bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in patterns of adolescent substance use from 1988 to 2011 in Sweden: a latent class analysis
Authors: Evans B , Kim Y , Hagquist C 
Published: November 2019

Abstract

Background
Prevalence rates of adolescent substance use have shifted over time, although potential changes in nuanced patterns of substance use remain unexplored. We examined patterns of adolescent substance use in Sweden and changes in these patterns between 1988 and 2011. Furthermore, we investigated whether gender and internalizing problems were associated with substance use and whether these associations changed over time.

Methods
The sample included all 15-16-year-old students in Värmland County, Sweden (N = 20,057). Survey data were collected eight times between 1988 and 2011 and analyzed as four cohorts (1988/1991, 1995/1998, 2002/2005, 2008/2011). We measured alcohol, tobacco and inhalant use and internalizing problems.

Results
A latent class analysis showed that a three-class model fit the data best (i.e. non/low use, experimental use, and polysubstance use classes). Class- and item-response probabilities changed over time: fewer adolescents exhibited riskier substance use patterns in the later cohorts. Boys were more likely than girls to be in the polysubstance use class compared to the non/low use class across all cohorts (all ps &lt; .001). Gender differences in experimental use differed across the cohorts. Adolescents who reported more internalizing problems were more likely to be included in the experimental and polysubstance use classes compared to the non/low use class (all ps &lt; .001) and this effect did not change over the study period.

Conclusions
We extended the research on trends in rates of substance use by mapping how patterns of substance use changed over time as well as how the effects of gender and internalizing problems shifted. While fewer adolescents exhibited riskier patterns of substance use in the later cohorts, these patterns were associated with experiencing more internalizing problems across the study period. Prevention efforts could be more effective by targeting patterns of substance use rather than prevalence rates.

Key messages
We tested whether patterns of adolescent substance use changed from 1988 to 2011 in Sweden. Fewer adolescents showed riskier substance use patterns in the late 2000s than in the earlier study years. Gender differences shifted over time for experimental use but not polysubstance use. Internalizing problems were consistently associated with riskier substance use patterns across the study period.
Lifestyle of young adults – changes and accumulation
Authors: Jääskeläinen T , Koponen P , Lundqvist A , Borodulin K , Koskinen S 
Published: November 2019

Abstract

Background
Young adulthood is a pivotal period for many lifestyle factors becoming established and later affecting health. However, current knowledge on key lifestyle factors among young adults is limited. This study aimed to examine the lifestyle of Finnish young adults and the changes in their lifestyle between the years 2000 and 2017. Further, the accumulation of health promoting and endangering lifestyle factors was evaluated.

Methods
The study is based on nationally representative data on young adults (aged 18 − 29 years) from the Health 2000 Survey (n = 1894; 90% participated) and the FinHealth 2017 Study (n = 1162; 54% participated). Lifestyle factors were assessed in the interview and by questionnaires. The five key lifestyle factors (use of vegetables, smoking, physical activity, sleep and alcohol consumption) were dichotomized for the evaluation of the accumulation. Weighted prevalences were analyzed by logistic regression taking into account the sampling design and non-response.

Results
In 2017, 32% (95% CI 25, 41) and 52% (95% CI 45, 60) of young men and women used fresh vegetables daily, respectively. In men, the prevalence had decreased in 2017 compared to 2000 (p &lt; 0.01). The prevalence of daily smoking had decreased (p &lt; 0.01) being 11% in both sexes in 2017. In men, the prevalence of the daily use of snuff had increased from 3% (95% CI 2, 5) to 8% (95% CI 5, 14) in 2017 (p = 0.01). In both years, three out of four were physically active at leisure-time and nine out of ten slept at least six hours per day. In 2017, half of the young adults reached 4 to 5 (maximum) health promoting factors whereas 17% (95% CI 11, 24) of men and 12% (95% CI 8, 18) of women reached only 0 to 2.

Conclusions
There have been both favourable and unfavourable changes in the lifestyle of young adults during the last decades. The accumulation of health promoting and endangering lifestyle factors was observed indicating needs to versatilely prevent risks for major public health problems.

Key messages
Many health-endangering lifestyle factors are comparatively common in young adults. It is important to prevent the accumulation of health-endangering lifestyle factors in young adulthood to lower the risks for major public health problems in future.
Sexual orientation openness and depression symptoms: A population-based study
Authors: van der Star A , Pachankis J E , Bränström R 
Published: November 2019

Abstract

Background
Sexual minorities (e.g., lesbian, gay, and bisexual individuals) are at higher risk for depression than heterosexual individuals. Lack of openness about one’s sexual orientation is a suggested source of these disparities, but it has been linked to both positive and negative mental health. Few population-based studies have explored the association between openness and depression, and potential mediators and moderators of this association, including social support and sexual orientation-based victimization.

Methods
Swedish respondents to the 2014 wave of the European Health Interview Survey were used to identify a population-based sample of self-reported sexual minorities. All individuals reporting a nonheterosexual identity (and a matched sample of heterosexuals) were invited to participate in a follow-back study in 2016 (n = 320). A total of 191 (59.7%) individuals completed the survey, of whom 80 reported a gay, lesbian, bisexual, or other nonheterosexual identity.

Results
This first nationally representative survey of sexual orientation openness showed that only about one third of the sample reported being completely open. We found no evidence of a direct association between openness and depression or a mediating effect of social support or victimization on this association. However, social support moderated this relationship, such that greater openness was linked to higher depression among sexual minorities reporting low levels of social support.

Conclusions
Our study suggests that sexual orientation openness is not directly related to lower risk of depression among sexual minorities, but is instead dependent on access to social support. Sexual minorities might need social support for navigating the stress of open self-identification.
Influence of Physical Activity, Protein Intake and Social Network on the Frailty development
Authors: Haider S , Dorner T E , Grabovac I 
Published: November 2019

Abstract

Background
Frailty, a geriatric syndrome, is associated with many adverse health outcomes. Risk factors include physical inactivity, low protein intake and an inadequate social network. In this analysis we aimed to assess the influence of these factors and their combination in an 11-year-follow-up study on a Europe-wide level.

Methods
The analysed dataset included 22,226 community-dwelling robust and prefrail persons aged ≥50 years (11 countries) from the Study on Health, Ageing and Retirement in Europe (SHARE). Frailty was measured with the “Frailty Instrument for Primary care of the Survey of Health, Ageing and Retirement in Europe”. Additionally, self-reported level of vigorous physical activity (PA), protein intake and satisfaction with social network were assessed. The impact of these parameters on the development of frailty was calculated using Cox regressions, adjusted for age, education, smoking, alcohol BMI, depression, long-term illness and each other.

Results
People who do not engage in PA, had a higher HRs for frailty development compared to people performing PA regularly [women: 1.62 (95%CI: 1.22-2.13); men: 1.83 (95%CI: 1.44-2.33)]. People with low protein intake did not have significant higher HR [women: 1.05 (95%CI: 0.80-1.37); men: 1.16 (95%CI: 0.93-1.46)]. Women with poor social network showed HRs of 1.34 (95%CI: 1.24-2.15)], men with poor social network had a HR of 0.88 (95%CI: 0.70-1.10). In general, we found that persons with a combination of two risk factors had a higher risk for frailty compared to those with no or only one. However, no significant synergy index could be found.

Conclusions
Regular PA, but also adequate social networks seem to be important factors in frailty prevention.

Key messages
Sufficient PA and satisfaction with social network were shown as modifiable factors to prevent frailty in an 11-year-follow-up study. A combination of two risk factors was associated with a higher risk for frailty compared to one, however, with no significant synergy index.
2.N. How to Advocate Scientific Evidence to Decision-makers?
Authors:   Organised by: EUPHAnxt, Global Health Next Generation Network, EUPHA (PHPP) Chair persons: Viveka Guzman - Ireland, Keitly Mensah - France
Published: November 2019

Abstract

Public health research aims to change the world, or at least contribute to the development of healthier and more equitable societies. However, the availability of health information does not inherently lead to its increased use in policy and decision-making. Significant gap remains between the knowledge of public health researchers and the actions taken by decision-makers. 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.
To this aim, we will present firstly a WHO approach for that on the basis of EVIPNet Europe. Member countries have benefited of EVIPNet Europe’s capacity building efforts, its training workshops, coaching and mentoring schemes, leading to increased knowledge and skills in view of identifying, accessing, appraising, synthesizing and communicating the best available evidence. The presentation will focus on the ways to trigger tangible changes at policy and legislative levels.
The second presentation will give more specific information about the process of real-life applications. Main question will be “How to advocate scientific evidence to decision-makers in the frame of evidence-informed policy-making?”. The presentation will help the participants to analyze to whom they are targeting, what their interests are and how to communicate scientific information to a decision-maker effectively.
Last but not least, common challenges of evidence-informed policy-making process in health care and ways to tackle them will be presented. By doing so, special attention will be paid to the methodologies for joint fact-finding, responsive evaluation and citizen science.
The workshop will engage participants interactively and leave time for answering their questions at the end.

Key messages
Public health professionals can influence health policies, if they learn strategies in communicating scientific evidence to decision-makers effectively. Providing correct skills to researchers when communicating about and advocating for the scientific evidence with policymakers will enhance the impact of evidence on policy making.
The health impact of heat waves in Europe: insights from national plans and key informant interviews
Authors: Vanderplanken K , van Loenhout J , van den Hazel P 
Published: November 2019

Abstract
In Europe, heat waves and extreme heat are known to cause an increase in morbidity and mortality. Moreover, climate change is expected to increase the number and intensity of heat waves, particularly in urban areas. In order to limit the negative health impact of heat waves, many European countries have developed heat health plans.
The SCORCH project has reviewed the national heat plans of 20 European countries. In addition, face-to-face interviews were conducted in 9 countries, involving key stakeholders who partake in the development, implementation and/or diffusion of the plans.
Combined, the national plans and interviews provide insights in the different types of warning systems, the scales of implementation, the stakeholders involved and their responsibilities and the vulnerable populations that are targeted. Moreover, we are able to evaluate the processes outlined in the national plans, and identify certain strengths and weaknesses. These results will support the development of heat wave plans for countries that currently do not have such plans yet.
Slowing improvements in life expectancy across European Economic Area countries
Authors: Ford J , Steel N , Aasheim E , Devleesschauwer B , Gallay A , Morgan D , Schmidt J , Ziese T , Newton J 
Published: November 2019

Abstract

Background
Life expectancy improvements have slowed down in several European countries since around 2011. The relative contributions from changes in specific conditions (e.g. cancers) and broader risk factors (e.g. smoking or austerity) remain unclear. We aimed to explore the different potential causes in 17 European Economic Area (EEA) countries.

Methods
We compared Global Burden of Disease (GBD) study estimates for life expectancy, years of life lost (YLLs) and population attributable fractions (PAFs) for risk factors, for 2005-2011 and 2011-2017 for 17 EEA countries. Three countries with the largest absolute improvements and three with the smallest were selected for analysis by gender, age, condition and risk factors.

Results
Norway, France and Belgium had the largest improvement in life expectancy (+1.5, +1.2 and +1.2 years respectively) from 2011 to 2017, and Germany, Iceland and the UK the smallest (+0.1, +0.2 and +0.2 years). Life expectancy reduced slightly for women aged over 80 in Germany and UK, men aged over 50 in Germany, and for men in all age groups up to 90 years in Iceland. Norway, France and Belgium saw faster improvements in YLLs from lung cancer and Norway and France for COPD in both men and women, and from self-harm in men, after 2011 than before. PAF for tobacco declined faster after 2011. Germany, Iceland and the UK saw slower improvements in cardiovascular disease and in Germany and the UK lung cancer. In Iceland, YLLs for cancers, self harm, respiratory disease, cirrhosis and dementia all worsened after 2011. PAF for tobacco remained high or declined less after 2011 in all 3 countries. PAFs for alcohol and drug use remained high in Iceland and UK.

Conclusions
Differential changes in major fatal diseases and risk factors help explain national changes in life expectancies, but national differences in data availability may affect results. Further research is needed into the ‘causes of the causes’, such as the 2008 economic crash in Iceland.

Key messages
Differential changes in major fatal diseases and risk factors help explain national changes in life expectancies. Norway, France and Belgium had the largest improvement in life expectancy from 2011 to 2017, and Germany, Iceland and the UK the smallest.
The Impact of Refugee Women’s Accommodation on Maternal Health Care Provision
Authors: Kasper A 
Published: November 2019

Abstract

Background
About 1/3 of the persons seeking asylum in Germany are female. The majority of all refugee women in Germany are currently of childbearing age. The maternity period requires specialized care. Maternal health care professionals monitor the physiological processes of maternity and the psychosocial well-being in order to allow an uncomplicated transition to maternity. On arriving in Germany there are different types of accommodation for refugee women: 1) shared reception centers (e.g. tents, containerbuildings, gyms), 2) collective shelters for particularly vulnerable refugees and 3) private apartments. Depending on the woman’s accommodation maternal health care professionals are confronted with different situations and conditions in providing care for these women. The aim is to analyze the impact of refugee women’s accommodation on maternal health care provision and professional’s actions.

Methods
Structured expert interviews were conducted with maternal health care professionals. The interviews were analyzed following the standards of qualitative thematic analysis with a special focus on refugee women’s accommodation and its impact on maternal health care provision.

Results
The accommodation situation does impact the provision of maternal health care as well as the actions and doings of maternal health care professionals. On the one hand there is a change in tasks, which are no subject to original maternal health care, such as organizing transportation. On the other hand there are challenges in actually executing particular maternal health care actions, such as taking the medical history or performing examinations where there is no or little privacy.

Conclusions
Accommodation conditions impact maternal health care provision in various ways. Therefore an enhancement of housing for refugee women may improve maternal health care provision and therefore maternal health for refugee women.
The Challenge of Digital transformation in Public Health in Europe?
Authors: Velez-Lapão L 
Published: November 2019

Abstract

Background
Healthcare systems are facing many challenges, from demographics to multi-morbidities that are associated with increasing the demand for more services. The new technologies are thought to be a solution to these problems. However, to address these problems with digitalization of healthcare it will imply the combination of proper use of technologies, aligned with integrated working-processes and skilled professionals.

Methods
This study provides a scoping review on existing public health digital services and aimed to identify the main digitalization challenges, from competencies to technology use. The databases of Pubmed and Ebsco were searched.

Results
17 papers were selected, and the three main priorities were identified. First, it will highlight the challenges associated with the digitalization of healthcare, the second the implementation of digital services, considering a method to design online service, the third the impact of digitalization on healthcare workforce performance. An overview of the major effects of transformative technologies (e.g. eHealth services, Internet of Things solutions, Artificial Intelligence) on the healthcare workforce will be addressed. Moreover, to what extent is the digital transition affecting formal qualifications of public health professionals? What are the major implications of technological change for future skill needs and competences of the public health workforce? Finally, the discussion examines the challenges of digitalization for public health services in Europe.

Conclusions
Proper digitalization of healthcare will enable changes in the paradigm of healthcare delivery as well as in the mechanism for patients’ participation and engagement. The sustainability of healthcare will depend on how efficient we will make digital-services design.

Key words
Digital health, Public Health, Digital Transformation, Public Health professionals, Europe
Q-Methodology Evaluation of a European Health Data Analytic End User Framework
Authors: Staines A , Boilson A , Connolly R , Davis P , Connolly J , Weston D , Gautier S 
Published: November 2019

Abstract

Background
MIDAS (Meaningful Integration of Data Analytics and Services) project is developing a big data platform to use a wide range of health and social care data to support better policy making. As part of the project evaluation, we have used Q-methodology, a well established approach, to understand the perspectives of the individual participants on their needs and how the MIDAS system is meeting them, at its current stage of development.

Methods
We defined a concourse of 36 statements relevant to project implementation and goals, by working from a logic model for the evaluation, and structured interviews with project participants. This was delivered online to participants. Analyses were done in the qmethod package. The first q-sort was done at 14 months into the project.

Results
16 people took part, 6 developers, 5 managers, 2 health professionals and 3 others. Three factors were identified in the data. These were tentatively labelled ‘Technical optimism’, ‘End-user focus’ and ‘End-user optimism’. These loaded well onto individuals, and there were few consensus statements. There were significant differences in perspectives between different groups of participants. In particular, two of the developers held opposite perspectives to most other participants on the third perspective identified. This was drawn to the attention of the participants, and a more intensive process of communication was set-up, seeking to reduce the divergence.

Conclusions
A Q-methodological approach to evaluating the implementation of a large and complex health ICT system showed considerable divergence between the perspectives of users, developers, and managers. Such divergences can lead to project failure. Q-methodology is a valuable tool has seldom been used in public health research.
Keywords: Q-Methodology, Public Health, Data Analytics, Decision Support.
Workshop: Impact of nutrition on non-communicable chronic diseases: a global perspective
Authors:   Organised by: EUPHA (FN), EUPHA (CHR) Chair persons: Tatjana Buzeti - EUPHA (FN), Iveta Nagyova - EUPHA (CHR)
Published: November 2019

Abstract

Non-communicable chronic diseases (NCDs) represent a public health issue due to their profound impact on population health. Major NCDs risk factors, including obesity, hypertension and diabetes, represent a threat of gigantic proportion, while intervention to prevent NCDs remains of paramount importance in order to decrease their burden over the next decades. Among others, quality of diets has changed substantially and a global shift to unhealthy diet high in calories and highly processed foods mainly due to the rapid urbanisation, increasing incomes, and inadequate accessibility of nutritious foods has been observed. As the burden of NCDs across the worlds remains unacceptably high, the international policy framework should aim to develop evidence-based policy approaches to reduce such burden globally.
In this context, the EUPHA Sections on Food and Nutrition and on Chronic Diseases aim to propose a joint workshop to provide the latest updates from leading scientists and experts involved in global health research, with a special focus on NCDs and nutrition-related risk factors.
The objectives of the present workshop are the following: To quantify the burden and temporal trends of non-communicable chronic diseases risk factors (such as obesity, elevated blood pressure and diabetes) all around the globe, with a focus on European countries; To assess the impact of nutrition-related risk factors on non-communicable chronic diseases; To explore socio-economic and cultural correlates to dietary changes in developed and developing countries; To discuss the usage of instruments aimed to identify best practices in food policies to prevent junk food consumption.
Organizing the present workshop would provide an important occasion for gathering experts in the field and sharing opinions with the audience in light of the presented results. All publication discussed have been published recently, others are ongoing projects, thus providing a unique opportunity to discuss about potential advocacy activities and policy approaches in the context of a EUPHA conference.

Key messages
The workshop will provide insights on the current burden of NCDs risk factors. The workshop will focus on dietary risk factors, their socio-economic determinants, and strategies to implement a healthy and sustainable diet globally.