bluuebunny/crossref_metadata_2025_split huggingface dataset:
Older family caregivers’ inadequate diet and social and health inequalities
Authors: Savela R M , Nykänen I , Koponen S , Suominen A L , Schwab U , Välimäki T 
Published: October 2023

Abstract

Background
Family caregivers may experience financial vulnerabilities due to their caregiving role, affecting their ability to afford appropriate food and ensure optimal nutrient intake. Therefore, this cross-sectional study aimed to assess the extent to which there are diet-related disparities among older family caregivers.

Methods
We included 125 family caregivers from Eastern Finland (mean age 74 y). Data on family caregivers’ health, nutritional status, and sociodemographic factors were collected at their households between June 2019 and December 2019. First, we assessed the sociodemographic factors associated with family caregivers’ inadequate diet. Then, we evaluated diet-related health disparities. The associations and predictors of diet-related disparities were assessed using the independent samples t-test, χ2-test, and binary logistic regression.

Results
The preliminary results show that family caregivers experiencing subjective poverty were less likely to consume two or more portions of fruit and vegetables per day (odds ratio = 0.11; 95% confidence interval 0.02-0.72; p = 0.021) and were more likely to be overweight. Furthermore, family caregivers’ inadequate diet (i.e., lack of daily fruit and vegetables and risk of malnutrition) was further associated with several health conditions, including comorbidity, depression, diabetes (type I and II), and osteoporosis.

Conclusions
Family caregivers have diet-related disparities, which may further lead to health inequalities. Family caregivers’ diet-related disparities require increasing attention in healthcare. Thus, addressing family caregivers’ food insecurity risk could enhance their health equity.

Key messages
• Older family caregivers’ inadequate diet is associated with social and health inequalities.
• We must assess the root causes of diet-related disparities among older family caregivers and the broad consequences to find solutions to narrow the inequalities.
Saxitoxin hazard! Detection of toxic algae in molluscs breeding areas in North-Western Adriatic Sea
Authors: Ragni L , Arnaboldi S , Cangini M , Guerrini F , Pistocchi R , Pezzolesi L , Penna A , Rubini S , Losio M N , Bertasi B 
Published: October 2023

Abstract

Background
Saxitoxin (SXT) can cause the paralytic shellfish poisoning (PSP) with severe impacts on both human health and marine ecosystems. Dinoflagellates are the major marine producers of STX and other variety of secondary toxic metabolites that can gather in molluscs becoming a risk for consumers’ poisoning. The aim of this work was to investigate the presence of the main algal species producing SXT in an area intended for molluscs breeding.

Methods
During 2020-2023, 40 seawater samples were collected from two macro-areas in the Adriatic Sea (North-Western) at different distances from the coast. After water filtration, DNA was extracted (DNeasy PLANT Mini Kit) and analysed with Real Time PCR for Alexandrium minutum and Gymnodinium catenatum detection. The possible ability to produce SXT was confirmed by sxt4A gene detection. Molecular results were compared with the microscopy gold-standard method.

Results
A. minutum was detected in 62.5% (CI 95% 0.47-0.75) of the samples, with 84% (CI 95% 0.65-0.94) of them possibly producing SXT. G. catenatum was found in 95% (CI 95% 0.83-0.99) of samples, with 73.7% (CI 95% 0.58-0.85) of them presenting STX gene. By microscopy, only Alexandrium spp. were identified without successful species identification. No other saxitoxin-producing genera or species were observed.

Conclusions
Our results underlined that A. minutum and G. catenatum can play an important role in the production of SXT, confirming their harmful presence in the areas intended for molluscs breeding. Microscopic identification can lead to an underestimation of the presence of potentially toxic algal species, stressing the relevance of improving molecular tools also in this field. These findings highlighted the importance of reporting and monitoring toxic algae presence, given the saxitoxin impact for food safety, and its significance for public health.

Key messages
• Saxitoxin-producing algae detection through molecular methods in molluscs breeding areas may represent an early warning useful to improve food safety and human health.
• Harmful algal monitoring can improve water management in a One Health perspective.
Risk assessment of exposure to multiple mycotoxins in the Icelandic population
Authors: Durão J , Eiríksdóttir A V , Halldórsson ÞI , Ólafsdóttir K , Twarużek M , Kosicki R , Viegas C , Assunção R , Viegas S , Martins C 
Published: October 2023

Abstract

Background
The proliferation of mycotoxin-producing fungi in agricultural settings poses a challenge for human health and nutrition around the world. Mycotoxins contaminate food sources and their negative health outcomes include carcinogenic, nephrotoxic and teratogenic effects. Potential risks are still poorly characterized and few studies assess exposure at an individual level. Thus, the goal of this study was to assess and characterize exposure risk to multiple mycotoxins in the Icelandic population.

Methods
Urine samples and data on urinary mycotoxins’ biomarkers (deoxynivalenol, zearalenone and ochratoxin A) from a pool of 171 individuals living in Iceland between 2020 and 2021 were used to estimate external doses through reverse dosimetry. For risk characterization, Hazard Quotient (HQ) and Margin of Exposure (MoE) approaches were applied for deoxynivalenol and zearalenone, and ochratoxin A, respectively.

Results
The Icelandic population was revealed to be exposed to multiple mycotoxins. Mean levels of deoxynivalenol and ochratoxin A were comparable to what have been reported in other European studies, while levels of zearalenone were considerably lower. Nevertheless, risk assessment revealed safe levels of exposure to deoxynivalenol and zearalenone (HQ &lt; 1) but MoE based on a neoplastic endpoint to ochratoxin A indicated a possible health concern for all participants (MoE &lt; 10000).

Conclusions
Although there are some uncertainties associated with a human biomonitoring approach, the results of this study confirm that mycotoxins are a growing threat to public health in the European continent. Since countries with different latitudes already present comparable levels of exposure, this is especially concerning in a climate change scenario. Further studies both on exposure assessment and specific effects on human health are required to accurately assess risk and introduce preventive measures.

Key messages
• The human exposome of the Icelandic population includes a mixture of mycotoxins.
• Risk assessment shows that mycotoxins pose a growing public health challenge in the European continent.
Collaboration between the National Institute of Health Somalia and the Public Health Agency of Sweden
Authors: Ahrne M 
Published: October 2023

Abstract

Public Health Agency Sweden (PHAS) has been funded by Sida to provide support and assist in capacity building of the National Institute of Health (NIH) Somalia for six years (2019-2025). The PHAS work closely with the Federal Ministry of Health Somalia, Member States and partners like WHO Somalia, Africa CDC and academic institutions to establish NIHS as an institution that can be sustained and grow over time, and that can contribute to the public health and health system infrastructure of Somalia. Main areas of collaboration 2019-2023 have been technical support to the joint taskforce on Integrated Disease Surveillance and Response (IDSR); supporting basic level field epidemiology training to front line health care workers; organizing workshops in data analyses, visualisation and reporting together with SPIDER/Stockholm University and Statistics Sweden. Building research capacity has included organizing a digital workshop: Reconstructing public health institutions in Somalia at the16th World Congress on Public Health 2020, Rome, Italy and support to the 1st NIH Research Conference 30 January - 1 February 2022 in Garowe, Puntland: “Laying the Foundation for Health Research in Somalia”. The hybrid conference attracted more than 180 participants from different universities. The tentative plan for the remaining project period include recruiting two Somali-speaking public health experts to develop the human resources and institutional capacities in order for NIH to become a centre of excellence for public health in Somalia. The main focus area for the remaining project period is supporting the development of the disease surveillance system including methods for analysis and reporting data. Research capacity workshops will be organized and supported, as well as a 2nd NIH Research Conference in 2024. Another important task is resource mobilization for long-term sustainability and coordination with other stakeholders.

Key messages
• Supporting the development of the disease surveillance system including analytical skills and reporting of data is key.
• Coordination with other stakeholders and resource mobilization for long-term sustainability is essential.
Exploring avoidable, preventable, treatable mortality trends and effect factors by income level
Authors: Yang H S , SY Kim  , JH Park  
Published: October 2023

Abstract

Background
Avoidable mortality (AM) mean death caused by insufficient health policy and health care intervention, and is a rising public health issue. Income polarization in healthcare utilization is a significant concern. The aim of this study was to derive the trend and effect factors of AM, treatable mortality (TM), preventable mortality (PM) according to income levels in South Korea over the period 2008-2017.

Methods
This serial cross-sectional analysis was conducted using national health information data from 2008 to 2017. AM was classified based on criteria presented by the Office for National Statistics in 2011. Age-standardized AM was analyzed annually according to income levels. The odds ratio of AM was examined using multivariable logistic regression after adjusting health behaviors and clinical variables collected in 2016-2017.

Results
There were persistent income inequalities in AM, and the degree of inequality was larger in PM than in TM throughout the period. Medical benefit recipients had an AM of about 8.5 times higher than the highest income quartiles, and men were three times higher than women. In 2016-2017, compared to the highest income quartile, the risk of TM and PM of medical benefit recipients was about 10 times higher and 1.5 times higher in the first quintile. The risk of AM remained significantly higher in low-income levels even after adjusting for health behaviors and clinical variables.

Conclusions
While AM in South Korea has decreased over time, it remains high in low-income levels. There was a statistically significant difference in AM based on income level. Therefore, inclusion in health policy and services development and in health promotion programs is urgently required to address avoidable deaths and health inequalities for low-income levels.

Key messages
• AM in South Korea have declined over time, but, compared to the highest income quartile, the risk of TM and PM of medical benefit recipients was about 10 times higher.
• Among health insurance eligible people, the first quintile, the more the proportion of TM and PM, and the highest income quartile, the lower the proportion of non-avoidable deaths.
The use of social media in the self-management of chronic diseases: views of patients and doctors
Authors: Dudina V , Judina D 
Published: October 2023

Abstract

Background
Despite the deep integration of social media into daily self-management practices of people living with chronic conditions, there are still conflicting opinions about the role of social media in disease self-management. Comparing the perspectives of patients and physicians is useful in understanding potential tensions and facilitating more effective collaboration between patients and physicians. The aim of the research was to find out the opinions of patients and doctors about the benefits and risks of using social media for disease self-management.

Methods
We used mixed methods convergent parallel design combined an internet survey and in-depth interviewing. We collected data from online questionnaire posted in online communities for people with chronic diseases on social media platforms Vkontakte and Facebook (N 204). The qualitative phase used in-depth interviews with doctors (N 23). We analyzed quantitative data in SPSS and qualitative data in Nvivo.

Results
From the perspective of patients, the main benefits include access to information about treatment through peer-to-peer expertise (70,8%) and sharing personal experience of disease (60,9 %). Patients indicated risks of unproved information (92,2%) and breach of anonymity (71,5%). All interviewed doctors were skeptical about benefits of the use of social media by patients. They see the main risks in the dissemination of unreliable and unqualified information about treatment and the destruction of the usual patterns of doctor-patient relationship.

Conclusions
There are contradictions between views of patients and doctors on benefits and risks of using social media in disease self-management. Doctors underestimate the role of social media in chronic diseases self-management and doubt in ability of patients to critically evaluate information.

Key messages
• Understanding differences in viewpoints can help improve doctor-patient relationships in an eHealth environment.
• Resalts promotes patient empowerment. Research was supported by RSF (project No 22-18-00261).
Value-based care models for chronic hepatitis B and C among vulnerable populations: a scoping review
Authors: Adduci A , de Mattia E , Paoletti F , D'Agostino M , Salerno P , Farina S , Boccia S , de Belvis A G 
Published: October 2023

Abstract

Background
Chronic viral hepatitis B and C are a significant public health burden worldwide. The prevalence of these infections is much higher among migrants than in the general population, due to factors such as inadequate access to healthcare. The EU VH-COMSAVAC project aims to implement community-based HBV/HCV models of care among migrant populations with documented high HBV/HCV incidence and prevalence, using person-centred referral processes. Our study aims to provide an overview of the scientific evidence on value-based models of care for prevention, treatment and linkage-to-care in high-risk groups.

Methods
This scoping review was performed in the context of the EU VH-COMSAVAC project, following the PRISMA-ScR Checklist, by searching on 5 databases: Medline, EMBASE, GlobalHealth, Scopus and Web of Science. Articles published up to December 2020 investigating models of care targeting migrant populations and related to HBV/HCV prevention, treatment and linkage-to-care, were included.

Results
Out of a total of 2,767 articles screened, 83 were included and preliminarly categorized according to stages of care (prevention, treatment and linkage-to-care) and Bodenheimer’ pillars. Further investigation will be conducted concerning the dimensions of patient experience; utilized resources; population health; care-team well-being.

Conclusions
Implementing patient-centered care models for critical public health issues among specific populations is becoming incresingly relevant. This study will provide the conceptual basis for building a value-based assessment tool capable of evaluating new models of care for prevention, treatment and linkage-to-care for hepatitis B/ C in high-risk groups.

Key messages
• In order to reach viral hepatitis elimination targets, initiatives must pay particular attention to high-risk groups.
• The value (population health, patient experience, care-team wellbeing and costs) of such care strategies should be assessed to contribute to their continuity.
Mapping activities on climate and health to the essential public health operations (EPHO)
Authors: McGurnaghan P , O'Donovan D 
Published: October 2023

Abstract

Issue/problem
Variation exists in the degree to which public health organisations are taking action on climate change and health. However, all countries must effectively and rapidly operationalise climate and health strategy in order to protect national and global population health. Among the challenges, public health systems can have difficulty in conceiving practical ways of taking action.

Description of the problem
Our objective was to develop a resource to support public health organisations in identifying how they can begin to address the issue of climate change and health. It was important for the resource to be balanced in terms of providing tangible examples whilst being sufficiently high level so as to enable translation to different contexts. The method involved using the World Health Organization's essential public health operations (EPHOs) as a framework upon which to describe suggested actions on climate change and health. A collection of expert reports on climate and health were selected and each of the ten EPHOs were cross-referenced against these.

Results
The results are illustrated in a spider diagram in which examples of public health activities are written around the ten standard icons of the EPHOs, and shown connected to these by adjoining and interconnected lines. The visual nature of the diagram is planned to assist the user in more readily appreciating the relevance of climate and health activities in the wider context of the conventional public health agenda.

Lessons
To our knowledge, potential climate change and health activities have not been mapped to the EPHOs before. Users are encouraged to adapt the diagram as a living document in their own organisations and to update it iteratively, as well as in the light of new published expert recommendations on climate and health. Since the model is based on the WHO EPHOs and contains only high level examples, it is hoped it could prove relevant across settings and countries.

Key messages
• Based on published recommendations, we mapped high level activities on climate change and health to the World Health Organization’s essential public health operations (EPHO).
• Since the model is based on the EPHOs, it is hoped it could prove relevant across settings and countries, and help to address barriers to public health action on climate and health.
Healthy ageing in a gentrified city: perspectives of older adults from Porto
Authors: Santos C J , Silva J P , Torres E , Barros H , Ribeiro A I 
Published: October 2023

Abstract

Background
Neighbourhood transformations like gentrification can affect health outcomes. Gentrification is understood as a set of processes of sociospatial change driven by investments in the built environment oriented to the preferences of affluent people. However, little is known about the impact of gentrification on older adults. We aimed to understand how older people perceive gentrification how it relates to healthy ageing.

Methods
This qualitative study, conducted in 2022, was based on nineteen semi-structured interviews of older adults (≥60 years) from the EPIPorto cohort living in Porto, a hotspot of gentrification. Individuals were selected through purposive sampling based on four features: sex, education, homeownership, and area of residence. Inductive thematic analysis was performed using NVivo.

Results
Most respondents identified changes in the physical environment and how it is used due to gentrification, namely concerning green and leisure spaces, food and beverages outlets, housing and commerce. It was also mentioned that gentrification leads to a shortage of affordable housing and weakens social cohesion. Participants described that changes in the physical environment due to gentrification can contribute positively to their well-being, while others admitted a higher cost of living and increased vulnerability to worse mental health. Yet, some interviewees revealed little or no influence of gentrification on healthy ageing.

Conclusions
Gentrification has dual and disparate effects on older adult's health and well-being. Policies should maximize the health benefits of gentrification, while protecting citizens from the negative effects.

Key messages
• Considering people’s perspectives on gentrification and healthy ageing is essential to plan age-friendly cities and achieving better health outcomes.
The obesogenic environment and incident cardiovascular disease in The Maastricht Study
Authors: Chan J A , Bosma H , Schram M T , Stehouwer CDA , Lakerveld J , Koster A 
Published: October 2023

Abstract

Background
The built environment has been identified as an upstream determinant of cardiovascular disease (CVD) in which neighborhood walkability and healthy food environments may promote increased physical activity and healthier dietary intake. Our aim is to determine if these neighborhood environments are associated with decreased incidence.

Methods
Data from 6,563 participants of The Maastricht Study and Geoscience and Health Cohort Consortium between the ages of 40-75 without history of CVD were analyzed. Objective walkability was measured by the 7-component Dutch Walkability Index while the food environment was an aggregate score of available food outlets, within 1000m Euclidian buffers around residential addresses of participants. Perceived walkability was obtained from the Abbreviated Neighborhood Environment Walkability Scale. Incident CVD was obtained from a follow-up questionnaire. A Cox regression analysis was performed with CVD morbidity time to event outcomes adjusting for demographic and socioeconomic covariates.

Results
Over a median follow-up of 7.2 years (1.0-12.0 years), 975 cases were reported. The most walkable neighborhoods were not associated with incident CVD for both perceived (HR: .80; 95% CI = .64, 1.00) and objective (HR: 1.14; 95% CI = .91, 1.43) neighborhood environment measures compared to those living in the least walkable neighborhoods. When considering individual CVD conditions, participants had statistically significant lower incidence of peripheral vascular disease in the highest perceived walkable neighborhoods (HR: .57; 95% CI = .41, .78). The healthiest food environments (HR: .84; 95% CI = .66, 1.06) were not related to incident CVD.

Conclusions
Objectively measured walkability and neighborhood food environment were not associated with overall incident CVD with participants in our study. We found perceived neighborhood walkability to be associated with lower incident peripheral vascular disease.

Key messages
• Research on the obesogenic environment should additionally be carried out in other regions to gain additional understanding of its effect on cardiovascular disease.
• Further study on the impact of walkable environments on individuals with peripheral vascular disease should be considered to understand its effect with this population.