bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparing health insurance and survey data in estimating prevalence of chronic diseases
Authors: Mertens E , Peñalvo JL , Vandevijvere S 
Published: October 2022

Abstract

Background
Population prevalence of chronic conditions can be estimated from national health surveys and from administrative data sources such as insurance records. This study evaluated the agreement between the Belgian Health Interview Survey (BHIS) and the Belgian compulsory health insurance data (BCHI) in ascertaining chronic hypertension, hypercholesterolemia and diabetes in Belgium.

Methods
The most recent cycle of BHIS (2018) provided the self-reported prevalence of diabetes, hypertension, and hypercholesterolemia among a representative sample of Belgian adults. For BCHI, the chronic conditions were attributed for every individual in the BHIS reviewing the medication prescription records identified using the ATC/DDD system. These two data sources were linked through unique identifiers by STATBEL. Disease prevalence, measures of agreement, and measures of concordance were estimated. Logistic regression was performed to determine the factors affecting agreement between BHIS and BCHI’s disease classifications.

Results
Data linkage was done for 9,753 individuals aged 15 years and older. From the sample, BHIS and BCHI respectively identified 5.9% and 5.6% diabetes cases, 18% and 24% of hypertension cases, and 18% and 16% of hypercholesterolemia cases. The kappa coefficient between BCHI and self-reported diabetes, hypertension, and hypercholesterolemia was 0.79, 0.59, and 0.49, respectively. Gender, age, and subjective health significantly affected the agreement in chronic condition classification between BHIS and BCHI.

Conclusions
Data on reimbursed drugs is a potential alternative method in the surveillance of chronic diabetes. This procedure could be used in estimating disease prevalence but further validation is needed to evaluate its applicability and bias in other chronic conditions.

Key messages
• BCHI is a possible alternative data source for the surveillance of diabetes in the population.
• BCHI overestimated hypertension and underestimated hypercholesterolemia prevalence.
Cervical cancer rates in relation to the Roma population distribution in Slovakia in 2013 – 2020
Authors: Plančíková D , Melichová J , Sivčo P , Majdan M 
Published: October 2022

Abstract

Background
Globally, more than 300 000 women die due to cervical cancer (CC) each year despite its high preventability and treatability in its early stages. This study aimed to analyse CC rates at the regional level in Slovakia from 2013 to 2020 in relation to the distribution of the Roma population.

Methods
An ecological study was conducted using data obtained from the relevant national and regional authorities in Slovakia. Mortality, incidence, precancerous lesions incidence and the number of colposcopy and oncocytology examinations per 100 000 females 15 years and older were calculated. Linear regression models were performed in the R Project to assess associations between the rates and the estimated percentage of the Roma population at the regional level after adjusting for the unemployment, at-risk-of-poverty rate, and average disposable household income per month.

Results
CC mortality in Slovakia declined from 10.0 in 2013 to 7.1/100 000 in 2020 (p &lt; 0.05). Average mortality ranged from 5.9 in the Presov region to 10.7 in Kosice. Incidence varied from 108 in 2019 to 160/100 000 in 2017, with the highest average rates in Bratislava and the lowest in Banska Bystrica (194 and 89/100 000). Precancerous lesions incidence rates significantly differed between the regions (400 in Kosice, 984/100 000 in Trnava). The average colposcopy and oncocytology examinations rates were found to be lower in Presov (177 and 226) and Kosice (166 and 223) compared to the other regions (318 and 283/100 000 on average). After adjusting for the selected factors, CC mortality (p &lt; 0.05), incidence (p &lt; 0.05) and both preventive examination rates (p &lt; 0.01) were statistically significantly associated with the percentage of the Roma population.

Conclusions
Substantial differences in CC rates and preventive examinations were identified at the regional level in Slovakia. To eliminate CC in line with the WHO Global Strategy, suitable approaches to reaching those at the highest risk should be implemented.

Key messages
• Substantial regional differences in preventive examination and cervical cancer incidence and mortality rates were identified in Slovakia in relation to the distribution of the Roma population.
• Strategies to eliminate cervical cancer should be adjusted to the regional differences and seek alternative approaches for implementing screening in hard-to-reach communities at the highest risk.
Increasing urban health awareness using an interactive approach: evidence from a school-based study
Authors: Zjalic D , Nachira L , Lanza TE , Perilli A , Paladini A , Santoli G , Heidar Alizadeh A , Ricciardi W , Moscato U , Cadeddu C 
Published: October 2022

Abstract

Issue
Urbanization is a cause of climate change, as cities are where these changes are most visible. Climate change also leads to significant inequalities and health issues in urban settings. In this context, urban health promotion is mandatory to increase adaptive capacity. Since the late 1980s the World Health Organization (WHO) has emphasized schools’ role in promoting health, as they can play a crucial role in increasing health awareness to future urban inhabitants.

Description
The objective of this pre/post-interventional study is to measure the awareness of urban health and green spaces among high school students and to rise it through an educational intervention. Four interactive sessions were delivered to 319 students from 13 to 18 years old in a high school in Rome, Italy during spring 2022. Data was gathered anonymously and analysed using descriptive and inferential statistics.

Results
A total of 192 (60%) students successfully completed the pre/post-intervention surveys. An increase in students’ knowledge of urban health and urban green areas was observed. Before the intervention 11.8% of participants were aware of urban health, whereas after the intervention 87.5% were aware. A rise across different areas appeared to be related to how many times the teachers repeated that concept during the intervention. For topics discussed in more than one session, the increase in correct answers averaged 13.9%. Two different trends emerged from the data analysis: one whose post-intervention test improved on most of questions and one whose post-intervention test remained unchanged.

Lessons
The results of the present study suggest that school-based interventions using interactive approaches on climate change and urban health are effective for increasing the knowledge level of scholars on these topics, and can be a useful way to promote health in an urban setting. This type of approach maintains high levels of concentration and interest in most students.

Key messages
• Urban health training activities in schools are needed to empower youth who live in urban settings.
• Interactive sessions keep student concentration high and improve their participation.
Coping strategies and barriers to coping in climate- vulnerable Bangladesh: a qualitative study
Authors: Lilier K , Selim SA , Raihan ST , Islam R , Das J , Danquah I , Sauerborn R , Bärnighausen K 
Published: October 2022

Abstract

With the mental wellbeing of billions of people at risk due to climate change, more research is required to better understand mental health and psychological implications of climate vulnerability. This research contributes to understanding how people in climate vulnerable populations psychologically cope with stress with crucial implications for adaptation efforts. We conducted n = 60 qualitative in-depth interviews with men and women in Bhola, Bangladesh to elicit the lived experiences of a climate vulnerable population. We analysed data following the tenets of Grounded Theory. Through our inductive analysis, we found coping strategies where participants highlighted what they did when encountering stress, such as ‘Resignation’ or ‘Help Seeking'. Barriers to coping were, among others, limited ‘Efficacy', ‘Time’ or ‘Stigma'. We categorized coping strategies with barriers as high-barrier coping strategies and, those without reported barriers, as low- barrier coping strategies. High-barriers restricted participants - especially women - in their coping efforts and led them to using low-barrier coping strategies. Some low-barrier coping strategies can be interpreted as maladaptive if used frequently, as they are unhealthy and draw upon resources needed to adapt for the future. Maladaptive coping strategies can thus impede long-term adaptation by reducing motivation and the ability and willingness to act. To enable adaptive coping, we recommend lifting the barriers to coping through community-led interventions where community workers create platforms for sharing problems and knowledge, such as group support meetings. Sharing and discussing could strengthen efficacy and open new opportunities for functional, adaptive coping. As the negative impacts of climate change will be felt globally with more intensity and frequency, enabling adaptive coping and removing barriers to coping in frontline communities will be essential to supporting physical and mental wellbeing.

Key messages
• Barriers to adaptive coping strategies can lead people to using maladaptive low-barrier coping strategies, which draw upon resources needed for long-term adaptation.
• Enabling adaptive coping by lifting barriers to coping in climate vulnerable populations is crucial to strengthen adaptation efforts.
Exposure to PM2.5 and cardiovascular diseases in Portugal – the contribute of PMCardImpact project
Authors: Martins C , Lima L , Gonçalves S , Assunção R , Serranheira F , Viegas S 
Published: October 2022

Abstract

Particulate matter with a diameter of 2.5 μm or less (PM2.5) are one of the air pollutants more detrimental to human health, being responsible for around 400 000 premature deaths in Europe every year. The cardiovascular diseases (CVD) and air pollution are linked, with existing evidence of a causal relationship between exposure to particulate matter and cardiovascular morbidity and mortality. Under the scope of PMCardImpact, a national funded project, data collected from Portuguese air monitoring platform (2005-2021) (&gt;60 stations) was used to estimate the attributable number of cases of acute myocardial infarction. The air monitoring data and parameters such as exposure-response factors will support the risk assessment in AirQ+ software (WHO Regional Office for Europe). Preliminary results showed that exceedances of Air Quality Directive in Portugal ranged between 0.1 % and 10.2% for PM10 and PM2.5 in 2019. Results obtained will include the number of cases of CVD attributable to exposure to PM2.5 in the Portuguese population. Four scenarios of exposure will be considered for presenting the results: current scenario of exposure, new WHO Air Quality guidelines, European Commission Air Quality Directive and lastly, a worst-case scenario. This assessment will be the starting point for calculation of the burden of disease of CVD that exposure to PM2.5 represent in Portugal. With a view to promote the science to policy interface, PMCardImpact project will make available to policy makers the needed supporting information to act, including actionable knowledge on air pollution trends and related health effects, to implement reducing air pollution policies.
This work is funded by FCT/MCTES through national funds to PMCardImpact (EXPL/SAU-PUB/0944/2021) and CESAM (UIDP/50017/2020 + UIDB/50017/2020 + LA/P/0094/2020).

Key messages
• PMCardImpact will make available to policy makers the needed supporting information to act to implement reducing air pollution policies.
• Risk assessment will allow to determine the number of CVD cases attributable to air pollution.
Health and medical apps - Same same but different? A review of definitions in public health and law
Authors: Maass L , Freye M , Pan C-C , Dassow H-H , Niess J , Jahnel T 
Published: October 2022

Abstract

The terms health app and medical app are often used interchangeably but do not necessarily mean the same. Medical apps can be regulated as mobile medical devices and therefore need to meet general safety and performance requirements. On the contrary, health apps are not part of this legal framework and do not need proof of their efficacy or guaranteeing data security. We need distinct definitions of health and medical apps to understand these terms better and regulate such technologies more effectively. We will provide an overview of health and medical apps definitions and a differentiation flowchart from public health and legal perspectives. A search in 6 databases identified 22 publications that defined health apps and 11 reports that described medical apps. The core elements of these definitions were identified through qualitative analysis. Health and medical apps share the same devices, technical functions and collect health data. While it can be highly challenging to decide which legal requirements have to be fulfilled by an app, we deem it unfit as a distinction criterion. It requires legal knowledge, which is neither suitable nor practical for users. However, medical device law is closely linked to the app’s intended medical or health purpose criteria, which allows a clear differentiation. Additionally, the difference in the user group can be used for separation. Our suggestion for the definition would be that health apps are software programs on mobile devices that process health-related data on/for their user. They can be used by every health-conscious person to maintain, improve or manage the health of an individual or the community. As an umbrella term, health apps include medical apps. They share the same technological functions and devices as health apps. Health professionals, patients, and family caregivers are the main user groups of medical apps. Due to the intended use for clinical purposes, medical apps can be regulated as mobile medical devices.

Key messages
• Separating apps based on legal regulation is impractical & can’t be expected from all stakeholders. Differencing between health and medical apps requires the user group and the health aim of the app.
• Health apps include medical apps. Since 2019, medical apps in Germany contain digital health applications (DiGA). Since 2022, medical apps partly include digital care applications (DiPA).
Gauging Public Health Literacy needs through Google Trends: the COVID-19 vaccination example
Authors: Rachadell J , Vareda R , Santos A 
Published: October 2022

Abstract

Background
The rollout of the COVID-19 vaccination program in Portugal was one of the most successful in the world. However, there was still a challenge for Public Health services to determine the health literacy needs of the population in the context of a new vaccine and the uncertainty of the pandemic. The goal of this study was to evaluate the usefulness of Google Trends data to gauge the health literacy needs of the general population during the pandemic.

Methods
A Google Trends search was performed for Portugal including 5 topics related to health literacy needs of the population (“vaccination”, “scheduling”, “isolation”, “booster dose” and “vaccination certificate” ) between the 28th of december 2019 and the 10th of march 2022. The variation shows the relative popularity of each term referring to the total number of Google searches during that period in a normalized scale of 0-100. The variation was compared to the number of doses administered daily in Portugal and key moments of the vaccination campaign as defined by the Directorate-General for Health in Portugal.

Results
The terms “vaccination” and “isolation” had a steady rise in popularity from December 2019 to January 2021. The term “vaccination” was the most popular search term with peak popularity in July 2021 and a downward trend followed by an ascent to a lower peak in popularity in January 2022. The terms “scheduling” and “vaccination certificate” both followed a similar pattern, though at lower popularity levels. The term “isolation” was low on popularity since February 2021, with a significant rise and peak in January 2022. This variation relates to key dates during the Portuguese vaccination campaign.

Conclusions
Google Trends data seems to correlate with key events during the Portuguese COVID-19 vaccination campaign. That data might be incorporated in the planning framework of health literacy activities for national and local Public Health services.

Key messages
• Google Trends might be an important source of information for public health teams.
• There is a need for further research into how Google Trends data can be incorporated with other sources of information to inform health literacy activities.
Social networks and health information sharing in COVID-19 pandemic
Authors: Phillips M , Weldon R , Patil U 
Published: October 2022

Abstract

Background
Understanding health information flow in social networks is important for designing effective health communications strategies and to achieve health literacy. Limited information is known about variation in social networks and health information sharing in the COVID-19 pandemic by demographic factors. Young people are of particular interest given their heavy exposure to digital media sources, which include considerable health misinformation.

Methods
Hawai'i (n = 324) residents between 18-35 completed a Spring 2021 online survey including questions on health information flow in social networks: (1) how many they talked to and (2) listened to about health. Two Poisson regression models were fit with gender, education, and race/ethnicity predicting social network size.

Results
Respondents were 67.6% female. Respondents discussed their own health with 2-3 people (M = 2.18, SD = 2.95) and listened to roughly the same number. Respondents who talked with a greater number of individuals about their own health were significantly more likely to have larger networks for listening to others (r (317) = .614; p&lt; .001). In the model for discussing their own health, as education increased so did social network size. For the model predicting discussing others’ health, gender was significant (p = 0.003); women listened to 30.6% more individuals than men. Most (73%) respondents had conducted a recent digital health search for either themselves or someone else, including for parents, grandparents, and children. Facebook (63%) and Instagram (58%) were the most popular online sources for COVID-19 health information.

Conclusions
Understanding social networks and digital health sources in young people are important for designing effective health communications to reach all communities, especially those experiencing health inequities, given the amount of health misinformation circulating and the need to build trust in public health communication.

Key messages
• Social networks provide access to critical health information including information obtained from digital sources.
• Gender and education were important predictors of social network size in COVID-19 health communications.
Digital health activism of patients with chronic diseases: discursive strategies and themes
Authors: Dudina V 
Published: October 2022

Abstract

Background
On the Internet, there are many online communities where people living with chronic life-threatening diseases can discuss their problems. On the one hand, digital health activism promotes patient empowerment and could lead to better disease self-management. But, on the other hand, digital health activism raises concerns as it undermines the monopoly of expert medical knowledge. The objective of the research was to reveal the main discursive strategies and themes represented in Russian-language online communities for people with chronic life-threatening diseases. It could help to gain a better understanding of the purposes and effects of digital health activism on patients.

Methods
Data were collected through the popular Russian-language social networking site “Vkontakte”. We selected open groups with memberships of more than 1000 users devoted to HIV/AIDS, cancer, tuberculosis, and diabetes. Discourse analysis and thematic analysis were implemented.

Results
Revealed discursive strategies include the patients’ rights advocacy and resistance to the established order of health care. Three main types of discursive themes were identified:
a. Overcoming shortcomings of the health care system such as lack of qualified doctors, medicine shortage, and unethical behavior of health care personnel.
b. Overcoming the monopolization of expert medical knowledge and criticizing some treatment approaches.
c. Overcoming stigma and discrimination associated with disease both in healthcare settings and in everyday life.

Conclusions
Research on digital activism of patients with chronic life-threatening diseases makes it possible to identify hidden discrimination practices and patient rights violations in healthcare settings. Members of online patient communities turn from objects of care into informed active subjects who critically evaluate medical prescriptions, are active in finding the better treatment, and in defending their rights.

Key messages
• The research contributes to the revision of the paternalistic model of patient-doctor interaction.
• Attention to digital activism is important for the identification of hidden issues in healthcare.The research was supported by RSF (project No 22-18-00261).
STOBE: A Long-COVID Syndromic Study using Real-World data in Brazil
Authors: Cavalini H , Qin Z , Zhen Y , Shi J Q , Shetty A , Neves V , Delanerolle G , Phiri P 
Published: October 2022

Abstract

Background
The COVID-19 pandemic has changed the way infectious diseases are perceived. Global healthcare systems have faced challenges since the start of the COVID-19 epidemic, particularly in developing countries. Some individuals with an acute COVID-19 diagnosis have developed symptoms persisting beyond 90 days. Long-Covid is the new term for this syndrome (LC). LC, on the other hand, is poorly known and appears to cause a wide range of symptoms, particularly among Brazilian patients. As a result, utilizing retrospective data from patients in Petrolina, Brazil’s largest city in the northeast, we conducted an exploratory epidemiology study.

Methods
A retrospective, cohort study design was used with a real-world dataset. The primary aim was to evaluate the prevalence of LC within Petrolina. The sample size was 1,164 LC patients. A comparative and subgroup analysis was conducted to evaluate demographics, comorbidities, clinical symptoms, and mortality. A k means model was used to assess disease severity using a clustering analysis based on the presence of comorbidities.

Results
The prevalence of physical symptoms identified was 69·5%. The strongest physical symptom was fever with resultant of 64·09% followed by pain, 43·64%. The prevalence of autonomic and neurological symptomatology was 8·59% and 8·16% respectively. A higher prevalence of autonomic symptoms were reported among older men of Black and Caucasian in comparison to Pardo. Disease severity within the sample could be associated with the presence of comorbidities which were identified based on medication history. Pregnant women have high rate of comorbidities. 529 patients have at least one comorbidity and 28·73% of them are pregnant.

Conclusions
It is useful to evaluate symptoms although a definitive diagnosis of LC is essential. This study provides insightful information around LC within a Brazilian population to develop better infection control protocols, as well as future management of similar pandemics.

Key messages
• This study could potentially improve the prognosis and mortality among LC patients with comorbidities.
• Our findings could be combined with other regional datasets to predict pattern inferences of LC spread, prognosis and morbidity, including for multimorbidity and pregnant patients.