bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Gradients in Alcohol Use Disorders with and without Depression: Immigrants vs Norwegians
Authors: Leonhardt M , Shawel Abebe D 
Published: November 2019

Abstract

Background
The social gradient in health runs from top to bottom of the socioeconomic spectrum. Poverty is associated with poor health and problematic unhealthy behaviors. Depression is strongly associated with social inequalities, while alcohol use disorders are not necessarily associated with a low socio economic status. Immigrants often have a lower social economic status than the host population. Research regarding alcohol use disorders, depression and a social gradient among immigrants is scare. The present study explores social gradients in persons with alcohol use disorders with and without depression and examines potential discrepancies between immigrant and native Norwegian patients receiving public specialist health care.

Methods
Data of 2.4 million native Norwegians and 468.496 immigrants, registered in the national mandatory Norwegian Patient Register and population data from Statistics Norway were analyzed. ICD 10 main diagnoses were used to identify patient groups - at least diagnosed once during 2008 - 2016. Immigrants had been pooled into 5 world regions. Logistic regression models have been applied to show associations between socio demographics/regions and alcohol use disorders and/or depression.

Results
African (OR = 0.35; 95%CI:0.27-0.44) and Asian (OR = 0.23; 95%CI:0.16-0.32) immigrants had a lower risk of developing alcohol use disorders with depression than Western Europeans (OR = 0.76; 95% CI:0.60-0.98), using native Norwegians as a reference. In general, persons with a lower socioeconomic status are more often affected of alcohol use disorder only (OR = 3.77; 95%CI:3.64-3.91) than with alcohol use disorder and concurrent depression (OR = 3.52; 95%CI:3.25-3.83).

Conclusions
To detect possible deficits in patient care, knowledge of social gradients in a marginalized group such as persons with alcohol use disorders and/or depression is essential. This may contribute to targeted and individualized health care- regardless of immigrant status.

Key messages
The risk of developing alcohol use disorders with depression varies between immigrants according to their origin. Persons with a lower socioeconomic status are more often affected of alcohol use disorder only than with alcohol use disorder and concurrent depression.
Sustained virological response to Do hepatitis C DAA treatments in migrants and non-migrants groups
Authors: Djaogol T , Fontaine H , Baudoin M , Protopopescu C , Marcellin F , Dorival C , Bourlière M , Delarocque-Astagneau E , Carrat F , Carrieri P 
Published: November 2019

Abstract

Background
Although the efficacy of direct acting antivirals (DAA) against hepatitis C (HCV) has been widely proven, data lack on their effectiveness in the most vulnerable groups. In France, despite universal health coverage, migrants cumulate vulnerabilities including delays in screening that may affect both access to care and treatment effectiveness. We tested whether DAA-treated migrants had sustained virological response (SVR) rates comparable to not-migrants.

Methods
We used data collected in chronic HCV-infected patients of the ANRS CO22 HEPATHER cohort, receiving a first treatment with DAA, with follow-up from 2012 until 2022. SVR was measured by PCR, 12 weeks after the end of treatment. The main covariate was a 4-category variable comparing migrants and non-migrants, with or without other vulnerability conditions (including drug use, unhealthy alcohol use, living in poverty, being a man who have sex with men). We used a Poisson regression model to assess the relationship between this covariate and SVR after adjustment for significant predictors and potential confounders.

Results
The analysis included 5,080 individuals, of which 17% classified as migrants with at least one vulnerability, 10% as migrants with no vulnerability, 39% as non-migrants with at least one vulnerability and 35% as non-migrants with no vulnerability. Median [IQR] age was 57 [51-65] years, 56% of individuals were men, and 96% had SVR. The multivariable analysis showed no significant difference between the 4-category covariate and SVR. In addition, we found that SVR rates increased steadily during follow-up.

Conclusions
This is the first analysis exploring differences in SVR rates among migrants and not-migrants. The lack of significant differences found despite the power of the study suggests that migrants respond to DAA treatment as well as any other group of HCV-infected patients. These data can help advocating better screening and access to treatment for HCV-infected migrants in France.

Key messages
No significant differences were observed between migrants and non-migrants in terms of effectiveness of DAA treatment. These findings can help improving access to HCV care for migrants.
Health and behavioral changes among international students at the University of Georgia
Authors: Lobjanidze M , Rada-Fernandez de Jauregui D , Kvanchakhadze R 
Published: November 2019

Abstract

Background
During last decade the number of international students is rising not only in developed, but in developing countries. In this matter, Georgia is not an exception. In 2006-2016, country enrolled more than 13 000 International students in 127 English language programs in 33 Higher Education Institutions. Study aimed to investigate health and lifestyle changes among international students of one of the largest universities of Georgia.

Methods
A cross-sectional survey was carried out in 2018 by web-based anonymous questionnaires among international and local students at the school of health sciences (UoG). Data was obtained on self reported physical health conditions, dietary patterns, physical Activity, sleep, study routine, smoking, alcohol and drug consumption, sexual life and stress factors.

Results
112 local and 50 international students of UoG from more than 10 countries participated in online survey. 77% of local and 37% of international participants were female. Students reported health problems related to digestion (43% local, 23% int), musculoskeletal system (20% local, 33% int), sleep (62% local, 43% int ), skin, hair and nail (29% local -28% int) after attending university. 22% of international students reported to start smoking after coming to Georgia and 50% evaluated own stress level as 7 out of 10 point scale. Moderate positive correlation was found between stress and health problems among international students (r = 0.447, p = 0.005). As a main stress factors international students indicated study routine, homesickness, sleep and financial difficulties.

Conclusions
Survey results indicate that social and physical environment changes as well as busy time schedule can be led to different health problems, and lifestyle changes among international students of UoG. Hence, health promotion campaigns, even among students of health sciences might play supportive role.

Key messages
22% of international students of UoG reported to start smoking after coming to Georgia and 50% evaluated own stress level as 7 out of 10. There is a need of health promotion campaigns, even among students of health sciences.
Combined sexual prevention targeted to LGBTI+ migrants: between ’outdoor’ and ’indoor’ hospial
Authors: Bouchet-Mayer C , Sow A , Kouadio-Sankadio C-P , Peltier A , Héteau F , Legrais F , Shelly M 
Published: November 2019

Abstract

Issue
It is estimated that there are about 10,000 HIV-positive and undiagnosed people in Île-de-France (French region). They are composed of 70% men, 40% of whom are MSM and 40% of sub-Saharan African migrants. A bridging process has been designed by the Public Health association AREMEDIA and developed in partnership with Fernand-Widal Hospital’s testing center, to reach underserved populations. From March 2018, a screening test session for sexually transmitted infections (STIs) is taking place weekly in the hospital walls. This action is dedicated to the population of ARDHIS association, which accompanies more than 1,000 people each year, seeking asylum because of their sexual orientation or gender identity.

Description of the problem
Despite the promotion of this ’indoor’ targeted consultation via ARDHIS volunteers and directly to asylum seekers during occasional community events, the consultation only allowed the screening of 23 people in 4 months. It has been decided to carry out screening ’outside the hospitals walls’, where the people are, in order to promote the return of results, treatment, access to PrEP, HBV vaccination at the weekly indoor hospital consultation. “Community health relays” training together with the development of phone contact procedures were developed to facilitate the access to the indoor consultation.

Results
The methodology made it possible to double the average number of consultations over the following 5 months from 5 to 10 consultations per 3-hour slot, not counting PrEP appointments and vaccines, which averaged 6 per session. By the end of 2018, 261 people were screened, 23 had a PrEP treatment and many were vaccinated. As the scheme continues to develop, the results from January to July 2019 will be reported.

Leçons
To reach the most at risk populations, specific public health approaches are needed, taking account the context and representations of the target populations. Community involvement has proven to be effective.

Key messages
To fight HIV, innovative devices are needed to reach targeted populations. This has allowed hundreds of LGBTI asylum seekers to be screened and a significant number to receive preventive treatment.
The way towards Migrant Sensitive Occupational Health Care System
Authors: Szilárd I , Marek E , Jaksa C , Katz Z 
Published: November 2019

Abstract

Background
The European Union (EU) is facing to the demographic challenge of the ageing society on the one hand and a growing influx of migrants on the other hand. Although since 2008 WHO repeatedly called member states for developing ’migrant sensitive’ health care system, still there is a significant shortage in education programs, aiming to build the required human capacity in general, and on the field of occupational health, no any initiative could be observed aiming to empower the service providers with the additional knowledge and skills for facilitating the safe integration of the migrant workforce into the EU’s economy.

Objectives
University of Pécs Medical School (UPMS) has integrated migrant and ethnic minority health - as a new overarching topic - in its optional and/ or regular training program. Occupational health and migration belongs to the compulsory part of the education.

Results
Each study year more than two hundreds Hungarian, English and German speaking medical students meet at least at a ’sensitization’ level the migrant specific aspects of occupational health. In order to improve and - in the need - even extend our program on this field, we have launched a ’quick response’ questionnaire research among the students, asking for their opinion, how they see the importance and necessity of this topic within the frame of their medical training. 67 % of the 2012 students highly and/ or mostly agreed with our initiative and 87 % founded the topic very relevant. The majority of the students have expressed that the training has changed their views.

Conclusions
The endowers of UPMS, as a WHO Collaborating Centre on the field of migration heath training and research are in accordance with WHO newly adopted ’Strategy and action plan for refugee and migrant health and achieves every year several hundreds of medical students who are already ’sensitized’ towards the health of migrants.

Key messages
EU economy needs migrant sensitive health workforce ont he field of occupational health. Medical studens understood the need for migration health training.
eHealth Literacy and Fertility – managing complex information in a digital environment
Authors: Sykes S , Wills J 
Published: November 2019

Abstract

Background
There is increasing reliance on the internet as a source of health information including for those seeking information about fertility. This study investigates how people access, understand and process online fertility information and engage with digital services.

Methods
Purposive sampling was used to recruit 27 participants from a range of groups including those diagnosed with infertility, those who successfully conceived after a period of infertility, same sex couples, those over 40 and younger people making decisions about delaying parenthood. Semi structured telephone interviews explored information seeking behaviour and ehealth literacy competencies. Data were analysed using thematic analysis.

Results
Digital platforms were identified as a primary source of information but presented barriers including gaps in content, and concerns about relevancy and complexity. Source credibility was a priority alongside a recognition that emotional drivers led to the active seeking of specific information. Participants described a journey from general information to specific, detailed and tailored content. Participants moved between conversational forums on social media sites and information based internet platforms as part of an ongoing process of identifying and understanding information. However, participants were typically purveyors of information in their real world relationships. Information was used to prepare for and understand interactions with health professionals.

Conclusions
Sources of digital information need to respond to the ehealth literacy competencies of users. Users go beyond the passive accessing of information through digital platforms and are actively engaged as contributors of information through social media and app based technology. The value placed on other people in accessing and understanding fertility information, through online forums and virtual communities, shows the importance and complexity of distributed health literacy.

Key messages
Digital platforms are a key source of information around fertility. Interaction with digital platforms is complex and requires the digital environment to respond to their ehealth literacy needs.
Artificial Intelligence-based tools to control healthcare associated infections: where do we stand
Authors: Scardoni A , Balzarini F , Cabitza F , Odone A 
Published: November 2019

Abstract

Background
Control of Healthcare associated infections (HAI) is a key public health concern in Europe. Current HAI surveillance systems are based on manual medical records review, vulnerable to misclassification and expensive. Artificial intelligence (AI) offers great potential to public health action and, specifically, to HAI control. Still, scant evidence is available on both its practice and impact.

Methods
As part of a broader multidisciplinary project, we conducted a systematic review to retrieve, pool and critically apprize all the available evidence on practice, performance and impact of AI-based HAI control programmes. We followed PRISMA guidelines and searched the Medline and Embase databases for relevant studies. Included studies were stratified by HAI type and outcomes of interest, including all possible performance measures, clinical, organizational and economic outcomes.

Results
We screened 2873 records, resulting in 27 papers included in the review. Studies were carried out in 9 countries, the majority in the US (56%), 18.5% in EU countries, 25.9% published in 2018. Two thirds of studies focused on selected types of infections. Study designs were very diverse and performance observed for HAI detection were very heterogeneous, precluding pooled calculation of summary diagnostic accuracy estimates in most instances, but generally higher than non AI-based models. The highest performance outcomes were Specificity and Negative Predictive Value. Overall performance measures of AI algorithms were: sensitivity range 19%-92%, specificity range 64%-96%, accuracy 70.2%-96.1%.

Conclusions
Use of AI algorithms for HAI surveillance of HAI has increased reliability compared to traditional surveillance or to automated surveillance models. With ongoing improvements in information technology, implementation of AI models will improve the quality and capacity of surveillance will support hospital HAI surveillance.

Key messages
Artificial Intelligence (AI) offer great potential to healthcare associated infections (HAI) control. Preliminary evidence show AI-based models have perform better than manual or automated models for HAIs detection.
Social capital and social networks
Authors: Corvo E , De Caro W 
Published: November 2019

Abstract

Introduction
Social capital can be defined as the ’sum of the resources, actual or virtual, that accrue to an individual or a group by virtue of possessing a durable network of networks or less institutionalized relationships of mutual acquaintance and recognition’. Nowadays there are a number of new way to have social relationship. Developing community and individual social capital is an important aspect for health promotion in order to decrease social isolation and health inequalities.

Methods
This research aims to detect to what extend online social networks can help in building social capital and decrease social isolation. An analysis of the content of an open Facebook group of people who are experiencing chronic diseases was carried out (7912 individuals).

Results
Text mining analysis was carried out, as well as a content analysis in order to identify which kind of social support and social capital emerged among participants. Results based on text mining (234.943 words) and thematic analysis (information, relationship, support) show that even virtual social group have an important impact on participants’ wellbeing and health. Participants seems to develop through participation all construct of social capital i.e. bonding, bridging and linking social capital. There is an overall increase in confidence and sense of community. However, virtual communication seems lacking of a number of crucial aspect of human interaction such as face to face communication or physical contact.

Conclusions
The use of social network as a new place of aggregation and socialization is an important aspect to look at. Virtual networks can have a role in developing relationship and to build trustiness on individuals. Public Health and Health Promotion, as well as health care professionals should be aware and concern about social capital as a key aspect of health and explore in depth the role of new social networks as a new way to build social capital and health of individuals and communities.

Key messages
Text mining as new useful tools for health research. Social capital and social network intersection.
Factors associated with activity limitation: are the risk patterns the same across Europe?
Authors: Von Der Lippe E , Baumert J 
Published: November 2019

Abstract

Background
The Global Activity Limitation Indicator (GALI) is part of the Minimum European Health Module and has been shown to be a valid indicator of functional limitations. The present study aims to identify determinants of GALI prevalence among adults in Europe.

Methods
We used data from the European Health Interview Survey (EHIS) Wave 2 which included adults aged 15 years and older and was conducted between 2013 and 2015 in all European Union member states. We examined patterns regarding age, sex, education and chronic diseases. After excluding some inconsistencies in the data the sample size was 284,732 respondents from 26 countries.
When making comparisons across countries one has to bear in mind that the data was collected through different modes, the indicators were obtained through various instruments and in some countries interviews were conducted not always with the target person, but with a proxy person.

Results
Our findings revealed that age and education are very strong determinants of functional limitation in all countries. Sex showed to be mostly non-significantly associated, however in some Eastern and Southern countries it plays a significant role. The additional factors examined showed less consistent picture. While chronic diseases with stronger disease burden were associated with higher limitation, diseases that are well treatable (like high blood pressure) showed in some countries strong associations with functional limitation while in others there was no clear relationship.

Conclusions
Having in mind the aging of the population, the problem with the functional limitation in higher ages will increase furthermore. This is an issue which should be taken into account in health promotion policies. The role of chronic diseases and their association with disability cannot be neglected. Prevention policies should put more effort in identifying earlier the vulnerable population (e.g. less educated) and promote health care initiatives.

Key messages
Age and education are strong determinants of functional limitation across all European countries. Sex showed inconsistent patterns. Functional limitation is in general strongly associated with chronic disease. However, differences in Europe were found with regard to some specific conditions.
Use of personal protective equipment among farmers in Nebraska, Lithuania, Latvia, and Slovenia
Authors: Achutan C , Girdžiūtė L , Vasiliauskas G , Kampuss K , Starič J , Rautiainen R 
Published: November 2019

Abstract

Background
Farmers in the U.S. and in Europe are at a high risk for injury and illness. Farmers have an increased risk of respiratory disease, noise-induced hearing loss, skin disorders, and eye injuries. Many of these health risks can be prevented or reduced through proper use of personal protective equipment (PPE). However, studies show low compliance of PPE use among farmers. The purpose of this study was to identify barriers to wearing PPE, and current health and safety training as potential targets for future intervention, in farmers in Nebraska, Lithuania, Latvia, and Slovenia. The European Cooperation in Science and Technology and the Central States Center for Agricultural Safety and Health collaborated on this study.

Methods
We administered a 7-item questionnaire to 57 farmers in Nebraska (n = 10), Lithuania (n = 22), Latvia (n = 10) and Slovenia (n = 15). The farmers primarily grew crops (corn, soy) and some raised livestock.

Results
We found that gloves, respirators, and safety glasses were the PPE most commonly worn; use of face shields were only reported in Nebraska and Lithuania. Only 45% reported wearing PPE always when they needed them. In Nebraska and Latvia, most farmers reported not wearing PPE because they are not readily available although they have them on the farm; in Lithuania and Slovenia, farmers cited time to don PPE and discomfort as primary reasons. The percentage of farmers who reported receiving training on the selection, use, and maintenance of PPE varied widely-13% in Nebraska, 14% in Lithuania, 40% in Latvia, and 67% in Slovenia. Farmers purchased PPE over the internet, supermarkets, and agricultural cooperatives.

Conclusions
This study provided an opportunity to understand current perceptions of PPE use and challenges, among a cross section of farmers in the U.S. and Europe. We recommend enhancing training through creative modules to address the needs of farmers.

Key messages
By identifying why farmers do not always wear PPE, we can design effective interventions to overcome this barrier; by knowing where they purchase them, we can provide education at these venues. This study is a joint collaboration between U.S. and European researchers. This global cooperation has highlighted some similarities but also differences within European countries.