bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health and social care near the end of life: Can policies reduce costs and improve outcomes?
Authors: Normand C , May P , Cylus J 
Published: October 2021

Abstract

Background
A key concern related to population ageing is how it will impact on health and social care use and expenditure trends. The belief that older people are more costly for health and social care systems than younger people is pervasive, and so the logic goes that having a larger share of the population at older ages may unsustainably accelerate growth in public health spending. In reality, the evidence suggests that the effects of ageing on health care costs will be modest and growth will be slow, but there will naturally be some additional care needs. Health and social care costs can nevertheless be particularly high for people near the end of life. In fact, the costs associated with end of life care largely explain why health and social care expenditures per person, on average, are higher for older people than for younger people, since most people die at older ages.

Methods
Literature review of patterns of service use and costs of care at the end of life; how needs for end of life care are likely to change with population ageing; and effects of end of life care interventions on patterns and costs of care.

Results
The evidence suggests that costs near the end of life vary greatly, and high overall costs are driven by service use by a small proportion of decedents.

Conclusions
Although the numbers of people with needs for palliative and end of life care will rise with population ageing, a review of the literature indicates that it is possible to reduce use of services and costs, and to improve patient experiences with well-designed palliative and end of life care interventions.
The politics of ageing: how to get policymakers to support lifecourse policies
Authors: Falkenbach M , Greer S , Lynch J , Gingrich J , Reeves A , Bambra C , Cylus J 
Published: October 2021

Abstract

Background
Given that there is not much evidence that ageing imperils the finance and provision of health care, why do so many policymakers act like it does?

Methods
We break conventional wisdom down into myths and realities, identifying the evidence against them.

Results
A first myth is that ageing produces unsustainable health care costs, which in turn, creates intergenerational conflict over public policy. A second myth is that older people behave as a single group, always pursuing policies that benefit themselves. The final myth is that decisions about policy are made by politicians who pander to that elderly block. The first reality is that most of the problems ascribed to inequality between generations (intergenerational equity) are actually problems of inequality within society as a whole that span across age groups (intragenerational equity). The second reality is that policies that address these broader inequalities are built on the life-course perspective, which focuses on identifying the policies which can make people happier and healthier at all ages by drawing on the context and circumstances under which aging occurs. The third reality is that it is possible to construct coalitions of politicians and interests that can develop and support sophisticated life-course policies that lessen the burdens of ageing and health on everybody.

Conclusions
Intergenerational inequality is not, and need not be, a significant problem for rich countries. It is substantially a product of current and past intragenerational inequality, and in fact inequality between generations often goes with inequality within generations. Intergenerational conflict is a distraction from policies that promote greater equality within and between generations, and talk of an ageing crisis is frequently just another version of longstanding arguments against public social investment from cradle to grave.
8.E. Workshop: One health approach to gain Youth engagement toward environmental issues
Authors:   Organised by: EUPHA-ENV,   Chair persons: Fabiana Rubba (Italy), Vlatka Matkovic Puljic (Belgium)
Published: October 2021

Abstract

Humanization of care is involved in promoting healthy behaviors including harmonization with environment, implementing an educational model of “one health” approach. A strong emphasis is placed in our project on strengthening environmental awareness of the young generation through education and other forms of youth engagement. We built an educational project that involved schools (almost 200 students). Students had a “one -health “core curriculum focused on Medicine and environmental issues; spill over and environmental issues; green economy end mathematical models affecting environmental changes; architectural issues involving environment. After skill building classes Young students focused on three main issues that will be presented during the workshop:
A liquid biopsy model to detect eventual pollutants A study concerning individual behavior impact A green sustainable architectural model
The three issues were developed as proposal for:
A model of Health vision based on multidisciplinary A Youth stand point concerning environmental actual proposal to implement the Green deal
Liquid biopsy is a new diagnostic concept useful to collect and analyze sample from different humans and animal matrices able to investigate the molecular features by blood, saliva, and any other body fluids which show a source of potential biomarkers. Further, particular strategies on the possible ways of regenerating the center of the cities to make it resilient to critical environmental impact, and models to redevelop the suburbs were developed. Finally, individual behaviors can affect either health care or environmental goals. The add value of this work may be to realize through citizen activism a powerful tool for climate action, sustainable development and environmental protection through Youth engagement toward an health model that include environmental determinants. Their stand point may be meaningful in order to gain proposals for the European Green Deal, according to the sub topic 1 objective: “specific educational programs, school curricula, trainings, networking activities and exchange of good practices in the area of climate change and education for sustainable development. Thus, it is becoming increasingly important to study and to derive from different approach results regarding the connection between environment, humans and animals and with a new diagnostic genomic not-invasive approach.

Key messages
Youth engagement toward health and environmental issues may contribute to citizen activism. One health model is consistent with a multidisciplinary approach to care and environmental goals.
Comparative study of nurses’ perception of barriers and facilitators for care coordination
Authors: Agerholm J , Koitzsch-Jensen N , Liljas A 
Published: October 2021

Abstract

Background
The hospital discharge process of older adults with complex health and social care needs requires coordination between multiple care providers. Providing insight to the care coordination from healthcare professionals' views is crucial to show what efforts are needed to manage the discharge process, and to identify strengths and weaknesses of the care systems in which they operate. The aim of this study was to examine nurses' perceptions on barriers and facilitators of good care coordination for older patients with complex health and social care needs being discharged from hospital in Copenhagen (DK) and Stockholm (SE).

Methods
Semi-structured interviews were conducted with 27 nurses involved in the coordination of the discharge process at hospitals and home healthcare services (Copenhagen n = 11, Stockholm n = 16). The interview guide included questions on the nurses' contributions, responsibilities and influence on the discharge process. They were also asked about collaboration and interaction with other professionals involved in the process. The data was analysed with a thematic content analysis approach.

Results
Main themes were communication ways, organisational structures and supplementary actions by staff. Preliminary findings include differences in the organisational structure of the two care systems in relation to integration between different actors and differences in how they consider access to patient information, which influences the coordination. There also seem to be discrepancies in care policies and outlined staff responsibilities compared to the actually work undertaken by the nurses in both care systems.

Conclusions
There are lessons to be learned from both care systems. The written e-communication between hospitals and home health care runs smoothly in Stockholm, whereas it is perceived as a one-way communication in Copenhagen. In Copenhagen there is more sector-overlapping work which might secure a safer transition from hospital to home.

Key messages
The written e-communication between hospitals and home health care runs smoothly in Stockholm, whereas it is perceived as a one-way communication in Copenhagen. In Copenhagen there is more sector-overlapping work than in Stockholm which might secure a safer transition from hospital to home.
Healthcare needs of young people transitioning back to the community after a custodial sentence
Authors: Biazus Dalcin C , Rodriguez A , Fernandes F , Swinney A , Bezerra Pinheiro AK , Rocha P , Lomba L 
Published: October 2021

Abstract

Background
People in prison have poorer health outcomes than the general population, added by the long-term impact of incarceration on mortality. Young people in custody face extra challenges associated with the stage of development. There is a lack of a tailored approach and policy to young people when transitioning back to the community. This paper draws from a PhD research that looked at the challenges to access healthcare during the transition back to the community. The specific question is: What are young people's healthcare needs when released from custodial sentences?

Methods
An ethnographic study conducted in Scotland in partnership with a community-based organisation. The participants were eight young people and ten practitioners that work in health and social care. Participatory observation and in-depth interviews were used to collect data during July 2019 and March 2020. Data analysis was conducted with Reflexive thematic analysis. NVivo supported data management.

Results
The identified needs were individualised issues, structural factors, mental health, substance use and geographical disposition of services. There is a need for mental support and continuity of care associated with substance use. The demand for local services is vital for healthcare provision. Healthcare needs go beyond the necessity of services and health issues. They are associated with stigma in the interaction with practitioners. Institutional practices and practitioners' attitudes reinforce non-explicit forms of discrimination and health inequalities.

Conclusions
Practitioners and policymakers need to focus on the person-centred approach. They need to listen to young people. Data showed a need for specific services, like mental health and drug use. Moreover, practitioners need to avoid stigmatisation and discrimination by a caring practice. Public health and social care policies need to address stigma and access to services for young people after a custodial sentence.

Key messages
It is necessary to avoid stigmatisation and improve access to services for young people transitioning back to the community after a custodial sentence. Public Health and social care policies need to address this marginalised group by offering person-centred approaches, continuity of care and support during re-entry.
9.B. Workshop: Burden of disease of COVID-19: strengthening the collaboration for national studies
Authors:   Organised by: COST Action CA18218-European Burden of Disease Network,   Chair persons: Sara Pires (Denmark), Elena von der Lippe (Germany)
Published: October 2021

Abstract

The spread of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was categorized as a pandemic by the World Health Organization in March 2020. Since the outbreak was first identified in December 2019 in Wuhan, China, the public health impact of the disease globally has been enormous. Estimating the burden of the disease at national level is useful for comparing its impact with other diseases in the population and across populations. The disability-adjusted life year (DALY) is one of the most used summary measure of population health, and the key metric in the Global Burden of Disease study. The European Burden of Disease Network (burden-eu) was established in 2019 to act as a technical platform for integrating and strengthening capacity in burden of disease assessment across Europe and beyond. It is structured in technical and disease-focused working groups focus. Since the start of the pandemic, burden-eu has developed tools and started initiatives to support countries in estimating the national burden of COVID-19. These include developing and harmonizing methodologies, disseminating technical materials, launching a working group and online forum, exchanging experiences and supporting capacity building, and planning future studies. This workshop consists of four presentations. In the first, we present a consensus methodology, data requirements and solutions to data gaps to estimate national-level burden of COVID-1. Next, we present as examples results of studies conducted in Germany and Scotland, and the status of an international effort to harvest real-world data derived from the health systems' response across Europe and internationally during the pandemic. The fourth presentation describes burden-eu's activities to promote capacity building to estimate the burden of COVID-19, and discusses the importance, needs and lessons learned of sharing experience and of communicating COVID-19 data. The workshop will end with ample time for discussions on current approaches and opportunities for methodological developments, challenges, possible solutions and potential for collaborations to increase implementation and utility of studies of COVID-19 burden globally.

Key messages
National burden of disease studies offer a means of monitoring the direct population health impact of COVID-19 infection in countries. International initiatives have emerged to promote harmonization of methods, share knowledge and support international collaboration across countries and public health authorities worldwide.
Building country-level capacity to estimate the burden of COVID-19
Authors: Pires S 
Published: October 2021

Abstract
The European Burden of Disease Network (burden-eu) joins 271 members from 50 countries. Upon the onset of the COVID-19 pandemic, several of these members started studies to estimate the burden of COVID-19 in their countries, and many others showed interest in taking steps to launch such studies. Capacity building is one of the key pillars of burden-eu, and the ultimate goal of several of its activities. In mid-2020, a group within burden-eu convened to establish an approach to support the network's members to establish national studies. First, the grouped discussed the methodology, data requirements and resources needed to implement a national study. Based on the output of these discussions, a comprehensive protocol was published on the network's website, and a scientific article was published in an open-access journal. To present this methodology, share already finalized studies, and discuss challenges and opportunities for future studies, in November 2020 burden-eu organized a public webinar, which was attended by over 100 participants. The network's website collects and continuously posts all published articles related to the burden of COVID Burden-eu. Burden-eu also formed the Burden of COVID-19 Working Group, which is open to all network members conducting or interested in implementing national studies. This group aims to share experiences in national burden of COVID-19 studies; support each other with calculations, model assumptions, data gaps; harmonize methodologies and align strategies for communicating results; and discuss research and upcoming evidence on long-COVID. The group meets regularly to achieve these aims. Lastly, the network launched an online discussion forum, where members can post questions and receive answers from peers in an interactive and rapid way. All these efforts have resulted in several studies being launched, and are allowing for harmonized approaches to be used and comparable estimates to be generated.
Urban Green Spaces and Public Health Outcomes: a systematic review of literature
Authors: Gianfredi V , Buffoli M , Rebecchi A , Croci R , Oradini-Alacreu A , Stirparo G , Marino A , Odone A , Capolongo S , Signorelli C 
Published: October 2021

Abstract

Background
As stressed by COVID-19 pandemic, urbanicity might represent a risk factor for chronic non-communicable diseases or generally impacting on healthy lifestyle, among them physical activity.

Methods
In light of this, we performed a systematic review aimed to explore the association between urban greenspaces and two important health indicators for both mental and physical health. In particular, our aims were to analyze the association between publicly accessible urban greenspaces exposure, and mental health outcomes (MH) and objectively-measured physical activity (PA). The review was conducted from 2000/01/01 to 2020/09/30 searching in two electronic databases: PubMed/Medline and Excerpta Medica dataBASE (EMBASE). Only articles in English were included.

Results
Out of 356, a total of 34 studies were included in our review, of which 19 assessed MH outcomes, the remaining dealt with PA. Only a few included studies found a non-effect or a negative effect on MH outcomes, whereas, all the others demonstrated a positive effect of urban greenspace and both MH and PA. However, our results stressed not only the importance of green space presence, but also the importance of maintenance, renovation, closeness to residential areas, the presence of interactive activities, and perceived security aspects.

Conclusions
To conclude, even some methodological limitations of the included studies, results are concordant in demonstrating that urban greenspaces show potentially beneficial effects on mental health and physical activity. Our results are significant for public health experts and policymakers involved in urban planning, community health promotion, and improvement of health and social equity.

Key messages
Urban green spaces are important factors, impacting on both physical and mental health. Policymakers involved in urban planning should pay more attention in urban green spaces.
Body weight, body composition and risk of SARS-CoV-2 infection in a large population-based sample
Authors: Deschasaux-Tanguy M , Bourhis L , de Lamballerie X , Carrat F , Touvier M ,   SAPRIS-SERO study group, Paris, France
Published: October 2021

Abstract

Background
Obesity has been identified as an important risk factor for COVID-19 severity. Besides, several reports also suggested that obesity (or a higher BMI) may also be associated with a higher susceptibility to SARS-CoV-2 infection although this remains unclear. Going beyond BMI, our objective was to study several anthropometric characteristics in relation to the seroprevalence of SARS-CoV-2 infection in a large population-based sample.

Methods
21,376 participants from the French NutriNet-Santé cohort study were included in the main analyses. An ELISA assay was used to detect anti-SARS-CoV-2 antibodies: 1027 participants were positive and 20,349, negative. Associations between a wide range of anthropometric characteristics (body mass index but also waist and hip circumference and body composition) and the seroprevalence of anti-SARS-CoV-2 antibodies were investigated using multi-adjusted logistic regressions.

Results
A positive yet unclear association was observed between BMI and SARS-CoV-2 seroprevalence in women (positive linear trend (P = 0.07) that was significant using restricted cubic splines (P = 0.04), but no association with standard categories of BMI). No association was observed in men. Waist circumference (P = 0.04) and waist-to-hip ratio (P = 0.01) associated with a higher seroprevalence in women while opposite trends were observed in men (P = 0.08 and 0.03 respectively). Body, trunk and visceral fat (all P &lt; 0.05), but not lean or muscle mass, associated with higher seroprevalence, especially in women.

Conclusions
Our results highlight a higher susceptibility to SARS-CoV-2 infection in women with higher body fat, suggesting that central adiposity may be an important factor to consider for risk stratification in the population.

Key messages
A higher seroprevalence of SARS-CoV-2 infection was observed in women with a higher body fat, but not in men. Central adiposity may be a risk factor for SARS-CoV-2 infection and not only for COVID-19 severity.
The new map of injuries in the aftermath of the COVID-19 pandemic: examples from north with south Europe
Authors: Alves T , Lund J , Papadakaki M 
Published: October 2021

Abstract
The aim of this paper is to describe the impact of the pandemic on injuries. Data from National Injury Surveillance System of Norway and Portugal during Covid-19 period were analyzed. In Norway hospital data on injury diagnoses were collected from a national emergency preparedness register established during the pandemic. The number of injured patients per day in the period 1 January-30 June 2020 were identified. The change in patient volumes over two three-week periods before and during the lockdown by sex, age, level of care, level of urgency, type of contact and type of injury were analysed. In Portugal we described the temporal trend in 2020 of the Home and Leisure Accidents(HLA) among vulnerable groups(0-19years, 65years+), who needed attendance in Emergency Department(ED) of the National Health Service Hospitals. In 2019 and 2020, 240 538 HLA episodes were recorded in the age groups of interest. In Norway, there was an overall reduction of 43% in injured patients during the first three weeks of lockdown. The decrease in patient contacts did not differ by sex, but was most pronounced among young people. Substantial reductions were observed for both acute and elective treatment and across all levels of care and types of contact, with the exception of indirect patient contacts. The change in patient contacts varied considerably by injury type, with the largest reduction observed for dislocations/sprains/strains and a lower decrease for burns/corrosions/poisoning. Similar trend was observed in Portugal on home and leisure accidents episodes rate registered in children and young people up to 19 years decreased by 24,0% during the 2020 year. In groups of 10-14 years the greatest significant decrease of 35,2% was observed, followed by groups of 5-9 years with a decrease of 24,1%. In 65-74 years an increase of 13,2% was recorded, with the highest increase(19,1%) among people aged 75+. Implications for the health systems and health policy planning will be discussed.