bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of nutritional risk factors on chronic non-communicable diseases
Authors: Grosso G 
Published: November 2019

Abstract

Background
modifiable risk factors, can help to identify emerging threats to population health and opportunities for prevention of chronic non-communicable diseases (NCD). Among various risk factors, poor nutrition quality has been identified as a leading determinant of NCD.

Methods
The Global Burden of Diseases (GBD) Study provided a comprehensive comparative risk assessment (CRA) of risk factor for NCD, quantifying the impact of behavioural, environmental and occupational, and metabolic risk-outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. Special focus on nutritional risk factors will be dedicated, discussing the proportion of disease-specific burden attributable to each dietary risk factor and the level of intake associated with the lowest risk of mortality.

Results
In 2017, over 30 million deaths were attributable to risk factors. When ranked, high systolic blood pressure was the leading risk factor, accounting for more than 10 million deaths, followed by, high fasting plasma glucose, and high body-mass index. A total of 11 million deaths were attributable to dietary risk factors. High intake of sodium, low intake of whole grains, and low intake of fruits were the leading dietary risk factors for deaths globally. However, important differences between regions and outcome (i.e., cardiovascular disease vs. cancer) have been registered. Besides the major aforementioned factors, underrated dietary risk factors, such as low calcium intake, have been found important contributors to cancer burden in certain developed countries.

Interpretation
The combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in NCD at the global level. These data provide a comprehensive picture of the potential impact of suboptimal diet on NCD mortality and morbidity, highlighting the need for improving diet across nations.
Variations in the use of caesarean section: a Comparison between France and Australia
Authors: Chevreul K , Shand A , Korb D , LeRoux E , Nassar N , Sibony O , Bisits A , Alberti C 
Published: November 2019

Abstract

Background
There has been a rise in obstetric intervention during labour and birth including rates of caesarean section around the world. The rates of caesarean section are lower in France (20%) than Australia (34%). Both countries have universal health care systems. Australia has a well-established program of obstetric benchmarking and national data collection for comparing maternal and perinatal outcomes taking into account maternity units and maternal characteristics. Although the optimal caesarean section rate is not known, variation in caesarean section rates raise questions about what is driving variation in practice and whether the right care is being delivered. The World Health Organisation has recently released non-clinical recommendations aiming to reduce unnecessary caesarean sections, including that births are classified by Robson classification for easier comparison.

Methods
We aim to compare rates of mode of birth in 2 tertiary hospitals- one in France and one in Australia using Robson classification. This project will investigate differences in patient casemix, and obstetric management that may lead to differences in outcome. In addition, we will try to explore differences in the health systems including clinical activity, induction rates, staffing (number, type (medical, nursing, midwifery)), and models of care.

Outcomes
Caesarean section is one of the most common operations performed in hospitals. Important variations of surgical rates raise question regarding whether access to this procedure is optimized. Determining current practice and outcomes of women in two different settings will provide important data to inform hospital practice and further research. In addition, this research may inform national guidelines about indications for caesarean section.
Socio-economic inequalities in timing of childhood immunizations in Scotland
Authors: Pearce A , Henery P , Cameron C , Dundas R , Katikireddi V , Leyland A 
Published: November 2019

Abstract
In Scotland, like many other European countries, childhood immunization coverage is generally high, often exceeding levels typically required to achieve herd immunity (95%): uptake of the primary vaccines (excluding rotavirus) is ∼96% (at 12month(m)), with the 1st dose of measles, mumps and rubella (MMR) at 97% (by 5 years). However, the recommended age to receive these vaccines is 2-4m and 12-13m respectively. Delays beyond these ages may indicate vaccine hesitancy or barriers to access and can increase the likelihood of disease outbreaks, especially if clustered among certain geographical or social groups. We used quantile regression to examine the age by which 95% coverage was met in different groups.
We analyzed data from the Scottish Immunisation and Recall System, for all children born in Scotland 2010-12 (n∼200,000), estimating proportions immunized ‘on time’ with the primary (by age 5m) and MMR (by 14m) vaccines. Next we used quantile regression (with 95% cut-points) to calculate the age by which 95% coverage was reached among this cohort of children, overall and according to neighbourhood deprivation (Scottish Index of Multiple Deprivation[SIMD] deciles).
As in national reports, uptake of the primaries (at 12m) and MMR (at 5y) was &gt;95%, with 91% and 89% immunized ‘on time’ (as defined above). Nationally, primary vaccines uptake reached 95% by age 7m. This varied by SIMD, from 6m in the least disadvantaged decile, to 9m in the most disadvantaged decile (difference 3m, CI: 2.7-3.3). Uptake of MMR reached 95% a year later than recommended (26m), with no discernible pattern by SIMD.
In Scotland, the age by which immunization levels meet those typically required to achieve herd immunity may be suboptimal, particularly for MMR and (for primary vaccines) disadvantaged neighborhoods. This same approach might be used in other nations with high coverage to identify population groups that may be experiencing barriers to access and inform local intervention content
Care trajectories of patients initiating dialysis as planned versus emergency procedure
Authors: Raffray M , Pladys A , Gao F , Couchoud C , Vigneau C , Bayat S 
Published: November 2019

Abstract

Background
Emergency dialysis is defined as a first dialysis session performed within 24 hours after the nephrologist’s assessment due to a life-threatening risk. Starting dialysis in emergency (ES) is associated with poorer outcomes compared to a planned start (PS). The aim of this study was to compare the pre-dialysis care trajectory between ES and PS patients.

Methods
Patients ≥ 18 years old who started dialysis in 2015 in France were included. Data from REIN were linked with the French national health database (SNDS). Individual characteristics at dialysis initiation, inpatient stays (number, duration and diagnosis), and consultations with general practitioners (GP) and nephrologists during the year before dialysis start were compared between ES and PS patients, as well as with national clinical practice guidelines.

Results
Among 8964 patients included, 30.6% started dialysis in emergency. These patients had more comorbidities than PS patients (19% of ES patients had 3 or more cardiovascular diseases versus 12.6% of PS patients, p &lt; 0.001). In the year before dialysis start, ES patients had a lower median number of inpatient stays (1 versus 2 for PS patients, p = 0.001) but had a longer mean duration of hospital stay (8.1 days versus 5.8 days for PS patients, p &lt; 0.001). ES patients had less consultations with a nephrologist (2.5 versus 4.5 for PS patients, p &lt; 0.001). However, the number of GP consultations was not different between the two groups (9.7 versus 9.4 for PS patients, p &lt; 0.064).

Conclusions
Nearly 1 in 3 patients started dialysis in emergency with more comorbidities at baseline than PS patients. Their one year pre-dialysis care trajectory was characterized by less frequent nephrological follow-up and a similar GP follow up, compared with PS patients. These results raise questions regarding access to coordinated care associating GPs and nephrologists. This issue of coordination will be investigated using qualitative methods.
Understanding the perspectives of older adults and elderly regarding vaccination; a snapshot in four European countries
Authors: Timen A , Eilers R , Lockhart S , Gavioli R , Paul S , Volo S 
Published: November 2019

Abstract
Prevention of infectious diseases in elderly by immunization is a prerequisite to ensuring healthy ageing. However, in order for the vaccine programs to be effective, these need to be provided by health care professionals who have up-to-date knowledge and high motivation. Furthermore, the knowledge and attitudes towards vaccination in the targeted age groups needs to be fully understood. When focusing on the information provision, it is important to know from whom or which institution older adults and elderly would like to receive and in which form.
In January 2019, an international project called the VITAL (The Vaccines and InfecTious diseases in the Ageing population) project was started, within the framework of IMI (Innovative Medicines Initiatives). One of the goals of the VITAL project is to develop strategies to educate and train health care professionals (HCPs) and to promote awareness among stakeholders involved in elderly care management.
We briefly focus on the results of studies undertaken in four European countries (Italy, France, The Netherlands and Hungary), which reveal the perspective of older adults and elderly regarding influenza, pneumococcal, herpes zoster vaccination and respiratory syncytial virus (RSV) as well as generic characteristics of the vaccines and diseases.
We will show how attitudes towards vaccination are represented in our study population and which determinants influence the decision-making process of accepting vaccination. Furthermore, we shall elaborate on how the decision-making process towards vaccination takes place and which additional information is needed.
In the second part of the session, we shall invite the audience to reflect on the findings and identify the factors they consider most important for setting up a training and education programme on vaccination.
Workshop: Tools and opportunities for health promotion
Authors:   Organised by: National Institute for Health and Welfare, Finland, EuroHealthNet, EU JointAction ChrodisPlus, EUPHA (HP), EUPHA (INJ),   Chair persons: Caroline Costongs - EuroHealthNet, Anne Lounamaa - EUPHA (INJ)
Published: November 2019

Abstract

Health promotion acknowledges the reciprocal relationship between health-related behaviours and the environments in which people live, considers that the environment is made up of different subsystems and emphasises the relationships and dependencies between these subsystems. Our workshop acknowledges the multi-faceted nature of health promotion and intends to provoke thinking, ideas and tools for health promotion to help to expand skills and knowledge to develop health promotion strategies, policies and interventions.
This workshop will offer examples and provoke discussions on how to develop, evolve and improve health promotion practices. First, an overview of the European health promotion landscape is presented. This information is based on data collection conducted in 2018 in the European Joint Action Chrodis Plus. Next, we have two interlinked presentations to describe how to institutionalize health promotion thorough legislation, assess health promotion actions nationwide, and foster development in municipalities enforced by legislation. These presentations illustrate the developments in Finland, offer examples and highlight the importance of ministerial level actions for health promotion. The nationwide benchmarking system for assessment has existed for over ten years and offers an example for other countries.
The two last presentations address specific health and well-being issues: (1) tobacco control in Portugal and Israel and (2) the promotion of older people’s health and well-being in Iceland. The presentation on tobacco control is an example of inter-dependencies of different stake-holders. The presentation from Iceland will stimulate a discussion on how to start and conduct the nationwide implementation of an evidence based health promotion intervention and what the role governments, municipalities, and NGOs should be.
The workshop is a regular workshop. Time for discussion is offered in four spots, (1st) after the first presentation, (2nd) after the second and third presentations, (3rd) after the fourth and (4th) final discussion after the fifth presentation.

Key messages
Promising methods for health promotion exist. The challenge is how to implement effectively. Legislation is a powerful tool to enhance health promotion practices.
Assessing health promotion practice in Finland with a benchmarking tool
Authors: Ståhl T 
Published: November 2019

Abstract
The Finnish Benchmarking System for Health Promotion Capacity Building (BSHPCB) is a nationwide system developed to assess structures, capacities and actions taken to develop health promotion practices at local level. BSHPCB data is collected biannually from all Finnish municipalities in the following sectors of administration: primary healthcare, basic education, upper secondary education, vocational education, physical activity and sport, municipal management and culture.
The data collection form and reporting format are based on the theoretical health promotion capacity-building framework, which has seven dimensions that the organization should consider: (1) commitment of the organization to the promotion of population health; (2) management of health promotion; (3) population health monitoring, needs assessment, and evaluation; (4) resources for health promotion; (5) common working practices; (6) public participation/partnership in the planning and evaluation of activities and services; and (7) other core health-promotion functions. Data has been collected since 2010 and results are published on-line (www.teaviisari.fi) within two months of data collection.
The online benchmarking tool serves multiple purposes: first, it provides national actors evidence base for assessing law enforcement and drafting new legislation and developing national strategies and action plans; second it gives regional actors good understanding of municipalities’ work and capacities in their region in order to support them and, third municipalities get feedback of their work, are able to benchmark their situation to similar municipalities and develop their health promotion practices. The development and use of BSHPCB has been encouraging. The coverage of the data serves a sound base for further development of the tool. The next steps involve strengthening the quality of the data and auditing practices.
Tools and approaches towards sustainable investment for health equity
Authors: Buzeti T , Brown C 
Published: November 2019

Abstract

Issue
The drive to deliver better results for the economy and for society is challenged by the daily pressures faced by policy makers to contain the public expenditure while delivering improved outcomes. This is evident also in the health sector where costs are perceived to be spiralling. As a result, the sector faces huge pressure to cut budget and services. On the other hand, the health sector is a minor contributor towards health equity, as social, economic and environmental determinants of health are mostly responsibility of other sectors. Health equity and well-being are outcomes of societal values, culture and policy choices, that create the conditions for prosperous lives for all, leaving no one behind.

Description
There are different approaches and tools that can be used for advocating, planning and monitoring investments for health equity. To name a few that the health system can introduce: mainstreaming equity into health services, employment, procurement and purchasing practices for better social and economic benefits; Health Equity Impact Assessment that supports implementation of Health Equity in All Policies and Agenda 2030; voluntary national review reporting on SDGs - all stressing the need for disaggregation of data, new evidence and methods, and monitoring.

Results/Lessons
Health equity is a complex issue that needs comprehensive response combining various approaches and tools in advocating, planning, implementing and monitoring. Besides situation analysis, more and more WHO Member States are requesting evidence about what works and how to do it. Therefore, tailor made assessment, solution development and monitoring is becoming a standard. This needs to be supported with continuous training and capacity building. WHO European Office for Investment for Health and Development developed a Health Equity Status Report and a flagship course on Equity in Health in All Policies, built on the latest evidence and tailored to country / community needs.
Panelists: Marleen Bekker
EUPHA (PHPP)
Wageningen University & Research, Netherlands
Contact: marleen.bekker@wur.nl
Diana Sonntag
EUPHA (ECO)
University of Heidelberg, Germany
Contact: diana.sonntag@medma.uni-heidelberg.de
Aileen Clarke
Warwick Evidence, The University of Warwick, Coventry, UK
Contact: aileen.clarke@warwick.ac.uk
Ana M Carriazo
Regional Ministry of Health and Families, Andalusia, Seville, Spain
Contact: anam.carriazo@juntadeandalucia.es
Sleep problems among immigrants
Authors: Øien-Ødegaard C , Straiton M , Kjøllesdal M K R 
Published: November 2019

Abstract

Background
The prevalence of insomnia has increased from 11.9% to 15.5% between 2001 and 2011. At the same time, there has been a strong increase in immigration, and today immigrants constitute about 14% of the population. However, we do not know if these increases are related. There is limited information about immigrants’ mental health problems, and more specifically, their sleep problems. There is an established association between low socioeconomic status and higher chance of experiencing sleep problems, and we aim to investigate if this also is the case for immigrants in Norway, and whether being an immigrant is a risk factor.

Methods
Using the Living Conditions Survey for Immigrants 2016, we conducted logistic regression analyses to investigate associations between sleep problems and socioeconomic status among immigrant groups. We also preformed analyses comparing the results for immigrants as a whole and the majority population.

Preliminary results
The analysis indicates a strong relationship between socioeconomic status and sleep problems for immigrants and the majority alike, but also a strong moderating effect of being in the majority population. Women have higher odds of experiencing sleep problems than men, but the odds are much higher for immigrant women than for majority women. When taking origin country into the analysis, we see that only 3 of 12 countries have significantly different odds than the majority. Men from Iraq and Iran have particularly higher odds, while Eritrean women have lower.

Conclusions
Sleep problems are associated with other mental health problems, unemployment, substance abuse and increased mortality. Our finding, that immigrants have higher odds of sleep problems, is something medical professional and teachers should be aware of. Several barriers need to be addressed to increase the level of help seeking. This includes enhanced access of health information, and availability of mental health services.

Key messages
Immigrants have higher odds than the majority population for experiencing sleep problems, also when controlling for socioeconomic status. Immigrant women are particularly exposed to sleep problems, although there are considerable variations according to country of origin.
Immigration status and cervical test screening: more underscreening and inequality social health
Authors: Sassenou J , Rigal L , Ringa V 
Published: November 2019

Abstract

Introduction
In France, public health authorities recommend cervical cancer screening (CCS) by a Pap test every 3 years for all sexually active women aged 25 to 65 years. Socioeconomic inequalities are observed in CCS and disparities in screening practices according to immigration status has been reported. The aim of this study was to compare income inequalities in cervical screening depending on immigration status.

Methods
The study was based on the 2012-2016 baseline data in the Constances cohort (N = 28905 women). Delayed CCS was defined by having last CCS for more 3 years. The main independant variables were monthly household income and immigration status. The women’s origin was divided into the following categories: French women born to two French parents (French origin), French women born to at least one foreign parent (immigrant origin), and women born to two foreign parent (immigrants). Immigrants were divided into two categories: women with French or not nationality (naturalized or foreign immigrant). The slope index inequality (SII) was computed to measure the income inequality in CCS non-adherence. Interaction test was used to compare SII depending on immigration status. We used imputation model.

Results
We confirmed the existence of a gradient with respect to migration origin for delaying CCS (21,9 % women of French origin, 26,5 % women of immigrant origin, 28,8 % immigrant, p &lt; 10-4). More income inequalities were observed depending on immigration status (SII French origin= 0,17 [0,16-0,18], SII immigrant origin= 0,28 [0,24-0,32], SII immigrant = 0,27 [0,25-0,31], p interaction &lt;0,001). Among immigrant women, we observed difference in social inequalities depending on French nationality (SII naturalized= 0,19 [0,15-0,23], SII foreign immigrant= 0,35 [0,30-0,40], p interaction &lt;10-4).

Conclusions
French women of immigrant origin and immigrant women are underscreened and social inequalities are stronger among them than French women of French origin.

Key messages
French women of immigrant origin and immigrant women are less detected for cervical cancer screening than French women. French women of immigrant origin and immigrant women are detected for cervical cancer screening with more social inequalities than French women of french origin.