bluuebunny/crossref_metadata_2025_split huggingface dataset:
SARS-C0V-2 vaccination in the context of employment: the legal framework in Hungary
Authors: Földes ME , Kaposvári Cs 
Published: October 2021

Abstract

Background
Deployment of SARS-CoV-2 vaccines has sparked the debate on action that employers can lawfully take to promote vaccination uptake among employees. Absenteeism reduction, liability concerns, occupational health and safety, protecting the health and safety of clients and service recipients might prompt such action. This raises questions about employees' freedom of choice and right to (refuse) consent. The research examined the related policy and regulatory framework in Hungary.

Methods
Legal and policy analysis was conducted on Hungary's immunization policy as well as its legal and regulatory framework for SARS-CoV-2 vaccines deployment. The focus was on health law and labour law to explore whether and how SARS-CoV-2 vaccination could be turned into a workplace safety requirement.

Results
In Hungary, SARS-CoV-2 vaccination is currently voluntary. However, the Hungarian Healthcare Act and Labour Code allow for making it mandatory by ministerial decree prescribing a vaccination obligation as an employment condition for certain jobs. The National Public Health Center determines on a yearly basis the list of jobs concerned. Individuals may only be exempted if their (current or foreseeable) underlying health conditions so require. Further to the Labour Code, if employers use negative incentives (e.g., sanctions) and positive incentives (e.g., bonuses) to enforce vaccination, they must satisfy the conditions of necessity, proportionality and non-discrimination.

Conclusions
Although SARS-CoV-2 vaccination is currently voluntary in Hungary, the legal framework for mandatory vaccination at work is put in place. When it comes to enforcing the vaccination obligation, sanctions imposed by employers and related application of the necessity and proportionality standards have not yet been tested in Hungarian courts.

Key messages
Regulation shall ensure protection of employees’ rights as part of SARS-CoV-2 vaccination policies. Measures promoting vaccination must respect the legal requirements of proportionality, necessity and non-discrimination.
Trends in associations between sickness absence, disability pension and paid work after age 65
Authors: Farrants K , Head J , Alexanderson K 
Published: October 2021

Abstract

Aim
The increasing workforce participation at higher ages may impact social insurance systems, however, this has hardly been studied at all. We investigated associations between sociodemographic factors, prior sickness absence, and prior disability pension, with being in paid work after age 65 and to what extent they then had any sickness absence, and if such associations changed over time.

Methods
We conducted three prospective cohort studies. We used longitudinal data from three nationwide registers linked at individual level covering all residents in Sweden who turned 65 years in 2000, 2005, or 2010 (N = 50,000, 68,000, and 99,000, respectively). Logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI) for the association between sickness absence and disability pension when aged 60-64 and a) being in paid work when aged 66-71, and b) having sickness absence when aged 66-71 among those in paid work, adjusted for sociodemographic variables in each of the three cohorts.

Results
Although the percentage of individuals in paid work when aged 66-71 increased substantially between the cohorts (2000 cohort 28.7%, 2005 cohort 39.5%, 2010 cohort 48.2%), associations of sociodemographic factors with being in paid work or having sickness absence when aged 66-71 remained steady. Both sickness absence and disability pension when aged 60-64 were negatively associated with working past 65 (sickness absence 2000 cohort OR 0.86, 95% CI 0.82-0.90; 2010 cohort OR 0.89, CI 0.87-0.92 - disability pension 2000 cohort OR 0.41, 0.39-0.44; 2010 cohort OR 0.36, CI 0.35-0.38). Sickness absence when aged 60-64 was positively associated with sickness absence after 65 (2000 cohort OR 2.16, CI 1.86-2.51; 2010 cohort OR 2.15, CI 1.98-2.33) while disability pension was negatively associated with sickness absence after 65 (2000 cohort OR 0.69, CI 0.52-0.92; 2010 cohort OR 0.83, CI 0.68-1.01).

Key messages
Rates of people in paid work &gt;65 increased much from 2000 to 2010; their sickness absence increased marginally, while associations of sociodemographic factors with paid work did not change over time. Prior sickness absence was associated with paid work and sickness absence after age 65, while disability pension before age 65 was associated with less sickness absence after 65.
Trends in adolescent mental health problems: Differences by SES and gender
Authors: Buli B , Larm P , Nilsson K , Giannotta F 
Published: October 2021

Abstract

Background
Studies in Sweden and elsewhere have shown that mental health problems have increased among adolescents in recent decades. Unlike the previous studies, we extend the investigation to the trends of various mental health problems, namely: psychosomatic symptoms, suicide attempts, depressive symptoms, and suicide ideations in the last two decades, from 2004 to 2020. We also investigate the moderating role of gender and SES on these trends.

Methods
Data were collected through repeated bi-annual cross-sectional surveys between 2004 and 2020 among 32061 adolescents (49% girls) in middle and upper secondary schools in a county of Sweden. We fitted two linear and two logistic regressions with gender and socioeconomic status (SES) as predictors, and by interacting them with year of survey, we examined if they are associated with trends in mental health problems.

Results
Psychosomatic and depressive symptoms remained stable overtime (β = -0.04, p = 0.12; and β = 0.007, p = 0.69, respectively). Trend in depressive symptoms has declined overtime only for girls (β = -0.07, p &lt; 0.005) while gender did not have effect on the trend in psychosomatic symptoms. Both psychosomatic (β = -0.09, p &lt; 0.001) and depressive (β = -0.08, p &lt; 0.001) symptoms have declined overtime only among those with high SES. Trends in both suicidal ideations and attempts were stable. Suicidal ideations declined overtime only for the girls (OR = 0.86, CI = 0.82 - 0.91, p &lt; 0.001). However, gender did not have significant effect on trends in suicidal attempts. Both suicidal ideations (OR = 0.97, CI = 0.95 - 0.99, p = 0.02) and suicidal attempts (OR = 0.98, CI = 0.96 - 0.99, p = 0.007) declined overtime among those with higher SES.

Conclusions
Mental health problems seem to decrease from 2004 to 2020, however only for girls and adolescents with high SES. This indicates an increase in health inequalities especially for youth with low SES.

Key messages
Mental health problems declined in the last two decades, especially among girls. Adolescents with low SES did not show the same mental health improvement, which indicated that health inequalities in adolescent mental health seem to have increased in the last two decades.
‘That decision really was mine...'. Self-reported healthcare controversies among intersex persons
Authors: Lampalzer U , Schweizer K 
Published: October 2021

Abstract

Background
After 20 years of debate on intersex care, there has been a slight movement away from the paradigm of ‘optimal gender' including early genital modification to conform to predicted gender identity towards a paradigm of ‘full consent' including the provision of full information about the risks, benefits and alternatives to interventions and the postponement of irreversible interventions on minors too young to give informed consent. However, controversy continues. Against this background, the aim of this study was to analyse core aspects of current debates in intersex care. Focus was placed on controversies about surgery on external genitalia; gonadectomies; the expressed wishes of patients under the age of consent; and how to deal with intersex within the family.

Methods
Eight guideline-based interviews were conducted with two people with intersex/diverse sex development conditions who had been subjected to surgery, two parents of children with an intersex/dsd condition, two medical doctors, and two psychologists. Data were analysed thematically.

Results and Conclusions
Findings indicate that while ‘full consent' influenced actions and debate, the persons involved held differing opinions about how this policy can or should be achieved. In addition, the data illustrated how concepts such as normalcy, identity and sexuality are relevant when dealing with intersex issues.
Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in day care centres – Lessons learned from a prospective analysis of outbreaks in Germany
Authors: Varnaccia G , Schienkiewitz A , Loer A-K , Hornbacher A , Wurm J , Kuttig T , Wess B , Schrick L , Jordan S , Loss J 
Published: October 2021

Abstract

Background
The role of children for the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is still unclear. The aim of our case-ascertained study is to examine transmission dynamics of SARS-CoV-2 among children and staff based on outbreaks in day care centres in Germany.

Methods
Based on day care centres with at least one reported case of SARS-CoV-2 we include 1-6-year-old children and staff of the affected group in the day care centre as well as their respective households. We test each study participant on acute and past SARS-CoV-2 infection with innovative child friendly tests and collect data on sociodemographics and symptoms. At four further measurement points within 12 days, the participants carry out the tests on SARS-CoV-2 by themselves. From October 2020 to May 2021, 25 day care centres with SARS-CoV-2 outbreaks participated and we included n = 244 children 1-6 years and n = 72 staff members in the study.

Results
First analyses from 25 outbreaks showed that the observed infection events in the examined day care centres were very different. Often, no or only few transmissions were found among the participants in the day care group, but in one day care centre, 13 people were infected: Between 0% and 81% of close contact persons in the day care centres were tested positive for SARS-CoV-2 in the study period. Children showed a similar percentage of secondary SARS-CoV-2 infections compared to adults (both 11%).

Conclusions
The study has been successful in detecting previously undetected infections of SARS-CoV-2 in day care centres. Results of these outbreaks examinations are presented regularly in public reports to inform public health decision-makers. By studying individual day care centre-related infection dynamics the data supplement the information from national reporting data.
An analysis of how lobbying by the alcohol industry has eroded the French marketing regulation law
Authors: Millot A , Gallopel-Morvan K , Maani N , Knai C , Petticrew M , Guillou-Landréat M 
Published: October 2021

Abstract

Background
In response to the positive association between alcohol marketing and young people's alcohol consumption, several countries have adopted marketing regulation laws. This is the case in France with the 1991 Evin Law, which prohibits advertising in media targeting young people and regulates content in authorized media. However, this law has faced intense opposition from its inception. The aim of this research is to identify the arguments and lobbying strategies deployed by the alcohol industry to undermine it.

Methods
We conducted semi-structured interviews with 18 French key informants involved in implementing and/or updating the Evin Law, including initiators of the law, former ministers, non-governmental organizations, national public health institutes and academic associations and institutions. A thematic analysis was conducted to highlight strategies and arguments employed by the alcohol industry to undermine the Evin Law using Savell et al. framework (2016).

Results
Several of the identified strategies and arguments to combat marketing regulations were similar to those identified in other countries, while some strategies and arguments were specific to the French context. These include highlighting winegrowing and its integration into decision-making bodies, and forming alliances with parliamentarians. These specific features may in part be explained by the economic significance of alcohol and wine at the heart of French culture.

Conclusions
For the first time, the long-term lobbying strategies and arguments used by the alcohol industry to weaken the Evin Law are analyzed from the perspectives of those closely involved in its implementation. This study may be useful for other countries that have - or are in the process of - implementing alcohol marketing regulation laws.

Key messages
The pioneering French alcohol marketing regulation law has faced intense opposition from the alcohol industry, in particular viticulture. Analyzing the strategies and arguments used by the alcohol industry to erode this pioneering law is important to better counter them.
Communicative health literacy of Hungarian adults – who are the most vulnerable?
Authors: Bíró É 
Published: October 2021

Abstract

Background
Good communication in health care can improve health outcomes and satisfaction of the patients and doctors. Therefore enhanced communicative health literacy is inevitable. This was the first time to assess communicative health literacy among the Hungarian adult population with a new measure developed within the framework of the European Health Literacy Survey 2019. The aim of the present survey was to provide a snapshot of communicative health literacy and determine the most vulnerable groups.

Methods
Data was collected by a polling company in a representative sample of the adult population (N = 1206) with computer-assisted telephone interviewing below the umbrella of the Health Literacy Survey 2019. The questionnaire included items among others on demographic and socioeconomic data, subjective well-being, and communicative health literacy. Statistical weights were applied to ensure that estimates reflect the general adult Hungarian population by gender, age group, educational level, settlement type.

Results
The mean age of the respondents was 48.0 years (standard deviation: 17.5 years), 47% of them were male. The mean score of the communicative health literacy scale was 86.8 (95% CI 85.5-88.1), and 13.3% of respondents had difficulties during communication in health care services. Explaining health concerns was the easiest task, while getting enough time in the consultation had the highest difficulty percentages. Communicative health literacy was lower among those who can be characterized by lower socioeconomic and worse health status, and belong to the older age group.

Conclusions
The findings suggest that the ill people and the members of the lower socioeconomic status are the most vulnerable regarding communicative health literacy, so special interventions are needed in order to enhance their health literacy. Maybe the first step can be the improvement of the communication skills of the health care professionals and implementing environmental changes.

Key messages
Getting enough time in the consultation was the most difficult for the respondents. Patients and people from lower socioeconomic status are the most vulnerable regarding communicative health literacy, so they need special attention.
A systematic literature review of studies estimating the risk factor attributable burden in Europe
Authors: Gorasso V , Nazaré Nogaro J , Charalampous P , Haagsma J , Monteiro Pires S , Von der Lippe E , Devleesschauwer B , Plass D 
Published: October 2021

Abstract
Along with the computation of disability-adjusted life years (DALY), the Global Burden of Disease (GBD) study uses the comparative risk assessment method to estimate the burden attributable to risk factors (RF). The methodology used for GBD studies has undergone continuous improvements through the years and across many independent studies. The European burden of disease network launched a series of systematic literature reviews (SLR) to explore key assumptions used in the European burden of disease (BoD) assessments. The SLR will give an overview of existing studies, including those estimating the BoD attributable to RF and focus on the different computational approaches. The SLR will also help to identify ways to harmonize computational procedures to enhance the comparability of RF attributable burden. The SLR involved four parallel reviews: non-communicable diseases, communicable diseases, injuries and RF. For the latter, we used a search strategy with terms describing the population (GBD area “European region”) and terms specifically used in comparative risk assessments (comparative risk assessment [CRA], attributable mortality/burden/risk). Studies published between January 1990 and April 2020 were included, without language restrictions. The search strategy was run in PubMed, Web of Science, Cochrane, and Embase. OpenGrey, OAIster, CABDirect, WHO, and targeted public health agency websites were screened for indexed grey literature. In addition, burden-eu members were asked to supplement the list of publications with any material available in their national public health institutes. The title, abstract, and full-text screening resulted in the final inclusion of 114 publications. The list of publications includes peer-reviewed articles and reports showing a variability in CRA analysis (e.g. use of exposure-response function, relative risks) and other methodological choices. Further data extraction and analysis is in process and will be presented during the workshop.
Barriers to CSE for children and young People with disabilities and how to overcome them
Authors: Michielsen Kristien 
Published: October 2021

Abstract
While sexuality education can support children and young people with disabilities in their sexual development and contribute to their wellbeing, challenges to its provision exist. In this part of the workshop, we will focus on CSE for children and young people with disabilities. More specifically, we will present the current scientific evidence on barriers to CSE for this specific group, based on a recently published paper in the Journal of Sex Education. We will present results of a scoping review based on scientific literature from 2006 up to 2020. Together, the identified studies present seven barriers to sexuality education for children and young people with disabilities, including the social misperception of people with disabilities as asexual and in need of protection which, combined with limited support for educators, resulted in noncomprehensive and normative sexuality education. Educators seemed inclined to redirect responsibility for sexuality education to others, and diversity among children and young people with disabilities, as well as cultural and religious diversity, makes it difficult to define a general approach. Finally, competing priorities related to the general health and wellbeing of children and young people with disabilities may appear to render sexuality education less important. Further, we will enter in discussion with the audience to discuss recommendations to overcome these barriers in different settings and countries. Finally, attention is given to best practices of doing research with children and young people with disabilities. We will present some best practices that can be applied in research on different topics and in different settings.
Symptoms of Anxiety and Depression among Italian UNiversity academics: the 2020 UN-SAD study
Authors: Del Pin M , Scarpis E , Ruscio E , Tullio A , Brunelli L , Brusaferro S 
Published: October 2021

Abstract

Background
The potential impact of demanding working conditions and career opportunities on the mental health of academic professionals has recently arisen some concerns, possibly resulting in psychological distress. This study aims to assess the prevalence of depression and anxiety within Udine University, comparing academic and administrative staff.

Methods
A cross-sectional survey involving regular (RP) and short-term academic professionals (STP), and administrative staff (AS) was carried out between June and December 2020 throughout the administration of an online anonymous survey. Prevalence of depressive and anxiety symptoms was assessed using PHQ-9 and GAD-7 tools. Demographic information about age, gender, marital status and seniority was collected. Relationship between mental health outcomes and professional role was analysed using nonparametric tests and ordinal logistic regression.

Results
All 5 university departments participated for a total of 366 people, being 109 of them STP, 146 RP and 111 AS. 55,7% of them were female, with a mean age of 47,9 years. Compared to administrative and regular staff, short-term professionals have a higher prevalence (95%CI) of both depressive (39,4% (30,8 - 48,8) vs 14,4% (9,6 - 21,0) vs 27,0% (19,6 - 35,9); p &lt; 0,001) and anxiety symptoms (STP: 33,0% (24,9 - 42,3); RP: 15,1% (10,2 - 21,8); AS: 22,5% (15,8 - 31,1); p &lt; 0.005). Multivariate models suggest an increased risk of depression OR 1.61 (0.98-2.64) and anxiety OR 2.08 (1.27-3.41) for female.

Conclusions
The higher prevalence of depressive and anxiety symptoms among STP could represent the effect on younger academics' mental health of the career uncertainty and challenging arena. The difference between AS and STP in psychological distress could be explained by the different job security status. More support should be given by universities to young academics for their both effective and healthy contribution to the progress of research.

Key messages
The high level of external pressure, referred as “publish or perish”, can play an important role in determining academics’ mental health. Investment to provide coping tools for young academics could be strategical for researchers’ empowerment.
Understanding climate health adaptation in practice: adaptation to the oak processionary moth in The Netherlands
Authors: Buist Y , Bekker M , Vaandrager L , Koelen M 
Published: October 2021

Abstract

Background
Understanding of climate health adaptation and its organisation and implementation is limited. This presentation focuses on the adaptation to the oak processionary moth (OPM). The OPM spreads out northwards through Europe, and human contact leads to reactions in skin mucous membranes, conjunctivitis, pharyngitis and respiratory distress. Literature has focused largely on the ecology and epidemiology of the OPM. However, there is limited understanding of the organisation and implementation of climate health adaptation knowledge and coordinating an effective response.

Methods
In an explorative case study we examined the current OPM adaptation strategies in practice. Semi-structured interviews with 26 actors in The Netherlands were held to unravel the problem and the complexities involved in OPM adaptation.

Results
The results indicate that the context of OPM adaptation is multidimensional, given the involvement of many interdependent actors. At regional and local level early networks emerge aiming to improve the effectiveness of OPM adaptation. At the national level the Knowledge Platform OPM was set up, in which actors collaborate to collect and share knowledge and experience. Nevertheless, OPM strategies are based on ad hoc approaches with ambiguous tasks and expertise. In addition, actors have different perceptions and values concerning health, sustainability, risks and responsibilities influencing decision-making processes, collaboration and a coordinated approach.

Conclusions
The generation of knowledge and its translation into practical strategies calls for interdisciplinary cooperation in knowledge development. Climate health adaptation involves more than technical and organisational solutions alone. It also entails the development of a shared problem perception and solution space in which citizens are also engaged. Therefore, implementation of vertical and horizontal coordination climate health adaptation strategies are required.