjustments, choosing online and outdoor activities, and/or withdrawing from places altogether.
Opponents of vaccines in Israel and their justifications to operating and spreading their position
Authors: Inchi L , Rottman A , Zaretzki C 
Published: October 2023

Abstract

Background
One of the things the world was waiting for during the COVID-19 epidemic was the development of a vaccine. However, there was also a growing fear of this expressed in the lack of compliance and even active resistance to the vaccine. Identifying and analyzing the justifications for resistance to vaccines could lead to a significant reduction of it, which would contribute to public health.

Aim
To examine the justifications that guide vaccine opponents, not only in not getting vaccinated, but also in spreading their opposition.

Methods
Qualitative research using text analysis of three central public websites, covering the spectrum of positions re- vaccines:
1. The Ministry of Health - identified as an ‘objective’ website.
2. Midaat - Science and Information for Family Health - identified as a website ‘in favor’ of vaccines.
3. PECC - Health, Science, Truth - identified as a website ‘against’ vaccines.
Findings: According to the Health Belief Model (HBM, 1956), the perception of being affected by the disease and the perception of the severity of the disease are low and therefore the threat perception is also low, as is the cost-benefit perception. The barriers to change perception expressed internal barriers, such as fear of a new vaccine and fear of foreign substances in the body; and external barriers, first and foremost a lack of trust in the government in general and the health system particularly, in addition to development of conspiracy justifications claiming that the vaccines are a mechanism of the government to control the population. Another justification related to the pharmaceutical industries’ financial interests, i.e., their attempts to get rich by ‘inventing a disease’ and providing a vaccine

Conclusions
Public trust has been significantly compromised as a result of conflicting and changing instructions, especially during lockdowns. Fake news were distributed on social networks. Necessitating a national confrontation with the issue.

Key messages
• It is important to identify the justifications vaccine opponents use, so that explanations focus on all concerns and developments of false agendas that damage public trust and hence public health.
• Israel should not take fake news lightly. The government must understand the negative consequences of it, and act to eradicate it through supervision, as is customary in other countries.