bluuebunny/crossref_metadata_2025_split huggingface dataset:
How social capital enabled healthcare access and navigation by vulnerable people during Covid-19
Authors: Zanni F 
Published: October 2022

Abstract

Background
Healthcare systems have become complex and fragmented, negatively affecting healthcare access and navigation. This is especially the case for socio-economically vulnerable people, who encounter organisational and administrative hindrances trying to access care. These difficulties have worsened during Covid-19. Scholarly literature recognises that - by moulding navigation practices - social capital may mediate between potential and realised access to healthcare. However, little is known about how this mediating work practically unfolds.

Methods
This case study aimed to understand how social capital might affect healthcare navigation practices. To do so, we investigated how the People’s Health Lab (PHL), a community-based organisation, supported socio-economically vulnerable people in navigating healthcare during the Covid-19 pandemic in Bologna, Italy. Nine months of participant observation were conducted both in person and digitally from July 2020 to March 2021. Twelve semistructured interviews were also conducted with volunteers of the organisation. Fieldnotes and interview transcripts were analysed through Thematic Analysis.

Results
PHL support activities addressed barriers to healthcare navigation by vulnerable people, which were found to be services fragmentation, bureaucracy and Covid-19 restrictions. Volunteers of the PHL connected vulnerable individuals to health services in manifold, flexible ways, working without standard operative protocols and relying on informal personal contacts within public services. This was found to be key in enabling navigation of healthcare during the first three waves of the pandemic.

Conclusions
Our study provides evidence about how structural, linking social capital - the material and nonmaterial resources mobilised through the relationships between heterogeneous groups (the People’s Health Lab, health authorities and vulnerable people) - can mediate access to fragmented healthcare systems by shaping navigation practices.

Key messages
• Contemporary healthcare systems – including universal ones – have become complex and fragmented, posing access and navigation challenges to their users, especially those socio-economically vulnerable.
• Linking social capital can mediate access to fragmented healthcare systems by flexibly mobilising material and nonmaterial resources through informal relationships between heterogeneous groups.
Promote equal access to COVID19 vaccination: strategies of the Local Authority Toscana SudEst, Italy
Authors: Marconi D , Magi S , Cotoloni C , Moscatelli C , Arniani S , Nisticò F , Nante N , Messina G 
Published: October 2022

Abstract

Background
In the area of the Local Health Authority Toscana Sud-Est (LHA) 13,5% of residents are foreigners. We aim to assess the impact of our intervention to COVID-19 vaccination coverage.

Methods
Since summer 2021, LHA has promoted vaccination sessions dedicated to foreign residents with free walk-in access, multilingual forms, flyers and TV interventions, cultural mediators and trained healthcare workers. We collected data about vaccination status of residents (28 December 2020-31 January 2022) and we analysed them using the software STATA to assess vaccine coverage by nationality and the effectiveness of our intervention. The results were adjusted for age and sex. We set significance level at p &lt; 0.05.

Results
On 31 July 2021, 78% of Italian residents (N = 685289) had received the first dose of vaccine, compared to only 43% of foreign residents (N = 106370). There was a 35% gap. On 31 January 2022, after our intervention, 89% of Italian residents and 71% of foreign residents had received the first dose of the vaccine. The gap was 18%. On 31 January 2022, 50% of residents of all nationalities had received two doses of the vaccine. A significant difference between Italian and foreign residents is still observed after adjustment for age and sex (OR 0.41 95% IC 0.40-0.41). Vaccination adherence is lower in females than males, for both Italian (OR 0.90 0.89-0.91) and foreign residents (OR 0.82 0.79-0.84). This is accentuated within some ethnic groups: Macedonians, Kosovars, Pakistanis.

Conclusions
The creation of dedicated service guaranteed to reach a high vaccination coverage in all the nationalities and to reduce the gap between host and foreign residents. In foreigners it is lower than in the hosts, so it is necessary to investigate possible cultural factors that may influence hesitancy. A lower vaccination coverage in females, especially in foreigners, may be due to an inferior participation in social and working life as a consequence of the gender gap.

Key messages
• The creation of dedicated interventions guaranteed to achieve high vaccination coverage in all nationalities.
• A lower vaccination adherence in females than males, especially in foreigners, may be due to an inferior participation in social and working life as a consequence of the gender gap.
The age of chronic diseases onset – the results of the longitudinal study
Authors: Skybova D , Slachtova H , Tomaskova H , Klanova J , Madar R 
Published: October 2022

Abstract

Background
A current aging of the European population call questions into how to protect a high quality of health in the elderly which was the reason to establish the longitudinal HAIE Project. As the baseline information, the longitudinal ELSPAC study results were used. The aim of the analysis was to learn a life-course-dependent risk factors of the onset chronic diseases in middle-aged population.

Methods
The cohort includes data on both parents. Their number decreased during the follow up from 4,500 to about 1,000 parents. The selected questionnaire data of the cohort gained at consecutive intervals during the years 1990-2010 were analysed descriptively, according the distribution of data by respective statistical methods and survival analysis. Differences between curves were tested by log-rank tests (significance level of 5%). The SW Stata v.15 was used.

Results
The mean age of mothers (N = 823) at study entry was 25.0 years (SD = 4.86), the age of fathers (N = 385) 28.8 years (SD = 6.05). Good self-reported health has decreased continually over time from more than 80% in both parents aged 30 to about 50% in the age of mid-forties. Most parents suffered from back pain, hypertension, and joint pain. The prevalence of diseases has raised over time. Problems with hypertension begin in women from the age of 38 (39 in men) and there was no statistically significant difference by sex (p = 0.265). Survival analysis found a significant difference by sex for depression (p &lt; 0.001) and physician-confirmed back pain (p &lt; 0.001), which affect parents from 35 years (significantly more in women than men).

Conclusions
The processed analysis will refine the findings of the longitudinal Project HAIE (CZ.02.1.01/0.0/0.0/16_019/0000798) and subsequent projects monitoring the factors influencing healthy aging. The (C)ELSPAC studies are supported by the projects RECETOX RI (No LM2018121) and CETOCOEN EXCELLENCE (No CZ.02.1.01/0.0/0.0/17_043/0009632).

Key messages
• About 50% of the mid-forties aged population did not declare good self-reported health. They suffered mostly from back pain, hypertension, and joint pain. The diseases prevalence has raised over time.
• The onset of hypertension begin from the age of 38 (39) with no difference by sex, depression and physician-confirmed back pain start from 35 years of age, significantly more in women than men.
Pharmacist care in hypertension management: systematic review of randomized controlled trials
Authors: Gastens V , Tancredi S , Kiszio B , Del Giovane C , Tsuyuki R , Paradis G , Chiolero A , Santschi V 
Published: October 2022

Abstract

Background
Hypertension management remains a major public health challenge in primary care. Recent hypertension guidelines recommend the involvement of pharmacists for team-based care management of hypertension. Our objective is to systematically review the evidence of the impact of pharmacist care alone, or in collaboration, on BP amongst hypertensive outpatients compared with usual care. One major focus is to assess the heterogeneity in the effects of these interventions to identify which ones work best in a given healthcare setting.

Methods
In collaboration with a medical librarian, a systematic literature search was conducted for any article published up to 22.10.2021 in MEDLINE, EMBASE, CENTRAL, CINAHL, Web of Science, and Trip databases. Randomized controlled trials assessing the effect of pharmacist interventions on BP among outpatients were included. The outcomes are the change in BP, BP at follow-up, or BP control. Results will be synthesized descriptively and, if appropriate, will be pooled across studies to perform meta-analysis. We published the study protocol in BMJ Open.

Results
A total of 1768 study records were identified by electronic database searching and loaded to the systematic review management software Covidence. After removal of duplicates, 1744 were independently screened based on title and abstract by two authors (VG, ST), and 242 full texts were evaluated. A total of 72 studies with 32641 patients are currently included for data extraction. These studies were published between 1973 and 2021 and conducted in different regions (North America: n = 34, Europe: n = 13, other: n = 25). The data extraction and analysis are ongoing. Results will be presented at the congress.

Conclusions
This systematic review provides updated evidence on the effect of pharmacist intervention on BP management. Heterogeneity in the effect of interventions will be carefully evaluated which will help the implementation of effective interventions in various healthcare settings.

Key messages
• Recent hypertension guidelines recommend the involvement of pharmacists for team-based care management of hypertension.
• This systematic review provides updated evidence on the effect of pharmacist intervention on blood pressure management.
The association between body fat percentage and self-reported depression in the United Arab Emirates
Authors: Al Balushi M , Ahmad A , Javaid S , Ahmed L , Al Maskari F , Abdulle A , Ali R 
Published: October 2022

Abstract

Background
The United Arab Emirates Healthy Future Study (UAEHFS) is one of the first large prospective cohort studies in the region which examines causes and risk factors for chronic diseases among adult UAE nationals. The aim of this study was to explore the relationship between body fat percentage (BF%) and the eight-item Patient Health Questionnaire (PHQ-8) as a screening instrument for depression among the UAEHFS pilot study participants.

Methods
We analyzed the UAEHFS pilot data to investigate the association between BF% and PHQ-8 adjusted for age and gender. We used multivariate logistic ordinal regression model. To impute missing values, 100 multiple imputations (MI) were performed using multivariate imputation of classification and regression tree. The statistical analysis was performed using R Statistical Software (version 4.2.0)

Results
Out of 517 participants, data from 487 (94.2%) were analyzed after excluding participants who didn't fill out the questionnaires. The median age was 30 years (Interquartile Range: 23 - 38). There were more males (67.8%) than females in the UAEHF pilot data. Approximately, 64 (13.1%) of the participant reported depression. The prevalence of obesity was 35.2% in this study population. The estimated odds ratio of BF% from the fitted multivariate logistic ordinal regression model was OR = 1.046 (95% CI: 1.012-1.08), and OR = 1.03 (95% CI: 1.003-1.057) for the omitted data, and MI (sensitivity analysis) respectively.

Conclusions
High body fat percentage was statistically significantly associated with high risk of reporting depression. Additional research is needed, using the main UAEHFS data (after recruitment is complete), to further investigate the association between body fat percentage and depression.

Key messages
• Our results can help contribute to the knowledge based on current and potential population mental health in the UAE and Gulf Region.
• The main finding of this study that excess body fat is associated with an increased risk of developing depression and vice versa; thus, this could add to the future direction of mental health research.
Two-decade trends and factors associated with overweight and obesity among young adults in Nepal
Authors: Shakya S , Neupane S , Absetz P 
Published: October 2022

Abstract

Background
Young adults are vulnerable to obesity due to different life stresses and challenges, leading to risks of cardiovascular and metabolic disorders. Studies on the long-term trends of overweight and obesity, especially among young people in Nepal are scanty. The problems among this productive age group should be checked and prevented at the earliest. The study aimed to assess more than two decades of trends from 1996 to 2019 of overweight and obesity among Nepalese young adults (18-29 years) and the socio-demographic factors associated with it.

Methods
We utilized data from the nationwide Demographic and Health Survey (DHS) and WHO STEPwise approach to surveillance (STEPS) survey. These surveys adopted multistage stratified cluster sampling techniques and used house-to-house structured interviews for data collection. We assessed the prevalence of overweight (BMI 25-29.9 kg/m2) and obesity (BMI≥30 kg/m2) in 1996, 2001, 2006, 2011, 2012, 2016, and 2019 among 18,714 young adults in total, and evaluated the associated socio-demographic factors from the 2016 survey, using logistic regression model.

Results
The preliminary study findings showed that from 1996 to 2019, overweight in women increased from 1.5% to 17.0%, and obesity from 0.1% to 3.4%. For men, overweight rose from 14.4% to 16.6%, and obesity from 1.3% to 2.5% from 2012 to 2019. Higher age was associated with higher odds of overweight and obesity compared to a younger age. Men were less likely to have overweight (AOR: 0.68, CI: 0.53-0.88) and obesity (AOR: 0.42, CI: 0.23-0.78) compared to women. Moreover, urban residents had higher odds of having obesity (AOR: 2.35, CI: 1.25-4.44) compared to rural residents.

Conclusions
Overweight and obesity have rising trends among young adults in Nepal. Older age, female and urban residence were associated with higher odds of overweight and obesity. Therefore, the interventions targeted to the risk groups can help in curbing the increasing obesity trends in Nepal.

Key messages
• The information on trends and the factors associated with overweight and obesity may help to identify needs and opportunities to halt the rising obesity trend and prevent risk factors.
• The study findings can guide in formulating a national strategy to combat overweight and obesity among Nepalese youths.
Trends in incidence of cervical cancer in England, 1985-2019
Authors: Fox L , Bannister P , Memon A 
Published: October 2022

Abstract

Background
Worldwide, cervical cancer is the 4th most common cancer in women. The highest incidence is observed in Africa (25.6/100,000) and the lowest in North America (6.1/100,000). Over 99% of cases are caused by human papillomavirus (HPV). In the UK, HPV vaccination has been offered to school children aged 12-13 years since 2008. We conducted a retrospective population-based cohort study to examine whether there have been changes in the incidence of cervical cancer in England during the past four decades.

Methods
Individual level data for women diagnosed with cervical cancer in England during 1985-2019 were obtained from the Office for National Statistics/Public Health England. Average annual incidence rates were calculated by two age categories (0-49, 50+ years) and all ages combined during the seven five-year time periods (1985-89 to 2015-19). The percentage change in incidence was calculated as change in the average annual incidence rate from the first (1985-89) to the last time period (2015-19). Index of Multiple Deprivation (IMD) quintiles (2015-19) were examined to determine the social gradient of the disease.

Results
During the 35-year study period, a total of 100,303 women with cervical cancer were registered in England. In women aged 0-49 years, the average annual incidence rates declined by about 20% (from 11.6/100,000 in 1985-89 to 9.3/100,000 in 2015-19), and in women aged 50+ years, the rates declined by about 64% (from 26.1/100,000 in 1985-89 to 9.5/100,000 in 2015-19). At all ages combined, the rate declined by 43%. With regard to the social gradient, about half of the cases occurred in women in the most deprived quintiles.

Conclusions
There has been a steady decline in the incidence of cervical cancer in England over the past four decades. These findings are consistent with reports from other Western countries. The finding of relatively increased risk of cervical cancer among women from most deprived communities needs further investigation.

Key messages
• Considering that over 99% of cervical cancers are potentially preventable, there is an urgent need to support low- and middle-income countries to roll out HPV vaccination programme.
• The difference in risk of cervical cancer by social gradient highlights the importance of reducing health and social inequalities.
The impact of smoking on immunological response to SARS-COV 2: a nationwide seroepidemiological study
Authors: Sahakyan S , Musheghyan L , Muradyan D , Sargsyan Z , Petrosyan V , Khachadourian V , Harutyunyan A 
Published: October 2022

Abstract

Background
Smoking influences cellular and humoral immune responses and affects the immune system by increasing inflammation and decreasing activity against infections. The current study investigates the association between smoking and immunological response to SARS-CoV-2 in the Armenian population.

Methods
We performed a nationwide cross-sectional seroepidemiological study among the adult population (≥18 years old) in Armenia. We used a multi-stage cluster random sampling to recruit participants from the capital city and all regions of Armenia. We invited selected participants to primary healthcare facilities to provide blood samples for antibody testing followed by a phone survey on demographic characteristics, smoking status, and other variables. Logistic regression analysis was used to test the relationship between smoking and having SARS-CoV-2 antibodies adjusted for other covariates.

Results
3483 people participated in the study (71% women). The total sample included 16.8% current smokers (n = 571), 8.6% past smokers (n = 294) and 76.4% never smokers (n = 2538). The prevalence of SARS CoV-2 antibodies among current smokers was statistically significantly lower as compared with never smokers (46.9% vs 73.4%, p-value&lt;0.001). In the multivariable logistic regression model, the odds of having SARS CoV-2 antibodies among the current smokers was 70% lower (OR 0.30, 95%CI: 0.22; 0.40) compared to never smokers, when adjusted for demographic factors and the time of PCR diagnosis of COVID-19. No statistically significant difference was found between past smokers and having SARS CoV-2 antibodies.

Conclusions
In addition to being a risk factor for various chronic diseases, smoking weakens immune response to infectious diseases, including COVID-19, worsening the outcomes. The significantly lower level of antibody prevalence among smokers with previous PCR confirmed COVID 19 implies a poorer immune response to the infection and not a lower risk of getting the infection.

Key messages
• Smoking weakens immune response and contributes to a higher burden of infectious diseases, such as COVID-19.
• Lower level of antibody prevalence among smokers indicates a poorer immune response to the infection rather than a lower risk of getting the infection.
Treatment burden and associated factors: a population-based survey in Central Denmark Region 2017
Authors: Pedersen MH , Duncan P , Lasgaard M , Friis K , Salisbury C , Larsen FB 
Published: October 2022

Abstract

Background
Exploring treatment burden at a population level can provide evidence of the types of patients who need special attention and support. We aimed to determine factors associated with high perceived treatment burden in a population-based survey of adults living in the Central Denmark Region (23% of the Danish population).

Methods
The Danish Multimorbidity Treatment Burden Questionnaire (MTBQ) was included in the 2017 Danish population health survey. 28,627 individuals aged 25 years or over participated (64% response rate). Individuals who reported having one or more medical conditions or attending regular health check-ups were asked to complete the MTBQ. A global MTBQ score was calculated (range 0-100) and both the continuous scores and a four-category grouping of the scores into no, low, medium and high burden were used to statistically assess the association between treatment burden and sociodemographic and health-related factors.

Results
13,407 individuals completed the Danish MTBQ (mean age 59 years). Treatment burden was negatively associated with self-related health (rs = -0.45, P &lt; 0.0001), health-related quality of life (rs = -0.46/-0.51, P &lt; 0.0001) and positively associated with the number of long-term conditions (rs = 0.26, P &lt; 0.0001) and perceived stress (rs = 0.44, P &lt; 0.0001). Higher treatment burden was associated with young age, male sex, high educational level, unemployment, not living with a spouse/cohabitant, living with child(ren) and specific long-term conditions, including heart disease, stroke, diabetes and mental illness.

Conclusions
This is the first known population-based study of treatment burden. The findings provide important evidence to policy makers and clinicians about sociodemographic groups at risk of higher treatment burden. We recommend that patient-perceived treatment burden is included when evaluating interventions targeting patients with long-term conditions and multimorbidity and health-care system reorganisations.

Key messages
• Treatment burden is associated with poor health and health-related quality of life and, among others, young age, male sex, unemployment, not living with a spouse, and specific long-term conditions.
• We recommend that patient-perceived treatment burden is included when evaluating interventions targeting patients with long-term conditions and multimorbidity and health-care system reorganisations.