bluuebunny/crossref_metadata_2025_split huggingface dataset:
Perception of the quality of medical care in patients from the LGBT+ community
Authors: Villegas-Dominguez J , Cárdenas Rendón D , Pérez Gómez T I , Cacho Alvarado A A , Coria Montiel J J , Barran Prior G , Marquez-Celedonio F G , Trujillo Peña G J 
Published: October 2023

Abstract

Background
Mexico does not have comprehensive care services for members of the LGBT+ community, who also still suffer from a social context that still develops between traditions of inequality and lack of inclusion. Objective: To determine the factors associated with the perception of good quality of medical care in patients from the LGBT+ community

Methods
A cross-sectional, observational, prospective and analytical study was carried out between November and April 2023. Members of the LGBT+ community of Veracruz, Mexico were included; Subjects with visual or hearing disabilities or some psychological disorder that affects the perception of behavior were excluded. Data collection was done through Google Forms. The SPSS v22 program was used, X2 test, Odds Ratio (OR) and confidence interval (CI95%).

Results
489 subjects were included, 295 (60.6%) use the public medical system, 155 (31.7%) consider a medical specialty is necessary to care for the LGBT+ community and 150 (30.7 %) indicates that the specialty should only be for care of patients with gender change; 297 (60.7%) perceive that they receive good quality medical care and 69 (14.1%) have perceived that they have been denied consultation because they belong to the LGBT+ community. The factors associated (OR/CI95%) to the perception of good medical care is the lack of: a family doctor (0.4/0.3-0.6), discomfort on physical examination (13.1/6.9-24.0), verbal abuse (13.3 /6.7-26.0), sexual harassment (5.1/2.7-9.5), physical harassment (11.5/4.7-28.0), discomfort of the doctor during the consultation (10/6.0-19.2), breach of confidentiality (7.2/3.7-14.1), denying care (12.7/6.3-25.6) (p &lt; 0.05).

Conclusions
The factors associated with the perception of a good quality of care in patients from the LGBT+ community are similar to those reported in the literature within any community, which invites health institutions to reinforce their inclusion programs, to reduce acts of discrimination.

Key messages
• Health systems need to consider care for the LGBT+ community from specialists who can make a comprehensive assessment that favors adequate medical care.
• Discrimination is still present within the medical care of patients from the LGBT+ community, so it is essential that the doctor is trained and sensitized in the processes of inclusion.
Determinants of COVID-19 vaccine uptake in the Netherlands: A nationwide registry-based study
Authors: Pijpers J , van Roon A , van Roekel C , Labuschagne L , Ferreira J A , Smagge B , de Melker H , Hahné S 
Published: October 2023

Abstract

Introduction
By September 2022, uptake of at least one dose of COVID-19 vaccine in the Dutch adult population was 84%. Ecological studies indicated lower uptake in certain population groups. We aimed to investigate determinants of COVID-19 vaccine uptake in the Netherlands at individual level to evaluate and optimize implementation of the vaccination programme and generate hypotheses for research on drivers and barriers of vaccination.

Methods
A retrospective database study was performed including the entire Dutch population &gt;18 years. Vaccination data (5 January 2021-18 November 2021) were at individual level linked to sociodemographic data. Voting proportions for political parties were added at neighbourhood level. Random forest analyses ranked sociodemographic determinants of COVID-19 vaccine uptake.

Results
The most important determinant for COVID-19 vaccine uptake was age; uptake increased until the age of 80 (67% in 18-35 years, 92% in 67-79 years and 88% in those &gt;80). Personal income and socioeconomic position ranked second and third, followed by migration status. Uptake was lower in individuals in the lowest income group (69%), receiving social benefits (56%), and individuals with two parents born abroad (59%).

Conclusions
Our finding that age is the most important determinant for uptake likely reflects the prioritisation of elderly in the programme and the general understanding of their increased vulnerability. However, our findings also reveal important other disparities in vaccine uptake. Lower uptake was found in individuals with lower income, lower socioeconomic status and a migration background. How to best address these inequalities for future vaccination campaigns requires further research.

Key messages
• COVID-19 vaccination likely contributed to increasing health inequity in the Netherlands.
• Targeting vaccination efforts towards elderly aiming to maximise the impact of vaccination in reducing the burden of COVID-19 seems to be effective.
Incidence and cost of COVID-19-related work absence based on social insurance data from Poland
Authors: Łyszczarz B 
Published: October 2023

Abstract

Background
COVID-19 pandemic and public health measures aimed at limiting the spread of the disease caused widespread work absence. This research aimed to identify the incidence of COVID-19-related short-term work absence and to estimate the cost associated with this absence.

Methods
The study used quarterly (Q) social insurance data from Poland (2020-2022). COVID-19-related absence was identified with four ICD-10 classification diagnoses: COVID-19; personal history of COVID-19; post-COVID-19 condition; and multisystem inflammatory syndrome associated with COVID-19. To identify work absence, the study relied on real-life, disease-specific data on the number of absence days from the Social Insurance Institution. Additionally, excess caregiving resulting from the pandemic was estimated based on all-cause caregiving days. To estimate the cost of work absence, the study relied on the human capital method.

Results
There were 15.2 million absence days resulting from four COVID-19-related diagnoses (2.1% of total all-cause absence days). Of these, COVID-19 caused 12.2 million absence days, followed by post-COVID-19 condition (2.9 million). Excess caregiving was a dominant pandemic-related work absence category, with 37.7 million work days lost. COVID-19 absence was concentrated in Q4-2020 and high in Q1-2021 and Q3-2022. On the other hand, the incidence of the remaining three diagnoses was the highest in Q1-2022. The total indirect cost of work absence was €4.3 billion, and 69.2% of this loss resulted from excess caregiving. For this cost category, 79.1% of costs were borne in Q2- and Q3-2020 when severe lockdowns were imposed.

Conclusions
The estimates show that COVID-19-related short-term absenteeism was a significant public health burden and translated to severe economic losses. The economic loss from caregiving resulted in more burden than the COVID-19 health-related absence.

Key messages
• There were 52.9 million work absence days from the COVID-19 pandemic in Poland until the end of 2022, resulting in an indirect cost of €4.3 billion.
• Most (∼70%) of the pandemic work absence and its cost resulted from caregiving responsibilities, which applied to care for the sick and children unable to attend educational facilities.
Beneficiaries of Temporary Protection (BOTPs) in Mid-West, Ireland: a retrospective analysis
Authors: McNamara R , Rushe E , Evans L , Niranjan V , Barnes M , O'Donnell P , Tobin M , Beatty K , Walsh F , Dee A 
Published: October 2023

Abstract

Since the outbreak of war in Ukraine, over 78,000 migrants have come to Ireland seeking protection. It is necessary to capture their demographics, to understand their immediate health concerns and to identify their additional service requirements to ensure that this cohort can continue to shelter healthily in Ireland. A retrospective cohort analysis was carried out on Health Needs Assessments (HNAs) undertaken for BOTPs in congregated settings. Date of entry to Ireland was captured on 1820 HNA forms returned to the Department of Public Health Mid-West Area E. Patterns in the demographics and the health service utilisation of arrivals, over the first year of conflict, were analysed. Participants were grouped by arrival date, Cohort 1 (24/02/22-20/09/22) (n = 1130) and Cohort 2 (21/09/22-03/03/23) (n = 690). The proportion of male adult arrivals increased from 32% in Cohort 1 to 36% in Cohort 2 and the proportion of older adults (&gt;65 yrs) increased by 40% in Cohort 2. The respondents that reported being pregnant increased from 0.5% of females (aged &gt;14) in Cohort 1 (n = 3) to 2.9% in Cohort 2 (n = 9). Cohort 2 reported lower uptake of COVID-19 vaccines, with 30% self-reporting as doubly vaccinated, compared with 44% of Cohort 1 (p &lt; 0.01). There were no significant differences in child immunisation rates between Cohort 1 + 2. Chronic disease status in both cohorts were consistent, with some exceptions. Statistically significant differences were noted (p &lt; 0.01) across different age groups for some chronic diseases, including heart disease and Diabetes Type 2. Differences in age and sex distributions between Cohort 1 and Cohort 2 will impact on the utilisation of health services. Higher rates of pregnancy may impact on primary care and maternity services. Low rates of child immunisation have resulted in the roll-out of a targeted catch-up vaccination programme for those aged 0-23 years. Predicting HNA trends will help to re-orient health services to meet the needs of these groups.

Key messages
• Differences in age and sex distributions between early (Cohort 1) and late (Cohort 2) arrivals will impact the utilisation of health services and must be accounted for when planning local services.
• Predicting trends of chronic disease and health needs has enabled local health service teams to carry out targeted interventions to ameliorate health and health service access for these groups.
Associations between retail food environment and organic food purchases in French households
Authors: Mejean C , Rollet P , Recchia D , Vonthron S , Perrin C , Somaraki M , Bricas N , Pérignon M , Charreire H 
Published: October 2023

Abstract

Background
The aim of our study was to assess the associations between organic food purchases of French households and their exposure to food outlets that sell organic foods, including organic food stores (selling only organic products) and standard food outlets, independently from households’ characteristics.

Methods
This cross-sectional study included 462 households from a quota sampling survey conducted in France. Share of expenditures for organic foods over a one-month period was assessed using food supply diaries and grocery receipts. The objective retail food environment (RFE) was assessed around the home and in activity space (AS) (i.e. areas around places of main activity and commuting journeys) using geographic information systems. Associations between RFE indicators and organic food purchases were assessed using multinomial logistic regression models, adjusted for households’ characteristics.

Results
Households exposed to organic food outlets around their home (OR presence vs. absence [95% CI]=2.27 [1.33; 3.89]) had higher expenses in organic foods. Households exposed to organic food outlets in their AS were also more likely to have medium (OR ≥ 3 organic food outlets vs. absence [95% CI]=2.52 [1.34;4.76]) or high organic food purchases (OR [95% CI]=1.90 [1.04;3.47]). The models that included different types of organic food stores confirmed the first ones: households who were exposed to organic specialized food stores (greengrocers, bakeries and butcher's stores) around home and in their AS were more likely to have medium or high organic food purchases. In addition, the distance to the nearest organic grocery food store was inversely associated with high expenses in organic foods (OR [95% CI]=0.57 [0.41; 0.80]).

Conclusions
These results suggest exposure to organic food outlets and their use are related, providing knowledge for cities’ commercial planning with the aim of promoting spatial access to organic food for their inhabitants.

Key messages
• Exposure to organic food outlets and their use are related.
• Food environment may influence consumers’ grocery shopping behaviors.
Ultra-processed food consumption, nutrition quality, and obesity prevalence in Israel
Authors: Keinan Boker L , Shimony T , Shahar D R 
Published: October 2023

Abstract

Obesity is associated with chronic disease and burdens individuals and health systems heavily. Obesity prevalence has increased globally in recent decades. Concurrently, consumption of natural and home-prepared foods has decreased while that of industrial and ultra-processed foods (UPFs) that may play a role in obesity etiology, has increased. Our aim was to assess the extent of UPF consumption, nutrition quality and obesity prevalence in Israel, using data from a cross-sectional National Health and Nutrition survey conducted in 2014-16 on a representative sample of 25-64Y individuals who were face-to-face interviewed and anthropometrically measured. Participants reported 24h dietary intake. Consumed foods were coded into 4 groups based on the NOVA method which classifies foods by their level of processing, from unprocessed foods to UPFs. Obesity prevalence was determined by body mass index (≥30Kg/m2), relative fat mass and waist circumference. Univariable and multivariable logistic regression models adjusted for potential confounders were used to assess associations between UPFs consumption and obesity prevalence. In 2,563 participants (mean age=42.2±11.1Y, 46.8% males), average UPFs consumption was 34.5% of total energy intake. Highest quartile of UPFs consumption was associated with younger age (p = 0.0015), lower physical activity (p &lt; 0.001) and current smoking (p = 0.0162). High consumption of UPFs was significantly associated with higher intake of energy, carbohydrates, saturated fat, and thiamin, and lower intake of protein, monounsaturated fatty acids, dietary fiber, folic acid, vitamin B12, Vitamin C, zinc and total fats. No association was found between UPFs consumption and obesity prevalence. In conclusion, high consumption of UPFs is associated with higher likeliness of unhealthy behaviors and lower nutrition quality in 25-64Y Israeli individuals. No association was found between UPFs consumption and obesity prevalence.

Key messages
• Consumption of ultra-processed foods is associated with lower nutrition quality.
• Consumption of ultra-processed foods was not associated with obesity prevalence.
Bacillus Cereus prevalence in human milk donations in a North Italy human milk bank
Authors: Abdul M E , Magagna G , Todeschi S , Finazzi G , Filipello V , Rossi F , Risso F M , Pezzotti E , Dioni E , Losio M N 
Published: October 2023

Abstract

Background
The importance of human milk in infants’ diets is well-known in the medical community. Unfortunately, breastfeeding isn't always possible for various reasons, human milk donation represents the main solution to this problem. The donated milk goes through a pasteurization treatment (62.5 °C for 30 minutes). Before consumption, the milk is tested to analyze the microbiological safety aspect, specifically: the protocol of a North Italian bank, provides for the total count of microorganisms and of Bacillus Cereus. The presence of B. Cereus in pasteurized milk samples has been witnessed in the last few years. B. Cereus infections in infants have consistently been reported and banked human milk could be one of the possible sources. This work aims to study the prevalence of B. Cereus in banked human milk sampled before and after pasteurization treatment.

Methods
Between 2020 and 2023 we tested 1055 samples, before and after the pasteurization treatment. The enumeration of B. cereus is performed in accordance with ISO 7932:2004. 100 µL of pure raw milk and two consecutive decimal dilutions in buffered peptone water were seeded on Bacillus cereus Agar (BCA) at 30° for 24h-48h. B. Cereus strains isolated were typed using the hemolysis test and BCA.

Results
We found 46 samples positives for B. Cereus from 1055 samples analyzed before the heat treatment. The number increased to 57 in the pasteurized samples. These data are confirmed by the typing of the isolated strains from the human milk.

Conclusions
The 4% of not pasteurized milk is discarded due to B. Cereus presence, and the rate increase to 5% in pasteurized milk. This information suggests that the heat treatment isn't capable to inhibit all the B. Cereus, and the increase of B. Cereus from not pasteurized to pasteurized need to be studied.

Key messages
• B. Cereus represents one of the main causes of noncompliance in banked human milk.
• Implementation of preventive/corrective actions is needed to prevent the contaminations led by the operators.
Key Performance Indicators in the Emergency Medical System: barriers and facilitators
Authors: Licata S , Valent F , Deroma L 
Published: October 2023

Abstract

Background
Within the EASY-NET research program (NET-2016-02364191), we developed and calculated a set of KPIs on time dependent conditions (trauma, acute myocardial infarction, stroke) to analyse the Emergency Medical System (EMS) of the Friuli Venezia Giulia Region (FVG, 1.2M inhabitants), Italy. The results were returned to health professionals by three annual written reports, a webinar, and a workshop (2019-2023). We aim to describe the major barriers and facilitators to the implementation, use and acceptance of those KPIs in FVG.

Methods
Barriers and facilitators were investigated in 2020 through an online survey (5 questions on the report's clarity, quality, and relevance) e-mailed to doctors and ward managers (Cardiology, Neurology, Intensive Care, Emergency Department) and in 2023 through a debriefing within the research team.

Results
The geographical reorganisation of the regional health service and the succession of different political and professional representatives were important barriers, which also made it difficult to have access to raw data. Moreover, metadata were rarely available and several changes in variable coding occurred. In addition, the KPI results were difficult to convey to professionals, especially with a text-only feedback (457 e-mails sent, 71 surveys completed; 21/71 knew the report, 4 had read it). On the other hand, since these were the first KPIs to be calculated on the EMS, professionals collaborated enthusiastically and found them useful (60/71 of the survey responders), the multimodal presentation being the most effective feedback (40 webinar users, 100 workshop participants, despite the pandemic). Last but not least, dealing with data was easier thanks to the unofficial help of former colleagues.

Conclusions
The implementation, use and acceptance of the KPIs are driven by close collaborations, but may be hindered by organisational rearrangements and a difficult access to raw data, especially when metadata are lacking.

Key messages
• KPIs are well accepted by the EMS professionals, although they are difficult to implement and introduce when political and organisational rearrangements take place.
• A difficult access to raw data and the lack of metadata hinder the KPIs’ calculation but close collaborations among data professionals are precious to overcome the problem.
Environmental sustainability and healthiness of nursing homes meals: an exploratory study from Italy
Authors: Conti A , Binala J G , Cortese L , Opizzi A , Gigante D , Barone-Adesi F , Panella M 
Published: October 2023

Abstract

Background
The food sector is responsible for more than the 30% of the total greenhouse gases emissions (GHGE), one of the leading causes of global warming. The adoption of healthy and sustainable food models has been identified as one of the possible effective interventions to face this challenge. In this regard, the healthcare sector's food chain is underinvestigated, with a lack of a global and comprehensive approach. Specifically, no research has been conducted yet in nursing homes. The aim of our study is to evaluate the environmental impact of the menu among residents of an Italian 130-beds nursing home, and to assess their adherence to the Planetary Health Diet (PHD), a dietary framework conceived by the EAT-Lancet Commission aimed to promote both human and environmental health.

Methods
We assessed a random sample of 20,000 combinations of servings. For each of them we estimated the Carbon Foodprint (CF) and the adherence to PHD using the life cycle assessment methodology and the Modified EAT-Lancet Diet Score, respectively. Threshold was set to 2.027 KgCO2eq/day for CF and to 23 for PHD adherence. Afterwards, we evaluated the composition of the menus and estimated the CF of each day with relative permutations given by the possibility of the different choices of dishes.

Results
We found a substantial variability of both CF and PHD adherence among permutations, with only a small proportion of them reaching the benchmarks. Furthermore, we found a negative association between CF and PHD adherence, with healthier menus generating less CO2eq emissions.

Conclusions
To our knowledge, this is the first study specifically assessing the environmental impact of food in a nursing home. The observed variability suggests the possibility of improving the proposed menus, with a potential beneficial impact on both human and environmental health. Further studies are needed, to deeply explore the current situation and the strategies for improvements on this topic.

Key messages
• Despite the relevance of the topic, this is the first study assessing both the environmental and health aspects of meals served in a nursing home.
• We found that healthier servings had a lower environmental impact, suggesting the possibility to improve menus with a beneficial impact for both human and environmental health.
Translating risk-benefit assessment evidence for policy making: outcomes of an international workshop
Authors: De Matteu Monteiro C , Membré J M , Thomsen S T , Monteiro Pires S 
Published: October 2023

Abstract

Background
Transitioning to sustainable, healthy, and inclusive food systems requires a multi-domain risk analysis approach. Integrated methods, such as health risk-benefit assessment (RBA), can support the formulation of coherent regulations by providing comparative information on potential trade-offs within the areas of food safety and nutrition. Despite extensive scientific developments and applications, RBAs have not yet been fully adopted by regulatory bodies. Hence, participatory science is needed to identify obstacles for implementation and communication of RBAs to optimize and ensure that generated evidence is compatible to regulatory needs.

Methods
As part of the EU funded project HOLiFOOD, an international workshop held in May 2023 brought together food regulators and other stakeholders from across Europe to identify bottlenecks in the use of RBA outputs in decision-making. The meeting included a key-note presentation, surveys, and group discussions.

Results
Thirty-seven participants from 19 institutions based in 13 countries attended the workshop. Obstacles identified were classified into one of the following themes: challenges of using RBAs to inform policymaking, opportunities and needs (e.g., reliability of methods), and communication of RBA outputs. Case studies targeting various foods groups or diets in different contexts is recommended.

Conclusions
Health RBA is a multidisciplinary method useful for prioritizing actions and ensuring transparency in decision-making. Case studies addressing the identified obstacles could increase the reliability of RBA methods and favour the adoption by regulatory bodies. Finally, moving towards holistic approaches may require further cross-departmental collaboration and, potentially, organizational changes of authorities in the future.

Key messages
• Risk-benefit assessment of foods is a robust tool to support public health policymaking.
• Engagement with risk managers and other stakeholders is essential to deliver, and effectively translate, fit-for-purpose scientific evidence.