bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of youth in the climate change debate
Authors: Van Den Hazel P 
Published: November 2019

Abstract
The impacts of climate change are not distributed equally. Some people will experience natural disasters first hand, some will be affected more gradually over time, and some will experience only indirect impacts. There are data from the United nations that show the interest of youth on climate change. Close to half a million youth around the world have taken action on climate change through SGP [small grants programmes] projects in their homes, schools and communities. (UNDP, 2015). 84% of the surveyed young people agree that they need more information to prevent climate change. (UNEP, 2011). Furthermore, about 73% of surveyed youth say they currently feel the effects climate change. (UNEP, GlobeScan Survey, 2008). Some 89% of youth respondents say young people can make a difference on climate change. [UNEP, 2008]. But only 9% of youth are very confident the world will act quickly enough to address climate change. [UNEP, 2008]. Young people are key actors in raising awareness, running educational programmes, promoting sustainable lifestyles, conserving nature, supporting renewable energy, adopting environmentally-friendly practices and implementing adaptation and mitigation projects[UNFCCC]. Action by youth, as protest school strikes or speeches to the UN by Greta Thunberg, urge immediate action from governments, business leaders and school leaders. There are different reasons for this action by youth. The psycho-social impacts of a changing climate are generally under lighted in these reasons. Are the responses by society enough to minimize suffering and promote resilience of youth in the face of the challenging impacts of climate change? Or do governments and businesses enough while they increasingly seem to be moving toward action on climate change, as they proclaim to cut their own emissions or be active in their energy transition? It is not clear whether those actions are enough to satisfy the next generation of customers, employees and decision makers.
Disease burden in the Nordic region. Results from the Global Burden of Disease Study 2017 (GBD 2017)
Authors: Knudsen A ,   GBD 2017 Nordic Collaborators
Published: November 2019

Abstract

Background
The Nordic countries - Norway, Sweden, Finland, Iceland, Denmark - combine liberal and open-market economies with public welfare and universal health services. As separate countries with differences in culture and lifestyle, important health differences may exist between them. The aim of this study was to compare life expectancy and disease burden by causes and risk factors in the Nordic countries, including Greenland as constituent country under Denmark.

Methods
Age-standardised overall, cause-, and risk factor-specific estimates of disability-adjusted life-years (DALYs), along with life expectancy, were analysed in the Global Burden of Diseases, Injuries and Risk Factors Study 2017 (GBD 2017). Sex and country specific estimates were compared with Nordic regional estimates.

Results
Males and females in Denmark (males: 78.8 years, 95% uncertainty interval 78.1-79.5; females: 82.7 years, 81.9-83.4), and males in Finland (78.6 years, 77.8-79.2) had lower life expectancy than the other countries. The lowest life expectancy and highest DALY rates were found among males and females in Greenland. Variation in DALY rates between the countries was primarily due to differences in mortality-related causes, including ischaemic heart disease, chronic obstructive pulmonary disease, lung cancer, alcohol use disorder, and self-harm. These causes dominated male DALYs. There was little country-wise variation in DALYs due to non-fatal diseases, which were dominant causes among females. Smoking and metabolic risk factors were important risk factors across countries, but contributed most to DALYs among males and females in Denmark, and males in Finland (alcohol use only).

Conclusions
The GBD framework facilitates within-region comparisons for benchmarking exercises and can guide policy development. The comparison of disease burden in the Nordic countries illustrates how differences in risk factors may drive life expectancy and disease burden differences in high-income settings.

Key messages
Diseases and injuries associated with mortality are important causes of disease burden among males, while non-fatal diseases dominates disease burden among females in the Nordic region. Risk factors differences may drive disease burden differences between the Nordic countries.
Neurodevelopmental multimorbidity and educational outcomes of 766,244 Scottish schoolchildren
Authors: Salim E , Fleming M , MacKay D F , Henderson A , Kinnear D , Clark D , King A , McLay J S , Cooper S A , Pell J P 
Published: November 2019

Abstract

Background
Neurodevelopmental conditions commonly co-exist in children but, in comparison with adults, childhood multimorbidity has attracted less attention in research and clinical practice.

Methods
Record linkage of five Scotland-wide databases produced a cohort of 766,244 children attending Scottish schools between 2009 and 2013. Autistic spectrum disorder (ASD) and intellectual disabilities were ascertained from records of special educational need in the annual Pupil Census and attention deficit hyperactivity disorder (ADHD) and depression through relevant encashed prescriptions.

Results
Neurodevelopmental multimorbidity (≥2 conditions) was identified in 4,789 (0·6%) children; with ASD and ADHD the most common combination. Multimorbidity was associated with significantly increased risk of school absenteeism (adjusted IRR 1·23, 95% CI 1·20-1·28), school exclusion (adjusted IRR 3·04, 95% CI 2·74-3·38), low attainment (adjusted OR 12·07, 95% CI 9·15-15·94) and unemployment (adjusted OR 2·11, 95% CI 1·83-2·45) with clear dose relationships evident between number of conditions (0, 1, ≥2) and the last three outcomes. The associations with multimorbidity were stronger in girls than boys. Co-existence of depression was the strongest driver of absenteeism and co-existence of ADHD the strongest driver of exclusion. Low attainment and unemployment were, in part, mediated by absence and attainment respectively, and were not driven by specific conditions but rather multimorbidity from any cause.

Conclusions
Structuring clinical practice and training around single conditions may disadvantage children with multimorbidity who are at significantly increased risk of adverse outcomes if their complex needs are not recognised and managed.

Key messages
Neurodevelopmental multimorbidity can have significant impacts on children’s education. A holistic healthcare approach is needed to reduce the address their needs and reduce the risk of adverse outcomes.
Job control and risk of disability pension in the nationwide Danish Work Life Course Cohort
Authors: Svane-Petersen A , Framke E , Sørensen J K , Rugulies R , Madsen I E H 
Published: November 2019

Abstract

Background
A large number of studies have found job control to be consistently associated with an increased risk of disability pension. However, most previous studies have measured job control by self-report, introducing possible reporting bias inflating the risk estimates. Furthermore, previous studies have not accounted for the potential selection of individuals with pre-existing risk factors for disability pensioning into low control jobs.

Methods
We analyzed data from the nationwide register-based Danish Work Life Course Cohort (DAWCO; n = 960,562 with approx. 6 million person-years). We measured job control annually by a job exposure matrix, based on a scale of five self-reported items from The Danish Work Environment Cohort Study, and disability pension using registers on public transfer payments. To account for potential selection into occupations with lower levels of job control, we included numerous life course confounders, including parental socioeconomic position and psychiatric and somatic diagnoses.

Results
Employees in jobs with lower levels of job control had increased risk of disability pensioning. The association attenuated after adjustment for confounders but was not explained by selection into job groups with lower levels of job control (hazard ratio: 1.16 (95% CI: 1.03-1.31).

Conclusions
Our findings suggest that lower levels of job control are associated with an increased risk of disability pension, and that this association is explained by neither reporting bias nor a selection of individuals with an increased risk of disability pensioning into job groups with lower levels of job control.

Key messages
Lower levels of job control appear associated with an increased risk of disability pension independent of life course confounders. Further research is needed on preventive measures in occupations with low levels of job control.
Epidemiological and nutritional transition in low- and middle-income countries
Authors: Stranges S 
Published: November 2019

Abstract

Issue/problem
In the last decades, the number of deaths from non-communicable diseases in developing countries has risen to those observed in developed countries.

Description of the problem
Nutritional research in developing countries has primarily focused on under-nutrition, particularly among vulnerable population subgroups such as women and children. However, while economic growth has a significant social impact at population level, there is suggestive evidence of an ongoing nutritional transition leading to concurrent under- and over-nutrition in the population.

Results
The ongoing nutritional transition in these settings has been mostly linked to the rapid process of urbanisation and westernization. Data from several developing countries suggest that improvements in developmental indicators is accompanied by higher availability of highly processed poorly nutritious foods. Regarding socioeconomic factors, results demonstrated that better education and better living standards were associated with higher odds of overweight/obesity after adjusting for confounders, including urban vs. rural setting. This is likely a consequence of the ongoing nutritional and epidemiological transition occurring in these settings. In fact, developing countries have not yet reached the same phase of nutritional transition as an economically affluent country, and while high-calorie diets comprising fast-food are the more economically affordable option in the latter, such diets are still reserved for the more affluent individuals in some developing countries, where economic growth has only just begun to allow affluent individuals to afford fast-food.

Conclusions
Understanding the underlying ecological and socioeconomic roots of both extremes of the nutritional status is vital to design successful public health interventions.
Geographical variations in access to expert centers for multiple sclerosis in France
Authors: Leray E , Mamadou F , Guilleux A , Roux J , Grimaud O 
Published: November 2019

Abstract

Background
Multiple sclerosis (MS) is a chronic neurological disease affecting about 100,000 persons in France. Disease management is mainly supervised by the neurologist, supported by the general practitioner (GP). The complexity of the disease, due to the variety of symptoms as well as the recent changes in the therapeutic arsenal, requires both a high level of expertise and coordination between the different health care providers. To face this challenge, integrated and coordinated network of services “MS expert centers” have been progressively set up from 2000 onwards. Our objectives are to describe referrals to MS expert centers over the 2010-2015 period, to look for geographic variations and if any, to identify potential determinants of access.

Methods
The analysis is performed on the French health insurance database which covers 97% of the French population. Geographic variations of access are explored, as well as association with the following parameters: demographics (age, sex), socio-economic characteristics (social deprivation index at residence, degree of urbanization), and density of health care services (GPs, neurologists, hospital beds).

Results
Overall, 112,415 people with MS (70% women, mean age 46 years) were included. Initial results show that over the study period, 98% of patient had at least one visit to GP, 87% to neurologist, and 36% in a CRC SEP.

Conclusions
The present study will assess to what extent MS patients have been able to take full advantage of an innovative organization of specialized care which was recently deployed in France. This model of care has been generalized by the French Ministry of Health in 2016 and 23 ‘competence and resource centers’ for MS (CRC SEP) are now covering the whole national territory. Further research will be performed to identify whether and how this has modified access to specialized coordinated MS care.
The EU Joint Action on Vaccination – capitalizing on existing knowledge
Authors: Sivela J 
Published: November 2019

Abstract
Vaccine hesitancy is considered a major global public health threat. Vaccine hesitancy stands for refusing or delaying the acceptance of vaccines, and it is influenced by matters, such as the lack confidence in the system providing the vaccines, inconvenience of vaccination services and individual risk perceptions. In a European context, the lack of confidence is often put forth as major reason behind low vaccine uptake. However, it is equally important to address matters relating to the accessibility and convenience of vaccination services.
The European Council and the European Commission have made several decisions aiming to strengthen vaccine confidence and uptake in Europe. The ongoing EU Joint Action on Vaccination (EU-JAV) is delivering a number of these. As a work package leader for the actions related to vaccine hesitancy and uptake, Jonas Sivelä will talk about the importance of capitalizing on existing knowledge and practices within Europe - and the potential we have in increased cooperation between countries, regions and actors. The EU-JAV develops a systematic overview and analysis of best practices, lessons learned and experiences from vaccine hesitancy and uptake related work. Such work can encompass different types of interventions and practices, for example, training of health care workers, communication policies, or initiatives aiming to increase the accessibility of vaccination services. The EU-JAV creates mechanisms and practical tools for disseminating the knowledge about this work for actors in the public health sector in order to strengthen their possibilities to encounter vaccine hesitancy.
3.L. Workshop: It’s time for timeliness in Health Technology Assessment
Authors:   Organised by: EUPHA (HTA), EUPHA (HSR) Chair persons: Chiara de Waure - EUPHA (HTA), Carlo Favaretti - EUPHA (HTA)
Published: November 2019

Abstract

The timeliness of the release of results is one of the most critical issue regarding Health Technology Assessment (HTA) and its potential to support decision-making. This matter may reflect the deep conflict between HTA doers and users. HTA is a form of evidence-based research, expected to timely inform decision-making at several levels - from health policy (macro) to hospital and clinical management (meso and micro) - ensuring accuracy and assessment of both short- and long-term effects of a health technology. HTA purpose therefore is to respond to real world needs, while not overlook a correct methodology. Fast developing health technologies have rapidly spread over the past decades, hence increasing demand for timely assessment aimed at their prompt implementation and management, especially at meso and micro decisional levels. Furthermore, the need for quick answers is emphasized by the pressures placed on policy-makers when a health technology is publicly promoted or contested. Furthermore, an ill-timed assessment can lead to several consequences, among which possible inequalities in access to healthcare. In order to address the challenge of timeliness, organizations involved in HTA should set up models and tools to deliver timely information. The aim of this workshop is to point out the timeliness of HTA as crucial in the decision-making process as a mismanagement of HTA system could be an obstacle to an appropriate healthcare policy. Else more, the workshop would like to critically present examples where research was on time or too late to be included in the decision-making process and elaborate on possible models to successfully deal with timeliness of HTA deliverables in particular at hospital level.

Key messages
The timeframe of HTA should ensure the accuracy of information and of methodological and legal steps, without forgetting the timeliness of delivery. Models and instruments should be implemented in order to guarantee the timeliness of HTA reports.
Workshop: A methodology for monitoring population health literacy in Europe – the HLS19 project
Authors:   Organised by: EUPHA (HP), Austrian Public Health Institute Chair persons: Jürgen M Pelikan - Austria, Dietscher Christina - Austria
Published: November 2019

Abstract

Health literacy (HL) is a critical determinant of health (WHO-Shanghai Declaration, 2016), i.e. of healthy life styles, of indicators of health status and of use and results of health care services. For Europe the European Health Literacy Survey (HLS-EU) in 2011 demonstrated, that a considerable proportion of general populations in the researched 8 European countries (and in more countries in later surveys) had limited health literacy and that there was a considerable social gradient of health literacy. The HLS-EU study also showed that HL impacted certain health risks, important indicators of health status and of use of professional health services. But besides these general trends for all researched European countries, there existed considerable variations in distributions and associations of health literacy between the researched countries.
Thus, since knowledge on health literacy of populations is relevant for planning health policy, the Solid Facts - Health Literacy of WHO-Europe (2013) recommended regular monitoring of population health literacy by standardized procedures. Since HL now is understood as a relational concept, HL can be measured on a personal or an organizational systems level. Also measures to improve HL can try to improve personal HL by offering better opportunities for learning or by developing Health Literate Organizations or settings to be more sensitive to personal HL of their users and be less demanding and more supportive for users.
Therefore in 2017 the Action Network on Measuring Population and Organizational Health Literacy (M-POHL) was initiated under the umbrella of the European Health Information Initiative (EHII) by WHO-Europe. M-POHL from its beginning combines a policy with a research agenda. About 25 member states of WHO-Europe already joined M-POHL. As a first project the European Health Survey 2019 (HLS19) is ongoing with 15 countries participating.
The workshop will inform about the vision and mission of M-POHL, about the methodology of the on-going HLS19 survey and about the way selected countries are using monitoring of HL for their health policy. Following 5 short inputs (60′), including two more general ones M-POHL and HLS19 and three on perspectives from countries, participants will have the opportunity (30`) to ask questions and discuss what M-POHL and HLS19 means or could mean for health policy of their country and their personal research or policy interests.

Key messages
Health literacy is a critical determinant of health which has to be monitored for general populations in all countries of WHO-Europe as a basis for national and European health policy. The Action Network of Measuring Population and Organizational Health Literacy (M-POHL) of WHO-Europe has started the Health Literacy Survey 2019 to provide data for evidenced-based health policy.
Using data on population health literacy as a basis for evidence-informed health policy
Authors: Dietscher D 
Published: November 2019

Abstract
An increasing body of evidence suggests that health literacy (HL) is relevant for health-related decisions in relation to treatment, prevention, and health promotion and, consequently, for health and health care outcomes. At the same time, data illustrate that huge proportions of populations in many countries are concerned by low levels of HL. The improvement of HL should therefore be an issue of concern for health policy.
In the sense of “what doesn’t get measured doesn’t get done”, internationally comparative data on HL - like those provided by HLS-EU (2011) - can provide important guidance for health policy and administration on where best to intervene. Austria is one of the eight countries that participated in HLS-EU. According to the data analysis, the percentage of the Austrian population affected by low levels of HL came second-to-last in the survey. This was a wake-up call for Austrian health policy, and numerous activities were initiated as a result.·
In 2012, Austria launched a national health target on improving population HL. Since 2013, specific objectives to improve HL have been integrated into the ongoing national health care reform process. In 2015, a national HL alliance was launched to coordinated activities. Today, the alliance has 5 defined program lines that are in huge parts inspired by the analysis of HLS-EU data, and Austria will participate in the next European HL survey starting in Autumn 2019 to get new data.
The examples of other countries - including those represented in the workshop - confirm the importance of internationally comparative data to trigger national attention and to start coordinated action on HL. According to the Austrian experiences so far, data analysis can support evidence-informed action in defined fields of activity. To remain active in a continuous and systematic way requires national capacity-building as well as the identification of and collaboration with stakeholders across sectors.