bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disability risks in past populations: Sweden from the 1800s until 1959
Authors: Vikström L , Junkka J , Lundevaller E Häggström 
Published: October 2022

Abstract

Background
While diseases in contemporary and past populations are thoroughly studied, the knowledge about disability and the risks of getting it is poor. Like diseases, disabilities increase with growing age affecting primarily elderly groups. Whether this notion holds historically and for other groups at risk for disability and differences over time is not known. This study estimates the disability risks in Swedish populations c. 1800-1959 by age, sex and disability type (sensory, physical, mental).

Methods
We use data on two historical populations in the 1800s (N = 36,500; 550 with disability) and 1900-1959 (N = 194,500; 4,700 with disability) drawn from digitized parish registers reporting socio-economic and demographic characteristics over lifetime and on disabilities. Cox proportional regressions estimate disability risks across time by group (age, sex, disability type).

Results
Our preliminary results based on unadjusted estimates from 1900-1959 suggest that the disability risks doubled or more. In the 1950s, women had 2.6 times higher risk than 50 years before, while it was 2.0 for men. The major rise started in the 1930s (Men 1.51; Women: 1.67), and grew in the 1940s (Men 1.80; Women: 2.14). Next, we will assess these risks by group and in the 1800s.

Conclusions
From 1900-1959, Swedish populations experienced consistently higher disability risks, which doubled for men and almost tripled for women. These risks increased while improvements in public health and economic growth would subsequently make Sweden internationally known as a modern welfare state. That health improvements did not reduce the disability risks but the reverse, was possibly due to higher recognition or labeling of disabilities.

Key messages
Medical studentś needs for an integration of climate change into the medical curriculum
Authors: Rybol L , Amelung D , Nieder J , Hachad H , Depoux A , Sauerborn R , Herrmann A 
Published: October 2022

Abstract

Background
The impacts of climate change (CC) on health comprise increased human morbidity and mortality. Consequently, physicians need to be systematically trained to address CC in their professional life. Due to lacking research on educational needs of medical students, we developed a survey instrument to assess studentś attitudinal and knowledge-based needs for the integration of CC into medical curricula and their readiness to learn.

Methods
Our survey was administered online to 788 students at the Medical Faculty of Heidelberg University between 06/2021 and 02/2022. Data analyses included descriptive statistics, reliability analyses as well as regression modeling with regard to readiness to learn.

Results
214 students participated in the survey, 170 fully completed datasets were included in the analysis. A majority of students (72.35%) (strongly) agreed that doctors carry a responsibility to address CC in their work setting, while only 4.71% (strongly) agreed, that their current medical training had imparted them with enough skill to do so. Students showed both considerable knowledge and interest in the area of CC, its health impacts, vulnerabilities and clinical adaptation (70.09% correct answers). Knowledge gaps were identified in the areas of health co-benefits and sustainable healthcare (55.53% and 16.71% of correct answers). 79.42% of students want to learn about CC through the integration into existing mandatory courses.

Conclusions
Results encourage the integration of CC topics with a focus on knowledge and professional role development into existing mandatory courses of the medical curriculum. Specifically, they also pinpoint health impacts and adaptation as greatest areas of interest for students and at health co-benefits and sustainable healthcare as areas with least prior knowledge.

Key messages
Results of a Qualitative Study on Disaster Nursing in a Coastal Region of Lower Saxony/Germany
Authors: Koppelin F , Palm D , Illiger K 
Published: October 2022

Abstract

The increase in heavy rainfall in recent years shows the need to consider disaster preparedness also for persons in need of assistance and care who are cared for at home or in old people's and nursing homes. Evacuation concepts in the event of a heavy rainfall event lasting several days with simultaneous power failure are hardly available for the vulnerable group so far. As part of the LifeGRID project funded by the Federal Ministry of Education and Research, the question is being investigated as to what regional challenges and requirements arise in the event of flooding and a prolonged power blackout in the Wesermarsch district. In addition, the question will be addressed as to how the current care situation of patients referred to electricity presents itself in such a situation. Within the framework of a qualitative design, expert interviews were conducted with care service managers in winter 2022. The four guided interviews were transcribed and their content analysed. In coping with the assumed catastrophic events, the interviewees see problem areas in the organisation, communication, form of care and target group, in addition to the regional characteristics. It became clear that there are not only unanswered questions regarding responsibilities in the event of a crisis, but also that the diversity of forms of care (e.g. private households) poses a particular challenge. The interviewees do not see any viable alternatives to secure communication in the event of a power failure and also see that respiratory patients, for example, have a special need for care (e.g. due to the limited battery life of the respiratory equipment). The results also show that the nursing experts have different views on how they should prepare for such a scenario. These range from passivity to proactivity. A clear need for action becomes visible for cooperation and networking of the relevant actors, promotion of disaster literacy as well as the necessity to adapt the training curricula.

Key messages
Understanding addiction in e-cigarette users – the EVAPE project
Authors: Lohner V , Schneider S , Andreas M , Szafran D , Grundinger N , Vollstädt-Klein S , Fong GT , McNeill A , Mons U 
Published: October 2022

Abstract

Background
Electronic cigarettes (e-cigarettes) are often advertised as a healthier option to combustible cigarettes and as smoking cessation aid. However, e-cigarettes are a growing health concern and their addictive potential remains to be fully understood. Within the EValuation of the Addictive Potential of E-cigarettes (EVAPE) project, we studied subjective and objective measures of addiction in relation to e-cigarette use.

Methods
This cross-sectional analysis was based on 832 participants of the first wave (2016) of England from the ITC Four Country Smoking and Vaping (4CV) Survey, who were using e-cigarettes daily or weekly for at least four months. Perceived addiction to e-cigarettes was categorised as very vs. not/somewhat addicted, and perceived addictiveness of e-cigarettes relative to combustible cigarettes as equally/more addictive vs. less addictive. Objective measures of addiction included urge to vape, time to first vape after waking, frequency of use, and used nicotine strength. We examined associations between these objective and subjective measures of addiction using multivariate logistic regression, adjusted for age, gender, education, and cigarette smoking.

Results
17.8% of participants reported feeling very addicted to e-cigarettes and 42.3% considered e-cigarettes equally/more addictive than combustible cigarettes. Those who felt very addicted had higher odds of regarding e-cigarettes as more addictive (OR 3.43 (95%-CI 2.29-5.19)). All objective measures of addiction were associated with higher perceived addiction, whereas only a shorter time to first vape was associated with perceived product addictiveness.

Conclusions
Subjective measures of addiction to e-cigarettes, in particular perceived addiction, correspond with objective measures. Understanding the addictive potential of e-cigarettes is the cornerstone for developing new strategies for prevention and treatment, and ultimately understanding their role from a public health perspective.

Key messages
Interaction between APOE ɛ4 genotype and education on mild cognitive impairment
Authors: Frank M , Hensel J , Baak L , Dragano N , Weimar C , Jokisch M , Schmidt B 
Published: October 2022

Abstract

Introduction
Studies have identified the apolipoprotein E (APOE) ɛ4 genotype to be a genetic risk factor for mild cognitive impairment (MCI) with environmental factors, such as education, modifying this genetic effect. The aim of this study was to investigate possible interaction of APOE ɛ4 status and educational attainment on MCI.

Methods
Information on education, MCI and APOE status was available for 3,829 participants from the Heinz Nixdorf Recall study. Logistic regression models were fitted to estimate sex- and age-adjusted odds ratios (OR) and 95% confidence intervals (95%-CI) for education (&lt;14 years vs. ≥14 years of education), APOE status (carrier vs. noncarrier) and the interaction between APOExeducation on multiplicative scale with MCI. To consider interaction on additive scale, the relative excess risk due to interaction (RERI) was calculated. The effect of APOE on MCI was additionally stratified by educational groups.

Results
A higher chance of MCI was observed for reporting &lt;14 years of education (OR: 1.37 [95%-CI: 1.11, 1.69]) and having a positive APOE ɛ4 status (OR: 1.27 [95%-CI: 1.04, 1.55]). Stratified analysis showed a stronger genetic effect of APOE ɛ4 status on MCI in participants with low education (OR: 1.42 [95%-CI: 1.12, 1.79)], compared to participants with higher education (OR: 1.00 [95%-CI: 0.67, 1.45)]. An indication for positive interaction between education and APOE ɛ4 status on MCI was found on additive scale (RERI: 0.52 [95%-CI: 0.01, 1.03]), no interaction on the multiplicative scale was observed.

Conclusions
Results gave indication for positive interaction on the additive scale of APOE ɛ4 status and education, showing stronger genetic effects on MCI in groups of low education. Socioeconomically disadvantaged environments and health behaviors related to low educational attainment may be responsible for an altered APOE ɛ4 expression. Higher educated groups seem to be better equipped to reduce their genetic susceptibility for MCI.

Key messages
Time period effects in work disability due to common mental disorders among young employees
Authors: Amin M , Mittendorfer-Rutz E , Björkenstam E , Virtanen M , Helgesson M , Gustafsson N , Rahman S 
Published: October 2022

Abstract

Background
Previous research on period effects in risk for work disability due to common mental disorders across employment sectors and occupational classes in young employees is lacking. Temporal changes in the healthcare system or social insurance policies or other structural/organisational changes could contribute to such time period effects. We aimed to investigate time period effects in the risk of work disability, defined as long-term sickness absence (LTSA) and disability pension (DP) due to common mental disorders (CMDs), among young employees according to their employment sector (private/public) and occupational class (non-manual/manual).

Methods
Three cohorts, including all employed individuals with complete information on employment sector and occupational class, aged 19-29 years and resident in Sweden on the 31-Dec-2004, 2009 and 2014 (n = 573,516, 665,138 and 600,889 individuals in cohort 2004, 2009 and 2014, respectively) were followed for four years. Crude and multivariate-adjusted hazard ratios (HRs and aHRs, respectively) with 95% confidence intervals (CIs) were estimated regarding the risk of LTSA and DP due to CMDs using Cox regression analyses.

Results
In cohort 2004, public sector employees had a higher relative risk for LTSA due to CMDs than private sector employees (aHR, (95%CI): 1.24, 1.16-1.34 and 1.18, 1.11-1.26 among non-manual and manual workers). These associations were similar in the later cohorts. Compared to cohort 2004, the rate of DP due to CMDs was considerably lower in the later cohorts leading to uncertainties in the risk estimates limiting the comparability for time period effects regarding the risk of DP due to CMDs across employment sectors and occupational classes.

Conclusions
Stricter regulation changes regarding the receipt of DP in Sweden, rather than other time period events, may have differentially affected the risk of work disability among young non-manual and manual employees working in the private and public sectors.

Key messages
Estimating the magnitude of surveillance bias in COVID-19
Authors: Tancredi S , Cullati S , Chiolero A 
Published: October 2022

Abstract

Background
Most European countries implemented COVID-19 surveillance systems based notably on the number of diagnosed infections. Using this number as an indicator of epidemic severity is however problematic since it is influenced by testing modality. Indeed, differences in the frequency of infections are partly due to differences in detection rates rather than to changes in the risk of infection, leading to a “surveillance bias”. Our goal was to estimate the magnitude of this bias in one region of Switzerland, using population-based seroprevalence as the best marker of epidemic severity.

Methods
We used data from serosurveys carried out on random samples of the adult population after the 1st (Jul-Oct 2020) and the 2nd wave of the pandemic (Nov 2020-Feb 2021), before the start of the vaccination campaign. To assess the scale of surveillance bias, we assessed the burden of COVID-19 between 2 waves comparing seroprevalence with the number of diagnosed cases (positive PCR or antigen tests).

Results
Out of 867 participants (46% men), 8% (IC 95%:4%-12%) and 19% (IC:15%-23%) had anti-SARS-CoV-2 IgG after the 1st and 2nd wave respectively, that is, a 11% increase between waves. The cumulative number of SARS-CoV-2 diagnosed cases was 2'355 after the 1st wave and 23'321 after the 2nd, that is, an increase of 20'966 cases between waves. Based on the number of diagnosed cases, the epidemic severity of the 2nd wave was 8-9 times higher compared with the 1st wave (20'966 vs 2'355 cases). Based on seroprevalence estimates, epidemic severity of the 2nd wave was less than 1.5 times higher compared to the 1st wave (11% vs 8%).

Conclusions
Due to changes in testing modalities, the number of cases is problematic to assess the burden of COVID-19 in different phases of the pandemic. Accounting for surveillance bias is necessary for accurate public health surveillance.

Key messages
Motivations and strategies underlying the adoption of the front-of-pack labelling scheme Nutri-Score
Authors: Sarda B , Fialon M , Ducrot P , Serry AJ , Galan P , Kesse-Guyot E , Hercberg S , Touvier M , Julia C 
Published: October 2022

Abstract

Front-of-pack nutrition labellings (FoPL) have gained traction in the European Union as tools to tackle the burden of nutrition-related chronic diseases. Multiple FoPL have been implemented by both governments and private actors. Under the European food labelling regulation, any FoPL is optional to display, although the legal framework is being revised for a harmonized FoPL to emerge. Since the implementation of the Nutri-Score in France in 2017, little data is available to understand the motivations and strategies underlying the adoption of the FoPL from a food business’ perspective. A cross-sectional study was conducted in March 2021 on food businesses having adopted the Nutri-Score in France through an online questionnaire. In total, 121 businesses completed the questionnaire, representing 32% of companies adopting the scheme and covering a variety of company types. Engaged businesses had a rather healthier portfolio of products according to the Nutri-Score (on average, 69% of engaged products were A or B and 12% were D or E), with disparities between retailers and national brands. Businesses mostly reported their engagement was motivated by a will to be transparent (76%) and to simplify nutritional information (67%) but still 19% reported that they engaged following external pressures. External pressures were more likely to play a role in the engagement if the company engaged in 2020 compared to those engaged before 2018 (P = 0.032), if the company was larger (P = 0.044) and if the scope of engagement included D or E products (poorer nutritional quality) (P = 0.033). Our study showed that the Nutri-Score, as an optional measure, is mainly used by businesses, especially national brands, as a tool to promote rather healthier products, while companies with products of lower nutritional quality are more likely to engage following external pressure. This highlights the relevance of enforcing a mandatory FoPL system, in line with the Farm to Fork strategy.

Key messages
Individual and food environment factors associated with the diet of disadvantaged adults in Flanders
Authors: Inac Y , de Clerq E , Van de Weghe N , Dury S , D'Hooghe S , Vandevijvere S , van Dyck D , Deforche B , De Ridder K 
Published: October 2022

Abstract

Background
Health inequalities partially remain due to differences in diet between socioeconomic groups. Examining the association between socio-ecological factors and the diet of socioeconomically disadvantaged (SED) individuals can enhance the development of interventions to decrease health inequalities.

Methods
In total, 278 SED adults residing in two Flemish municipalities completed a survey addressing sociodemographics, diet, health and their perceptions of the food environment. The objective food environment was examined by assessing food retailer information in street network-based buffers of 500m and 1000m around participants’ addresses. Linear regression was used to test assumptions.

Results
Individual factors such as poor subjective health (OR0.58;CI 0.34-0.97), food insecurity (OR0.60;CI 0.38-0.94) and living alone (OR0.86;CI 0.75-0.98) were negatively associated with healthy dietary habits such as daily fruit and vegetable (FV) consumption. Positive perceptions on the availability of FV were positively associated (OR1.09;CI 1.02-1.17) with daily FV consumption. Objective food environmental factors showed a stronger association with unhealthy dietary habits. A greater amount of retailers within 1000m walking distance was negatively associated with fast-food (OR0.96;CI 0.94-0.99) and sugar-sweetened beverages (SSB) consumption (OR0.93; CI 0.88-0.98). More supermarkets within 500m distance was negatively associated (OR0.77;CI 0.58-0.97) with SSB consumption, while more convenience stores within a 1000m distance was positively associated (OR1.48;CI 1.17-1.88) with SSB consumption.

Conclusions
Our findings suggest that factors associated with the diet of SED adults differ according to food and drink items. Interventions focused on this population should take these differences into account.

Key messages
The community pharmacy model for colorectal cancer screening: policy insights from Italy
Authors: Deandrea S , Della Valle PG , Battisti F , Mantellini P , Mantovani W , Narne E , Odone A , Senore C , Brusa P , Calsolaro R 
Published: October 2022

Abstract

Background
Despite its effectiveness, compliance to colorectal cancer (CRC) screening remains low. Different strategies to improve the adherence were identified, such as the involvement of new stakeholders as the community pharmacists. In Italy a recent national project fuelled the development of this strategy, scaling-up the collaboration between screening programmes and pharmacies formerly at the local level up to the national level.

Methods
The regional representatives of the CRC screening programmes provided to the National Screening Monitoring Centre the agreements arranged between the Regions/Autonomous provinces and their respective pharmacy owners representatives. The agreement decrees were analysed describing the fecal occult blood test pathway (e.g. kit supply and delivery) and supplementary activities provided by the pharmacies together with the CRC screening kit delivery, such as health promotion ones.

Results
Information was received from 18 Regions and Autonomous provinces (86% of the total). Regarding the economic compensation, the amount of money paid for each kit varies a lot, with a range from 0 to 18 EUR. The number of process phases covered by the agreements ranged from a maximum of 16 (out of 18) to a minimum of 0. The processes that were included most often were the supply of the kit, the delivery of the kit, and education/awareness of CRC screening (68.8%), followed by sample transfer to the laboratory, test tube tracing and counselling (62.5%). Among the processes less covered there were the warehouse management and awareness of other healthcare initiatives (12.5%), and only in one case a supplementary agreement on delivery of preparation for intestinal cleansing was included.

Conclusions
The arrangements between pharmacies and CRC screening programmes in Italy are very diverse and unique model is missing. Collaboration between programs and pharmacies is promising and quality standards of the service should be set at international level.

Key messages
Social capital and STIs testing among young men in Stockholm, Sweden: A cross-sectional study
Authors: Canabarro APF , Eriksson M , Nielsen A , Salazar M 
Published: October 2022

Abstract

Background
Testing for sexually transmitted infections (STIs) is highly accessible in Sweden, but young men's testing rate is considerably lower than young women's. Social capital (SC) might shape people's STIs testing patterns. However, such association has not been studied among young men before. This study assessed the prevalence of different forms of SC and if they increase STIs testing among young men in Stockholm, Sweden.

Methods
This population-based cross-sectional study was conducted in 2018 and included 523 men aged 20-29 years living in Stockholm. Bonding SC (having helped someone; having received help; having someone to share inner feelings with), institutionalized trust SC (in school; healthcare; media) and STIs testing behavior (never tested, tested only in the last 12 months, only more than 12 months ago, or both before and after the last 12 months) were assessed. Weighted adjusted multinomial logistic regression tested the associations between SC and STIs testing.

Results
High levels of bonding SC (range: 86.5 - 95.5%), as well as trust in healthcare (76.7%) and school (64.8%) were reported. Having helped someone (aRRR 6.1, 95% CI 1.7 - 21.6), having received help (aRRR 8.1, 95% CI 2.6 - 24.7) and having someone to share feelings (aRRR 4.0, 95% CI 1.7 - 9.2) were associated with being tested for STIs more than 12 months ago. Trust in media was the only institutional trust significantly associated with STIs testing (tested in the last 12 months: aRRR 2.5, 95% CI 1.1 - 5.4; both before and after: aRRR 3.8, 95% CI 1.6 - 8.9).

Conclusions
Peer-to-peer interventions using bonding SC should be used to promote STIs testing. More studies are needed to understand how trust in media increases testing for STIs. Although trust in healthcare and school were not statistically associated with testing, the high overall trust in these institutions reported in our study could be harnessed to implement sexual education programs promoting STIs testing among young men.

Key messages