bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monitoring measles outbreaks using emergency department data in France
Authors: Noel G , Franke F , Forgeot C , Piarroux J , Viudes G , Caserio-Schönemann C 
Published: November 2019

Abstract

Background
Measles’ outbreaks still occur in industrialised countries and reactive monitoring of the disease is needed. In France, measles’ monitoring is based on a mandatory notification (MN).

Methods
In France, for each emergency department (ED) visit, an Electronic ED Abstract (EEDA) is transmitted to the OSCOUR® network included in national Syndromic Surveillance System. EEDA include the diagnosis at discharge using International Classification of Disease (ICD-10). This study aims to evaluate the correlation between the number of measles MN and the number of ED visits related to measles and to calculate the positive predictive value (PPV) of diagnosis at discharge of measles in ED. The study period covered the third wave of the 2008-2011 French outbreak. From 2010 to 2011, we analyzed EEDA transmitted from 32/53 ED of the PACA region and regional measles MN. Using weekly aggregated data, the correlation between the number of measles cases given by both MN and ED sources was assessed (Pearson coefficient). In the 4 ED (2 pediatric) of the teaching hospital of Marseille, electronic medical files coded as measles were reviewed to evaluate the PPV of the diagnosis coded according to the national MN case definition (gold standard).

Results
2,949 MN were transmitted and 1,306/1.3 million visits in ED were coded as measles. The peak of the outbreak was reported the same week by EEDA and MN. The correlation between EEDA and MN was strong (0.91; p &lt; 0.001). Hospitalization rate was 20.7% and 21.0% according to EEDA and MN (p = 0.81). Among 363 medical files coded as measles in the 4 ED, 14 cases (3.9%) did not fulfilled the national case definition (PPV: 96.1 [IC95%: 94.2-98.1]), 86 (23.7%) fulfilled criteria for “clinical case” and 263 (72.5%) for “confirmed case".

Conclusions
Most of the time, ED visits coded as measles fulfilled diagnosis criteria. Our results suggested that EEDA (better reactivity) could be complementary to MN (better completeness) to monitor measles.

Key messages
Most of the time, ED visits coded as measles fulfilled diagnosis criteria: PPV of coded medical diagnosis in ED for measles is high. Reactivity of ED data monitoring could usefully complete mandatory notification for measles surveillance.
Prevalence and risk factors of hepatitis B in Tunisia
Authors: Lahchaichi A , Hadj M Ben , Bouguerra H , Talmoudi K , Bahrini A , Bahri O , Letaief H , Hazgui O , Hannachi N , Bouafif N Ben Alaya 
Published: November 2019

Abstract

Background
Hepatitis B virus (HBV) infection is a major public health problem. Data related to epidemiology, distributions and outcomes of VHB infections in Tunisia remains scarce. This work aimed to study the prevalence of HBV infections and their distribution as well as the main risk factors associated to HBV infection.

Methods
Our study was a cross-sectional household- based study carried out among a representative sample of 22 275 from January 2014 to December 2015. Sampling was based on the National Census of 2014. For data collection, questionnaires were administrated by trained investigator and blood samples were sent to the Reference laboratory for analysis of HBV markers.

Results
Among 21720 surveyed subjects, 19663 subjects had a laboratory tests and the serological results reached to 19155. Overall prevalence of HBs Ag was 1.7% [1.6-1.9]. Prevalence of HBsAg was significantly higher in men (2.1% against 1.4%; p &lt; 10-3), in age group more than 20 years (2.1% against 0.1% p ≪10-3) and in the Central region (2.3%; p &lt; 10-3). Among the associated risk factors in univariate analysis were chronic dialysis, dental care, surgical intervention, hospitalization, traditional circumcision, scarification and multiple sexual partners. Multivariate analysis showed that male gender, age over 20 years, center and south regions, hospital follow-up of a chronic pathology and having a family member chronic carrier of HBs Ag were the associated risk factors of HBV infection and vaccination was the only protective factor.

Conclusions
Our study allowed to have a clear estimate of the national prevalence of HBsAg and to classify Tunisia as a country of low endemicity of Hepatitis B. This decline is mainly due to the introduction of vaccination since 1995 and the improvement of the health system. However, more efforts should be paid to reduce nosocomial transmission and traditional high-risk behaviors.

Key messages
Tunisia has become a country of low endemicity for hepatitis B. This was a result to the introduction of vaccination since 1995.
Human papillomavirus infections and cervical cancer screening in Tunisian women
Authors: Bouguerra H , Hechaichi A , Letaief H , Ardhaoui M , Ennaiefer E , Bougatef S , Chahed K , Mechala M , Boubaker S , Alaya N Ben 
Published: November 2019

Abstract

Background
Human papillomavirus (HPV) infections are a significant public health problem with global estimations over 520 000 new cases and 274 000 deaths due to cervical cancer. In Tunisia, cervical cancer is the third cause of cancer in women but only a few prevalence studies conducted in specific populations are available. The present study aims to estimate the national prevalence of HPV infection and cervical cancer testing among Tunisian women.

Methods
We conducted a population-based cross-sectional study in 2014. We included all sexually active women aged 18 years and older, present in primary health care centers the day of the study. Data collection was based on a standardized questionnaire including socio-demographic data, high-risk behaviors and previous cervical screening. HPV detection and typing was only done for betaglobin positive PCR-test. Ethical considerations were respected.

Results
The total number of surveyed women was 1494 and the overall prevalence of HPV infection was 7.5% IC95% [5.9%-9.0%]. The most common genotypes were HPV6 (21.9%) and HPV16 (11.5%). Prevalence of high-risk HPV was higher than low-risk HPV; 4.8% IC95% [3.7%-6.2%] and 3.8% IC95% [2.8%-4.8%] respectively. The prevalence of previous cervical screening was 36.6% (95% CI [34.3%-39.2%]). This rate was significantly associated with age (p &lt; 10-3); from 13.9% among those &lt;30 years to 49.3% among those ≥ 50 years.

Conclusions
Our survey provides an important overview of the current situation of HPV infection among Tunisian women. National prevalence of HPV infection was 7.5% but only 36.6% of women had a previous cervical cancer screening. This coverage remains poor, thus the need of targeted education and encouraging strategies to reduce cervical cancer burden in Tunisia.

Key messages
National prevalence of HPV infection is not negligeable in Tunisia, especially high risk HPV infections. Cervical screening is still low among Tunisian women, hence the need for education targeted to this population.
Welfare state impact on mental wellbeing of the oldest old in Europe: A multilevel survey data study
Authors: Kalseth J 
Published: November 2019

Abstract

Background
Improving the health and wellbeing of the oldest old population is a key public health policy concern considering the rapid aging of the world’s population. The purpose of this study was to investigate the impact of the welfare state on different aspects of mental wellbeing of the oldest old population in Europe. Several approaches to measure welfare state types were compared.

Methods
The study used individual level data from Round 6 of the European Social Survey to measure six dimensions of mental wellbeing among the 80+ population including countries belonging to the European Union or European Economic Area. Welfare state types were measured using one welfare state- and three elderly care regime typologies, as well as three welfare state dimensions based on factor analyses of several welfare state characteristics. Welfare state impact on mental wellbeing was analysed by multilevel regression analyses, controlling for age and gender.

Results
The preliminary results show that universalistic and service-based regimes, as e.g. Nordic countries, are associated with higher level of subjective wellbeing and social trust, but not psychological wellbeing, compared to family-based regimes with low formal support. East Europe have lower scores on all dimensions compared to Nordic countries. The welfare state dimension capturing prioritisation of health and social services and gender equality is positively associated with all wellbeing aspects, whereas the factors capturing labour market participation of seniors and income equality respectively, are only significantly associated with subjective wellbeing and social trust.

Conclusions
The result point to caring approaches with high level of formal support and gender equalisation as key to enhance all aspects of mental wellbeing for the oldest old. Stimulating long duration of working life and reducing income inequalities have the potential to increase life satisfaction and happiness and social trust.

Key messages
Welfare state matter for the mental wellbeing in the oldest old population. General measures, supporting formal care, labour market participation and income and gender equality will also benefit the oldest old.
Development of a barometer to display and monitor health and wellbeing on the neighborhood level
Authors: Hilger-Kolb J , Röhrbein H , Kairies H , Heinrich K , Hoffmann K 
Published: November 2019

Abstract

Background
Neighborhoods and their characteristics play a key role for establishing and maintaining health and wellbeing of their residents. However, before programs promoting health and wellbeing in the neighborhood can be planned and implemented, it is necessary to identify local needs for action. This is especially important for the stakeholders that work in the neighborhood (e.g., employees of the local community, headmasters of schools). We thus developed exemplary for Herzogenried -a neighborhood in the German city of Mannheim- a barometer that aims to assess and monitor health and wellbeing in the neighborhood and indicates potential needs for action.

Methods
We conducted a detailed literature search to identify indicators that were associated with health and wellbeing in neighborhoods. Based on the search we created a primary list of indicators, which we presented and discussed during 15 meetings with a total of 26 different stakeholders. Available data on the indicators agreed on were checked for accuracy, statistically processed, and visualized for incorporation into the barometer.

Results
The barometer consists of the following eight dimensions which in total include 80 indicators: population structure, population development, household structure, material wellbeing, education, family and upbringing, health, and personal security. The barometer also includes a map that displays structural characteristics of the neighborhood such as physicians, schools, supermarkets. An important challenge we faced was the availability of indicators as some of them were only accessible at the community level or for specific age groups.

Conclusions
The barometer offers a comprehensive overview on the neighborhood, provides first hints for the local stakeholders on needs for action, and helps to prioritize the issues that should be addressed to promote health and wellbeing in Herzogenried. It will also serve as a prototype for other neighborhoods in the future.

Key messages
The barometer was planned to serve as a transferable tool to identify and prioritize action steps for neighborhood development and to help promoting health and wellbeing of their residents. As the barometer displays indicators relevant for various community stakeholders it can serve to identify joint goals and thus foster stronger trans-sectoral collaboration at the neighborhood level.
The use of digital devices in the field of healthcare in Bulgaria
Authors: Kilova K , Milkov D , Mateva N 
Published: November 2019

Abstract

Background
The opportunities that information and communication technologies provide in the field of healthcare are many and constantly growing. Thanks to them, consumers have access to health information, consultations and remote treatment and connection with medical centers. They help to improve health promotion activities, whose mission is to promote health as a core value. The aim of the present study is to explore the attitudes regarding the use of digital devices in the field of healthcare of Bulgarian population.

Methods
A direct anonymous survey was conducted among 356 respondents, randomly selected and with an average age of 38.26 ± 0.15 (110 men and 246 women). The study was conducted from October 2018 to April 2019. The data analysis was performed using the statistical software SPSS v.23.0.

Results
The results showed that 78.9% of respondents have used or are willing to use digital devices to search for and record health information. A statistical gender difference was found in the answer to the question of using a digital device for self-registration of information (χ2 = 28.6, P &lt; 0.05), as women are more likely to do so. More than 75% of respondents are willing to share health information with a medical professional in real-time via the internet. Older people are more reserved and hesitant about providing health information to a state agency (66.7%). The smartphone and computer/laptop are among the most preferred digital modalities in the healthcare field, with men and younger respondents more likely to use digital devices in relation to their health (χ2=39.9, P &lt; 0.05). Women are more critical about the use of information and communication technologies in healthcare (χ2=48.2, P &lt; 0.05).

Conclusions
The present study found a positive attitude among all respondents towards the introduction of modern technologies in the healthcare field and the opportunity of remote contact with medical professionals, using personal digital devices.

Key messages
The opportunities that information and communication technologies provide in the field of healthcare are many and constantly growing. The aim of the present study is to explore the attitudes regarding the use of digital devices in the field of healthcare of Bulgarian population.
Parents and health professionals’ opinions on information tools on mandatory childhood vaccines
Authors: Hennequin C H , Vergelys C V , Chauvet L C , Cortaredona S C , Dube E D , Verger P V 
Published: November 2019

Abstract

Background
South-eastern France is marked by insufficient vaccination coverage for several vaccines and some mistrust of its population towards vaccination. In this context and given the application of new vaccination obligations for early childhood, we carried out a qualitative survey to study opinions of parents and health professionals (HPs) on information tools on vaccination (ITV).

Methods
An inventory of French existing ITV was conducted to select a diverse set of 17 ITV for our qualitative evaluation. In 2018, we carried out 26 individual interviews with parents of young children (recruited in nurseries and kindergartens) and 5 focus groups with HPs (nurses, general practitioners, midwives and pediatricians; n = 33).

Results
Most parents appreciated videos for their convenience: they used them to discover new/complex subjects in an entertaining way. Paper ITV remained essential mostly among parents with high socio-economic status (SES) or marked vaccine hesitancy, who also requested detailed information and scientific sources. Some parents of low SES considered ITV difficult to understand because of their length, quantity of information and scientific language. For HPs, giving their patients a paper ITV is a way to show the importance they attach to their patient’s questions. HPs reported reluctance using videos during consultations. Some HPs stated their need for guidance on two aspects: 1) key discussion points to use when giving an ITV to parents and 2) most appropriate timing to give ITVs: prescription, injection…

Conclusions
In the pool of tested ITV, articulation and formatting of arguments are not always optimal for HP and parents use. Tailored ITV should be available for the different needs of HP and parents, especially, for the latter, according to their SES and hesitancy profiles. ITV adapted to use during consultation are necessary.

Key messages
Information tools on vaccination (ITV) are not always optimal for HP and parents use. ITV should be tested and better adapted to the patient profile and consultation context.
How often do partial disability pensioners end up on a full disability pension?
Authors: Polvinen A , Laaksonen M 
Published: November 2019

Abstract

Background
Extending working lives and deferring retirement have been important topics of discussion in recent years. Full disability pensioners seldom work, but most partial disability pensioners continuing working while receiving a pension. However, very little is known about how often partial disability pensioners end up on a full disability pension. The aims of this study were to investigate to what degree partial disability pensions become full disability pensions, and how age, gender, marital status, education, unemployment or a disability diagnosis are associated with that.

Methods
The register data included 2,969 Finns who were aged 18-59 years and whose partial disability retirement started in 2010. The follow-up period ranged from 2010 to the end of 2015. Cox models were used to estimate hazard ratios for full disability retirement.

Results
Approximately 40 per cent of the partial disability pensioners ended up on a full disability pension during the follow-up period. Partial disability pensioners who were older, had a lower educational level or a history of unemployment, or who suffered from mental disorders ended up on a full disability pension more often than others. The risk of full disability retirement was 1.5-fold among those with mental disorders compared to those with musculoskeletal diseases.

Conclusions
Partial disability pensioners with a low education, a history of unemployment or who suffer from mental disorders experience a higher risk of ending up on a full disability pension. More focus should be paid to improving education, preventing mental health problems and unemployment in order to help the disabled work longer.

Key messages
Preventing partial disability pensioners from ending up on a full disability pension can extend their working lives. Partial disability pensioners with a low education, a history of unemployment or poor mental health more often stop working altogether. More focus should be paid to improving these issues.
Effect of smoking behaviour before and during pregnancy on Low head circumference at birth
Authors: Kharkova O , Odland J 
Published: November 2019

Abstract

Background
Smoking during pregnancy leads to adverse pregnancy and birth outcomes. Compared to the number of studies on low birth weight, the influence of maternal smoking on low head circumference at birth is not well documented. The aim of the study was to assess an effect of smoking behavior before and during pregnancy on low head circumference at birth.

Methods
The study is based on the Murmansk County Birth registry. Our study includes women who delivered a singleton pregnancy after 37 weeks of gestation (N = 44,486). Smoking information was self-reported and assessed at the first antenatal visit during pregnancy. Low head circumference was defined in according to the World Health Organization as Mean value minus 2 standard deviations for girls and boys separately. Using logistic regressions we adjusted for maternal age, residence, ethnicity, education, marital status, alcohol abuse, year of delivery, body mass index, pregnancy diabetes, gestational age, and excessive weight gain.

Results
A dose-response relationship was evident between the number of cigarettes smoked per day during pregnancy and the odds of low head circumference at birth (adjusted OR1-5 cig/day = 1.69 with 95% CI: 1.31-2.19; OR6-10 cig/day = 2.08 with 95% CI: 1.63-2.65; and OR ≥ 11 cig/day = 5.19 with 95% CI: 3.89-6.92). Compared to non-smokers, quitting smoking during the first trimester of pregnancy had no significant effect on low head circumference at birth (adjusted ORquitters = 1.04 with 95% CI: 0.80-1.34).

Conclusions
Despite dose-response relationship was observed between maternal smoking and low head circumference at birth, women who stopped smoking during the first trimester were at no higher risk of having a baby with the low head circumference as compared to non-smokers. Our findings underline a continued need for actions against maternal smoking.

Key messages
women who stopped smoking during the first trimester were at no higher risk of having a baby with the low head circumference as compared to non-smokers. A dose-response relationship was evident between the number of cigarettes smoked per day during pregnancy and the odds of low head circumference at birth.
Neighborhood disparities in stroke and socioeconomic, urban-rural factors using stroke registry
Authors: Padilla C , Grimaud O , Nowak E , Timsit S 
Published: November 2019

Abstract

Introduction
Despite major improvements in management over recent decades, stroke remains a devastating disease in Europe and geographic disparities persist. Determining the spatial distribution of stroke may be useful for both epidemiological research and health services planning. The aim of this study was to estimate stroke incidence rates in Pays de Brest (Western France) and to explore the presence of geographic clusters associated with socioeconomic and urban-rural characteristics.

Methods
The study included incidence stroke cases aged 60 years and more from the Stroke Brest registry for the period 2008 to 2013 aggregated at the census block level. Poisson and negative binomial regression models were used to explore determinants of disease risk. Geographically weighted regression (GWR) was used to allow estimation of local regression coefficients.

Results
Between 2008 and 2013, 3088 cases aged 60 years were identified in Pays de Brest. The incidence of stroke was 6.67 per 1 000 inhabitants. Living in a rural neighborhood with a higher level of blue collar and of farmer was associated with higher age adjusted stroke incidence rate ratio (IRR) 1.23, [95%CI 1.09-1.39]. Higher risk was also found in a city center neighborhood with a higher level of blue [IRR 1.22, 95%CI 1.04-1.49]. Local Poisson GWR models achieved the best fit and suggested evidence of spatially varying regression coefficients and clusters of higher incidence.

Conclusions
Our study contributes to a better understanding of the relationship between stroke risks and contextual characteristics such as socioeconomic circumstances and urban rural setting. This will help targeting areas for specific public health prevention.

Key messages
Variations of stroke were marked according to socioeconomic and urban-rural setting of the living area. This study will help targeting areas for specific public health prevention.