bluuebunny/crossref_metadata_2025_split huggingface dataset:
A methodology for monitoring population health literacy in Europe – the HLS19 project
Authors: Pelikan J , Nowak P , Bobek J 
Published: November 2019

Abstract
Health literacy (HL) matters for health of people and for use and results of health care. Therefore knowledge on HL is relevant for evidence based health policy. But there is evidence on considerable variation of distributions and associations of HL between European countries. Furthermore HL is impacted by health promotion and health care policy interventions. Therefore it makes sense to monitor HL in each European country on a regular basis in a standardized form that allows for benchmarking between countries. A first European Health Literacy Survey (HLS-EU) in 2011 in eight member states supported by the European Commission introduced measurement of population HL in Europe. Based on the results of this survey WHO-Europés “The Solid Facts - Health Literacy” (2013) recommended institutionalized regular measurement and monitoring of HL.
To implement this recommendation in 2017 the Action Network on Measuring Population and Organizational Health Literacy (M-POHL) was initiated under the umbrella of the European Health Information Initiative (EHII) by WHO-Europe, with already 25 countries participating. From its beginning M-POHL combined a policy with a research agenda and developed a documents on it vision and mission: The Vienna Statement on the measurement of population and organizational health literacy in Europe (2018).
As a first project the European Health Literacy Survey 2019 (HLS19) has been planned and implemented. Based on the comprehensive concept and definition of population HL and the design and questionnaire of the HLS-EU study a common study design and a further developed instrument has been developed by representatives of 15 participating countries. Most import measurement of digital HL has been included into the HLS19 study and a new short form HLS-Q12 of the HLS-EU47 has been constructed. The presentation will give an overview on the research questions, the design and the instruments, the pretesting and the data collection of HLS19.
ED visits and hospital admissions of foreigners for psychiatric disorders in Rome from 2007 to 2018
Authors: Nardi A , Migliara G , Angelozzi A , Caminada S , Giffi M , Isonne C , Pirro F A , Bertazzoni G , Villari P , Vito C De 
Published: November 2019

Abstract

Background
First generation immigrants are at high risk of psychiatric disorders (PD). Moreover, cultural and migration related factors can act as barriers in the access to care. The aim of this study was to analyze the emergency department (ED) visits and the subsequent admissions to Umberto I, a large teaching hospital in Rome, for PD from 2007 to 2018 and to highlight the differences between Italian citizens and foreigners.

Methods
Adult patients were divided in 11 Nationality Groups (NGs). Basing on ICD9 codes, PD were classified in 5 categories: psychotic, mood, anxiety, personality and substance abuse disorders. Descriptive statistics were conducted for gender, age, educational level and triage. Poisson regression models, adjusted for sociodemographic variables, were used to estimate incidence rate ratios (IRRs) of different NGs, both for visits and hospital admissions, for the five psychiatric categories and for PD as a whole.

Results
In the period of interest there were 11,965 ED visits for PD, of which 19.2% made by foreigners. Compared to Italians, all NGs showed higher percentages of ED visits for PDs, except for Southern Asian (SA) and East-Southern east Asian (ESA); SA and ESA, together with Other Africa population, showed also higher proportion of psychosis. Regarding admissions, ESA had the highest percentage overall, while more than half of foreigner nationality groups had higher percentages of admissions for psychosis than Italians. Poisson regressions showed that only EU citizens have greater risk of ED visit (IRR 1.69, IC95% 1.46-1.96) and of hospital admission for PD (IRR 1.23, IC95% 1.02-1.49) than Italians, while Romanians, SA and ESA have lower risk.

Conclusions
Different risk in ED visits for PDs among NGs can be due to heterogeneity in psychopathology, cultural factors, barriers, and migrant status. More studies are necessary to better understand the needs of foreigners and to enhance their mental health service use.

Key messages
The risk of ED visit and hospital admission for psychiatric disorders differ among foreign populations. Different study design are needed to understand which cultural and migration related factors influence the risks, in order to provide more tailored mental health services for high risk populations.
Risk of macrosomia and low birthweight among immigrants in Belgium, a perfect mirror?
Authors: Racape J , Sow M , Schoenborn C , Spiegelaere M De 
Published: November 2019

Abstract

Background
Both low birthweight (LBW) and macrosomia are associated with increased risk health conditions but risk factors of macrosomia among immigrant are understudied. One hypothesis is that some migrant groups at high risk for LBW have correspondingly low risk for macrosomia, and vice-versa. Our objective was to analyze LBW and macrosomia among immigrants according to naturalization, time since naturalization and socioeconomic status in Belgium.

Methods
The data came from the linkage between the Brussels birth and death registers, the national register of migrant trajectories and the social security register for the years 2004-2010. We used logistic regression to estimate the odds ratios of the associations between LBW and macrosomia according to maternal nationality and time since naturalization, taking into account socioeconomic status (SES), parity and maternal age.

Results
Data relate to all singleton births among Belgian, Maghrebi, Sub-Saharan African and Turkish women (n = 76 312). Compared to Belgians, we observed lower risk of LBW but higher risk of macrosomia among Maghrebi women (p &lt; 0.0001). Among Turkish and Sub-Saharan African mothers the risk of LBW is higher than the Belgian (p &lt; 0.001) but the risk of macrosomia is similar to Belgian mother. The results show a U-shaped increase of LBW and decrease of macrosomia with time since naturalization for all migrant groups. Results did not change after adjustment with maternal characteristics and SES. In parallel, we observe an improvement of SES among all migrant groups.

Conclusions
Our results show an increase of LBW rates and a decrease of macrosomia among Maghrebi, Sub-Saharan African and Turkish women with time since naturalization. The risk of macrosomia completely mirrors the risk of LBW for Maghrebi mother but not for Sub-Saharan African and Turkish women. Further studies would help to better explain risk factor and social determinants of macrosomia among immigrant.

Key messages
We observed an increase of LBW but a decrease of macrosomia with time since naturalization among immigrants. Patterns of macrosomia do not completely mirror those of LBW among different migrant groups.
The health situation of children and adolescents with migration background in Germany
Authors: Santos-Hövener C , Kuntz B , Frank L , Koschollek C , Ellert U , Hölling H , Thamm R , Schienkiewitz A , Lampert T 
Published: November 2019

Abstract

Introduction
Although more than one third of minors living in Germany have a migration background (MB), valid data on the health of this population are still lacking. The German Health Interview and Examination Survey for Children and Adolescents in Germany (KiGGS wave 2, 2014-2017) provides population-based data to make reliable statements on the health of adolescents with and without MB.

Methods
Survey data from KiGGS wave 2 are used to describe the general health status, mental health and the prevalence of allergic diseases in 3-to 17-year-old children and adolescents (n = 13,568). To determine overweight, body height and weight are measured (n = 3,463). In addition to MB (without/one-sided/two-sided), the socio-economic status (SES) and the length of stay of the parents in Germany are taken into account.

Results
Children and adolescents with two-sided MB show a physician-diagnosed atopic dermatitis (3.5%vs.6.9%) and attention deficit hyperactivity disorder (ADHD) (1.5%vs.5.1%) less frequently than their peers without MB, but more often a moderate or poor general health status (6.1%vs.3.9%). Adolescents with two-sided MB are also more often affected by overweight than those without MB (22.1%vs.12.2%). If only participants with MB are considered, their health situation is often associated with the SES and partly also with the length of stay of the parents.

Discussion
Health differences between children and adolescents with and without MB vary by the observed indicator. The heterogeneity of children and adolescents with MB, which can be partly determined by the SES or the length of stay of the parents, should be considered in target-group-specific interventions.

Main messages
The vast majority of children and adolescents in Germany grow up healthy and a MB is not per se associated with a poorer health status. Our results suggest that considering MB as the sole determinant of health to reflect the impact of migration on health is insufficient.

Key messages
Migration background is not per se associated with a poorer health status. Socioeconomic status and parents’ length of stay are derminants associated with poorer health outcomes among children and adolescents with migration background.
Cloud-computing and precision medicine: Big data offers big opportunities
Authors: April A 
Published: November 2019

Abstract
Research on large shared medical datasets and data-driven research are gaining fast momentum and provide major opportunities for improving health systems as well as individual care. Such Open Data can shed light on the causes of disease and effects of treatment including adverse reactions side-effects of treatments, while also facilitating analyses tailored to an individual’s characteristics, known as personalized or precision medicine. Precision medicine treatments will take personalization to the next level and be effective for individual patients based on their genomic, environmental, and lifestyle factors. High-throughput sequencing technologies and open databases have made precision medicine possible but up to now only large research centres could handle the large scale technology needed for its processing. Aside from issues such as user trust, data privacy, transparency over the control of data ownership, and the implications of data analytics for personal privacy with potentially intrusive inferences, recent advances by Berkeley using open source Big Data technologies and Cloud Computing Services has allowed precision medicine studies to be conducted by small and agile research labs and researchers around the world.
Association between legal status, prenatal care utilization, severe perinatal and maternal morbidity
Authors: Eslier M , Schmitz T , Luton D , Mandelbrot L , Estellat C , Azria E 
Published: November 2019

Abstract

Background
Some groups of migrant women have a higher risk of inadequate prenatal care utilization (PCU), severe maternal morbidity (SMM) and severe perinatal morbidity (SPM). To better understand this association, our aim was to assess the association between the legal status and PCU, SMM and SPM during pregnancy.

Methods
The analysis was performed in the database of the multicenter prospective PreCARE cohort. All pregnant women registered for delivery in 4 university hospital maternity units in Paris north area from October 2010 to May 2012 were included (N = 10 419). Women whose pregnancies ended before 22 weeks of gestation or who delivered in another maternity unit were excluded (N = 820). Women were distributed according to legal status in 4 groups: non-migrants, migrants with French or European nationality, legal migrants and undocumented migrants. The associations between the legal status and the composite variables of prenatal care utilization, SMM and SPM were tested through multivariate logistic regressions also adjusted for maternal characteristics.

Results
The illegal status was associated with increased risk of inadequate prenatal care utilization [adjusted odds ratio (aOR) 2,52 (2,10 - 3,01)]. Overall, the prevalence of SMM was 3,2 % and SPM 7,0 %. The illegal status was associated with higher risk of SMM [aOR 1,84 (1,21 - 2,79)], especially severe hypertensive disorder of pregnancy [aOR 2,29 (1,19 - 4,40)]. However, no significant association with SPM was found [aOR 1,29 (0,95 - 1,74)]. The sensitivity analysis demonstrates that results do not change after exclusion of women who arrived less than 12 months before delivery and those who started their follow-up after 14 weeks of gestation.

Conclusions
The illegal status was associated with an inadequate prenatal care utilization and a higher risk of SMM, especially severe hypertensive disorder of pregnancy.

Key messages
The illegal status was associated with increased risk of inadequate prenatal care utilization. The illegal status was associated with higher risk of severe maternal morbidity during pregnancy.
Degree of consistency of parental dietary and sedentary behavior rules as indicators for overweight
Authors: Ruiter E L M , Fransen G A J , Kleinjan M , Molleman G R M , van der Velden K , Engels R C M E 
Published: November 2019

Abstract

Background
To increase our understanding of the effect of parenting on the child’s likelihood of becoming overweight, we attempted to identify typologies based on how consistently parents apply dietary and sedentary behavior rules, and we examined whether these typologies are associated with energy balance-related behaviors in children and/or with the prevalence of overweight children.

Methods
Data were obtained from a cross-sectional survey of the Community Health Service in Nijmegen, the Netherlands in which a total of 4,865 parents of children aged 4-12 years participated. Data were collected using validated self-report questionnaires. To identify typologies based on how consistently parents apply dietary and sedentary behavior rules, we performed latent class analyses. We then performed regression analyses to examine the correlation between these typologies and socio-demographic characteristics, dietary and sedentary behaviors, and overweight.

Results
Latent class analyses revealed the existence of the following four distinct, stable classes/typologies; parents who have: (1) no dietary behavior rules, plus indulgent sedentary behavior rules; (2) indulgent dietary behavior rules, plus no sedentary behavior rules; (3) overall indulgent rules; (4) overall strict rules. Children of parents with overall strict rules (class 4) had significantly healthier dietary and sedentary behaviors compared to the children of parents in the other three classes. Children 8-12 years of age with parents in class 2 were the most likely to be overweight; compared to the children of parents in classes 1, 3, and 4, the parents in class 2 had the lowest level of education and the higher number of Turkish and Moroccan immigrants.

Conclusions
These results underscore the need for parents to establish strict rules for their children, particularly regarding sedentary behaviour in order to minimize the child’s likelihood of becoming overweight.

Key messages
The results underscore the need for parents to establish strict rules for their children, particularly regarding sedentary behaviour in order to minimize the child’s likelihood of becoming overweight. These results may contribute to making healthcare professionals aware that children of parents who do not apply sedentary behavior rules are more likely to become overweight.
Development of ethical governance framework for an mHealth platform for the management of Parkison’s
Authors: Timotijevic L , Peacock M , Hodgkins C , Egan B M 
Published: November 2019

Abstract

Background
The ubiquity of mobile devices promises to address the need for continuous management of chronic conditions at lower costs. Its rapid expansion, particularly in public health, is currently largely consumer-driven and lacking in acceptable frameworks for its wider adoption into the healthcare systems. The aim of this study is to identify the key parameters to consider in developing a governance framework for a Parkinson’s Disease Management MHealth platform. The Parkinson’s Disease Manager (PDM) system was developed to gather symptom information from patients with PD via wearable devices and a specially designed app and stored securely in a cloud, for use by clinicians, health researchers and policy makers.

Methodology
Twelve stakeholders were interviewed in the UK including clinicians, data managers, the public. First, the participants’ existing views about sharing personal and then specifically health data online were explored. Secondly, participants were introduced to PDM via a diagram and encouraged to explore the risks and benefits of the system with a minimum of guidance. Finally, they were asked what risks they thought might be posed by a series of specific scenarios presented through vignettes and how such issues might be addressed.

Results
Thematic analysis identified eight emerging themes which clustered around two overarching categories: 1. The key challenges of the system identified included: Establishing appropriate governance; Protecting the data; Ensuring sustainability; Building trust; 2. The proposed solutions included: Ethically informed governance; Embedded data custodians; Sustainable funding and engagement; Trust through transparency.

Conclusions
The patient’s heuristic assessment of risks and benefits is mediated by trust, which can be initially gained by association with individuals and organisations already deemed trustworthy and then consolidated and sustained through transparency and delivering on promises.

Key messages
The effective system design, must ensure that standards of transparency, data protection and informed consent are upheld if the coming eHealth revolution is ever to realise its true potential. The use of diagrams and vignettes to support qualitative interviews helped elucidate the importance of balancing protection, utility and sustainability to build and maintain trust.
A cross sectional survey to estimate prevalence of asthma in Reunion Island, Indian Ocean
Authors: Solet J L S , Raherison-Semjen C R S , Mariotti E M , Le Strat Y L S , Gallay A G , Bertrand E B , Jahaly N J , Filleul L F 
Published: November 2019

Abstract

Background
Previous studies on asthma mortality and hospitalizations in Reunion Island indicate that this French territory is particularly affected by this pathology. However, no estimates are provided on the prevalence of asthma among adults. In 2016, a cross-sectional survey was conducted to estimate the prevalence of asthma and to identify its associated factors in the adult population of Reunion Island.

Methods
A random sample of 2,419 individuals, aged 18-44 years, was interviewed by telephone using a standardized, nationally validated questionnaire. Information was collected on the respiratory symptoms, description of asthma attacks and triggering factors for declared asthmatics, as well as data on the indoor and outdoor home environment. “Current asthma” was defined as an individual declaring, at the time of the survey, having already suffered from asthma at some point during his/her life, whose asthma was confirmed by a doctor, and who had experienced an asthma attack in the last 12 months or had been treated for asthma in the last 12 months. “Current suspected asthma” was defined as an individual presenting, in the 12 months preceding the study, groups of symptoms suggestive of asthma consistent with the literature.

Results
The estimated prevalence of asthma was 5.4% [4.3-6.5]. After adjustment, women, obesity, a family member with asthma, tenure in current residence and presence of indoor home heating were associated with asthma. The prevalence of symptoms suggestive of asthma was 12.0% [10.2-13.8]. After adjustment, marital status, passive smoking, use of insecticide sprays, presence of mold in the home and external sources of atmospheric nuisance were associated with the prevalence of suspected asthma.

Conclusions
Preventive actions including asthma diagnosis, promotion of individual measures to reduce risk exposure as well as the development of study to improve knowledge on indoor air allergens are recommended.

Key messages
Individuals with suspected asthma who have not been medically diagnosed have been identified. Consequently, the development of a strategy to improve the diagnosis of asthma on Reunion is recommended. Aerating homes to reduce indoor moisture and mould growth, maintaining hygiene standards through cleaning, limiting the use of spray insecticides and household cleaning sprays at home.
Round table: Toward a better living with schizophrenia
Authors:   Organised by: EUPHA (PMH) Chair persons: Jutta Lindert - EUPHA (PMH)
Published: November 2019

Abstract

According to the Global Burden of Disease Study, schizophrenia causes a high degree of disability, which accounts for 1.1% of the total DALYs (disability-adjusted life years) and 2.8% of YLDs (years lived with disability). In the World Health Report [The WHO World Health Report: new understanding, new hope, 2001. Geneva]. In addition to the direct burden, there is considerable burden on the relatives who care for the sufferers.
The workshop aimed to present and discuss different facets of what could be done for these persons and their families’ members in the light of what has been done in some European countries, which have conducted reforms.
The round table will be introduced by presentations from two countries very much involved in psychiatric reforms which will present their attempts and results: first Italy with its emblematic radical deinstitutionalization model setting up a law to close down the psychiatric hospitals. The to-day situation will be presented underlying the huge diversity across Italian provinces and the dramatic lack of resources in some of them. Second the Portuguese reform will be described with a shift of psychiatric care toward general hospitals and its complete integration into health care catchment areas resulting in a increase of out patient acts among them home visits and a decrease of full time hospital admissions.
Then a French three-year research program that focused on themes that aims to improve the every day well-being of people living with schizophrenia will be presented. This program aimed to provid new insights on their integration from different angles: information about the disease by doctors at diagnostic annoucement, on internet and actions to take on health administrator training against stigmatisation that could be extended to a larger public.
Lastly the program allowed to interviewed face to face up to 67 people: 20 persons with schizophrenia, 20 person with bipolar disorders and 27 close ones to schizophrenic patients. A semi-structured interview collected information on the different aspects of care experiences plus “The Brief Illness Perception Questionnaire” allowed to measure and compare perceptions of the disease. This will allow to present the very positive effects of a program toward family members and patients themselves: “psychoeducation” that is a structured educationnal intervention which provides information and guidelines on how to react with their family member and influences positively the patient’s outcome as the well being of both patient and family members.
Each presentation will extensively be discussed with the attendance and followed by some recommandations

Key messages
Although schizophrenia is a severe disorder much could be done to alleviate the burden on the patients and their family members. Reorganising the care systems trough adequate policies, setting up policies against stigmatisation and providing educational intervention should promote patients and families empowerment.