bluuebunny/crossref_metadata_2025_split huggingface dataset:
Urban Health as a Complex System
Authors: Damiani G , Sapienza M 
Published: October 2020

Abstract
The 17 Sustainable Development Goals (SDGs) are a complex system comprising 169 targets and about 230 indicators. Urban Health could be considered a complex system since it deals with 15 out of 17 SDGs, excluding the two related to life below water and life on land. According to the World Health Organization, to achieve the SDGs, countries have committed to organize Urban Health initiatives to improve the social, economic, and physical environments promoting health and sustainability globally. Cities will become more inclusive, safer and more sustainable, which are important driving forces to implement the development equation. To set up a framework to point out that Urban Health is a complex system oriented to the achievement of the SDGs. It has been conducted an extensive literature review on databases (PubMed, Embase, Web of Science and Scopus) using keywords in 3 strings combined with Boolean operators: SDGs and Urban Health, Urban Health as Complex System and Urban Health, Environmental Health and Public Health as Complex Systems. In addition, a grey literature review has been carried out. Out of 1005 publications, 21 were eventually included: 14 publications relate to the interdependent relationships between SDGs and Urban Health, with regard to the association between Urban Health and complex system, 3 publication studied the effects and implications of such correlation, 4 focused on Environmental Health and Public Health in relation with the complex system. The selected publications suggested methodologies aimed at setting up an urban health framework to achieve SDGs. There is an initial orientation focused on the study of Urban Health problems aimed at achieving SDGs from the perspective of complex systems. We highlight the need to conduct further studies on a more detailed framework in order to address this type of approach.
Mapping of education of health professionals in health promotion; a European survey
Authors: Patja K , Bonello M , Dorottya A , Orhan R , Huis int'Veld T , Soethout M 
Published: October 2020

Abstract
Health behaviours comprise over half of risk of Non-communicable Diseases. Lifestyle interventions need collaborative approaches in healthcare; this makes health professionalś knowledge and skills in advocating lifestyle interventions crucial. However less is known about educational programs of professionals in Europe about health promotion. So, a project commissioned by Consumers, Health, Agriculture and Food Executive Agency (Chafea) in years 2018-2020 was carried out in all EU countries.
Over 15 professions were included in this study. Information was obtained from national education providers, European associations of health professionals and national authorities. Study questions included: 1) how are health professionals being trained in health promotion in the EU? 2) what competencies professions require? 3) what methods are used? 4) what are the good practices? A three-stage data collection and analyses were carried out in order to answer these questions: a) desk research b) on-line survey for education content, methods and practices c) good practices assessment.
Final report is to be concluded and published in April 2020, but first indications show that a) there are guidelines of competencies in health promotion in different levels of education (graduate, post-graduate and continuous professional development) b) good practices were found in all health professions b) all health professions provide description of health promotion competencies, c) traditional teaching methods (lectures and assignments) are most often used and d) there is a need for of digital health coaching and health economics practices.
There is a need for capacity building and joint development in the European countries. Willingness to create European network of faculties, education regulators and professional associations is obvious and all parties acknowledge the need for support developing good practices and improving professional competencies in health promotion.

Key messages
There was a need for mapping of educational programs of professionals in Europe about health promotion. There is a need for capacity building and joint development in the European countries.
Feasibility of HCV micro-elimination: HCV test and treatment in two harm reduction services in Milan
Authors: Mazzilli S , Sebastiani T , Casigliani V , Cocca G , Stemat A , Nicola C , Selva P , Catani C , Tavosci L , Ranieri R 
Published: October 2020

Abstract

Background
Most of Harm Reduction Service (HRS) users represent a crucial high-risk population for blood borne infections, including HCV. With the advent of new direct antiviral agents (DAAs), HCV micro-elimination in this setting has become feasible. We evaluated HCV treatment cascade in two HRSs located in Milan.

Methods
We collected data on demographics, substance abuse history, HIV prevalence, HCV prevalence, testing and treatment on all register HRS users on 1 January 2019. Data collection was closed on 1 January 2020.

Results
A total of 881 HRS users (732M,149F) were included (median age: 45). The majority was addicted to heroin 67.5% (595), 24.1%(212) to cocaine, 5.3%(47) to THC and 3.1%(27) to other substances. The 28.0%(247/881) reported current or prior judiciary problems, 168/881(19.1%) were under psychiatric treatment. HCV serological screening (HCVAb) was performed for 587/881(66.7%), 113/881(12.8%) were in process, 2/881(0.2%) refused, 179/881(20.3%) were not HRS user anymore. 364/587(62%) resulted HCVAb positive, of whom 288(79.1%) were tested for HCV RNA. Among them 123/324(37.9%) were positive, 165/324(50.9%) were negative. Among HCVAb positive, 116/364(31.9%) were tested for HIV and 92(79.3%) resulted HIV positive. Among HCV RNA positive 92/123(74.8%) were initiated on DAAs treatment. Compliance to treatment was high; one treatment failure was registered. Individuals tested for HCV and HCVAb positive people had an average age significantly higher than the individuals not tested and HCVAb negative people (p &lt; 0.001). Heroin user had a higher likelihood of being tested both for HCVAb and for HCV RNA and of being positive to the HCVAb test (p &lt; 0.001).

Conclusions
Our study demonstrate that it is feasible to achieve good efficacy and compliance for HCV treatment among people who use drugs when decentralising treatment to HRS. To achieve the viral hepatitis elimination agenda goals, HRS-based model of treatment provision needs to be implemented at larger scale.

Key messages
Decentralising HCV test and treatment to harm reduction services is an effective strategy to achieve HCV micro-elimination among people who use drugs. Young people and people who are addicted to other substance than heroin resulted more difficult to link to HCV care through the harm reduction services. They require tailored intervention.
Cultural mediators are needed to fulfill Right to health for all
Authors: Magnusson M , Jama I-Z 
Published: October 2020

Abstract
The Right to health framework supports available, accessible and acceptable health care of high quality for all (AAAQ). Health of migrants often worsen in the new country. AAAQ may be hindered by poverty, discrimination, health cares' shortcomings and misunderstandings, respectively. Advocating for marginalised groups' Right to health include action. Interventions based on shared influence, participation and control need to be launched. Cultural mediators (CM), i.e. persons that are knowledgeable in both cultures and with networks in migrant groups help overcome lingual problems, lack of trust and uneven power relations. This resource needs to be further examined.
How can a CM strengthen AAAQ in a public health setting? Women with Somalian origin living in an underserved neighborhood in Sweden contacted the Public Health Unit of a local hospital, asking for support for a health focused group-activity. Weight loss after delivery was a primary concern. Women gathered monthly 2018-19. The objective was to support healthy life style habits drawing on issues raised by the women. The intervention was conducted by group talks, led by the CM and a public health planner. Methods were based on Social Cognitive Theory focusing on self-efficacy.
The CM recruited women, helped them to find the venue, encouraged them to trust the public health planner and broadened perspectives to include female genital mutilation, children's food, how to seek care and workforce issues. Trust developed over time. 70 women participated. Reported gains were raised awareness of ones' rights, increased self-efficacy in relation to food, physical activity and how to support children to a healthy life style. Support for a healthy lifestyle was made more available, accessible and acceptable by the cooperation with the CM, as was the quality of the support.
A CM bridges distances regarding spoken language, trust and cultural understanding. S/he puts forward perspectives and needs from the group in question

Key messages
The Right to health framework highlights areas that need to be in focus when advocating for health equity. Health care workers in settings with many migrants should strive to include cultural mediators in planning, execution and evaluation of interventions.
Prevalence and associated factors of gaming disorder among pre-clinical students in a medical school
Authors: Aktuna A , Hassoy H , Durmaz S , Durgun K , Sarbat O , Ergin I , Koybaşi E 
Published: October 2020

Abstract

Background
The aim of this study is to determine the prevalence of gaming disorder and associated factors among pre-clinical students in a medical school.

Methods
This cross-sectional study was carried out in 2019 at Ege University Faculty of Medicine. The research population consisted of 1162 pre-clinical medical students. Gaming disorder which is dependent variable was evaluated with “Game Addiction Scale”. Gamers who played games in the last 6 months were categorized in four groups as addicted, problem, engaged and normal. Independent variables are; socioeconomic characteristics, mental health status, habits, use of technology and gamer preferences. Multinominal regression analysis was used with the reference category as 'normal'.

Results
The response rate was 88.6% (n = 1030). 72.9% of all participants were gamers. 69.1% of gamers were men and the average age was 20.4±1.19. The prevalence of engaged, problem and addicted gamers in all participants was 8.3%, 12.6% and 2.6%; in the gamers, it was 11.3%, 17.3% and 3.6% respectively. The multivariate analysis showed that male sex was associated with being engaged (OR = 2.63, 95%CI [1.38, 5.01]), being problem (OR = 2.42, 95%CI [1.25, 4.69]), being addicted (OR = 5.95, 95% CI [1.30, 27.30]). Attention deficit and hyperactivity disorder (ADHD) was associated with being engaged (OR = 2.37, 95%CI [1.31, 4.27]), being problem (OR = 2.62, 95%CI [1.44, 4.79]), being addicted (OR = 4.42, 95%CI [1.85, 10.60]). Preferring online multiplayer games was associated with being engaged (OR = 2.03, 95%CI [1.12, 3.70]), being problem (OR = 2.18, 95%CI [1.18, 4.02]), being addicted (OR = 5.35, 95% CI [1.21, 23.66]).

Conclusions
One in every four students has a gaming disorder risk. Gamers who are male, have ADHD and prefer online multiplayer games have increased risk. There is a need for prospective studies that will evaluate the gaming disorder and its social determinants among medical students. Students should be directed to recreational activities.

Key messages
One in every four medical students has a gaming disorder risk. Gamers who are male, have attention deficit and hyperactivity disorder and prefer online multiplayer games have increased risk. There is a need for prospective studies that will evaluate the gaming disorder and its social determinants among medical students. Students should be directed to recreational activities.
Impacts of international labor migration on the mental health and well-being of left-behind children
Authors: Antia K , Boucsein J , Deckert A , Dambach P , Racaite J , Surkiene G , Jaenisch T , Horstick O , Winkler V 
Published: October 2020

Abstract

Background
Labor migration is a challenge for the globalised world due to its long-term effects such as the formation of transnational families with the particularly vulnerable groups of left-behind children (LBC). These families, where family members of migrant workers are 'left-behind' are becoming common practice in many developing countries. In this systematic literature review, we aimed to investigate the impacts of parental labor migration on the mental health and well-being of their LBC.

Methods
Following the PRISMA guidelines, we performed a systematic literature search in English using PubMed, PsychINFO, Web of Science, Cochrane Library and Google Scholar for studies, investigating mental health and well-being among LBC who live in transnational families. Case-reports, qualitative studies as well as opinion papers were excluded. We summarized the evidence and additionally compared quantitative results.

Results
25 studies were selected for the final analysis. We found that mental health and well-being outcomes of LBC differ across regions and sometimes even within regions. Only studies conducted in South America and South Asia observed purely negative effects. Overall, LBC show abnormal SDQ (Strengths and Difficulties Questionnaire) scores and report higher levels of depression and loneliness, than children who do not live in transnational families. Evidence suggests that gender of migrant parent, culture and other transnational family characteristics such as family arrangement, the role of the mother and the role of the father contribute to the well-being and psychological health of LBC.

Conclusions
International migration of parents has more negative than positive effects (e.g. through remittances) on the mental health and well-being of LBC. However, the effects strongly depend on family arrangements and care giving practices in migrants' sending countries.

Key messages
Further research utilizing longitudinal data is needed to better explore the complex and long-term effects of parental migration on LBC. Multidimensional family characteristics are crucial and should be better explored when examining the impacts of migratory separation on left-behind children.
The number of years lost in 30-year work life spans of people with type 1 and type 2 diabetes
Authors: Nexø M A , Pedersen J , Andersen I , Cleal B , Bjørner J B 
Published: October 2020

Abstract

Background
Although diabetes is among the most common causes of lifelong disability, no studies have yet outlined work disability from a life course perspective. This study estimated the number of years people with type 1 and type 2 diabetes lost in a work life span compared to people without diabetes

Methods
Individuals aged 18-65 years, diagnosed with type 1 (n = 33,188) or type 2 diabetes (n = 81,930) were identified from national registers from the entire Danish population and age and gender matched with controls without diabetes (n = 663,656), for period 2000-2017. WLE in years were estimated as time in employment from age 35 to 65. We used a life table approach with multi-state Cox proportional hazard modelling (95% Confidence Intervals: CI). Age was the underlying time-axis. Inverse probability weights accounted for differences between populations. Analyses were performed separately for sex, educational status, and types of diabetes in 5-year age intervals.

Results
Individuals with type 1 diabetes and type 2 diabetes had significantly shorter WLE compared to people without diabetes in the 30-year span. Type 1 diabetes: WLE ranged from 8 years shorter among women with short education [-8.0; CI:-11/-5.0] to 4 years shorter [-4.4; CI:-6.6/-2.3] with high education; WLE in men ranged from -6.4 [CI:-8.7/-4.0] with short education to -3.0 [CI:-4.5/-1.5] with high education. Type 2 diabetes: WLE ranged from -6.5 [CI: -8.9/-4.0] in women with short education to -2.9 [CI: -4.5/-1.3] with high education. WLE in men ranged from -7.0 [CI: -9.4/-4.5] with short education to -3.7 [CI: -5.4/-2.0] with high education.

Conclusions
The substantial number of years lost in a work life span for individuals with type 1 or type 2 diabetes, highlight need for new strategies that prevent work disability, particularly for individuals with short education.

Key messages
Individuals with type 1 diabetes and type 2 diabetes had between 9 and 3 years shorter work life expectancies compared to people without diabetes in a 30-year span. The work life spans are substantial shorter for individuals with type 1 or type 2 diabetes with short educations.
Evidence-based reporting, methods and content of allergy-specific digital training programs
Authors: Lander J , Drixler K , Dierks M L , Bitzer E M 
Published: October 2020

Abstract

Background
The World Allergy Organization frames allergies as a “major global public health issue”, due to the consistently high prevalence of, e.g., allergic rhinitis (up to 30%). Digital training programs (DTPs) may help fostering self-management and provide allergy-specific information, given, for instance, their good accessibility. We aimed to assess an exploratory sample of allergy-specific, interactive and feedback-oriented DTPs towards the extent to which these tools meet established criteria for the reporting, methods, and content of evidence-based (digital) health information.

Methods
We searched for DTPs via scientific databases and online sources and developed a checklist from established scientific guidelines for digital health information. The checklist contained 44 items covering 11 domains related to content (e.g. evidence-base), structure (e.g. trainer qualification) and impact (e.g. user perspective).

Results
15 DTPs covered an average of 37% of the items (score 33/88). Items relating to intervention (58%), content (49%), and data safety (60%) were frequently considered, as opposed to user safety (10%), qualification of staff (10%), effectiveness (16%), and user perspective (45%). In 13 of 15 DTPs, a minimum of 3 domains were not covered at all. Regarding evidence-based content, 46% scored on use of scientific research, 53% on regular information update, and 33% on provision of references.

Conclusions
Allergy-specific DTPs conform only partly to established criteria for evidence-based (digital) health information and education. The named methodological and content-wise shortcomings pose considerable obstacles for users. While there have been related, general criticisms earlier, this study provides empirical evidence via the example of allergy-specific DTPs.

Key messages
For DTPs to add value, service providers and health information experts need to cooperate much closer to reduce the 'reporting vs. requirements' gap. Cooperation is also needed to agree essential methodological and content-wise features of DTPs and similar services.
Health disparities by neighborhood socioeconomic status and the role of spatial spillovers
Authors: Dekker L H , Rijnks R H , Mierau J O 
Published: October 2020

Abstract

Background
The contextual determinants of population health disparities across neighborhoods with similar socioeconomic characteristics are not well understood. We aimed to estimate subjective and objective population health measures within and between neighborhoods with similar socioeconomic status (NSES) scores, and the (in)direct potential of a spillover effect of NSES of adjacent neighborhoods.

Methods
Based on whole-population neighborhood data we determined the percentage of inhabitants with good/very good self-assessed health (SAH) and with at least one chronic disease (CD) in 11,521 neighborhoods with on average 1,470 inhabitants. Neighborhoods were classified by the quintile of a composite NSES score. Spatial lag of X models was applied by including neighborhood cross-sectional units on population density, the percentage of inhabitants aged 65 and over, and the NSES of adjacent neighborhoods by constructing a spatial weights matrix.

Results
Substantial population health disparities in SAH and CD both between neighborhoods with different and similar NSES scores were observed, with the largest SAH variance in the lowest NSES group. These differences were only partially explained by neighborhood characteristics. Neighborhoods adjacent to higher SES neighborhoods showed a higher SAH and a lower prevalence of CD, adjusted for other explanatory variables. When NSES in the first decile would be increased to the NSES of the quintile median, the direct effect on SAH would increase by 5.6% in the lowest NSES group. Spillovers would lead to an additional increase of 1.7% in all NSES groups.

Conclusions
Population health differs substantially among neighborhoods with similar socioeconomic characteristics, which can partially be explained by a socioeconomic spillover effect. The mechanisms behind these spillovers need further study, but may already provide interesting leads to policy design aimed at improving population health outcomes of deprived neighborhoods.

Key messages
Neighborhood population health is partially affected by a SES spillover effect. This study provides interesting leads to policy design aimed at improving health outcomes of deprived neighborhoods.
Malnutrition and Socio-economic Factors in HIV Infected and Uninfected Under 5 Children in Zambia
Authors: Ng'andu M N , Moonga G M , Banda J B 
Published: October 2020

Abstract
Malnutrition contributes to more than one third of all child deaths, although hardly listed as the direct cause. In sub-Saharan Africa, malnutrition accounts for about 2% of deaths and 3% of Disability adjusted life years (DALYs) among under-5 children. In Zambia, 35% of under-5 children are stunted, 4% wasted, 12% underweight and 5% overweight. Malnutrition and HIV interact in complex ways that increase vulnerability to and worsen each condition therefore we sought to determine factors associated with malnutrition among under 5 children in Zambia.
Using Stata version 14.2, we extracted and analysed sample data of 159 children aged 0-59 months from the 2016 ZAMPHIA population-based survey, that used a two-stage cluster sampling design. We used Generalised Linear Models to measure socio-economic factors associated with malnutrition. P-value of less than 0.05 was set as level of statistical significance.
Factors associated with malnutrition included gender, child's HIV status and wealth index which showed an association with stunting, wasting and being underweight. The 16 (10%) under-5 children living with HIV were significantly more affected by stunting (38% vs 33%), wasting (19% vs 11%) and underweight prevalence (38% vs 10%) than the remaining 143 who were HIV negative. Our sample prevalence was similar to national stunting (33% vs 35%) and underweight prevalence (13% vs 12%) but had three times higher wasting prevalence (12% vs 4%).
A high prevalence of malnutrition was found in HIV positive compared to negative under 5 children, wealth index showing an association with malnutrition. Eliminating malnutrition is key to attaining SDG 3 which is to end preventable deaths of newborns and children under 5 years of age.

Key messages
All types of malnutrition had a higher prevalence in HIV infected than uninfected under five children in Zambia. Wealth index is a socio-economic factor that is associated to all types of malnutrition in under-five children in Zambia.