bluuebunny/crossref_metadata_2025_split huggingface dataset:
A tool to identify potential primary care presentations in the hospital emergency department
Authors: Schütze H , Rees R , Asha S , Eagar K 
Published: October 2020

Abstract

Background
Access to primary care has an impact on health outcomes and is a significant public health issue. Limited access to primary care has seen non-urgent presentations to hospital emergency departments continue to rise globally. A lack of a universal workable definition of what a primary care presentation is has impeded national and international estimations of the true burden. Our aim was to develop a standardised code frame to identify potential primary care patients in the emergency department to allow accurate data estimations to be made, and help inform future interventions.

Methods
An audit of medical records was conducted in two major hospitals in Sydney, Australia. A code frame was developed, tested and applied retrospectively to five years of data.

Results
Of 601,168 presentations to the emergency department, 171,906 (29%) were deemed to be potential primary care presentations. The code frame had a sensitivity of 99.9% and a specificity of 49.0%.

Conclusions
This standardised code frame enables accurate retrospective local and national data estimations of the impact of primary care presentations in the emergency department, which was previously not available. The code frame could be used prospectively to evaluate interventions such as diverting patients to primary care settings, and to identify populations for specifically targeted interventions. The conservative nature of the code frame ensures that only those that can safely receive care in a primary care setting are identified as potential primary care.

Key messages
This robust tool will enable more accurate data estimations of primary care appropriate presentations in the emergency department, which can assist planning and policy efforts. It can be easily adapted to incorporate triage codes in international settings and provides a useful tool for comparing international trends.
Association between ward-transfers and hospital-acquired infection: a study using routine data
Authors: Boncea E , Expert P , Costelloe C 
Published: October 2020

Abstract
Ward-transfers have become more common as hospital staff balance patient needs with bed availability on specific wards. However, increased movement through the hospital may leave patients more vulnerable to potential infectious pathogen transmission routes via increased exposure to contaminated surfaces and more contacts with individuals. This may increase their risk of hospital-acquired infections (HAIs), an adverse event associated with greater antibiotic resistance, patient costs, morbidity, and mortality. This study aimed to quantify the association between the number of ward-transfers undergone during a hospital spell and the outcome of HAI. As elderly patients comprise a large proportion of hospital users and are a high-risk population for HAIs, analysis was focused on people over 65-years old.
A retrospective case-control study was undertaken using data extracted from electronic health records and microbiology cultures of non-elective medical admissions to a London hospital trust between January 2016 and December 2018 (n = 24,439). Logistic regression was used to obtain the odds ratio for developing a HAI as a function of the number of ward-transfers until onset of HAI for cases, or hospital discharge for controls, while controlling for covariates including length of stay, procedures and comorbidities. Each additional ward-transfer increased the odds of developing a HAI by 8% (OR 1.08; 95%CI:1.04-1.12).
The hospital is a complex environment, and interventions should be viewed in light of their impact on the system as a whole. These findings indicate that non-essential ward-transfers of elderly patients should be minimised. This may lower the incidence of infections in this population, potentially reduce the number of pathogen transmission routes in hospitals and alleviate staff burden incurred by ward-transfer associated procedures.

Key messages
We analysed 3 years of patient movement and microbiology data of elderly patients in a London hospital trust. Each ward-transfer increased the risk of developing a hospital-acquired infection by 8%. Reducing the number of non-essential ward-transfers patients undergo may lower the incidence of hospital-acquired infections; the decision to move a patient should therefore be carefully considered.
Potentially Preventable Hospitalizations for Chronic Conditions among Youth
Authors: Sentell T , Choi S Y , Ching L , Uchima O , Keliikoa L B , Irvin L , Pirkle C 
Published: October 2020

Abstract

Objective
Chronic, preventable conditions like diabetes and hypertension previously seen primarily in adults are increasing among young people. Chronic disease-related potentially preventable hospitalizations (PPH) are costly. The study goal was to quantify potentially preventable hospitalizations (PPH) for chronic disease in those aged 5-29 years in one diverse state of the USA.

Methods
With Hawai'i statewide inpatient 2015-2016 data across all payers, we used standard metrics to capture asthma, diabetes, and hypertension PPH. Denominators were obtained by age group, gender, race/ethnicity, and living in O'ahu vs. other Hawaiian Islands from American Community Survey data. A multivariable negative binomial regression model predicted having a PPH adjusting for age group, gender, race/ethnicity, and O'ahu residency.

Results
Six percent (775) of inpatient hospitalizations among young people, representing 455 unique individuals, were PPH for a chronic disease. The types of PPH inpatient hospitalizations include diabetes (436), asthma (261), heart disease (64) and hypertension (14). The number of PPH visits per individual ranged from 1-20 with a mean of 1.7 (SD: 2.28) visits. The total cost of these PPH during this 2-year time period was $16,762,262. Among unique individuals with a chronic disease PPH (N = 455), the mean age was 17.5 (SD: 8.2); 55% were male. In the multivariable model, those who were between 10-14 years (RR:0.47;0.32-0.69) and 15-19 years (RR:0.46;0.31-0.69) were significantly less likely to have a PPH compared to those aged 5-9 years. Other Pacific Islanders were significantly more likely to have a PPH (RR: 3.08; 2.05-4.63) compared to whites.

Conclusions
Many hospitalizations by those aged 5-29 years were PPH. Pacific Islander youth had PPH chronic disease disparities. Chronic disease prevention and management is critical. Solutions may include equitable chronic disease prevention policies and improving access to culturally relevant care.

Key messages
This study reveals important disparities in youth that may lead to future health risks as well as current poor outcomes.
Other Pacific Islanders were at significantly increased risk for PPH for chronic disease compared to other racial/ethnic groups from early childhood to young adulthood.
Using human-centered design to improve the quality of vaccine communication
Authors: Rath B 
Published: October 2020

Abstract
In recent years, one-on-one vaccine communication has become more important that ever. Research has shown that an intact parent-paediatrician relationship is the most important predictor for positive attitudes toward immunisation. Yet, much of the discussion around the benefits of vaccines and the risk of vaccine preventable diseases has also moved online. New communication channels and discussion fora are evolving rapidly, and their use may differ significantly among different sociodemographic groups.
These recent developments have implications for the work of policy makers. Public health messaging will need to be tailored to different subsectors of the population, such as those primarily interested in maternal-infant care, adolescent health, or travel medicine. Mobile applications, telemedicine, video blogs, and other digital fora provide room for science-informed vaccine communication extending beyond the brief conversations at the doctor's office. Each mode of communication may have its own impact, but pediatricians will need to get involved in bridging the communication gap between policy makers and public health agencies on one hand, and children and families on the other.
We will discuss the results of recent projects undertaken by the Vienna Vaccine Safety Initiative using the innovation technique of Design Thinking to move the experience of children and their caretakers back into the center of the conversation. We will provide practical examples of human-centered design i) to improve the understanding of individual-level disease severity in flu patients, ii) to empower parents to keep the vaccination records in their family up-to-date, iii) to improve safety reporting at the point of care, and iv) to enable migrant populations to report missed immunizations and other health needs. We will invite active discussion with the audience while providing critical analysis of lessons learnt and implications for health policy and future research.
Why should gender-sensitive health reports be intersectional?
Authors: Merz S , Jaehn P , Mena E , Pöge K , Strasser S , Saß A C , Rommel A , Bolte G , Holmberg C 
Published: October 2020

Abstract

Background
A key focus of both epidemiology and PHMR is the identification of health inequity between population groups and its determinants. However, scholars in the social sciences have criticised prevalent approaches of describing health differences according to single social categories like sex/gender or race/ethnicity, glossing over significant heterogeneity within and relations between presumed population groups. Applying these critiques to the field of PHMR, we would argue that intersectionality scholarship offers vital impulses for the study of health inequity by focusing on several, interrelated social categories and emphasising the structural determinants affecting unique population subgroups differently.

Methods
We mapped existing approaches to describing population differences in health. We also conducted a literature review on intersectionality scholarship in public health and then synthesised results to develop a conceptual framework for deploying intersectionality to epidemiology and PHMR.

Findings
We identified four key principles through which the reporting on subgroup differences could be strengthened: addressing the internal heterogeneity of population groups; contextualising inequities and focusing on societal power relations rather than individual characteristics; deploying novel multivariable modelling approaches in data analysis; and aiming towards the empowerment of population groups rather than deploying deficit-oriented and paternalistic models.

Discussion
To be discussed are the unique contributions of intersectionality to PHMR compared to other approaches, for example from social epidemiology or medical anthropology.
Integration of refugees: the interactive dynamics of health, education and employment
Authors: Jervelund S 
Published: October 2020

Abstract

Background
Host countries have a great interest in the integration of refugees to decrease spending on social welfare services, increase social coherence and secure the labour force and economic growth. While recent political trends in the Nordic countries have been focusing on “employability” as a key to integration, the outcomes from education and employment on health has been less considered. The presentation sets the scene for the Nordic comparative research on refugee children and youth and motivates the focus on the interrelatedness of health, education and employment

Methods
The presentation will draw on existing theories and empirical literature as well as CAGE findings from comparative quantitative analysis of register data and qualitative studies based on interviews and observations.

Results
Socio-economic conditions impact health through many interrelated pathways, including risk and protecting factors in both the country of birth and in the host country, as well as age at migration. But poor health may also impair education and entry into the labor market, which is particularly relevant for the refugee population. Using a life course framework, the introduction will shed light on this interrelatedness reflected in the evidence from CAGE. Since varying welfare policies may shape the integration and life chances of young refugees in the Nordic countries differently, the gain of investigating this interrelatedness through Nordic comparisons will be underscored.

Conclusions
Welfare policies related to refugees need to take into account the interrelations between inclusive health care, successful education and entrance into the labour markets. Adapted educational programmes to catch-up with the majority population, training of integration officers at the local level and diversity competent health services may explain successful integration and give young refugees better life chances in exile.
Using social network analysis to analyze obesity and other public health issues related to food consumption
Authors: Casacuberta D 
Published: October 2020

Abstract
Digital social networks, such as Instagram, Facebook or Twitter are both repositories of cultural tendencies and common social interests, as well as devices to expand and extend such tendencies among the general population. A relevant number of such cultural tendencies do have an impact in public health. In this talk we will focus on one of the such common cultural tendencies: food consumption. People like to share recipes, new diets, pictures or what they are eating, and so on. Thanks to geolocalization, it is relatively easy to find out the geographical origins or such entries and posts, and see how a food consumption tendency is distributed around the world. Understanding how such digital entries are copied and distributed or “liked” by other users can help us to both see how a tendency generates and how it spreads, as well as its global and local acceptance by users. During the talk we will analyze how data obtained from such digital social networks, specially Twitter, Facebook and Instagram, are being used to analyze patterns of food consumption that can become public health problems, associated with obesity, anorexia, unhealthy diets, etc. We will focus on the epistemic innovations associated with these investigations, analyzing the strengths and weaknesses that have machine-based approaches versus more qualitative analyzes, and assess the epistemic reliability of those approaches.
Environment and health as a driver of transformation
Authors: Jevtic M , Bouland C 
Published: October 2020

Abstract
As technology progresses, social inequality grows, the gap widens, and the environment continues to suffer. Furthermore, the social environment in societies is “ruffled” and does not appear to be constructive toward well-being. New inequalities are emerging in the availability of technology, climate change, education. The achievement reports on the Sustainable Development Goals (SDGs), also point out to the need of reviewing individual indicators.
The UN Human Development Report estimates that children in highly developed countries have a 55% chance of obtaining high education, as opposed to children born in underdeveloped countries where only 3% of them have a chance of high education. In underdeveloped countries, according to the UN data, 17% of them die by the age of 20, while in developed countries this is 1%. The gap in the opportunities of young people in different living environments is quite pronounced nowadays. If this process does not get stopped, it can be irreversible.
The directions of transformation necessary to achieve the SDGs, while respecting the principles of equality, quality of life preservation and improvement, are divided into six groups. Transformations should aim at: an educated workforce, an innovative economy, gender equality and social protection, health and wellbeing for all, universal health care and support for healthy lifestyles. Transformation is also a prerequisite for: climate neutrality, circular economy, decarbonisation, renewable energy and industrial development. Sustainable agriculture and food production, conservation and restoration of natural resources, as well as sustainable, green urban environments and support for small communities also require radical changes. An indispensable factor for transformation is that both digital and modern technologies align with sustainable development, respecting human rights privacy and social inclusion.
A more comprehensive approach offering instruments in one portal to facilitate higher uptake
Authors: Rossmann C , De Bock F 
Published: October 2020

Abstract
The good practice portal of the Federal Centre for Health Education (BZgA) consists of a nationwide collection of projects and interventions to promote the health of socially disadvantaged groups at community/setting level. An exchange platform (inforo) is also offered via the operating agency, although its use is still limited. The results of the evaluation of the platform suggest that the provision of practical projects and exchange of knowledge alone is not sufficient to support policy makers and practitioners who want to promote health in the community/setting.
There is a need for advice on needs assessment, selection and appropriate implementation of health promotion measures. A comprehensive approach currently being tested in the field of activity promotion for older people is the provision of a web-based “toolbox” comprising the following tools: assessment instruments for analysing the need for health promotion measures, a user-friendly intervention/project database and broader evidence synthesis documents, as well as information on project management (organisational, legal, financial).
Following the example of other best practice portals, a ranking methodology was developed to make the level of effectiveness of interventions visible and the evaluation requirements transparent. Evidence synthesis documents provide an entry point to learn more generally what works in a particular area of health promotion. In order to make the “toolbox” accessible to policy-makers and practitioners, information from previous studies was used in the development with regard to content and graphical presentation.
BZgA is currently working on integrating evidence into the good practice portal. The evaluation of the toolbox in a small area of health promotion will provide initial insights into the inclusion of evidence and its added value. This presentation will conclude with a discussion of possibilities for improvement, challenges and limitations of this approach.
The added value of European collaboration to improve the uptake of best practices
Authors: Maassen A , Sostongs C 
Published: October 2020

Abstract
In 2019, members of the EuroHealthNet Partnership established the first Thematic Working Group on Health Promotion and Disease Prevention Programme Registers with the intention of becoming 'the competence engine for Programme Registers in Europe.' The group's objectives include to exchange experience, to initiate joint projects, to identify and further develop common topics relevant to Programme Registers, and to share findings in scientific papers and international conferences. Through such activities, the group builds the foundation for a more systematic and scientific European approach to translating evidence into practice and provides a forum for liaison and exchange between EU Member States, the European Commission, and international partners.
Programme registers are only as relevant as they are influential in professionals' and policy makers' decision-making around intervention selection. Facilitating uptake of best practices requires an understanding of incentives, disincentives and decision-making processes, as well as how to make the programme registers more prominent and user-friendly. Outcomes from the 2020 Working Group meeting in Cologne will be presented, including case studies from across Europe, as well as recommendations to improve the uptake of best practices, tailored to portals at different stages of development.
Feasibility and acceptability in health centers of screening for chlamydia in deprived population
Authors: Lobertreau E , Goethals L , Oriol M , Vincent I , Amsallem E 
Published: October 2020

Abstract

Issue
The French Health Insurance (FHI) is in charge of the governance of 100 Health Examination Centers (HEC). HEC provide evidence-based interventions in prevention, focused on deprived population. In France, Chlamydia trachomatis (Ct) infection is the most sexually transmitted infection, especially among young women.

Description of the problem
To assess the feasibility of systematic screening Ct infection, in HEC, among 18-25 years women and 18-30 years men, with a focus on self-sampling. Pragmatics questions were: how the youth accept the screening of Ct infection (especially the self-taken vaginal swabs)? Was the feasibility and Ct positivity similar between deprived and non-deprived population (according to the EPICES score)? A cross-sectional multicenter survey was performed in 13 HEC in January 2018.

Results
Screening was proposed to 1702 eligible young people (sexually active and no recent Ct treatment). 90.3% [88.8-91.6] accepted and participated: 44% women, 54% deprived people. Among women, 76.8% [73.4-79.9] used self-taken vaginal swabs, others urinary tests. Rates did not differ according to deprivation (p = 0.96). Screening was performed in 1487 people (96.7% for deprived vs 97.7% for non-deprived population, p = 0.258). Ct detection rate was 4.7% [3.7%-5.9%], significantly higher for deprived population (6.5% vs 2.5%, p &lt; 0.001).

Lessons
The results demonstrated the feasibility of Ct screening in HEC with a good acceptance among youth even among young deprived. The performance rate of the test was similar according to deprivation. However, deprivation was associated with having a positive Ct result. This feasibility led to the implementation of Ct screening in all HEC.

Key messages
Chlamydia trachomatis screening can be easily implemented even in deprived populations that accept and perform it as well as non-deprived populations. Promoting access to Chlamydia trachomatis screening to deprived populations might contribute to reduce social inequalities in health.