bluuebunny/crossref_metadata_2025_split huggingface dataset:
Heatwave-related Mortality in Australia: Who's impacted the most?
Authors: Varghese B , Beaty M , Panchuk S , Mackie B , Chen C , Jakab M , Yang T , Bi P , Nairn J 
Published: October 2020

Abstract

Background
The impacts of heatwaves on the risk of mortality have been well-documented worldwide. However, impacts are not equally spread across the population with certain subgroups and locations affected more than others, warranting local evidence to guide and improve prevention and adaptation strategies. The objectives of this study were to identify the person and area-level socio-demographic, health, and environmental factors that modify the heatwave-mortality association in Australia.

Methods
Warm-season (October-March) mortality (2007-2017) were obtained from the Australian Bureau of Statistics. Heatwaves were defined using Excess Heat Factor, a normalised metric of heatwave severity. A time-stratified case-crossover design was used to model heatwave-mortality associations at the Statistical Areas 2 (SA2) spatial unit. Effect modification by person and area-level factors was assessed using interaction terms.

Results
Nationally, mortality increased by 2% (Relative Risk-RR 1.02; 95%CI: 1.01-1.03) during heatwaves with 1418 excess deaths (95%CI: 723-2113). But impacts varied with the highest effect observed in Adelaide (RR 1.08; 95%CI: 1.04-1.12) and Regional Tasmania (RR 1.11; 95%CI: 1.04-1.18). A gradient of impact was found within locations, for example, vulnerable SA2s in Adelaide were featured by a higher proportion of people in rental housing, inaccessibilities (vehicle and internet), low vegetation, newer houses, and a prevalence of respiratory and psychological diseases. Person-level factors included those: renting privately, with a low English-speaking ability, with chronic health conditions (diabetes, asthma/chronic obstructive pulmonary diseases) and using antidepressants, anxiolytics and sedative medications.

Conclusions
Our results, leveraging person and area-level linked data, highlight the need to consider contextual and individual risk factors and the importance of developing place-based targeted interventions to reduce heatwave health impacts.

Key messages
Heatwaves increase mortality in Australia. Heatwave-vulnerability is determined by individual and community-level factors.
Trajectories of socioeconomic inequality in social, cognitive, and motor development: A birth-cohort
Authors: Verheijen M S , Houweling A J , Oude Groeniger J , Jansen P W , Van Lenthe F J 
Published: October 2020

Abstract

Background
The World Health Organization's main strategy to reduce health inequalities in adulthood is preventing socioeconomic inequalities in early childhood. Yet, little is known about how children's socioeconomic position (SEP) shapes their development over time. Therefore, we investigated trajectories of socioeconomic inequality in early child development.

Methods
Data (n = 5104) was used from Generation R, a prospective population-based cohort in The Netherlands. SEP inequalities (defined by maternal education) in trajectories of internalizing and externalizing problems (mother reported Child Behavior Checklist at 1.5, 3, 5, and 9 years), and of language and motor development (mother reported Child Development Inventory at 0.5, 1, 1.5, 2, 3 and 4 years) were estimated using linear mixed models with standardized scores at each time point.

Results
Low SEP children had more internalizing (B = 0.72, 95%CI=0.51;0.95) and externalizing (B = 0.25, 95%CI=0.10;0.40) problems at 1.5 years, but better language skills at 1 year (B = 0.50, 95%CI=0.36;0.64), and better fine (B = 0.26, 95%CI=0.12;0.40) and gross motor (B = 0.40, 95%CI=0.25;0.55) skills at 0.5 years of age than high SEP children. For internalizing and externalizing problems, inequalities decreased over time. The low SEP advantage regarding language scores reversed in early childhood, and at 4 years of age, low SEP children (B=-0.38, 95%CI=-0.61;-0.15) had substantially worse language skills than high SEP children. For motor skills, the low SEP advantage at baseline decreased over time and disappeared around 4 years.

Conclusions
Socioeconomic inequalities in early child development differ by developmental domain: whereas inequalities in problem behavior and motor skills decreased over time, inequalities in language development increased. This indicates that low SEP children are already at a cognitive disadvantage before entering primary education, providing further evidence that interventions are needed before the age of 4.

Key messages
We investigated trajectories of socioeconomic inequality in early child development within a Dutch prospective birth cohort. Results showed that socioeconomic inequalities in child development decreased over time for emotional, behavioral and motor development, but increased for cognitive development.
Lessons in Public Health Leadership
Authors: Latif S 
Published: October 2020

Abstract

Background
The UK Faculty of Public Health (FPH) is a world leader in developing a dynamic competency-based curriculum and delivering high quality training and professional development of a multidisciplinary public health specialist workforce in the UK. This includes capacity building and shaping tomorrow's public health leaders.

Objectives
Strong Leadership is increasingly the need of the day to deal with the complex public health challenges in a rapidly evolving and shifting global landscape. Can a public health curriculum and training (like that of the FPH) provide the framework for the knowledge, skills, attitudes and behaviours required for producing world class public health systems leaders?

Body of the session
Key principles of developing systems leadership include providing an enabling environment, developing the right skill mix, acquiring relevant knowledge, framing placements with experienced supervision and appropriate coaching and mentoring are some of the elements built into the training opportunities for public health registrars, their supervisors and new consultants. This presentation will give an overview of some lessons in public health leadership, the skills and knowledge base required to perform effectively as a public health systems leader and explore some of the challenges faced by the world of public health. The panel will encourage interactive discussion to share the learning from other countries and systems required to develop the next generation of public health leaders.

Conclusions
Public health, of all specialties, lends itself best to lead across and beyond organisational boundaries, lead without authority and create change whilst not being in charge. It is imperative that systems are put in place to train, develop and build public health leaders for tomorrow.
Introduction of a new method for measuring young children’s mental health at child health clinics
Authors: Fält E , Fabian H , Tökés A , Sarkadi A 
Published: October 2020

Abstract
The Child Healthcare Services (CHS) in Sweden offer regular health check-ups and reach almost all 0-5-year-old children. Parents of all children aged 3 to 5 are invited for a free check-up around their child birthday. Although one of the objectives of the CHS is to detect mental health problems, evidence-based methods are not used for this purpose at the Child Health Clinics (CHC). Therefore, we assumed that introduction of a new instrument (the Strengths and Difficulties Questionnaire - SDQ) to assess children's emotional and behavioural problems through parent and teacher reports, would not only help to test the hypotheses in our population-based trail (Children and Parents in Focus), but it would also address CHC's needs to detect children's mental health problems.
Three months into the study, we realised that a lower than expected number of SDQs were returned by parents and teachers. We started exploring the problem through individual interviews with nurses, parents and preschool teachers. Results showed that nurses found it useful for their assessment to have access to preschool teachers' SDQ-ratings. Parents were also positive to the procedure but had concerns regarding confidentiality of the responses. Preschool teachers were least positive, fearing labelling of children and negative parental reactions. We used a range of facilitation strategies such as educational meetings, outreach visits and newsletter to support nurses in implementation of the new procedure. To address parental concerns, we removed some of the questions and redesigned the questionnaires. This resulted to an overall increase of 10-15% in the response rate.
The findings suggest that implementing the SDQ at CHCs to assess the mental health of 3-5-year-olds is feasible, but reaching all children remains a challenge that requires more attention.
Potential of standard perinatal data for measuring maternal integrity in childbirth
Authors: Miani C , Batram-Zantvoort S , Razum O 
Published: October 2020

Abstract

Background
Measuring the phenomenon of violation of maternal integrity in childbirth (e.g. obstetric violence) relies in part on the completeness of maternity care providers' data. The population coverage and linkage possibilities that they provide make for a great untapped potential. Although violation of integrity is a complex phenomenon best measured with dedicated instruments, standard data provide details about the birth and care received. Relevant variables include justifications of medical procedures (e.g. episiotomy) and characteristics of the birth process (e.g. length of labour). Demographic variables can be used for intersectional analyses to track potential discrimination -a dimension of violation of integrity in childbirth.

Methods
Using a baseline questionnaire and perinatal data obtained from hospitals, birth centres and midwifes in the BaBi study (Germany), we compared the completeness of integrity-relevant variables across providers and depending on the demographic and clinical characteristics of the women. We investigated potential for analysis from an intersectional perspective.

Results
Our analyses included 908 births, of which 32 outside hospital. There were 634 vaginal birth vs. 274 caesarean sections. We found poor reporting on demographic variables, in particular with regard to the 'region of origin' variable (correct origin recorded for half of the migrants). There was better reporting by midwives than by hospitals for “soft indicators”, such as the position of the women during birth (100% vs. 87.6%).

Conclusions
Putting more emphasis on completeness of standardised data could increase their potential for research. Healthcare setting, organisational culture and working conditions might determine what is judged important in terms of reporting; therefore, targeted education may improve this process. Next, we will interview care providers to understand data collection constraints and priorities and potential reporting bias in real-life settings.
Mental health among women victims of violence consulting at “Maison des femmes” (Women's Home), a French center providing multidimensional care
Authors: Hatem G , Roland N , Bardou M , El-Khoury F 
Published: October 2020

Abstract

Context
In Europe, at least one in three women experience physical and/or sexual violence in her lifetime. This gender-based violence affects the victim's physical and mental health. Women victims of violence are at risk of developing mental health disorders such as post-traumatic stress disorder (PTSD) and traumatic dissociation. However, few recent studies have examined the prevalence of PTSD and other mental health problems among women victim of violence, making the development of research interventions to manage these symptoms challenging.

Methods and implications
The “Maison des Femmes” institute (MdF; Women's Home) is the only one of its kind in France. It provides care and support for women victim of violence. The multidimensional services provided at MdF consists of physical and mental health care as well as social and judicial support in a confidential and secure environment. “AVeC-L”(Accompagnement des femmes Victimes de ViolenCes à La Maison des Femmes), is an intervention research project (pilot study + comparative trial) which aims to examine and compare the mental health of adult women consulting at MdF and in two local health centers. In the currently ongoing pilot study, we measure the presence of PTSD and its intensity using the PTSD Checklist for DSM-5 in 80 participants. We also measure traumatic dissociative symptoms, and quality of life, and substance use. Using qualitative research, we also examine the women's perception of the effect of the care provided at MdF and at the two others local health centers.

Expected results and implications
The “Avec-L” pilot study will estimate the prevalence of PTSD and dissociative symptoms among women victims of violence who consult at MdF. It will also provide information on women's perception of the provided care. These results will contribute to the design of a larger intervention trial (pre and post comparison) evaluating the effect of the multidimensional support and care at MdF on women's mental health.
Public Health measures to control the spread of COVID-19 amongst the migrant population in Malta
Authors: Melillo T , Medialdea-Carrera R M C 
Published: October 2020

Abstract

Issue
In the last 10 years, the migrant population residing in Malta has increased exponentially. The COVID-19 epidemic impacted disproportionally migrants which are often in disadvantaged positions due to the lower socioeconomic status, communication barriers and lower education levels.

Description of the Problem
During the COVID-19 epidemic migrants were particularly affected due to multiple factors including communication barriers, restriction measures imposed, loss of employment, challenges accessing the healthcare system, travel ban and mental health issues. Ports were closed preventing disembarkation of migrant boats and asylum request applications were put on hold.

Results
As of the 16th of June, a total of 30.2% (n = 198) confirmed COVID-19 cases were migrants. A strategy to support migrants was designed and implemented. The COVID-19 outbreak in a migrant centre resulted in all the 800 residents being placed in lock-down for 38 days (5th April till 13th May) and a total of 50 COVID-19 cases. Migrant boats that arrived before ports were closed were placed under quarantine. Migrants reported difficulties seeking healthcare, using the helpline, and higher exposure risk due to overcrowded living conditions.

Lessons
Migrants faced additional challenges due to the impact of the pandemic. The public health response measures implemented for the general population were not always feasible or accessible for the migrant population including hygiene recommendations, access to testing, isolation and quarantine and access to accurate scientific information. The mental health impact of COVID-19 among migrant populations was enhanced due to loneliness, lack of communication with their families and financial instability. Challenges accessing the healthcare system, understanding the restriction measures and the evolving public health recommendations were highlighted. Future strategies to control epidemics should always include specific plans to support migrant populations.

Key messages
The public health strategy must incorporate specific plans to support migrants in order to control and reduce the impact of the COVID-19 epidemic. Transdisciplinary policy needs to be developed considering the ethical, socio-economical, psychological and human right aspects of the migrant population.
The impact of ultra-processed food on carbon, water and ecological footprints of food in Brazil
Authors: da Silva J T , da Cruz G L , Rauber F , Louzada M L , Kluczkovski A R G , Frankowska A , Schmidt X , Reynolds C , Bridle S , Levy R B 
Published: October 2020

Abstract

Background
Ultra-processed foods (UPF) have been associated with major diet-related public health issues that share underlying drivers with climate change. Both challenges require major changes to the food system and so the potential benefits to health and the environment present a double motivation for transformation. Our aim is to assess the impacts of UPF on total greenhouse gas emissions (GHGE), water and ecological footprints in Brazil food purchases.

Methods
We have used data from 4 Brazilian Household Budget Surveys (1987, 1996, 2003, 2009). Each food item was classified into NOVA food groups (unprocessed/minimally processed, culinary ingredients, processed and ultra-processed). The information was linked to nutrition and footprint data. Purchases were converted into grams per capita per day to estimate total energy (kcal), percentage of energy from UPF, as well as total GHGE, water and ecological footprints. We performed linear regression to calculate year-adjusted means of footprints per 1000 Kcal by year-specific quintiles of UPF participation in the total energy. The data were analysed in R v.3.6.1 and STATA SE 14.1.

Results
The mean UPF participation in total energy varied from 13% (SD 2.4) in the 1st UPF quintile to 29% (SD 5.1) in the 5th quintile. The footprints increased linearly across quintiles: the mean g CO2eq varied from 1312 in the 1st to 1721 in the 5th UPF quintile (p-trend&lt;0.001); the mean litres of water varied from 1420 in the 1st to 1830 in the 5th quintile (p-trend&lt;0.001); the mean m2 varied from 9.4 in the 1st to 12.3 in the 5th quintile (p &lt; 0.001).

Conclusions
The environmental impacts were higher for Brazilian diets with a larger fraction of energy from UPF. Specifically, low UPF diets seem to have lower GHGE, water and ecological footprints. Our findings offer new motivators for dietary change to simultaneously healthier and more sustainable eating patterns and will be of relevance to consumers and policymakers.

Key messages
Diets high in UPF cause more climate impact than diets with lower levels of UPF. Healthy and sustainable dietary patterns should be low in ultra-processed foods.
Development of a web-platform for dynamic monitoring of population health in Geneva: Specchio project
Authors: Baysson H , Joost S , Attar Cohen H , Guessous I , Stringhini S 
Published: October 2020

Abstract

Background
In order to provide efficient public health decisions making, it is crucial to obtain reliable and recent data on the state of health of the population. For that purpose, a web-platform for the dynamic monitoring of the health status and well-being of the population is being developed in the Geneva canton.

Methods
Using a dedicated website, recruitment will be carried out over 5 years so as to enroll up to 20 000 volunteers, resident in Geneva and aged ≥ 18 years, followed-up for at least 10 years. Once connected to the website, participants will fill a general self-administered questionnaire on their socio-demographic and lifestyle characteristics, anthropometry, health status, physical activity and diet. Environmental, behavioral and occupational exposures will also be evaluated via more specific questionnaires. Current addresses of residence will be geocoded and linked to geographical databases to passively gather information on noise, air pollution, green areas, and other exposures. Surveillance of health events will be implemented via yearly self-administered on line questionnaires and potentially via passive linkage to medical databases (medical file) and health registries with the participants' consent. For a subsample of volunteers, biochemical samples and biomarkers will be collected.

Results
The pilot study shows that the project is feasible, potentially cost-effective but requires innovative methodologies for ensuring long term follow-up. Different communication strategies used for recruitment and long-term participation need to be implemented ensuring trust from participants, different levels of health literacy and the need of justice.

Conclusions
Specchio is a new project aimed at setting up a digital longitudinal health study in Geneva. Challenges concerns the determinants of participation, recruitment and attrition, quality of data and ethics. Long-term funding by the Directorate General of Health Geneva is currently under evaluation.

Key messages
This digital longitudinal health study will enable dynamic monitoring of the health status and well-being of Geneva residents and will enable efficient public health decision making. Specchio is a new project funded by the Directorate General of Health Geneva.
Disease burden of edentulism – Dental Clinic of Vojvodina, Serbia, 2008-2019
Authors: Lainović T , Novta E , Balázs Á , Maravić T , Dragosavljević S , Blažić L 
Published: October 2020

Abstract

Background
Although there is a decline in the global prevalence of edentulism over the past decade, the tendency is opposite in Serbia. The aim of this study was to estimate the disease burden of edentulism at the Dental Clinic of Vojvodina, tertiary referral public health institution of the northern province of Serbia.

Methods
Disease burden was expressed in disability-adjusted life years (DALYs). Prevalence (P) was calculated on the database of all patients from 2008 to 2019 at the Dental Clinic of Vojvodina using IBM SPSS Statistics. The number of diagnosed cases rehabilitated by complete dentures was an indicator of edentate people. A total sample of 76287 patients was examined, including 1620 patients restored with complete dentures (44.94% male, 55.06% female). Disability weight (DW) for severe tooth loss was taken from the “Disability weight for the Global Burden of Disease 2013 study”. The prevalence-based years lived with disability (YLD) were calculated as YLD = P x DW. Due to the non-fatal outcome of edentulism, DALY estimates were based on YLDs only (YLL=0).

Results
For the observed period, the total disease burden (per 1000) was 1.42 DALYs (0.64 for men and 0.78 for women). During observed years, DALYs increased (from 1.66 in 2008 to 1.73 in 2019), in association with population aging, and insufficient support from public health insurance for oral prevention and treatments. For both sexes, DALYs increased gradually with age. The results for age-stratified DALYs (per 1000) were: 0.005 (age 0-24), 0.049 (age 25-34), 0.55 (age 35-44), 2.66 (age 45-54), 4.41 (age 55-64), 7.89 (age 65-74), 8.04 (age 75-84) and 9.05 (age 85-94).

Conclusions
Considering the calculated disease burden, edentulism has been posing an increasing challenge for the health system in Serbia over the past decade. The quantified burden could contribute to the improvement of evidence-informed policymaking in public oral health in Serbia.

Acknowledgment
Supported by “Burden-EU” COST Action

Key messages
The calculated DALYs show an increase in burden of edentulism in Vojvodina, Serbia. DALYs calculations could improve the insufficient monitoring of oral health status in Serbia.
Self-Management Approach and Reciprocal Learning for Type 2 Diabetes (SMART2D) - the contextualisation of evaluation methods
Authors: Diavadanam M 
Published: October 2020

Abstract
The SMART2D aims to support self-management through community and facility interventions for people at risk of and with type 2 diabetes. The evaluation of implementation and impact were based upon a common theory of change, and common methodological frameworks. The focus of the presentation is on the methods and results of the contextualisation of evaluation tools and methods.