bluuebunny/crossref_metadata_2025_split huggingface dataset:
External validation of the HCM Risk-Kids model for predicting sudden cardiac death in childhood hypertrophic cardiomyopathy
Authors: Norrish Gabrielle , Qu Chen , Field Ella , Cervi Elena , Khraiche Diala , Klaassen Sabine , Ojala Tiina H , Sinagra Gianfranco , Yamazawa Hirokuni , Marrone Chiara , Popoiu Anca , Centeno Fernando , Schouvey Sylvie , Olivotto Iacopo , Day Sharlene M , Colan Steve , Rossano Joseph , Wittekind Samuel G , Saberi Sara , Russell Mark , Helms Adam , Ingles Jodie , Semsarian Christopher , Elliott Perry M , Ho Carolyn Y , Omar Rumana Z , Kaski Juan P 
Published: October 2021

Abstract

Aims
Sudden cardiac death (SCD) is the most common mode of death in childhood hypertrophic cardiomyopathy (HCM). The newly developed HCM Risk-Kids model provides clinicians with individualized estimates of risk. The aim of this study was to externally validate the model in a large independent, multi-centre patient cohort.

Methods and results
A retrospective, longitudinal cohort of 421 patients diagnosed with HCM aged 1–16 years independent of the HCM Risk-Kids development and internal validation cohort was studied. Data on HCM Risk-Kids predictor variables (unexplained syncope, non-sustained ventricular tachycardia, maximal left ventricular wall thickness, left atrial diameter, and left ventricular outflow tract gradient) were collected from the time of baseline clinical evaluation. The performance of the HCM Risk-Kids model in predicting risk at 5 years was assessed. Twenty-three patients (5.4%) met the SCD end-point within 5 years, with an overall incidence rate of 2.03 per 100 patient-years [95% confidence interval (CI) 1.48–2.78]. Model validation showed a Harrell’s C-index of 0.745 (95% CI 0.52–0.97) and Uno’s C-index 0.714 (95% 0.58–0.85) with a calibration slope of 1.15 (95% 0.51–1.80). A 5-year predicted risk threshold of ≥6% identified 17 (73.9%) SCD events with a corresponding C-statistic of 0.702 (95% CI 0.60–0.81).

Conclusions
This study reports the first external validation of the HCM Risk-Kids model in a large and geographically diverse patient population. A 5-year predicted risk of ≥6% identified over 70% of events, confirming that HCM Risk-Kids provides a method for individualized risk predictions and shared decision-making in children with HCM.
Addressing inequalities and research funding in the post-COVID-19 era
Authors: Whiting Edward 
Published: October 2021

Abstract
The panelist will provide insights on how a charitable foundation focused on health research assess priorities to tackle global health challenges. The Wellcome Trust is also a member of the Global Health Innovative Technology Fund (GHIT), which funds R&D for anti-infectives and diagnostics for diseases primarily affecting developing countries. COVID-19, related comorbidities, and their overall impact affect communities across the world. Global collaboration and real-time sharing on pathogen surveillance, sharing data/samples is key to ensure equitable access, particularly as the effects of COVID-19 are not be felt evenly across the world's population. Furthermore, the effects of mental health problems, escalating infectious diseases and COVID-19, can devastate communities for generations. It is important to consider both cross-country, as well as intra-country variations, and set clear priorities for LMICs, as well as for vulnerable groups and those most at risk in developed countries. Coalescing priorities and capturing narratives are key elements into brokering dialogue and establishing innovative partnerships to overcome long-standing and emerging challenges. At the time of the COVID-19 pandemic, and with more people living with its long-term effects, incl. suffering loss and trauma, and we need to both get infectious diseases under control, as well as to fund discovery research in a context-relevant manner. Beyond the current crisis, we also need to consider how to build resilience in our communities, factoring in the effects of other parameters, as for example, climate change. Moving forward, it is important to look at innovative models of collaboration, incl. for R&D, and to combine research to advocacy, whilst at the same time raising awareness to support the generation and implementation of evidence-informed policies.
Sleep and its effect on mental health among adolescent and adult population
Authors: Stranges S 
Published: October 2021

Abstract
The global prevalence of mental disorders is on the rise and sleep disorders have been recognized among one of the major contributors affecting well-being and longevity of both young and adult population. Sleep habits are multifaceted and arise from complex interactions between socio-environmental, behavioral, and psychological factors, and any disruptions in the balance of the previous may negatively alter sleep duration and sleep quality leading to sleep disorders, however this phenomenon may vary by age and sex. Emerging evidence suggest that adolescents entering pubertal development face many sleep changes due to biological factors like delay in circadian rhythm and decreased homeostatic sleep pressure as well as due to social factors which may lead to sleep disorders subsequently affecting adolescents' mental health. Sleep hygiene among young population is of primary importance especially as chronic sleep disruption may be a risk factor for mental disorders and multimorbidity along the lifespan, and importantly these association have been proved to be bi-directional. Thus, public health initiatives and guidelines to promote sleep hygiene should emerge in order increase the awareness of sleep disorders and their role in prevention and management of mental disorders.
Dietary factors affecting cognitive and sleep disorders
Authors: Godos J 
Published: October 2021

Abstract
Globally, there has been a substantial rise in the prevalence of mental disorders, including cognitive and affective disorders, having a considerable impact on sleep and life quality. Attributable to the lack of effective treatment of some of this conditions, lifestyle, behavioral and dietary factors gained a great attention given their modifiable nature and possible implication in the pathogenesis of mental disorders. A great body of evidence indicates that in the last decades an escalation of overnutrition as a consequence of the transition from traditional dietary patterns, based on fresh and plant-based foods, in favor to Western-like dietary patterns, rich in high-calorie processed and ultra-processed foods, has been observed. Unarguably, such diets, low in plant-based foods rich in bioactive compounds, shown to be beneficial for the central nervous system through modulation of various pathways controlling brain signaling and homeostasis, may have been one of the leading contributors to the sudden rise in the prevalence of mental disorders. Consistently, a greater intake of calorie-dense foods causing an alteration in hormonal homeostasis in the context of glucose metabolism and adiponectin regulation, has been recognized as a risk factor for mental health, as least partially mediated by the direct link to the global rise in the prevalence of obesity. Brain disorders are among leading causes of non-communicable diseases and shortened lifespan and therefore public health advocates need to address and apply the recent developments in food science to propose population guidelines for mental health prevention.
Digital health literacy among Greek students during COVID-19 pandemic
Authors: Sakellari E , Lagiou A 
Published: October 2021

Abstract

Background
Misinformation especially provided through internet is a serious public health threat, and during the COVID-19 pandemic this problem has even amplified, which became known as an information epidemic, a.k.a. infodemic. This is a common problem also in university students who access their information about health via Internet and social media. Digital health literacy (DHL) is an important skill to handle online information and make judgments about their quality and reliability. This study is part of the global COVID-HL survey, aiming at assessing DHL in university and their COVID-19 related health and information needs.

Methods
After receiving ethical approval, data was collected through an online questionnaire among students from one of the largest Universities in Greece. Descriptive statistics as well as bi- and multivariate analyses were conducted using SPSS.

Results
604 university students (mean age 24.3, 73.3% females) completed the survey. 28% indicated that they found it very difficult/ difficult to find the exact information they were looking for, 20.4% to make a choice across all information accessed, and 45.1% stated it is very difficult/ difficult to decide whether the information was reliable or not. According to the descriptive analysis, 25.6% of the students found it very difficult/ difficult to apply the information in their daily life, 23.7% to decide if the information they found is applicable to them and 16.3% to use the information they found to make decisions about their health. Greater satisfaction from information about COVID-19 was significantly associated with greater probability of having sufficient skills in “information search”, “evaluating reliability” and in “determining relevance”.

Conclusions
The results of the study indicate that there is a need to strengthen DHL among university students and develop skills for seeking information on the Internet through health education interventions.
Access to stroke care in Europe: results of a vignette approach
Authors: Quentin W 
Published: October 2021

Abstract

Background
Stroke is a major cause of death and disability in Europe. European guidelines for patients with ischemic stroke (about 85% of all strokes) recommend rapid access to hospital care and rehabilitation after discharge from hospital. Information on access to stroke care in Europe is limited.

Methods
A stroke vignette was developed reflecting typical patient characteristics and a recommended patient pathway: ambulance transfer to hospital, fast-track diagnostic work-up, thrombolysis and mechanical thrombectomy, stroke unit treatment, and inpatient rehabilitation. Experts in 12 countries were asked to complete a survey on service coverage, cost sharing, physical access (availability) and other barriers to access. Survey results were analysed and access to services was categorized into good, medium, bad before summarizing results across countries.

Results
Completed surveys were received from ten countries, including Bulgaria, Estonia, France, Germany, Lithuania, the Netherlands, Poland, Portugal, Slovakia, and the UK (England). Stroke patients in France, Germany, and the Netherlands have relatively good access, while substantial barriers exist in Bulgaria, Estonia, Poland, and Slovakia. In Bulgaria, rehabilitation is not covered by the National Health Fund; and rehabilitation capacity is very limited in Estonia, Poland, and Slovakia, leading to limited access. Almost all recommended services are formally covered by public financing schemes, but insufficient availability or organisational problems limit access to thrombolysis in Bulgaria, France, Lithuania, Poland, and Portugal or thrombectomy in Bulgaria and the UK (England).

Conclusions
While stroke related services are formally covered in almost all countries, considerable access problems exist in several countries. Future cross-country surveys of access to stroke care should collect quantitative data related to proportions of patients receiving particular services as well as qualitative data on access barriers.
Understanding access to palliative care for cancer patients in Europe: a vignette approach
Authors: Shuftan N 
Published: October 2021

Abstract

Background
Palliative care encompasses all treatment and care options available for people with serious illness, such as incurable, life-threatening cancer. The goal of palliative care is to improve and maintain quality of life for both patients and their families. It focuses on the assessment and management of pain and other symptoms, addressing caregiver needs, and coordination of care. It requires early identification and coordinated treatment of problems in the physical, functional psychological, social or spiritual dimension.

Methods
A palliative care vignette was developed reflecting typical patient characteristics and a recommended patient pathway for advanced lung cancer: chemotherapy to shrink tumors and alleviate symptoms, opioids for pain, benzodiazepines for breathlessness and anxiety, laxatives for constipation due to opioid use, psychosocial assessment followed by psychotherapy and/or antidepressants, and counselling for family carers. Experts in 12 countries were asked to complete a survey on service coverage, cost sharing, physical access (availability) and other barriers to access.

Results
The presentation will report on findings from a cross-country perspective for each of the categories mentioned above (work is currently ongoing). Individual country examples will be used to highlight outliers and draw policy lessons for the future.

Conclusions
Palliative care has received considerable socio-political support in recent years, due primarily to epidemiological developments. Depending on severity, life expectancy and the patients' personal circumstances, it can be delivered in a variety of settings, including private residences, assisted living facilities, acute and long-term care hospitals, hospice residences, correctional facilities, and homeless shelters. As a result, access barriers might be particularly complex to identify and overcome. Cross-country learning can be an important catalyst for future improvements.
Tool-HLCA: An intervention to promote the health literacy of school-aged children
Authors: Schulenkorf T , Okan O , Bauer U 
Published: October 2021

Abstract

Background
School-aged children are often exposed to health-related information from digital sources. However, there are no interventions in schools to help them deal with these appropriately. Installing health literacy in schools succeeds more easily if it can be linked to existing curricular requirements. This study aims to implement a toolbox to address (digital) health literacy of school-aged children (grades 7 and 8) in German secondary schools by combining existing media frameworks with health literacy.

Methods
Based on analysing a mandatory curriculum on media literacy in the state of North-Rhine-Westphalia in Germany and elaborating its commonalities with health literacy, we developed the toolbox for strengthening (digital) health literacy in school-aged children. Currently, the toolbox is being piloted in the school-setting in order to gain feedback from children and teachers.

Results
The mandatory media literacy framework for classroom teaching in German schools addresses the health literacy core competencies find, understand, appraise and use information. By using that framework and integrating health as a topic, this toolbox fits to the German core curriculum and will ensure that the toolbox is familiar and can be used with low thresholds by schoolteachers. The toolbox addresses digital health literacy including exercises to evaluate health-related information on different online platforms. It provides topic-specific tasks (e.g. coronavirus, vaccination, nutrition) and evaluation criteria for identifying mis- and disinformation.

Conclusions
The toolbox is an opportunity to enhancing (digital) health literacy in school-aged children by highlighting the intersections of the mandatory curriculum on media literacy and the core competencies of health literacy. In the long term, this kind of curriculum analysis serves as a methodological blueprint for educationalists to integrate health literacy into schools in many ways.
My body, my decision: the lived experience of young people with a variation in sex characteristics in New Zealand
Authors: Steers D , Andrews G 
Published: October 2021

Abstract

Background
Young people born with a variation in sex characteristics (VSC), or disorders of sex development (DSD) face numerous challenges in navigating issues relating to identity and to their lived and embodied experience. There is limited research amplifying the voices of young people with a VSC in the literature, especially in Aotearoa/New Zealand. There has been issues raised from a Humans Rights perspective which public health forums are yet to address.

Methods
This original qualitative study provides an up-to-date picture of the lived experiences of 10 young people with a VSC in Aotearoa/New Zealand using face to face interviews and thematic analysis. The research was conducted in collaboration with the advocacy group, Intersex Youth Aotearoa, and explored the level of support provided by health services, peers and advocacy groups in relation to the ways the participants viewed themselves and their bodies, and their health related decision-making.

Results
Our research reveals the pressure on young people with a VSC to conform to cultural and societal norms, specifically, heteronormative and traditional constructs of how male and female bodies should look prevalent within Aotearoa/NZ society. Such views, often held and perpetuated by health professionals and parents, contributed to the complexities surrounding identity, agency and acceptance of difference experienced by these young people. Young people wanted the right to bodily autonomy.

Conclusions
Implications of these findings are: better public education of VSC, development of resources for parents and young people and advocacy for psychological and peer support systems for young people.
Common Agricultural Policy (CAP) from a Public Health Perspective
Authors: Erklavec U , Birt C , Pushkarev N 
Published: October 2021

Abstract
European Common agricultural policy (CAP) can impact several health outcomes like increased antibiotic resistant infections, poor health of farm workers and unhealthy diets which lead to several non-communicable diseases. Rapid literature review of public health recommendations for a new CAP covers several topics from environment, pesticides, livestock and antimicrobial resistance (AMR) to diet, food systems and others. Recommendations on pesticides are to periodically upgrade minimum standards of pesticides, reduce or abandon the use of pesticides and sustainable management of water quality in agriculture. In relation to livestock and antimicrobial resistance, EU should dedicate financial resources for programmes aimed at decreasing animal numbers, stop support for industrial livestock production through CAP subsidies and adopt low-antibiotics farming methods. To ensure better diet and food systems we need sustainable dietary guidelines, food labelling schemes, public procurement of healthy, local and seasonal foodstuffs, food education and campaigns, promoting food systems thinking at all levels, increase productivity of fruit and vegetable cultivation and social innovation in food supply chains. Other recommendations state that CAP should end support for wine sector and that CAP should include training, payment of adequate wages and health and safety standards, and lastly implementation of Health impact assessment of CAP. Agricultural policy is a very complex field with many stakeholders and consequently also implications on many levels. To make health a more visible and important objective, we need more public health experts to take part in advocacy for healthier CAP.
E-Cigarette-Only and Dual Use among Adolescents: Emerging Behaviours with Different Risk Profiles
Authors: Bowe A , Doyle F , Stanistreet D , Durcan M , Major E , O'Connell E , Kavanagh P , O'Donovan D 
Published: October 2021

Abstract

Background
E-cigarette-only use and dual-use are emerging behaviours among adolescent nicotine product users which have not yet been sufficiently explored. This study examines the epidemiology of, and the factors associated with, nicotine product use in adolescence, specifically defined as e-cigarette only, conventional cigarette only and dual-use.

Methods
This is a cross-sectional analysis of the 2018 Planet Youth survey completed by 15-16 year olds in the West of Ireland. Current nicotine product use, defined by use at least once in the past 30 days, was categorised as e-cigarette only, conventional cigarette only, and dual-use. The characteristics and risk factor profiles of the population are described, according to nicotine product use, using chi-square tests for categorical data and t-tests for continuous data. A main effects multinomial logistic regression model was used to compare the association between potential risk and protective factors across categories of use.

Results
Among 4422 adolescents 22.1% were current nicotine product users, consisting of 5.1% e-cigarette only users, 7.7% conventional cigarette only users, and 9.3% dual-users. Risk factor profiles differed across categories of use. Frequent participation in team sport significantly reduced the odds of conventional cigarette and dual use but had no association with e-cigarette only use (Cig only: adjusted odds ratio (AOR) 0.63, 95% confidence interval (CI) 0.44-0.90; Dual-use: AOR 0.63, 95% CI 0.43-0.93, E-Cig only: AOR 1.31, 95% CI 0.87-1.97, p = 0.199). Similarly, having higher value for conventional social norms reduced the odds of conventional cigarette and dual use but not e-cigarette only use.

Conclusions
This is the first study to show, among a generalisable sample, that dual-use is the most prevalent behaviour among adolescent nicotine product users in Ireland. Risk factor profiles differed significantly across categories of use with important implications for youth tobacco control policy.

Key messages
This is the first study to show that dual use of conventional and electronic cigarettes, an under-researched behaviour, is the most prevalent form of nicotine product use among adolescents in Ireland. Risk factor profiles of e-cigarette only, conventional cigarette only, and dual users differ significantly, and this has important implications for prevention initiatives and tobacco control policy.
Mental health policy response to COVID-19: lessons learned
Authors: Jakubauskiene M 
Published: October 2021

Abstract

Background
Good mental health is critical to the functioning of society and recovery from COVID-19 pandemics. Corona pandemics is considered as crisis, causing uncertainty and unpredictability resulting in fear and high levels of psychological distress in populations. Mental health impacts occur as an impact of the virus or as the consequences of physical isolation. Mental health of other specific (vulnerable) populations affected by the COVID-19. Mitigating the hazardous effects of COVID-19 on mental health is an international public health priority. The aim of the study is to review mental health policy responses to COVID-19 crisis internationally and present successful examples as well as learned lessons.

Methods
A rapid clustered review of evidences reflecting mental health policy responses in the face of COVID-19 pandemics has been conducted.

Results
COVID-19 pandemics is an indisputable emergency for health systems and challenge for mental health care. Major mental health policy response measures should be based on whole of society approach and include access to remote mental health service provision as well as emergency mental health and psychosocial services especially to vulnerable populations in order to strengthen social cohesion and social support. COVID-19 crisis, on the other hand, might also be considered as an opportunity to improve the scale and effectiveness of mental health services and increase funding to mental health care and psychosocial services. It raised concerns and stimulated discussion about the re-shifting institutional long term care more into community based service approach.

Conclusions
Ensuring preparedness and planning of mental health service is an important for staying ahead of mental health impacts that will be long term, complex, and may take time to fully emerge. Further transdisciplinary research on mental health system, policy and COVID-19 epidemics prevention, preparedness, responses and impacts is needed.