bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of social deprivation on the dynamic of the SARS-CoV-2 infection in France
Authors: Smaili S , Pelat C , Chatignoux E , Kelly-Irving M , Delpierre C , Vandentorren S 
Published: October 2022

Abstract

Background
The association between health inequalities and the SARS-CoV-2 infection dynamic remains to be studied in France. The objective of this study was to analyse the relationship between an area-based deprivation indicator and SARS-CoV-2 infection indicators, during four epidemic waves running from August 4th 2020 to January 27th 2021 (second wave), January 28th to June 24th 2021 (third wave), June 25th to October 28th 2021 (fourth wave), and October 29th 2021 to March 29th 2022 (fifth wave).

Methods
We analysed weekly indicators of SARS-CoV-2 infection, extracted from the national testing information system: incidence, positivity and testing rates. The associations of these outcomes with the European Deprivation Index (EDI) quintiles were estimated with negative binomial generalized additive models adjusted for epidemic waves, population density (sparsely, moderately, densely populated), region (random effect) and interactions between epidemic waves and the variables EDI, population density, and region.

Results
The most deprived areas had a higher positivity rate than the least deprived ones during the second, third and fourth waves, but a lower rate during the fifth wave. They also had higher incidence during the third and fourth waves, but a similar incidence than the least deprived areas during the second wave, and even a lower rate during the fifth wave. The testing rate was lower in the most deprived areas than elsewhere, irrespective of the epidemic waves.

Conclusions
People living in the most deprived areas were less likely to be tested and more likely to test positive than people living in less deprived areas. The lower incidence, positivity and testing rates during the fifth wave in the most deprived areas may be explained by the enacted change in policy whereby screening tests were no longer free. These findings may reflect structural differences in access to care and lower capacity to benefit from prevention measures by deprived populations.

Key messages
• People living in the most deprived areas were less likely to be tested for COVID-19 irrespective of the epidemic waves.
• Health authorities should address the issues of social inequalities more rapidly and target prevention strategy to disadvantaged populations.
Factors influencing the implementation of school interventions: a systematic review
Authors: Butscher F , Ellinger J , Mall C 
Published: October 2022

Abstract

Background
To investigate contextual factors that influence the implementation of obesity prevention interventions in school addressing children with low socioeconomic status (SES) is very important. Evidence about these factors helps to improve the implementation, which can promote the health of children with low SES and therefore reduce health inequity. We aimed to systematically identify, critically appraise and summarize the evidence on implementation of school-based interventions promoting obesity prevention for children with low SES.

Methods
A systematic search in seven databases was conducted with the main inclusion criteria 1) school-based interventions and 2) age group 5-14 years. The Consolidated Framework for Implementation Research and its five domains and 39 categories was used to analyze the data deductively. If necessary, inductive sub-categories were defined within the categories. Contextual factors are assessed in the domain Outer Setting with four categories (A-D).

Results
6.446 studies were screened and 16 studies fulfilled all inclusion criteria. Seven studies reported contextual factors in the four categories A. Needs & resources of parents (N = 4), B. Cosmopolitanism (N = 4), C. Peer pressure (N = 2), and D. External policy (N = 4) with seven sub-categories in total. In the following are examples for reported aspects in the sub-categories. In the sub-category D.2 Existing policy, policy in line with the intervention was a facilitator for implementation (N = 2), whereas lack of control over administrative changes and food served in cafeteria due to policy were reported as barriers (N = 2).

Conclusions
Intervention research as well as applied health promotion should consider the complexity and interdependency of influencing factors for successful implementation. Albeit contextual factors are hardly changeable, they should be considered and addressed to reduce health inequity.

Key messages
• More research is needed with detailed reporting of influencing factors, as detailed information is those of relevance for practice.
• Contributing to standardized analysis and reporting in implementation research by using a comprehensive framework.
Prevalence of chronic diseases among United Arab Emirates University students: cross-sectional study
Authors: Bashir MM , Alshamsi M , Almahrooqi S , Alyammahi T , Alhammadi W , Alshehhi S , Alhosani H , Alhammadi F , Al-Maskari F 
Published: October 2022

Abstract

Background
Chronic disease burden is increasing globally. In Arab Gulf Countries, the burden has increased exponentially over the past five decades due to rapid economic growth and urbanization. In the United Arab Emirates (UAE), chronic diseases are the leading cause of mortality and economic burden, hence, there is need to explore their patterns for targeted interventions. Studies among university students in Europe and the United States show chronic diseases prevalence ranging from 16.5% to 30.0%, respectively. To our knowledge, this is the first study in the Gulf region to assess multiple chronic diseases among university students. Our study describes the prevalence and patterns of multiple chronic diseases among UAE University (UAEU) students.

Methods
We conducted a descriptive cross-sectional study among UAEU students ≥18years from July to October 2021. Online questionnaire was used to collect data. Self-reported chronic diseases were described and compared between male and female students using chi-square and t tests. Other students’ characteristics were also explored. All analyses were conducted using STATA statistical software.

Results
902 students participated in the study with mean age of 21.9±5.2yrs. 79.8% were females. 80.7% were undergraduates. The prevalence of self-reported chronic diseases was 23.0%. Obesity, Diabetes and Asthma/Allergies were the commonest (12.5%, 4.2% & 3.2%, respectively). 34.8% of the students were either overweight or obese. Overall chronic disease prevalence was similar between males and females [27.5% vs 21.8%, 0.104] though it was significantly higher among postgraduates, students who are older, married and have family history of diabetes. 4.7% of the students reported 2 or more chronic diseases.

Conclusions
Our study showed that more than 1 in 5 of the students reported at least one chronic disease. This shows the need for proactive chronic disease screening and prevention programs to meet the health needs of the students.

Key messages
• Prevalence of chronic diseases (Diabetes, Prediabetes, Obesity, Hypertension, Asthma/Allergies, Lipid disorders, Thyroid disorders, GI disorders, and CVDs) was high among the university students.
• Universities should commit to researching students’ health and creating targeted health policies and interventions, as chronic diseases have direct and indirect negative impact on students’ education.
The economic burden of Diabetes Mellitus in Belgium from 2013 to 2017
Authors: Pinheiro V , Gorasso V , Devleesschauwer B 
Published: October 2022

Abstract

Background
Considering the growing prevalence of chronic disease and diabetes mellitus (DM) in Belgium, alongside population aging, insight into the economic burden of DM is essential for decision makers. To the best of our knowledge, there is no research on the subject in Belgium. Thus, our aim was to estimate the direct and indirect costs associated to DM in Belgium between 2013 and 2017.

Methods
On a first phase, we performed a retrospective observational study, calculating the direct (i.e., ambulatory care, hospitalizations and medications) and indirect (work absenteeism, by multiplying mean daily wage and days absent from work) costs in the Belgian population with DM in 2013-2017. Data was retrieved from the Belgian Intermutualistic Agency (which manages compulsory health insurance) database and the Belgian Health Interview Survey database, namely DM prevalence, healthcare costs, days absent from work and sociodemographic and health factors. Subsequently, negative binomial regression models were used to assess the association of mean yearly costs to DM and adjustments for age, education level, physical activity, sugared drink consumption and body-mass index were included. Mean incremental costs were estimated through recycled predictions, considering the observed DM prevalence in Belgium in the study period and a counterfactual scenario with null prevalence.

Results
We found a direct mean yearly incremental cost of €2 477 per DM patient, in Belgium, associated with age, low educational level and low physical activity. In the total Belgian population, the total yearly incremental healthcare cost of DM was €1.5 billion. Indirect yearly incremental cost of DM resulted to be not significantly different from the population without DM.

Conclusions
DM has a major economic burden in Belgium, one that is expected to continue to rise in the future, alongside population aging. These results are essential for health planning and resource allocation.

Key messages
• DM has a major economic burden in Belgium, especially when it comes to direct health expenditures with ambulatory care, hospitalizations and medications.
• Considering the growing prevalence of DM and population aging, these results are essential for health planning and resource allocation.
Mitigating effects of desert dust storms in asthmatic children: health visitors’ perceptions, Cyprus
Authors: Kinni P , Kouis P , Charalambous M , Kakkoura MG , Elia SA , Kampriani E , Achilleos S , Panayiotou A , Middleton N , Yiallouros PK 
Published: October 2022

Abstract

Background
Countries of the Mediterranean basin such as Cyprus are experiencing frequent desert dust storm (DDS) events that adversely impact children with asthma. As school health visitors (SHVs) have important role in asthma management, we examined SHVs practices and perceptions on asthma management and their level of engagement in school-based interventions to mitigate DDS- health effects.

Methods
A descriptive cross-sectional survey was conducted among SHVs across state schools in Cyprus via an anonymous questionnaire, which rated the importance of asthma management measures (10-point scale), current implementation of these practices (1=never - 5=always), and regulatory authorities’ preparedness to respond to DDS events (1-5 Likert scale).

Results
Responses from 78 of the 93 SHVs (84%), with an average work experience of 13.5 years (SD 7.3), revealed discordance between high perception of the importance of asthma management measures and their actual implementation, with poor scoring especially in assessment of asthma control (M = 2.4, SD = 1.5), tracking school absenteeism (M = 2.1, SD = 1.0) and monitoring of asthma triggers (M = 1.9, SD = 1.4). Any DDS-related measures (e.g. air quality real-time monitoring, warnings, recommendations, awareness campaigns, etc) were implemented very infrequently. Ratings of authorities’ preparedness were moderate (&lt;3.5), and only slightly higher in the health versus the educational or other government services. SHVs who recognized the severity of DDS and potential impact on asthmatic children were more likely to support school-based interventions for DDS events (OR = 7.3, 95% CI: 2.1-25.3).

Conclusions
Asthma management practices in school settings in Cyprus are suboptimal and responses during DDS are fragmented. While SHV’s awareness and support for interventions is high, this is not reflected in current practices. A concerted effort is needed for adoption of policies and implementation of action plans for DDS within school settings.

Key messages
• Suboptimal asthma management policies and practices were found to be implemented in schools in Cyprus, a country highly exposed to dust events.
• School health visitors recognize the health impact of desert dust on asthmatic children and support the plan for dust-mitigation programmes in schools, despite authorities’ low preparedness.
Expectations of patients for the implementation of new nursing technology
Authors: Klawunn R , Dierks ML 
Published: October 2022

Abstract

Background
New technologies, including robots, incidence detection or patient mobilization units, are increasingly assumed to support nurses in their routines while improving care quality. In the Nursing Care Centre Hanover study (funded by the German ministry of education and research), new technologies are implemented in a hospital ward and used by nurses in their routines. As part of this study, hospital patients were interviewed regarding the question: What are patients’ expectations for the implementation of new technology into care delivery?

Methods
Between August 2019 and February 2020, 17 semi-structured interviews were conducted with patients from the project ward. To stimulate a response, 8 presentation of technologies by video and text (3 per interview) were given during the interviews. Interviews were recorded, transcribed and coded by evaluative, qualitative content analysis. The coded material was then interpreted in light of the research question.

Results
Patients anticipate positive and negative effects of new technology concerning themselves, but they also expect effects on nurses: Health, safety and health service quality improvements might be positive effects for patients, but they are concerned about emerging threads to health by unintended consequences. They raise concerns about the possible inabilities of elder patients to use technology properly. Patients expect physical and emotional stress release for nurses when using technology, but they fear the replacement of nurses. This would have negative consequences for patients, like social isolation due to being cared for by machines.

Conclusions
Patients have ambivalent perceptions of new technologies in nursing care. They have a differentiated view of possible consequences, not merely for themselves but also for nurses. In general, they are positive about the implementation, but this must be carried out under certain conditions, so that technology is used in a supportive, but not replacing, manner.

Key messages
• The patients’ perspective must be take into account for the implementation of nursing technology to avoid negative, unintended consequences.
• Inclusion and consideration of older patients and their technology skills can be a relevant factor for advancing the adoption of new technology into care delivery.
Locality based Approach for containment of COVID-19 Infections in Pakistan’s High risk Districts-ICT
Authors: Noreen N , Naveed I , Bashir F 
Published: October 2022

Abstract

Background
In May 2020, considering gradual restoration of all economical activities the Government of Pakistan updated containment strategy from locking down the whole country to locking down high-risk areas to mitigate COVID-19 spread. All districts having ≥300 cases/100,000 population. COVID-19 case incidence and test positivity rates by real-time RT-PCR before and after zonal lockdown were compared to assess whether the locality-based lockdowns can be used as an alternative to country lockdown to contain COVID-19 spread.

Methods
Smart lockdowns were implemented in ten localities in the Islamabad Capital Territory (ICT), having a population of 60,000 from 12 May 2020 to June 3, 2020. Movements were restricted. Entry and exit points were guarded by police. Any person with symptoms of fever, cough, or sore throat tested by real-time RT-PCR methods and reported within 24 hours of collection. To compare the rate of active cases and positivity rate by weeks, we performed a z-test for two proportions and set p &lt; 0.05 as the level of significance.

Results
The red zone had 60,000 persons in 2.00 square kilometers. The rate of active COVID-19 cases significantly decreased (p &lt; 0.0001) during intervention from 300/100,000 population pre-containment time to 22/100,000 population after the first three weeks of lockdown. The COVID-19 positivity rate also decreased significantly (p &lt; 0.0001) from 24% (24/78) pre-containment to 5.3% during containment. A total of 3800 people were tested in the following three weeks of intervention and 26 cases were detected.

Conclusions
The smart lockdowns approach reduced COVID-19 transmission in the ICT district. This type of intervention was recommended to reduce the COVID-19 infection spread

Key messages
• Reduced COVID-19 transmission in the ICT district.
• Keeping balance between life and economy.
The effect of BMI at cancer diagnosis on survival of patients with head and neck carcinoma
Authors: Pastorino R , Boffetta P , Hashibe M , Yuan-Chin A , Boccia S 
Published: October 2022

Abstract

Background
Previous findings suggest a positive association between body mass index (BMI) and survival from head and neck cancer (HNC). The aim of this study is to investigate the prognostic role of BMI at the time of diagnosis in a large international cohort of HNC patients.

Methods
We performed a pooled analysis of studies included in the INHANCE consortium. Cases were adults with HNCs of the oral cavity, oropharynx, hypopharynx, and larynx. We used Cox proportional hazards models to estimate the adjusted hazard ratios (HR) for overall survival and HNC-specific survival, by cancer site. Subgroups analyses were performed according to smoking status and duration of follow-up.

Results
The study included 10,177 patients from 10 studies worldwide with a median follow-up of 48 months; 3654 patients (35.9%) died from all causes, including 1202 (11.8%) from HNC. Underweight patients had lower overall survival (HR = 1.69, 95% CI: 1.31-2.19) respect to normal BMI patients (BMI=18.5-24.9 kg/m2) with consistent results across the HNC sites. In HNC-specific mortality analyses, the survival for underweight patients was not significant, except for underweight patients with oropharyngeal cancer (HR = 1.43, 95% CI: 1.11-1.83). Overweight and obese patients for oropharyngeal cancers had a favourable HNC-specific survival (HR = 0.50 (95% CI: 0.33-0.75) and HR = 0.51 (95% CI: 0.36-0.72), respectively). Among never smokers, overall BMI status was not associated with HNC-specific survival. Among ever smokers overweight and obese categories showed a favourable HNC-specific survival (HR = 0.69 (95% CI: 0.56-0.86) and HR = 0.70 (95% CI: 0.61-0.80)).

Conclusions
Our findings show that high BMI values increase the survival rates in smoking patients with HNC, suggesting that a nutritional reserve may help patients survive HNC cancer. This effect, however, may be partly explained by residual confounding, reverse causation, and collider stratification bias.

Key messages
• Our analysis reports the results of the largest available pooled analysis on the prognostic significance of BMI in the survival of 10,177 HNC patients from 10 studies worldwide.
• Lower overall survival was observed in underweight patients for all HNC sites and a lower HNC-specific survival was observed with oropharyngeal cancer. Adiposity could serve as a nutrient reserve.
Birth order and sickness absence: register-based evidence from Finland
Authors: Reini K 
Published: October 2022

Abstract

Background
In working ages, sickness absence is strongly related to persons’ health condition. We studied how birth order was associated with receipt of sickness absence, distinguishing mental disorders, musculoskeletal disorders and injuries.

Methods
A follow-up study based on the entire Finnish population was conducted for sibling groups born 1969-1982, in which each sibling was observed from age 35 years in the period 2004-2018. Focus was on within-family variation in first-time sickness allowance receipt. Stratified Cox regressions were estimated using Stata 16.

Results
Each increase in birth order was associated with a higher risk of sickness absence. For mental disorders, the hazard ratio as compared to first borns was 1.03 (95% CI: 0.98, 1.08) of second borns, 1.10 (95% CI: 0.99, 1.22) of third borns, and 1.52 (95% CI: 1.25, 1.85) of fourth or higher borns. Corresponding numbers for musculoskeletal disorders were 1.12 (95% CI: 1.07, 1.17), 1.19 (95% CI: 1.09, 1.30) and 1.15 (95% CI: 0.96, 1.38), and for injuries 1.06 (95% CI: 1.01, 1.12), 1.09 (95% CI: 1.21, 1.14) and 0.96 (95% CI: 0.77, 1.20), respectively. These associations were notably stronger for women than men, but modestly influenced by mother’s age at birth, educational level, occupation, income and family composition.

Conclusions
The study was the first to provide evidence about an interrelation between birth order and sickness absence, utilising diagnose information and family fixed effects methods. A clear birth order pattern was observed for these main causes, but not for a residual group that consisted of other miscellaneous causes. Higher birth order was found associated with a higher risk of sickness absence, and particularly so for mental disorders and muscoloskeletal disorders in women. The underlying mechanisms behind these associations constitute an avenue for future research.

Key messages
• Using sibling fixed effects, the study was the first to analyse if sickness absence by main cause is associated with birth order in working ages.
• First-born siblings were the least likely to be sick because of mental or musculoskeletal disorders, and the associations were notably more accentuated for women than men.