bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in socioeconomic inequalities in childhood BCG immunization coverage in Pakistan
Authors: Zaheer S , Kanwal S , Shafique K 
Published: October 2020

Abstract

Background
Although, WHO notes that there has been 'tremendous progress' towards controlling spread of Tuberculosis (TB) by 2015, situation in endemic countries like Pakistan need global attention. Pakistan currently ranks fifth among TB-high burden countries and it accounts for 61% of the TB burden in the WHO Eastern Mediterranean Region. We aim to explore the trends in relative and absolute socioeconomic inequalities in BCG vaccination coverage.

Methods
Data from Pakistan Demographic and Health Surveys (PDHS) 2006-7 (n = 9177 data used 8442), and 20012-13 (n = 13558, used n = 6982) were used. Information was collected from all mothers in reproductive age group, regarding BCG vaccination of their children aged &lt; 5 years. Wealth index and education were used to assess socioeconomic position. Socioeconomic inequalities for BCG vaccination coverage were assessed by calculating Relative Index of Inequality (RII) and Absolute Index of Inequality (SII).

Results
Although reported frequency of not getting the child BCG vaccinated has decreased over the decade (25% in 2006, 18% in 2013). Nevertheless, socioeconomic inequalities in BCG vaccination have significantly widened over the last decade. Education related inequalities [2006-7 Urban: SII=-1.34 (-0.91, -1.76); 2012-13 Urban: SII=-1.88 (-1.43, -2.32)]; [2006-7 Rural: SII=-1.31 (-0.96, -1.65); 2012-13 Rural: SII=-1.54 (-1.13, -1.94)] have increased. Similarly, wealth related inequalities [2006-7 Urban: SII=-1.27 (-0.91, -1.62); 2012-13 Urban: SII=-1.75 (-1.37, -2.12)]; [2006-7 Rural: SII=-1.19 (-0.98, -1.39); 2012-13 Rural: SII=-1.72 (-1.43, -2.00)] have increased.

Conclusions
Widening absolute inequalities in BCG vaccination coverage among children over the last decade in a TB-high burden country gives rise to global concern, at a time when world aims for tuberculosis free future. The results warrant the essential public health efforts to avoid further widening in TB related socioeconomic inequalities in Pakistan.

Key messages
The results warrant the need to continue monitoring of TB control at population level. Study findings may help to improved TB management programs to initiate evidence-based guidelines for maternal and child health.
Sociodemographic inequalities in lifestyle patterns of the population of a large Brazilian city
Authors: Medina L P B , Barros M B A , Barros Filho A A 
Published: October 2020

Abstract
Knowledge of avoidable exposures to noncommunicable diseases from the analysis of health behaviors or practices, and of attitudes and care related to lifestyle is an important strategy in identifying issues emerging to health and opportunities for the prevention of these problems. It was intended to analyze the combination of behaviors related to health, food and lifestyle, identify behavioral patterns and verify the inequalities present in its association with sociodemographic characteristics of the population of Campinas, São Paulo. This is a cross-sectional study conducted in 2014/15 that evaluated 1,205 people aged 20 years or older. From the behaviors regular consumption of raw and cooked vegetables, fruit and beans, consumption of low-fat milk, concern with salt intake, habit of reading food label, concern with the use of pesticides, consumption of organic foods, practice of leisure-time physical activity, consumption of meat with fat, frequent consumption of sausages and soft drinks, current smoking, alcohol abuse and short sleep duration were extracted through analysis factorial by main components. The association of these patterns with the variables gender, age and income were tested. Three lifestyle patterns were identified and nomined. The 'Healthy Advanced' lifestyle pattern was associated with females, the elderly and the best income groups can be identified; the 'Healthy Prudent' was associated with older adults, with the elderly and with the intermediate income segment. The 'Unhealthy' pattern was associated with males, with young people and did not have an association with income. It can be concluded that healthy lifestyle patterns were more present in female groups, with older age and better income level. The less healthy pattern was found more frequently among men and young people. It is noteworthy that this last pattern did not differ between income strata indicating that unhealthy practices may be equally disseminated in these groups.

Key messages
The better lifestyle patterns were more present in female groups, with older age and better income level. The less healthy pattern was found more frequently among men and young people, and did not differ between income strata.
Geospatial analysis of emergency services use for public health assessment and intervention
Authors: Cassourret G 
Published: October 2020

Abstract
The population is increasingly using emergency care services around the world. The underlying interrogation is whether this increase is a consequence from a dysfunction in healthcare provision, from a deterioration in the health status of the population or from socioeconomic determinants.
We performed geospatial analyses with 3-year 1,081,026 Emergency Medical Services (EMS) responses in Paris and its suburbs. Incidence of calls per population and complaints were compared, at the neighborhood level, with demographic and socioeconomic determinants. Associations with characteristics of the health system such as the density of primary care doctors were also studied. Spatial autocorrelations were searched with Moran's I analyses.
We found a positive correlation between the incidence of EMS calls by population for respiratory problems, and the level of poverty as well as the unemployment rate (p &lt; 0.001). There was no significant correlation between psychiatric complaints and socioeconomic determinants. There was a strong correlation between calls for birth or imminent birth by woman of childbearing age and the unemployment rate among women, the unemployment rate overall and household median household income (p &lt; 0.001). There was no correlation between the density of primary care providers and EMS activity by population.
EMS data allowed us to powerfully identify specific socioeconomic determinants of health for a 7 million-inhabitant population at the district level. Results could be used to design and implement tailored public health interventions for maximum impact. The overuse of emergency services does not seem to stem solely from the decrease in the supply of primary care doctors. Innovatively, monitoring the actual use of emergency services could responsively inform policy makers and agencies responsible for prevention and health promotion about the specific needs of the population and the consequences of decisions on the organization of the provision of care.

Key messages
The use of emergency services is a valid metric to evaluate the health status of the population and identify socioeconomic determinants. It gives specific guidelines for public health interventions. Geospatial analyses can efficiently identify the specific needs of a population at the neighborhood level. It can participate to the evaluation of the organization of healthcare provision.
Are contextual socioeconomic factors associated with diarrhea in Mozambique children under age 5?
Authors: Moreira de Sousa A 
Published: October 2020

Abstract

Background
Diarrhea is still highly prevalent in Mozambique children under age 5, which leads to avoidable morbidity and mortality. Specific socio-economic variables may influence diarrhea prevalence.

Methods
Secondary data analysis with the application of multiple logistic regression models on the data of 10026 living children under age 5 from Mozambique's Demographic Health Survey (DHS) report from 2011. Data were collected from June 2011 to November 2011 and had a household sample size of 13919. RStudio 1.1.442 was chosen as the statistical software to conduct the multiple regression modeling and the graphic representation of the results.

Results
From the 10026 children under age 5, 10.6% of them (1064) had diarrhea in the last 2 weeks. The prevalence of diarrhea during that period was 1.25 times higher in the urban areas in comparison with the rural areas (adjusted OR [95% CI]: 1.25 [1.03-1.52]). Households with a higher number of children had 12% less risk, per children's group (adjusted OR [95% CI]: 0.88 [0.80-0.96]). No increased risk of diarrhea was found for other variables, including sanitation, source of drinking water and refrigerator presence.

Conclusions
Urban areas and Households with fewer children are more likely to have a higher diarrhea risk while adjusting for other variables. It is important to notice that WASH variables such as sanitation and source of drinking didn't seem to lower diarrhea risk in Mozambique's context. Further research should take into consideration a greater sample and identify other possible reasons that may explain the high prevalence of diarrhea.

Key messages
Several factors may influence the prevalence of diarrhea in Mozambique. Beside the existence of sanitation infrastructure, there maybe be the need to improve its quality.
The Girls Active Project: a school-based intervention to increase adolescent girls’ physical activity
Authors: Mc Quinn S , Belton S , Staines A , Sweeney M 
Published: October 2020

Abstract

Background
National and international evidence indicate that adolescent's physical activity (PA) participation rates are low. In Ireland, 93% of adolescent girls (vs 86% boys) do not reach recommended PA guidelines for health. Literature indicates that socio-economic status is a predictor of PA participation. The aim of this study was to work with a socio-economically disadvantaged school in Dublin (Ireland) and, using the behaviour change wheel (BCW) framework, design the components of a school-based intervention to increase adolescent girls' PA levels.

Methods
A circular development process was undertaken to collectively design the intervention in accordance with the steps recommended by the BCW. One all-girl, socio-economically disadvantaged post-primary school was invited to take part. Public and Patient Involvement (PPI), alongside a cross-sectional, mixed-methods study design, was used to identify the barriers and facilitators to PA using both quantitative questionnaires, and three semi-structured focus groups.

Results
Girls (n = 287) felt they would be more active in school if they had 'more time to do it' and they 'developed a habit of doing it'. The qualitative data identified influence of their peers, beliefs about their capabilities, setting goals and lack of reinforcement as additional themes. Just 1.4% of students in this sample self-reported meeting the recommended PA guidelines. The BCW design process, informed by the data, PPI members and research team resulted in the selection of specific intervention functions and behaviour change techniques.

Conclusions
The PA levels of adolescent girls are far below recommended guidelines for optimum health. Helping schools to fulfil their PA promoting role should be a public health priority. The BCW provided a systematic framework for developing a PA school-based intervention. The feasibility and preliminary efficacy of the Girls Active Project will be examined.

Key messages
Physical activity levels of adolescent girls in Ireland are far below recommended guidelines for health. Using Public and Patient Involvement, and the Behaviour Change Wheel provided a well-founded framework with which to develop a school-based intervention to improve Physical Activity levels.
Health promotion program in regular primary school “We Learn to Accept Diversity”
Authors: Skes M , Polić-Vižintin M , Šostar Z , Hladki Z 
Published: October 2020

Abstract

Background
One of the main goals of National Strategy of Equal Opportunities for People with Disabilities from 2017 to 2020 is the encouragement of their full participation in education, family and community life. According to Croatian Register of People with Disabilities, 86,274 people with disabilities live in the City of Zagreb in 2019. That accounts for 10.8% of the total population of the city, of which 10.1 % is under the age of 19. In the school year 2019/2020 in 110 regular primary schools, 4,035 children with disability were included.

Objectives
The aim of this project is to educate students, parents, staff and experts in education system in health literacy skills about the categories of disability types, how to appropriate communicate and support them to realize their opportunities, to reduce of stereotypes regarding children with disabilities, fight against discrimination and stigma.

Results
Andrija Stampar Teaching Institute of Public Health in partnership with City office for Social Protection and People with Disabilities carries out the project “We Learn to Accept Diversity” - Creating a Healthier life for Children with Disabilities in elementary school in the City of Zagreb. In the period from 2018 to 2019, a total of 24 health workshops were conducted through which 525 pupils were educated. The results of students’ creative expression are integrated into the educational brochure “How can I help You?”.

Conclusions
A disabling condition or diagnosis of impairment does not define individuals, their abilities and talents, or health status and health behaviors. The final evaluation with extremely positive reactions of professionals and students in these primary schools, indicated that the program should become an integral part of school prevention programs and implement expend to the other primary schools.

Key messages
It is important to expand the knowledge base and raise awareness of health determinants for children with disabilities in health promotion activities. Health sector should promote, analysis, advocate and continue educate for healthier lifestyle children with disability, but community and policy are to support and complement the actions.
The epidemiology of polypharmacy in a large cohort with linked health records in Scotland
Authors: Khezrian M , Murray A D , McNeil C , Johnston M , Myint P K 
Published: October 2020

Abstract

Background
Our understanding of the potential harm of taking multiple medications in older, multi-morbid populations is limited. We aimed to investigate the prevalence of polypharmacy and its association with hospitalisation in a large cohort with linked health data.

Methods
Prescription data and hospital admission records of the Aberdeen Children of the 1950s (ACONF) Cohort were extracted from the National Health Services Scotland database and linked from 2011-2016. We estimated polypharmacy by measuring monthly drug exposure for 1) total number of prescribed medications and 2) total number of defined daily doses (DDDs). Cox proportional hazard models (adjusted for demographics, socioeconomic circumstances and health conditions) were used to examine the association of polypharmacy and hospitalisation.

Results
Prescription records were linked for 8,713 cohort members. Mean age at baseline was 58.5 years (SD = 1.5) and 50% were female. 1,994 individuals (23%) had at least one health condition and 8% of population had multimorbidity. The proportion of cohort with polypharmacy assessed using taking 5+ medications and taking 5+ DDDs at baseline were 12.7% (female=12.6% vs male=12.7%, P = 0.179), and 15.5% (female=13.8% vs male=17.1%, P &lt; 0.001) respectively. Of all the cohort, 4,365 admitted to hospital (mean follow-up of 3.5 years, total 30,269 person-years). Adjusted hazard ratios for hospitalisation were 1.51 (95 % CI 1.39,1.64, P &lt; 0.001) for polypharmacy measured by number of medications and 1.40 (95 % CI 1.29,1.51 P &lt; 0.001) for polypharmacy estimated by number of daily doses.

Conclusions
Polypharmacy is independently associated with increased risk of hospitalisation. This association could signify polypharmacy as a risk factor and a marker of poor outcome. Data linkage can generate evidence-based information for future policy and health services to improve polypharmacy measurement and management.

Key messages
Data linkage is a cost effective and contemporary return on the investment in data collection and research in public health. Improvement in evidence to better understand the relationship between polypharmacy and health outcomes should be a priority to optimise treatment in older people with various chronic conditions.
The opioid crisis: 18 years of opioid prescriptions in spine patients
Authors: Calvachi P , Mezzalira E , Boaro A , Duey A , Bolivar F , Mekary R , Smith T R , Aglio L , Gormley W 
Published: October 2020

Abstract

Background
The US opioid epidemic continues to afflict patients and the healthcare system. Surgery remains a risk factor for opioid misuse, and treatment of low back pain in orthopedics and neurosurgery is one of the largest introductions of opioids into the community. The objective of the study is to understand how opioid prescribing practices for spinal surgery have evolved in two academic hospital in the last 18 years.

Methods
Data were obtained from the Research Patient Data Registry for Brigham and Women's and Massachusetts General Hospital from January 2000 to December 2018. Patients included had a primary diagnosis of degenerative diseases, trauma, spinal infection, spinal deformities, or spinal pain symptoms/syndromes; were aged &gt; 18 years; and had an opioid prescription. Covariates included demographics, diagnoses, comorbidities, procedures, opioid type, number of prescriptions, route of administration, doses and length of prescription.

Results
A total of 38,250 patients with spine-related diagnoses received an opioid prescription. The median age was 63 years (18-107), 50% male and 86% white. A total of 32,304 patients (84.4%) received at least one opioid prescription during their hospitalization. The sum of opioid prescriptions filled (inpatient and outpatient) were 889,868 between 2000 and 2018 (55.2% oral, 41.7% intravenous). Oxycodone was the most prescribed. The dose of ≥ 50 morphine milligram equivalents MME/day was reduced from 65.0% in 2000 to 17.3% in 2018, and doses ≥ 90 MME/day dropped from 26.9% in 2000 to 6.4% in 2018. However, the duration of prescription has increased from 4.1% having an opioid prescription for &gt;7 days in 2000, to 21.7% in 2018.

Conclusions
Opioid prescription rates for spinal surgery patients have increased since 2000, declined temporarily in 2016, but are rising again. Physicians are prescribing fewer MMEs per day but have increased longitudinal dosing, which still leaves patients at risk for misuse and opioid use disorder.

Key messages
Between 2000 and 2016 there was an increase of 140 times the number of opioid prescriptions for spine patients. More interventions and non-pharmacological solutions are needed to reduce this public health epidemic.
Health Alliance for Digital Development and Action (HADDA)
Authors: Elmi M 
Published: October 2020

Abstract
SPIDER's Digital Health Programme in Somalia - HADDA - supports Somalia's National Plan for health system strengthening through the use of digital tools for data and knowledge sharing. By deploying and tailoring a Health Information Management System for the country's health system, the programme will enhance the capacity of healthcare workers, whilst enabling policy makers to analyse public health data, plan, manage and deliver quality healthcare for all in Somalia. To realise this, a number of Maternal and Child Health Clinics and referral services will be selected that will connect the entire care pathway in Puntland and Galmudug linking them to the Federal Ministry of Health. Based on the outcome of a needs-assessment in the selected regions, the evidence will determine the required digital infrastructure and human resources and skills necessary for the programme to succeed. SPIDER, in alliance with the Somali government authorities, will engage and mobilise key stakeholders, practically adhering to the digital principles for development for the strengthening of the health system. In tandem with the implementation of project activities, SPIDER will support an independent and ongoing research programme to monitor the outcomes of programme. This will help to improve the methods of application, manage risks, and sustain the results.
A model for the capacity building of Somalia midwifery educators through a blended, web-based Master Programme
Authors: Osman E 
Published: October 2020

Abstract
In most low-resource settings maternal and child mortality and morbidity are major public health concerns and closely related to sub-optimal care, and the most cost-effective response is to scale up women's access to quality midwifery care (Renfrew et al., 2014). It is further recognized that midwives educated per international standards, integrated in the health care system, and working in interdisciplinary teams in providing midwifery care could decrease maternal deaths (Renfrew et al., 2014). Somaliregion suffers from a shortage of qualified health care professionals, including midwives, the training of health care professionals is essential for the situation to improve. In this workshop, we will present the implementation of the Master Programme in Sexual and Reproductive Health and Rights in three universities in Somaliland and Puntland as well as the impacts that a net-based program can have on individuals' professional development.
The Roadmap for Action on AMR
Authors: Berg A 
Published: October 2020

Abstract
The speaker will present the perspective of civil society, as well as its extensive work to raise awareness and bring together stakeholders committed to tackling AMR across Europe. The Stakeholder Network on AMR, hosted within the European Commission's Healthcare Policy Platform, along with the resulting Roadmap for Action on AMR will be presented. The speaker will explain how the Roadmap and the key strategies and targets identified encompass a 'One-Health' approach, emphasising that AMR can only be addressed through concerted cross-sectoral actions, ranging from infection prevention, better diagnostics and supporting Member States in implementing National Action Plans. The links between AMR and other EU initiatives such as the emerging Cancer Plan, the Farm to Fork Strategy and the European Green Deal will also be elaborated on. Finally, the role of the European Parliament in ensuring that AMR stays high on the agenda and mobilising Member States to act, will be discussed in the context of a newly established MEP Interest Group on AMR with an ambitious strategic work programme for the Parliamentary term 2019 - 2024.