bluuebunny/crossref_metadata_2025_split huggingface dataset:
The IMIRA (Improving Health Monitoring in Migrant Populations) - project in Germany – Lessons learned und implications for health monitoring
Authors: Santos-Hövener C , Schumann M , Schmich P , Gößwald A , von Schenck U , Lampert T 
Published: November 2019

Abstract

Background
A quarter of the population living in Germany are people with a migration background (PMB). In this context, the Robert Koch Institute (RKI) has the task of designing the health monitoring system that has been established in recent years in such a way that PMB are adequately taken into account in statements on the health situation of the German population.

Methods
The Improving Health Monitoring in Migrant Populations (IMIRA) project was initiated at the end of 2016 with the aim of improving the inclusion of MMH in health monitoring. Literature research, expert interviews and feasibility studies were carried out to identify strategies for access routes, recruitment measures, the dismantling of language barriers and the inclusion of MHH, which are incorporated into the concept of Monitoring 4.0, the further development of RKI health monitoring.

Results
In order to sustainably improve the accessibility of PMB in RKI health monitoring, a sequential study design with multilingual administration modes is planned within interview surveys. Personal contact through home visits and face-to-face interviews as well as the use of interpretation are essential to increase the willingness to participate. Strengthening the diversity sensitivity of the staff, as well as anti-discriminatory reporting, and promoting the participation of PMB and practitioners are additional components.

Conclusions
The IMIRA project has led to important findings that will be implemented in the long-term health monitoring of the RKI. The improved accessibility of PMB for health surveys enables a reflected presentation of the health situation of PMB, which does justice to the heterogeneity of the population living in Germany.

Main messages
• In order to include PMB sustainably in health monitoring we need to, develop dynamic study designs, bridge language gaps, establish personal contact, increase diversity sensibility and encourage participation of PMB in development of research processes.
Dyslipidaemia among Ghanaian migrants in Europe and their compatriots in Ghana: the RODAM Study
Authors: van der Linden E L , Agyemang C 
Published: November 2019

Abstract

Background
Sub-Saharan African (SSA) populations are believed to have a favourable lipid profile compared to European populations. However, geographical differences in the lipid profile of a homogenous SSA population residing in different geographical locations have not yet been assessed.

Methods
We used data from the multicentre, cross-sectional RODAM study including Ghanaian adults residing in rural and urban Ghana and in London, Amsterdam and Berlin (n = 5482). Dyslipidaemias were defined based on the 2012 European Guideline on Cardiovascular Prevention. The age-adjusted prevalence of dyslipidaemias was compared between the sites using prevalence ratios (PRs) adjusted for lifestyle and dietary covariates in different models.

Results
The age-standardised prevalence rate of high total cholesterol (TC) and LDL-cholesterol (LDL-C) was lower in rural than in urban Ghana and Ghanaian migrants in Europe. Adjusted PRs of high TC and LDL-C were higher in urban Ghana (TC PR = 2.15, 95% confidence interval 1.69-2.73) and Ghanaian migrant men (TC PR = 2.03 (1.56-2.63)) compared to rural Ghana, but there was no difference between rural and Ghanaian migrant women (TC PR = 1.01 (0.84-1.22)). High triglyceride levels were as prevalent in rural Ghana (11.6%) as in urban Ghana (12.8%), but were less prevalent in Ghanaian migrant women (2.0%). In both sexes, low HDL-cholesterol was most prevalent in rural Ghana (50.1%) and least prevalent in Europe (12.9%).

Conclusions
The lipid profile of Ghanaians varied by geographical location, and differential gradients of the individual dyslipidaemias could be observed between the locations. Additional research is needed to identify factors driving these differential risks in order to assist prevention efforts.

Key messages
The lipid profile of Ghanaians in urban Ghana and Europe is less favourable compared to the lipid profile of rural Ghanaian residents. Substantial differences in lipid profiles could be observed between the geographical locations.
Effectiveness of school-based interventions to prevent anxiety & depression in young people
Authors: Caldwell D. 
Published: November 2019

Abstract

Background
The prevalence of anxiety and depression is increasing among children and young people (CYP). Evidence suggests 1/2 of mental illness is apparent by age 14 and 3/4 by early adulthood. Globally, there is growing interest in prevention of anxiety and depression in CYP.

Methods
We report the findings from a systematic review and network meta-analysis (NMA) of school-based interventions to prevent anxiety and depression in CYP. NMA enables the simultaneous comparison of multiple interventions in a single evidence synthesis, retaining the identity of each intervention analysed and ranking of interventions according to the probability that each is best for a given outcome. Bayesian analyses were conducted in OpenBUGS, & random effects NMA were conducted for the primary outcomes of post-intervention self-report anxiety and depression.

Results
NMA were conducted for universal and targeted populations, in primary, secondary & tertiary educational settings. In universal primary settings, there is no evidence that any intervention reduced depression or anxiety. In universal secondary settings, CBT & mindfulness-based interventions suggest a reduction in anxiety symptoms relative to usual curriculum but was not observed for depression symptoms. In targeted secondary settings, exercise appears effective for reducing anxiety symptoms relative to no intervention. For prevention of depression symptoms, CBT appears effective. In targeted primary settings, there is no evidence that any intervention is effective. Few tertiary institution-based interventions met our inclusion criteria.

Conclusions
standard meta-analyses require lumping over interventions such that intervention specific effects may be masked (e.g. psychological intervention vs control). This NMA has identified the specific interventions which may prevent anxiety and depression in CYP. However, we observed considerable uncertainty and no intervention appears effective across every population and setting.

Key messages
Network meta-analysis enables the simultaneous comparison of multiple interventions in a single evidence synthesis, retaining the distinct identity of each intervention analysed. We observed considerable uncertainty for effectiveness of school-based interventions to prevent anxiety and depression. No single intervention appears effective across every population and setting.
Prospective study on chronic diseases and healthcare costs for the south of France region, 2016-2028
Authors: Davin B , Cortaredona S , Guagliardo V , Nauleau S , Ventelou B , Verger P 
Published: November 2019

Abstract

Background
In France, Health Regional Agencies (HRA) have to elaborate a Public Health Plan for the 5 coming years. For estimating future population health needs and associated costs to adapt the health services on the regional territory, the HRA in southeastern France requested a prospective analysis, based on demographic and epidemiologic scenarios about major chronic diseases, to evaluate future trends.

Methods
Six chronic diseases were selected: diabetes (1 or 2), cardiovascular diseases, respiratory diseases, cancers, neurological diseases and dementia. We used medico-administrative data from the National health insurance fund, and adapted algorithms to identify people with these diseases. We calculated prevalence rates according to gender and age and used two alternative scenarios (a constant one, and a trend-based one) to estimate the number of people with chronic diseases in 2023 and 2028, starting in 2016. We also estimated future healthcare costs according a constant and a trend-based scenario.

Results
The algorithms detect reasonable rates of disease compared to official rates available for 2016. Due to demographic (ageing) and/or epidemiologic trends, the number of people with chronic diseases will highly increase during the next ten years in the South of France region. For instance, between 2016 and 2028, there will be from 15% to 20% more people with diabetes. Associated costs will also be higher (+33% between 2016 and 2028), especially those granted to nursing care (+40%).

Conclusions
Burden of diseases and health expenditures are going to increase in the future. Projections are needed to help policymakers anticipating the required health services adaptation. Medico-administrative database are an invaluable source of data to do so. The next step of this project will consist in estimating those trends for smaller geographical areas.

Key messages
Data of the French Health Insurance fund can be used to predict future prevalence of chronic diseases and healthcare costs. South of France will face a main increase of people with chronic diseases.
The concurrence of chronic diseases among unemployed and employed persons: a register-based study
Authors: Yildiz B , Schuring M , Knoef M G , van Zoonen L , Burdorf A 
Published: November 2019

Abstract

Background
The first aim of this study was to describe the prevalence of chronic diseases and multimorbidity among employed and unemployed persons. The second aim was to investigate associations of sociodemographic characteristics with the prevalence of chronic diseases and multimorbidity.

Methods
Data linkage of large-scale registries on employment status, medication use and sociodemographic characteristics for all Dutch residents in 2016 was applied. In total, 5,074,227 subjects aged 18-65 years were included in the study. The prevalence of six common chronic diseases and multimorbidity was investigated among unemployed and employed persons. Multivariate logistic regression analyses were performed to examine associations of sociodemographic characteristics with the prevalence of chronic diseases and multimorbidity.

Results
Unemployed persons had a higher prevalence of psychological disorders (18.3% vs 5.4%), cardiovascular disease (20.1% vs 8.9%), inflammatory diseases (24.5% vs 15.8%), and respiratory illness (11.7% vs 6.5%) compared to employed persons. Unemployed persons were more likely to have one (OR 1.30, 95% CI 1.29-1.31), two (OR 1.74, 95% CI 1.73-1.76) and at least three chronic diseases (OR 2.59, 95% CI 2.56-2.61) than employed persons. Older persons, women, lower educated persons and migrants were more likely to have one, two, and at least three chronic diseases. Especially at younger ages, psychological disorders and inflammatory conditions were more prevalent but declined from middle age onwards among unemployed persons, whereas as slight increase from middle age onwards was observed among employed persons.

Conclusions
Using objective data, this study provided evidence for inequalities in the prevalence of chronic diseases and multimorbidity, indicating employment status to be an important determinant of health. Policy measures and health interventions should target chronic diseases and multimorbidity, especially among unemployed persons.

Key messages
Using objective data, this study showed that unemployed persons had a higher prevalence of chronic diseases and multimorbidity compared to employed persons. In particular older persons, women, lower educated persons and migrants were more likely to have chronic diseases and multimorbidity.
Predictors of overall mortality among people living with HIV/AIDS in Brazil, 2007-2015
Authors: Santos M E , Ribeiro R A , Protopopescu C , Nishimwe M , Yaya I , Carrieri M P , Araujo W N 
Published: November 2019

Abstract

Background
In Brazil there are 926,742 people living with HIV/AIDS (PLWHA). Despite the introduction of antiretroviral therapy (ART) in 1996 and treatment for all in 2014, mortality has increased in some regions. This study aimed to estimate the factors associated with overall mortality in PLWHA to recommend public health actions.

Methods
We studied PLWHA aged ≥18 years old, followed-up from 2007 to 2015 in the universal health system in Brazil. We used a national database (disease reporting, laboratory tests, ART and death notifications). Kaplan-Meier method and Cox model were used in survival analysis. The outcome was all-cause deaths. The explanatory variables measured at baseline were sociodemographic characteristics, HIV transmission mode and coinfections by hepatitis B (HBV) and C (HCV). The time-varying variables were CD4 cell count, viral load (VL) and ART status.

Results
Study population (n = 411,281) was mainly male (61%), under 40 years old (61%), Caucasian (37%), with basic education (43%), heterosexual HIV-infection mode (41%), resident in Southeast region (48%). The co-infection rate was 2.5% for HCV, and 1.4% for HBV. Median time to ART initiation was 83 days. During the follow-up period (median: 4 years), 61,757 deaths occurred (6% HCV-coinfected and 2% HBV-coinfected). The global mortality rate was 3.44 [95% confidence interval: 3.42-3.47] per 100 person-years (PY) during 1,793,417 PY. The factors associated with increased mortality in multivariable analyses were male gender, age over 40, non-Caucasian race, HIV infection by drug use, resident in North, Northeast and South regions, HCV and HBV coinfection, VL ≥ 200 copies/mL and starting ART with CD4&lt;200 cells/mm3.

Conclusions
Although PLWHA start ART in less than 3 months after the beginning of follow-up, there is still late treatment (at CD4&lt;200 cells/mm3). Screening should target all populations regardless of risk group. Coinfected individuals should also be early treated for HCV and HBV infections.

Key messages
The results of our study show that all populations should be target for HIV screening regardless of risk group. PLWHA coinfected with hepatitis B and hepatitis C should be also early treated for hepatitis coinfections.
Ultra-processed food intake and cardiovascular disease risk in the NutriNet-Santé prospective cohort
Authors: Srour B , Fezeu L K , Kesse-Guyot E , Allès B , Chazelas E , Deschasaux M , Hercberg S , Monteiro C A , Julia C , Touvier M 
Published: November 2019

Abstract

Objective
To assess the prospective associations between consumption of ultra-processed foods (UPF) and the risk of cardiovascular diseases.

Methods
105159 participants aged at least 18 years (median age 41.5 years) from the French NutriNet-Santé cohort (2009-2018) were included. Dietary intakes were collected using repeated 24 hour dietary records, designed to register participants’ usual consumption for 3300 different food items, and categorized according to their degree of processing by the NOVA classification. Associations between UPF intake and risk of cardiovascular, coronary heart, and cerebrovascular diseases assessed by multivariable Cox proportional hazard models, adjusted for known risk factors.

Results
UPF intake was associated with higher cardiovascular disease risk (n = 1409 cases; HR for an absolute increment of 10 in the percentage of UPF = 1.12(1.05-1.20); P = 0.0008), coronary heart disease risk (n = 665 cases; HR = 1.13(1.02-1.24); P = 0.02), and cerebrovascular disease risk (n = 829 cases; HR = 1.11(1.01-1.22); P = 0.02). These results remained statistically significant after adjustment for several markers of the nutritional quality of the diet (saturated fatty acids, sodium and sugar intakes, dietary fiber or a Healthy pattern derived by principal component analysis) and after a large range of sensitivity analyses.

Conclusions
In this large observational prospective study, higher consumption of UPF was associated with higher risks of cardiovascular, coronary heart, and cerebrovascular diseases. These results need to be confirmed in other populations and settings, and causality remains to be established.

Key messages
The consumption of ultra-processed food is associated with an increased risk of cardiovascular diseases. As the French Public Helath agency recommends, their consumption should be limited. Nutritional composition, food additives, contact materials, or neoformed contaminants might play a role in these associations and further studies are needed to understand their relative contribution.
Social gradient in health literacy among primary healthcare users in Cyprus
Authors: Andreou N , Nicolaou C , Papastavrou E , Middleton N 
Published: November 2019

Abstract

Background
Health literacy (HL) is a critical determinant of health and citizens’ control over their health. The European Health Literary consortium developed a conceptual model and related HLS-EU-Q47 tool of four cognitive and three health domains and showed high levels of inadequate HL in eight European countries.

Methods
This methodological and descriptive study evaluated the metric properties of the tool in a new setting and assessed HL among a Greek-Cypriot population. Differences in HL by social position and health behaviours was assessed.

Results
A sample of 300 adults from a General Hospital participated, 65%:35% urban vs rural, 15.3% divorced/widowed, 33% tertiary education, as expected according to census. 53% rated their health as “less than good”, 45.6% were current or past smokers and mean BMI was 26.8 (SD 5.2). Cronbach’s alpha coefficient for internal consistency was &gt;0.80 for cognitive (access, understand, appraise, and apply) and health sub-scales (healthcare, prevention, health promotion). A three factor structure explaining 52.1% of the variance was identified in exploratory factor analysis (“access to information”, “prevention and promotion-related literacy” and “user-provider interaction”). Half of the participants (50.7%) reported inadequate or problematic HL with statistically lower HL in older age-groups but no difference by urban: rural status. A clear social gradient was observed by education, income and subjective social position on a 10-step ladder. Regular alcohol consumption and low physical exercise were related with low HL, but not smoking or BMI.

Conclusions
HLS-EU-Q47 showed good metric properties in a new language and setting. The proportion of population with inadequate or problematic HL appears high but consistent with findings from other European populations. The observed social gradient in HL supports the criterion known-group validity of the tool as well as highlights an important aspect of health inequality.

Key messages
There is support for HLS-EU-Q47 as a valid and reliable measure of health literacy. A high proportion of the Cypriot population with problematic health literacy with a clear social gradient.
Environmental Challenges as Mental Health risks and oppotunities in the light of SDGs
Authors: Jevtic M , Bouland C 
Published: November 2019

Abstract

Background
Environmental risk factors such as air pollution, contaminated water, climate change, soil pollution, chemical exposures, ultraviolet radiation, noise pollution and others potentially contribute to diseases and mental disorders, such as depressive and anxiety disorders. Taken together mental, behavioral and neurological disorders accounted for 10% of the global disease burden in 2015 and is expected to increase to 15% by the year 2020.

Methods
We will identify health promoting factors on the background of the changing disorders spectrum. Based on a narrative review we identified as potentially environmental mental health promoting factors quality green areas, e urban planning, sanitation and public transportation, and decrease in noise pollution.

Results
Using the sustainable development goals (SDGs) as a benchmarking tool in national, regional and local development plans, citizens are empowered to improve their mental health through improved environment. Discussion: Mental health is an underresearched area in the field of environmental health. Intersectoral and interdsiciplinary collaboration can contribute to overcome boudnaries of specific disciplines and build bridges to support the overall goal of promoting and supporting mnetal health and reducing the burden of mental and neurological disorders.
Environment and mental health – developing a research agenda
Authors: Lindert J 
Published: November 2019

Abstract

Background
Environmental research and research on mental and neurological disorders remains largely separated. Research methods in both fields are different using diverse approaches. Aim of this talk is to highlight differences and commonalities in research methods in the fields of environmental and neuropsychiatric epidemiology.

Methods
A scoping review of methods was preformed using databases such as PUBMED, ISI Web of Science, Embase, CINHAL and PSYCHINFO.

Results
The search yielded several hundred citations. The search will be updated in July 2019 to provide the most recent results in the workshop. So far the review suggests that the fields of environmental epidemiology and neuropsychiatric epidemiology still are separated. Discussion: Approaches to build a joint research agenda will be discussed. Some methods which are used in both subdisciplines of epidemiology will be described in detail in the workshop. Likewise, challenges in collaboration will be discussed with the audience. This discussion with workshop participants is a possibility to learn from each other and build interdisciplinary bridges.
G-CSF spending: Cost Impact of an intervention conducted in a French area: Pays-de-la-Loire
Authors: Chaslerie A C , Fuchs B F , Grude F R , Bourgeois H B , Vigneau Victorri C V , Garrec N G 
Published: November 2019

Abstract

Issue
Granulocyte colony-stimulating factors (G-CSF), recommended by international oncology guidelines as a prophylaxis of febrile neutropenia are expensive drugs. Despite biosimilars marketing since 2008, G-CSF spending represents a major and growing expense for health insurance.

Description of the problem
Between 2010 and 2013 an unsustainable increase of G-CSF spending by 20% occurred in a French area: Pays-la-Loire. An intervention based on guidelines was carried out to the oncologists involved in ambulatory cancer care to reduce G-CSF spending by improving prescription and promoting biosimilars. Hospital oncologists have been the main target. A partnership between physicians and pharmacists of the Brittany - Pays-de-la-Loire Cancer Dedicated Observatory network and the Pays de la Loire Medical Department of Health insurance composed the operational team involved in the work. Interrupted time series analysis based on the French national health data system database were chosen to assess the impact of the intervention on G-CSF spending, their prescription and biosimilars use.

Results
Twelve professional meetings were performed to cancer medical teams from 7 community hospitals and 5 private hospitals of the Pays-de-la-Loire region. This intervention reduced G-CSF spending by 11% and improves G-CSF local use.

Lessons
This type of multi-stakeholder intervention carrying common to various health actor’s messages represents a promising tool to improve the quality of care and the control of health expenditure. These results and the possible cost saving showed have encouraged the heads of French health insurance to promote this action in 2019 in the whole France.

Key messages
In the current context of unsustainable increases in cancer cares related costs in France the rational use of G-CSF’s seemed to be one available resources. biosimilar promotion for ensure broad access to innovative cancer therapeutic for patients and finance cancer prevention campaigns.