bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of a school-based intervention for adolescents and teachers to promote mental health among refugee and migrant adolescents
Authors: Osman F , Sarkadi A , Feldman I , Tökés A , Perez-Aronsson A , Torp L , Durbeej N 
Published: October 2020

Abstract
Refugee youth have often experienced trauma during relocation and continue to face adversity in their host country in the form of acculturation stress, residence insecurity, social isolation, and experiences of discrimination. These experiences are associated with a significant risk of developing mental health problems such as post-traumatic stress disorder (PTSD). This cluster randomised trial aims to evaluate the effectiveness of a school-based intervention that provides a manualized, trauma-focussed programme called Teaching Recovery Techniques (TRT) to target refugee and migrant youth and an In-Service Teacher Training (INSETT) programme to teachers. The study will consider the impact of the intervention on the mental health of adolescent refugees and their guardians who participate in the TRT programme. It will also consider the intervention's impact on the interrelationships between teachers and parents and teachers' cultural competence, as well as the social support and school belonging experienced by adolescents who do not participate in TRT but whose teachers receive INSETT training. Further details on TRT and INSETT, trial design and preliminary findings will be presented at the workshop.
Psychiatric care utilization among children in refugee families – a Swedish population-based study
Authors: Berg L , Hjer A , Mittendorfer-Rutz E 
Published: October 2020

Abstract

Background
Previous studies have demonstrated a high prevalence of mental health problems, in particular depression, anxiety, and posttraumatic stress disorder (PTSD), among individuals with experiences of war, persecution, and torture. Mental health problems can affect parenting and the well-being of the children. However, few large-scale studies have investigated the intergenerational effects of psychological trauma on children in refugee families.

Methods
Register data on all children living in Stockholm, Sweden, in 2016 (&gt;90 000) were used to investigate utilization of child and adolescent psychiatric care in relation to parental PTSD, in foreign-born and Swedish-born refugee children compared to non-refugee children.

Results
In total, 13% of children in refugee families had a parent who had been treated for PTSD. Preliminary results showed an increased risk of psychiatric care use among foreign-born refugee children (HR: 2.68, 95% CI: 2.08-3.44) and in Swedish-born children in refugee families (HR: 1.86, 95% C.I: 1.43-2.41), whose mothers had been treated for PTSD. No association was observed in relation to PTSD diagnoses in fathers.

Conclusions
The findings indicate that refugee children with experience of PTSD of the mother were more than twice as likely to have been in contact with child and adolescent psychiatric services. This underlines the importance of making mental health care available so that adequate support and treatment is offered to refugees and their children.

Key messages
This study contributes with important information on the intergenerational effects of psychological trauma in refugee families. In order to prevent mental health problems in refugee children, Public health interventions for their parents with PTSD are crucial.
29.A. Workshop: Implementation of smokefree prisons across a national prison estate: experience from Scotland
Authors:   Organised by: University of Stirling (UK),   Chair persons: Alastair Leyland - UK, Kate Hunt - UK
Published: October 2020

Abstract

Objective
To present findings from the multi-methods, 3-Phase Tobacco in Prisons (TIPs) study, a comprehensive evaluation of the development, preparation for, implementation and outcomes of smoke free policy across Scotland's prison. Prisons had partial exemption from UK policy banning smoking in enclosed public spaces, and became one of few workplaces with continued exposure to secondhand smoke (SHS). Prison smoking bans have been introduced elsewhere, but evidence of the process and impact of implementing smokefree prisons is sparse. By presenting papers using different methods (objective measurements of SHS; qualitative focus group/interview data, surveys with people in custody and staff; prisoner purchasing data and an economic analysis), the workshop will demonstrate the success of implementing smokefree prison policy and the factors contributing to this success and related outcomes. It will discuss some of the challenging issues and decisions which other jurisdictions may face when considering a smokefree policy.

Format
The format of the workshop will comprise oral presentations from members of the TIPs research team. This will begin with an overview of a) the rationale for and challenges of implementing smokefree policies in the prison context, and b) the methods used during the three phases of the TIPs study. There will then be presentations on: (i) SHS exposure pre-post ban; (ii) experiences and opinions of staff including the use of e-cigarettes in prisons; (iii) the impact of smokefree policy on prisoner spend in the 'canteen' (prison shop); the impact of smokefree prison policy on medications dispensing; (v) the economic impacts of the smoke-free prison policy.
As a study of an entire national prison service. This evaluation of the development, planning, implementation and impact of smokefree policy demonstrates the importance of research evidence for policy implementation, providing new evidence for other jurisdictions contemplating bans on smoking in prisons.

Key messages
Smokefree prison policy can be successfully implemented with support, partnership working and good communication. Exposure to secondhand smoke in prisons rapidly declines.
Changes in exposure to second-hand smoke following a smoking ban across a national prison system
Authors: Demou E , Dobson R , Sweeting H , Brown A , Sidwell S , O'Donnell R , Hunt K , Semple S 
Published: October 2020

Abstract

Background
Prisons were one of few workplaces where smoking was still permitted after the smoking ban in indoor public places in Scotland in 2006. This study compares SHS exposure assessments in Scotland's 15 prisons six months after smokefree policy was introduced (in Nov 2018) with levels measured in 2016 before the policy was announced.

Methods
In 2016, 128,431 mins of PM2.5 (marker of SHS) concentration data were collected from residential halls and 2,860 mins for 'task-based' measures; 2019 figures were 126,777 and 3,073 mins. Six days of fixed-site monitoring in halls in each prison commenced on 22.5.19. Task-based measurements were conducted to assess SHS for specific locations and activities (e.g. cell searches). Typical daily PM2.5 exposure profiles were constructed for the prison service and time-weighted average exposure concentrations were estimated for shift patterns for residential staff pre- and post-implementation of the policy. Staff self-reports of exposure to SHS were gathered via surveys.

Results
Measured PM2.5 in residential halls declined markedly; median fixed-site concentrations reduced by &gt; 91% compared to baseline. Changes in the task-based measurements (89% average decrease for high-exposure tasks) and time-weighted average concentrations across shifts (&gt;90% decrease across all shifts), provide evidence that staff exposure to SHS has significantly reduced. The percentage of staff reporting no exposure to SHS rose post-ban.

Conclusions
This is the first study to objectively measure SHS levels before, during and after implementation of smokefree policy across a country's prison system. The dramatic reduction in SHS exposures confirm complementary qualitative data and stakeholder reports of the ban's success in removing tobacco. The findings show that SHS can be effectively eliminated through a well-applied smoking ban in the challenging context of prisons; and are highly relevant for other jurisdictions considering changes to prison smoking rules.
Understanding how corporations both drive & use neoliberalism to block progress in public health
Authors: Miller D 
Published: October 2020

Abstract
This paper examines the role of corporations in the creation and utilisation of think tanks, lobby ventures and front groups, both nationally and internationally. It examines how these were implicated in the introduction of neoliberalism in the 1970s/80s. It briefly tells the story of the development of the Mont Pelerin Society and how its acolytes 'littered the world' with free market think tanks which then did battle in the struggle to introduce neoliberalism. It examines how this led to the 'disembedding' (Polanyi 1944) of political and economic elites from society via the rise and maturation of a wide range of intermediary institutions and organisations including three main kinds of groups: National and transnational policy planning groups; Think tanks and think tank networks; lobbying and public relations consultancies. This part of the paper concludes by examining the role of those industrial sectors that have had the most significant Public Health footprint in the neoliberal revolution, in each of the three kinds of groups mentioned above.
The paper then turns to the concrete advantages that these ongoing changes gave specific corporate actors with negative public health effects
Breast cancer screening: a survival analysis in Algarve, Portugal
Authors: Rodrigues Gouveia C , Horta Correia F , Pereira R , Ferrinho D , Almeida D 
Published: October 2020

Abstract

Background
Breast cancer is the leading cause of cancer death in women worldwide and it is an health concerns in Algarve, a southern region in Portugal. The mammographic screening is performed with the aim of early detection and reduce mortality due to breast cancer. However, there are some controversies with mass screening due to overdiagnosis, overtreatment and false-positive results. We examined whether tumor characteristics were different for women with breast cancer diagnosed via mass screening compared with women non-participants of the screening programme. We also explored the survival differences between the groups.

Methods
We performed a cohort study using the data obtained from Registo Oncológico Nacional, the Portuguese national cancer registry, and the regional breast cancer screening programme. The Chi-squared test, Fisher exact test, and Mann-Whitney test was performed to test the differences with the screening status. For survival analysis, the Kaplan-Meier curves were examined and then we used Cox regression to explore the differences in survival by screening status.

Results
The worsen stages and the HER2 expression were significantly associated with being a non-participant of the regional screening programme. The survival time was also different with women screened having a bigger survivance when compared with non-participant. After the adjustment for variables associated with screening status, there was no evidence that the risk of women with breast cancer screening-detected was different from women non-participant.

Conclusions
Screening status was associated with a better tumor stage and non HER2 expression. Despite the lead-time bias, it was not identified survival differences between screening status, which is in agreement with other breast cancers survival analysis. These results are in agreement with the commission of the regional breast cancer screening programme in identifying precociously the breast cancers.

Key messages
Breast cancer screening in Algarve identify precociously the breast cancers. There is no evidence that the risk of women with breast cancer screening-detected was different from women non-participant in breast cancer screening in Algarve.
Mortality Outcomes in People Experiencing Homelessness Across England: a population-based study
Authors: Menezes D , Lewer D , Yavlinsky A , Tinelli M , Aldridge R 
Published: October 2020

Abstract

Introduction
The number of people experiencing homelessness in England has increased since 2010 and a recent systematic review and meta-analysis demonstrated high levels of mortality in this group across high-income countries. In this study we examine the death rates in people experiencing homelessness after discharge from hospital.

Methods
This is a study of linked hospital admission records and mortality data for two groups. First, a “Homeless group”: people seen by 17 specialist homeless discharge schemes between 1 November 2013 and 30 November 2016. Second, an “IMD5 group”: A matched group of patients who live in deprived areas and have the same age and sex, and were discharged from the same hospital in the same year as the homeless patient. Our analysis entailed calculating mortality rates across each group and by the number of comorbidities.

Results
The mortality rate for the IMD5 group was 1,935 deaths per 100,000 person years, compared with 5,691 for the homeless group, giving a rate ratio of 2.9 (95% CI 2.5-3.5). The mortality risk increased with the number of comorbidities. Individuals in the IMD5 group with zero comorbidities had a death rate of 831 per 100,000 person-years, compared with the homeless group for which the corresponding figure was 2,598 and or those with 4+ comorbidities were 7,324 (IMD5) and 12,714 (homeless). This suggests a 'super-additive' interaction in which the effect of morbidity on mortality risk after discharge is greater for homeless patients. Survival at 5 years for the homelessness group was for men 80% (95% CI 77-85) and women 85 (95% CI 81-87).

Conclusions
This study shows that the well-established inequity in mortality for people experiencing homelessness exists after discharge from hospital and is greatest for the most unwell patients. Our results suggest a need for greater emphasis on prevention of homelessness, early healthcare interventions and improved hospital discharge arrangements for this population.

Key messages
The well-established inequity in mortality for people experiencing homelessness exists after discharge from hospital and is greatest for the most unwell patients. Our results suggest a need for greater emphasis on prevention of homelessness, early healthcare interventions and improved hospital discharge arrangements for this population.
The social epidemiology of Zika: stigma, transmission, and prevention in Brazil
Authors: Collier K M 
Published: October 2020

Abstract
Zika Virus continues to pose a threat to public health in Brazil. In the absence of an infrastructure-focused approach to eradication, it is crucial to understand points of intervention that may increase preventative action in the population. There has been a lack of studies on how socioeconomic and demographic factors relate to attitudes and behaviors surrounding Zika. The purpose of this study was to investigate factors influencing stigma, transmission knowledge, and prevention method use in Brazil.
This study relied on nationally-representative data collected for the 2016/2017 AmericasBarometer survey. A multi-stage national probability sample design was used, yielding 1,532 participants. Items were selected representing three thematic categories: stigmatizing attitudes, accuracy of transmission knowledge, and the frequency of prevention method use. Multi-level modeling was used to assess the relationship between each item and gender, urban/rural living, income, and education, nested by region.
Education level was the strongest and most common predictor overall in this study. Higher levels of education were associated with less stigma against those with Zika, t(677)= 3.41, p &lt; 0.01, and more accurate transmission knowledge, t(1326)=5.31, p &lt; 0.001. For prevention method use, female gender was the strongest predictor, t(1408)=4.85, p &lt; 0.001. These relationships did not differ significantly by region.
The governmental response to Zika thus far has focused primarily on vector control. This has had limited success and placed the burden of prevention primarily on women and girls. The results of this study suggest that, in the absence of structural change, targeted interventions may be necessary to increase the accuracy of Zika-related knowledge and prevention method use. In addition to community-level interventions, advocacy for equitable access to education and increased availability of comprehensive family planning are critical.

Key messages
There are multi-level barriers to Zika knowledge and prevention use that will require structural, community, and individual-level interventions. Severe weather events driven by climate change will further damage fragile water/sanitation infrastructures in Brazil. Multi-sector collaboration is needed for environmental and population health.
Precarious employment and stress: any differences between objective or subjective measures of stress?
Authors: Julià M , Pozo O , Gómez-Gómez A , Bolíbar M 
Published: October 2020

Abstract

Background
Precarious employment is an emerging social determinant of health and health inequalities. It is known that it has an impact on health and could be a potential stressor. This study aims to examine the association between precarious employment and stress measured in two different ways: subjectively (questionnaire) and objectively (cortisol and its metabolites concentrations in hair, considered biomarkers of chronic stress).

Methods
Cross-sectional study in a sample of 256 workers of Barcelona, Spain, aged 25-60. We conducted a survey including questions on multidimensional precarious employment assessed by EPRES (Precarious Employment Scale), and perceived stress (measured through the Perceived Stress Scale (PSS)). We also collected hair samples to measure cortisol and metabolites concentrations. The associations between precarious employment and stress were assessed using lineal regression models, stratified by sex and adjusted for age and BMI.

Results
Preliminary analyses show an association between precarious employment and perceived stress for both men and women (B = 5.4,CI95%:3.8-7.1 and B = 5.4,CI95%:3.2-7.7 respectively). While we did not find significant association between precarious employment and Cortisol, we did in several biomarkers of the Hypothalamic-pituitary-adrenal axis for the case of women: 20α-Dihydrocortisol (B = 2.4;CI95%:0.1-4.6), 20β-Dihydrocortisol (B = 1.6;CI95%:-0.4-2.7) and 11-Dehydrocorticosterone (B = 0.6;CI95%:0.0-1.2).

Conclusions
This study found evidence of association between precarious employment and stress. The results were more robust when stress is measured by means of subjective self-reports than by objective measures of cortisol metabolites, implying that precarious employment has a clearer impact on wellbeing and mental health than in physical and hormonal responses. Further research is needed to validate and understand differences among outcomes, as well as differences between men and women.

Key messages
Some evidence of association between precarious employment and stress, measured both by subjective self-reported measures and by objective measures of cortisol metabolites existed. More research is needed to understand the differences between objective and subjective stress on the impact of precarious employment and differences among indicators for men and women.
Precarious employment and mental health in European welfare state regimes: a multilevel approach
Authors: Padrosa E , Julià M 
Published: October 2020

Abstract

Background
Precarious employment (PE) is a key social determinant of health that is, in turn, shaped by the broader institutional framework of the country in which it is embedded. At the same time, evidence sustains that welfare state regimes (WSRs) have a decisive role in determining people's health. However, the interaction effect between them is yet to be studied from a public health perspective. This article examines how WSRs, PE and mental health (MH) relate in Europe, and whether this relationship differs between women and men.

Methods
Data were derived from the European Working Conditions Survey 2015. PE was measured through the Employment Precariousness Scale for Europe (EPRES-E), validated for comparative research in 22 European countries, which were classified into five WSRs (Bismarckian, Anglo-Saxon, Scandinavian, Southern and Central-Eastern). MH was measured through the WHO-5 Well-Being Index. In a sample of 30,795 formal employees, we performed multilevel poisson regression models stratified by women and men.

Results
Results show a gradual association between PE quartiles and poor MH (PR Q2=1.37 CI95% [1.13-1.65], Q3=1.86[1.51-2.30], Q4=2.96[2.31-3.81] men; PR Q2=1.15[0.97-1.37], Q3=1.48[1.22-1.79], Q4=2.06[1.64-2.58] women) after adjusting for control variables. Further, the Scandinavian WSR displayed an overall protective effect for MH among men, as compared with the Bismarckian (PR = 0.58[0.34-0.99]). Regarding the interaction effects, these were only significant in the Central-Eastern WSR, which was found to boost the negative association between PE and MH among women (PR = 1.17[1.03-1.33]).

Conclusions
These findings point to a differential effect of WSRs on the negative relationship between PE and MH according to gender.

Key messages
European welfare state regimes unequally affect the negative association between precarious employment and mental health. This differential is also gender-based, since the Central-Eastern regime further deteriorates the mental health of precarious employees only among women, as compared to the Bismarckian.
Impact of social determinants on incarceration and women’s mental health in Brazil
Authors: Lindner S R 
Published: October 2020

Abstract
The health status of prison population in Brazil is worrying. Prisons in the country are often overcrowded and host a large proportion of population with pre-existing health problems, that may be aggravated in prison. The conditions of confinement are decisive for the health-disease process and the relationship between problems and health needs of the population. The current increase of the number of prison population contribute to increase the risk of infectious diseases and worsen the general health conditions of those incarcerated.
Mental health disorders are highly prevalent in the prison population globally, including: personality disorders, such as antisocial personality disorder, major depression, and psychotic illnesses, neurodevelopmental disorders, and intellectual disability (ID). Self-harm and suicide attempts are also overrepresented in the prison population.
The prison conditions may worsen the pre-existing mental health problems of those incarcerated. Compared to men, women in prison are particularly vulnerable to mental health disorders, because of several factors including the women's social role and peculiar social stressors affecting women's condition. The social determinants such as: employment, housing and education status; poverty, social exclusion and discrimination; gender-based violence, stigma and adverse life events are particularly affecting the mental health of women incarcerated prior to prison, often worsening when they enter prison. Mental health of women in prison in Brazil represents a public health and security problem. Based on research data the presentation will discuss the status of mental health of women in prison in Brazil.