bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eye & Diabetes in Morocco: Where are we from the global screening guidelines?
Authors: El Harrak Y 
Published: October 2023

Abstract

In Morocco, the prevalence of diabetes in the adult population is 12.4% (WHO). Diabetic Retinopathy (DR) is the 2nd cause of blindness. Nearly 1 million people worldwide are blind due to diabetes. The aim of our work is to study the epidemiological profile of patients with diabetes in ophthalmology and to determine the observance of the follow-up guidelines. This is a descriptive study carried out at the Vision Clinic of Tetouan-Morocco, including all diabetic patients who presented to the ophthalmology consultation of the same doctor, between June 2022 and December 2022. The study involved 500 patients, including 217 men and 283 women, with an average age of 62 years. The average duration of diabetes was 11.5 years. 1 out of 3 diabetic patients was unaware that diabetes was a blinding disease and 3 out of 4 patients did not follow a specific diet. 1 out of 8 patients has an annual ophthalmological check-up. 55% of the patients have a screening every 2-5 years, when 7% haven't had their eyes checked in the last 10 years. Visual complaints accounted for 58% of the motivations for all consultations, while diabetes only accounted for 30%. Depending on the duration of the condition, diabetes represents 60% of the reasons for consultation among new diabetics (1 year) whereas it represents only 20% among diabetics over 10 years old. Eye examinations revealed a proliferative DR in 24% of the cases and a non proliferative DR in 22%. In 31%, there was no sign of DR and in 23%, the fundus was inaccessible due to cataract. The prevalence of proliferative DR increases with years of diabetes, reaching 40% in diabetics over 20 years old. The results of this work prove that diabetes is still underestimated by the Moroccan population. This is probably related to a lack of information of the target population. Thus, health professionals should strengthen their education in order to establish a better monitoring and screening policy aimed to reduce the occurrence of an avoidable blindness.

Key messages
• Less than one Diabetic out of 3 consults an ophthalmologist for their diabetes & Only one diabetic out of 8 consults annually in ophthalmology.
• The older the diabetes, the less regular is the consultation in ophthalmology & One out of 4 diabetics will already have proliferative diabetic retinopathy at their ophthalmological consultation.
Integrating One health into public policies: a One health policy screening tool
Authors: Bekker M , Bron B , van Zeben J , Siebenga J , van de Poel W 
Published: October 2023

Abstract
The One Health High Level Expert Panel in 2022 issued a new international consensus definition of One health: ‘One Health is an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems. It recognizes the health of humans, domestic and wild animals, plants, and the wider environment (including ecosystems) are closely linked and inter-dependent. The approach mobilizes multiple sectors, disciplines and communities at varying levels of society to work together to foster well-being and tackle threats to health and ecosystems, while addressing the collective need for clean water, energy and air, safe and nutritious food, taking action on climate change, and contributing to sustainable development.’ From a democratic public policy perspective, One Health is aimed at weighing the values, interests, issues and partial solutions of interdependent components of a complex adaptive ecosystem, and seeking a balance in trade-offs between them. The One Health policy screening tool provides an overview as input to the political designation of balanced policy priorities that is the responsibility of EFA. The aims of the tool are (1) to inform a reconsideration of the government's weighing of One Health aspects, as well as (2) to assess the policy proposal's integrative capacity for One Health. The tool supports the identification of potential policy impacts or lacking consideration of a range of One Health core aspects, and a rapid appraisal of the current integrative level of One Health aimed policies. The purpose is a desktop screening by EFA policy advisors based on existing information to be completed within a few days. Following the OHHLEP 2022 definition, the tool offers a relative quick, non-exhaustive overview of the broad One Health spectrum, and references to existing open access impact assessment frameworks, global or EU databases of core aspect composite country indicators, and policy guidance resources.
DALY attributable to air pollution associated with tracheal, bronchus, and lung cancer in Europe
Authors: Vojvodic K , Todirovic J , Terzic-Supic Z 
Published: October 2023

Abstract

Background
The evidence of the impact of air pollution on respiratory health is present in recent studies and evaluated in the WHO 2021 Air Quality Guidelines. Air pollution is connected with DALYs associated with tracheal, bronchus, and lung cancer attributable to air pollution especially in low- and middle-income countries. is an avoidable risk factor.

Methods
We analyzed Disability-Adjusted Life-Years (DALY) rates associated with tracheal, bronchus, and lung cancer per 100,000 among all ages attributable to air pollution. Estimates were taken from the Global Burden of Disease Study 2019, for ten countries with the highest DALY rates per 100,000 of tracheal, bronchus, and lung cancer in 2019: Monaco, Hungary, Montenegro, Serbia, Poland, Bosnia and Herzegovina, Bulgaria, Greece, Netherlands, and North Macedonia.

Results
The highest DALY rate per 100,000 attributable to tracheal, bronchus, and lung cancer was in Monaco (3210.03), followed by Hungary (2196.24), Montenegro (2108.75) and Serbia (2020.06). The highest DALY rate of tracheal, bronchus, and lung cancer attributable to air pollution was in Serbia (388.22), Bosnia and Herzegovina (380.64), Montenegro (378.26), and North Macedonia (331.63). The highest percentage of DALY of tracheal, bronchus, and lung cancer attributable to air pollution was in Bosnia and Herzegovina (22.15%), North Macedonia (21.59%), Serbia (19.23%) and Montenegro (17.94%).

Conclusions
Air pollution is a significant contributable factor in the prevalence of tracheal, bronchus, and lung cancer. In the ten observed countries with the highest DALY rates of respiratory cancers, the highest percentage of DALY of tracheal, bronchus, and lung cancer attributable to air pollution was in four Ex - Yugoslavia countries. These countries are in emerging need of public health regulations and policies in order to reduce air pollution.

Key messages
• The highest DALY rate of tracheal, bronchus, and lung cancer attributable to air pollution was in four Ex - Yugoslavia countries.
• There is an emerging need for public health regulations and policies in order to reduce air pollution and its consequences.
The role of time in healthy living environment networks: current research and future directions
Authors: Janssen LMS , Bekker M , van der Steen M 
Published: October 2023

Abstract

Background
Societal challenges in the context of healthy living environments are complex, requiring networked collaboration from heterogenous actors. As it takes time before environmental investments accrue health effects, long-term networks emerge with dynamics that are unpredictable. Recent literature gives reason to believe that time plays an important role in managing networks, and can potentially help understand the dynamics in healthy living environment contexts. This study aims to identify gaps in how the literature reports on the role of time in healthy living environment networks. We identify avenues for future research.

Methods
A scoping review of the literature yielded 27 papers published between 2012 and 2022 about collaborative practices for a healthy living environment. We collected data on general characteristics, and references to time in relation to the context, collaborative process, and outcomes of networks described in each paper.

Results
The majority of the literature does not report on temporal dimensions in networks for a healthy living environment. In the literature that does include references to time, temporal dimensions remain an implicit and passive variable. For example, studies describe the evolution of environmental or health problems and their time horizon. If temporal dimensions are manifest in descriptions of the collaboration itself it mostly concerns the evolution of processes, their time horizon, and references to tempo. Strategic use of timing and adaption, as well as realizing long-term impact are the most important dimensions in terms of network actions.

Conclusions
No studies systematically analyze the role of time. Future research should fill this gap to enrich our understanding of how, when, and why time shapes networked governance and outcomes for a healthy living environment. Applying these concepts further can help to develop new steering tools for practitioners involved in collaboration.

Key messages
• The role of time in governance of healthy living environment networks remains limitedly studied.
• Future research should study the (strategic) role of temporal dimensions in healthy living environment governance.
(Re)-discovering rivers benefits in the City: a One Health approach
Authors: Porcherie M , Giroux G , La Cann P , Glorennec P , Thomas M F 
Published: October 2023

Abstract

In the context of climate change and increasing urbanization, urban bathing is emerging in France and elsewhere, thus bringing us to question how we can maximize the benefits for the health of populations and minimize the risks. The multidisciplinary URB-bain project studies the feasibility of bringing bathing back to the urban environment. In a One Health approach, it combines 1/ the study of health risks associated with the chemical and microbiological analyses quality of the water of two potential bathing sites (Metz, France) and 2/ a socio-historical and political approach to the use of urban bathing in France, Europe, and Canada. This paper will present the first results of axis 2. Two types of qualitative data were collected: semi-structured interviews and documentation. Interviews were conducted with technicians, decision-makers, and NGOs. Eighteen interviews were performed (10 in Metz, France, 3 in Paris, and 5 in Quebec, Canada), recorded, transcribed, and analyzed (N'Vivo 12©). Other sites were documented (Copenhagen, Berlin). The causality model between urban bathing and health developed within the framework of the project and the principles for operationalizing the One Health concept (collaboration, coordination, communication, capacity building) guided the analysis. Documentation analysis showed a renewed interest in urban bathing in France since the 1990s, culminating in 2017 in Paris with the opening of a pool in the Canal de la Villette under pressure from citizens and motivated by the hosting of the Olympic Games in 2024. In France, health considerations focused on regulatory issues based on bacteriological quality for the institutions. The water bodies’ ecological and chemical status is neither a concern nor a One-health approach. Social accessibility and gender equity in the public space are important issues. The analysis of the interviews, still in progress, will help to put the initial results into perspective with the other sites studied.

Key messages
• Urban bathing is a public health issue in a context of climate change.
• Urban bathing is a one-health issue.
The relationship between neighborly social capital and health outcomes
Authors: Maykrantz S A , Kost J E , Neck C B , Houghton J D 
Published: October 2023

Abstract

Background
There is increasing interest in understanding the relationship between social capital and undesirable health outcomes. Social capital theory suggests that better health outcomes may result from certain “neighborly” aspects of social capital.

Methods
This study used secondary data from the Social Capital Index. Bivariate correlations were calculated between neighborly social capital and health outcome variables. Next, neighborly social capital variables were entered as predictors of health outcomes in a series of stepwise regressions. Regional comparisons were conducted across four U.S. regions. Comparisons of the regression model structures were conducted by applying a model derived from one region to the data from another region and contrasting the resulting crossed R2 with the original direct R2 to identify differential regression weights across the four regions that warrant interpretation.

Results
The correlation and regression analyses showed significant negative relationships between three neighborly social capital variables (% who do favors for their neighbors, % who worked with neighbors to improve something, and % who trust all or most of their neighbors) and health outcomes including: % in fair/poor health, premature mortality rate, % diabetic, and % obese. In regional comparisons, only the South region had a direct and crossed R2 significantly different from other regions, with this difference largely attributable to an unexpected positive relationship between trusting neighbors and negative health outcomes in the South.

Conclusions
Interventions to increase neighborly social capital may help to alleviate negative health outcomes in the U.S. Anomalously, in the South, trusting neighbors may be related to worse health outcomes.

Key messages
• Being neighborly may enhance positive health outcomes in most parts of the U.S.
• Strong social support impacts urban health.
Understanding the complex systems of climate change and NCDs: A Causal Loop Diagram
Authors: Hunter R , Garcia L , Dagless S , Whiting S , Racioppi F , Wickramasinghe K 
Published: October 2023

Abstract

Background
WHO has identified climate change as one of the greatest health threats of the 21st century. At the same time, noncommunicable diseases (NCDs), including cardiovascular diseases, diabetes, chronic respiratory disease and cancer, are the leading cause of death globally and in the WHO European Region, are responsible for around 90% of deaths and 84% of years lived with disability each year. However, the complex relationships between climate change and NCDs are not well understood.

Methods
The aim of this research was to identify, discuss and map the linkages between factors and policy actions designed to prevent NCDs and address climate change. Objectives included to: discuss and clarify the pathways of how NCDs and climate change relate to each other and the co-benefits to addressing both using Group Model Building methods; to identify key multi-sectoral actors and priority actions for international collaboration and national responses to NCDs and climate change. We co-designed and created a Causal Loop Diagram (CLD) with local stakeholders, following the principles of Group Model Building.

Results
29 participants were involved in the workshop included WHO staff and experts in NCD prevention and/or climate change and health and health emergencies. The CLD was meaningful to the stakeholders as a consensual and co-produced understanding of the problem, as well as forming the basis of a tool to explore the future impact on how sectoral and multi-sectoral public policies to address these complex challenges are shaped and implemented. Participants identified a range of priority actions that, in their view, could impact and help reshape the system and influence NCDs and climate change in Europe.

Conclusions
The CLD was reflective of the various stakeholders’ experience, knowledge, perceptions, and views about the factors, and the inter-relationships between these factors, by which climate change influences NCDs and NCD risk factors in Europe.

Key messages
• Climate change is one of the greatest threats of the 21st century.
• Systems thinking approaches can help identify ‘win-win’ solutions to complex issues.
Active recreational and silvicultural co-use of forested areas: an innovative forest management study
Authors: Haugset A S , Sollid-Bolås T , Myhr A 
Published: October 2023

Abstract

Issue
Forests are crucial in the sustainability transition to a biobased modern society. However, forests may also be recreational sites, and positively affect human health and well-being. Modern silvicultural harvesting practices alters the landscape overnight, and hence may affect the recreational and public health promoting use of it.

Description of the problem
Municipalities, as owners of urban forest areas, may actively support inhabitants’ recreational use of near-by forested areas by 1) allocate resources to local voluntary organizations who facilitate for recreational users and 2) actively facilitate for continuous recreational use while practicing modern silviculture. In 2020-2022, an innovative integrative forest management approach was tested in a municipality in mid-Norway. This study explores how the local forests are used for recreational purposes, and how potential conflicts in land use can be mitigated or prevented.

Results
The forest areas are mostly used for health-promoting activities like exercise, walking, general recreation, and seasonal harvesting of wild berries and mushrooms. Half of the users get to the forest by foot or bicycle. Easy access, closeness to home, free parking arrangements and access to maps of the areas is important to users. Most users were well-informed about local forest-based businesses and carbon sequestration in wood and held that forests should be harvested and regenerated. They showed a high tolerance for forestry if the footpaths were cleared immediately. However, three out of four users want to be informed before harvesting. A small share of users wants educational posters about forest ecosystems.

Lessons
A pre-existing low conflict level between modern forestry and recreational forest use may be maintained by quite simple and modest means. In this municipality information posters were placed by the footpaths and an arena for discussions, information and co-creation of recreational facilitation was established in 2022.

Key messages
• Near-urban forests are frequently used for exercise and recreational activities, especially if easily accessible.
• Harmonious co-use of forest areas, even in times of timber harvesting, is supported by rapidly recovering the footpaths and by notifying inhabitants in advance.
Asthma prevalence and environmental exposure in children and adolescent in Slovenia – a pilot study
Authors: Rejc T , Kukec A , Mlakar A , Carli T , Krivec U , Zver A 
Published: October 2023

Abstract

Background
The last data on asthma prevalence (13.9 and 17.4%) in children in Slovenia is from 2002. The aim is to assess the asthma prevalence and environmental risk factors in two selected schools in Slovenia, as a pilot study for a national cross-sectional survey.

Methods
We conducted a cross-sectional pilot study in two primary schools in Slovenia. Observed population were children and adolescents aged 6-7 and 12-13 years. Observed outcome was current asthma diagnosed by a physician, reported by parents. To get the desired information we formulated a new questionnaire which was content validated. In the School 1 teacher distributed the questionnaires for parents to fulfill it. In the School 2 the questionnaires were delivered to parents at the parental meeting together with the presentation of the study and short lecture. We calculated the response rate, the prevalence of asthma, asthma symptoms, allergy, genetic background and exposure to environmental risk factors.

Results
Response rate in the School 1 was 24%, in the School 2 was 100%. We got data about 53 out of 127 children and adolescent. None of the parents reported a diagnosed asthma in their child or adolescent, 17% reported symptoms of asthma, 11% wheezing, 8% allergic rhinitis, 40% of children were living within 200 meters of a busy road, 34% were exposed to moisture and mold, 9% had chronic respiratory infection in their early childhood and 13% mothers smoked during pregnancy.

Conclusions
Newly developed questionnaire efficiently acquired information about exposure to environmental risk factors and asthma or allergy symptom. To get higher response rate, delivering the questionnaires at the parental meeting was more effective. Considering the reported symptoms of asthma in undiagnosed cases, further investigation of health records is needed to recognize the potential undiagnosed asthma cases. The latter suggests the benefits of the HIS / HES (Health Interview / Examination Survey) methodology.

Key messages
• HIS (Health Interview Survey) and HES (Health Examination Survey) design type methodology ensure us the quality data on asthma prevalence.
• To efficiently assess the asthma prevalence, the adherence to medical guidelines and unification of the methodology to diagnose asthma in children by pediatricians is of an extreme importance.
Exposure to surrounding greenness and well-being in Portugal, a cross sectional study
Authors: Resendes D S , Uva M S , Morgado P 
Published: October 2023

Abstract

Background
Positive mental health effects of nature have been studied before with relevant associations between the two easily found in literature. However, there is still a lack of population based studies that focus on the effect that the amount of surrounding greenness might have on well-being.

Objectives
This study aims to evaluate the effects of exposure to surrounding greenness in the residential area with well-being based on the Mental Health Inventory 5-items (MHI-5) score from 0-100 (less to more well-being).

Methods
We used data from participants of the 2015 National Health Examination Survey (INSEF) which uses complex sampling methods to represent the Portuguese population and includes 4911 participants. Data regarding socioeconomic status, urbanization level, education, sex, age, postal code and well-being score was extracted. We then calculated the average surrounding greenness using the Normalized Difference Vegetation Index (NDVI) in a 300m and 1km buffer around each participant's residency and divided it by tertiles (from less green to most green). Log linear regression models controlling for confounder effects were applied.

Results
For the 300m buffer living in the 2nd tertile of greeness compared to the 1st tercile decreased the average well-being score by around 4% (ExpB=0.969, 95% p &lt; 0.05). Living in the 3rd tercile (most green) had less to almost no effect (ExpB=0.989, 95% p &lt; 0.05). Sensitivity analysis in a 1km buffer and the stratified analysis for sex and urbanization, also show a 4% decrease in well-being in the 2nd tertile and little to no effect in the 3rd.

Discussion
This study has found an association that is contrary to most literature on this subject, the study design might be subject to selection biases and misclassification of exposure. Further analysis should be done with relation to qualitative aspects of green space, accessibility to green areas and the roles of social cohesion and physical activity.

Key messages
• Population based study done in Portugal regarding the association between well-being and surrounding greenness.
• Findings point to a negative association between increased surrounding greeness and well-being.