bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic resistances of S. aureus in refugee accommodations – an investigation from the microbiological perspective
Authors: Kiemann I 
Published: November 2019

Abstract

Background
Antimicrobial resistance (AMR) has been added to the list of the “Ten threats to global health” of the WHO. Due to varying rates of AMR persistence in the different countries of the world, there is concern that migration might foster the burden of antibiotic resistance in Europe. As calculated before, prevalence of AMR is elevated in refugees. Refugees are supposed to have higher risk for AMR prevalence, constituted by the conditions in the European host countries and the countries of origin or transit. In European refugee accommodations poor sanitation, overcrowded living conditions and barriers accessing health care services are feasible risk factors. One example for AMR bacteria is the Methicillin-resistant Staphylococcus aureus (MRSA). In the last decades, S. aureus became a global threat for healthcare, through the gain of AMR genes.

Methods
Nasal swabs voluntarily provided by refugees living in accommodations in Bielefeld (Germany) were checked for presence of S. aureus. After identification by 16S rRNA sequencing the isolates were typified and antibiotic resistances were phenotypically detected by broth dilution method. For MRSA, the resistance genes were identified by PCR.

Results
Nasal swabs of participating refugees contain antibiotic resistant S. aureus, including MRSA. Some isolates are resistant against various therapeutic antibiotics, like clindamycin and erytromycin. Nearly all isolates are resistant against penicillins. Resistances against vancomycin and the reserve antibiotic linezolid were not detected.

Conclusions
Efforts to reduce AMR rates in Europe focus on surveillance, screening and antimicrobial stewardship. As the living situation in host countries is expected to be a risk factor for AMR persistence, host countries may also consider improving the accommodation of refugees.
The construction of alliances in the field of health: about addictions
Authors: Josseran L 
Published: November 2019

Abstract
The construction of alliances in the field of addictions is a key topic to develop effectiveness and efficiency public health policies.
The short-term economic stakes can not be the alpha and the omega of public policies. Whether general or sectoral, such as agriculture, they must take into account their impact on the health of populations established by scientific work.
Estonia: Problems created by border-trade for applying high-tax alcohol policy
Authors: Täht T , Laarmann H 
Published: November 2019

Abstract
In early 2000s, Estonia had one of the highest levels of alcohol consumption globally. In 2008, the average salary could buy 62 litres of strong spirits, compared with 28 litres in 2000; the increase of affordability was one of the highest in the EU. Since then, alcohol consumption per capita has been reduced by a third, which has also led to a reduction in related problems: mortality from alcohol-related illnesses has fallen by 40%. This was achieved with the progressive adoption of measures that rely heavily, but not exclusively, on increasing excise taxes. In 2014 a comprehensive alcohol policy document was adopted, paving the way to the measures in all 10 areas of WHO global strategy to reduce harmful use of alcohol. Since then Estonia has launched treatment programme and awareness campaigns, restricted advertising and the exposure of alcohol in the public sphere.
By 2017, the over-exploitation of the tax-based measures backfired. The twofold alcohol price difference between Estonia and Latvia, resulting from doubling the excise tax for beer and raising significantly those for other alcoholic beverages, caused an unintended increase in cross-border trade between the two countries. This, in turn, caused a new wave of public discussion around pricing policies, and a loss of popular support for tax increases. As a first step to address the problem, the government halved the tax increase planned for February 2018, thus increasing beer tax by 9% and spirits tax by 5%. Tax increases scheduled for 2019 and 2020 were cancelled, and taxes on spirits, beer and cider were cut by 25% instead. This resulted in Latvia decreasing their spirits taxes by 15% in turn. This development forces health promoters to seek new ways to reduce harm to public health and win back support to healthy policy choices.
Round table: Applying multidisciplinary sciences to improve paediatric primary care for children in Europe
Authors:   Organised by: EUPHA (CAPH) Chair persons: Danielle Jansen - EUPHA (CAPH), Jochen Ehrich - Germany
Published: November 2019

Abstract

Considerable progress has been made in improving child health and well-being in Europe over the past 40 years, with great reductions in neonatal, and child deaths, and in deaths from causes such as vaccine-preventable diseases. Paediatric primary care (PPC) has significantly contributed to these advances. However, there are still differences between and within countries regarding the content and organizations of primary care for children that might have an impact on important aspects such as access and availability of primary care. These cross-country and within-country differences together with current and future challenges in child health care, such as increasing prevalence of chronic and long-term conditions, fragmentation of care and shortage of health personnel, pose a complex challenge for European countries. Working towards an approach to tackle these challenges requires the vision, input and collaboration of multidisciplinary sciences.
In this workshop four perspectives are brought together with the goal to learn from each other’s experiences and to establish a common knowledge base on how to collaborate between different disciplines and sciences to bring PPC to a next level. The first presentation will be from a public health perspective and is about the comparison of actual and desired organization and content of adolescent health services. The second presentation will be a paediatrician’s perspective and stresses the importance of an adequately trained paediatric workforce. The third presentation will be from a sociological perspective and focuses on the societal scale drivers framing health among children and their families. In the final presentation a philosophical perspective will be given on adherence to therapy, resilience and resonance in the treatment triangle of ‘patient-family-therapist’. The presentations will be followed by a round table discussion in which the audience will be involved: the presenters will answer questions and discuss with the audience how we should create better and sustainable PCP by making use of multiple disciplines and sciences.

Key messages
Differences between and within countries regarding the content and organizations of primary care for children might have an impact on important aspects such as access and availability of primary care. Working towards an approach to tackle challenges in paediatric primary care requires the vision, input and collaboration of multidisciplinary sciences.
Children deserve adequately trained doctors
Authors: Illy K 
Published: November 2019

Abstract
Children treated in different European countries continue to have very variable outcomes. Among several factors that might affect these outcomes, organisation of primary care services for children and training programmes for primary care clinicians are likely to be important factors.
Children have an unquestionable right to health, safety, and wellbeing. Children have the right to access the highest possible standards of health-care services and facilities, both in primary health care and when they need specialised care. Any restriction of provision of appropriate care would contradict article 24 of the UN Convention on the Rights of the Child.
Paediatric primary care is an academic and scientific discipline dealing with all issues affecting the health and wellbeing of infants, children, and adolescents from birth to adulthood in the context of their family, community, and culture. The primary clinician, ideally a paediatrician, is the first contact for children until they reach adulthood and is thus responsible for provision of comprehensive and continuing care throughout infancy, childhood, and adolescence.
Paediatric care in both primary care and hospital settings needs special knowledge, ethics, empathic behaviour, and access to services, including disease prevention and health promotion. These aspects are therefore mandatory for all paediatric training both for paediatricians and family doctors.
There should be a structured and accountable paediatric training programme for all doctors providing first-line care to children in primary care. When family doctors provide primary health care close collaboration with paediatricians and adequate continued training in both paediatrics and primary care is advised. Moreover, all children need timely access to professional paediatric advice.
Global trends of chronic non-communicable diseases risk factors
Authors: Di Cesare M 
Published: November 2019

Abstract

Background
One of the global targets for non-communicable diseases is to reduce, by 2025, the rise in global trends of major non-communicable diseases (NCDs). We aimed to estimate worldwide trends in NCD risk factors.

Methods
Data from the NCD Risk Factor Collaboration (NCD-RisC) allowed the analysis of over 128 million children, adolescents, and adults with available information on height and weight, 4.4 million participants with data on diabetes through measurement of its biomarkers, and 19 million adults that had measured the blood pressures.

Results
No changes in age-standardised mean BMI in girls and boys from 1975 to 2016 were registered in eastern Europe, while an increase of up to 1.00 kg/m2 per decade was reported in central Latin America (for girls) and in Polynesia and Micronesia (for boys). Global prevalence of obesity increased from less than 1% in 1975 to 5.6% and 7.8% in 2016 in girls and boys, respectively. In adults, prevalence of obesity increased from 3.2% in 1975 to 10.8% in 2014 in men, and from 6.4% to 14.9% in women. Global diabetes prevalence increased from 4.3% in 1980 to 9.0% in 2014 in men, and from 5.0% to 7.9% in women; the lowest prevalence in 2014 has been recorded in northwestern Europe. The number of adults with diabetes in the world increased from 108 million in 1980 to 422 million in 2014. Estimation from current trends shows that only a minority of countries (mostly in western Europe) have a 50% or higher probability of halting the rise of diabetes by 2025. Global prevalence of raised blood pressure was more than 20% in both men and women in 2015. Globally, the number of adults with raised blood pressure increased from 594 million in 1975 to 1.13 billion in 2015, with the increase largely in low-income and middle-income countries.

Interpretation
The burden of NCD risk factors is partially due to population growth and ageing. However, lifestyle factors play a crucial role in NCD prevention.
Socio-economic determinants of nutrition transition in Southern European countries
Authors: Iacoviello L 
Published: November 2019

Abstract

Issue/problem
Traditional dietary patterns in southern European countries are changing into less healthy choices, especially among the younger generations.

Description of the problem
There is consistent evidence of a transition from Mediterranean foods preference toward a higher consumption of high-caloric and hyper-processed foods. Potential reasons for the observed nutrition transition or barriers for adopting healthy dietary pattern across the borders of the Mediterranean basin are represented by lifestyle changes, food globalization, economic, and socio-cultural factors.

Results
Emerging socioeconomic inequalities in other domains of healthy dietary behaviors such as dietary variety, access to organic foods and food purchasing behavior seems to affect Southern Mediterranean countries while countries in Northern Europe and some other Countries around the world are currently embracing a Mediterranean-like dietary pattern. A potential cause of this downward trend could be the increasing prices of some food items of the Mediterranean diet pyramid. Recent evidence has shown a possible involvement of the economic crisis, as material resources becoming strong determinants of the adherence to the Mediterranean diet just after the recession started in 2007-2008 in part of Europe. Undesirable dietary modifications possibly linked to the current economic crisis were mainly reported by lower socioeconomic groups.

Interpretation
Traditional healthy dietary patterns have become socioeconomically patterned, and the prominent role of financial over cultural resources in determining the adherence to this pattern should be taken into account. The current economic crisis represents a major health threat for the general population but in particular for the most vulnerable socioeconomic groups, possibly leading to wider gaps in terms of risk/protective factors across socioeconomic categories.
Workshop: Access to health services in health systems providing universal coverage
Authors:   Organised by: French National Institute of Health and Medical Research Chair persons: Olivier Grimaud - France, Helmut Brand - Netherlands
Published: November 2019

Abstract

Universal health coverage (UHC) is part of the global WHO strategy to improve health. UHC and equity in access to care fall within the shared principles and values of EU health systems. However, as reported in 2016 by the Expert panel on effective ways of investing in health (EXPH), significant amount of unmet needs persisted both between and within EU member states. Access to health services encompasses the dimensions of affordability, user experience and availability of services with potential barriers arising at individual, providers or health systems levels. Health needs are constantly evolving as a consequence of population ageing and of health care technology development. Consequently access to care does not simply mean availability of a single component of care, but rather to an array of pertinent, coordinated, cost-effective and timely primary and specialized health and social interventions.
Measuring performance in that respect is beyond the ability of commonly used “national level” indicators of access. Available research suggests that achieving ubiquitous access to optimal care across territories and populations (eg socioeconomic groups) is hard to achieve. This applies to the whole spectrum of health interventions, from preventive care such as immunizations to multidisciplinary interventions required for the management of chronic diseases. In this context, the workshop proposes to present examples of policy initiatives and results from research projects focusing on access and use of health care conducted in a variety of settings. The aims are to share knowledge about methods used in measuring variations of access, to improve understanding of their determinants and to identify avenues for improving performance.
The workshop is proposed by a multidisciplinary and international group of research teams. It will start with a short introduction from the chair (5 minutes, Olivier Grimaud) followed by five presentations (10 minutes) addressing the issues of variations in access and use of care from different research teams and in a variety of settings. The first presentation will report on an innovative policy aiming at improving UHC in India. The following presentations will illustrate the challenges of providing access in high income countries, including, Scotland, France and Australia. In the last part of the workshop (30 minutes) comments from Prof Helmut Brand (former expert panel member of the EXPH) will introduce a general discussion with the audience moderated by the chair.

Key messages
Even when the conditions for universal health coverage are in place, providing equitable access to quality care remains a challenge. Understanding variations in access to care would help improve performance and equity.
Reflections on life-course vaccination: the England experience
Authors: Edelstein M 
Published: November 2019

Abstract
Since the introduction of the expanded programme on immunization in the 1970s, vaccination has evolved from being an intervention of early infancy to being a programme targeting individuals at all stages of life including birth, infancy, childhood, teenage years, pregnancy and adulthood. The UK has been at the forefront of this lifelong approach to vaccination and has introduced vaccines at all stages of life in its national schedule, including vaccination against hepatitis B at birth, Meningococcal disease group B in infancy, influenza in primary school years, Meningococcal disease groups A, C, W and Y in teenage years, pertussis in pregnancy and shingles in older adults. Based on a range of studies conducted by Public Health England, This session will reflect on some of the challenges brought on by the life course approach in the UK including issues of access in different age groups, choosing the right age and settings for vaccinations, age-specific attitudes to vaccination and subsequent communication strategies, and challenges with monitoring a life-course programme.
Striking a balance between accuracy and timeliness in HTA: an elusive task
Authors: Petelos E 
Published: November 2019

Abstract

Issue
HTA is a decision-making tool. Users need high-quality and timely evidence to ensure sound resource allocation and timely access to innovation. High-quality HTA recommendations are time-consuming to generate, requiring high-quality evidence and timely evidence synthesis, as well as mechanisms to ensure timely recommendation release and feasible implementation of guidance.

Description of the problem
HTA submissions, issuing recommendations and implementation guidance oftentimes have no transparent timelines, with high accuracy posing unique challenges for timeliness. We can broadly examine such challenges in the context of methodologies and processes. Accuracy ensures longer-term validity of decision-making, however, HTA should not be used only for new technologies but also revision of previous decisions through timely re-assessment, ensuring obsolete technology disinvestment.

Effects/changes
Through the exploration of models and tools previously implemented across jurisdictions and settings, such as early-warning systems, conditional approvals and horizon scanning, it will be demonstrated that well-defined prioritisation criteria accepted by both doers and users, adequate capacity and sound preparation of stakeholders are all key elements to ensure the highest possible degree of timeliness and accuracy, and to strike a balance between the two. Particular attention will be paid to critical challenges for public health access and delivery, i.e., emerging technologies and complex interventions, highlighting how horizon scanning ought to start at the discovery, rather than development phase and transparency challenges. Technology tracking and mechanisms for standardizing methodologies and processes will also be discussed.

Lessons
Monitoring and evaluating the impact of HTA methodologies and processes in a transparent manner needs to become an inherent part of HTA to ensure existing and future challenges of accuracy and timeliness can be adequately addressed.
Multimodal health promotion – An approach to successful aging
Authors: Gudlaugsson J , Jonsson P , Janusdottir L , Janusson D , Janusson A , Gudmundsson I , Thordarson E , Aspelund T 
Published: November 2019

Abstract
Multimodal health promotion (MHP) is especially relevant for older persons, because of their high rate of disability, functional dependence, and use of healthcare resources. The purpose of this health promotion and research project was to assess the immediate and long-term effects of MHP on functional fitness (FF), body composition (BC), health and quality of live (HQL), and cardio metabolic risk factors (CMRF).
The main objectives of the project are; 1) to promote health of older age groups so they; a) can take part in the future, both better and longer, in the activities of daily life, b) can live longer in an independent residence, c) can prevent or delay entry into residential and nursing homes, d) have the opportunity to work longer in the labor market; 2) to improve the quality of life of older age groups; 3) to reduce government and municipalities expenditures.
The MHP consisted of three 6-month periods with emphasis on daily endurance training and twice-a-week strength training. This was supported by monthly lectures with emphasis on nutrition, use of medicine in connection with training, healthy ageing, mindfulness, goal-settings in old age, endurance, strength and flexibility training, and how to train. The design was a suitable sample with baseline assessment and three 6-month MHP phases.
After each MHP phase, positive improvement was seen in FF, BC, HQL and CMRF. Males and females retained achieved changes and improved further at the end of each 6-month measurement. Our results suggest that regular MHP can improve or prevent decline in functional fitness in older individuals, reduce cardio metabolic risk factors, influence their health and lifestyle and positively affect their ability to stay independent, thus reducing the need for institutional care. MHP is feasible and beneficial in older populations as an integral part of prevention in municipalities and management of chronic age-related disorders.
Early life socioeconomic position and adult systemic inflammation: the role of gene regulation
Authors: Carmeli C , Kutalik Z , Kelly-Irving M , Delpierre C , Bochud M , Kivimaki M , Vineis P , Chadeau-Hyam M , Dermitzakis E , Stringhini S 
Published: November 2019

Abstract

Background
Adverse socioeconomic conditions in childhood affect systemic low-grade inflammation in adulthood. Studies in animals and humans suggest that socioeconomic conditions get under the skin from early life thus contributing to shape pro-inflammatory phenotypes. Although the existence of socioeconomic differences in gene regulation of the immune function have been described previously, no study has so far assessed the extent to which these differences actually explain socioeconomic variations in inflammatory markers.

Methods
First, we ran 2-sample Mendelian Randomization (MR) methods to identify putative genes whose expression drives C-reactive protein (CRP) levels in blood. We used two databases with summary statistics of associations between single nucleotide polymorphisms and gene expression (eQTLGen, N = 31,486 individuals) and CRP (CHARGE, N = 148,164 individuals) in blood. We tested 10,701 genes and retained those with FDR&lt;0.05. Second, we used individual-participant data from a Swiss population-based study (SKIPOGH, N = 723) to estimate the proportion of the effect of paternal occupational position (SEP) on low-grade inflammation in adulthood (CRP&gt;3mg/L) mediated by the selected genes. We estimated odds ratios and mediated proportions through counterfactual-based mediation models.

Results
We identified 426 genes driving CRP levels (robust to unmeasured confounding thanks to MR). They jointly mediated the effect of low father’s occupation on inflammation in adulthood for a proportion up to about 70% [95% confidence intervals (CI) 11-90%] and with an odds ratio of 1.53 [95% CI 1.05-2.15] compared to individuals with high paternal SEP. Analysis of the effects of life-course SEP trajectories (upward, downward and stable low from paternal to adult SEP) on gene regulation revealed trajectory dependent effects.

Conclusions
We suggest that adverse childhood SEP affects systemic inflammation in adulthood through a long-lasting effect on gene regulation.