Journal: Frontiers in Public Health

Abbreviation

Front. Public Health

Publisher

Frontiers Media

Journal Volumes

ISSN

2296-2565

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2014 - 201982020 - 202521
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Publications 1 - 10 of 29
  • Differences in mortality in Switzerland by citizenship during the first and second COVID-19 waves: Analysis of death statistics
    Item type: Journal Article
    Plümecke, Tino; Mikosch, Heiner; Mohrenberg, Steffen; et al. (2022)
    Frontiers in Public Health
    Background: Early in the COVID-19 pandemic, it became apparent that members of marginalized populations and immigrants were also at risk of being hospitalized and dying more frequently from COVID-19. To examine how the pandemic affected underserved and marginalized populations, we analyzed data on changes in the number of deaths among people with and without Swiss citizenship during the first and second SARS-CoV-2 waves. Method: We analyzed the annual number of deaths from the Swiss Federal Statistical Office from 2015 to 2020, and weekly data from January 2020 to May 2021 on deaths of permanent residents with and without Swiss citizenship, and we differentiated the data through subdivision into age groups. Results: People without Swiss citizenship show a higher increase in the number of deaths in 2020 than those who were Swiss citizens. The increase in deaths compared to the previous year was almost twice as high for people without Swiss citizenship (21.8%) as for those with it (11.4%). The breakdown by age group indicates that among people between the ages of 64 and 75, those without Swiss citizenship exhibited an increase in mortality (21.6%) that was four times higher than that for people with Swiss citizenship (4.7%). Conclusion: This study confirms that a highly specialized health care system, as is found in Switzerland, does not sufficiently guarantee that all parts of the population will be equally protected in a health crisis such as COVID-19.
  • Does “individual placement and support” satisfy the users’ needs?
    Item type: Journal Article
    Viering, Sandra; Jäger, Matthias; Nordt, Carlos; et al. (2015)
    Frontiers in Public Health
    This study aims to investigate clients’ satisfaction with individual placement and support (IPS) at the University Hospital for Psychiatry Zurich (PUK). Furthermore, this study aims to investigate if clients feel the approach of IPS as a useful approach to fulfill their needs. One hundred twenty-five people were recruited from one of the three IPS services of PUK and were asked to complete a structured questionnaire. The following IPS services were available: (i) randomized controlled trial (RCT) ZHEPP (www.zhepp.ch), (ii) RCT ZInEP (www.zinep.ch), and (iii) us clinical supported employment service of PUK (IPS-PUK). The clients mostly indicated that IPS was generally useful and fitted their needs. Overall satisfaction of the participants with the IPS services of the PUK was very high. Furthermore, client satisfaction and symptom severity are inversely associated. In conclusion, participants of the IPS services received the support they were looking for. This means that the approach of IPS fits the needs of different patient groups and can be used without any modifications. The most important limitation is the unequal group sizes. Therefore, the obtained results need to be strengthened by future research.
  • Assessing brain-muscle connectivity in human locomotion through mobile brain/body imaging: Opportunities, pitfalls, and future directions
    Item type: Journal Article
    Gennaro, Federico; de Bruin, Eling (2018)
    Frontiers in Public Health
    Assessment of the cortical role during bipedalism has been a methodological challenge. While surface electroencephalography (EEG) is capable of non-invasively measuring cortical activity during human locomotion, it is associated with movement artifacts obscuring cerebral sources of activity. Recently, statistical methods based on blind source separation revealed potential for resolving this issue, by segregating non-cerebral/artifactual from cerebral sources of activity. This step marked a new opportunity for the investigation of the brains’ role while moving and was tagged mobile brain/body imaging (MoBI). This methodology involves simultaneous mobile recording of brain activity with several other body behavioral variables (e.g., muscle activity and kinematics), through wireless recording wearable devices/sensors. Notably, several MoBI studies using EEG–EMG approaches recently showed that the brain is functionally connected to the muscles and active throughout the whole gait cycle and, thus, rejecting the long-lasting idea of a solely spinal-driven bipedalism. However, MoBI and brain/muscle connectivity assessments during human locomotion are still in their fledgling state of investigation. Mobile brain/body imaging approaches hint toward promising opportunities; however, there are some remaining pitfalls that need to be resolved before considering their routine clinical use. This article discusses several of these pitfalls and proposes research to address them. Examples relate to the validity, reliability, and reproducibility of this method in ecologically valid scenarios and in different populations. Furthermore, whether brain/muscle connectivity within the MoBI framework represents a potential biomarker in neuromuscular syndromes where gait disturbances are evident (e.g., age-related sarcopenia) remains to be determined.
  • Spatial risk for a superspreading environment: Insights from six urban facilities in six global cities across four continents
    Item type: Journal Article
    Loo, Becky P.Y.; Tsoi, Ka Ho; Axhausen, Kay W.; et al. (2023)
    Frontiers in Public Health
    This study sets out to provide scientific evidence on the spatial risk for the formation of a superspreading environment. While specific environmental, exposure-related, activity-related and human mobility factors have been examined in isolation, it is only recently that a synthesis of the analysis in specific geographical settings and at a city scale has been conducted. This is the research gap that this study aims to fill. Focusing on six common types of urban facilities (bars, cinemas, gyms and fitness centres, places of worship, public libraries and shopping malls), it first tests whether visitors’ mobility characteristics differ systematically for different types of facility and for different locations. Stemming from classical locational theories, geographers have shown that facility agglomeration is not only associated with external economies of scales but also different social mix of people. The latter has implications on the spatial spread of contagious diseases. In order to establish wider evidence, this study collects detailed human mobility data in six major global cities (Chicago, Hong Kong, London, São Paulo, Seoul and Zurich) across four continents to examine whether visitors’ mobility patterns are consistent. Most of these travel surveys were conducted by governments in a city-wide manner with random sampling strategies. The total number of survey respondents of the six cities is 287,210. Based on the research findings, a kernel density function is employed to derive the risk surface in each city based on the spatial risk class and nature of activities. Finally, it makes recommendations that balance the control of the pandemic and the daily life of the urban population. Thinking beyond complete city lockdowns, a more differentiated and location-sensitive policy of disease control and exit strategies is proposed.
  • Can digital health researchers make a difference during the pandemic? Results of the single-arm chatbot-led Elena+: Care for COVID-19 interventional study
    Item type: Journal Article
    Ollier, Joseph; Suryapalli, Pavani; Fleisch, Elgar; et al. (2023)
    Frontiers in Public Health
    Background: The current paper details findings from Elena+: Care for COVID-19, an app developed to tackle the collateral damage of lockdowns and social distancing, by offering pandemic lifestyle coaching across seven health areas: anxiety, loneliness, mental resources, sleep, diet and nutrition, physical activity, and COVID-19 information. Methods: The Elena+ app functions as a single-arm interventional study, with participants recruited predominantly via social media. We used paired samples T-tests and within subjects ANOVA to examine changes in health outcome assessments and user experience evaluations over time. To investigate the mediating role of behavioral activation (i.e., users setting behavioral intentions and reporting actual behaviors) we use mixed-effect regression models. Free-text entries were analyzed qualitatively. Results: Results show strong demand for publicly available lifestyle coaching during the pandemic, with total downloads (N= 7’135) and 55.8% of downloaders opening the app (n=3’928) with 9.8% completing at least one subtopic (n=698). Greatest areas of health vulnerability as assessed with screening measures were physical activity with 62% (n=1000) and anxiety with 46.5% (n=760). The app was effective in the treatment of mental health; with a significant decrease in depression between first (14 days), second (28 days), and third (42 days) assessments: F2,38=7.01, p=.003, with a large effect size (η2G=0.14), and anxiety between first and second assessments: t54=3.7, p=<.001 with a medium effect size (Cohen d=.499). Those that followed the coaching program increased in net promoter score between the first and second assessment: t36=2.08, p=.045 with a small to medium effect size (Cohen d=.342). Mediation analyses showed that while increasing number of subtopics completed increased behavioral activation (i.e., match between behavioral intentions and self-reported actual behaviors), behavioral activation did not mediate the relationship to improvements in health outcome assessments. Conclusions: Findings show that: (i) there is public demand for chatbot led digital coaching, (ii) such tools can be effective in delivering treatment success, and (iii) they are highly valued by their long-term user base. As the current intervention was developed at rapid speed to meet the emergency pandemic context, the future looks bright for other public health focused chatbot-led digital health interventions.
  • The consequences of ultra-processed foods on brain development during prenatal, adolescent and adult stages
    Item type: Review Article
    Mottis, Gaia; Kandasamey, Pratheba; Peleg-Raibstein, Daria (2025)
    Frontiers in Public Health
    Ultra-processed foods (UPFs) are highly refined formulations of non-nutritive compounds containing elevated amounts of sugar, fat, sodium, food additives, and dietary emulsifiers. Consumption of UPF is robustly linked to a range of non-communicable diseases, including obesity, type 2 diabetes, cardiovascular disease, and mental disorders in adults. While substantial research highlights the negative health impacts of UPFs in adulthood, their effects on brain development during critical periods of biological vulnerability, pregnancy, childhood, and adolescence, remain underexplored. During pregnancy, significant metabolic and physiological adaptations occur to support fetal growth, making maternal diet quality essential for optimal perinatal outcomes. Poor maternal nutrition, including high UPF consumption, has been associated with an increased risk of hypertensive disorders, gestational diabetes, and adverse birth weights, potentially predisposing offspring to metabolic health disorders later in life. Similarly, in early childhood, inadequate nutrition is a key risk factor for developmental impairments, influencing cognitive function and long-term health outcomes. Adolescence, another critical stage of brain maturation, is particularly susceptible to the effects of micronutrient deficiencies, often exacerbated by diets high in UPFs, which can impair neurodevelopment and cognitive performance. As UPFs continue to dominate modern diets, accounting for over 50% of total energy intake in some developed nations, understanding their long-term impact on brain development is crucial. Early-life exposure to UPFs may contribute to lasting cognitive deficits and increased susceptibility to mental health disorders, emphasizing the urgent need for targeted dietary interventions and public health strategies aimed at pregnant women, children, and adolescents.
  • Older adults' needs and requirements for a comprehensive exergame-based telerehabilitation system: A focus group study
    Item type: Journal Article
    Seinsche, Julia; de Bruin, Eling; Carpinella, Ilaria; et al. (2023)
    Frontiers in Public Health
    Introduction: Telerehabilitation in older adults using information and communication technologies (ICTs) provides therapy, which is potentially equally effective as traditional rehabilitation, yet more accessible. This study aimed to analyze the needs and requirements of older adults (OA) and healthcare-professionals (HP) toward ICTs and telerehabilitation in general as well as toward a specific novel exergame-based telerehabilitation system (COCARE system, Dividat). Materials and methods: The COCARE telerehabilitation system enables individual training based on exergames, as well as an assessment system and a digital centralized case management. Six focus groups with in total 34 participants were conducted. A mixed-methods approach was used comprising questionnaires and semi-structured interviews. Results: Both OA and HP would engage to an exergame-based telerehabilitation program. Major motivating factors are the relevance of such a training for health and the entertainment component of exergames. Main requirements are simplification of the system, variety, a personalized training, a constantly available contact person, and comprehensive instructions for use. Besides, HP praised the system's motivational effect, but remained concerned about risk of falls and social isolation. Conclusion: ICTs for telerehabilitation are accepted by OA and HP but should be adapted hardware- and software-wise to address OA' age-stemming vulnerabilities (e.g., risk of falls) and low ICT literacy.
  • Exposure assessment during paint spraying and drying using PTR-ToF-MS
    Item type: Journal Article
    Sabic, Srdjan; Bell, David; Gasic, Bojan; et al. (2024)
    Frontiers in Public Health
    Spraying is a common way to distribute occupational products, but it puts worker's health at risk by exposing them to potentially harmful particles and gases. The objective of this study is to use time-resolved measurements to gain an understanding of spray applications at the process level and to compare them to predictions of exposure models. We used proton transfer reaction time-of-flight mass spectrometry (PTR-ToF-MS) at 1-s time resolution to monitor the gas phase concentration of the solvents acetone, ethanol, butyl acetate, xylene and 1-methoxy-2-propy acetate during outdoor spraying and indoor drying of metal plate under various conditions of outdoor air supply. We found that during spraying, gas-phase exposure was dominated by the more volatile solvents acetone and ethanol, which exhibited strong concentration variations due to the outdoor winds. During drying, exposure strongly depended on the strength of ventilation. Under conditions with high supply of outdoor air, our measurements show a near-exponential decay of the solvent concentrations during drying. Conversely, under conditions without outdoor air supply, the drying process required hours, during which the less volatile solvents passed through a concentration maximum in the gas phase, so that the exposure during drying exceeded the exposure during spraying. The concentrations measured during spraying were then compared for each of the substances individually with the predictions of the exposure models ECETOC TRA, Stoffenmanager, and ART using TREXMO. For these conditions, ECETOC TRA and Stoffenmanager predicted exposures in the measured concentration range, albeit not conservative for all solvents and each application. In contrast, ART largely overestimated the exposure for the more volatile solvents acetone and ethanol and slightly underestimated exposure to 1M2PA for one spraying. ECETOC TRA and ART do not have options to predict exposure during drying. Stoffenmanager has the option to predict drying together with spraying, but not to predict the drying phase independently. Our study demonstrates the importance of considering both the spray cloud and solvent evaporation during the drying process. To improve workplace safety, there is a critical need for enhanced exposure models and comprehensive datasets for calibration and validation covering a broader range of exposure situations.
  • The Terms of “You(s)”: How the Term of Address Used by Conversational Agents Influences User Evaluations in French and German Linguaculture
    Item type: Journal Article
    Ollier, Joseph; Nißen, Marcia Katharina; von Wangenheim, Florian (2022)
    Frontiers in Public Health
    Background: Conversational agents (CAs) are a novel approach to delivering digital health interventions. In human interactions, terms of address often change depending on the context or relationship between interlocutors. In many languages, this encompasses T/V distinction—formal and informal forms of the second-person pronoun “You”—that conveys different levels of familiarity. Yet, few research articles have examined whether CAs' use of T/V distinction across language contexts affects users' evaluations of digital health applications. Methods: In an online experiment (N = 284), we manipulated a public health CA prototype to use either informal or formal T/V distinction forms in French (“tu” vs. “vous”) and German (“du” vs. “Sie”) language settings. A MANCOVA and post-hoc tests were performed to examine the effects of the independent variables (i.e., T/V distinction and Language) and the moderating role of users' demographic profile (i.e., Age and Gender) on eleven user evaluation variables. These were related to four themes: (i) Sociability, (ii) CA-User Collaboration, (iii) Service Evaluation, and (iv) Behavioral Intentions. Results: Results showed a four-way interaction between T/V Distinction, Language, Age, and Gender, influencing user evaluations across all outcome themes. For French speakers, when the informal “T form” (“Tu”) was used, higher user evaluation scores were generated for younger women and older men (e.g., the CA felt more humanlike or individuals were more likely to recommend the CA), whereas when the formal “V form” (“Vous”) was used, higher user evaluation scores were generated for younger men and older women. For German speakers, when the informal T form (“Du”) was used, younger users' evaluations were comparable regardless of Gender, however, as individuals' Age increased, the use of “Du” resulted in lower user evaluation scores, with this effect more pronounced in men. When using the formal V form (“Sie”), user evaluation scores were relatively stable, regardless of Gender, and only increasing slightly with Age. Conclusions: Results highlight how user CA evaluations vary based on the T/V distinction used and language setting, however, that even within a culturally homogenous language group, evaluations vary based on user demographics, thus highlighting the importance of personalizing CA language.
  • Early recognition of high risk of bipolar disorder and psychosis: an overview of the ZInEP “early recognition” study
    Item type: Journal Article
    Theodoridou, Anastasia; Heekeren, Karsten; Dvorsky, Diane; et al. (2014)
    Frontiers in Public Health
    Early detection of persons with first signs of emerging psychosis is regarded as a promising strategy to reduce the burden of the disease. In recent years, there has been increasing interest in early detection of psychosis and bipolar disorders, with a clear need for sufficient sample sizes in prospective research. The underlying brain network disturbances in individuals at risk or with a prodrome are complex and yet not well known. This paper provides the rationale and design of a prospective longitudinal study focused on at-risk states of psychosis and bipolar disorder. The study is carried out within the context of the Zurich Program for Sustainable Development of Mental Health services (Zürcher Impulsprogramm zur Nachhaltigen Entwicklung der Psychiatrie). Persons at risk for psychosis or bipolar disorder between 13 and 35 years of age are examined by using a multi-level-approach (psychopathology, neuropsychology, genetics, electrophysiology, sociophysiology, magnetic resonance imaging, near-infrared spectroscopy). The included adolescents and young adults have four follow-ups at 6, 12, 24, and 36 months. This approach provides data for a better understanding of the relevant mechanisms involved in the onset of psychosis and bipolar disorder, which can serve as targets for future interventions. But for daily clinical practice a practicable “early recognition” approach is required. The results of this study will be useful to identify the strongest predictors and to delineate a prediction model.
Publications 1 - 10 of 29