bluuebunny/crossref_metadata_2025_split huggingface dataset:
21.I. Round table: Comparing and designing the politics and policies for better economic and social welfare
Authors:   Organised by: EUPHA Public health policy and politics section,   Chair persons: Marleen Bekker - EUPHA-PHPP
Published: October 2020

Abstract
While the political and social determinants of health have become accepted among academic researchers, health inequalities in the health policy and political arenas are still predominantly addressed as outcomes of citizens' lifestyle and behavioural choices. The rise of populist radical parties across Western countries brings renewed urgency to communicating with elected leaders and policy makers about the importance of tackling the social (as well as behavioral and medical) determinants of health. Recent publications such as 'Health in Hard Times. Austerity and Health Inequalities' (Clare Bambra, 2019) and 'Health Equity in England: The Marmot Review 10 Years On' (Marmot et al, 2020) find that financial and economic policies in large part contribute to stagnating and even reversing population health trends in the UK and across Western countries. The underlying political system of decision-making needs to be clarified in order to effectively engage and exert influence.
This workshop aims to strengthen countervailing power and competence in understanding the policy trajectories that effectively target the larger ambitions of economic and social welfare including reduced health inequalities. We provide participants with basic knowledge, methods and tools to carry out practice-based comparative analysis of public health politics and policies across different countries.
The workshop consists of: A 20-minute mini-lecture by Julia Lynch, who will present key findings and the underlying methodology of her recent book Regimes of inequality: The political economy of health and wealth. This book systematically used historical institutionalist-methods and process tracing to compare the policies and politics aimed at reducing health inequalities in Finland, France and the UK from the 1990s to the present.A 15-minute panel reflection: The panel, consisting of Clare Bambra, Karien Stronks, and Holly Jarman, will relate this to their own key research and impact.A 25-minute plenary discussion of examples, questions and contributions to tackling inequalities in political and social determinants of health. Examples are labour market participation policies, progressive fiscal policies or policies resolving illiteracy or household financial debt.

Key messages
Health inequalities are a political choice. Learning by comparison increases capacity to improve policies on the social determinants of health as well as capacity to increase political influence.
Monitoring health and well-being of children and adolescents in Germany since 2003
Authors: Goesswald A , Lange M , Hoffmann R , Houben R 
Published: October 2020

Abstract

Background
KiGGS - the German Health Interview and Examination Survey for Children and Adolescents is part of the German health monitoring framework providing data analyses and recommendations for politics based on own primary data collection and secondary data from other sources. In 1998, the Robert Koch Institute was commissioned by the Federal Ministry of Health to develop approaches and instruments for a health survey for children and adolescents aged 0 to 17 years.

Methods
KiGGS is conducted at regular intervals and acts as a central source of information that collects wide-ranging, reliable data on child and adolescent health. KiGGS comprises a cross-sectional and a longitudinal component. Until now, three nationally representative surveys have been performed: KiGGS baseline (2003-2006), Wave 1 (2009-2012) and Wave 2 (2014-2017). The baseline sample comprises 17,641 children and adolescents. The KiGGS cohort is the longitudinal component of the study. To date, two follow-ups have been accomplished.

Results
The repeated cross-sectional surveys have provided a profound data basis in order to calculate prevalences and conduct context analyses for each period and identifying changes over time in physical and mental health status, health behaviour, utilisation of health care services and prevention as well as social, family and environmental factors. Additionally, the longitudinal data enable to analyse developments in health and their influencing factors during the life course. Reports and recommendations based on KiGGS data have been useful to support the implementation of national health programs for children and adolescents, e.g. for the prevention of childhood obesity.

Conclusions
Regular health interview and examination surveys are necessary to provide reliable data to derive recommendations for health politics. Furthermore, they offer a robust method to evaluate actions taken to prevent illness and promote positive health behaviour on the population level.
21.L. Workshop: To what extent can we trust our data on trends in mental health among adolescents?
Authors:   Organised by: Nordic Collaboration on Positive Mental Health,   Chair persons: Charli Eriksson - Sweden, Katrine Madsen - Denmark
Published: October 2020

Abstract
Mental health complaints have increased among school-aged children in the Nordic countries, especially among girls according to survey data in the Nordic countries. Moreover, the consumption of mental health services among adolescents has also increased. However, criticism from qualitative researchers have questioned the validity of the response to survey questions and the interpretation of the results. This controversy has been public in the media both in Denmark and Sweden.
The objectives of the workshop are to describe trends in mental health among adolescents in the Nordic countries, review criticism of mental health indicators, discuss measurement and analytical options, and consider consequences for policy making. Moreover, the workshop will discuss the situation in other parts of the worlds.
Researchers in five Nordic countries have collaborated in the Health Behaviour of School-aged Children (HBSC) study to mental health. School-aged children, 11-, 13- and 15-year olds (n = 112,000) have participated in HBSC surveys. Of key concern are psychosomatic complaints (1985-2018), but trends will also be presented for indicators of excellent self-rated health and high life satisfaction (2002-2018), with additional indicators of positive mental health (Warwick Edinburgh Mental Well-being Scale, General self-efficacy, Self-esteem) from the 2017/18 HBSC data collection.
There has been an increase in the psychosomatic complaints among girls and boys, in all age groups and in the five Nordic countries. Strengths and limitations of epidemiological surveys will be discussed. The impact of different frequency cut points will be presented as well as the heterogeneities regarding profiles of adolescents with different combination of negative and positive mental health indicators. Moreover, qualitative studies and registry-based analysis will be used as contrasting evidence. The qualitative studies on symptom perception indicate that the prevalence of problems may be overestimated, and data from psychiatric care and prescription of drugs show important increase.
After an introduction and two presentations the workshop will be a dialogue with the participants. First the core similarities and differences between countries will be explored. Then the policy implications will be discussed.

Key messages
The HBSC survey design give thousands of adolescents and children across dozens of nations the ability to be heard through a reliable and valid methodology. It is important to use indicators according to their intended use, monitoring of population trends, developing causal networks of determinants, screening of clinical cases or as diagnostic tools.
21.M. Workshop: How to learn from interventions for context-adapted solutions to improve migrants reproductive health
Authors:   Organised by: EUPHA Migrant and ethnic minority health section,   Chair persons: Sonia Dias – EUPHA-MIG, Sarah Fredsted Villadsen - Denmark
Published: October 2020

Abstract
Although considerable research identifies the challenges that immigrant women experience in terms of inequitable access to and quality of reproductive care, less is known about models of care that can overcome such barriers. In recent years, a range of intervention projects has addressed this issue with a specific focus on the interactional dynamics between the women and the health system. Subsequently, diverse implementation and evaluation research is being conducted and it can provide valuable insights for knowledge exchange and transfer across contexts. Adapting interventions that have worked elsewhere can save resources and make progression faster. Decisions on when, to what extent, and how to adapt interventions are not straightforward, particularly when assuming that intervention effects depend on contextual interactions in complex systems. No guidance currently addresses these questions comprehensively. This workshop is intended to shed light on the developing work of country-specific implementation and evaluation studies and discuss strategies for good practice to improve reproductive health among immigrant women across contexts, digging into methods for adaption to the context when transferring interventions. The workshop will be structured in a first part with presentations and a second part with open discussion involving the audience. The short presentations of the first part will cover examples of initiatives to improve health outcomes for immigrant women based on implementation and evaluation studies conducted in diverse European countries with a common ground of having an increasingly ethnic diverse population, ethnic disparities in reproductive outcomes and suboptimal care. In the second part of the workshop, a presentation on methods and challenges for adaption of interventions to the context when transferring complex interventions will be the starting point for the interactive discussion with all workshop participants. The discussion will focus on how to acknowledge that context matter while still insisting on learning from each other experiences across settings. By learning from each other, using the current implementation and evaluation research as a starting point, this workshop will inform the development of an overarching guidance on adaptation of complex reproductive health interventions.

Key messages
Cross-country sharing of implementation researches on interventions to improve migrant women’s reproductive health, inform the context specific adaptation. Interactive session to discuss strategies for successful adaptations of complex reproductive health interventions across contexts.
Telemedicine and mental health: coming of age?
Authors: Ohannessian R , Scardoni A , Bellini L , Salvati S , Amerio A , Odone A 
Published: October 2020

Abstract
Telemedicine is the practice of medicine from distance using information technology and include mainly teleconsultation via video and/or chat, teleexpertise to request the opinion of a specialist, and remote patient monitoring to improve the follow-up of patients. The use of telemedicine in mental health and most specially psychiatry has been one of the first use case described in the scientific literature, via video teleconsultation, due to the absence of physical patient examination. One of the oldest telepsychiatry case from the literature was published in 1973 for patients assessed from 1968 with the Massachusetts General Hospital in Boston, USA.
Despite its medical and technical ease, telepsychiatry is still not widely spread and integrated into healthcare systems due to organisational and implementation challenges. More recently, telepsychology and other telemedicine interventions in mental health have been growing across the globe, including for mental wellbeing promotion and prevention of mental health conditions in specific environments. The rise of consumer digital healthcare directly through mobile app and dedicated websites is also to be considered in the wide opportunities of telemedicine opportunities to address mental health issues at a global scale. Various models needs thus to be considered between digital only care and blended approach mixing face-to-face and digital ways, as well as telemental health delivered only via the existing healthcare system or via new private digital players. The objective of the presentation is to describe the spectrum of existing telemedicine interventions in mental health, the digital features enabling its adoption and the assessment of its impact on clinical and public health outcomes.
Has the Netherlands created a healthy food environment for its citizens? Application of the Food Environment Policy Index (Food-EPI)
Authors: Djojosoeparto S K , Kamphuis C B M , van Lenthe F , Poelman M P 
Published: October 2020

Abstract

Background
Healthy food environments have the potential to improve population nutrition and decrease NCDs. The aim of the study was to assess the efforts of the National Government in the Netherlands towards creating healthier food environments using the Healthy Food Environment Policy Index (Food-EPI).

Methods
We compiled evidence on national food environment policies in the Netherlands for each of the 47 indicators. This document has been verified for completeness and accuracy by Dutch governmental officials. A panel of independent, nongovernment experts specialized in nutrition, obesity or chronic diseases, was provided with this evidence and rated the extent of implementation of Dutch policies by benchmarking these policies against international best practices during an online survey in May-July 2020. The experts also rated to which extent policies could lead to a decrease or widening of socio-economic inequalities in dietary intake. In addition, experts formulated actions to improve food environment policies in the Netherlands.

Results
This is the first interdisciplinary study to assess food environment policies developed and set by the Netherlands. The overview of national level policies resulted in a evidence document, describing policies (or the lack thereof) for each of the 47 indicators. The evidence document shows that the Netherlands has mostly voluntary policies, mainly through the National Prevention Agreement (launched in 2018) and Agreement on Product Improvement (launched in 2014). Results from the online survey and the formulated actions will be presented during the conference. The results will reflect the experts' ratings supported by documented evidence and will provide meaningful guidance to governmental officials and public health advocates in their efforts to improve the food environment policies in the Netherlands.
A study on implementation of food-related policies in Poland using the Healthy Food Environment Policy Index
Authors: Romaniuk P , Kaczmarek K , Brukało K , Grochowska-Niedworok E , Lobczowska K , Banik A 
Published: October 2020

Abstract

Background
Existing studies indicate obesity and diseases associated with diet and sedentary lifestyle as leading health problem in Poland that cannot be solved without explicit public intervention. The purpose of this study is to evaluate actions to create a healthy food environment, undertaken by public authorities in Poland.

Methods
We used the Food Environment Policy Index (Food-EPI) to describe the Polish national food environment policy. We analysed available government documents, studies, reports, legal acts and other relevant materials to compile a evidence document, which has been then validated with government officials. In the next stage (March 2020), national policies will be subject to assessment in reference to international best practices by independent experts through an online Delphi study. Results of the survey will be then used during a national workshop (April 2020) in order to formulate and prioritize actions.

Results
For 15 out of 47 indicators we found no evidence for government actions that would meet the criteria set out in the Food-EPI definition. In case of the other 6 indicators it was observed that the existing solutions are non-binding and result from government-independent policies. The lack or limits of government involvement was observed in particular in the domains related to food promotion, food provision, food in retail, and Health in All Policies. Results from the online study and the workshop will be presented during the conference.

Conclusions
The preliminary results obtained through the review of the evidence point to the need for intensified government activities in the area of shaping food policy in Poland. Full conclusions will be formulated after the study is completed. Preliminary findings of the Food-EPI project suggest the need for strengthening food environment policy in Poland.
Low economic growth and health inequalities in a rich country: 27-year Japanese time series
Authors: Hiyoshi A , Honjo K , Platts L G , Suzuki Y , Shipley M J , Iso H , Kondo N , Brunner E J 
Published: October 2020

Abstract
This presentation extends the public health theme in relation to Sustainable Development Goal #8, focusing on the health inequality trend in Japan. it is important to understand whether low economic growth is compatible with a low level of health inequalities. Unlike the UK and USA, life expectancy in Japan continued to improve despite a stagnant economy.
Ten triennial waves of a nationally representative survey in Japan, 1986-2013 (n = 731,647) were used. Slope and Relative Indices of Inequality (SII and RII respectively) in relation to net household income and self-rated good health were calculated. Analyses were stratified by sex and age, for children, working-age adults, younger old and older old, given age differences in relation to labour market. Time trends of SII and RII were tested during the period of economic stagnation 1992-2013.
In all age groups, prevalence of good health declined slightly from its peak in 1995 but increased after 2007. In 1992 among children, working-age adults and younger old, health inequality based on SII was small, about 10% lower prevalence of good health in those with lowest compared to highest income. Among working-age adults, time trends of health inequalities based on SII narrowed from 1992 and then widened after 2002 (quadratic trends in men and women p &lt; 0.05), resulting in the magnitude of health inequality returning to its level at the beginning of economic stagnation in 1992 but not exceeding it. Time trends in relative inequality (RII) were qualitatively similar to those in absolute inequality (SII).
The long-term low-growth Japanese economy appears compatible with maintaining and improving population health and holding health inequalities at current levels. This evidence is of great significance for sustainable development and the health of current and future generations.
Influenza burden estimates in Portugal: seasons 2013/14 to 2018/19
Authors: Torres A R , Kislaya I , Silva S , Gomez V , Machado A , Nunes B , Guiomar R , Rodrigues A P 
Published: October 2020

Abstract

Background
Reliable influenza burden estimates are essential for a true understanding of the influenza epidemics' impact; informed decision-making and effective risk communication. This study aimed to estimate the influenza burden in Portugal in 2013/14 - 2018/19 seasons.

Methods
We estimated seasonal influenza burden, ranging from medically attended influenza cases in primary care to influenza-attributable deaths, using surveillance data. Data were collected for influenza like illness (ILI) epidemic periods, determined by the Moving Epidemic Method. Medically attended influenza cases were estimated by multiplying the number of ILI cases in primary care by the percentage of influenza-positive samples. Hospitalized severe acute respiratory infections (SARI) positive for influenza estimates were computed, multiplying the number of SARI by the percentage of influenza-positive samples. To determine influenza-attributable deaths, a Poisson regression model was used.

Results
The median number of medically attended influenza cases in primary care was 33,668 (325.8 cases per 10,000 population), ranging between 21,393 in 2017/18, [Influenza B and A(H1) co-dominance] and 61,768 in 2014/15 [Influenza B and A(H3) co-dominance]. The median number of SARI positive for influenza was 8,724 (84.4 cases per 10,000 population), ranging between 7,099 in 2013/14 [A(H1) and A(H3) co-dominance], and 9,125 in 2014/15. The median number of influenza-attributable deaths was 3,311 (32.0 cases per 10,000 population), ranging between 96 in 2015/16 [A(H1) dominance], and 5,224 in 2014/15.

Conclusions
Higher mortality, and higher rate of medically attended influenza cases, were found in seasons with A(H3) circulation. Little variability was observed in the number of influenza-positive SARI. The relationship between the number of SARI and the number of deaths requires further investigation. This work highlights the need of health surveillance systems for a better understanding of the influenza impact.

Key messages
Lower burden of influenza is found in seasons with A(H1) co-dominance. Higher burden of influenza is found in seasons with A(H3) circulation. Health surveillance systems are essential to provide data for a better understanding of the epidemiology and extent of seasonal influenza.
Antipsychotics and mortality among elderly with dementia: a population based study in the Lazio region
Authors: Bargagli A M , Cascini S , Agabiti N , Kirchmayer U , Marino C , Davoli M , Vanacore N , Canevelli M 
Published: October 2020

Abstract

Background
Most dementia patients experience one or more behavioral and psychological symptoms (BPSD) at some time during their illness, in particular in the middle and later stages. Antipsychotic drugs (AP) are often prescribed off-label for treating BPSD, despite concerns about safety and limited efficacy. The impact of AP on short- and long-term mortality has not been fully assessed.

Objective
To assess the association between the use of APs and short- and long-term mortality in a cohort of dementia patients aged ≥ 65 years residing in the Lazio region.

Methods
We use data from regional health information systems to conduct a retrospective age, gender and comorbidity matched cohort study with a 1:3 matching ratio to pair dementia patients new AP users with non-users. For the exposed participants, the index date was defined as the date of the first drug prescription; the same date was used for non-users matched subjects. Patients were enrolled on 31/12/2016 and followed-up from the index date through 2018. Four cohorts were enrolled to analyze mortality at 30, 60, 180 and 65 days from the index date. Adjusted estimates were obtained with propensity score matching using the Greedy Nearest Neighbor Matching algorithm.

Results
We enrolled 34,625 individuals (67% females, mean age 82 years) distributed as follows: 30 days cohort, 4321 users vs 12,960 non-users; 60 days cohort, 4202 users vs 12,606 non-users; 180 days cohort, 3641 users vs 19,923 non-users; 365 days cohort, 2618 users vs 7854 non-users. Multivariate analyses showed a statistically significant excess mortality at 60, 180, and 365 days since the first prescription (HR: 1.83, HR: 1.63, and HR: 1.62, respectively).

Conclusions
This study showed that antipsychotics increase short- and long-term mortality risk in older adults with dementia. The prescription of AP should be carefully evaluated and, if it is the best option for patient and caregiver, stringently monitored.

Key messages
Antipsychotic medication use is associated with an increased all-cause mortality in elderly with dementia. The mortality risk increases in 60 days after starting their use and remains elevated at 1 year.