bluuebunny/crossref_metadata_2025_split huggingface dataset:
Undetected hypertension in primary care – a public health iceberg?
Authors: Young L , Bibi H , Rasheed R 
Published: October 2022

Abstract

Background
Hypertension is largely asymptomatic and contributes to considerable lifetime cardiovascular morbidity and mortality, costing the NHS £2.1 billion annually. The national prevalence of hypertension is 13.7 % and lack of a national screening programme, despite meeting aspects of the Wilson Junger criteria, adds to delays in detection and treatment. Earlier detection could mitigate future cardiovascular risk. We wanted to understand the potential of detection of prehypertension in primary care to see if this fits the Wilson and Junger criteria for a screening programme.

Methods
GP records of adult patients n = 2178 with a known diagnosis of hypertension on the hypertension register from a practice population of 10,000 patients (prevalence is 22%.) were analysed for the prevalence of prehypertension systolic 120-139 mm hg and diastolic bp of 80-89. The average length of prehypertension, the time delay in detection and treatment were assessed, alongside the prevalence of clinical and therapeutic inertia.

Results
A retrospective analysis of a sample size of 1809 patients out of 2178 patients (83.1%) with known hypertension across 3 primary care sites over 20 years was undertaken. Of these 1809 patients, we found that 1095 patients (60.5%) were prehypertensive prior to being diagnosed. The mean time interval between detection of prehypertension to a formal hypertension diagnosis was 10.6 years, with a standard deviation of 7.89 years with no variation with age or sex. However, 588 patients (32.5%) did not have readings within the prehypertensive ranges prior to diagnosis and were opportunistically detected. 51 patients (2.82%) never had readings recorded within the prehypertensive range.

Conclusions
Prehypertension predates hypertension by an average of 10.6 years. Offering annual screening nationally to patients of risk groups e.g., those with a family history, obesity, and alcohol excess, would enable earlier detection, treatment, and considerable cost saving.

Key messages
• Prehypertension predates hypertension; therefore, hypertension meets the Wilson Junger criteria for earlier detection by a screening programme, which is lacking in the UK.
• Offering a national scheme to screen for hypertension to those at a higher risk, can only be considered a benefit to the public and should be implemented.
Changes in perceived health status in older men and women during the COVID-19 pandemic
Authors: Autric-Tamayo G , Sánchez-Román M , Rodríguez-Blázquez C , Rojo-Abuín JM , Ayala A , Forjaz MJ , Molina MA , Rojo-Pérez F , Rodríguez-Rodríguez V , Fernández-Mayoralas G 
Published: October 2022

Abstract

Background
The COVID-19 pandemic has severely impacted older people. The disease and the measures to combat it have had a differential impact according to gender, with higher mortality rates in men and worse psychological and social consequences in women. The objective of this work is to analyze the changes in perceived health of older people in Europe during the first months of the pandemic and to assess the combined role of age and gender.

Methods
Wave 8 data of SHARE-corona (Survey of Health, Aging and Retirement in Europe) (n = 51,695, aged≥50) collected between Jun-Aug 2020 were used. Perceived health status was explored with a question on whether there has been a change compared with the health status before the COVID-19 outbreak (response options: worse, the same and better). Two-way ANOVA with interaction and Student's t-test with Bonferroni correction were used to compare the effects of gender and age group (50-59 years, 60-69 years, 70-79 years, and ≥80) in changes in perceived health.

Results
Differences in perceived health were observed by age, as well as by gender in participants aged ≥70 years (F = 91.94; p &lt; 0.001). These differences were significant both by gender (F = 19.39; p &lt; 0.001) and age (F = 191.79; p &lt; 0.001). No interaction was detected between both factors (p = 0.170), which allowed their effect to be studied individually. Among the people who reported a worsening in their perceived health, women aged 70 to 79 years predominated (11.1%), followed by men aged 80 and over (15.3%) and women of the same age group (16.4%).

Conclusions
The results suggest an association between the change in perceived health during the pandemic and age. Women have a slightly worse health status than men in all age groups. Therefore, gender can be considered as an influential factor in perceived health in old age, which in turn can have a potential impact in the quality of life of older people.

Funding
Projects Ref. H2019/HUM-5698 and Ref. 202010E158.

Key messages
COVID-19 and religion: evidence and implications for future public health challenges
Authors: Sisti LG , Buonsenso D , Moscato U , Malorni W 
Published: October 2022

Abstract

Background
Religious and cultural beliefs strongly influence people's attitudes and behaviors that, in turn, may positively or negatively affect both individual and public health. In this regard, we aimed to collect and analyze evidence on the impact of religion in the current COVID-19 pandemic.

Methods
We performed a scoping review investigating both scientific and grey literature available on the topic from the onset of the pandemic to September 2021. Pubmed, Web of Science and Google Scholar were investigated and a hand-search on Google was also performed. Studies dealing with religion and COVID-19 were included and narratively summarized according to topics.

Results
46 articles were included in the review. Predominant topics emerged were 1) religious pilgrimages and rituals worldwide being relevant to COVID-19 outbreaks, especially in the first pandemic wave 2) difficulties to engage the Closed Religious Communities (e.g. Haredi, Amish, etc.) in which community way of life, restrictions in using media and resistance to comply to preventive measures were identified as significant COVID-19 risk 3) COVID-19 unofficial treatments and vaccine hesitancy also supported by concerns on the religious acceptability of vaccine composition or firm interpretation of the Ramadan fasting 4) a fuel of religious discrimination 5) religious communities and leaders strongly trusted in conveying COVID-19 information.

Conclusions
Our findings highlighted how religion has represented both a risk for the spreading of the virus and a precious opportunity to convey evidence-based and culturally-sensitive COVID-19 information engaging people in fighting the pandemic. To be prepared for similar future challenges, scientists, politicians and health professionals need to acknowledge the role that culture and religion have in influencing people's lives to design specific health policies and strategies to ensure that all people are effectively engaged in health production and protection.

Key messages
Impact of COVID-19 pandemic on inequalities in mortality: an analysis in Piedmont and Emilia-Romagna
Authors: Strippoli E , Zengarini N , Di Girolamo C , Bartolini L , Aversa C , Costa G 
Published: October 2022

Abstract

Background
Italy was heavily hit by the COVID-19 pandemic. According to official statistics, during 2020 there were more than 75,000 excess deaths compared to the average expected mortality in 2015-2019. General mortality (GM) is a good measure of both the direct and indirect effects of the pandemic because it's exempt from potential bias due to misclassification of events. Evidence shows a greater burden of disease and mortality attributable to COVID-19 among disadvantaged populations, with the risk of an exacerbation of existing health inequalities. We aim to analyse the trend of social inequalities in mortality during the first pandemic year in two Italian regions (Piedmont and Emilia-Romagna) using data from Administrative Population Registries (APR) and statistical databases.

Methods
Data on deaths occurred between Jan 2015 and Jan 2021 in subjects ≥65, stratified by educational level, were obtained from Regional APR and the Census. Using a time series approach, we computed Standardized Mortality Rates (SMR), Relative Index of Inequalities (RII) and Slope Index of Inequalities (SII), adjusted by age, gender, month and region. SMR, RII and SII from March 2020 were forecasted using Holt-Winters method and compared to the observed values in the same period.

Results
SMRs were higher than expected during the two 2020 epidemic waves (Mar-Apr, Oct-Dec) in both regions. RII didn't increase significantly. Absolute inequalities instead rose in Piedmont during both pandemic waves, mostly among women, and in Emilia-Romagna in March among men.

Conclusions
The impact of the pandemic on inequalities in GM has been at least of the same size of the impact of other mechanisms of unequal mortality. APR coupled with sociodemographic data are a quick and reliable source for assessing the unequal impact of the COVID-19 pandemic on health. Further research is needed to explore mechanisms underlying these effects e.g. inequalities in cause-specific mortality and access to health services.

Key messages
Tobacco product menthol and flavour bans: their utility for LMIC and lessons from the EU ban
Authors: Hiscock R , Silver K 
Published: October 2022

Abstract

Background
Flavoured tobacco products increase smoking uptake and create dependence. By June 2020 all cigarettes with a characterising flavour, including menthol were banned across the EU, UK and Moldova but many low and middle income countries (LMIC) are yet to develop and implement bans despite high smoking prevalence. This paper has two objectives: to establish whether (1) flavoured tobacco products are present and marketed in LMIC and (2) the experience of bans in Europe can guide development of legislation elsewhere.

Methods
Research involved analysis of menthol/flavour market data, review of academic and commercial literature and online media.

Results
The median menthol/capsule market share of the cigarette market grew significantly in middle income countries (p &lt; 0.05) between 2005 and 2019, both in lower and upper middle-income countries [lower: 2.5% (IQR: 0.5-4.0) to 6.5% (IQR: 3.6-15.9); and upper: 4.0% (IQR: 0.8-9.8) to 12.3% (IQR: 3.5-24.3)]. No market data were available on low-income countries, but the academic literature suggested high prevalence of menthol use in Zambia. Tobacco industry strategies underpinning growth of menthol/flavoured tobacco use in LMICs included in-store marketing and display, colourful packs and non-conventional flavour names. Tobacco industry attempts to circumvent the EU ban included introducing new flavoured tobacco products and accessories not included in the ban and exploiting the ban on characterising flavour (as opposed to an ingredient ban) by introducing cigarettes with lower levels of menthol.

Conclusions
Banning flavoured and menthol cigarettes in LMIC would impact a growing proportion of smokers in these countries. From the European experience, menthol and flavour bans that include all tobacco products and accessories and ban flavour as an ingredient rather than a characterising flavour is recommended. Currently, lack of marketing bans and standardised packaging in LMICs exacerbate the impact of flavours.

Key messages
Quantifying the burden of Hypercholesterolemia among Adolescents in India
Authors: Kirti K , Singh SK 
Published: October 2022

Abstract

Hypercholesterolemia is a kind of hyperlipidemia in which an individual's blood contains excessive non-high-density lipoprotein (non-HDL) cholesterol and low-density lipoprotein (LDL) cholesterol, which has emerged as a significant covariate of coronary heart disease. Descriptive, bivariate and multivariable regression analyses were used to unearth the current hypercholesterolemia levels, probable risk factors, and its impact on other metabolic diseases among adolescents using data on 35,830 adolescents aged 10-19 years from the Comprehensive National Nutrition Survey, India, 2016-18. Findings suggest that the mean lipid levels for total cholesterol, LDL, HDL, and triglycerides were 140.6, 84.1, 47.3, and 95.3, respectively, with females bearing the higher burden. The study further identified early adolescents, urban residents, and overweight individuals at a higher risk of having elevated non-HDL. Western and Eastern regions bore higher LDL levels. Further, for a unit increase in TSFT risk of having high LDL increased by 2.55 times. Zinc deficits are at 2.13 times higher risk compared to zinc sufficient. Adolescents consuming unhealthy diets were at higher risk of elevated LDL. The study contends that it is essential to prevent the increasing levels of lipid profiles among Indian adolescents. Vitamin and mineral deficiencies and unhealthy dietary habits are significantly associated with high LDL and non-HDL levels. In the longer run, this might cause the early onset of complex cardiometabolic disorders, which would disrupt the individual's social and economic well-being. Hence, appropriate interventions are needed to curtail these early onsets by primarily focusing on adolescents.

Key messages
The design of a user-centred m-health application for caregivers of children undergoing ORL surgery
Authors: Dobrina R , Cassone A , Brunelli L , Zanchiello S , DeVita C , Starec A , Bicego L 
Published: October 2022

Abstract

Background
In the context of common surgical procedures in pediatric otorhinolaryngology (ORL) patients, providing for education to families for hospitalization, surgery, and postoperative home management has been shown to improve peri-operative outcomes. In this regard, the use of Mobile Health Applications (MHA) is increasing. However, for these tools to be needs-appropriate and effective, their development requires a user-centred approach.

Methods
Our study aimed to explore the informational needs and preferences - in terms of features and functionalities - of health care providers and ORL patients’ caregivers (end-users) to inform the development of an MHA supporting ORL peri-operative process effectively. The study was conducted at a 136-bed maternal and child health hospital in Trieste. A user-centred participatory study design was employed, and the methodology steps were informed by the 3 cycles of the Information System Research Framework (Schnall et al., 2016).

Results
The Relevance cycle was performed to better understand the environment as well as end users’ (64 participants) informational needs and desired features for the MHA. Five critical information/education moments of the ORL perioperative period were identified. In the Rigour cycle a literature review was performed to identify further key topics relevant to understanding ORL end-users’ needs and relevant features for the MHA. In the Design cycle the final contents were defined to be displayed on the MHA spread across the 5 identified moments. A randomized controlled trial will then be conducted to evaluate the effectiveness of the MHA compared to standard care.

Conclusions
Triangulation of data sources collected by experts, ORL patients’ caregivers, and healthcare professionals ensured the rigour of the methodology adopted in the study. Moreover, such a MHA user-centred developed MHA favours end-users positive health outcomes and organizational benefits of health services.

Key messages
Maternal respectful care and Post-Traumatic Stress Disorder among postpartum mothers in Israel
Authors: Abu-Hamad S , Daoud N 
Published: October 2022

Abstract

Background
Maternal Respectful Care (MRC) approach was recommended by the WHO for improving maternal birth experience and mental health. We examined the association between MRC and Post-Traumatic Stress Disorder (PTSD) among postpartum women.

Methods
A cross-sectional study took place between November 2020 and October 2021. 817 postpartum women (Jewish- 444 Arab-373) were interviewed via Zoom due to Covid-19 limitations. MRC was measured by 26 statements from disrespectful/ abusive care during childbirth in facilities (DACF); 4 statements from the Mother on Respect questionnaire (MOR-feeling mistreatment based on ethno-national background, level of command of the Hebrew language and disagreement with the staff); and 4 statements regarding abuse of the NorVold Abuse Questionnaire (NorAQ). PTSD was measured by Solomon et al.'s tool, and dichotomized into 12 score cutoff. (Yes /No PTSD).

Results
PTSD prevalence was 14.3%, significantly higher among Palestinian-Arab compared to Jewish women (22.0%,7.9%, respectively), and it was higher in women who had lower MRC scores: did not receive postpartum education (19.9%,11.9 % respectively) received; received midwife support 11.7%,18.4% didn't receive; reported racism 26.1%,11.4% not; Felt humiliated at healthcare services vs. not (16.8% , 10.6%, respectively); women who reported mistreatment based on national/cultural background, compared to others (MOR) (36.6%,13.1%, respectively). In the multivariate analysis after adjusting to different independent variables, Palestinian-Arab women were 6.04 times at risk for PTSD (OR = 6.04,95% CI = 3.38-10.78),Women who reported racism are 2.14 times more likely to PTSD (OR = 2.14, 95% CI = 1.30-3.54). Women who reported feeling humiliated visiting the health care system are 2.08 times more likely to PTSD (OR = 2.08,95% CI = 1.23-3.52).

Conclusions
MRC is an important factor for maternal PTSD among postpartum women and it should be considered specifically among minority women.

Key messages
Direct and indirect costs attributable to musculoskeletal disorders in Belgium
Authors: Gorasso V , Van derHeyden J , De Pauw R , Pelgrims I , De Ridder K , Vandevijvere S , Vansteelandt S , Vaes B , De Smedt D , Devleesschauwer B 
Published: October 2022

Abstract

Background
Within the European Union, musculoskeletal (MSK) disorders represent the most prevalent and costly work-related health problems affecting about 45 million workers. Since middle-aged people during their formative and peak income-earning years are predominantly affected, MSK disorders are the major contributors to the loss of productive life years in the workforce compared with other non-communicable diseases. This study aimed to summarize the average yearly economic impact of low back pain (LBP), neck pain (NKP), osteoarthritis (OST) and rheumatoid arthritis (RHE) in Belgium from 2013 to 2017.

Methods
Direct costs, measured by reimbursed expenditures for medical services and medications, were derived by the national health insurer. Indirect costs were computed by multiplying the mean number of days absent from work (derived by the Belgian health interview survey, as prevalence data) with the average gross daily wage. Multivariate regression models were used to explore the extent to which average yearly costs were associated with MSK disorders. The method of recycled predictions allowed to estimate the marginal effect of each MSK disorder on costs.

Results
25% of Belgian adults were affected by at least one MSK disorder that incurred on average to 1,524€ per capita. LBP was the most costly disorder (2,405€ per capita) followed by NKP (2,260€ per capita). In the working population, 15% had at least one MSK disorder with an average indirect cost of 3,083€ per capita. People with LBP were the only showing a significantly higher indirect cost compared to a population without LBP, with an adjusted cost per capita of 5,875€.

Conclusions
The adult Belgian population is largely affected by MSK disorders. Every year the total adjusted healthcare cost amounted to more than 3 billion Euros. Additionally, on average every year Belgium spends around 2 billion Euros for work absenteeism related to one of the MSK disorders.

Key messages
Development and internal validation of a new life expectancy estimator for multimorbid older adults
Authors: Gastens V , Chiolero A , Anker D , Feller M , Bauer D , Rodondi N , Del Giovane C 
Published: October 2022

Abstract

Background
Multimorbidity is highly prevalent among older adults and associated with a shorter life expectancy. Many guidelines recommend tailoring preventive care of multimorbid people according to life expectancy. Indeed, patients with a relatively short life expectancy might not have the time to benefit from a preventive care intervention. Our objective was therefore to develop and internally validate a life expectancy estimator for older multimorbid adults.

Methods
We analysed data of the OPERAM (OPtimising thERapy to prevent Avoidable hospital admissions in Multimorbid older people) cohort study in Bern, Switzerland. 822 hospitalized participants aged 70 years old or more, with multimorbidity (3 or more chronic medical conditions), and polypharmacy (use of 5 drugs or more for &gt;30 days) were included. Our main outcome was time to all-cause mortality assessed during 3 years of follow-up. Candidate predictors included demographic variables (age, sex), clinical characteristics (Charlson-Comorbidity-Index, number of drugs, body mass index, weight loss), smoking, functional status variables (Barthel-Index, falls, nursing home residence), and hospitalization. We internally validated and optimism corrected the model using bootstrapping techniques. We transformed the 3-year mortality prognostic index into a life expectancy estimator using the Gompertz survival function.

Results
At baseline, the participants (58% men) had a median age of 79 years (min: 70; max: 99). They took daily a median of 10 chronic medications (min: 5; max 38). During 3 years of follow-up, 292 participants (36%) died. The analysis is ongoing and results will be presented at the congress.

Conclusions
A life expectancy estimator eventually helps personalising care to prevent under- and overuse of preventive care in the growing older population.

Key messages
Changing epidemiology and trends in incidence of kidney cancer in England, 1985-2019
Authors: Salari Y , Bannister P , Memon A 
Published: October 2022

Abstract

Background
Kidney cancer is the 7th most common cancer in the UK, accounting for 4% of all new cancer cases. The risk factors for kidney cancer include obesity, smoking, hypertension, and exposure to certain environmental and occupational carcinogens. We conducted a retrospective population-based cohort study to examine whether there have been changes in the incidence of kidney cancer in England during the past four decades.

Methods
Individual level data for patients diagnosed with kidney 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).

Results
During the 35-year study period, a total of 197,819 new cases of kidney cancer were registered in England (62.4% males, 37.6% females). In young people aged 0-49 years, the average annual incidence rates increased by 164% in males and 144% in females (from 1.4/100,000 in 1985-89 to 3.7/100,000 in 2015-19 in males and from 0.9/100,000 in 1985-89 to 2.2/100,000 in 2015-19 in females). In older people aged 50+ years, the rates increased by 129% in males and 147% in females (from 24.5/100,000 in 1985-89 to 56.0/100,000 in 2015-19 in males and from 11.9/100,000 in 1985-89 to 29.4/100,000 in 2015-19 in females).

Conclusions
There has been a steady and significant increase in the incidence of kidney cancer in England over the past four decades. The largest increase (164%) was observed in young males aged 0-49 years, which was unexpected. Considering the risk factors for kidney cancer, further research is needed to understand the role of environmental/occupational exposures in causing kidney cancer.

Key messages