bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of hepatitis B and C, HIV, and syphilis among people who inject drugs in Germany
Authors: Steffen G , Krings A , Zimmermann R 
Published: October 2022

Abstract

Background
We piloted a future monitoring system among people who inject drugs (PWID) in Germany (DRUCK2.0). Monitoring is needed to inform and support the viral hepatitis/HIV/STI elimination process in Germany by providing regular up-to-date prevalence and behavioural data for this key population.

Methods
PWID aged 16+ years who injected drugs within the last 12 months were recruited by time location sampling via low threshold drug services and opioid substitution treatment (OST) practices during routine services in Berlin and Bavaria between 01/06/2021 and 28/02/2022. All participants filled a questionnaire on sociodemographics, behaviour and access to care and were tested for hepatitis B and C (HBV, HCV), HIV and syphilis using capillary dried blood spots. All received a 10 Euro incentive voucher.

Results
In total, 495 PWID were included, median age was 39 years [range 18-66], 68% (336/494) were male, and 23% (114/492) born outside Germany, mostly in eastern Europe. Of all participants, 58% (275/477) reported recent use of unsafe needles/syringes and 77% (372/485) detention experience. Current OST was reported by 62% (304/487). Prevalence was 46% (229/495) for cured HCV, 26% (130/495) for active HCV, 17% (80/482) for cured HBV, 1.2% (6/483) for active HBV, 2.7% (13/482) for HIV and 2.1% (10/473) for previous Syphilis. Serological HBV vaccination coverage was 24% (115/475). Of all, 95% (453/475) reported previous HCV testing. Of those with cured/active HCV infection 88% (296/337) knew about their infection and 56% (161/285) of them reported previous/current treatment.

Conclusions
To decrease the heavy burden of infection among PWID in Germany, targeted measures regarding access to HCV treatment, HBV vaccination, and harm reduction (safer use measures, OST) need to be implemented and rolled out. Nationwide regular monitoring of indicators in this key population is needed to guide the elimination progress of viral hepatitis and HIV in Germany.

Key messages
• High burden of active Hepatitis C infection and low Hepatitis B vaccination coverage among people who inject drugs in Berlin and Bavaria require improved access to treatment and prevention efforts.
• National Monitoring is needed to inform and support the viral hepatitis/HIV/STI elimination process among people who inject drugs in Germany.
Quality of life assessment in breast cancer patients during palliative treatment in Indonesia
Authors: Gayatri D , Efremov L , Wienke A , Mikolajczyk R , Kantelhardt EJ 
Published: October 2022

Abstract

Background
This study aimed to prospectively assess quality of life (QOL), QOL domains, and pain severity in advanced stage breast cancer patients during palliative oncology treatment in Indonesia.

Methods
Advanced stage breast cancer patients &gt; 18 years (n = 160) who began palliative oncology treatment were enrolled in the study using convenience sampling. They completed the EORTC QLQ-C15-PAL questionnaire and pain severity (Visual Analogue Scale, VAS) score at three-time points (baseline (T0), three-(T1) and six-months (T2) follow-up). The repeated measures analysis of variance (ANOVA) model was used to assess the QOL, QOL domains, and pain severity changes over time adjusted for age, place of residence, marital status, and Karnofsky Performance Status score at baseline. We classified the change over time in three qualitative groups (deterioration, improvement, or trivial/no difference). We considered it clinically relevant if patients had a 10-point difference.

Results
The mean age of included patients (n = 159) was 50 years. Most lived in an urban area (72.3%), had low education (71.7%), and were married (81.8%). The repeated measures ANOVA showed that the QOL score, emotional functioning, fatigue, dyspnea, appetite loss, constipation, and VAS pain score remained stable over the 6-months period. In contrast: physical functioning declined (medium to large deterioration (-19.8 (95% CI -27.2 to -12.5)) between T0 to T2), however there was an improvement in the insomnia domain (medium improvement (-13.4 (95% CI -19.9 to -6.9)) between T0 to T2).

Conclusions
Our findings indicated that advanced stage breast cancer patients adapted well to palliative oncology treatment over six months of observation. There was deterioration in physical functioning, but improvement in insomnia. However, more attention is needed from clinicians to achieve improvement in the overall QOL score and specific QOL domains.

Key messages
• Focusing on improvement overall QOL score and specific QOL domains will lead to better advanced stage breast cancer patients’ satisfaction and care.
• Information is limited on palliative treatment satisfaction in low and lower middle-income countries, therefore this study has important impact on further policy considerations in Indonesia.
Hospital admissions and mortality for STEMI and NSTEMI during COVID-19 outbreak: a meta-analysis
Authors: Altobelli E , Angeletti PM , Marzi F , D'Ascenzo F , Petrocelli R , Patti G 
Published: October 2022

Abstract

Background
During SARS-CoV-2 pandemic, various studies have shown a significant reduction of Emergency Department (ED) presentations for acute cardiac diseases requiring in-hospital management. The aim of our study was to quantify hospital admission and mortality, comparing pandemic period and pre-pandemic period in different countries.

Methods
We performed an updated meta-analysis of observational studies to quantify on a large basis the impact of the SARS-CoV-2 outbreak on patients admitted to the ED for STEMI and NSTEMI. The literature research was conducted on PubMed, EMBASE, Scopus, Science Direct, Web of Science and Cochrane database registry on 6 January 2022. We performed a random-effect model meta-analysis.

Results
A total of 61 studies were included: came from Italy, China, Germany, Israel, Turkey, France, Helvetic Confederation, India, Poland, Spain, US, UK, Albania, Austria, Egypt, Greece, Iran, Ireland, Japan, Pakistan, Portugal, Saudi Arabia and Canada. Hospital admissions for STEMI decreased in most country. The countries with the high levels of reduction were Italy (IRR = 0.68) and Germany (IRR = 0.69). Mortality rates for STEMI increased differently among countries analyzed: p = 0.003. The highest mortality rate was in Serbia (OR = 2.15), followed by Italy (OR = 1.97), Pakistan (OR = 1.69) and France (OR = 1.55). Among the High-Income countries, the highest mortality rate was in Italy (OR = 3.71), the highest among the Upper-Middle-Income was in Serbia (OR = 2.15) and the highest among Low- Middle-Income was in Pakistan (OR = 1.69). Regarding NSTEMI, hospital admissions showed that Italy had the lowest value for with IRR = 0.59. Among countries, the meta-regression subgroups analysis, showed statistical difference (p &lt; 0.001).

Conclusions
Our meta-analysis may represent a robust snapshot that might help healthcare systems manage and assist an expected higher number of people coming to the hospitals for severe, post-acute cardiological issues in the future.

Key messages
• The study shows hospital admission and mortality, comparing pandemic period and pre-pandemic period in different countries.
• Epidemiological data suggests that one-fourth to one-third of MI patients, in large areas of the globe, during the COVID-19 pandemic in 2020, remained at home and did not have access to ED.
Temporal trends of suicidality among adolescents in the last decade in Piedmont, Northwestern Italy
Authors: Berchialla P , Bersia M , Koumantakis E , Ferracin E , Comoretto RI , Charrier L , Dalmasso P 
Published: October 2022

Abstract

Background
Over the last decade, trends of suicidality among adolescents remain unclear. We conducted a cross-sectional study using surveillance data collected over the past 10 years in the Piedmont region, Italy, to explore temporal trends in suicidality among hospitalized adolescents.

Methods
This was a retrospective study over an 11-year period of time. The target cohort was adolescents aged 13-19 discharged from inpatient/day-hospital care with at least one suicidality-related ICD9-CM code (i.e., suicidal ideation-SI, suicidal risk-SR and suspected suicide-SS) between 2011 and 2021 in Piedmont (Northwestern Italy). Social-economic related data is available from Census 2011. Yearly incidence rates (IR) were calculated based on the overall hospitals’ catchment population and by sex. Poisson regression model was estimated to evaluate the trend over time and the association with sex, and a potential effect of the COVID-19 pandemic. A non-linear trend was allowed by modelling natural splines.

Results
We included 490 adolescents (median age: 15 years, IQR: 13-16), 380 girls and 110 boys, with ICD9-CM codes for SI (264; 53.9%), SR (142; 29%), SS (90; 18.4%) at first discharge. Girls showed a higher risk of repeated inpatient care than boys (19.2% vs 7.3%, p &lt; 0.01). Since 2013, yearly suicidality IRs started increasing linearly in boys (+1.7/100,000 per year, 95%CI: 0.7-2.8). Apparently, suicidality IRs increasing in girls were observed since 2011 (+5.8/100,000 per year, 95%CI 2.8-8.9) and were significantly higher than in boys (p &lt; 0.001).

Conclusions
Suicidality among young inpatients increased in Piedmont during the last decade. Females seemed to be more affected than males. Further research is needed to better understand gender-related risk factors for suicidality.

Key messages
• There has been an increase in the number of adolescents reporting suicidal ideation in the last decade, especially in girls.
• Intervention strategies are urgently needed to reverse a potentially alarming trend in suicidality among young people.
Dietary supplements intake among youth: preliminary results of a multicentric survey
Authors: Protano C , De Giorgi A , Valeriani F , Gallè F , Liguori G , Spica VR , Vitali M 
Published: October 2022

Abstract

Background
In the last decades, a wide spread of dietary supplements (DSs) has been observed worldwide. However, DS use is not always motivated by real nutritional needs. In this context, commercial strategies and peers’ suggestions seem to play an important role in determining this habit, with harmful effects on consumers’ health. This cross-sectional study was aimed to evaluate the DS consumption patterns among a sample of undergraduate students attending 14 Italian universities.

Methods
An anonymous web questionnaire was used to collect information about DS use and consumption habits, related motivations and possible adverse effects. The survey is still ongoing and its conclusion is expected to be on May 2022.

Results
On a total of 2019 participants enrolled so far (69.7% female, mean age 22.8±4.7), 72.6% reported the use of at least a DS in the last six months. Multivitamin and multimineral products were the most used, being reported by 35.8% of the participants, while caffeinated energy supplements were the less reported (2.0%). The main reason for DS use was to deal with a specific deficiency following a physician or nutritionist indication (47.8%). The 3.4% of participants reported the occurrence of negative outcomes, mainly gastrointestinal disorders (74%).

Conclusions
These preliminary results evidenced a wide use of DSs in the studied population. Although the main motivation was a nutritional need with a medical recommendation, a notable proportion of the sample assumed DSs without any specific prescription. Thus, it is essential to increase the knowledge about DSs and related threats deriving from their inappropriate use in the population, especially among youths. Further analysis will allow to identify possible correlations with socio-demographic and behavioural variables.

Key messages
• It is essential to increase the knowledge about dietary supplements to avoid an inappropriate use in the population.
• Youths are the most exposed to this consumption.
Nutritional composition of substitutes for meats and sausages on the German market
Authors: Gréa C , Roser S , Hoffmann I , Storcksdieck genannt Bonsmann S 
Published: October 2022

Abstract

Background
Substitutes for meats and sausages are growing both in demand and supply in Germany. Monitoring their nutritional composition helps characterise this novel product group in terms of its dietary contribution.

Methods
Data on substitutes for meats and sausages were collected in a baseline survey in 2016 and an in-depth follow-up survey in 2021. In both surveys, mandatory nutrition declaration (“Big 7”) and other packaging information were collected via online research and supermarket visits. Products were categorised according to the substituted animal products and their contents of energy, fat, saturated fatty acids, and salt investigated. Changes in energy and nutrient contents between baseline and follow-up survey were assessed statistically using Welch’s t-test.

Results
The follow-up survey included 421 meat substitutes and 292 sausage substitutes, split into 27 subgroups. Substitutes for meat products like meat strips and schnitzel show widely varying energy contents. Sausage substitutes show higher medians for fat, saturated fatty acids and salt than meat substitutes; spans of salt content (0,1-4,0 g per 100 g product) and saturated fatty acids (0,1 g - 23,0 g per 100 g product) are particularly wide. Relative to the baseline survey, which included 69 meat substitutes and 61 sausage substitutes, the follow-up revealed significantly higher contents of energy and saturated fatty acids overall and in some subgroups (e.g. nuggets and burger patties). The sole significant reduction was seen for energy in substitutes of precooked sausages.

Conclusions
The observed wide spans of energy and nutrient content imply 1) the potential to reformulate substitutes for meats and sausages at the top end of the spectrum 2) the availability of healthier choices within the various subgroups. The increases shown in energy and saturated fatty acids content warrant further monitoring.

Key messages
• Wide spans of energy and nutrient contents reveal the potential for the development of more nutritionally favourable substitutes for meats and sausages.
• As substitutes for meats and sausages are perceived to have nutritional advantages the observed increases in energy and saturated fatty acids contents over time should be further monitored.
How can policies to reduce obesity be more effective and equitable following the COVID-19 pandemic?
Authors: Gallagher Squires C , Isaacs A , Coleman P , Hawkes C 
Published: October 2022

Abstract

Despite being a public health priority in the UK for decades, rates of childhood obesity are continuing to rise along a highly unequal socioeconomic gradient. COVID-19 has radically changed daily life, altering the economy, work, social lives and engagement with the food environment. This research aimed to investigate families’ lived experiences of food in the COVID-19 pandemic to understand how policies to reduce obesity can be more effective and equitable. We conducted a remote longitudinal qualitative study, engaging 62 parents of school or nursery age children in England. Participant demographics were diverse in terms of socioeconomic status and ethnicity. Participants took part in semi-structured interviews and photo-elicitation three times at six-month intervals between October 2020 and December 2021. The role of food in day-to-day life shifted in the context of changes brought about by the pandemic. Whether this led to healthy or unhealthy food practices was shaped by socioeconomic resources. Food became a key source of pleasure in daily life as social and leisure activities were restricted in lockdowns. As schools and childcare closed, when this work fell on one parent food became a source of relentless work and parents sought more convenient options. Those with financial resources were able to access healthier convenient options (e.g. meal boxes), while low incomes restricted parents to low-cost options (e.g. ready meals and fast food). For those experiencing financial insecurity, food became a financial management strategy and parents sought discounts and promotions to save money to cover other non-food essentials. These contexts have the capacity to occur again both on a large scale (e.g. disruptions to the food system) and in the context of an individual’s lifetime (e.g. ill health or job loss). Policy now has a window of opportunity to implement learnings from this period and shape obesity prevention policy to be more effective and equitable.

Key messages
• COVID-19 has revealed the multiple resources and systems of support that underpin families’ ability to eat well and, when disrupted, can limit capacity to procure and prepare nutritious foods.
• Policies designed to improve diets must consider the multiple roles food plays in everyday life, beyond just a source of nutrition, to ensure actions are effective and equitable.
Cost-effectiveness of hospice-based palliative care in Kazakhstan
Authors: Salikhanov I , Crape B , Wieser S , Katapodi M 
Published: October 2022

Abstract

Background
According to the Quality of Death Index, Kazakhstan ranks 50th out of 80 countries assessed. Currently, some form of inpatient end-of life care in Kazakhstan is provided by only 9 hospices, palliative care units and mobile teams. In 2020, the total number of palliative care beds did not exceed 980 across the country, while around 135,000 patients need palliative care at any given time.
Objective: To assess the effectiveness and cost-effectiveness of hospice-based palliative care for cancer patients compared to usual hospital care in cancer centers across Kazakhstan from societal perspective.

Methods
A total of 182 family caregivers were recruited, 104 in a hospice group and 78 in a control (palliative units). Patients’ state of health and family caregivers’ burden been measured using Palliative Outcome Scale (POS) and Zarit Burden Inventory (ZBI) on 14th day of the inpatient palliative care. Direct and indirect medical costs as well as family caregivers’ out-of-pocket expenses associated with the care has been collected. The cost-effectiveness analysis was conducted by calculating the difference between mean cost of treatment, including OOPs, over 14 days of treatment. Uncertainty around the cost-effectiveness estimates was explored by generating 10,000 resamples using bootstrapping.

Results
At 14 days, patients’ mean quality of life was 2,4 points better (95% CI: 0,06 - 4,9) in the hospice group compared to the control. Family caregiver burden was 4,6 points better in the hospice group (95% CI: -0,26 - 9.3). Mean treatment costs, including direct medical costs and out-of-pocket expenditures over 14 days were $31 lower for the hospice group (95% CI: $29 - $32). There was a significant correlation between the total cost of treatment and patients’ quality of life (rxy = 0,58; p &lt; 0,01). The cost-effectiveness plane graphically represents 10,000 replications, 85% of them showed that hospice care has better outcomes and lower costs than the control group.

Key messages
• Hospice-based palliative care is cost-effective compared to the care provided in palliative units of cancer centers.
• There is a significant correlation between patients’ quality of life and family caregivers’ burden.
Development of a refugee health assessment toolkit for specific populations to support primary care
Authors: Boshari T , Hassan S , Hussain K , Billett J , Garry S , Weil L 
Published: October 2022

Abstract

Issue/problem
The United Kingdom (UK) hosts c.136,000 refugees and last year received the most asylum applications in two decades. Despite this, expertise in migrant health is not widespread in general practice, with few comprehensive toolkits available to support crucial initial health assessments of new arrivals.

Description of the problem
A large influx of Afghan refugees entered the UK in autumn 2021. In London, primary care practitioners quickly identified a lack of readily accessible, comprehensive guidance to support them in conducting health assessments for arrivals with a complex range of needs. This was compounded by many in primary care having little or no experience of migrant health.

Results
To address this gap in advice on conducting initial health assessments, a bespoke toolkit was created. The toolkit consolidated advice from a range of partners and resources: the UK Afghan migrant health guide, clinicians with humanitarian experience, front-line practitioners, Doctors of the World, and those leading on the health and public health response. The toolkit ensured greater consistency in the nature and content of assessments, considered not only primary needs but also broader wellbeing, and was responsive to both anticipated and known health priorities.

Lessons
The initial health assessment toolkit for Afghan migrants was well received by frontline staff and has implications for international practice in other areas providing similar health support. The toolkit and associated supporting information has formed a template that can be rapidly adapted to suit emerging needs, as has been done for new arrivals from Ukraine. This work has fed into best practice by the UK National Asylum Steering Group and is to be a case study for a WHO project on country-specific health assessments.

Key messages
• The toolkit is a proof of concept for partnership working towards holistic initial health assessments of new migrants in primary care, bringing together best evidence and pragmatic practice.
• This work has implications for other countries experiencing similar trends in migration and providing health support to an increasing number of new refugees.
Mina Svar: A tool for measuring social impact
Authors: Salari R , Westberg J , Moum Å ,   Youth in Save the Children programs, Thell M , Dyar O , Sarkadi A 
Published: October 2022

Abstract

Background
Each year, numerous initiatives are carried out to improve the outcomes for youth living in vulnerable areas. However, the impact of these initiatives is rarely measured, partly because there is no reliable, valid, relevant and easy-to-use tool available to measure the impact of social investments from the youth perspective. Mina Svar is an app co-created with youth that aims to address this gap.

Methods and results
Save the Children led the collaboration in defining a measurement framework. Experts from Save the Children, researchers from Linköping University, and representatives from Accenture, Skandia and Apoteket as well as youth themselves were involved in an iterative process. Five interconnected areas were identified as central: democracy and influence, education, work, housing and neighbourhood, and health. The first version of Mina Svar included 34 items. Researchers from Uppsala University were involved to help with testing the psychometric properties of Mina Svar in a sample of 237 youths. We examined the tool’s internal consistency, content validity and structure validity. Analyses showed that all the subscales except democracy and influence had good internal consistency (0.70 and higher). However, inspection of individual items revealed that several items lacked clarity and many items did not comprehensively reflect the related constructs as intended. Confirmatory factor analysis suggested a poor fit for the proposed model (CFI = 0.52 TLI = 0.56, and RMSEA = 0.103). Currently, we are going through a second iterative process to increase the reliability and validity of Mina Svar. The work involves refining the framework, rewriting ambiguous items, generating new items, and re-examining the psychometric properties of the revised version.

Conclusions
Mina Svar is a promising short multidimensional survey tool which offers a potential solution to tackle the problem with measuring the impact of social investments from the youth perspective.

Key messages
• Mina Svar is an app-based assessment tool co-created with youths living in vulnerable areas.
• Mina Svar is a promising short multidimensional tool which offers a potential solution to tackle the problem with measuring the impact of social investments.