bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between psychological distress in mid-life and hospital-based multimorbidity
Authors: Johnston M , Black C , Mercer S W 
Published: October 2020

Abstract

Background
Mental ill-health is common with significant impact on individuals and services. Using healthcare records to identify poor mental health missed individuals who do not seek healthcare treatment. A screening questionnaire (General Health Questionnaire (GHQ)) can detect psychological distress. However, before considering implementing such a screening tool, we need to understand if it detects those at high risk of experiencing poorer outcomes. Hospital-based multimorbidity is a rising healthcare challenge. The aim was to assess the prevalence of psychological distress in mid-life and its influence on hospital-based multimorbidity by older age in the Aberdeen Children of the 1950s (ACONF) cohort.

Methods
Prospective cohort study using ACONF. GHQ-4 was measured in mid-life from questionnaire. Multimorbidity (2 or more co-existing conditions) was measured using linked hospital records in older age (15 years after the questionnaire). The relationship between psychological distress (GHQ-4 score of 1 or more) and multimorbidity was assessed using logistic regression with adjustment for key life-course variables.

Results
Of 5,839 individuals (48% male, mean age 48), psychological distress prevalence was 20% and was associated with being female, lower childhood cognition, lower educational attainment, lower adult social class, unemployment, higher adult body mass index, smoking and alcohol misuse. In comparison to the asymptomatic reference group, the odds ratio for multimorbidity in older age in those with psychological distress was 2.2 (95% CI 1.8-2.7) in the unadjusted model. In the adjusted model this was 1.4 (95% CI 1.1-1.8).

Conclusions
1 in 5 individuals in the general population in mid-life had psychological distress. This was associated with hospital-based multimorbidity by older age. Intervening early could reduce costs to both individuals and healthcare services. The next step is research of the cost-effectiveness of population screening for psychological distress.

Key messages
Psychological distress in mid-life is associated with hospital-based multimorbidity by older age. Screening for psychological distress early in life should be explored as an intervention to reduce costs to individuals and healthcare services.
Loneliness, social isolation and healthcare utilisation in the general population
Authors: Christiansen J , Pedersen S S , Andersen C M , Qualter P , Lund R , Lasgaard M 
Published: October 2020

Abstract

Background
The present prospective cohort study investigated the association of loneliness and social isolation with healthcare utilisation in the general population over time. We also investigated the synergistic effect of loneliness and social isolation on healthcare utilisation.

Methods
Data from the 2013 Danish “How are you?' survey (n = 29,472) were combined with individual-level register data from the National Danish Patient Registry and the Danish National Health Service Registry in a 6-year follow-up period (2013-2018). Negative binomial regression analyses were performed while adjusting for baseline demographics, chronic disease, and healthcare utilisation during the follow-up period.

Results
Loneliness was significantly associated with number of GP visits (incident-rate ratio (IRR) = 1.06, 95% confidence interval (CI) [1.01, 1.13]), emergency admissions (IRR = 1.19, 95% CI [1.03, 1.37]) and number of hospital admission days (IRR = 1.32, 95% CI [1.08, 1.62]). No significant associations were found between social isolation and healthcare utilisation with one minor exception, in which social isolation was associated with less planned admissions (IRR = .88, 95% CI [.78, .99]). Finally, loneliness and social isolation demonstrated a synergistic effect on number of visits to the GP (IRR = .87, 95% CI [.78, .98]) and number of hospital admission days (IRR = .67, 95% CI [.45, .98]).

Conclusions
Our findings suggest that loneliness is a risk factor for primary and secondary healthcare utilisation, independently of social isolation, baseline demographics, chronic disease, and healthcare utilisation during the follow-up period.

Key messages
Loneliness is an independent risk factor for healthcare utilisation in the general population. Social isolation is not associated with healthcare utilisation in the general population.
Future Health Scenarios at the global level
Authors: Goren E 
Published: October 2020

Abstract
Understanding potential patterns in future population levels is critical to anticipating and planning for changing age structures, resource and health care needs, and environmental and economic landscapes. Forecasting future population under prospective policy scenarios is an invaluable tool to investigate the potential consequences of today's policy decisions as they unfold over time. Future Health Scenarios (FHS) at the Institute for Health Metrics and Evaluation (IHME) produces future population forecasts under reference and alternative policy scenarios modelled as a function of fertility, migration, and cause-specific mortality rates. In this workshop, we will introduce FHS's forecasting methodology framework that also includes forecasting of cause-specific non-fatal health loss, including years lived with disability (YLD), DALYs and healthy life expectancy. We will discuss challenges and solutions to forecasting using statistical models as a function of drivers of health, and highlight forecasting results publicly available in IHME's viz tools.
A ‘futures’ approach towards the wellbeing of future generations in Wales and beyond
Authors: Azam S 
Published: October 2020

Abstract
'Futures' is a way of thinking about future uncertainty. It is not about predicting the future but is about developing alternative futures or scenarios and using them to inform how best to move towards the preferred future. This approach has been explored and applied to Wales, the UK, which has the Well-being of Future Generations (Wales) Act 2015. This Act has been globally recognised as a unique sustainable development legislation, putting Wales at the forefront of creating a different future for generations to come. Whilst most public bodies have always had responsibilities in delivering a range of services to support health and wellbeing, one of the key innovative requirements of the Act is the focus on the 'future', which by definition requires new and different approaches. This in turn means new tools, new skills and a new and different mind-set in which planners, commissioners, policy makers and service providers need to take a long-term view to addressing health and well-being. The presentation will explore the various approaches, methods and tools for 'futures' thinking and how this innovative agenda is progressing in Wales.
28.H. Workshop: Health Preparedness
Authors:   Organised by: EUPHA, CHAFEA, DG SANTE,   Chair persons: Anne-Marie Yazbeck - CHAFEA
Published: October 2020

Abstract
This session will take stock of national, EU and global health preparedness for serious cross border threats to health. As we have all seen, health preparedness and global health emergency preparedness frameworks are essential, as highlighted by the advent of COVID-19. Events such as these may be rare but are a perfect example of why engaging in health preparedness and response planning is essential. These novel types of viruses are not the only cause for the need for health preparedness, which extends to more standard planning of health systems, pandemic influenza plans and other unexpected but serious events such as the deliberate release of biological or chemical agents. This discussion will therefore review health preparedness, using the example of COVID-19, as well as reviewing the gaps identified and what more must be done at EU, national, regional and global levels to ensure health preparedness is effective to protect our societies.

Key messages
Health preparedness and global health emergency preparedness frameworks are essential for protecting health. Engaging in health preparedness and response planning is essential for an effective response to public health emergencies.
Monitoring health inequalities in Barcelona
Authors: Borrell C , Artazcoz L , Pasarín I , Rodríguez-Sanz M , Palència L , Pérez K 
Published: October 2020

Abstract
In Spain, the Public Health Law approved in 2011 foresees the creation of a Surveillance System on Social Determinants of Health and Equity. However, although information on health inequalities has been reported in technical reports and scientific articles before, it is not until now with the change of the Spanish government the political will to set up the more strategic surveillance system approved and foreseen in 2011 is there.
The change of government in some cities can be an opportunity to advance in the surveillance of health inequalities and policies to tackle them. In Barcelona, for instance, there is a wealth of information and research on health inequalities, but in the past health inequalities was not clearly prioritised on the political agenda. Hence, although health inequalities have been presented in many reports, a monitoring and surveillance system has not been available nor a prioritised task. This has now changed and as part of Spain's engagement in the Joint Action Health Equity Europe project (JAHEE) a system for Monitoring Health Inequalities in the city of Barcelona is being established. During the course of the JAHEE project the objectives of the system and target populations will be defined, sources of information and indicators identified, dissemination and evaluation structures set up before finally, in the next step, the system is to be implemented. The ambition is that the new monitoring system on health inequalities set up in Barcelona in its final form, will make out a part of the information systems of the Public Health Observatory of the city of Barcelona.
In this presentation, we will learn more about the establishment, the content and the experiences gained while setting up the new monitoring system on health inequalities in Barcelona - from defining the objective of the system to implementing it.
Common mental disorders in young refugees in Sweden: the role of education and duration of residency
Authors: Mittendorfer Rutz E , Helgesson M , Norredam M , Sijbrandij M , Jamil de Montgomery C , Björkenstam E 
Published: October 2020

Abstract

Background
Studies investigating risks of common mental disorders (CMDs) in refugee youth are sparse. The current study examined health care use due to CMDs in unaccompanied and accompanied refugee youth and Swedish-born, and the role of education and residency duration.

Methods
This register-based, longitudinal cohort study included 743,671 individuals (whereof 33,501 refugees) between 19-25 years, residing in Sweden in 2009. Refugees were classified as unaccompanied/accompanied. Risk estimates of CMDs, measured as health care and antidepressant treatment, between 2010-2016 were calculated as adjusted hazard ratios (aHR) with 95% confidence intervals (CI). Highest attained education in 2009, and residency duration were examined as potential modifiers.

Results
Compared to Swedish-born youth, refugees had a lower risk of treated major depressive and anxiety disorders (aHR): 0.73 (95% CI 0.68-0.78) and 0.74 (95% CI 0.70-0.79) respectively), but a higher risk for posttraumatic stress disorders (PTSD). Compared to Swedish-born, unaccompanied had an 8-fold elevated risk for PTSD (aHR: 8.40, 95% CI 6.16-11.47) and accompanied refugees had a nearly 3-fold risk of PTSD (aHR: 2.78, 95% CI 2.29-3.37). Rates of PTSD decreased with years spent in Sweden. The risk of CMDs decreased with increasing education.

Conclusions
Young refugees had a lower risk of treated depressive and anxiety disorders, but a higher risk for PTSD. In refugees, the rates of anxiety disorders increased slightly over time, whereas the rates of PTSD decreased. Last, low education was an important predictor for CMDs.

Key messages
Our study highlights the need to specifically focus on stress-related mental disorders in studies on refugees as risk estimates might differ. Moreover, providing scalable low-intensity interventions to address CMDs including posttraumatic stress are an important first step in order to prevent prolonged suffering and persistence of PTSD in refugee youth.
Adaptation of the Problem Management Plus programme for Syrian, Eritrean and Afghan refugee youth
Authors: Alozkan Sever C , Cuijpers P , Bryant R , Dawson K , Mittendorfer-Rutz E , Holmes E , Sijbrandi M 
Published: October 2020

Abstract

Background
Common mental health problems are prevalent among refugee minors and impair their daily functioning. Due to various barriers such as lack of culturally appropriate treatments, waiting lists, and stigma they have limited access to care. Problem Management Plus (PM+) was developed by the World Health Organization to address these barriers. PM+ is transdiagnostic, delivered by non-professional helpers, and consists of 5 sessions of problem-solving skills, behavioural activation and stress management. PM+ is effective in reducing adults' distress and improve functioning. We aimed to adapt PM+ for refugee minors and add an emotional processing module to target symptoms of posttraumatic stress disorder.

Methods
We culturally and contextually adapted PM+ for use in Syrian, Eritrean and Afghan refugee minors (age 16-18 years). Data were collected through: 1) free list interviews with Syrian, Eritrean and Afghan refugee minors (n = 30), 2) key informant interviews with knowledgeable refugees (n = 6), professionals (n = 6), policy makers (n = 6) and 3) focus group discussions (n = 24). Data were analysed in ATLAS.ti through inductive and deductive framework analysis.

Results
The interviews with youth revealed daily life problems around the following themes: language, family and peers, and substance use. The overall results suggested the need for culture- and age-specific adaptations of 1) the PM+ manual content (language, metaphors, illustrations) and 2) intervention delivery (modality, content and presentation of the trauma processing module, and duration).

Conclusions
This study led to specific adaptations of PM+ for refugee adolescents to be used in two randomized controlled trials in the Netherlands and Sweden.

Key message
Refugee minors face numerous barriers reaching mental health care. Scalable, culturally adapted psychological interventions should be developed and evaluated to address common mental disorders in refugee youth.
New models and taxonomies to understand and address the commercial determinants of health
Authors: Gilmore A B , Robertson L , Petticrew M , Maani Hessari N 
Published: October 2020

Abstract
Current models of the determinants of health risk framing public health problems and solutions in ways that obscure the role that the private sector, in particular large transnational companies, play in shaping population health. This presentation will propose a new conceptual model of the commercial determinants of health which recognises the commercial sector's direct, indirect, upstream and downstream influences on health. It will also present emerging evidence-based taxonomies that draw together evidence on the key corporate practices which stymie the implementation of effective public health policies. In so doing, the presentation will explore how we move from understanding to addressing the commercial determinants of health.
Towards reimbursement of mobile digital health applications? An international comparison of practices
Authors: Degelsegger-Márquez A , Panteli D 
Published: October 2020

Abstract

Background
The hitherto largely unregulated market of mobile digital health applications is undergoing significant changes, particularly concerning the growing segment of apps that aim at integrating care processes or replacing traditional forms of diagnosis or therapy. The inclusion in the benefit basket of statutory health systems is of relevance when exploring viable business models for app developers.

Description of the problem
So far, countries largely limit coverage to apps developed by authorities within the statutory health system, or provide guidance for payers in the form of app lists or quality assessment criteria. However, there are new regulatory efforts aiming to promote innovation for mobile digital health applications by creating pathways to general reimbursement, as exemplified by the 2019 German Digital Healthcare Act.

Results
Our contribution illustrates how evidence-based reimbursement decisions can be configured for mobile digital health applications. We will compare frameworks from different contexts, including the new German regulation, the UK's NHS App Store and the Evidence Standards Framework for Digital Health by NICE as well as the work of the French National Health Authority (Haute Autorité de Santé). Building on case studies, we will provide a typology of practices, which covers elements spanning consumer guidance to assessment approaches to full reimbursement decision-making.

Conclusions
Based on the proposed typology, we will discuss challenges and opportunities of reimbursement systems for mobile health apps from a public health perspective and seek to refine the typology by incorporating input from session participants and profiting from the global nature of the conference.
Violence prevention in vulnerable groups: the case of children and gender-based violence
Authors: Kumar B 
Published: October 2020

Abstract
As of January 2018, nearly 50 million children had been uprooted from their homes due to violence, poverty or natural disasters. In 2016, one in four people seeking asylum in the EU are children.
An analysis of nationally representative survey data on the prevalence of violence against children in 96 countries estimates that 1 billion children globally have experienced emotional, physical or sexual violence in the past year. The UN Convention on the Rights of the Child, ratified by nearly all states, must be fully implemented complied with. To support the implementation of the Convention, ten UN agencies incl. WHO have published the INSPIRE Handbook a technical package with seven strategies to end violence against children.
Another significant public health issue that needs to be addressed is sexual and gender-based violence (SGBV). Evidence shows that being an irregular migrant or asylum seeker appears to make an individual more vulnerable to SGBV, including sexual assault and rape by traffickers and smugglers. Working alongside displaced communities and with different partners across multiple sectors are the strategies to reduce the risks of SGBV and to ensure support for survivors.
What factors are related to non-participation in colorectal cancer screening?
Authors: Portillo Villares I , Solis Ibinagagoitia M , Unanue-Arza S , Martinez-Indart L , Lebeña Maluf A , Idigoras I , Bilbao I , Diaz-Seoane M 
Published: October 2020

Abstract

Background
The Basque Health Service (Spain) approved the Colorectal Cancer (CRC) screening programme in 2008; targeted at residents (50 to 69 years old) by biennial faecal immunochemical test and colonoscopy in positive cases. Total coverage was reached in 2014. Despite our high participation rate (72.3%), some people have never been screened, probably due to several factors (socio-economic factors, lifestyles, comorbidities, health preventive actions, etc.). The identification of these factors could be crucial in order to improve the results and impact of the programme.

Methods
Cross sectional descriptive study. All invited population in a complete round between 2015 and the first trimester of 2017 were included. Data base was linked to registered health risk factors, preventive activities managed by Primary Care and socioeconomic deprivation index. Univariate and multivariate analyses were performed by SPSS 23.0.

Results
515,388 people were invited and 71.9% participated. Non-participation is significantly (p ≤ 0.001) related to: being men (OR = 1.10); younger than 60 (OR = 1.18); smoker (OR = 1.20); hypertensive (OR = 1.14) and diabetic (OR = 1.40), as well as to having a severe comorbidity (OR = 2.09) and very high deprivation (OR = 1.15). Low use of Primary Care services (OR = 2.39) and inappropriate control of risk factors also increase the likelihood of not participating.

Conclusions
Several factors addressed in Primary Care influence the participation in the CRC Screening Programme. Its results and impact (decreasing incidence and mortality) could be improved if individual and socioeconomic factors are taken into account to increase participation. Primary care and social networks are key in further planned interventions.

Key messages
Decreasing inequalities in the screening participation is one of the most important objectives in this Public Health strategy. Primary Care plays a key role in all the screening programmes’ implementations.
Transforming a global order in New Zealand to reduce health inequities in service provision
Authors: Rawson E 
Published: October 2020

Abstract
St John has been providing service in New Zealand for nearly 140 years since its arrival. It has now close to 4000 staff and nearly 20000 Members and over 8500 volunteers.
In New Zealand the major work of St John is its Ambulance service providing front line first responders to crash, medical emergency and other life-threatening situations. St John New Zealand also provides a number of 'Community Health' initiatives focused on strengthening communities and prevention. In recent years St John has recognised that they have not engaged well with Indigenous communities and that their organisation in New Zealand must become skilled and relevant in addressing the needs of the Indigenous people of New Zealand, as they suffer the greater burden of disease and illness than any other population in the country. St John NZ Community and Health Services are embarking on a process of transformation through re-orienting its culture and practice by adopting Public Health approaches and an equity lens over all its programmes. They also have committed to understanding and using Indigenous knowledge to support this re-orientation to most effectively engage and implement programmes that will reduce Indigenous health inequities. This presentation will describe the process by which they will be implementing their strategy for change and highlight best practice for working with Indigenous communities.

Key messages
Indigenous Knowledge is key to addressing Indigenous Health inequities. Mainstream Public Health can learn from Indigenous Public Health approaches.