bluuebunny/crossref_metadata_2025_split huggingface dataset:
Costs of loneliness: the association between loneliness and healthcare expenditure
Authors: Meisters R , Westra D , Putrik P , Bosma H , Ruwaard D , Jansen M 
Published: October 2020

Abstract

Background
Loneliness is a growing issue. It has been associated with a range of unhealthy behaviors, poorer health, and increased morbidity. However, the healthcare costs of loneliness are poorly understood as limited existing research on loneliness focused on older age populations, few expenditure categories, and controlled for just a few potential confounders. Our study aims to fill this evidence gap.

Methods
Multiple sources were combined into a dataset containing a nationally representative sample (n = 341,376) of Dutch adults (&gt;18 y.o.). The association between loneliness and total, general practitioner (GP), specialized, pharmaceutical, and mental healthcare expenditure was tested using Poisson and Zero-inflated negative binomial models, controlling for numerous potential confounders (i.e. demographic, socioeconomic, lifestyle-related factors, self-perceived health, and psychological distress), for multiple age groups. Excess expenditure attributed to loneliness was extrapolated to the entire population.

Results
Controlling for demographic, socioeconomic, and lifestyle-related factors, loneliness was indirectly (via poorer health) associated with higher expenditure in all categories. In fully adjusted models, it showed a direct association with higher expenditure for GP and mental healthcare (0.5% and 11.1%, respectively). The association with mental healthcare expenditure was stronger in younger than in older adults (for ages 19-40, the contribution of loneliness represented 61.8% of the overall association).

Conclusions
Loneliness contributes to health expenditure both directly and indirectly, particularly in younger age groups. This implies a strong financial imperative to address this issue.

Key messages
Loneliness is associated with increased healthcare expenditure independent of demographic and socioeconomic factors. Excess healthcare expenditure related to loneliness are particularly apparent in mental healthcare and in younger age groups.
Engaging the youth: co-designing health promotion messages
Authors: Finlay S 
Published: October 2020

Abstract
We were all young once, right? Moreover, many of us still feel young despite our birth certificate suggesting otherwise. Does that mean we understand what health promotion messages are going to resonate with young people today? Does it mean we know which platforms messages for young people should be used?
The short answer is no. This is particularly true for marginalised communities whose needs are often very different and therefore require tailored communication. Marginalised communities such as Indigenous people, the LGBTQI community, migrant populations and refugees.
Youth is a perfect time to communicate prevention, sexual and reproductive health and other health promotion messages. Young people are our future leaders. As health professionals, we want to make sure they transition to adulthood as healthy in mind and body as we can. Part of that is developing health promotion messages which reach with young people.
However, too frequently, messages are not tailored for young people; therefore, not equipping them with the knowledge and skill to make healthy choices. To ensure that as health professionals that we are maximising our impact with young people, we need to co-design health promotion messages with them.
Like with many Indigenous people in colonised countries, half of the Aboriginal and Torres Strait Islander population, Australia's Indigenous people are under the age of 30. Young Australian Indigenous people's health and wellbeing needs are distinctive because of the uniqueness of their culture as well as the historical, political and social context (Azzopardi 2017). To ensure that health promotion effectively reaches its target audience, a co-design methodology is often employed with Aboriginal and Torres Strait Islander people. This presentation will detail the development of co-designed quit smoking and suicide prevention health promotion campaigns to demonstrate their effectiveness. A method that can be applied with other young people for maximum impact.
“Sometimes you need to go beyond the manual” – TRT facilitators’ experiences when refugee youth disclose suicidal ideation
Authors: Gupta-Löfving S , Wijk K , Warner G , Sarkadi A 
Published: October 2020

Abstract
Community-based mental health interventions offer a way to reach lots of people when there is a high level of need. However, it is important to consider safety aspects when pushing interventions out to community settings. Teaching Recovery Techniques (TRT) is a manualised intervention based on trauma-focused cognitive behavioural therapy for children and adolescents reporting symptoms of post-traumatic stress. Facilitators with no previous therapeutic experience or specialist training in psychiatry are eligible to deliver the intervention after a three-day training workshop. Although TRT was not developed for a specialist health care setting, a substantial number of refugee minors who receive the TRT programme in Sweden report severe high-risk psychiatric symptoms. The objective of this study was to examine how facilitators, without extensive psychological training, experience the intervention including the inbuilt safety protocol when participating refugee minors are in an unstable setting and disclose suicidal ideation. Semi-structured interviews were conducted with TRT facilitators. Data were analysed using systemic text condensation. Findings will be presented at the workshop.
'I felt like a human being' – An exploratory, multi-method study of refugee involvement in the development of mental health intervention research
Authors: Warner G , Baghdasaryan Z , Osman F , Lampa E , Sarkadi A 
Published: October 2020

Abstract
The purpose of this study was to pilot and methodologically appraise innovative patient and public involvement (PPI) evaluation tools and to describe a case study of refugee involvement in the development of mental health intervention research. 'Refugee Advisors' were involved in the development of a randomised controlled trial protocol evaluating a brief group intervention for refugee children experiencing symptoms of post-traumatic stress in Sweden. During an 8-hour research meeting, observation and questionnaire data were collected using the Active Involvement of Users in Research Observation Schedule and Questionnaire, followed by a focus group discussion. The multi-method approach demonstrated good feasibility. There were clear examples of how the advisors influenced research development e.g. recruitment strategy, cultural brokerage among study group participants, outcome measure validation. The advisors described a perceived impact on the research, equality and acceptance, and knowledge gain. A sense of appreciation and empowerment was also interpreted. However, potential issues relating to the relevance of contributions and use of an interpreter were identified.
Different diagnostic groups and labour market marginalization among refugee youths
Authors: Chen J , Mittendorfer-Rutz E , Klimek P 
Published: October 2020

Abstract

Background
Refugees are at increased risk of labor market marginalization (LMM), which is of high Public Health importance. However, little is known whether specific multimorbidity patterns increase the risk of LMM in this group. We sought to examine whether different diagnostic groups associate with subsequent unemployment and disability pension in refugee youth as compared to their counterparts born in Sweden.

Methodology
We analyzed 249,245 individuals between the age of 16 and 26 at 31.12.2011 from a combined Swedish registry. Refugees were matched to five second-generation-native-born Swedes. LMM was defined as disability pension or &gt; 180 days of unemployment, 2012-2015. Relative risks (RR) were calculated for 114 diagnostic groups (2009-11) with regard to the two outcome measures.

Results
The mean age was 23±1.7 years, 2,841 (1.1%) received disability pension and 16,323 (6.5%) individuals experienced unemployment. The majority of diagnostic groups was associated with a higher risk for unemployment and a lower risk for disability pension in refugees. Hypertensive diseases and external causes of morbidity showed higher risk ratios of unemployment for refugees compared to Swedish-born: RRs (95% Confidence Interval) 6.8 (3.16, 14.6) and 6.31 (4.45, 8.94), respectively. Diabetes and mental disorders were associated with higher risk estimates for disability pension in refugees: RRs (95% CI) 2.4 (1.02, 5.6) and 1.8 (0.80, 3.9), respectively.

Conclusions
Diagnoses are differentially associated with LMM in refugee youth as compared to Swedish-born individuals. In order to prevent LMM in refugees, early intervention for the identified diseases is important.

Key message
The importance of diagnostic groups for subsequent LMM differs for young refugees and Swedish-born individuals. Findings are also divergent regarding the measure of LMM.
Smokefree policy and medication dispensing for people in prison: interrupted time series analysis
Authors: Leyland A , Tweed E , Byrne T , Conaglen P , Craig P , Graham L , McMeekin N , Boyd K , Pell J , Hunt K 
Published: October 2020

Abstract

Background
Previous evaluations of smokefree prison policies have suggested improvements in self-rated health and some smoking-related symptoms. No studies to date have investigated impacts on medication use as proxy measures of objective ill-health or as indicators of potential negative unintended consequences. These is limited evidence to date on these important outcomes.

Methods
We obtained from NHS National Services Scotland aggregate data on medication items dispensed in prisons, based on individual named patient medication records, and from the Scottish Prison Service data on the prison population, for the period Jan 2013-Nov 2019. Items of interest comprised those for smoking cessation (varenicline and buproprion); nicotine replacement; specific smoking-related health conditions (glyceryl trinitrate; inhaled bronchodilators and steroids; antibiotics; chloramphenicol eye drops; and proton pump inhibitors and H2 receptor antagonists), and potential unintended mental health consequences (anti-depressants). We also included a set of negative controls for which dispensing was not expected to be affected by the new smokefree policy (anticonvulsants, excluding pregabalin and gabapentin). Analyses were undertaken using AutoRegressive Integrated Moving Average (ARIMA) time series methods, with the dates of the policy's announcement and of implementation included as pre-specified breakpoints.

Results
The results of ARIMA modelling of medication dispensing are confidential until May 2020 due to their sensitivity and will be available to present at WCPH 2020.

Conclusions
The use of routinely available dispensing data as an indicator of objective health impacts and potential negative unintended consequences provides novel insights into the effectiveness of smokefree prison policies. Results will be of interest to international jurisdictions considering such policies and to those seeking to harness the potential of administrative data for natural experiments.
Manufacturing epidemics: industry influence on trade and governance and how to address it
Authors: Friel S 
Published: October 2020

Abstract
The significant structural, instrumental and discursive power of food corporations has led to the development of trade agreements that enable pursuit of private actors' financial interests to the detriment of nutrition and health. This presentation will examine the ways in which food corporations have influenced and used trade treaties. Drawing on lessons from previous trade and health successes, the paper will also outline ways in which we can recalibrate the power differentials such that the interests of weaker social actors can be achieved.
Major health system reforms in 27 European countries in 2018 and 2019
Authors: Quentin W , Polin K , Hjortland M , van Ginnekin E , Maresso A 
Published: October 2020

Abstract

Background
Countries in Europe are continuously reforming their health care systems. Often similar reforms are happening simultaneously in different countries, and policymakers would benefit from considering reform experiences made abroad. However, no systematic information is available about reforms happening simultaneously across countries. This presentation provides an overview of major health reform trends in Europe in 2018 and 2019.

Methods
For the HSPM network's annual meetings in 2018 and 2019, information was collected from national experts on the three most important health reforms in each country happening in that year. In the 2019 survey round, experts were also asked to provide an update on the status of the three reforms they had reported in 2018. Subsequently, all reforms were clustered independently, assigning each reform to one (or several) of 11 categories.

Results
In 2018, national experts reported on 78 reforms from 26 European countries. Together, more than one-third of the reforms fell under three clusters: 'coverage & resource generation', 'purchasing & payment' and 'hospital care'. Each of these clusters included reforms from at least nine countries. In 2019, national experts reported 79 reforms from 27 countries. The top clusters were 'primary & ambulatory care' and 'governance', with fourteen and twelve reporting countries respectively. Most 2018 reforms (47/78) were still reported as ongoing in 2019, indicating the complexity of many reforms. More than 20 reforms were reported as implemented, while six reforms were abandoned.

Conclusions
Health reforms in different countries often focus on similar topics. Some countries are experimenting with reforms that have already been implemented or abandoned in other countries. There is huge potential for cross-country learning as information on reform experiences may provide inspiration for reforms or help avoid the making the same mistakes in another country.
'Orange is the new Blue': the start of organised colorectal cancer screening in a Milan penitentiary
Authors: Gandolfi C E , Iemmi D , Lari C , Danese R , Silvestri A R 
Published: October 2020

Abstract

Issue
According to the United Nations basic principles for the treatment of prisoners, they “shall have access to the health services available in the country without discrimination on the grounds of their legal situation”. In Italy this principle is executed by national legislation allocating responsibility for inmates' health directly to the National Health Service. In the Metropolitan City of Milan this duty is fulfilled by the Agency for Health Protection (ATS) that guarantees medical assistance in its penitentiaries.

Description of the problem
In Italy, cancer screening activities are considered essential levels of assistance i.e. guaranteed to all citizens. In fact, organised colorectal cancer (CRC) screening is offered by ATS, free of charge, to males and females, aged 50 to 74, in the form of a fecal immunochemical test every 2 years. Unfortunately, CRC screening uptake remains low among fragile patients, such as jail inmates, who are hard-to-reach by standard organised screening efforts. In 2019 the ATS Preventive Medicine Screening Unit began a small pilot organised CRC screening program, specific for inmates, starting in one of the city's main penitentiaries: Casa di Reclusione Milano Bollate, comprising 1200 inmates, and recently appointed nationwide referral center for elderly inmates.

Results
Inmates represent a large scarcely screened population that, following implementation of an organised tailored CRC screening program, showed high willingness to participate. Organised cancer screening programs may thus be necessary to guarantee maximum uptake among prisoners.

Lessons
Tailoring the organised CRC screening program to the prison-setting may increase adherence and ensure standardised coverage of the target population, eliminating disparity in the CRC screening service, and hopefully others in the future.

Key messages
Tailoring an organised CRC screening program to the prison-setting may increase adherence and ensure standardised coverage of the target population, eliminating disparity in the CRC screening service Organised screening programs could achieve extensive coverage and enhance equity of access in this hard-to-reach fragile population.
A shadow cast on a successful CRC screening programme, features of Interval Cancer FIT
Authors: Idigoras Rubio I , Bilbao Iturribarria I , Solís Ibinagagoitia M , Diaz Seoane M , Fernandez Landa M J , Portillo Villares I 
Published: October 2020

Abstract

Background
Colorectal Cancer (CRC) Screening started in 2009 inviting biennially to carry out an immunochemical quantitative occult blood test (FIT). Overall coverage was reached in 2014 The aims of this study were to determine the main features of Interval Colorectal Cancer (CRC), related to FIT (IC_FIT= false negatives of the FIT) on the population-based screening Programme (BCSP)

Methods
All invitees from 2009-2016 were included in the study and with a follow-up by the Screening Coordination Centre according to the European Guidelines. Specific software was developed for the BCSP and able to be linked to medical records and cancer registries. Variables included: age at invitation, sex, type of participant (initial, regular, and irregular), TNM stage, and location (C-18.0-C-20.0), FIT threshold. Sensitivity Specificity and LR ratios were performed throughout all the period for FIT test. SPSS 23.0

Results
1,386,538 valid invitations were registered between 2009 and 2016. With a high participation rate (69.3%) and a total of 926,379 FIT negatives (94.1%). 444 CI_FIT were found before the next invitation to FIT. Most in men 60.7% (n = 278), higher on the oldest age group (60-69 years of age). 33.4% where found on regular participants on the screening. 82.1% of IC_FIT in previous rounds the FIT threshold was &lt;10µHb/ g. Most of the IC_FIT 54.1% found on advanced Stage of the tumor, and located on the right colon (44.4%), but ringing a bell the 30.4% located on Rectum. The cumulative incidence for IC-FIT was 3.52 (IC95% 3.21-3.87) x 10,000 negative cases. Sensitivity for FIT was lower in women than men (87.7; CI 95% 85.8-89.4 vs 88.9%; CI95% 87.6-90.1) but not significant. Cumulative incidence for IC-FIT is significantly higher in men than women

Conclusions
The BSCP in the Basque Country shows a low incidence of Interval Cancer due to FIT. However, right colon and rectum location must be taken into account in further studies, in order to decrease the IC_FIT

Key messages
Participation on a BSCP is essential to decrease Incidence and mortality despite the IC_FIT (false negatives of the test). Most of the persons (82.1%) of IC_FIT group in the previous round of participation, the FIT threshold was very low.
Analysis of population-based and worksite cancer screening in Japan
Authors: Takahashi H , Machii R , Nakayama T 
Published: October 2020

Abstract

Background
In some European countries, cancer screening is conducted and evaluated by the nation. In Japan, about half of cancer screenings are conducted by the government or local governments, while the other half is in a worksite, conducted by business owners and insurers as part of a welfare program. The Ministry of Health, Labor and Welfare (MHLW) have prepared guidelines for cancer screening in worksite and provided specific recommendation methods to practitioners. For an understanding of its use does not progress, it is necessary to identify problems.

Methods
A research group, organized by the MHLW grant, surveyed 20 major insurers in Japan about the guidelines for cancer screening in worksite. The contents of the questionnaire are related to the establishment of a system with a view to organizing screening, and consist of a total of 45 items. Answers to these questions were obtained in the following format. (1. Yes, 2. No, 3. Can't answer, 4. Can't understand the meaning of the question)

Results
Around 30% of insurers were able to answer all items, but 70% were not able to answer any items. Approximately 10% of the respondents answered that they had implemented the items in the guidelines, while 70% did not, and 20% can't answer or can't understand the meaning of the question. The reasons for not being able to answer were that the terms were difficult to understand, there was no need to grasp the data of cancer screening, and there was a legal problem and personal information could not be obtained.

Conclusions
This suggests that employers and insurers differ in their understanding of cancer screening, resulting in various implementations and evaluations. In order to establish organized screening in the whole country, it is necessary to develop a system that can also evaluate data, such as cancer screenings and health check conducted in worksite. It is also important to improve the literacy of cancer screening practitioners.

Key messages
Integrating cancer screening across the country. Improving the literacy of cancer screening practitioners.
Smoking while using contraceptives: Risk perception and behavioral intention to quit
Authors: Van Der Heijde C M , Hilverda F , Vonk P 
Published: October 2020

Abstract

Background
Combining smoking with contraceptives containing ethinylestradiol increases the risk at several health issues, such as thrombosis, cardiovascular diseases and pulmonary embolism, especially when women are 35 years or older. It is important to inform women at an early stage and encourage them to quit smoking or change their contraceptive. The aim of this study is twofold. 1) using the Protection Motivation theory, we examine the predictors of the intention to quit smoking or change the currently used contraceptive method. 2) we provide insight into women's preferred ways to be informed and possible facilitators to change their behavior.

Methods
68 Women, between 25 and 60 (mean age 30.6, sd 6.6; academic degree 78%), using the combination of smoking and ethinylestradiol containing contraceptives of a General Practice in Amsterdam, The Netherlands, filled in a questionnaire. Predictors were cigarette dependence (cds-5), perceived severity, vulnerability, response efficacy and self-efficacy. Outcome variables: intention to quit smoking or the current contraceptive.

Results
The average intention to quit smoking was higher (3,26 on a 5-point scale) than the average intention to quit the contraceptive method (2,47 on a 5-point scale). The predictors vulnerability, education level and reason for contraceptive use significantly predicted the intention to quit smoking (F(3, 65) = 40.22, p = .03), while self-efficacy and education level significantly predicted the intention to quit the contraceptive method. (F(2, 66) = 32.36, p =.02)

Conclusions
Risk perception stimulates women to quit smoking, while perceiving oneself capable of quitting or having alternatives is related to contraceptive change. A second wave of data is collected to enlarge the sample size. We add a qualitative study to get insight into strategies to alter women's behavior. This study will inform risk communicators and health care professionals, ultimately resulting in less women with this combination.

Key messages
Quitting smoking is potentially popular in a group of women with the risky combination of smoking with contraceptives containing ethinylestradiol. Risk perception stimulates women to quit smoking, while perceiving oneself capable of quitting or having alternatives is related to contraceptive change.