bluuebunny/crossref_metadata_2025_split huggingface dataset:
Etiologic and prognostic roles of frailty, multimorbidity and socioeconomic characteristics in the development of SARS-CoV-2 infection and related severe health outcomes: systematic reviews of population-based studies
Authors: Makovski T , Ghattas J , Devleesschauwer B , Carcaillon-Bentata L ,   PHIRI WP5.2working group
Published: October 2022

Abstract
The study had 2 objectives, to: 1) evaluate the etiologic roles of frailty, multimorbidity and socioeconomic status on SARS-CoV-2 infection probability, hospitalization, intensive care unit (ICU) admission, mechanical ventilation and COVID-19 related mortality; 2) investigate the prognostic roles of mentioned risk factors on the likelihood of hospitalization, ICU admission, mechanical ventilation, COVID-19 mortality, functioning, quality of life, disability, mental health and work absence. Three systematic reviews were performed, for each risk factor. The reviews shared first screening steps relying on a common population-based approach. Initial search took place on 7 April 2021 in PubMed, Embase, PsycINFO and WHO Covid-19 database. An update was performed for frailty only, on 1 February 2022, due to the scarce literature retained initially. Prospero registration number: CRD42021249444. Initial search retrieved 10 139 records; 411 studies were read in full text. An update for frailty retrieved 565 records. Finally, the total number of included studies was: for multimorbidity, objective 1 N = 2, objective 2 N = 13; frailty, objective 1 N = 2, objective 2 N = 3; socioeconomic characteristics, objective 1 N = 57, objective 2 N = 30. The risk of severe short-term outcomes such as mortality, ICU admission or hospitalization increased with increasing disease burden and socioeconomic deprivation. Literature on long-term impacts was not identified. The evidence indicates a dose-effect association across all risk factors and outcomes. There is a lack of work conducted on population-based representative samples accounting for frailty and multimorbidity. Measures of multimorbidity and frailty were heterogeneous between studies. Most of the studies observing socioeconomic determinants were performed in the USA and the UK; hence the need for more research in different contexts. Further evidence is required in order to estimate the impact of crisis among general population.
Trans* people’s access to gender-affirming health care: A European comparison
Authors: Breckenkamp J , Thirugnanamohan J , Stern A , Razum O , Namer Y 
Published: October 2022

Abstract

Background
Trans* people's life satisfaction is correlated with established legal frameworks for gender recognition and access to trans*-specific health care (Transgender Europe [TGEU], 2021). TGEU's guidelines to human rights-based principles of trans*-specific health care highlight bodily integrity/autonomy, free self-determination of gender, quality, specialized and decentralized care, and the right to determine reproductive paths as important pillars of gender affirming health care. We conducted a policy comparison across Europe regarding access to gender-affirming health care to assess how adherence to human rights-based principles could be strengthened.

Methods
We compared access to health care across four main domains: legal framework (e.g., legally recognised genders), insurance coverage (e.g., out of pocket costs), access barriers (e.g., legal requirements to access gender-affirming surgery), and health care offers (e.g., hormone replacement therapy). Criteria were developed in guided brainstorming sessions. Three researchers rated 28 countries across 28 items based on available policy documents.

Results
The majority of European countries prescribes a medicalised gender-affirming process rather than a self-decided process. Psychiatric diagnosis is also required in most countries to access gender-affirming health care. Gender-affirming health care is partly financed by statutory health insurance in most of the countries. Not all countries authorise full gender-affirming health care. Especially where statutory health insurance-covered gender-affirming health care relied centralised on single outpatient clinics or hospitals, waiting times between 6-24 months are found.

Conclusions
Many European countries fail to fully comply with TGEU's guidelines to human rights-based principles of trans* health care. Given the negative impact of access barriers on life satisfaction, European countries should target these shortfalls in ensuring gender-affirming health care.

Key messages
• Non- or only partly covered trans* health care contributes to health inequality.
• Regarding trans* people, European countries need to strengthen human-rights based access to gender-affirming health care.
Environmental health perception by Brussels inhabitants: comparison between a top-down raising awareness and citizen science
Authors: Incourt P , Herbrich L , Bouland C 
Published: October 2022

Abstract
The effects of the environment on health are well documented and prove to be a real public health problem. It is therefore essential to raise public awareness of these issues to induce preventive and protective behaviours. We focused on two methods: passive information transmission (top-down approach) and citizen science (bottom-up approach). The study aims to compare both approaches while raising awareness among Brussels citizens. We created two groups: a traditional awareness group, receiving infographics by email, and a citizen science group, carrying out immersive activities with researchers. All enrolled participants filled out a questionnaire before and after. The “top-down” group (n = 137) received 3 infographics. The citizen science participants deep-dived into the environmental health body of knowledge, carried out individual measurements of air quality and noise pollution along a city walk and analysed, together, the results in groups to design actions. The citizen science sessions were finalised by a focus group. All sessions enjoyed and developed knowledge and awareness of environmental health. Accompanying citizens in developing knowledge was beneficial and required for environmental health empowerment. It showed the added value of citizen science in raising curiosity, creativity, and capacity building. The participants showed different socioeconomic statuses and demonstrated an appetite for understanding the exposures measured during the walks. Our results integrate several SDGs among those SDG4 and SDG3, since by raising awareness of participants, we enabled them to improve their capacities in becoming actors in their health. The risk of developing health problems related to the environment is higher in lower socio-economic groups, due to a greater vulnerability and the inequitable environment distribution between neighbourhoods. Pro-environmental behaviour fosters reduced exposure for now and future generations.
Whole grain intake, overall diet quality and key components of sustainable diets in Finnish adults
Authors: Tammi R , Männistö S , Reinivuo H , Tapanainen H , Rautanen J , Maukonen M , Päivärinta E , Pajari A-M , Kaartinen NE 
Published: October 2022

Abstract

Background and objectives
Whole grains have been deemed a core component in diets promoting human health and environmental sustainability. Yet, research is scarce on whole grain intake in relation to overall diet quality and diet sustainability. We aimed to examine the association of whole grain intake with overall diet quality and key components of sustainable diets (fruits, vegetables, legumes, red and processed meat, plant-based and animal-based proteins) in Finnish adults.

Methods
Our data comprised 3127 adults (58% women, energy underreporters excluded) aged 18 − 74 years participating in the population-based FinHealth 2017 Study. Dietary intake was assessed by a validated 134-item food frequency questionnaire. Food, nutrient, energy and whole grain intakes were calculated utilizing the Finnish Food Composition Database. Overall diet quality was examined by the modified Baltic Sea Diet Score (excluding cereals). Associations were assessed by linear regression analysis adjusted for relevant confounders.

Results
Whole grain intake was positively associated with overall diet quality and fruit consumption (p &lt; 0.001) in women and men. A positive association also occurred with plant-based protein intake (p &lt; 0.001, women and men). Yet, whole grain intake was inversely associated with legume consumption in women (p = 0.001), while no association was found in men (p &gt; 0.05). The association between whole grain intake and the intake of animal-based proteins and red and processed meat was inverse (p &lt; 0.001) in both sexes. No association was found between whole grain and vegetable intakes (p &gt; 0.05).

Conclusions
Our results suggest that whole grain intake is associated with healthier diets and more sustainable protein intake in Finnish adults. However, challenges in furthering healthy and sustainable diets in the population may occur regarding legume consumption. Legumes are especially important in plant-based diets as they complement cereals as a source of essential amino acids.

Key messages
• Higher whole grain intake may indicate higher overall diet quality and more sustainable protein intake in Finnish adults.
• Legume consumption requires further attention among Finnish adults with high whole grain intake despite their generally higher overall diet quality and more sustainable protein intake.
Quality of facility-based maternal and newborn care around the time of childbirth during the COVID-19 pandemic
Authors: Lazzerini M , Covi B , Mariani I , Drglin Z , Arendt M , Hersoug Nedberg I , Elden H , Costa R , Drandic D , Pessa Valente E 
Published: October 2022

Abstract

Background
Multi-country studies assessing the quality of maternal and newborn care (QMNC) during the COVID19 pandemic, as defined by WHO Standards, are lacking.

Methods
Women who gave birth in 12 countries of the WHO European Region from March 1, 2020 - March 15, 2021 answered an online questionnaire, including 40 WHO Standard-based Quality Measures.

Results
21,027 mothers were included in the analysis. Among those who experienced labour (N = 18,063), 41.8% (26.1%- 63.5%) experienced difficulties in accessing antenatal care, 62% (12.6%-99.0%) were not allowed a companion of choice, 31.1% (16.5%-56.9%) received inadequate breastfeeding support, 34.4% (5.2%-64.8%) reported that health workers were not always using protective personal equipment, and 31.8% (17.8%-53.1%) rated the health workers’ number as “insufficient”. Episiotomy was performed in 20.1% (6.1%-66.0%) of spontaneous vaginal births and fundal pressure applied in 41.2% (11.5% -100%) of instrumental vaginal births. In addition, 23.9% women felt they were not treated with dignity (12.8%-59.8%), 12.5% (7.0%-23.4%) suffered abuse, and 2.4% (0.1%-26.2%) made informal payments. Most findings were significantly worse among women with prelabour caesarean birth (N = 2,964). Multivariate analyses confirmed significant differences among countries, with Croatia, Romania, Serbia showing significantly lower QMNC Indexes and Luxemburg showing a significantly higher QMNC Index than the total sample. Younger women and those with operative births also reported significantly lower QMNC Indexes.

Conclusions
Mothers reports revealed large inequities in QMNC across countries of the WHO European Region. Quality improvement initiatives to reduce these inequities and promote evidence-based, patient-centred respectful care for all mothers and newborns during the COVID-19 pandemic and beyond are urgently needed.
Funding: The study was financially supported by the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy.
Are loneliness interventions effective in reducing loneliness? A meta-analytic review of 128 studies
Authors: Lasgaard M , Løvschall C , Qualter P , Laustsen LM , Lim MH , Maindal HT , Hargaard AS , Christensen J 
Published: October 2022

Abstract

Loneliness is widely acknowledged as a growing public health concern, accelerated by the onset of the COVID-19 pandemic. However, our knowledge about the effectiveness of interventions to reduce loneliness across the lifespan, including knowledge of different intervention strategies, is limited. This preregistered systematic review and meta-analysis aimed to evaluate the effect of interventions to reduce loneliness. The systematic review identified 136 studies. The meta-analysis included 128 studies comprising 54 randomised controlled trials (RCTs) (n = 6,379), 23 multi-cohort studies (n = 2,882) and 48 single-cohort studies (n = 3,009). A small to moderate statistically significant effect was detected (RCTs; SMD = -0.47, multi-cohort studies; SMD = -0.24, single cohort-studies; SMD = -0.42). Using the GRADE system, confidence in the estimates was assessed as low or very low, implying that the estimates may potentially be higher or lower. No statistically significant differences were found between age groups. Psychological treatment, social support interventions, and social and emotional skills training appeared to be the most effective intervention strategies in reducing loneliness but there is currently no strong reason to prefer one intervention strategy over another. Further analyses demonstrated that the long-term effects (i.e., one to six months after the intervention) were comparable to the short-term effects (i.e., up to four weeks after the intervention). Findings from the current meta-analyses provide overall evidence of the effectiveness of loneliness interventions. Given methodological limitations, including the heterogeneity of the reviewed studies, it remains unclear who the interventions would help the most. Overall, there is a need for rigorous and high-quality development and evaluations of interventions for loneliness.

Key messages
• The findings of this meta-analytic review suggest that interventions designed to reduce loneliness are effective.
• Psychological treatment, social support interventions, and social and emotional skills training are the most promising interventions, albeit the magnitude of the effects is moderate.
Low confidence in systematic reviews of digital interventions for physical activity promotion
Authors: Matthias K , Mergenthal L , De Santis KK 
Published: October 2022

Abstract

Background
The field of digital public health aims to promote and improve the health of people and communities through the application of digital interventions (DIs). Systematic reviews (SRs) show that many DIs target physical activity (PA) promotion. ‘A Measurement Tool to Assess Systematic Reviews’ (AMSTAR2) is a valid and moderately reliable appraisal tool with 16 items that can be used to derive an overall confidence rating (OCR: high, moderate, low or critically low) in the results of a SR. This cross-sectional study aimed to appraise SRs of DIs for PA promotion.

Methods
This study using 30 SRs was embedded within a scoping review with a published protocol (doi:10.2196/35332). Following electronic searches in 03/2021 in MEDLINE, PsycINFO, and CINAHL two authors independently selected and appraised the SRs. AMSTAR2 appraisal outcomes were expressed as (1) OCRs according to the AMSTAR2 scoring guidelines and (2) as percentage scores (fulfilled items/16 items). Appraisal outcomes were assessed using descriptive statistics.

Results
The 30 SRs were published in 2007-2021 and included 5-60 primary studies. Most SRs (27/30) received ‘critically low’ OCR, while ‘low’ (2/30), ‘moderate’ (1/30) or ‘high’ (0/30) OCRs were seldom. The 21 SRs published after AMSTAR2 implementation in 2018 onwards received higher percentage scores (mean±SD of 53±15%) compared to 9 SRs published before 2018 (44±13%). In addition, the 11 SR with a protocol received higher percentage scores (59±13%) compared to 19 SRs without a protocol (45±15%) and had fewer critical weaknesses (median: 2 vs. 4).

Conclusions
High quality SRs are needed for making public health decisions. AMSTAR2 assigns mostly low and critically low OCR to SRs of DIs for PA promotion. These SRs should not be relied on as a source of accurate evidence. Our results show that SR reporting guidelines need to be better followed.

Key messages
• According to AMSTAR2 the overall methodological quality of systematic reviews of digital interventions for physical activity promotion needs improvement.
• Better adherence to established reporting guidelines for systematic reviews in public health context is needed.
Vaccination coverage trends in European Union from 1980 to 2020: A joinpoint Regression Analysis
Authors: Causio FA , Villani L , Mariani M , Pastorino R , De Waure C , Ricciardi W , Boccia S 
Published: October 2022

Abstract

Vaccinations are successful, cost-effective public health interventions; nevertheless, vaccine hesitancy represents a concern and several EU countries have implemented mandatory vaccinations to counteract it. The assessment of vaccination coverage data is helpful to clarify the reason behind this choice better and assess its impact. Data were extracted from the WUENIC database as of July 2021. All the 27 EU countries were included, considering the period from 1980 to 2020 (depending on data availability). Coverage indicators on seven vaccinations scheduled during the first year of life to prevent nine vaccine-preventable diseases were considered. Joinpoint regression was run using Joinpoint Trend Analysis Software 4.9.0.0. For each coverage indicator, the last two trends in time identified by the joinpoint regression were considered to identify countries with a positive vaccination coverage trend (having either the last trend significantly positive or the second last significantly negative but followed by a trend reversal) or a negative coverage trend (having either the last trend significantly negative or the second last significantly positive but followed by a trend reversal). To assess each country, we collated together information on each coverage indicator. A total of 180 jointpoint regressions were run. At least one joinpoint was observed in 144 cases: 39 (27.1%) showed a significant positive trend, and 49 (34%) had a significantly negative one. In 36 cases, there was a single trend lacking a joinpoint, either positive (21, 58.3%), negative (8, 22.2%), or not showing a change (7, 19.4%). Overall, 14 countries had mostly negative vaccination coverage trends, whereas 13 had mostly positive vaccination coverage trends. Systematised data collection and analysis of vaccination coverage trends are needed to support public health systems. EU countries differ broadly, but the overall situation shows that coverage trends are a key issue to be addressed.

Key messages
• Vaccination coverage in the EU shows a general negative trend. The assessment and comparison of coverage trends across EU countries could make policymakers able to respond to critical issues timely.
• Mandatory vaccinations have been issued in different countries to prevent vaccination coverages from decreasing. Some countries have not issued any mandate but show high vaccination coverages.
Menstrual inequity in Spain: a cross-sectional study
Authors: Medina-Perucha L , López-Jiménez T , Jacques-Aviñó C , Holst AS , Valls-Llobet C , Munrós-Feliu J , Martínez-Bueno C , Pinzón-Sanabria D , Vicente-Hernández MM , Berenguera A 
Published: October 2022

Abstract

Background
Menstrual inequity has an impact on (menstrual) health outcomes and emotional wellbeing. It is also a significant barrier to achieve social and gender equity. The aim of this study was to assess menstrual inequity and its associations with sociodemographic factors, among women and people who menstruate (PWM) aged 18-55 in Spain.

Methods
A cross-sectional online survey-based study was conducted in Spain in March-July 2021. Data were analysed through descriptive statistical analyses and multivariate logistic regression models.

Results
22,823 women and PWM participated (Mean age=33.2, SD = 8.7). Over half had accessed healthcare services for menstruation (61.9%) and had partial/no menstrual education pre-menarche (58.4%). Lifetime menstrual poverty was 22.2-39.9%. Main risk factors for menstrual poverty were identifying as non-binary (aOR: 1.67, 95% CI, 1.32-2.11), being born in non-European or Latin American countries (aOR: 2.74, 95% CI, 1.77-4.24), and not having a permit to reside in Spain (aOR: 4.27, 95% CI, 1.94-9.38). In turn, menstrual poverty protective factors were having completed university education (aOR: 0.61, 95% CI, 0.44-0.84) and not experiencing financial hardship in the last 12 months (aOR: 0.06, 95% CI, 0.06-0.07). Besides, 75.2% of participants indicated having overused menstrual products because of not having access to adequate menstrual management facilities. Menstrual-related discrimination was reported by 44.0% of women and PWM. Menstrual discrimination risk was higher among non-binary menstruators (aOR: 1.88, 95% CI, 1.52-2.33). Menstrual-related work (20.3%) and educational (62.7%) absenteeism was reported.

Conclusions
Our study suggests that menstrual inequity in Spain is widespread, especially among those more socioeconomically deprived, vulnerable migrant populations and non-binary and trans menstruators. Findings from this study are being useful to inform future research and menstrual (health) policies.

Key messages
• Menstrual inequity especially impacts socioeconomically deprived, gender nonconforming menstruators and vulnerable migrant populations in Spain.
• Menstrual inequity research is crucial to address social inequities of health and develop menstrual policies.
Associations between perceptions and sick leave duration in dyads of workers and significant others
Authors: Snippen NC , de Vries HJ , Roelen CAM , Hagedoorn M , Brouwer S 
Published: October 2022

Abstract

Background
Dyadic processes of workers and significant others like partners, family members and friends can play an important role in adaptation to chronic disease, thereby influencing health and work outcomes. This study aimed to increase our understanding of dyadic processes in sick leave duration of workers with chronic diseases. We examined illness perceptions, return to work expectations (RTWE) and perceptions about significant other responses (i.e., engagement, buffering and overprotection) of workers and their significant others in relation to sick leave duration.

Methods
This study used survey and registry data of 90 dyads of sick-listed workers with a chronic disease and their significant others. Simple and multiple regressions in which perceptions of workers and significant others were included simultaneously were used to examine associations with sick leave duration.

Results
Workers’ and significant others’ perceptions were moderately to strongly correlated (r ranged from .46 to .80). Sick leave duration was associated with illness perceptions of both workers (b = 8.58, p=.001) and significant others (b = 6.46, p=.008), with more negative illness perceptions associated with a longer sickness absence. In the multiple regression, illness perceptions explained 12.3% of the variation in sick leave duration. Sick leave duration was also associated with RTWE of workers (b=-76.87, p&lt;.001) and their significant others (b=-92.47, p&lt;.001), with more positive RTWE associated with a shorter sickness absence. The RTWE of dyad members accounted for 24.5% of the variance of sick leave duration.

Conclusions
Illness perceptions and RTWE of workers and their significant others are strongly interdependent and associated with sick leave duration of workers with chronic diseases. A dyadic approach targeted at improving illness perceptions and RTWE of both workers and significant others might be more effective than an individualistic approach in preventing long-term sickness absence.

Key messages
• Return to work expectations and illness perceptions of workers and their significant others are associated with the duration of sickness absence of workers with chronic diseases.
• A dyadic approach targeted at both workers and their significant others might be more effective than an individualistic approach in the prevention of long-term sickness absence.