bluuebunny/crossref_metadata_2025_split huggingface dataset:
High to low, low to high: neighbourhood socioeconomic trajectories and birth outcomes
Authors: Burgos Ochoa L , Bertens L C M , Steegers E A P , Been J V 
Published: October 2020

Abstract

Background
A growing body of literature has consistently linked neighbourhood socioeconomic status (SES) with adverse birth outcomes. However, the available evidence is based on cross-sectional indicators of neighbourhood SES, which fail to reflect neighbourhoods' dynamic nature. The objective of this study was to explore the relationship between temporal trajectories of neighbourhood socioeconomic change and adverse birth outcomes.

Methods
The study population consisted of registered singleton births occurred in the Netherlands 2003-2017 between 24 and 41 weeks of gestation (N = 2,335,449). Based on neighbourhood socioeconomic data from The Netherlands Institute for Social Research, we categorized neighbourhoods into longitudinal SES trajectories (e.g. stable, declining, ascending). Multilevel logistic regression models were used to estimate the relationship between neighbourhood SES trajectories and birth outcomes, i.e., preterm birth and small-for-gestational-age (SGA).

Results
Living in a Stable Low SES neighbourhood was associated with higher odds of preterm birth (OR[CI]=1.10[1.06; 1.14]), and SGA (OR[CI]=1.15[1.12; 1.18]), compared to living in Stable High SES areas. Also, women living in a Declining (Middle to Low SES) neighbourhood had higher odds for preterm birth (OR = 1.08[1.03; 1.14]) and SGA (OR = 1.10 [1.06; 1.15]), compared to Stable High SES areas.

Conclusions
Women from neighbourhoods with long-term low or declining SES were more likely to experience adverse birth outcomes. Policies aimed at mitigating the effect of long-term neighbourhood disadvantage or preventing neighbourhoods' decline have potential to benefit early life health outcomes.

Key messages
Women living in long-term low or declining socioeconomic status neighbourhoods were more likely to experience adverse birth outcomes. Our results can provide guidance to policies aimed at improving early life health outcomes.
Age-dependency in mortality of Finnish family caregivers: a nationwide register-based study
Authors: Mikkola T M , Kautiainen H , Mänty M , von Bonsdorff M B , Kröger T , Eriksson J G 
Published: October 2020

Abstract

Purpose
Mortality appears to be lower in family caregivers than in the general population. However, there is lack of knowledge whether the difference in mortality between family caregivers and the general population is dependent on age. The purpose of this study was to analyze all-cause mortality in relation to age in family caregivers and to study their cause-specific mortality using data from multiple Finnish national registers.

Methods
The data included all individuals, who received family caregiver's allowance in Finland in 2012 (n = 42 256, mean age 67 years, 71% women) and a control population matched for age, sex, and municipality of residence (n = 83 618). Information on dates and causes of death between 2012 and 2017 were obtained from the Finnish Causes of Death Register. Flexible parametric survival modeling and competing risk regression adjusted for socioeconomic status were used.

Results
The total follow-up time was 717 877 person-years. Family caregivers had lower all-cause mortality than the controls over the follow-up (8.1% vs. 11.6%) both among women (hazard ratio [HR]: 0.64, 95% CI: 0.61-0.68) and men (HR: 0.73, 95% CI: 0.70-0.77). Younger adult caregivers had equal or only slightly lower mortality than their controls, but after age 60, the difference increased markedly resulting in over 10% lower mortality in favor of the caregivers in the oldest age groups. Caregivers had lower mortality for all the causes of death studied, namely cardiovascular, cancer, neurological, external, respiratory, gastrointestinal and dementia than the controls. Of these, the lowest was the risk for dementia (subhazard ratio=0.29, 95%CI: 0.25-0.34).

Conclusions
Older family caregivers have lower mortality than the age-matched controls from the general population while younger caregivers have similar mortality to their peers. This age-dependent advantage in mortality is likely to reflect selection of healthier individuals into the family caregiver role.

Key messages
The difference in mortality between family caregivers and the age-matched general population varies considerably with age. Advantage in mortality observed in family caregiver studies is likely to reflect the selection of healthier individuals into the caregiver role, which underestimates the adverse effects of caregiving.
Prescription of physical activity: expectations of patients consulting in primary care in Yvelines
Authors: Astruc A , Kanso C , Blanchard J C 
Published: October 2020

Abstract

Background
Since 2016, French law has allowed general practitioners to prescribe adapted physical activity (APA) to patients with long-term health conditions. Studies have demonstrated that physicians are interested in this practice but very few have surveyed patient expectations.

Objective
The objective of this work was to study patients' expectations regarding the prescription of APA.

Materials and Methods
This is a quantitative descriptive study treating data obtained from a survey carried out in general practice offices in the department of Yvelines between June and September 2019. The inclusion criteria for patients were: above 18 years old and present in the waiting room.

Results
252 patients were surveyed in 9 doctors' offices. We received 90 % of responses. Prescription of APA is a good idea for 95,2 % of patients, 80,2 % were motivated to join an APA program and 67,4 % thought that prescription of APA would increase their motivation. The main constraints to physical activity practice were lack of time (59,9 %) and lack of motivation (31,7 %). The main practices that would help patients to better adhere to an APA program were group sessions supervised by a professional (64,7 %) pursued by a follow up with their doctor (41,7 %). 53,2 % of patients considered that it would be important to monitor their physical activity through a connected device. Factors independently associated with the motivation to participate in the APA program were a female gender (p &lt; 0,01), a bachelor's degree (p = 0,01), a general opinion that prescription of physical activity is a good idea (p &lt; 0,01).

Conclusions
Our results revealed an enthusiasm with patients for APA prescription, which is interesting for the promotion of PA in general medicine.

Key messages
Our results revealed an enthusiasm with patients for prescription of physical activity. Prescribing physical activity to patients seems to be an innovative way to promote physical activity.
Theory to practice: How the City of Utrecht develops a Health and Equity in all Policies approach
Authors: Weber M , Droomers M 
Published: October 2020

Abstract

Introduction
We witness an increase in Health in All Policies approaches worldwide. In Utrecht this inter-sectoral and multi-level governance approach is strong since several years. Utrecht has made progress in linking spatial challenges with social challenges, aiming for healthy urban living for all. An example is social renovation, in which social housing corporations combine physical renovation with social programs in Overvecht, the most socio-economically deprived neighbourhood in Utrecht. The project addresses social determinants of health, such as income, education and employment, and subsequently improvement of health of the residents.

Methods
In April 2020, social renovation of an apartment building of around 180 households will start. During the exploration phase, community workers carry out door-to-door visits. This forms the basis for community development activities and provides the possibility to refer residents directly to professional assistance. After one year, the actual renovation starts. Following, new residents are purposely selected and assigned to the newly renovated flats that have been vacated during the process.

Results
Impact of the social renovation process on health and health determinants will be evaluated. The door-to-door visits are used to interview the residents about their wellbeing, stress, mental and physical health condition, sense of mastery, financial problems, perceived safety, and social and physical living environment. Interviews will be repeated during the community development phase (after six months), and just before the start of the physical renovation (after one year).

Discussion
Social renovation aims to contribute to and preferably improve residents' personal living conditions and social living environment, instead of just improving their housing conditions. Lessons learned from this process will inspire replication and upscaling in other neighbourhoods.
Tackling antimicrobial resistance in the community
Authors: Tonkie-Crine S , Abel L , Van Hecke O , Wang K , Butler C 
Published: October 2020

Abstract
Antibiotic prescription is a major driver of antibiotic resistance. The majority of antibiotic prescribing occurs in community care settings, often for respiratory infections. A substantial proportion of prescriptions are issued not according to guidelines, particularly for acute respiratory infections which can be self-limiting. Prescribers in these settings need support to prescribe antibiotics more prudently. Patients and the public also need support to manage infections which are self-limiting. This presentation presents a summary of how antimicrobial stewardship (AMS) activities are being used in community settings. Firstly, types of community-level interventions are discussed, including those aimed at clinicians, patients and the public. Next, we assess interventions based on their effectiveness at reducing antibiotic prescriptions or use and their cost-effectiveness. Finally, we discuss directions for future research and consider how the research to date could influence policy.
25.K. Workshop: Unleashing the power of large routinely collected data for the benefit of public health
Authors:   Organised by: EHESP (France),   Chair persons: Olivier Grimaud - France, Alastair Leyland - UK
Published: October 2020

Abstract
As for many other scientific domains, public health is nowadays contemplating the opportunities of using but also the challenges of mastering large routinely collected data ('big data') in order to generate knowledge, and to inform and evaluate decisions and policies. In a wide perspective, “public health relevant big data” extends from the “omics” to social network postings.
In this workshop we will concentrate on electronic health records and medical claims data (hereafter referred to as eHRs) which are increasingly being used in public health research and practice. Depending of the national and historical contexts, eHRs encompass details pertaining not only to hospital admissions but also to deaths and infectious diseases registrations, prescriptions and contacts with health services. As a result, eHRs datasets are both long (ie, vast number of records) and wide (i.e., vast amount of information per record). Although the usual public health and epidemiological concepts of inference and causation are still relevant for the analysis of big health data and interpretation of their results, a new set of methodological approaches is also necessary to tackle them. These include for instance quasi-experimental/natural experimental analysis, data mining and machine learning. Recent reviews have demonstrated that these data science terms have corresponding concepts in public health research. This workshop will discuss the use of large routinely collected data in public health with a specific focus on eHRs. The objectives are: to understand the specificity of eHRs in the wider domain of big data; to discuss the challenges imposed when using such data (e.g., data heterogeneity, fragmentation, handling, access, privacy), to discuss how the analysis of big data can assist public health researchers, evaluators and policy-makers; to discuss their advantages and limitations; to outline the methodological, legal and ethical challenges that this entails. Following a brief introduction, the workshop will continue with 5 presentations drawing from a variety of national contexts. The spectrum will spread from countries where eHRs and data linkage have been applied for some years (e.g., Finland, Singapore), to others where development are more recent (France) or even being initiated (Brazil). Together, the presentations will address issues related to the development of big data set, access and training of users and implementation in public health research and practice. The remaining time will be dedicated to interaction with the audience and conclusion.

Key messages
Access and use of big data in the context of public health practice and research is spreading fast. The challenges ahead consist of maintaining and securing vast amount of heterogeneous health and related data, and in building the capacity to analyse them using old and new analytical approaches.
French Health big data experience: The evolution of the national health insurance information system
Authors: Le Meur N , Gao F 
Published: October 2020

Abstract
The French national health insurance information system created in 1999 is one of the largest global data warehouse of medico-administrative data, covering nearly 66 million inhabitants and containing more than 160 billion records, including all outpatient health expenditures. Recent legislation has enlarged the scope of information and access to the data warehouse. Initially created to reimburse patients, the national health insurance data warehouse has developed into a powerful tool for conducting public health research.
Public health researchers and epidemiologists have long studied population health determinants, including access to and impact of health care interventions, through hypothesis driven investigations based on experimental (randomized controlled trials) or quasi-experimental designs (e.g. cohort or case control studies). In such studies, efforts are centred on data validity rather than scope or volume. Nowadays the availability of medical claims and electronic health records (eHR) allows users not only to address similar research questions at no or little cost for data collection, but also to extend the scope of research questions to the analysis of care pathways, the evaluation of public health policies, the impact of interventions in real-life conditions.
Striding away from the conventional hypothesis driven research paradigm, public health researchers have started exploring the power of applying data mining approaches on eHR. As demonstrated in the omics revolution, data driven approaches are discovery-generating tools with explanatory and predictive power. Could data mining methods applied to eHR deliver similar breakthroughs in Health Services Research? What new knowledge and tools must the public health research community acquire to embrace this new research paradigm? These are the issues that we will discuss, with illustrations, during this presentation.
The national strategy for suicide prevention in the Netherlands: on the road to zero suicides
Authors: Franx G 
Published: October 2020

Abstract

Background
In the Netherlands, 1829 persons (11.6/100.000) ended their life by suicide in 2018. Two out of three suicides concern men, most of them in the age group of 50-55. Suicide amongst youth is rising, especially amongst youngsters between 10-25. Around 40 persons a day, predominantly young and female, are treated in Dutch hospitals after having attempted suicide. Only 40% of those who die by suicide have been in touch with healthcare professionals. These figures made the Dutch government to put in place a national strategy for suicide prevention.

Methods
This strategy follows the WHO's guidance and covers a range of measures in public health as well as in the health care sector. Its implementation is coordinated by “113 Suicide prevention”, the national centre of expertise on suicide prevention in the Netherlands.

Results
A broad package of measures is being implemented simultaneously, targeting the entire population as well as specific vulnerable groups, such as youngsters, persons with LGBT related issues and persons with mental health needs. We initiated several collective preventive measures, such as media guidelines for safe reporting, a public awareness campaign against stigma, reduction of access to deadly means or places; selective prevention initiatives, e.g. training over 3400 of gatekeepers to detect and address suicidal thoughts with desperate persons; and indicated suicide prevention strategies including screening, treatment and follow up of patients with suicidal behaviour in general practice or mental health hospitals. In this presentation the different components of the Dutch strategy for suicide prevention will be described more in detail, and experiences and first results of the different components will be addressed.

Conclusions
The relevance of the Dutch national strategy is related to the broad package of measures implemented simultaneously in many domains of society, but closely monitoring and evaluating the effect stays challenging.
Suicide prevention in Slovenia in the context of public health
Authors: Roškar S , Vinke M 
Published: October 2020

Abstract

Background
Suicide mortality in Slovenia has decreased with 30% in the last two decades, from 28,25 per 100,000 in 2003 to 17,08 per 100,000 in 2018. Nevertheless, the country's suicide rate remains markedly above the EU average. Only from March 2018, Slovenia has a National Strategy for Mental Health 2018-2028, with one of the priority areas being suicide prevention and a strategic goal of decreasing suicide mortality by 15% in the next 10 years.

Methods
Specific objectives are aimed at (i) raising of mental health awareness and literacy, particularly in relation to suicide, (ii) early identification of people at risk, (iii) access to help and mental health provision for people at risk of suicide, (iv) reduction in alcohol use, (v) restriction of access to the means of suicide.

Results
Many of suicide prevention initiatives in Slovenia are being implemented on the local, regional, and national level. They include universal and targeted approaches such as collaboration with different gatekeepers (e.g. general practitioners, first responders, school workers, media), screening programs for at risk individuals at the primary health care level (e.g. PHQ-9), network of psychological counselling services, etc. Two interventions will be presented in more detail, namely (i) collaboration with media representatives on responsible reporting on suicide (a 'pre-post' comparison of reporting revealed statistically significant improvement in 6 out of 10 guidelines) and (ii) a population screening for depression and referral program for individuals aged &gt; 35.

Conclusions
The aforementioned decrease in suicide mortality, timely coincides with the launch of multiple preventative activities. Even though further sound research is necessary to confirm a statistically significant relationship between the observed decrease and these preventive initiatives, it is probable that these actions contribute to the stagnation (and even decline) in the suicide rate in our country.
Practical lessons learnt from the worldwide implementation of 115 community-based interventions for suicidal prevention
Authors: Hegerl U 
Published: October 2020

Abstract

Background
Depression and other psychiatric disorders are the main cause for suicidal behaviour. The community based 4-level-intervention concept adapted by the “European Alliance against Depression” (www.EAAD.net) has been found to have preventive effects not only on depression but also on suicidal behavior in several but not all controlled studies. The 4-level intervention concept comprises training and support of primary care providers (level 1), a professional public relation campaign (level 2), training of community facilitators (teacher, priests, geriatric care givers, pharmacists, journalists) (level 3), and support for self-help of patients with depression and their relatives (level 4).

Methods
This 4-level intervention has in the meanwhile been implemented in more than 115 regions worldwide. A systematic assessment of the practical experiences, as well as a systematic process analysis and an implementation research were performed.

Results
Important findings of this research are: i) the relevance of a strong bottom-up element in the implementation process, ii) the synergistic and catalytic effects generated by becoming simultaneously active at the four different intervention levels, and iii) the crucial advantage of combining the partly overlapping topics of depression and prevention of suicidal behaviour. The latter approach is highly relevant having in mind the unclear risk-benefit-balance of anti-suicidal public campaigns, which are likely to result in a lowering of the threshold by normalization of suicidal behavior. More detailed information on these findings will be presented.

Conclusions
Systematic research on the on-going community based 4-level intervention program can add useful insights in suicide prevention strategies.
25.M. Workshop: Improving migration health information systems: Task-Force for facilitating action
Authors:   Organised by: University of Pecs (Hungary),   Chair persons: Kayvan Bozorgmehr - Germany, István Szilárd - Hungary
Published: October 2020

Abstract
Health information systems have not kept up with the demands and needs created by the sharp rise in human mobility over the past three decades. Most health information systems operate in national silos, and fail to provide a fully accurate, reliable and timely picture of the health and health care situation of a world on the move. As such, health needs of a large number of international migrants go unrecognized, and health systems fail to produce the evidence required for migrant-sensitive service planning, monitoring and public health action. The generation of such essential evidence relies on the inclusion of migrant health in health information systems in a consistent, comparable and ethically acceptable manner. A high-level consensus conference in Pecs (October 2019) noted the need for greater harmonisation and international cooperation on migrant health information systems, including data collection, analysis and dissemination. Taking the status quo of health information systems as a starting point, the workshop aims to present steps towards health system reforms which make information systems more sensitive and responsive to the health needs of increasingly mobile human populations. To this end, the workshop brings together researchers, policy makers and health professionals from different fields and institutions, to share existing knowledge, and by jointly exploring the following questions: What measures can we take to facilitate the harmonisation of migrant health indicators and data collection methods to ensure cross-border comparability, compatibility and completeness of data?How can we effectively improve international cooperation and governance of data management in order to share and transfer data for reasonable analysis, advocacy, and action?How can we initiate health systems reforms towards the above aims, considering that health systems are complex adaptive social constructs which are often resistant to change and not linear?What ethical and data protection considerations must be made when collecting, analysing and sharing migrant health data?How can build the required human resource capacities?

Key messages
Evidence based development of ‘migrant sensitive health care system’ requires specific, consistent and comparable health data Health systems harmonization on the field of migration requires supportive policy, guidance, infrastructure and trained human resources