bluuebunny/crossref_metadata_2025_split huggingface dataset:
Policies to reduce availability of tobacco products in the retail environment
Authors: Kunst AE , van den Putte B , Veldhuizen EM , Kuipers MAG 
Published: October 2022

Abstract

Background
After implementation of a tobacco vending machine ban in 2022 and a supermarket sales ban in 2024, the Dutch government intends to further phase out tobacco sales after 2030 by prohibiting sales in petrol stations and small outlets. This study aims to understand 1) the impact of these policies on tobacco outlet availability, and 2) differences in tobacco outlet availability by area socioeconomic status (SES) in the Netherlands.

Methods
Between September 2019 and June 2020, all potential tobacco retailers in four Dutch cities (Amsterdam, Eindhoven, Haarlem, and Zwolle) were visited and mapped using Global Positioning System (GPS). Expected reductions in tobacco outlet availability were calculated per policy measure. Tobacco outlet density was calculated using ESRI ArcMap version 10.4.1. The association between neighbourhood SES and tobacco outlet availability was estimated with linear and logistic regression model.

Results
We identified 870 tobacco outlets and an outlet density of 6.2/10.000 capita. The potential sales bans in petrol stations and small outlets would reduce the number of outlets (resp. -7% and -43%) and the outlet density (resp. -0.4 and -2.7). In Eindhoven, Haarlem, and Zwolle, neighbourhoods with high-SES compared to low-SES were less likely to contain a tobacco outlet (OR:0.71, 95%CI:0.59-0.85) and had a lower outlet density (ß:-1.20, 95%CI:-2.20;-0.20). In Amsterdam, the associations were inverse (OR:1.22, 95%CI:1.05-1.40; ß:3.50, 95%CI:0.81;6.20).

Conclusions
The availability of tobacco outlets varies within and between cities depending on the distribution of the built environment. Future tobacco control policies targeting the retail environment should focus on limiting the overall number tobacco outlets and especially small outlets, which may benefit low SES neighbourhoods in mid-sized cities most.
Impact of smoke-free policies in hospitality venues and the home environment on smoking behaviour and exposure to second-hand smoke: results of two systematic reviews
Authors: da Costa Senior YY , Rozema AD , Kunst AE , Kuipers MAG 
Published: October 2022

Abstract

Background
Smoke-free policies (SFPs) have proven to be effective in protecting people from exposure to second-hand smoke (SHS) and lowering smoking rates. Our aims were to assess the impact of SFPs in hospitality venues (e.g. bars) on smoking behaviour of young people and to assess the impact of SFPs in the home environment on smoking behaviour and exposure to SHS.

Methods
Two reviews were conducted. The first was conducted in June 2020. We searched PubMed, Embase, and Scopus for studies that assessed the association between any form of SFPs in hospitality venues and a measure of smoking behaviour among young people (aged 10-24 years). The second review will be conducted in June 2022. Searches will be conducted in PubMed, Embase, Web of Science, PsycINFO and CENTRAL. We will search for studies that assess the association between any form of SFPs in the home environment (e.g. multi-unit housing) and a measure of smoking behaviour (e.g. initiation) or SHS exposure.

Results
Nine studies (publication years 2005-2016) were included in the first review, of which the majority used a quasi-experimental design. Four studies evaluated SFPs in hospitality venues specifically. Two studies reported that strict, but not weaker, SFPs decrease progression to established smoking. Two other studies provided mixed results. Five studies also included other workplaces, of which three studies found significant decreases in current smoking, smoking frequency, and/or smoking quantity. The results of the second review will be presented in detail during the workshop, however an exploration suggests that SFPs in the home environment may prevent smoking and SHS exposure.

Conclusions
Most studies of the first review found that SFPs in hospitality venues are associated with a decrease in smoking behaviour among young people. Their results indicate the need for strict smoke-free legislation without exemptions. The conclusions of the second review will be presented during the workshop.
Associations of pre-existing comorbidities and COVID-19 in-hospital mortality: an unCoVer analyses
Authors: Mertens E , Ademovic E , Majdan M , Soriano JB , Trofor AC , Peñalvo JL 
Published: October 2022

Abstract

Background
Accumulated evidence on risk factors for adverse COVID-19 outcomes revealed that old age and male sex are main associates, next to pre-existing comorbidities, as analysed from scattered single cohorts of hospitalised COVID-19 patients of accessible electronic medical records. Hence, evidence from federated analyses is called for to provide a more comprehensive and robust analyses of risk factors.

Methods
Using the unCoVer network, i.e., a research platform of 29 partners for the expert use of patient data as routinely gathered in real-world healthcare settings, present analyses restricted to available data of four hospitals from Spain, Slovakia, Romania and Bosnia and Herzegovina covering 8,287 hospitalised COVID-19 patients. In-hospital death after COVID-19 diagnosis was examined in relation to common pre-existing comorbidities using virtual pooling of logistic regression models adjusted for age and sex.

Results
Patients were on average 60.1 (± 20.9) years, 50.7% were male, almost half (43.3%) had at least one pre-existing comorbidity (17.4% having obesity, 21.9% hypertension, 18.0% diabetes and 13.7% cardiovascular diseases (CVD)), and 12.6% died during hospitalisation. Patients with comorbidities had a higher risk of mortality that was increasing with the number of comorbidities: from a virtual pooled odds ratio of 1.16 (95%CI: 0.96, 1.40) for one vs none to 1.30 (1.04, 1.64) and 2.14 (1.64, 2.79) for two and three or more comorbidities, respectively. Of the comorbidities, highest risk was seen for CVD (1.68; 1.40, 2.01), followed by hypertension (1.40; 1.19, 1.64) and diabetes (1.27; 1.07, 1.50), and the lowest for obesity (1.13; 0.94, 1.37).

Conclusions
By federated analyses, this study confirmed that the number of comorbidities was a strong risk factor for in-hospital death after COVID-19, in particular CVD. The unCoVer platform pursues using scattered data sources by innovative computational resources and integrated information for enhanced impact.

Key messages
Absence among National Health Service workers during the COVID-19 pandemic in Portugal
Authors: Alves J , Nunes C 
Published: October 2022

Abstract

Background
By March 2020, the first Covid-19 cases were detected in Portugal. While the National Health Service (NHS) faced an increased demand for health care, anecdotal evidence showed that the NHS absenteeism rose. This might be explained by outbreaks in healthcare units, COVID-19 infection due to close contact with patients, self-isolation and quarantines, and family challenges originated by lockdowns. The present work aimed to quantify the absenteeism among NHS workers during the COVID-19 pandemic in Portugal.

Methods
This study used data for the number of NHS workers and absence days (2015-2021), from the Portuguese NHS Transparency Portal and the Strategy and Planning Office. Absenteeism was compared, before and after the pandemic onset, in absolute terms, and as absence rates (number of absent days as a percentage of potential workforce days). Additionally, we performed an interrupted time series analysis, by fitting a Poisson regression model with level change. We controlled for data seasonality using Fourier terms (pairs of sine and cosine functions).

Results
From 2015 until March 2020, the average monthly absence rate was of 12.2, rising to 14.4 in the remaining period. This represented an increase of 18% in the absence rate. The interrupted time series showed an increase of 10.8% in the NHS absenteeism after the pandemic onset [Relative risk =1.10; 95% confidence interval (CI) 1.10-1.11; p &lt; 0.01]. When accounting for seasonality in the data, the model showed an increase of 11.0% in the NHS absenteeism [Relative risk =1.11; 95% CI 1.01-1.22; p &lt; 0.05].

Conclusions
These results highlight the excess of absence days among the NHS workers during the COVID-19 pandemic. In future healthcare crises, health professionals should be protected, by assuring a safe workplace and making protective equipment available. Only then will be possible to reduce constraints in healthcare assistance, guarantee the adequate response, and contain the absence costs.

Key messages
Using R programming to inform and improve case notification procedures in a local public health unit
Authors: Ruas H Barrilaro , Capucho R , Ferreira V Melo 
Published: October 2022

Abstract

Issue/Problem
COVID-19 was declared a pandemic in March 2020. Information systems, particularly those related to laboratory testing notification, became extremely important as a mechanism of fast identification of cases. In Portugal, any test performed in a professional setting is of mandatory notification.
For a local public health unit in northern Portugal, much like in other regions worldwide, challenges related to lack of human and material resources were felt over the course of the pandemic.

Description of the problem
In 2021, an intensive surveillance strategy was implemented using up to date notification database analysis through R programming, focusing on simplified data availability for contact tracing team members and accuracy of notifications submitted by laboratories, including verification of individual identifying information.

Results
Some laboratories were identified has having lower data completion rate, which had negative effects on contact tracing timeliness, while others failed to notify tests conducted. Public Health workers warned partners of these failures and worked with them to develop solutions. Interventions included facilitation of access to technologies to notify test results, as well as revision of internal processes to ensure correct patient identification. During the intervention, successful notification rates were increased, and new informal and formal partnerships were developed, leading to faster identification of clusters.

Lessons
Establishing partnerships with stakeholders and developing support systems is beneficial towards epidemiological surveillance efforts. Adequate analysis of notification procedures was an important step towards standardization and correctness of information required for epidemiological surveillance.

Key messages
Covid-19 Vaccination and the issue of insurance status
Authors: Schröpfer D , Fortunato R , Devaud N , Koppensteiner R 
Published: October 2022

Abstract

Issue
It is estimated, that 11000 - 14000 people that live in Zurich do not have health insurance (∼3% of pop.). Covid-19 vaccination in Switzerland required an online registration (‘Vacme') with name, address and health insurance number. Health insurance in Switzerland is only accessible to people with registered residence in the country. This systematically excluded people without right of residence, health insurance or internet access.

Description
To address this issue the health service of the city Zurich organized a vaccination site for the uninsured from 14.06.2021 onward. To achieve this a simplified registration procedure was established, which allowed us to offer Vaccination to everybody, independent of their insurance status. Instead of the health insurance number, on site personal used a dummy number and the address of our site to register those patients. To remove language and technological barriers. In order to lower, the inhibition threshold for people without legal residence the Police department was informed and agreed not to circulate the area of the vaccination site on vaccination days.

Results
Between 14.06.2021 and 19.02.2022, 880 people came for vaccination of which 603 (69%) were clearly identifiable as individuals from non-insured populations. (See Graph)

Lessons
It is therefore critical not to forget these people when organizing public health measures, especially when addressing a pandemic or other infectious diseases (HIV, Hepatitis). A group specific information approach is of paramount importance to reach such subpopulations. Non-insurance is a known barrier for universal access to care.
Acknowledgements: We would like to thank the involved departments of the city Zurich, chief medical officer canton zurich, our collaboration partners and the staff of our vaccination site.

Key messages
Schistosomiasis control in adults: a call for action towards the goal of universal health coverage
Authors: Gruninger S , Rasamoelina T , Rakotoarivelo R , Doumbia C Oumar , Lorenz E , van Dam GJ , Schwarz NG , May J , Rakotozandrindrainy R , Fusco D 
Published: October 2022

Abstract

Background
Schistosomiasis is a high-burden parasitic disease and endemic in tropical climates, such as Madagascar. Recently it is emerging in Europe. Chronic infections lead to disabilities including loss in work productivity. Current control strategies focus on school-aged children, thereby systematically excluding adults. The goal to eliminate the disease as a public health problem is aligned with the Sustainable Development Goals agenda, including Universal Health Coverage (UHC). We aim at assessing the distribution of schistosomiasis among adults in Madagascar, in order to promote more targeted public health initiatives against the disease.

Methods
In a cross-sectional study, 1477 blood samples were collected at three primary health-care centers in Madagascar from 03.21 to 01.22. A semi quantitative PCR assay was used to assess the presence of Schistosoma. Positivity rates with 95% Confidence Intervals (CI) were reported by gender and age groups.

Results
Our study population had a balanced gender distribution with 54.2% [CI: 51.7;56.8] of females and a median age of 37 years (IQR: 24-48). Preliminary results show an overall Schistosome positivity rate of 59.5% [CI: 57.0;62.0]. Positivity was higher in males 62.4% [CI: 58.7;66.1], than in females 57.1% [CI: 53.5;60.5]. Highest positivity was seen in the 18-34 year age group with 66.2% [CI: 62.7;69.6]. Lowest positivity of 46.2% [CI: 39.2;53.2] was observed in adults aged over 55 years.

Conclusions
Our preliminary results provide evidence of high positivity rates of schistosomiasis among adults in a highly endemic country. Differently from many studies, males seem more affected than females. The youngest age group, representing the more active workforce of a population, shows a higher positivity rate. Our data suggests that, in the logic of UHC and health as a human right, public health strategies for schistosomiasis need to be re-addressed towards a universal coverage of affected individuals.

Key messages
Health status of people with intellectual disabilities: A systematic literature review
Authors: Griebler U , Griebler R , Weber G 
Published: October 2022

Abstract

Background
People with intellectual disabilities (ID) have a right to the highest level of health and to non-discrimination in health care. There are an estimated 89,000 people with ID living in Austria. Little is known about their health status and about their health care. We carried out a systematic review with the aim to provide an overview of comparative studies on the health status and health behaviour of people with and without ID.

Methods
The systematic literature search was conducted in 3 electronic databases for the search period 2008 to March 2020, supplemented by a reference list check and a search of relevant websites. Abstracts and full texts were dually screened, data extraction was performed by one person and checked by a second. Bias risk was assessed by two people using the AXIS tool for cross-sectional studies. Results were summarised narratively.

Results
A total of 73 publications were included. The literature review reveals a very clear picture: people with ID have a shorter life expectancy, are more affected by illness and health problems, are more likely to have health-related limitations in daily living and are more likely to die from potentially preventable causes of death that could be avoided either through preventive measures or by high-quality medical care.

Conclusions
To better assess the health situation of people with ID in Austria, Austria-specific data is needed. Furthermore, systematic initiatives in the areas of prevention, health promotion and health care are necessary. People with ID should therefore be systematically considered in all strategies and processes in the health sector. In terms of health literacy, a stronger information policy towards people with ID and towards their relatives and health care professions would be indicated.

Key messages
Associations between biomass fuel use and child health: a community-based study in Bhaktapur, Nepal
Authors: Schwinger C , Kvestad I , Chandyo RK , Hysing M , Ulak M , Shrestha M , Ranjitkar S , Shrestha L , Strand TA 
Published: October 2022

Abstract

Background
Biomass fuel use for cooking is widespread in low- and middle-income countries. Previous studies have mainly focused on adverse health outcomes in adults or specific diseases. In a cohort among young children living in Bhaktapur, Nepal, we aimed to describe the association between the use of biomass cooking fuels in families with child health using measures of linear growth, cognition and chronic illness.

Methods
Caregivers of 600 marginally stunted children aged 6-11 months were interviewed about their primary source of cooking fuel at enrolment into a randomized controlled trial. Children's body length (n = 572) was measured at age 18-23 months. At the same time, blood samples (n = 497) were taken, and we measured leukocyte telomere length (LTL) as a marker of chronic disease risk. We chose LTL expressed as z-scores as a measure of chronic disease. Cognitive abilities were measured by the Wechsler Preschool and Primary Scale of Intelligence, 4th edition (WPPSI-IV) and NEPSY-II subtests when the children were 4 years old (n = 531). Associations were estimated in multiple regression models.

Results
About 18% of all families used biomass as primary cooking fuel. Children from families using biomass fuel were on average slightly shorter (mean difference 0.14 Z-scores, 95% CI: 0.28, 0.00), had lower IQ scores (mean difference 2.2 (95% CI: 0.5, 3.9), and shorter LTL (mean difference: 0.09 (95% CI: 0.05 to 0.13) compared to those not using biomass fuel. The observed associations were unaltered after adjusting for relevant confounders.

Conclusions
In children from households in poor, urban neighborhoods in Nepal, biomass fuel use for cooking was associated with health indicators for child growth and cognition as well as longevity and chronic illnesses reflected in shortening of telomeres. As this was an observational study, residual confounding cannot be excluded. Our findings support the ongoing effort to reduce exposure to biomass fuel in low-resource settings.

Key messages
ATHLOS Healthy Ageing Scale score as the predictor of mortality in Poland and the Czech Republic
Authors: Kozela M , Pająk A , Ayuso-Mateo JL , Bobak M , Lu W , Pikhart H , Polak M , Sanchez-Niubo A , Stepaniak U , Haro JM 
Published: October 2022

Abstract

Background
A novel tool to measure healthy ageing was developed by the ATHLOS consortium (Ageing Trajectories of Health-Longitudinal Opportunities and Synergies). ATHLOS Healthy Ageing Scale, constructed using harmonized data from 16 independent ageing cohorts, was designed to contribute to worldwide research on healthy ageing. The aim of the analysis was to assess the relation between ATHLOS Healthy Ageing Scale and all-cause mortality in Central European populations.

Methods
Participants of the Polish and Czech HAPIEE cohorts (baseline age 45-69 years) were followed for 14 years. ATHLOS Healthy Ageing Scale was based on over 40 health indicators related to intrinsic capacity and functional ability. Cox proportional hazards models were used to determine the relationship between the ATHLOS Healthy Ageing Scale scores and all-cause mortality.

Results
As many as 9,922 Polish and 8,518 Czech participants had non-missing data on the ATHLOS Healthy Ageing Scale score and mortality (1828 and 1700 deaths, respectively). After adjustment for age, dose-response associations with mortality in both genders and countries were found (HR for lowest vs. highest quintile of the ATHLOS Healthy Ageing Scale: 2.98 and 1.96 in Czech and Polish women and 2.83 and 2.66 in Czech and Polish men, respectively). Only modest attenuation was observed when additionally adjusted for education, economic activity, smoking and self-rated health.

Conclusions
The ATHLOS Healthy Ageing Scale was found to be a good predictor of all-cause mortality in urban populations of Poland and Czechia. This composite indicator seems to be an important contributor to a better assessment of healthy ageing.

Key messages
COVID-19 contact tracing apps in Europe, technological feat or failure?
Authors: Santos A , Rachadell J , Vareda R 
Published: October 2022

Abstract

Background
In the context of infectious disease control (IDC), public health services (PHS) have been under great pressure during the COVID-19 pandemic, especially with the burden of contact tracing. Most European Union countries have developed contact tracing apps for smartphones (CTA) with the goal of aiding PHS in IDC. CTAs generally use proximity data from mobile devices to determine a user's risk of exposure to SARS-CoV-2, thus providing testing and isolation recommendations. This review aimed to study the acceptance and adoption of CTAs in Europe.

Methods
5 European countries were selected: Germany, Spain, France, Ireland, Italy. A literature review was carried out and official sources of information from each country were consulted in order to compare the adoption of each national CTA. Criterias included number of downloads, rating in the app stores, costo of development, proportion of positive tests registered. Potential factors influencing population adherence to CTAs were also investigated.

Results
In proportion to their population, the number of downloads varied significantly in each country (18 % in Spain, 67% in France, 75% in Ireland). Except for Spain, all countries integrated additional functions into the CTA to increase its uptake, such as access to the vaccination certificate. App stores ratings ranged from 3.0 (Spain) to 3.9 (France and Ireland). The proportion of tests added in the apps varied significantly (1% in Italy and Spain, 4% in Ireland, 10% in France and 17% in Germany). Concerns that lead to the non-use of CTAs were related to data protection, smartphone battery drainage and app bugs.

Conclusions
CTAs as a way to identify contacts from a positive case had a low impact in the analyzed countries, with low population adherence being an important factor. Adding more features within the apps, minimizing bugs, and increasing public confidence in data privacy seem essential to increase uptake in the future.

Key messages