bluuebunny/crossref_metadata_2025_split huggingface dataset:
Capacity building and support from international organizations
Authors: Hoejskov P 
Published: October 2020

Abstract
WHO has a critical role to provide the evidence for action to improve food safety and to support Member states to effectively collect, analyse, report and use data on foodborne diseases. In 2006, WHO launched the initiative to estimate the global burden of foodborne diseases. The estimates were published in 2015 and showed that every year, 31 selected food-associated hazards contribute to 600 million people falling ill and 420,000 people dying because of contaminated food. About 40% of the burden was borne by children under 5 years of age. Due to limitations of diseases surveillance systems and the fact that not all ill people seek medical care, the estimated burden is recognised to be only the 'tip of the iceberg'. The actual burden is expected to be significantly higher.
In line with global and regional action frameworks and based on country support plans and biennial collaboration agreements with Member States, WHO, in collaboration with its partners and collaborating centres, provides technical assistance to Member States to strengthen national food safety systems. This includes technical assistance to generate, collect and analyse food safety information underpinning evidence.
Information about the burden of foodborne diseases is important to inform policy, guide resource allocation and to determine potential prevention and control measures for food safety. Acknowledging that most food safety policy work takes place at country level, WHO is developing tools for Member States to estimate the national burden of foodborne diseases. The tools are being developed to build capacity in Member States to collect, analyse and use foodborne disease data, prioritize specific food safety issues, identify risk factors in foodborne diseases and provide a baseline against which future food safety interventions can be evaluated.
Community-based participatory research in population-based health surveys - a case example from East Friesland (Germany)
Authors: Sisenop F S , Natan M N , Lindert J L 
Published: October 2020

Abstract

Background
The ongoing community-based participatory research (CBPR) project is based on a representative cross-sectional study on health and well-being in a rural region of Germany (n = 655).

Methods
We use a wide array of participatory methods to involve the general public, politicians and experts such as conferences open to the public including the use of the Mentimeter app, e-participation via an online-forum, working groups on topics identified by the public, a Delphi survey elicit expert opinions and focus groups to get deeper knowledge on key aspects.

Results
The results confirm the interest the public has in understanding better scientific research in the field of public health. The diversity of people (most notably age, social background) is a challenge in reaching out to people. Presenting statistical data to non-experts requires the researchers to re-think ways of presenting data, therefore basic knowledge on data research has to be taught. Usage of the tools such as the Mentimeter app offers a low-threshold for empowering people to take part in participatory conferences.

Conclusions
Sustainability is of utmost importance for participatory research. The population not only has the need but deserves timely information on results. Key challenges are communication, building trust and implementing sustainable CBPR projects. CBPR helps in building mutual trust, knowledge and science - public co-operations. Conferences open to the public that are tailored to the public`s needs and competences show the great interest people have in scientific knowledge generated through population-based surveys. By participatory research, Public Health Science can contribute to society, empower the general public.

Key messages
There is an existing interest in CBPR by the general public. It can be assumed that promoting CBPR in a sustainable manner will increase that interest. The diversity of participants is a challenge as well as communicating scientific data to non-experts.
18.M. Workshop: Institutional barriers and support influencing the health and well-being of LGBT individuals
Authors:   Organised by: EUPHA Sexual and gender minority health section,   Chair persons: Corina Lelutiu-Weinberger - USA, Richard Bränström - EUPHA-SGMH
Published: October 2020

Abstract
Research studies from many parts of the world have demonstrated significantly elevated risk of poor mental health among lesbian, gay, bisexuals, and transgender (LGBT) individuals compared to cisgender and heterosexual individuals. A growing body of evidence suggests that the elevated risk of poor mental health among LGBT people can be partly attributed to greater exposure to stigma-related stress and institutional barriers, such as, limited access to adequate health care, discriminatory legislation (e.g., regarding recognition of same-sex unions), and limitations in open expression of identity.
Today many governmental public health agencies call for policy and intervention programs addressing specific needs of LGBT individuals. Still, the public health consequences of discrimination towards LGBT individuals have only recently been a topic of investigation and current knowledge in the area is limited.
This workshop will include presentations of studies on strategies to reduce healthcare inequalities including the barriers LGBT individuals face when they access care and give examples of how institutional support can be provided. Laetitia Zeeman and Nigel Sherriff from University of Brighton, will present results from a European Union funded pilot project. Dr Corina Lelutiu-Weinberger from Rutgers University will present results from a study of the influence of gender affirmation and discrimination on transgender individuals mental health in a large US sample. Next, Daniel Hagen from New York University will present data analysing the protective effects of legal same-sex unions on the mental health of lesbian and gay couples. Lovro Markovic will present a study of predictors of being open with an LGBT identity in the workplace among employees in Austria.

Key messages
Although encouraging promising practices to reduce LGBT healthcare inequalities have been initiated in many parts of the world, much remains to be done to ensure equal access to care for all. Barriers to social integration in the form of discriminatory marriage legislation and work-place discrimination can have a negatively influence on LGBT individual's health and well-being.
20.C. Round table: Harnessing the digital transformation of disease prevention: a focus on m-health and genomics
Authors:   Organised by: EUPHA Public health epidemiology section, EUPHA Public health genomics section, EUPHA Digital health section, EUPHA Health promotion section,   Chair persons: Róza Ádány - EUPHA - PHG, Anna Odone - Italy
Published: October 2020

Abstract
Digital transformation in the health sector is one of the key drivers of innovation that can contribute to the health systems goals of being more effective, resilient, and sustainable. In December 2019, EUPHA published a conceptual framework on the potential value of digitalization for public health. In this framework the two digital health technologies that can impact disease prevention and health promotion are m-health and genomics, which are also two key facilitators of the broader asset of technologies that allow for a greater personalization of health and care. Digital transformation, however, is not only a technical process but an organizational and cultural one. In view of such complexity, there is a growing need for robust evidences to support digital solutions and the related organizational models that can positively contribute to such health system goals. In this context it is worth mentioning the latest report on the Digital Transformation of Health Services from the Expert Panel on Effective Investing in Health, which outlined some positive impacts in terms of effectiveness and cost-effectiveness of m-health interventions. In this field of genomics, the use of polygenic scores (PRS) for common disease risk assessment are becoming an important area of development that warrants close attention from public health professionals as it brings the potential for improving the effectiveness and efficiency of current models of health promotion and disease prevention.
This WS aims to convene a discussion between different stakeholders including academia, industry, international organizations and policy makers to discuss the current evidence and implications that such new technologies have for public health practitioners, and suggests next steps to support the adoption of technology that currently demonstrate their value for population health.

Key messages
Although digital technologies brings the potential to improve adherence to health promotion and prevention at population level, the real value needs to be addressed from well conducted large studies. PRS might increase the effectiveness and reducing the costs of available preventive interventions: we need large studies to address the clinical utility for implementation in healthcare.
Key drivers for and requisites to harness digital tools for personalized healthcare
Authors: Boccia S , Pastorino R 
Published: October 2020

Abstract
The technologies that allow for a deeper understanding of the human 'omic infrastructure are creating unprecedented opportunities for disease prevention, diagnosis, and treatment and for disease monitoring on a personalised basis, both within the health system and beyond. As all the new technologies and their applications advance, they are likely to play an integral role in shaping healthcare and the ways in which citizens manage and optimise their health. The 'omic profiling have the potential to be considered a useful component of health management since birth, but the extent to which it really represents an added value in terms of improved outcomes and quality of life needs additional evidences. The use of PRS in health subjects is an important area of development for public health and warrants close attention, but there is still a good deal to learn about how to maximise benefits for population health. When it comes to digitalization, we can anticipate that its impact on health, health care delivery and health systems will be profound. It will likely (further) affect the different phases of health care delivery, including health promotion, prevention, primary care, specialised care, long term care, social care, and self-care. In this context, a key challenge is to ensure that all people enjoy the benefits of digital technologies for everyone. Establishing the critical digital infrastructure, training the workforce, improve citizens awareness, and secure safeguarded systems to protect data as a central issue to fostering patients and citizens trust in data sharing, are key aspects that we need to address now. Additionally, we must make sure that all the innovation and technologies helps to reduce the inequities in our world, instead of becoming another reason people are left behind.
Health and wellness tourism in Sicily: development and enhancement
Authors: Arnone R , Bue S L , Parenti I 
Published: October 2020

Abstract

Background
The Health Counselor of Sicily in Italy, appointed the “Forum Meridiano Sanità” 2020 dedicated to Health Tourism (HT). Sicily is a member of the Italian network “Mattone internazionale salute” that focus the development of Health Tourism aiming at: Establish the state of art on HT;Defining a strategy to give visibility of the services targeting health tourists;Defining joint actions/projects to strengthen Italy's attractiveness and the action plan to promote/valorize health performances and the touristic services offered.
Sicily, making use of its cultural/environmental characteristics, landscapes, climate, food traditions and its Mediterranean diet, wants to be accounted for a destination on health/wellness tourism. Target groups are seniors, disabled people and people affected by particular pathologies Contribution of Sicilian Region (Sicilian Health Government and CEFPAS) and of the European program 2021-2027 are promoting in Sicily the implementation of such in the development of the “Health and Wellness Tourism”. In order for this to be integrated in a broader framework a discussion on the first European Charter on Health Tourism will be developed with participants.

Results
The “working table” has elaborated a document “Framework on health and tourism - the interregional point of view” containing the definitions of Health tourism, a state of art of the national/European legislative framework and a mapping of the touristic flow and the needs of seniors. The Regional Health Government is also starting articulations with other Regional Governments (e.g. Tourism/Environment). Strategic alliances/resources able to transform the tourism sector, should focus a strategic policy agenda for health prevention/promotion linked to a wider concept of general wellness.

Key message
Promote health/wellness tourism targeting seniors and people with disabilities/pathologic diseases is considered worth the investment.
Impact of Immediate ART Initiation and Patient Health Expenditures: A Stepped-Wedge Randomised Trial
Authors: Steinert J I , Geldsetzer P 
Published: October 2020

Abstract

Background
Healthcare expenditures for HIV care pose a major economic burden on households in sub-Saharan Africa. While immediate initiation of antiretroviral therapy (ART) for all HIV-positive patients has important health benefits, it is unknown how this profound change in HIV care provision will affect patients' healthcare expenditures. This study, therefore, aims to determine the causal impact of immediate ART initiation on patients' healthcare expenditures in Eswatini.

Methods
This stepped-wedge cluster-randomised controlled trial enrolled fourteen public-sector healthcare facilities in rural and semi-urban Eswatini. Facilities were randomly assigned to transition at one of seven time points from the standard of care (ART eligibility at CD4 counts of &lt; 500 cells/mm3) to the immediate ART for all intervention (EAAA). The primary outcome was total patient-borne healthcare expenditures during the preceding 12 months. We used mixed-effects negative binomial regressions adjusted for secular trends and clustering at the facility level.

Results
2261 participants were interviewed over the study period. Participants in the EAAA phase reported a 45% decrease (RR: 0.55, 95% CI: 0.39, 0.77, p &lt; 0.001) in their total past-year healthcare expenditures compared to the standard-of-care phase. Patients' healthcare expenditures for private and traditional healthcare providers were 93% (RR 0.07, 95% CI: 0.01, 0.77, p &lt; 0.001) lower in the EAAA than the standard of care phase. Self-reported health status was similar between study phases.

Conclusions
Despite a higher frequency of HIV care visits for newly initiated ART patients, immediate ART initiation lowered patients' healthcare expenditures because they sought less care from private and traditional healthcare providers. This study adds an important economic argument to the World Health Organisation's recommendation for countries to abolish CD4-count-based eligibility thresholds for ART.

Key messages
This is the first experimental study to examine the impact of immediate ART initiation on patients’ healthcare expenditures and thus obtain a causal estimate of the economic benefits of immediate ART. Immediate ART initiation in Eswatini reduced HIV patients’ healthcare expenditures, at least partially through decreasing care-seeking from traditional and private healthcare providers.
Artificial Intelligence in Drug-Resistant Tuberculosis Diagnosis. Systematic Review & Meta Analysis
Authors: Herman B , Sirichokchatcawan W , Pongpanich S , Nantasenamat C 
Published: October 2020

Abstract

Background
Artificial Intelligence (AI) models possess potential screening or diagnosing Drug-Resistant Tuberculosis. This meta-analysis aimed to elaborate on the performance of AI models in predicting drug-resistant TB compared to the gold standard.

Methods
A systematic search of full-paper articles from Pubmed/MEDLINE and SCOPUS published between January 2005 and April 2020 was conducted. Studies involving whole-genome sequencing or human subject data that used drug-susceptibility test results as a reference standard were retrieved. Hierarchical summary receiver-operating characteristic (HSROC) and bivariate model were performed to calculate pooled sensitivity and specificity. Heterogeneity and publication bias were also assessed.

Results
25 Models form four genome-based studies, four radiology-based studies, and two clinical and demographic-based studies were included. The radiology-based models, mainly built with the Convolutional Neural Network (CNN), possessed pooled sensitivity of 58% (95%CI 50%-65%), and a pooled specificity of 75% (95% CI 47%-91%) for detecting MDR-TB. Genome-based models outperformed other models despite developed with simpler classifiers (CART/GBT/LR). The genome-based studies reached pooled sensitivity of 92% (95%CI 90-93%), pooled specificity of 98 (95% CI 96%-98%) in predicting isoniazid resistance. For predicting rifampicin resistance, the pooled sensitivity and specificity were 93% (95%CI 90%-94%) and 98% (95% CI 96%-98%) respectively. The Artificial Neural Network (ANN) demonstrated superiority rather than the Classification and Regression Tree (CART), and logistic regression (LR) on the clinical and demographic model in predicting drug-resistant TB.

Conclusions
Simple classifier performs better in genomic data whereas the CNN model works best in high-dimensional data, such as radiology images. The ANN model indicates a preferred model for data obtained from clinical and demographic parameters. (PROSPERO number CRD42020167439)

Key messages
Artificial Intelligence model through machine learning and deep learning possess a good diagnostic performance for drug-resistant tuberculosis. Artificial Neural Network model outperforms other technique. The model built from genomic data shows the best performance, followed by model from patient-based data and radiology/imaging data.
The association of nurses’ informatics competence with distress and information system-related stress
Authors: Laukka E , Kaihlanen A-M , Gluschkoff K , Virtanen L , Heponiemi T 
Published: October 2020

Abstract

Background
Ability to use information systems is a crucial part of nurses' competence, but evidence on whether this competence is associated with stress among nurses is lacking. As part of the 'Towards socially inclusive digital society: Transforming service culture' (DigiIN, funded by the Strategic Research Council, project 327145), we examined the associations of registered nurses' informatics competence with distress and information systems related stress.

Methods
The data was collected in Finland with an electronic survey at the end of 2018. The sample comprised 1639 nurses. Analyses of covariance were used to examine whether the nurses' informatics competence was associated with distress and information system-related stress. In addition to overall informatics competence, we also examined the associations of four dimensions of informatics competence (terminology based documentation; e-documentation according to structured national headings; general IT competency; patient-related digital work) with dependent variables. Models were adjusted for age, gender and employment sector.

Results
Nurses' overall informatics competence was associated with lower distress (F = 9.90 p = 0.002), but not with information system-related stress. The analyses with four competence dimensions showed that patient-related digital work competence was associated both with lower distress (F = 3.95 p = 0.047) and information system-related stress (F = 4.63 p = 0.032). In addition, general IT competency was associated with information system-related stress (F = 12.6 p &lt; 0.001).

Conclusions
Especially lack of patient-related digital work competence seems to stress nurses. Supporting nurses in patient-related digital work and improving nurses' general IT competency by training could decrease their stress related to information systems and improve their wellbeing.

Key messages
Nurses should be supported more in patient-related digital work. Nurses’ high IT competency is associated with lower stress, and thus, healthcare organizations may benefit from providing more IT training for nurses to decrease their stress levels.
Data-driven chronic care delivery pathways visualization Methods: protocol for a systematic review
Authors: Siqueira do Prado L , Allemann S , Viprey M , Schott A-M , Dediu D , Dima A L 
Published: October 2020

Abstract

Background
Faced with increasing illness burden and costs, healthcare systems are working towards integrated care to streamline services and improve efficiency, especially for chronic conditions. Routine care delivery data stored in various electronic healthcare databases (EHD) has the potential to support chronic care coordination if information is integrated and accessible at the point of care. Care delivery pathways (CDPs) can be constructed by linking multiple data sources and extracting time-stamped healthcare utilization events and other medical data related to individual or groups of patients over specific time periods; CDPs may facilitate communication on current practice and ways of improving it. We aim to identify and describe the methods proposed to quantify and visualize CDPs.

Methods
A literature search was performed in PubMed (MEDLINE), Scopus, IEEE, CINAHL and EMBASE, without date restrictions. We will describe CPDs methods from 3 perspectives relevant for EHD use in long-term care: (1) clinical (what clinical information is used and how was it considered relevant?), (2) data science (how was the method developed and implemented?), and (3) behavioral (which behaviors and interactions are promoted among users and how?). Data extraction will be performed via deductive content analysis using selected frameworks, and inductive analysis to identify additional relevant features. We will compare these characteristics to identify common, infrequent, or missing features, and extract recommendations for future initiatives.

Results
The literature search identified 2349 entries, currently under title and abstract selection by 4 coders. This study will produce a comparison and synthesis of clinical, data, and behavioral features of CDPs methods and derive recommendations for CDP construction.

Conclusions
This review works towards a common basis for visualizing and quantifying CDPs across healthcare systems, an essential prerequisite for interoperable digital health.

Key messages
Visual feedback on health care trajectories, especially for chronic conditions, may support informed decisions and planning future care episodes to advance towards person-centered integrated care. We describe and compare technical and clinical characteristics of visual feedback methods available for care pathways, and behaviors they may promote in care planning, to inform future initiatives.