bluuebunny/crossref_metadata_2025_split huggingface dataset:
Suicide prevention in France put to the test by COVID-19
Authors: Jollant F 
Published: October 2022

Abstract

Introduction
Each year, nearly 9,000 people die from suicide in France, and more than 150,000 attempt suicide. In spite of a decrease for the last 30 years, rates of suicide in France remain higher than the European mean. Since 2018, a national suicide prevention strategy of the Ministry of Health has been in place. In 2020, this new strategy has been exposed to the COVID-19 pandemic.

Methods
First, the different actions of the national suicide prevention strategy will be presented, followed by the results of the available data regarding the impact of COVID-19 on suicidal gestures. These data are 1) hospitalizations for self-harm (ICD-10 codes X60 to X-84) from the national health database; 2) calls to poison control centers and 3) visits to the emergency room for a suicide attempt. The latest figures available will be presented.

Results
The analysis of these data compared to 2019 highlights two main periods. Between March and December 2020, a significant decrease in suicide attempts was observed (8.5%), with a rapid drop during the first week of the first confinement in mid-March 2020, in women and men, and in all age groups except old-aged people. Since January 2021, a significant increase in suicide attempts has been observed among teenage girls, including high-lethality acts. Moreover, among the young and the elderly, the figures are now similar to 2019. Only numbers for middle-aged adults continue to decline.

Conclusions
The impact of the COVID-19 pandemic on suicide attempts appears to be variable over time, according to age and gender. The old-aged people and young people, especially adolescent girls seem to have suffered the most from this situation. It is still too early to know whether the new national suicide strategy has had any positive impact. However, the pandemic has highlighted certain weaknesses in the French system, in particular the lack of recent data on mortality by suicide, and the heavy dependence on a fragile mental health medical system.
Self-stigma in suicide prevention of mental health professionals
Authors: Roškar S , Kralj D , Andriessen K , Krysinska K , Vinko M , Podlesek A 
Published: October 2022

Abstract

Introduction
Stigma is one of the main factors hindering help-seeking, which can have debilitating effects on mental health and even lead to suicidality. Stigma can affect the general public but also mental health professionals. In this study we examined mental-illness and help-seeking self-stigma as well as public stigma of suicidal behavior among suicidologists.

Methods
Invitation to participate in the study was sent to 518 member of the Internat.l Assoc. for Suicide Prevention. 89 participants (55 female, 34 male; 17% response rate) completed the survey. We gathered sociodemographic data, data on personal history of mental illness and suicidal behavior and on different types of stigma. We hypothesized that help-seeking self-stigma is predicted by sociodemographic attributes and personal history of mental illness and that self-stigma related to mental illness and suicide act as mediators.

Results
Personal experience with mental illness predicted mental illness self-stigma. There was no significant predictive value of other variables (age, gender, years working in suicidology) for self-stigma of mental illness and suicide behavior. Both types of self-stigma (mental illness and suicide behavior) were correlated. Mental-illness self-stigma was shown to be a stronger predictor of help-seeking self-stigma than self-stigma of suicide behavior, though the effect did not reach statistical significance. Self-stigma of suicide behavior showed no independent contribution to help-seeking self-stigma.

Conclusions
Mental healthcare professionals represent a particularly vulnerable group for developing mental health issues and suicidality. However, due to fear of being perceived less competent by colleagues and the public, they often disguise their mental struggles and are reluctant to seek help. These pilot findings warrant further research to better understand self-stigma and its impact on help-seeking behavior in order to prevent suicidality in this population.
A composite index of avoidable hospitalization to assess primary care quality: an Italian experience
Authors: Damiani G , Cuomo M , Mencancini C , Burgio A , Solipaca A , Catania D , Heidar Alizadeh A , Arcaro P , Baglio G 
Published: October 2022

Abstract

Background
In Italy, primary care (PC) ensures universal health coverage while containing costs. However, the assessment of its quality still remains an issue. Evidence has shown that high-quality outpatient care, through timely interventions to prevent complications of “ambulatory care sensitive conditions”, may avoid hospitalization. Aim of the study is to analyse the performance of PC in the Italian regions, using a composite and synthetic index of avoidable hospitalizations.

Methods
Hospital discharge data from 119 Italian geopolitical areas were analysed for the 2017-2019 triennium and for 2020, separately. According to the “Italian National Outcomes Evaluation Programme” methodology, 9 avoidable hospitalization indicators covering 5 nosological fields (infectious, respiratory, metabolic, cardiovascular and mental diseases) were combined in a synthetic index, calculated as the weighted mean of their standardized scores (with equal weights for each field). Using “natural breaks” technique, the areas were grouped into 5 clusters: “high”, “medium-high”, “medium”, “medium-low” and “low”.

Results
The analysis showed a marked heterogeneity at intra-regional level for the pre-pandemic triennium, with areas of homogeneity in regions with higher levels of hospitalization. The “medium” cluster, which is the widest, included 36 areas variously distributed across regions. The comparison with 2020 confirmed the geographical patterns observed for the previous triennium, despite a general reduction in hospitalizations due to the pandemic.

Conclusions
As a proxy indicator of PC quality, this index can aid decision makers in prioritizing quality improvement actions. However, in order to obtain a comprehensive evaluation, a joint reading of this index with other healthcare indicators is recommended.

Key messages
• High-quality PC is essential in maintaining appropriate hospitalization levels.
• The composite synthetic index proposed could aid PC quality assessment.
The impact of SARS-CoV-2 on emergency health care in a referral acute-care center in northern Italy
Authors: Ferrari A , Parente F , Iudica G , Porretto M , Simonetta D , Minet C , Mosca S , Panatto D , Orsi A , Icardi G 
Published: October 2022

Abstract

To assess how SARS-CoV-2 has changed the demand for in-person health care, we retrospectively analyzed data on access to the emergency department (ED) of San Martino Hospital, the referral acute-care center in the Liguria region (Northwest Italy). 181,699 records of patients diagnosed with an ICD-9 code between 2019 and 2021 were considered. In comparison to pre-pandemic levels, following the introduction of social distancing measures, the median number of ED visits declined by 41.4% in 2020 and by 28.1% in 2021. The period of maximum drop in access (-58.6%) corresponded to the 2020 11-12th calendar weeks and coincided with the highest rates of COVID-like illness - defined as either ILI or LRTI cases - identified through an operator-dependent syndromic surveillance system (+340%; 19.5% of total ED attendances). In terms of relative impact, in 2020 and 2021 non-urgent ED codes decreased (by 6.7% and 7.3%) and both urgent and emergency ED codes increased (by 4.8% and 3.8% the former; 5.5% and 8.8% the latter), even so, the absolute number of ED access fell drastically for all codes. Urgent codes, in particular, experienced the most severe decrease, shifting from a pre-pandemic value of 25,009 to 18,826 in 2020 and 19,528 in 2021. With regards to diagnosis, in 2020, respiratory infections saw the highest increase (+3.3%) while traumas and eye diseases saw the highest decrease (-1.1% and -3.8%, respectively). This trend reversed in 2021 during which respiratory infections decreased (-2.2%) and traumas increased (+2.2%). Despite the admissions of males and the elderly being routinely lower, these categories experienced the greatest increase in access for respiratory infections: +3.9% and +10.1% in 2020; +2.8% and +7.4% in 2021. While reduction of non-urgent ED visits indicates that the high pre-pandemic access levels may have been avoidable, the significant decline in non-COVID-19 urgent accesses potentially points to an increase in delayed and missed care.

Key messages
• During the COVID-19 pandemic – possibly due to fear and underestimation of symptoms – there was an overall reduction in ED accesses that potentially points to an increase in delayed or missed care.
• The reduction in non-urgent attendances indicates that high pre-pandemic accesses may have been avoidable and that a reduction in unnecessary ED visits is an attainable goal for healthcare systems.
The top three causes of prematuremortality in Belgrade 2020
Authors: Rosić N , Šantrić Milićević M , Stevanović A , Bjegović Mikanović V , Terzić Šupić Z , Todorović J , Terzić N , Stojisavljević S , Albreht T 
Published: October 2022

Abstract

Background
Analysis of years of life lost (YLL) due to premature deaths during the COVID-19 pandemic can direct decision-makers towards specific public health recommendations in order to improve health and lives of people. Our study aimed to examine the existence of age- and sex-specific patterns of the three most common causes of premature death in Belgrade during the first year of the COVID-19 epidemic.

Methods
Mortality data disaggregated by age, sex and cause of death, as well as the estimated number of inhabitants and remaining life-expectancy by age-groups for Belgrade was provided by the Statistical Office of the Republic of Serbia. YLLs were calculated using the methods of the Global Burden of Disease Study, without garbage code redistribution. Mortality rates were standardized according to the European Standard Population. We acknowledge the support from the COST Action 18218 - European Burden of Disease Network.

Results
In 2020 in Belgrade, according to the share in all-cause YLLs, cardiovascular diseases ranked first (36.2%), followed by neoplasms (25.7%) and COVID-19 (11.1%). However, on average, COVID-19 generated higher number of YLLs per death case (11.9) than cardiovascular diseases (9.2), but fewer than neoplasms (13.9). In total of 31,943 YLLs due to COVID-19, men had 1.7 times more YLLs than women. By age groups, the highest YLL share due to COVID-19 was among men aged 45-49 (16%) and 70-74 (16%) and among women aged 20-25 (33%) and 25-29. years (29%). In men, COVID-19 YLL rate was 2,488 per 100,000 and was higher after standardization (2,714). In women, COVID-19 YLL rate was 1346 per 100,000 and was lower after standardization (1,245).

Conclusions
In Belgrade, COVID-19 was the third cause of premature mortality in 2020. The difference between COVID-19 YLL rates in men and women were even more prominent after standardization. Future research is needed to determine the synergistic impact of COVID-19 and other causes of premature death.

Key messages
• In 2020, COVID-19 was among the top three causes of premature mortality among male and female contingents of the Belgrade population.
• Assessing the causes of premature mortality is important for determining community health priorities.
Real-life effects of nudging and pricing strategies in the supermarket to promote healthy diets
Authors: Stuber JM , Mackenbach JD , Lakerveld J , Beulens JWJ 
Published: October 2022

Abstract

Background
Unhealthy dietary patterns pose a major public health challenge. Individual-level efforts to promote heathy diets (e.g. nutrition education) have limited effect on the long term. Context-specific interventions focussing on point-of-purchase may create opportunities for sustainable dietary changes. We evaluated real-life effects of nudging and pricing strategies in supermarkets on dietary intake.

Methods
In this parallel cluster-randomised controlled trial, we randomized 12 Dutch supermarkets in socially deprived neighbourhoods to a control group (n = 6), or intervention group (n = 6). Healthy food nudges were implemented in intervention stores across 13 food groups, combined with healthy product price decreases and unhealthy product price increases. Eligible participants were aged 30-80 years and regular shoppers at participating stores. The primary outcome was dietary guideline adherence measured via an index score (0-150), at baseline and after 3, 6 and 12 months. Secondary outcomes included parameters of cardiometabolic health (HbA1c, lipid profile, and waist circumference), the percentage of healthy food purchases in the supermarket, socio-cognitive factors, and supermarket customer satisfaction. Effects were analysed with linear mixed models.

Results
This study included 173 participants from intervention clusters and 220 from control clusters. Preliminary evaluation of the 3-month follow-up data revealed no effectiveness of the nudging and pricing strategies compared to the control supermarkets in terms of dietary guideline adherence (β -0.8, 95%CI -4.2; 2.7). Results on all outcomes will be available at time of the conference.

Conclusions
This novel supermarket trial is the first to evaluate real-life long-term effects of nudging and pricing strategies based on a comprehensive set of study outcomes and using a strong methodological design. Findings can direct future design of context-specific interventions focussing on the promotion of healthy diets.

Key messages
• Context-specific interventions focussing on point-of-purchase may create opportunities for sustainable dietary changes.
• Findings from this supermarket trial testing real-life and long-term effects of nudging and pricing strategies can direct future design of context-specific interventions focussing on healthy diets.
Circadian nutritional behaviours and risk of cardiovascular disease 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

Meal timings and daily night-time fasting periods can synchronise the circadian system, which regulates the cardiovascular system. The present study aims to evaluate the prospective associations between circadian nutritional behaviours, defined by meal timing and frequency, and the risk of cardiovascular diseases. We used data from 103,389 adults (79% females) in the French NutriNet-Santé study, 2009-2021. Circadian nutritional behaviours were assessed using repeated 24h food records during the first two years of follow-up. We examined the associations between circadian eating behaviours and risk of cardiovascular, coronary heart and cerebrovascular diseases by multivariable Cox proportional hazard models. During a median follow-up of 7.2 years, 2036 incident cardiovascular diseases were diagnosed. A later first meal of the day was associated with a higher risk of cardiovascular diseases (HR per hour increase = 1.06, 95% CI 1.01 - 1.12). A later last meal of the day was associated with a higher risk of cerebrovascular diseases (HR per hour increase = 1.08, 95% CI 1.01 - 1.15). Among women, a later last meal was also associated with a higher risk of cardiovascular disease (HR per hour increase = 1.08, 95% CI 1.01 - 1.15). We found no evidence for an association between night-time fasting duration nor meal frequency, with risk of cardiovascular diseases. This study suggests that the habit of eating a later first meal, and a later last meal (in women) could be associated with a higher risk of developing circulatory diseases. These results need to be confirmed in other largescale studies before they can be transferable to clinical practice.

Key messages
• Beyond nutritional quality of meals, meal timing could also be a risk factor for cardiovascular disease.
• If confirmed in other largescale studies, early breakfast and dinner could be considered in preventive strategies of cardiovascular diseases.
Gambling disorder and chronic diseases in Finland: a nationwide register study
Authors: Grönroos T , Salonen AH , Latvala TA , Kouvonen A 
Published: October 2022

Abstract

Background
Previous register-based studies on comorbidity have mainly focused on gambling disorder (GD) and psychiatric disorders. However, knowledge on somatic health of persons with GD is also needed. This nationwide register-based study aims to examine the gender-specific prevalence rates of chronic diseases and conditions among the Finnish adults with GD.

Methods
This study utilizes aggregated data of persons aged 18 and over with GD diagnosis (corresponding to pathological gambling, ICD-10; F63.0) in 2011-2020. The data were retrieved from the Finnish nationwide health registers: Register of Primary Health Care visits and Care Register for Health Care, including specialised outpatient and inpatient health care, and inpatient social care. All diagnostic groups were included. Corresponding figures for the total population with same age range were presented as reference numbers.

Results
The preliminary results showed that 2,617 persons with the median age of 33.5-36.0 were diagnosed with GD (men n = 1,858; women n = 759). Despite the fact that the prevalence rates of the general population were not age-adjusted, many chronic diseases and conditions were more prevalent among persons with GD compared with the general population. The prevalence rates of psychiatric disorders (87.5% vs 29.2%) and nervous system diseases (23.9% vs 15.2%) were particularly high. Musculoskeletal diseases (61.6% vs 55.8%) and digestive diseases (30.2% vs 27.6%) were also slightly more prevalent. Memory disorders (1.1% vs 5.3%), cardiovascular diseases (25.3% vs 41.0%), and cancer (15.6% vs 24.4%) were less prevalent. Among persons with GD, all comorbid diseases were more prevalent among women than among men.

Conclusions
Psychiatric disorders and nervous system diseases are exceptionally prevalent in persons with GD. These findings highlight the need for health and social care professionals to recognize that persons with GD may additionally have other disorders that need attention.

Key messages
• Mental disorders are the most common comorbidity among persons with GD, however, many somatic chronic diseases are also common.
• Comorbidities are more common among women with GD than among men with GD.
Ethnic and socioeconomic inequalities in relation to air pollution exposure in the Netherlands
Authors: van den Brekel L , Lenters V , Mackenbach JD , Hoek G , Wagtendonk AJ , Lakerveld J , Grobbee DE , Vaartjes I 
Published: October 2022

Abstract

Background
Air pollution (AP) contributes to a large disease burden and some populations are disproportionately exposed. It is unclear to what extent AP exposure differs across ethnic groups in the Netherlands and how this intersects with socioeconomic position (SEP). First, we identified differences in AP exposures between ethnic groups in the Netherlands. Second, we examined the interrelationships between ethnicity and SEP in relation to AP exposures.

Methods
We assessed AP exposures for residents of the Netherlands in 2019 (N = 17,251,511). Home address AP levels were estimated by dispersion models of the National Institute of Public Health and the Environment (RIVM). We linked exposure estimations of particulate matter &lt;10 or &lt; 2.5 μm (PM10, PM2.5), nitrogen dioxide (NO2), and elemental carbon (EC) to demographic data gathered by Statistics Netherlands. Absolute and relative differences in AP levels across ethnic groups were assessed. We conducted multivariable linear regression analyses and estimated marginal mean exposures to evaluate differences by ethnicity, SEP, age and sex within urban and rural areas. We tested for interactions and stratified accordingly.

Results
For the 40 largest minority ethnic groups (N &gt; 18,314 per group), exposure to all pollutants was higher than for ethnic Dutch, with up to 1.5-fold differences for NO2. After stratification for urbanity and SEP, ethnic exposure inequalities persisted. For ethnic Dutch and some migrant groups, we found the lowest AP exposures in the middle SEP group (i.e. U-shaped trends), while we found linear patterns in other large migrant groups, with higher exposures at lower SEP.

Conclusions
Exposure to PM10, PM2.5, NO2, and EC was consistently higher in minority ethnic groups compared to ethnic Dutch. The association between SEP and AP levels showed different patterns between the majority ethnic Dutch and some of the largest minority ethnic groups. Further research is needed to define the equity and health implications.

Key messages
• Minority ethnic groups in the Netherlands are consistently exposed to higher levels of air pollution (PM10, PM2.5, NO2, and EC) than the ethnic Dutch population.
• Depending on the ethnic group, the association between SEP and air pollution exposure was either linear (i.e. lower exposures at higher SEP) or U-shaped (i.e. lower exposures in the middle SEP group).
Exposure to phthalates, potential endocrine disruptors, in an infant cohort in Modena, Italy
Authors: Lugli C , Palandri L , Ferrari A , Barbieri R , Trevisani V , Passini E , Lucaccioni L , Facchinetti F , Righi E 
Published: October 2022

Abstract

Phthalates are pollutants ubiquitous in the environment. Human exposure to phthalates and their endocrine disrupting effects have been widely studied. Therefore, the European Union forbids phthalates in toys, cosmetic and kitchenware manufacturing. However, phthalate metabolites can still be found in human biological matrices. The purpose of this study is to investigate phthalate exposure over time in a group of Italian healthy newborns. In a prospective cohort study, we enlisted 187 women who gave birth in the University Hospital of Modena, Italy, between January 2019 and May 2020. Urine samples from women after delivery and from their infants at birth, 3 and 6 months were collected and 8 metabolites of 6 phthalates were analysed. Descriptive statistics were calculated and preliminary correlation coefficients tests were performed. Monoethylphthalate (MEP) was always detectable in urine samples. MEP, monomethylphthalate and diethylhexylphthalate metabolites showed an increasing trend over time, while monobutylphthalate and monobenzylphthalate showed decreasing levels over time. Associations between levels of phthalates metabolites in mother and infant pairs at birth were found for a few metabolites, while metabolites in infant samples at 3 and 6 months appeared often significantly associated. Infants’ phthalate exposure in Modena is still high and prolonged over time, even to those more toxic and strictly regulated. As phthalates presence in indoor environment can be a risk factor especially for the most fragile groups of population, such as children, public Health campaigns addressing childbearing age women should stress about the risk posed by these substances and how to avoid their exposure. Moreover, regulatory actions and a stricter legislation should be considered.

Key messages
• In Italy infant exposure to phthalates, including those strictly forbidden, appears still high and continuous over time.
• Public heath intervention and stricter regulatory actions should be considered.