bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are vaccine shortages a relevant public health issue in Europe?
Authors: Filia A , Rota M C , Grossi A , Martinelli D , De Graaf T , Dominguez A , Tuells J , Sormunen P , Jønsrud K , Rezza G 
Published: October 2020

Abstract

Background
National immunisation programmes depend on an adequate supply of vaccines but shortages have become more frequent globally in recent years. Vaccine shortages can lead to missed opportunities for vaccination and a greater risk of occurrence of vaccine-preventable diseases (VPD).

Methods
The EU-Joint Action on Vaccination is a European Commission-funded project* which aims to strengthen cooperation between European countries against VPDs, including improvement of vaccine supply and preparedness. In this context, from February to May 2019, we conducted a survey amongst persons in charge of national immunisation programmes or of vaccine supply/procurement in EU/EEA, to collect information on vaccine shortages in the previous three years.

Results
Twenty-one of 28 invited countries responded, of which 19 reported at least one shortage, for a total of 115 shortage events. The median number of shortages per country was 5 (range 0-15). At the time of survey completion, there were ongoing shortages in six countries. DT/dt-containing combination vaccines, hepatitis A, hepatitis B and BCG vaccines were the most frequently involved vaccines. Supply and production issues, and global shortage, were the most frequent causes. Median duration of shortages was five months; 34% caused a disruption in immunization services. Procurement and purchase methods varied by country. Only half of countries have recommendations or procedures in place to address shortages.

Conclusions
Vaccine shortages are a serious public health issue in the EU. Causes are complex and multifaceted and more research is needed to understand the economic and market-related causes. Improved communication between public health authorities, manufacturers and regulatory agencies is essential. Procurement and tender mechanisms should be improved. In case of vaccine shortages, all countries should have procedures or recommendation in place regarding the use of alternative vaccines or vaccination schedules.

Key messages
Vaccine shortages are a relevant public health issue in the EU. More research is needed on the complex and multifaceted causes of vaccine shortages. Timely communication between supply and demand is needed and procurement and tender mechanisms should be improved.
Introducing Critical Tiriti Policy Analysis: A new tool for anti-racism from Aotearoa New Zealand
Authors: Came H , O'Sullivan D , McCreanor T 
Published: October 2020

Abstract

Issue/problem
Te Tiriti o Waitangi (te Tiriti) was negotiated between the British Crown and Indigenous Māori in 1840. Māori understood the agreement as an affirmation of political authority and a guarantee of British protection. The Crown understood it as a cession of sovereignty. Te Tiriti places a mandatory obligation on the Crown to protect and promote Māori health that has not been upheld.

Description of the problem
Ethnic inequities in health outcomes have been allowed to flourish in Aotearoa. We explored to what extend te Tiriti could be a anti-racism tool that health policy could be usefully evaluated against?

Results
We introduce Critical Tiriti Analysis (CTA) a new form of critical policy analysis. CTA involves reviewing policy documents against the Preamble and the Articles of the Māori text of te Tiriti o Waitangi. The review process has five defined phases: i) orientation; ii) close reading; iii) determination; iv) strengthening practice; and v) Māori final word. We present a working example of CTA using the New Zealand Government’s Primary Health Care Strategy. This policy analysis found poor alignment with te Tiriti overall and the indicators of its implementation that we propose.

Lessons
This paper provides direction to public health practitioners wanting to improve Māori health outcomes and ensure Indigenous engagement, leadership and substantive authority in the policy process. It offers an approach to analysing policy that is simple to use and, inherently, a tool for advancing social justice.

Key messages
CTA is an anti-racism tool for holding the Crown accountable for Māori health. CTA could be adapted and applied in other colonial contexts to advance Indigenous health.
Societal Impact of Pain thematic network – from European recommendations to national implementations
Authors: Badreh S , Kynman S , van Griensven J , Branco M , Votta M , Morlion B 
Published: October 2020

Abstract

Issue
Pain puts a serious burden on individuals and society. The Societal Impact of Pain (SIP) aims at improving pain care policies by gathering a broad coalition of multi-disciplinary organisations.

Description of the problem
Uncontrolled pain can decrease people's quality of life and has a serious impact on individuals and society. The SIP Thematic Network focuses on improving policy-making via the creation of a network of stakeholders by sharing best practices and available data to draft recommendations with the goal to call for a European Framework addressing the societal impact of pain. SIP has been selected in 2018 as a Thematic Network as part of the EU Health Policy Platform and produced a Joint Statement that focuses on four key areas: (1) Indicators, (2) Research, (3) Education, and (4) Employment. The Joint Statement has been used as a basis for projects and initiatives at national level, aligned with the four key priorities.

Results
Nine SIP national platforms have been established in Belgium, Finland, France, Ireland, Malta, Netherlands, Portugal, Slovenia, Spain under the guidance of the European SIP platform. Each platform has identified one or more key areas of the Joint Statement to take concrete actions for implementation. For example, SIP Belgium released a national SIP Joint Statement with the goal to improve the (re)integration of pain patients in the workforce and society.

Lessons
The selection of SIP as a Thematic Network on the EU Health Policy Platform provided opportunities to identify the key areas for impactful pain policy work and led to concrete actions for implementation on national level. More at www.sip-platform.eu

Key messages
Continuation of the dialogue on the EU Health Policy platform is important to improve existing policies and to increase collaboration amongst all key stakeholders. Structured implementation of policy recommendations on national level is important in order to improve pain care.
Sports betting in Serbia- National survey on lifestyles in Serbia: substance abuse and gambling
Authors: Todorovic J , Terzic-Supic Z , Piperac P , Divjak J 
Published: October 2020

Abstract

Background
Sports betting has been one of the gambling games which are strongly associated with problem gambling. The aim of our study was to examine the association of social (socio-demographic and socio-economic) and lifestyle characteristics of sports bettors in Serbia.

Methods
The cross-sectional study was the secondary analysis of the data from the National Survey on lifestyles in Serbia: substance abuse and gambling, conducted during 2014. The questionnaire consisted of 158 items. The first part was on socio-demographic characteristics. The second was on lifestyle characteristics with Beverage Specific Quantity Frequency - BSQF Instrument developed during Standardized measurement of Alcohol-related troubles-SMART project, Kessler psychological distress scale, Problem Gambling Severity Index (PGSI), use of illicit drugs, and prescription/ non-medical prescription drug use. The sports betting was assessed with yes/ no question: 'Have you played sports betting in the past 30 days?'

Results
The 10% of participants reported sports betting in the past 30 days. The sports betting was associated with being male (OR:11.22, 95% CI: 7.62-16.53), aged 18-44 (OR: 2.33, 95% CI: 1.78-3.07), living in urban areas (OR: 1.79, 95%CI: 1.41-2.28), being single (OR: 1.35, 95 % CI: 1.06-1.72), having secondary education (OR: 1.47, 95% CI: 1.09-1.98), being unemployed (OR: 2.71, 95% CI:1.35-5.45), employed (OR: 3.00, 95 % CI: 1.53-5.90), or student (OR: 3.86, 95% CI: 1.83-8.17), binge-drinking (OR: 1.94, 95% CI: 1.39-2.71), non-medical prescription drug use (OR: 1.78, 95% CI: 1.22-2.59) and low/ moderate (OR: 12.82, 95% CI: 8.50-19.33), and problem gambling (OR: 43.38, 95% CI: 11.75-160.11).

Conclusions
The association of sports betting with risk behaviors among young males should be a concern for public health authorities.

Key messages
The prevalence of the past 30 days betting in Serbia is 10%. Sports betting is associated with risk behaviors.
Health and wellbeing of sexual minority youth – the School Health Promotion study in 2019 in Finland
Authors: Klemetti R , Luopa P , Kivimäki H 
Published: October 2020

Abstract

Background
Sexual minority youth have an increased risk for depression, anxiety disorders and bullying. In addition, particularly boys have an increased risk for sexual harassment. However, information on their general health and wellbeing is scarce. The purpose of this study is to examine the general health and wellbeing of sexual minority youth compared to heterosexual youth.

Methods
Data from the national School Health Promotion study 2019 were used including youth from comprehensive (N = 87026), upper secondary (N = 44498) and vocational schools (N = 23366). The proportion of sexual minority youth in comprehensive school was 8.5%, in upper secondary school 10.3% and in vocational school 7.5%. Each of the following issues was asked by using one question: general health, life satisfaction, loneliness, and worry about own mental health. Anxiety was measured by GAD-7 (Generalized anxiety disorder) and depression by PHQ-2 (Patient health questionnaire). Data were analyzed by school level and sex using cross-tabulations with Chi-square tests.

Results
Response rate at comprehensive school was 73% and at upper secondary school 69% but at vocational schools it couldn't be estimated reliably. Sexual minority youth reported significantly more often poor or average general health (44.2% vs. 18.2%) and loneliness (26.5% vs. 8.5%) but less often life satisfaction (50.0% vs. 78.5%) compared to heterosexual youth. They had significantly more often experienced depression (40.4% vs. 14.5%) and anxiety (31.4% vs. 10.4%) and worried more often about their mental health (65.6% vs. 28.5%) than other youth. Differences remained after stratifying the data by school level and sex.

Conclusions
This large population-based study including both sexual minority and heterosexual youth suggests that sexual minority youth have poorer outcomes in general health and wellbeing than heterosexual youth. More detailed analyses are needed to find out associated factors.

Key messages
Sexual minority youth at each school level and all sexes had poorer outcomes in each studied health and wellbeing indicator compared to heterosexual youth. Low-threshold services and support as well as more accepted atmosphere in society are essential to guaranteeing better health and wellbeing for sexual minority youth.
Describing the objective and subjective mental health care needs of minor refugees in Germany
Authors: Fretian A , Podar D , Razum O , Namer Y 
Published: October 2020

Abstract

Background
Half of the estimated 70.8 million forcibly displaced people are under the age of 18. Clinical studies assessing prevalence of mental illness, commonly depict them as a particularly vulnerable group. However, screening instruments are not enough when establishing the need for mental health care. By supplementing them with subjective measures, we aim to provide insight into the mental health care needs of otherwise overlooked groups.

Methods
Data were collected between February and November 2019 in German schools and refugee accommodations via tablet based self-assessment. Adolescents between 12 and 18 years of age coming from Syria, Afghanistan, and Iraq were invited to participate. The Hopkins Symptom Checklist-37 (HSCL) was used to measure internalizing and externalizing symptoms (i.e. objective need; cut-off score = 69). A single item was used to assess the subjective need for mental health care: “Do you think that you have emotional difficulties for which you need help?”

Results
A total of 259 participants completed the questionnaire. While 22.4% reported an emotional issue for which they need help (missing values=22.4%), the HSCL (α=.90) identified 10.4% of participants to be at risk for a mental health disorder (missing values=18.5%). Most participants (62.5%) reported neither objective nor subjective care need. However, 23.7% (n = 36) of those not identified as at risk said they have emotional difficulties, while 5.9% (n = 9) of those at risk stated they do not have an emotional issue.

Conclusions
Our sample showed lower levels of mental health issues as measured by the HSCL, when compared to samples of refugee minors in Germany (33.7%) and Norway (17.2%). Especially vulnerable groups are those who report problems, but are not identified by the screening measure as at risk and those identified as at risk, but do not perceive to have mental health difficulties. Public health interventions need to develop tailored strategies to reach these groups.

Key messages
Screening instruments are not enough when establishing the need for mental health care of vulnerable populations. Subjective and objective need should be considered when establishing who gets mental health care.
Health behaviours of education professionals: any room for improvement? A study of French employees
Authors: Vercambre M-N , Temam S , Billaudeau N , Kab S , Zins M 
Published: October 2020

Abstract

Background
Education professionals have a role to play in health education, both as knowledge providers and role-models. To appraise their health awareness, we compared their health behaviours to those of non-education employees.

Methods
Using inclusion data of the CONSTANCES French cohort (2012-2019) and adjusting for important confounders (sex, age, education,...), we alternately compared three indicators of risky conducts (at-risk drinking, current smoking, past year-cannabis use) and two indicators of unhealthy lifestyle (low physical activity, overweight/obesity) between education professionals (n = 14730) and a random sample of non-education employees (n = 34244). Among education professionals, we distinguished between teachers (n = 12820), school principals (n = 372), principal educational advisers (n = 189), school health professionals (n = 128), and school manual/service staff (n = 1221).

Results
Teachers were less likely than non-education employees to be at-risk drinker, to smoke, to have used cannabis in the past year and to be overweight/obese. Other non-teaching education professionals were also rather less involved in risky conducts than non-education employees. Nonetheless, school principals and principal educational advisers reported more often low physical activity and school principals and manual/service staff were more prone to overweight/obesity than non-education employees.

Conclusions
In this large nationwide sample of French employees, education professionals were rather less involved in risky conducts than other non-education employees with a similar demographic and socioeconomic profile. Yet, non-teaching education professionals showed punctually unhealthy lifestyle indicators, suggesting a window of opportunity to improve both their own health and, indirectly through role-model, that of the youth with whom they interact daily.

Key messages
Education professionals, especially teachers, appear more health-conscious than average. There may still be room for improvement toward a healthier lifestyle. In addition, the average observed may be quite far from the recommended public health target, so that any action to enhance education professional’s health behaviours will have societal benefits.
Disability pension among persons with chronic illness: Differential impact of a Danish policy reform
Authors: Mathisen J , Jensen N K , Bjorner J B , Brønnum-Hansen H , Christensen U , Thielen K , Gadeberg A K , Andersen I 
Published: October 2020

Abstract

Background
Denmark implemented a reform in 2013 that tightened the disability pension criteria and expanded a subsidized job scheme. Before the reform, disability pensions were most often granted because of chronic disease and more often to persons with low job qualifications. However, no evaluation has assessed whether the effects of the reform differ according to social class. This register-based, nation-wide cohort study investigates potential differential impact of the reform according to labor market affiliation.

Methods
A pre-post study design was used to compare the probability of being granted disability pension or flexi-jobs five years after vs. five years before the reform. Data were available from 480,809 persons between 40 and 65 years of age who suffered from at least one of six types of chronic disease. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated.

Results
The probability of being granted disability pension was halved after the reform (HR = 0.49, CI: 0.47 - 0.50). The impact was strongest for persons previously receiving cash benefits (HR = 0.38, CI: 0.33-0.43) or sickness absence benefits (HR = 0.31, CI: 0.24 - 0.39). Also, the impact was stronger for persons working in manual jobs than for persons working in non-manual jobs. The probability of being granted flexi-job decreased by one fourth (HR = 0.76, CI: 0.74 - 0.79).

Conclusions
After the reform, it was less likely for persons with chronic illness to be awarded disability pension or subsidized job-schemes. The impact on disability pensions was largest among those who were already outside the labor market or work in manual jobs.

Key messages
The rates of disability pensions and subsidized job-schemes decreased after the reform. The impact was larger for persons outside the labor market and for those working in manual jobs.
Development and empowerment of community health promoters in Prilep – North Macedonia
Authors: Shapkoski V 
Published: October 2020

Abstract
Hidden discrimination in treatment, inability to pay for health services, insufficient information about health and social rights, are just some of the obstacles faced by Roma population and other marginalized communities in terms of achieving health rights in North Macedonia. Previous experience has shown encouraging community activism and following social determinant in the exercise of health rights are of particular importance for achieving positive outcomes.
Therefore, in the past year, a group of 18 Roma community activists called Community Health Promoters was formed. Their task was to monitor community movements, share promotional materials, initiate discussions on health care topics, identify what problems citizens are experiencing especially the ones that may be a sign of systemic barriers. What is also very important and, to our opinion, a revolutionary step to building up this group is that we had additional 4 non-Roma activists who voluntarily applied to be part of it. Community Health Promoters by the end of the previous year reached the number of 22 people (18 Roma and 4 non-Roma).
More than 100 individual cases and 2 major systemic barriers to the exercise of rights have been identified - the first concerned the right to health insurance for persons who have just turned 18 years and are not in regular education, and the second on inadequate regulation in the new Law on Social Protection, regarding the obligation for the beneficiaries to seek allowance from his/her adult children not living in their household. In both cases, written reactions were submitted to the competent bodies. In the first case, a notification was received that a technical solution to the problem was already been prepared, and in the second case, within one month, an amendment to the Rulebook was made, for more appropriate regulation.
Through these two cases, it has been demonstrated that this approach is critical to achieving adequate and equal access to health protection for all.

Key messages
If the legislation is not for all, it is not a right but a privilege. Community-based work is the only way to find out if the laws are applicable for all or just for the few.
Urbanization, Poverty and Child Health: Findings from Taiwan Birth Cohort
Authors: Chiang T L , Chiang W L , Chang L Y 
Published: October 2020

Abstract

Background
We are living in an urban age. This study aims to examine whether living in big cities can be of help to reduce the health gap between the rich and poor children.

Methods
Data for the analysis came from the Taiwan Birth Cohort Study with a nationally representative sample of 18,814 children who completed the first (6-month) and eighth (12-year) waves of household interview survey. Poverty was defined as parental income below US$1,000 per month. Residence area was grouped into two groups: big city and non-big city; big city was defined as a national or provincial city. Children's health at age 12 was rated by mothers and divided into two groups: poor and non-poor. Multiple logistic regression was used to examine the joint effect of urbanization and poverty on children's health.

Results
We found that children who lived in poverty were more likely to have poor health than those who did not live in poverty (28.2% v 19.9%). When children were grouped according to the combination of residence at age of 6 months and 12 years old, we found that the prevalence of poor health at age 12 was the highest for poor children who lived continuously in big city (35.8%), followed by poor children who moved to big city (30.0%), poor children who lived continuously in non-big city (26.7%) and poor children who left big city (25.0%). Importantly, the prevalence of poor health for non-poor children was much lower and varied less across different residence groups, ranging from 19.7% to 21.4%. The interaction of poverty and urbanization on children's health was statistically significant (p &lt; 0.05) in multiple logistic regression analysis.

Conclusions
Our findings suggest that living in big cities be detriment to the health of children in poverty and widen the health gap between rich and poor children. Thus it is extremely important to shape urbanization for children, particularly for poor children.

Key messages
The poor children who live in big cities are more likely to have the worst health. We shall pay attention to the joint effect of urbanization and poverty on children’s health in order to reduce health inequalities.