bluuebunny/crossref_metadata_2025_split huggingface dataset:
Best practices and training for preparedness and response at airports
Authors: Heidrich J , Angrén J , Schwarz D , Klahr A , Dirksen-Fischer M 
Published: November 2019

Abstract

Introduction
Airports are important points of entry (PoE). More than 2.5 billion passengers pass through Europe’s airports every year. The nature of airports provides manifold opportunities for interactions among persons from all over the world and their environment with the potential for exposure, transmission and spread of infectious disease. Therefore, training, preparedness and response (P&R) to public health risks and events at airports are of utmost importance. The EU Joint Action Healthy Gateways airports branch (HGair) aims to strengthen P&R at airports in a multidisciplinary way.

Methods
Based on the international health regulations (IHR) and on previous research, HGair investigates P&R using a multi-method approach and offers a variety of training activities. A survey to identify best practices on IHR core capacities, event detection, surveillance, management and contingency planning at airports is being carried out. Training methods include face-to-face trainings on European, national and local level, table-top and simulation exercises as well as web-based training.

Results
Main results of HGair are best practice catalogues, a tool for contingency plan development and assessment at airports, a depository of P&R training materials and table top/simulation exercises, standardized operation procedures for vector control at airports and for inspection of aircrafts for vectors, a web-based platform and network of experts to communicate and notify rapidly in case of cross-border risks to health at airports and in air travel. So far, completed questionnaires (n = 14) on best practices in P&R were received from designated airports in 13 European countries, showing variations in reported practices.

Conclusions
European airports report different P&R practices. Deliverables and results of HGair provide the opportunity to strengthen IHR core capacities at airports and to harmonize surveillance and management of cross-border health threats in the air travel sector.
Untethered lives: Barriers to societal integration as predictors of the sexual orientation disparity in suicidality
Authors: Bränström R , van der Star A , Pachankis J E 
Published: November 2019

Abstract

Background
Despite increasing legal protections and supportive attitudes toward sexual minorities (e.g., those who identify as lesbian, gay, and bisexual [LGB]) in recent decades, suicidality remains more common among this population than among heterosexuals. While barriers to societal integration have been widely theorized as determinants of suicidality for the general population, they have not been comprehensively explored to explain the sexual orientation disparity in suicidality and/or compared to more established contributors.

Methods
Data come from the cross-sectional Swedish National Public Health Survey, which randomly collected data from individuals (16-84 years of age) annually from 2010 to 2015 (1,281 (2.2%) self-identified as LGB). Analyses examined sexual orientation differences in suicidality (i.e., past-12-month ideation and attempts), and explored the role of barriers to societal integration (i.e., not living with a partner or children, unemployment, and lack of societal trust) in explaining this disparity over-and-above more commonly explored psychological (e.g., depression, substance use) and interpersonal (e.g., discrimination, victimization, lack of social support) suicidality risk factors.

Results
Compared to heterosexuals, suicidal ideation and attempts were more common among both gay men/lesbians (AORideation: 2.51; AORattempts: 4.66), and bisexuals (AORideation: 3.76; AORattempts: 6.06). Barriers to societal integration mediated the association between sexual orientation and suicidality even in models adjusting for established risk factors for suicidality.

Conclusions
The disproportionate barriers to societal integration that LGB individuals experience seem important contributors to the elevated risk of suicidality among sexual minorities. Preventive interventions should consider innovative ways to foster societal integration within sexual minority populations and to adjust hetero-centric social institutions to better include sexual minorities.
Sex, age and socioeconomic inequalities in older people’s unscheduled care
Authors: Levin K , Crighton E 
Published: November 2019

Abstract

Background
In Scotland, unscheduled care is usually received at hospital accident and emergency (A&E) departments or referral by GPs to medical assessment units (MAU). Almost a quarter attendances are for those aged 65 years+. Demand for unscheduled care will increase as the population ages. This study measures inequalities in unscheduled care presentations among those aged 65 years+.

Methods
A&E and MAU attendance data between April 2017 and March 2018 for Glasgow residents were analysed. Data were modelled using poisson modelling for outcome measures attendances, rate of attendance and length of stay, adjusting for agegroup, sex and deprivation. A second set of models also adjusted for time of day, month and referral source, including interaction terms.

Results
While there was a higher number of attendances among females (RR and 95% CI = 0.30 (0.28, 0.32)), and among those aged 65-69 years compared with older ages (RR = 0.03 (0.01, 0.06)), modelling rates showed that males were significantly more likely to attend (RR = 0.14 (0.13, 0.16)) and that likelihood rose with age, eg RR for 85+ years significantly greater than 80-84 years, significantly greater than for 75-79 years etc. There was no gender difference in length of stay but this increased with increasing age. Attendance was significantly more likely for those living in the most deprived quintile of deprivation (RR = 0.30 (0.27, 0.34) compared with the most affluent quintile). SES inequalities in attendance and length of stay became less pronounced with increasing age. Referrals via 999 emergency services increased with age while referrals by GP and NHS24 reduced with age. Attendance was more likely in December (RR = 0.15 (0.11, 0.18)) and likelihood of a morning attendance reduced significantly with increasing age and deprivation.

Conclusions
Inequalities in attendance, length of stay and methods of referral are observed which should be considered when planning to meet the demand for unscheduled care.

Key messages
Age, sex and socioeconomic inequalities in unscheduled care exist even at the oldest ages. When planning to meet the demand of future unscheduled care, patterns of current use and population projections should be considered in tandem.
Body mass index and mortality in relation to age and follow-up of 30 years in large Austrian cohorts
Authors: Nagel G , Peter R S , Föger B , Concin H 
Published: November 2019

Abstract

Background
Obesity and its health consequences will dominate health care systems in many countries during the next decades. Prevention programs have been implemented. However, the optimum body mass index (BMI) in relation to all-cause mortality on population level is still a matter of debate.

Material and Method
Data 1/1989-6/2005 of the Vorarlberg Health Monitoring & Prevention Program (VHM&PP,) and 8/2005-12/2015 for Vorarlberg provided by the Main Association of Austrian Social Security Institutions were analyzed. In both cohorts, information was available on age, sex, measured height and weight as well as the date and cause of death. Generalized additive models were used to model the mortality rate as function of calendar time, age and follow-up.

Results
The VHM&PP cohort consisted of 85,488 men and 99,873 women and the later of 129,817 men and 152,399 women. In the second cohort, men (mean age 48 (SD16.9) vs. 45.3 (SD 15.5) and women (48.3 (SD 17.7) vs. 45.6 (SD 16.6) years) were slightly older than in the VHM&PP cohort. The average BMI was slightly higher in men (26.1 (SD4.0) vs. 25.7 (SD3.8) kg/m2) but not in women (24.6 (SD 4.8) vs. 24.7 (SD 4.9) kg/m2), respectively. In the VHM&PP cohort more ever smokers were found in both men (40.3 vs. 22.4%) and women (24.8 vs. 18.4%) than in the subsequent cohort.
BMI optimum increased slightly between 1985 and 2015, from 24.9 (95%-CI: 24.0-25.9) to 26.4 (25.3-27.3) in men and from 22.4 (21.8-23.1) to 23.3 (22.5-24.5) kg/m2 in women. However, age and follow-up had major impact on the increase. In younger age the associations are quite stable, while in men over 50 years and in women over 60 years the BMI optimum decreased with length of follow-up.

Conclusions
Overall the BMI optimum increased slightly over time. However, age and follow-up had major impact on the association. These results suggest, that prognosis of obesity related diseases has improved over time. To detangle this further research is necessary.

Key messages
In Austria the BMI optimum increased slightly over time. Age and follow-up time had major impact on the association.
Association between psychosocial stress and obesity among migrant and non-migrant Ghanaians
Authors: Baratin C , Beune E , van Schalkwijk D , Agyemang C 
Published: November 2019

Abstract

Background
Psychosocial stress is associated with obesity in some populations, but it is unclear whether the association is related to migration.

Aim
This study explored associations between psychosocial stress and obesity among Ghanaian migrants in Europe and non-migrant Ghanaians in Ghana.

Methods
Cross-sectional data from the RODAM study were used, including 5898 Ghanaians residing in Germany, the UK, the Netherlands, rural Ghana, and urban Ghana. Perceived discrimination, negative life events and stress at work or at home were examined in relation to body mass index (BMI) and waist circumference (WC). Linear regression analyses were performed separately for migrants and non-migrants stratified by sex.

Results
Perceived discrimination was not associated with BMI and WC in both migrants and non-migrants. However, negative life events were positively associated with BMI (β = 0.78, 95% CI, 0.34 to 1.22) and WC (β = 1.96, 95% CI, 0.79 to 3.12) among male Ghanaian migrants. Among non-migrant Ghanaians, in contrast, stress at work or at home was inversely associated with BMI and WC in both males (β=-0.66, 95% CI, -1.03 to -0.28; β=-1.71 95% CI, -2.69 to -0.73, respectively) and females (β=-0.81, 95% CI, -1.20 to -0.42; β=-1.46, 95% CI, -2.30 to -0.61, respectively).

Conclusions
Negative life events are associated with increased body weight among Ghanaians in European settings, whereas stress at work or at home is associated with reduced body weight among Ghanaians in Ghana. More work is needed to understand the underlying factors driving these differential associations in order to assist prevention efforts.

Key messages
Negative life events are associated with increased body weight among Ghanaians in European settings, whereas stress at work or at home is associated with reduced body weight among Ghanaians in Ghana. More work is needed to understand the underlying factors driving these differential associations in order to assist prevention efforts.
Association between detection of non-diabetic hyperglycaemia and vascular complications
Authors: Palladino R , Tabak A G , Khunti K , Valabhji J , Majeed A , Millett C , Vamos E P 
Published: November 2019

Abstract

Background
The benefit of screening for non-diabetic hyperglycaemia (NDH) is still debated. Furthermore, the associated risk of vascular complications following a diagnosis of Type 2 diabetes (T2D) in people previously detected as NDH in real-world settings is not known. We examined the presence of vascular disease in newly diagnosed T2D individuals by glycaemic status within 3 years of diagnosis.

Methods
We identified 159,736 individuals diagnosed with T2D from the Clinical Practice Research Database in England between 2004 and 2017. We used logistic regression models to compare presence of microvascular (retinopathy and nephropathy) and macrovascular (coronary artery events, cerebrovascular and peripheral arterial disease) disease at the time of T2D diagnosis by prior glycaemic status. Models were adjusted for age, sex, ethnicity, deprivation, smoking status, blood pressure, cholesterol, and number of primary care visits.

Results
There was a strong association between baseline glycaemic status and presence of microvascular complications at diabetes diagnosis (normoglycaemia 30.7%, no glycaemic test 36.7%, NDH 42.4%). Similarly, prevalence of macrovascular disease was lower for those with normoglycaemia(26.9%) compared with NDH(29.8%). Compared with individuals with normoglycaemia, those detected with NDH before the diagnosis of T2D had 76% and 53% increased odds of retinopathy and any microvascular complications (AOR 1.76, 95%CI 1.69-1.85; AOR 1.53, 95%CI 1.41-1.65), and 7% higher odds of diagnosis of acute coronary events (OR 1.07, 95%CI 1.03-1.12) at time of diagnosis of T2D.

Conclusions
Microvascular and macrovascular diseases are detected in 40 and 20% of newly diagnosed T2D. NDH before the diagnosis of T2D was more likely associated with microvascular complications and acute coronary events. Detection of NDH might represent opportunities for reducing the burden of microvascular disease through heightened attention to screening for microvascular complications.

Key messages
Detection of non-diabetic hyperglycaemia before the diagnosis of Type 2 diabetes was more likely associated with microvascular complications and acute coronary events. Detection of non-diabetic hyperglycaemia might represent opportunities for reducing the burden of microvascular disease through heightened attention to screening for microvascular complications.
Strategies and practical examples
Authors: Schmitt T 
Published: November 2019

Abstract
Various tools and mechanisms can help to increase the use of scientific evidence in policy development by making policymakers appreciate, understand and incorporate such scientific information into policy decisions. As part of this process, it is crucial that researchers and public health practitioners acquire the ability to translate their knowledge and become skilled on communicating the evidence effectively.
The European Observatory on Health Systems and Policies supports and promotes evidence-based health policy-making through comprehensive and rigorous analysis of the dynamics of health-care systems in Europe. It engages directly with policy-makers and experts, and works in partnership with research centers, governments and international organizations to analyze health systems and policy trends.
In this presentation, concrete strategies will be given for advocating scientific evidence. The focus will lie particularly on the process of real-life applications of evidence-informed policy-making. By this way, it will help the participants to analyze to whom they are targeting, what are their interests and how to communicate scientific information to a decision-maker effectively based on specific examples from the European Observatory on Health Systems and Policies.
Earnings among people with multiple sclerosis in Sweden, by education and occupation
Authors: Murley C , Wiberg M , Tinghög P , Alexanderson K , Palmer E , Hillert J , Stenbeck M , Friberg E 
Published: November 2019

Abstract

Background
Multiple sclerosis (MS) may affect the individual’s working life. We aimed to 1) investigate the mean levels and distributions of earnings among people with MS (PwMS) before and after MS diagnosis compared to people without an MS diagnosis, and whether such differences in earnings were associated with educational level or occupation and 2) assess the prevalence of sickness absence (SA) and disability pension (DP).

Methods
Population-based cohort study (10 years prior to 5 years after MS diagnosis) using microdata linked from nationwide Swedish registers of all individuals aged 30-54 with MS diagnosed in 2003-2006 (n = 2553) and references without MS (n = 7584) randomly selected by stratified matching (sex and age). Annual mean earnings, by educational level and type of occupation, were compared with t-tests. Tobit regressions investigated the associations of earnings with individual characteristics. Lastly, the proportions on SA and DP, stratified by educational level and type of occupation, were examined in the diagnosis year and 5 years later.

Results
Differences in earnings between PwMS and references were observed beginning one year prior to diagnosis and increased with time. PwMS had lower mean earnings for the diagnosis year (difference=SEK 28,000, p-value&lt;0.05), and the difference had more than doubled (p-value&lt;0.05) 5 years later. These differences remained after taking educational level and type of occupation into account. PwMS with university education and/or more qualified occupations had mean earnings most like their respective references’. PwMS had higher prevalence of SA and DP than the references, in both the diagnosis year and 5 years later.

Conclusions
Earnings of people with MS were lower than references’ already one year before diagnosis, and the gap increased thereafter. Results indicate that educational level and type of occupation are of importance for earnings. Moreover, SA and DP were more common among people with MS.

Key messages
Our results indicate that working-aged people with MS have less earnings than references already one year before diagnosis and that thereafter this gap in earnings increases with time. Education and occupation were influential in explaining the people with MS’ heterogeneous earnings, with a hierarchal ordering of who maintained similar earnings to their respective peers.
Implementation of health promotion activities in mental health care in Denmark
Authors: Møller J E , Møller A , Ledderer L 
Published: November 2019

Abstract

Background
People suffering from serious mental illness face a high risk of lifestyle-related health problems, and higher mortality and morbidity rates than the rest of the population. The solution to the problem has been to integrate health promotion initiatives in mental health care. In Denmark psychiatric departments have implemented a new strategy and mental health nurses are now asked to screen for risk factors. The aim of this study is to explore how mental health nurses experience working with the screening of risk factors amongst patients with mental illnesses as part of their health promotion activities.

Methods
We employed a qualitative research design using an interactive approach. Two focus group interviews (n = 7; n = 5) were conducted with mental health nurses attending a mental health specialist training in Denmark in 2018. The interviews lasted 1 ½ hours, were recorded and transcribed verbatim. Data were organized using NVivo 12 software and a qualitative content analysis was used to describe experiences in a conceptual form.

Results
The implementation of health promotion activities in mental health care created two different types of dilemmas for the mental health nurses: 1) dilemmas related to health promotion that involved discrepancies between patients’ autonomy and wishes, and the health promotion activities that were offered; 2) system-related dilemmas originated from structural factors and working with screening for risk factors. The mental health nurses developed various strategies and found new solutions to navigate these dilemmas.

Conclusions
Mental health nurses found it challenging to implement health promotion activities in mental health care, although they generally found these activities meaningful. They developed new strategies to overcome the dilemmas.

Key messages
Health promotion initiatives need to be adapted to mental health nurses’ existing mental healthcare practices in order for them to be meaningful. Screening of risk factors is insufficient as a health promotion activity in mental health care.
Workshop: Bridging the Gap in Digital Public Health in Europe
Authors:   Organised by: EUPHA (DH) Chair persons: Luís Velez-Lapão - Portugal, Anthony Staines - Ireland
Published: November 2019

Abstract

Europe is facing several health challenges and public health plays an important role in it. However, to address the increasing demand for public health services, public health institutions need to tackle digitalization in a proper and evidence-based way. Digital health comprises both an organizational and a technological component. While the technological one has been widely addressed, the organizational one got little attention so far. This is due to a lack of knowledge regarding the understanding of the new role of organizations that provide digital health services. Public health is a field deeply dependent on data and with an important opportunity to leverage information technology. Digital health could, within 10 years establish a new paradigm in public health. The public health professionals need urgently to tackle digital health to bridge the gap with others areas of healthcare. Moreover, since public health is a multi-disciplinary activity we want to take the opportunity to debate digital public health with European experts from different fields of knowledge.
Three presentations from the point of view of People, Technology and Services. Digital health should be addressed as an evidenced-based approach towards both improving health professionals performance and quality of life of patients.
This workshop aims at: To create the momentum towards the proper use of digital technologies in public health by discussing the main challenges and opportunities for European Public Health.To establish a forum to discuss digital public health solutions based on evidence to better improve the adoption of these tools in the public health profession;To have a serious discussion after 3 presentations that will clarify the main challenges and opportunities;After de presentations, a debate will be guide to help identify the main challenges for digital public health in Europe;

Key messages
Public Health Digitalization is essential to address health inequalities in Europe. The workshop identifies what are the main priorities for a sustainable EU public Health digitalization. Mutual learning, knowledge and good practice exchange in using digital technology can be organised in various ways – we show practical current examples on how it has been done.