bluuebunny/crossref_metadata_2025_split huggingface dataset:
Junk food advocacy. Countering the industry
Authors: Moore AM M 
Published: October 2020

Abstract

Background
The junk food and alcohol industries have taken a page from the tobacco industry play book in an attempt to resist regulation through delay, self-regulation and effective lobbying. The junk food industry internationally is constantly seeking to increase sales at a time when the obesity crisis continues to grow. The industry thrives through widespread marketing with a particular focus on children.

Methods
An assessment of the number of lobbyists engaged to influence members of Parliament in Australia is being conducted to understand attempts to influence policy. This follows a scan of the lobbyists' register by Daube et al in 2018 that found the junk food industry had 33 direct and 13 indirect lobbyists. A re-examination of the register in 2020 is expected to reveal an increase in these numbers as international junk food companies become more concerned about regulation by government in areas such as front of pack labelling and marketing. There will also be an examination of the State and Territory registers in an attempt to understand the extent of influence in all governments across Australia.

Discussion
This examination is focused on the Australian Parliament/s. However, the message will be similar world-wide. Many companies have been challenged about their approaches to marketing and the sales of junk food. However, despite some attempt at corporate responsibility (Ronald McDonald House), they continue to sell their products to the detriment of community health.

Presentation
The presentation will focus on the importance and methods of countering the efforts of industry to increase availability of junk food by opposing regulation. It will also provide a series of steps that public health advocates can take in order to persuade governments of the importance of protecting community health through appropriate regulation of the marketing and sales of junk food.

Key messages
Junk food industry employs multiple lobbyists to resist regulatory reform. There are tools available for public health advocates to counter this influence.
Up to Their Old Tricks. Tobacco Companies and eCigarettes
Authors: Moore AM M 
Published: October 2020

Abstract

Background
Tobacco companies face an ever-increasing rate of marginalisation. They use eCigarettes as an opportunity to improve their credibility. In the past it was “just filter it” and “light cigarettes”. More recently, Philip Morris established a “Foundation for a Smoke-free World” pumping millions of dollars into distorting arguments about harm reduction.

Methods
The presentation will examine tactics used in traditional and social media to promote eCigarettes and to undermine arguments put by opponents. Tactics deployed that will be examined are: Use of the term harm reductionWithout the harm minimisation context that includes supply reduction and demand reductionAttacks launched in social media platforms such as twitter and FacebookOn individuals who publish papers identifying harms associated with eCigarettesPapers that are critical of eCigarettesDeployment of lobbyists in parliaments and to governmentsPresenting eCigarettes are a viable method of quitting tobaccoOther tactics
Specific examples will be provided illustrating cherry-picking, distortion of peer review and translation of this material into the traditional and social media

Discussion
The methods deployed by tobacco companies have been successful in some countries and have been countered in others. To enhance arguments, Big Tobacco has deployed public health figures like Dr Derek Yach and Dr Moira Gilchrist. Public Health England is one example of a strong and successful supporter of an open market for eCigarette.. A similar story is true in the USA and New Zealand. In Australia, both government and opposition have required approval by the Therapeutic Goods Administration consistent with other smoking quitting aids. The policy is that that these devices should be available to those who really need them after they have been proven as efficacious and not causing significant harm.

Key messages
Tobacco giants are distorting eCigarettes policy as a way of improving credibility. Public health advocates do have the tools to counter big tobacco approaches.
Evaluation and cost estimation of laboratory tests overuse through a CCDSS in a university hospital
Authors: Vallone D , Tamburrano A , Carrozza C , Urbani A , Cambieri A , Nicolotti N , Sanguinetti M , Laurenti P 
Published: October 2020

Abstract
Computerized Clinical Decision Support Systems (CCDSS) are information technology-based systems that use specific patient characteristics and combine them with rule-based algorithms. The aim of this study is to conduct a survey to measure and assess the over-utilization rates of laboratory requests and to estimate the monthly cost of inappropriate requests in inpatients of the “Fondazione Policlinico Universitario A. Gemelli IRCCS” Care Units.
This observational study is based on the count of rules violations for 43 different types of laboratory tests requested by the Hospital physicians, for a total of 5,716,370 requests, over a continuous period of 20 months (from 1 July 2016 to 28 February 2018). Requests from all the hospital internal departments (except for Emergency, Intensive Care Units and Urgent requests) were monitored. The software intercepted and counted, in silent mode for the operator, all requests and violations for each laboratory test among those identified.
During the observation period a mean of 285,819 requests per month were analyzed and 40,462 violations were counted. The global rate of overuse was 15.2% ± 3.0%. The overall difference among sub-groups was significant (p &lt; 0.001). The most inappropriate exams were Alpha Fetoprotein (85.8% ± 30.5%), Chlamydia trachomatis PCR (48.7% ± 8.8%) and Alkaline Phosphatase (20.3% ± 6.5%). All the exams, globally considered, generated an estimated avoidable cost of 1,719,337€ (85,967€ per month) for the hospital.
This study reports rates (15.2%) similar to other works. The real impact of inappropriateness is difficult to assess, but the generated costs for patients, hospitals and health systems are certainly high and not negligible.

Key messages
It would be desirable for international medical communities to produce a complete panel of prescriptive rules for all the most common laboratory exam. That is useful not only to reduce costs, but also to ensure standardization and high-quality care.
Development of a neighborhood drivability index and its association with transportation behavior
Authors: den Braver N R , Lakerveld J , Gozdyra P , van de Brug T , Moin J S , Fazli G , Brug J , Moineddin R , Beulens J W J , Booth G L 
Published: October 2020

Abstract

Background
To develop and validate a drivability index for the City of Toronto and examine its association with transportation mode choice.

Methods
We used exploratory factor analysis to derive distinct factors (clusters of one or more environmental characteristics) that reflect the degree of car dependency in each neighborhood, drawing from candidate variables that capture density, diversity, design, destination accessibility, distance to transit, and demand management. Area-level factor scores were then combined into a single composite score, reflecting neighborhood drivability. Negative binomial generalized estimating equations were used to test the association between driveability quintiles (Q) and primary travel mode (&gt;50% of trips by car, public transit, or walking/cycling) in a population-based sample of 63,766 Toronto residents enrolled in the Transportation Tomorrow Survey (TTS), adjusting for individual and household characteristics, and accounting for clustering of respondents within households.

Results
The drivability index consisted of three factors: Urban sprawl, pedestrian facilities and parking availability. Relative to those living in the least drivable neighborhoods (Q1), those in high drivability areas (Q5) had a significantly higher rate of car travel (adjusted rate ratio (RR):1.80,95%CI:1.77-1.88), and lower rate of public transit use (RR:0.90,95%CI:0.85-0.94) and walking/cycling (RR:0.22,95%CI:0.19-0.25). Associations were strongest for short trips (&lt;3 km) and in analyses where both residential and workplace drivability was considered (RR for car use in high/high vs. low/low residential/workplace drivability: 2.18, CI:2.08-2.29).

Conclusions
This novel neighborhood drivability index predicted whether local residents drive or use active modes of transportation and can be used to investigate the association between drivability, physical activity, and chronic disease risk.

Key messages
The association between neighborhood drivability and car use was strongest for short trips. The drivability of the neighborhood where people work is a strong determinant of car use.
Co-creating nature-based solutions for healthy and sustainable cities: Urban public health approach
Authors: Skodra J , Zorita S , Garcia Perez I , Moebus S 
Published: October 2020

Abstract

Issue
Urban green spaces are necessary for developing healthy and sustainable cities. Benefits of Nature-based solutions (NBS) that increase the amount and quality of urban green go beyond environmental aspects (noise/air pollution mitigation) and have positive impact on mental health, active lifestyles and social cohesion. However, there is a need for the transdisciplinary co-creation processes including multidisciplinary partners and local community to ensure that different population groups use NBS and that health, social and environmental benefits are maximised. The Horizon2020 project CLEVER Cities (2018-2023) focuses on the development of NBS in deprived areas to address health, socio-economic and ecological challenges in a transdisciplinary co-creation approach.

Description
The three pilot cities, Hamburg, London and Milan, have formed Urban Innovation Partnerships (UIP) based on the stakeholder mapping. Each UIP involves citizens, companies, universities and local authorities to support CLEVER Action Labs (CAL) as alliances of local actors involved in the co-creation and assessment of place-based NBS interventions. The Theory of Change method (impact chain) was used to structure the transdisciplinary process, by initially determining the desired long-term outcomes related to the above-mentioned challenges. Proceeding from the identification of the local conditions, the necessary “outputs” were identified to achieve short-term and intermediate outcomes, which themselves lead to the determined long-term outcomes.

Results/lessons
Preliminary results show that Theory of Change provides a good structure for transdisciplinary discussions as well as an overview of a complex transformative change, underlying assumptions and unintended negative effects. Involving urban public health experts is essential to determine the relationship between different NBS and health outcomes, to maximize health benefits for all population groups and to reduce potential side effects.

Key messages
Inclusion of local community in the collaborative co-creation process is essential to ensure that NBS is adapted to their needs and that the desired health and wellbeing outcomes are achieved. The involvement of urban public health experts in the Theory of Change is essential to raise the awareness about the relationship between NBS interventions, their use and multiple health outcomes.
Financial performance of public hospitals: a cross-sectional study among Polish providers
Authors: Dubas-Jakóbczyk K , Kocot E , Kozieł A 
Published: October 2020

Abstract

Background
there is growing evidence of a positive association between health care providers' financial standing and the quality of care. In Poland, the instable financial situation and growing debt of public hospitals has been a source of concern for more than two decades now. The objectives were: (1) to compare the financial performance of public hospitals, depending on the ownership and organizational form; (2) to analyze whether there is an association between financial performance and the chosen variables (e.g., total assets, revenues).

Methods
we conducted a cross sectional study covering the whole population of public hospitals operating in 2018. The total number of included units was 805 (659 classic public hospitals, 17 research institutes and 129 corporatized). The hospitals' financial outcomes were measured by several variables and compared between the hospital groups; Spearman's rank correlation was calculated and a multivariable logistic regression model was performed.

Results
in 2018, the majority of public hospitals in Poland (52%) generated a gross loss, while 40% hospitals had overdue liabilities. There were statistically significant differences between hospital groups, with university hospitals and those owned by counties (local hospitals) being in the most disadvantageous situation. Also, corporatized public hospitals performed worse than those functioning in the classic legal form of independent health care units. All three variables which can be used as proxy indicators of hospital size (total assets, revenues or costs) were positively correlated with the value of overdue liabilities and the debt ratio, and negatively correlated with the gross profit margin.

Conclusions
there is high diversity in public hospital financial standing in Poland, with numerous units facing liquidity problems in 2018. Urgent actions are needed to measure and monitor the potential impact of financial performance on the quality of care.

Key messages
The instable financial situation and growing debt of public hospitals in Poland has been a source of concern for more than two decades now. In 2018, local hospitals owned by counties as well as highly-specialized university clinics and research institutes were in the most disadvantageous financial situation.
Out of pocket expenditure for availing maternal health care services in Northern India
Authors: Singh A , Jain P , Kumar S , Singh S , Singh N 
Published: October 2020

Abstract

Introduction
Maternal and child health comprise one of the most important parameters of the health situation in a country at any given time. Maternal and new born child's health are inter-related to a great extent and while improving one, we might greatly affect the other; hence, joint efforts are required to cope with the rising demands of better healthcare for both. Out-of-pocket expenditure act as a major deterrent, especially to underprivileged communities, in accessibility to maternal health care services and knowledge of the determinants of maternity related expenses helps in outlining policies.

Material and Methods
This is a community based cross sectional study conducted in state of Uttar Pradesh between July 2019 to December 2019 among 848 women who delivered in past six months at a public health facility. A pretested, semi structured questionnaire was used to collect data. The data thus collected was entered into Microsoft Excel spreadsheet and was analysed using Statistical Package for Social Sciences (SPSS) version 24.0, IBM Inc. Chicago, USA software.

Results
The analysis showed that the median OOPE was INR 1000 (US$ 13.89) which varied between INR 950 (US$ 13.19) for normal delivery and INR 4900 (US$ 68) for caesarean section. OOPE for availing diagnostic facilities especially ultrasound with a median value of INR 500 (US$ 6.94) contributed to the major share. Women from households with income more than INR 7500 (US$ 104.17) per month, education higher than high school, primi-gravida, occupation of mother and type of delivery were significant predictors for high OOPE. Awareness level about various free entitlements in public health facility was significantly associated with overall out of pocket expenditure.

Conclusions
Although services at the public health facility in India are supposedly provided free of cost, considerable out of pocket expenditure is still incurred on beneficiaries while availing maternity services.

Key messages
Out of pocket expenditure is a major deterrent in availing institutional deliveries in public health facilities. Zero-cost, equitable and accessible maternal health care services through timely access to health care facilities is of paramount importance for reducing MMR and IMR in every country.
Developing a National Public Health Laboratories Policy and Strategy
Authors: Boncy J 
Published: October 2020

Abstract
With the support of the European Union, the National Laboratory for Public Health and partners did an analysis of the primary healthcare and hospital laboratories in health facilities and identified strengths and weaknesses of the national network of public health laboratories. With that knowledge the LNSP developed in a participatory way a new national Laboratory Policy and thereafter a Strategic Plan 2019 - 2024 that guides the country in strengthening the labs at all levels. This is very much needed as Haiti still suffers of high levels of malaria, tuberculosis, HIV and other infectious diseases. The policy fits in the international Health Security Agenda.
Most important lesson learned: by a systematic step by step process of analysis, policy formation and action planning, a research institute can - with support of stakeholders - make an impact on policies and practices.
5.H. Workshop: Developing more responsive systems to deliver catch-up vaccination to migrants arriving in Europe
Authors:   Organised by: ESGITM,   Chair persons: Michael Edelstein - UK, Teymur Noori - Sweden
Published: October 2020

Abstract

Background and Objectives
Migrants are thought to be one of several under-immunised groups in Europe, and involved in outbreaks of vaccine preventable diseases - including the recent large pan-European outbreak of measles. They may be under-immunised because of poor functioning of the health systems in countries they come from, because of barriers to catch-up vaccination and health services on arrival to Europe, and vaccine hesitancy may play a role. Amid substantial migration to Europe in recent years, ECDC public health guidelines for newly arrived migrants to EU/EEA countries have defined new recommendations, including focusing on catch-up vaccination in adult migrants. Yet there is an urgent need to better define what strategies work to improve vaccine coverage and to better understand the views of migrant communities, which will be the focus of this workshop. In this workshop we will explore various facets of migration and vaccination in the European context, and seek audience participation in better defining innovative implementation models and models of best practice to improve vaccine coverage in migrant populations residing in the region.

Workshop plan
The workshop will start with 15-minute presentations by each of the 4 speakers (to include a short Q&A after each talk). This will then move into a 30-minute audience discussion centred around seeking specific feedback on examples of innovation, good practice, and lessons learned across EU/EEA countries in engaging migrants and improving vaccine coverage in this group.

Speakers and topics
Sally Hargreaves (St George's, University of London): Are migrants to Europe an under-immunised group and involved in outbreaks? implications for health systems, policy, and practice.

Elizabeth de Vito (Università degli Studi Di Cassino e del Lazio Meridionale, Italy)
Barriers and facilitators to catch-up vaccination in migrant populations: defining effective and cost-effective implementation strategies.

Ines Campos-Matos (Public Health England, UK)
Vaccination on the move for asylum seekers and refugees: evidence, policies and practicalities.

Christina Louka (University of Groningen, The Netherlands)
Perspectives of asylum seekers, refugees, and other migrant groups on approaches to catch-up vaccination on arrival to Europe.

Key messages
Migrants are likely to be an under-immunised group in Europe, with new ECDC guidelines outlining key recommendations for catch-up vaccination on arrival. There is a need to better define more effective strategies to improve vaccine coverage in migrant populations in Europe.
Are migrants to Europe an under-immunised group and involved in outbreaks? Implications for health systems, policy, and practice
Authors: Hargreaves S 
Published: October 2020

Abstract
Migrant populations (defined as foreign-born) in the EU/EEA may be one of several under-immunised populations yet their role in outbreaks of vaccine-preventable diseases (VPDs) has been poorly defined to date. In this talk, SH will summarise our current understanding of the problem and explore implications for heath systems in Europe, policy, and practice in light of new ECDC guidelines detailing approaches to vaccination in recently arrived migrants to Europe.
The power of administrative data in national studies: experiences from the Scottish Burden of Disease study
Authors: Grant I , Wyper G M A , Fletcher E , McCartney G , Stockton D 
Published: October 2020

Abstract
In 2013, the Scottish Burden of Disease Study (SBoD) study set out with an ambitious aim of comprehensively estimating the burden of 132 causes of ill-health and mortality. The study utilised the rich and widespread data which is recorded as a by-product of individual encounters across the universally available and free at point-of-contact healthcare services in Scotland, and other long-standing survey initiatives. It was carried out as an independent national burden of disease study, but used Global Burden of Disease methodology for disability weights. In 2017, our first report outlined the contribution of causes of disease and injury of DALYs. This was followed up in a 2018, with a further report highlighting the effect of socioeconomic inequalities in DALYs.
In this presentation we will show the key steps involved in undertaking the SBoD study drawing on available data sources in Scotland. From the Scottish experience we will highlight important issues in knowledge translation for national burden of diseases studies to consider when specific choices are made on the methodological inputs into calculations for both YLL and YLD, specifically: (i) the differential impact between different life tables; (ii) the impact of differences in severity distributions; and (iii) the impact of using different standard populations when directly standardising rates.
Health is everyonés business - private sector partnerships for a healthy planet and healthy people
Authors: Ersbøll C 
Published: October 2020

Abstract

It is clear that we need to accelerate transformational change to address complex and inter-connected global challenges such the climate crisis, growing populations and the NCD pandemic. The private sector has a leading role to play in providing equitable and sustainable access to key determinants of health and well-being, including clean water, clean air, healthy and nutritious food and affordable and quality healthcare. Charlotte Ersbøll will argue that when businesses unite with other partners, they can be a powerful force for good. She will present examples of UN Global Compact initiatives convening businesses, UN, academia and civil society partners to set a new agenda for planetary health in business, such as the platform “Putting a Human Face to Climate Change” which helps businesses understand where they have the greatest potential impact and can best deliver science-based co-benefits for climate, food systems and health.

Panelists:
Guy Fones
Secretariat of the GCM/NCD, Office of the Deputy Director-General, WHO, Geneva, Switzerland
Contact: fonesg@who.int
Margot Neveux
World Obesity Federation, London, UK
Contact: mneveux@worldobesity.org
Filippo Addarii
PlusValue, London, UK
Contact: filippo.addarii@plusvalue.org