bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nitrites and nitrates dietary exposure from natural sources and additives and type-2 diabetes risk
Authors: Srour B , Chazelas E , Debras C , Druesne-Pecollo N , Agaesse C , Szabo de Edelenyi F , Sellem L , Kesse-Guyot E , Deschasaux-Tanguy M , Touvier M 
Published: October 2022

Abstract

Nitrates and nitrites occur naturally in water and soil and are commonly ingested from drinking water and dietary sources. They are also used as food additives. The epidemiological evidence linking exposure to nitrites/nitrates with type-2 diabetes (T2D) risk is scarce. We aimed to study these associations in a large population based prospective cohort study. Overall, 104,168 adults from the French NutriNet-Santé cohort study (median follow-up time 6.7 years) were included. Associations between intakes of nitrites and nitrates (evaluated using repeated 24h dietary records, linked to a comprehensive food composition database and accounting for details of commercial names/brands of industrial products) and risk of T2D were assessed using cause-specific multivariable Cox proportional hazard models adjusted for known risk factors (sociodemographic, anthropometric, lifestyle, medical history, and nutritional factors). During follow-up, 969 incident T2D cases were ascertained. Total nitrites and nitrites from natural sources were both positively associated with higher T2D risk (HRtertile 3 vs.1=1.29 (95% CI 1.06-1.56), Ptrend=0.004, and 1.27 (95% CI 1.05-1.54), Ptrend=0.01, respectively). Participants with higher exposure to nitrites from food additives (i.e. above the sex-specific median), and specifically those having higher exposure to sodium nitrite (e250) had a higher T2D risk compared with those who were not exposed to food additive nitrites (HRtertile 3 vs.1=1.58 (95% CI 1.28-1.94), Ptrend&lt;0.001, and 1.59 (95% CI 1.30-1.96), Ptrend&lt;0.001), respectively). There was no evidence for an association between nitrates of any source and T2D risk (all Ptrend&gt;0.4). In this large prospective cohort, a higher dietary exposure to nitrites (from both natural sources and food additives) was associated with higher T2D risk. These results provide additional evidence in the context of current discussions about updating regulations on the use of nitrites as food additives.

Key messages
• A high exposure to dietary nitrites (from both natural and food additive sources) is associated with an increased risk of type-2 diabetes.
• These findings support further regulations concerning the use of nitrites as food additives in processed meats.
Circadian nutritional behaviours and risk of type 2 diabetes in NutriNet-Santé
Authors: Srour B , Palomar-Cros A , Andreeva VA , Fezeu LK , Julia C , Bellicha A , Kesse-Guyot E , Romaguera D , Kogevinas M , Touvier M 
Published: October 2022

Abstract

Skipping breakfast and late-night-eating have been associated with risk factors for type 2 diabetes (T2D). However, less is known about the link between daily timing and frequency of food intake and risk of developing T2D. The objective of the present study is to investigate the associations between circadian nutritional behaviours, defined by meal timings and frequency, and risk of T2D. 103,312 adults (79% females, mean age at baseline=42.7) from the French NutriNet-Santé cohort were included. Participants’ circadian nutritional behaviours were assessed using repeated 24 h dietary records. Associations of time of first and last meal of the day, meal frequency and of nighttime fasting duration with risk of T2D were assessed by multivariable Cox proportional hazard models adjusted for known risk factors. During a median follow-up of 7.3 years, 963 new cases of T2D were ascertained. Compared with subjects reporting on average a first meal before 8AM, those having a first meal after 9AM had a higher risk of developing T2D, HR = 1.59 (1.30 to 1.94). A late time of last meal (after 9PM) was associated with a higher risk of T2D, HR = 1.28 (1.06 to 1.54), but this association was no longer significant after adjusting for time of first meal. Each additional eating episode was associated with a reduction of the risk of T2D, HR = 0.95 (0.90 to 0.99), p-value=0.01. Overall, nighttime fasting duration was not associated with risk of T2D, except in participants having breakfast before 8AM after a nighttime fasting duration of more than 13 hours (HR = 0.47, 0.27 to 0.82). In this large prospective study, circadian nutritional behaviours were associated with risk of T2D. Daytime nutritional behaviours and specifically an early first meal was associated with a lower risk of type 2 diabetes. If confirmed in other largescale studies, an early breakfast should be considered in preventive strategies for type 2 diabetes.

Key messages
• If confirmed in other largescale studies, an early breakfast could be considered in preventive strategies for type 2 diabetes.
• Beyond nutritional quality of meals, meal timing could also be a risk factor for type-2 diabetes.
Group discussion: Challenges and key elements to be addressed when transferring GP
Authors: Txarramendieta J , Roca J , Zahorka M , Strand Kudajewski K , Papa R , Dolecek Z 
Published: October 2022

Abstract
In this group discussion, all speakers will participate in a group discussion. The moderator will launch questions to speakers, and attendees will be encouraged to make contributions to the group discussion.
Access to health literacy best practices and the role of health libraries (BiblioSUS Network BVS) in Brazil
Authors: Saboga-Nunes L , Santini LA , da Silveira F , Moro E , Estabel L 
Published: October 2022

Abstract

Introduction
Health Literacy (HL) has received recognition of its role and is proposed as a key element of incrementing wellbeing in public health. In the south, this discussion is engaged but a dialogue north-south needs to be incremented to allow further comprehension and implementation of HL best practices. The BiblioSUS Network in Brazil engaged in this discussion while it aims to expand and democratize access to health promotion & HL best practices, disseminated through the virtual health libraries (BVS). As a distribution model of content production by the Ministry of Health in Brazil it reaches a large audience in the country.

Methods
The target of this research includes BiblioSUS workers, representing the most diverse areas of knowledge and the community served by the Network. Data collection included an online survey on HL using the HLS-EU-BR instrument.

Results
The study involved 717 members of the Network and community users of cooperating libraries. Inadequate (12%) and problematic (36%) HL levels revealed that 48% had low levels of HL. The analysis of the 12 variables to assess community's health information needs, showed that 83% of participants do not use the network for health promotion needs, 70.4% do not use for quality of life purposes, but that 41.4% use it for related diseases issues.

Discussion
This research is the first of its kind and emphasize the need to promote health promotion and HL by several means (e.g. like BiblioSUS Network libraries). Communities need to be reached out to help them make decisions favorable to health in everyday life and settings (e.g. home, community, work). While health promotion and disease prevention are targeted, the Brazilian population need to have easier access to reliable health promotion information, in order to contribute to citizens’ empowerment in health.
The effect of active breaks on cognitive performance and classroom behaviour: the I-move study
Authors: Masini A , Ricci M , Marini S , Ceciliani A , Barone G , Gori D , Bragonzoni L , Sansavini A , Tessari A , Dallolio L 
Published: October 2022

Abstract

Background
Active Breaks (ABs) intervention involves short bouts of moderate to vigorous physical activity (MVPA) conducted during or between curricular lessons by the appropriately trained teachers. The aim of the Imola Active Breaks Study (I-MOVE study) was to evaluate the effect of an ABs intervention on cognitive function and classroom behaviour in primary school children.

Methods
The study was quasi-experimental, and it involved two groups attending a primary school in Imola (Bologna, Italy). The Active Breaks group (ABsG) performed the I-MOVE protocol consisting in 10 minutes of ABs divided in warm up, tone-up with high intensity interval training and cool-down. This is repeated three times a day for one year and half. The control group (CG) continued with regular lessons. The baseline assessment was conducted in October 2019 and the follow-up in May 2021. Cognitive performance was assessed using working memory test and classroom behaviour was monitored using an “ad hoc questionnaire”.

Results
Working memory performance increased significantly more in the ABsG (change: 1.30±1.17) than in CG (0.96±1.20), p &lt; 0.05. Almost the entire sample of the children wanted to continue with this intervention in the next following year. Children reported improvements in their school-life quality, including feeling better in class (75.40%) and in school (82.50%) when using ABs. Improvements were also reported in children time-on-task behaviours: 52.90% said they work easily in class, 52.90% that they could listen more clearly, 58.80% reported they can stay seated easily, and 59.60% that they learned better and were more focused after ABs.

Conclusions
In conclusion the program has proven to be very effective on the children's cognitive improvement and classroom behaviour. Since the ABs intervention demonstrates these positive effects, its implementation in schools can have a beneficial, sustainable and long-term impact on childhood health.

Key messages
• ABs intervention represents a cost-effective strategy to be implemented in the school settings regardless of the age and sex differences, to make the school a more dynamic environment.
• Despite the pandemic difficulties, the ABs intervention proved to be sustainable, and to have a positive effect on classroom behaviour by improving children’s concentration and attention in class.
Trust and emotional difficulties in adolescence: findings from a Swedish cohort study
Authors: Brolin Låftman S , Östberg V , Raninen J 
Published: October 2022

Abstract

Background
Trust is a key component of a socially sustainable society, and is typically divided into general trust (referring to trust in other people) and institutional trust (referring to trust in the public institutions of society). Trust tends to be developed and formed early in life. While a plethora of research has reported positive links between trust and health in adults, the aim of this study was to examine the associations between general and institutional trust and emotional difficulties in mid and late adolescence.

Methods
Data were derived from the Swedish cohort study Futura01, using information collected amongst 3622 grade 9 students (∼15-16 years, t1) who were followed-up two years later (∼17-18 years, t2). General and institutional trust was measured by indices based on five items each at both t1 and at t2 (range 1-4). Emotional difficulties were measured by the Strengths and Difficulties Questionnaire (SDQ) subscale at both t1 and at t2 (range 0-10). Control variables included family type and cash margin at t1 and upper secondary school program (academic vs. vocational) at t2. Linear regressions were performed using the first difference (FD) approach, analysing the change in emotional difficulties (t2-t1) regressed on the change in general and in institutional trust (t2-t1), respectively.

Results
Analyses simultaneously adjusting for change in both dimensions of trust showed inverse associations between the change in general trust and the change in emotional difficulties (b=-0.21, 95% CI -0.39, -0.04) and between the change in institutional trust and the change in emotional difficulties (b=-0.22, 95% CI -0.35, -0.09).

Conclusions
Increases in general and in institutional trust between ages 15-16 and 17-18 years were associated with a corresponding decrease in emotional difficulties. The findings suggest that trust is a social determinant of emotional difficulties in adolescents. Endeavours to enhance trust in this age group are relevant.

Key messages
• Changes in trust were inversely associated with changes in emotional difficulties in adolescents.
• The findings indicate that efforts to reinforce trust in adolescents are relevant.
Indoor metals pollution and metabolic outcomes among Italian children
Authors: Renzetti S , Schito M , Borgese L , Cirelli P , Cagna G , Patrono A , Peli M , Ranzi R , Lucchini RG , Placidi D 
Published: October 2022

Abstract

Background
Through this study, we aimed to test the association between the exposure to metals measured in indoor dust and metabolic outcomes among children living in areas with environmental exposure to metals.

Methods
The project “Health impacts of environmental exposure to airborne pollutants in the sites of Brescia and Taranto, Italy: increase knowledge to address preventive intervention of local and global relevance” (ISEIA) enrolled 130 children aged 6 to 13 years (51.5% females) resident from pregnancy in highly industrialized areas of the Brescia province, Northern Italy. Metabolic outcomes including BMI, fasting blood glucose and blood creatinine were measured. The concentration of a mixture of 10 metals in indoor dust was determined through an X-ray fluorescence portable analyzer (p-XRF). Linear regressions and Weighted Quantile Sum (WQS) regression were applied to test for the association between metal exposure and metabolic outcomes. All models were adjusted for age, gender, socio-economic status and area of residence.

Results
A significant association was observed between Cd and blood creatinine (β = 0.01; 95%CI=0.001, 0.02; p-value=0.028) when considering each individual metal separately in the model. WQS regression showed a positive significant association between the mixture of metals and fasting glucose (β = 0.87; 95%CI 0.14, 1.61; p-value=0.023) identifying Mn, Cr and Cu as the elements with the higher weights, while a marginally significant association was found between the metal mixture and blood creatinine (β = 0.01; 95%CI=-0.001, 0.02; p-value=0.075) where Cd and Ti showed the highest weight.

Conclusions
We assessed the potential association between exposure to metals in indoor household dust and blood glucose and creatinine. Our results contribute to clarifying the role of metal exposure in the burden of non-communicable diseases although further studies are needed to better understand the relationship between metal exposure and metabolism.

Key messages
• The metal mixture in indoor household dust is associated with an increase in fasting glucose.
• Cd concentration in indoor household dust is associated with an increase in blood creatinine.
Suicide Patterns in Malta: pathways for prevention
Authors: Cachia J 
Published: October 2022

Abstract

Background
Suicidal behaviour is the result of several risk factors, such as acute stress, severe depression, violence, sexual abuse, etc. A mental public health approach to suicide prevention needs to look beyond the demographic characteristics of deaths by suicide and to take into account specific country determinants. Available clinical information can help identify and quantify risk, analyse patterns of behaviour, explore links between risk and behaviour and generate possible suicide prevention pathways.

Methods
162 deaths by suicide for the period January 2015 - June 2021 in Malta are analysed against available clinical information. Major sources of detailed clinical information include obligatory notifications to the Commissioner for Mental Health of all cases of persons involuntarily admitted to acute psychiatric services and other medical records held within the Maltese public mental health system.

Results
81% of 162 deaths by suicide for the period under study were males, two-thirds of them between 25 and 54 years. The preliminary findings have confirmed that less than 50% of these deaths had previous contact with the public health system. The two main diagnostic criteria among deaths with recent psychiatric admission/s were acute stress reaction to personal life events and very severe mood disturbances, particularly depression. There seems to be increased risk among migrants and foreign workers residing and working in Malta. The frequency of prior admissions, age-related issues, the time-event relationships, and relevance of elicited clinical findings are still being evaluated and will be presented in more detail in the workshop.

Conclusions
Exploring risk factors within the history of cases of suicide through available clinical information can contribute to the development of suicide prevention pathways, relevant to the specific context of local communities.
Supporting decision making on public health and social measures in response to COVID-19- The PHSM calibration tool
Authors: Cocciolone D , King K , Latta A , Lindmark S , Owen L , Perehinets I , Roman C , Sane J , Schmidt T , Wippel C 
Published: October 2022

Abstract

Public health and social measures (PHSM) are preventative measures taken by individuals, communities and government institutions at national and local levels to prevent and reduce transmission of an infectious disease - in this instance SARS-CoV-2. The decision to introduce, adapt or lift PHSM should be based primarily on a situational assessment of the intensity of transmission of SARS-CoV-2 and the capacity of the health system to respond to subsequent increases in hospital admissions, but must also consider the effects these measures may have on the general welfare of society and individuals. The WHO Regional Office for Europe developed an online public health and social measures (PHSM) calibration tool to assist Member States in decision-making relating to PHSM implementation during the COVID-19 pandemic. The tool, designed to be used primarily by policy-makers in national and local government authorities, provides guidance based on a situational-level assessment framework that is determined by the level of community transmission and the overall capacity of health systems and public health services within a country or region to respond. By using a combination of country-reported and user-input data, the tool automatically generates a situational assessment and corresponding PHSM guidance for users, summarized in a downloadable report.

Reference
https://phsm.euro.who.int/calibrationTool
Covid-19 Vaccination and the issue of insurance status
Authors: Schröpfer D , Fortunato R , Devaud N , Koppensteiner R 
Published: October 2022

Abstract

Issue
It is estimated, that 11000 - 14000 people that live in Zurich do not have health insurance. For the vaccination against Covid-19 in Switzerland one had to register oneself on a website (Vacme) with your address and a Swiss health insurance number was required. This systematically excluded any people without insurance or Sans Papiers.

Description
To address this issue the city physician service Zurich organized a vaccination program for the uninsured from 14.06.2021 onward. To achieve this a code which could be used instead of the regular insurance number was organized and the staff recorded personal information of patients on site to remove language and technological barriers. Furthermore, the Police department was informed and agreed not to circulate the area of the vaccination service on vaccination days to minimize access-barriers for patients without legal residency.

Results
Between 14.06.2021 and 19.02.2022, 880 people came for vaccination of which 603 were clearly identifiable as individuals from vulnerable populations with no insurance. After initial organization, other vaccination centers in Switzerland were able to use the substitute number to vaccinate people without health insurance as well..

Lessons
There is a sizeable amount of people living without registration or/and health insurance. It is therefore critical not to forget these people when organizing public health measures, especially when addressing a pandemic or other infectious diseases (HIV, Hep C). Non-insurance is a known issue for universal access to care.
Acknowledgements: We would like to thank the hold crew of the ambulatorium kanonengasse at SAD

Key messages
• When fighting a pandemic it is of utmost importance to reach as many people as possible.
• Acess must be possible also for vulnernable people.
Ultra-processed food intake is associated with worse mental health in Southern Italian individuals
Authors: Grosso G , Godos J , Micek A 
Published: October 2022

Abstract

Background
A growing body of literature suggests that inclusion of ultra-processed foods (UPFs) in the diet may be associated with various non-communicable diseases, including obesity, cardiometabolic diseases, and increased mortality. However, one of the most underrated research topics is represented by the potential role of diet for mental disorders. The aim of this study was to explore whether there was an association between UPF consumption and mental health outcomes in a cohort of southern Italian individuals.

Methods
Demographic and dietary data from 1572 adults living in southern Italy was collected. Food items were categorized by the level of processing according to the NOVA classification. Multivariate logistic regressions were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between UPF intake and mental health outcomes, including sleep quality and depressive symptoms.

Results
Individuals in the highest quintile of UPF intake were more likely to have low sleep quality compared to those with the least intake (OR = 1.54, 95% CI: 1.02-2.34). Among the main component of sleep quality, high UPF intake was associated with sleep latency and efficacy individually. No apparent associations were found between UPF intake and depressive symptoms. However, when considering different age groups, younger individuals (age &lt;40 y) consuming more UPF were more likely to have depressive symptoms than low consumers (OR = 3.50, 95% CI: 1.53-7.99).

Conclusions
These findings show a potential association between UPF consumption and mental health outcomes. Further studies are needed to understand whether the retrieved relation depends on alteration of the physiological feeding patterns leading to food-anticipatory and binge-type behaviors or on nutritional (i.e., high sugars and unhealthy fats) and non-nutritional factors (i.e., additives) triggering pro-inflammatory pathways.

Key messages
• Ultra-processed food consumption is associated with worse sleep quality and depressive symptoms in Italian adults.
• The detrimental associations between ultra-processed food consumption and depressive symptoms seem stronger among younger individuals.