bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preventable newborn deaths: analysis of the newborn infection component in Brazil from 2007 to 2017
Authors: Oliveira E S , di Moura A F , Viana T R F , Oliveira N R , Barbosa L P , Almeida P C , Cardoso MVLML 
Published: October 2020

Abstract
The Universal Agenda 2030 was developed by representatives of all countries as an action plan covering the three dimensions of sustainable development: economic, social and environmental. 17 objectives were agreed upon, highlighting objective 03, which aims to ensure a healthy life and promote well-being for all at all ages, having as one of the established goals to end preventable deaths of newborns by 2030. Infections neonatal care reflects deficits in health care, covering the entire perinatal period, and it is necessary to understand its causes in order to promote quality preventive and health promotion actions. The question is: what are the causes that make up the indicator of early neonatal mortality, due to preventable causes in Brazil between 2007 to 2017? Retrospective study carried out between September and October 2019 using secondary data collection from Department of Informatics of the Unified Health System - SUS (DATASUS). The outcome variable was early neonatal mortality from preventable causes and the independent variable was the infections component of the newborn). Twelve preventable causes of death have been identified in this category: congenital rubella syndrome; congenital syphilis; neonatal tetanus; diphtheria; haemophilus and non-haemophilus meningitis; human immunodeficiency virus diseases; neonatal infections; pneumonia; acute infections of lower airways; bacterial diseases and intestinal infectious diseases. The main cause of preventable death was infections from the neonatal period, which include congenital viral diseases (cytomegalovirus and herpes simplex); newborn bacterial septicemia; congenital parasitic diseases; omphalitis of newborn with or without mild hemorrhage; intra-amniotic infection of the fetus, neonatal infection of the urinary tract and/or skin. There is a need for more effective public health actions to modify the neonatal mortality situation, as well as health surveillance actions.

Key messages
Warn about causes of perinatal mortality that can be avoided. Strengthen the fulfillment of objective 3 of the 2030 Agenda to ensure and promote health in the perinatal period.
Potential years of life lost in Campinas-Brazil between 2000-2017 due to external causes of death
Authors: Komoda D S , Fernández M R B , Cordeiro R C 
Published: October 2020

Abstract
The Potential Years of Life Lost indicator is an alternative to the use of traditional indicators to evaluate impacts of external causes of death for its ability to evaluate the magnitude of premature death. This study aims to evaluate the impact in the PYLL of premature deaths due to external causes in Campinas, between 2000 and 2017, and to show selectiveness of violence targeting the poor.
We performed a cross-sectional epidemiological study describing the PYLL due to external causes in the city of Campinas between 2000 and 2017. Amongst the variables studied, focus was given to the Human Development Index by Neighborhood (HDIN) of each individual (obtained by relating addresses to the official HDIN census), to evaluate impact of poverty in PYLL, mainly in homicides. A total of 12175 people died from external causes between 2000 and 2017. The distribution of the PYLL in the year 2000 indicated a loss of 35.8 years for every 1000 inhabitants with a high decrease until 2005 to an average of 17.45 from 2005 to 2017. Although we observed this decrease in PYLL, analysis by social strata shows disparities between PYLL of the rich and poor. When all external causes were considered, low and very low-HDI population had the most significant PYLL (27 and 30.3 respectively) compared to high and very high-HDI population (18.3 and 9.9 respectively), and when only homicides were taken into account, an even greater disparity was observed between the lower-HDI and higher-HDI stratas (overall average of 16.55 and 5.55 respectively).
Through PYLL analysis, we could observe the selectiveness of violence towards the low and very low-HDI population, which shows that, public policies that aim improve population health cannot be restricted to health sectors, but also include socio-economic actions against social inequalities and income concentration.

Key messages
Although external causes of death seems to be decreasing in Campinas, violence seems to target the poor. Any policy that aims to prevent violent causes of death must necessarily take into account social disparities.
Housing deterioration: a multi-dimensional index and validation in shared refugee accommodation
Authors: Mohsenpour A , Biddle L , Krug K , Bozorgmehr K 
Published: October 2020

Abstract

Background
Asylum seekers and refugees (ASR) are struggling for residential autonomy while awaiting the results of their asylum case. As housing is a known upstream determinant of and fundamental resource for health, it is important to monitor housing quality of state-provided shared refugee accommodation. We constructed, validated and field-tested a new and quick-to-apply index to measure the degree of Small-area Housing Environment Deterioration (SHED).

Methods
Conceptualizing housing quality as characteristics and maintenance of physical environment, we developed the SHED based on the “Broken Windows”-index (BWI). We conducted a validation study with seven raters at two time points, assessing measures of inter-/intra-rater reliability and internal consistency, complemented by cognitive interviews. Further, we field-tested the index in a random sample of 58 shared refugee accommodations and assessed its convergent validity against ASR's satisfaction with their living places (EUROHIS QOL).

Results
SHED assesses five domains (windows/glass, walls/roof, garbage, graffiti, outside spaces), complemented by a rating of the overall living environment. The validation study delivered an 'almost perfect' prevalence- and bias-adjusted Kappa (PABAK) of 0.87 (0.82-0.91) for intra-rater, 'substantial' to 'almost perfect' PABAK's between 0.71 (0.52-0.91) and 0.91 (0.87-0.91) depending on the rater (all p &lt; 0.001), and a Cronbach's α of 0.80. The index's construct validity is based on the BWI and converges with the ASR's subjective satisfaction with their living places. Cognitive interviewees enjoyed the simplicity and speed of the SHED and guided the creation of a manual for future use.

Conclusions
The index demonstrated high measures on objectivity, reliability, and internal consistency. It proved its applicability in a field-test and showed convergent validity with ASR's satisfaction with their living place within shared refugee accommodation.

Key messages
We have constructed an objective, reliable, internally consistent and valid index assessing the degree of deterioration of small-area housing environment. SHED offers opportunities for monitoring the physical quality of collective accommodation centres and filling the research gap on associations between housing quality and health.
Air pollution and social deprivation as the risk factors of cardiovascular diseases in Poland
Authors: Poznanska A , Seroka W , Stokwiszewski J , Wojtyniak B 
Published: October 2020

Abstract

Background
The prevalence of cardiovascular diseases (I00-I99; ICD-10) is known to be higher in deprived and polluted areas. This Polish district-level study focuses on a possible synergistic effect of deprivation and PM-10 concentration on mortality and hospitalised morbidity due to I00-I99 in 2015-2017.

Methods
This study concerns all 141 districts where PM-10 has been monitored by the Chief Inspectorate of Environmental Protection. The Generalized Linear Model method was used to assess the contribution of PM-10 concentration, the deprivation index (DI, a published synthetic measure of district's social status), the percentage of urban dwellers in the district, and their interactions with PM-10 to age-standardised mortality and hospitalisation rates. Demographic data come from Statistics Poland, and the hospitalisation ones from NIPH-NIH. The analysis was conducted for males, females, their 65+ aged subcohorts, and general population.

Results
For all cohorts, PM-10 pollution significantly contributes to the increase in both hospitalisation and mortality rates (e.g. for males 7% [95%CI: 2-12%] and 12% [3-21%] per 10μg/m3, respectively). The deprivation impact is also significant (e.g. for males p = 0.004 and 0.006), the DI standardised regression coefficients exceed 2-3-fold these of PM-10. The PM-10 effect was found stronger in rural areas than in the urban ones. In the case of hospitalisation, no synergy was found between PM-10 and DI, while negative synergy effect was observed for mortality (e.g. p = 0.030 for males, 0.011 for males aged 65+).

Conclusions
Both deprivation and PM-10 concentration increase hospitalised morbidity and mortality due to I00-I99, however, only for hospitalisation is the effect additive. Unexpectedly, the impact of air pollution on mortality is lower in deprived areas. This effect is even stronger for older population.

Key messages
The impact of social status on mortality and hospitalised morbidity due to cardiovascular diseases in Poland exceeds that of the environmental factor (PM-10 concentration). The negative synergic effect of deprivation index and PM-10 concentration on mortality was identified - the impact of air pollution is lower in deprived areas.
Strengthening partnerships for Roma children’s participation in health policy and practice in Europe
Authors: Larkins C , Saitovic M , Milkova R , Bereményi A 
Published: October 2020

Abstract

Background
Whilst some Roma children thrive, many experience poor health, housing and nutrition. This is linked to antigypsyism, economic inequalities, poor experiences of healthcare and other denials of social citizenship. Children globally are demonstrating about climate change, an issue of particular importance to those Roma children living in the most polluted and hazardous conditions affected by environmental waste and climate related risks. Academic and policy discourse recognises that finding solutions requires involvement of Roma children and young people, but to date there is very little research in this field. This paper explores how Roma children (aged below 18) can guide policy and practice to promote public health and sustainable development goals.

Methods
A review of literature on participatory practice with Roma children and young people was combined with a qualitative European survey (conducted Feb - June 2020) in English and Bulgarian. Critical realist analysis of data identified mechanisms that enabled inclusive and impactful participation in public health related matters, for whom and in which circumstances.

Results
Preliminary results, illustrated with examples from three European countries, indicate that participatory practices are more inclusive where Roma children lead identification of the issues they wish to address; there are explicit links to current service and policy opportunities; intergenerational and intersectional alliances are built; opportunities are community- based, not simply engaging with children in education; and pathways towards employment are offered. Partnership with Roma and Pro-Roma NGOs is vital.

Conclusions
Success in public health related participatory practice with Roma children is promoted by using inclusive methods and making links between everyday challenges and local, national and international policy (reflecting on structural inequalities). There is need to build decision-makers' capacity and commitment.

Key messages
Roma children can be effective partners in public health policy and practice. Supporting Roma youth leadership enables inclusiveness.
How does reserve capacity influences transition into upper secondary school among adolescent Finns?
Authors: Koivusilta L , Acacio-Claro P , Rimpelä A 
Published: October 2020

Abstract

Background
Educational inequalities occur when differences in educational outcomes are more strongly related to students' background than their own academic efforts. During adolescence, psychosocial resources such as social support and self-efficacy, collectively termed “reserve capacity” may serve as a pathway to educational transitions and help reduce educational inequalities. We study how reserve capacity affects transition of adolescents into upper secondary school in terms of non-placement or placement into vocational or academic track.

Methods
We use data from 9th graders in 128 schools at the 14 municipalities of Helsinki Metropolitan region who participated in the MetLoFin follow-up survey in 2014 (n = 7,344 students). The data were linked with the national Joint Application Registry containing information on whether student was placed in academic (65%) or vocational (32%) track or had no placement (3%) for upper secondary schools. Multinomial logistic regression models, adjusted for sex and school, were fitted to analyse the effect of students' background and reserve capacity on type of educational placement.

Results
Students whose parents had low education were more likely to be in vocational than academic track compared to those whose parents had high education (OR = 2.5 95% CI: 2.1-3.0). Having a foreign background increased the risk of having no placement than academic placement (OR = 1.5 95% CI: 1.1-2.2) compared to native students. Low social support and low self-efficacy predicted vocational placement of students relative to academic track but not no placement compared to academic placement. Academic grades remained strongest predictor of placement.

Conclusions
Students' background still determine educational outcomes, but psychosocial resources could likely reduce educational inequalities and ensure successful educational transitions in adolescence.

Key messages
Social backgrounds impact adolescents’ educational transitions. Adding students’ psychosocial resources could reduce educational inequalities.
Mortality inequalities in Rome: the role of individual education and real estate market
Authors: Cesaroni G , Venturi G , Paglione L , Angelici L , Marino C , Davoli M , Agabiti N 
Published: October 2020

Abstract

Background
Several indicators at individual and area level have been used to stratify the population. The aim of this work was to investigate the association between real estate prices, education and health status in Rome.

Methods
We used the administrative cohort of residents in Rome at the 2011 census. We followed subjects aged 18+ from 2011 to 2016 using anonymous record linkage procedures with administrative databases. The census includes several individual information, comprising sex, age, education, and residential urbanistic zone. From mortality register we collected date and cause of death. Real estate prices (€/m2) were available for each urbanistic zone. We classified the population in five categories according to the quintile of the distribution (1=highest prices, 5=lowest prices). We used adjusted Cox regression models to estimate the hazard ratios (HRs) and 95%CIs.

Results
We selected 2,053,668 subjects, not living in institutions at the time of the census survey. Women were 54% of the population; the mean age was 52 years (sd 18), 22.5% had a high education (university degree) and 37% a low education (≤ junior high school). During the follow-up, 126,548 subjects died. As expected educational level was strongly associated with all-cause mortality (39% higher risk of low vs. high educated). The mortality risk increased with decreasing real estate prices, taking account of age and sex. Compared to subjects living in highest prices areas, those living in level 2 areas had a HR = 1.08 (95%CI: 1.06-1.10), those in level 3 had a HR = 1.14 (95%CI: 1.12-1.16), those in level 4 a HR = 1.16 (95%CI 1.14-1.18), and finally those living in the cheapest areas a HR = 1.22 (95%CI: 1.20-1.25). When we considered both education and real estate prizes, the HRs marginally decreased.

Conclusions
There is an independent association of both individual education and socioeconomic characteristics of the area of residence and all-cause mortality.

Key messages
There are strong socioeconomic inequalities in Rome. A simple indicator such as real estate prices can be used to tackle inequalities.
Processes of co-producing a complex community based intervention in a disadvantaged neighborhood
Authors: Termansen T 
Published: October 2020

Abstract

Background
Empowerment-based community interventions which may include co-production in local decision-making have become more and more common to address health and social inequalities. However knowledge concerning how best to develop and implement such interventions in a disadvantaged neighborhood is sparse. The purpose of this study is to look into the processes and potentials of co-producing a community restaurant in the socially disadvantaged neighborhood Tingbjerg in Copenhagen. The study is part of the initiative Tingbjerg Changing Diabetes which is based on the Supersetting approach involving multiple stakeholders in Tingbjerg. The purpose of the Restaurant is to engage residents and building capacity through participation in cooking workshop, social dining and co-production processes.

Methods
The study is based on Community Action Research (CAR). It mixes in depth ethnographic fieldwork and participation in the processes of developing the restaurant with participatory methods engaging residents in the development process, interviews with stakeholders and residents and using program theory to guide the process. The study is still ongoing, but data from five months participant observation and interviews with 5 stakeholders has been gathered to date with participatory methods planned.

Preliminary findings
Findings show that processes of co-producing and implementing a community restaurant in Tingbjerg through a Supersetting approach are characterized by agility, context sensitivity, adaptability and trust building, and that these have the potential to ensure resident participation, capacity building and sustainability.

Conclusions
Adaptability, context sensitivity and engaging multiple stakeholders in a long term commitment are imperative when working to build community capacity. In addition, participation and co-production are concepts that have to be carefully considered and applied stepwise and over a long period of time when working with vulnerable groups.

Key messages
Sustainable and effective community interventions in disadvantaged neighborhoods rely on strong and long term commitments by multiple partners, adaptability and context sensitivity. Co-production with vulnerable groups has the potential of being empowering, but only when applied contextually and stepwise.
Developing a literature-based systems map of determinants of dietary intake in low-income groups
Authors: Sawyer A , van Lenthe F , Kamphuis C , Poelman M , Djojosoeparto S , Roos G , Terragni L , Nicolaou M , Waterlander W , Stronks K 
Published: October 2020

Abstract

Background
Inequalities in obesity and related non-communicable diseases pertain in part to less healthy dietary intake in disadvantaged groups. Examining determinants of intake as a complex adaptive system - i.e. interconnected determinants exerting non-linear influence on outcomes - honours the complexity of dietary choices, behaviours and intake, and could inform policies. This study used literature to map the complex system underlying dietary intake in low-income groups, to identify system structure and goals perpetuating poorer dietary outcomes.

Methods
A systematic umbrella literature review examined determinants of dietary outcomes in children, adolescents and adults. Inclusion criteria were: • Low-income sample; analysis by income (Non-)systematic review of quantitative/qualitative, observational/intervention studiesHigher/upper-middle-income countriesExposures: individual, sociocultural, physical, political determinants/correlates; effect modifiers
Excluded outcomes were: breastfeeding, alcohol and neophobia.
Using causal loop diagramming, extracted data on determinants, associations and interpretation were embedded in a systems map of mechanisms driving dietary intake. System structure (e.g. sub-systems) and goals (e.g. feedback loops) were analysed.

Results
A systems map of hypothesised mechanisms driving dietary intake in low-income groups was developed from 43 reviews and expert consensus. The system comprised sub-systems: 1) accessibility, 2) household resources, 3) financial constraints, 4) health/biology, 5) knowledge, attitudes and beliefs, 6) sociocultural influences. Identified sub-system goals could undermine healthy intake opportunities, e.g. energy-dense food choices for cost-efficiency, heightened exposure to energy-dense foods determining preferences.

Conclusions
The literature-based systems map articulates the systemic basis of poorer dietary outcomes in low-income groups. Understanding system structure and goals will inform equitable policy.

Key messages
Dietary intake in low-income groups is driven by a complex system of mechanisms which may perpetuate poorer dietary outcomes. Existing literature was synthesised as a systems map; identification of structures and goals of the system can inform health equity policies.
Period poverty in rural Uganda; an exploration of the challenges and the need for intervention
Authors: Kennedy C , Severe J 
Published: October 2020

Abstract

Background
Period poverty refers to a lack of access to safe means of managing menstruation. It affects the education, health and dignity of millions of women and girls globally. This study aims to identify the barriers facing menstruating girls in rural Uganda, investigate the effects of period poverty in this demographic and assess the need to implement a programme to tackle challenges identified.

Methods
A qualitative study was undertaken in a community setting. 42 Participants were selected in Bududa, Uganda using convenience sampling. School-age girls supported by The Shelo Foundation (charity no.1155142) who had begun menstruating and adults in positions of responsibility in the community were interviewed to gain a cross sectional understanding of the questions posed. Data was collected prospectively in semi-structured interviews over a four-week period in July 2013. Questions focused on access to essential hygiene materials, challenges faced when menstruating (with a focus on accessing education) and possible solutions to the barriers reported. Interview transcripts were analysed; the common concepts were identified, and conclusions drawn from the results.

Results
Inability to access sanitation products, due to financial poverty and local availability, was the main challenge highlighted throughout the analysis of the interview transcripts. The other common themes included lack of suitable hygiene facilities, absence of education on menstruation and the vulnerability of menstruating girls to abuse and stigma. Analysis found that on average girls were missing three days of school a month due to their periods, equalling 18% of the academic year.

Conclusions
Period poverty disadvantages school-aged females in Bududa, Uganda. Financial poverty, lack of education and stigma contribute to period poverty. An intervention programme including accessible sanitation products and education is recommended to tackle this gender inequality for girls in this population.

Key messages
A lack of sanitation products, subpar education and stigma contribute to period poverty in Uganda and negatively impact female education with menstruating students missing up to 18% of a school year. An intervention programme incorporating access to sanitation products alongside education is recommended to tackle period poverty in this population and improve women’s health and female education.