bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stroke as an Antecedent Risk Factor for Depression among Post-Menopausal Women
Authors: Banerjee S , Huth J , Burkholder G 
Published: October 2021

Abstract

Background
As many as one out of every three individuals develop depression after stroke. Numerous studies have also shown a link between depression and increased rates of mortality after stroke. Additionally, the risk factors and characteristics of stroke are different between men and women. However, the association between stroke and depression has not been investigated in postmenopausal women in a nationally representative sample.

Methods
The association between currently active depression [score ≥ 10 on a Patient Health Questionnaire (PHQ)-9 scale] and self-reported history of stroke were assessed among participants from the 2005-2010 National Health and Nutrition Examination Survey (NHANES). All post-menopausal women from the nationally representative NHANES study were included in the analysis. Multivariable complex samples logistic regression was used to calculate multivariate-adjusted odds ratios (ORs) of depression.

Results
Out of the 3,636 (representative sample=44,110,822) postmenopausal women, the mean age was 62.6 ± 0.33. The ethnic distribution was 77.3% non-Hispanic Whites, 10.9% non-Hispanic Blacks, 7.5% Hispanics, and 4.3% other nationalities. In age-adjusted analysis, individuals with a history of stroke had 2.5-fold higher odds of active depression than those without a history of stroke (OR 2.57, 95% CI 1.57-4.19, p &lt; .001). Controlling for vascular risk factors (diabetes, hypertension, C-reactive protein, and BMI) of depression and socio-demographic risk factors (age, ethnicity, and income level) attenuated the effect (OR 2.16, 95% CI 1.17-3.99, p &lt; .05).

Conclusions
A significant association between previous stroke and current depression was found in this population, independent of vascular disease risk measures among post-menopausal women. These findings highlight the possible importance of screening for and treating depression among stroke survivors. Longitudinal studies need to be conducted assessing the mental health impact of stroke.

Key messages
Occurrence of stroke may lead to an increased likelihood of depression, especially among post-menopausal women. Due to the global COVID-19 pandemic, surveillance efforts should include mental health complication including those related to stroke.
Health sector engagement on the implementation of SDGs in Turkey
Authors: Gacal F , Çağlayan Ç , Yavuz M , Yavuz M 
Published: October 2021

Abstract
Turkey is a country with major environmental and climate threats, so implementing the SDGs offers significant potential to improve people's health and well-being. The Turkish government aims to take a voluntary approach to SDGs. In Turkey's 2019 report, SDG-3 on Good Health and Well-being, which is coordinated by the Ministry of Health, was promoted as one of the goals with the most progress. Non-communicable diseases (NCD) have become the main cause of death; in Turkey, the share of NCDs in total disease burden was 69.7% in 2002, and rose to 82% in 2017. In the light of the latest Lancet findings, it is clear that the NCDs burden will increase further with climate change, thus the link between health and climate should be strengthened in SDG implementation. Turkey's latest Climate Change Action Plan 2011-2023 offers an opportunity for the health sector to do so (and thus also advancing the implementation of SDG-13). To strengthen the Turkish health sector's capacity to engage on the implementation of SDGs and other relevant climate and environment policies, HEAL, HASUDER (the Association Of Public Health Specialists) and Kocaeli University, Department of Public Health launched a network in April 2020, called “Health Collaboration on Climate Change and Environment Project (CISIP)”. The project, which is financed by the EU, will organise a range of webinars, trainings, materials and facilitate exchanges for better evidence-based and health promoting policy-making. So far, these three organisations/institutions have engaged with more than 30+ different health organisations that are keen to work on the environment, climate and health intersections. The presentation will share some lessons learnt from recent CISIP activities and discuss the opportunities and challenges for the implementation of SDGs 3 and 13 in Turkey.
Continuum beliefs and mental illness stigma: A systematic review and meta-analysis of correlation and Intervention studies
Authors: Peter L-J , Schindler S , Sander C , Schmidt S , Muehlan H , McLaren T , Tomczyk S , Speerforck S , Schomerus G 
Published: October 2021

Abstract
Promulgating a continuum model of mental health and mental illness has been proposed as a way to reduce stigma by decreasing notions of differentness. In a systematic review and meta-analysis, we examined whether continuum beliefs are associated with lower stigma, and whether continuum interventions reduce stigma. We searched three electronic databases (PubMed, Web of Science and PsycINFO) yielding 6726 studies. After screening, we included 33 studies covering continuum beliefs, mental illness and stigma. Of these, 13 studies were included in meta-analysis. Continuum beliefs are consistently associated with lower stigma. Interventions were effective in manipulating continuum beliefs but differ in their effects on stigmatizing attitudes. We discuss whether and to what extent attitudes towards people with mental illness can be improved by providing information on a mental health-mental illness continuum. It appeared to be relevant whether interventions promoted a feeling of “us” and a process of identification with the person with mental illness. We discuss implications for the design of future interventions using the example of our current online anti-stigma intervention, which was developed on the basis of these considerations, containing gamified elements with the purpose of identification and involvement.
Validity of self-reported data to assess the prevalence of overweight, hypertension and cholesterol
Authors: Pelgrims I , Devleesschauwer B , Doggen K , Vandevijvere S , M De Clerq E , Vansteelandt S , Van der Heyden J 
Published: October 2021

Abstract

Background
Accurate data on the risk factors of non-communicable diseases is essential to build evidence-based prevention programs. In Belgium, this is assessed through self-reported (SR) data from the Belgian health interview surveys (BHIS) in a wide population sample or through objective measures from small-scale surveys (such as the Belgian health examination survey [BHES]). It has been shown, however, that relying on SR data leads to a prevalence underestimation. The objective of this study is to assess the agreement between SR and measured overweight, hypertension and high cholesterol and to provide information to do a valid correction for measurement error.

Methods
The BHIS/BHES 2018 database was used (n = 1184). Kappa coefficient was used to assess the agreement between SR and measured hypertension (systolic BP &gt; 140 mmHg, diastolic BP &gt; 90 mmHg, or reported use of medication for hypertension) and ICC was used to assess the agreement between SR and measured BMI. SR high cholesterol was compared to a measured total serum cholesterol &gt;190 mg/dl.

Results
Risk factor prevalence based on SR data is severely underestimated. The agreement between SR and measured data is high for BMI (ICC: 0.92), moderate for hypertension (Kappa: 0.49) and poor for cholesterol (Kappa: 0.05). Using SR data, 45% of the people with a measured hypertension and 22% of the people with a measured high cholesterol are detected. With regressions based on the SR risk factor, age, sex and education, the measured BMI and hypertension can be predicted with a good accuracy (BMI: R2: 87%, HBP: AUC: 86%). A lower accuracy is observed for the cholesterol model (AUC: 65%). Using predicted values instead of SR data yields higher estimates of people suffering from overweight (+8% relative increase), obesity (+12%), hypertension (+24%) and cholesterol (+36%).

Conclusions
Using SR data yields to an underestimation of the prevalence of obesity, hypertension and high cholesterol in Belgium

Key messages
Relying on SR data to assess the prevalence of overweight, hypertension and high cholesterol requires a correction for measurement error. Using the predicted values from regression models based on the SR risk factor, age, sex and education, yields higher estimates of people suffering from overweight, hypertension and cholesterol.
Understanding the factors that contribute to the similarities and differences in SARS-CoV-2 testing strategies across Europe
Authors: Kamga S , Voordouw B , Koopmans M , Timen A 
Published: October 2021

Abstract

Background
Since the beginning of the COVID-19 outbreak, the importance of testing suspected cases has been stressed by various governments and international organizations. Early in the pandemic, the WHO's Secretary General emphasized the need to ‘test, test, test'. Nonetheless, there were some evident differences between European Member States' testing strategies. In order to get an understanding of why and how these differences developed we conducted a mixed methods study in several EU member states.

Methods
We conducted semi-structured interviews with 11 professionals with expertise in public health, laboratory diagnostics and policymaking in 8 European countries, namely Croatia, Italy, Latvia, Malta, the Netherlands, Spain, Latvia, Italy, Slovenia. Based on interview results, a questionnaire is developed to quantify to which degree a larger audience of public health, laboratory and policy-making professionals believe identified factors played a role in the national SARS-CoV-2 testing strategy.

Preliminary results
3 factors seem to play an important role in the diagnostic capacity and testing strategy. Firstly, differences in the countries' available stockpile and their ability to efficiently procure diagnostic equipment influenced testing strategies. Secondly, the variation in institutions that took ownership of the issues of developing, executing and developing the policies led to differences in the testing strategies. Lastly, all countries aimed to follow international advice and guidelines, which led to the convergence of testing strategies over time.

Conclusions
In order to be prepared for a pandemic of COVID-19's scale and make necessary adjustments in capacity building, it is important that Member States understand the factors that play an important role in both their own and other European countries' diagnostic preparedness strategies.
Competences in the management of health regions: Germany, Poland and Spain
Authors: Romaniuk P , Behrens Y , Morales I , Kaczmarek K , Cassens M , Rodríguez López C 
Published: October 2021

Abstract

Background
Germany has a comprehensive and diverse network of health regions, Spain has partial health regions and in Poland this model is not yet present. The purpose of this study is to summarize and compare the experiences of Spain and Germany in terms of health network managers activity, along with a potential and conditioning for the existence of similar structures in Poland, to determine what competences they need in each country and what are the similarities and differences between them.

Methods
In the three countries, 18 in total qualitative interviews were conducted with experts and stakeholders from the health sector, public administration, the health economy and health regions. The interviews focused on the current state of the health systems as well as the required competences of a regional health network manager. They were analysed for content. The following categories were created: Health, management, social skills and other competences.

Results and discussion
There is an overlap in the required competences in the three countries. A knowledge in the field of public health, the organisation and assessment of health services as well as communication and management skills are of importance. In addition, there are competences in fund raising and legal matters. Country-specific competencies and areas must be taken into account, e.g. in Germany addressing people with a migration background is a more central issue than in Poland, while in the latter country high pressure has been put on the soft skills.

Conclusions
European competence profile for managers of regional health networks is possible, which harmonizes with and complements the competence profile of public health specialists. Nonetheless, national profiles require to highlight different critical competences adapted to local conditions.

Main message
The competences of a regional health network manager are predominantly cross-national.
Support Asylum and Vulnerabilities through e-health: SAVe as a healthcare continuity tool
Authors: Diodati A , Sisti LG , Cammilli M , Fazioli C , Cimarra D , Mirisola C , Costanzo G 
Published: October 2021

Abstract

Issue
Migrants and refugees (M&Rs) could present different vulnerabilities and health conditions. The high geographical and setting mobility of migrants within the reception system as well as the legal and administrative variability can impact negatively the continuity of care of eventual vulnerabilities and diseases.

Description of the practice
The Italian National Institute for Health Migration and Poverty developed an IC platform to take care of migrant's health over its migration pathway in the hosting country. SAVe guarantees both the health assessment at the border and the following steps of clinical care. It offers specialized tools guiding health professionals to evaluate M&Rs' vulnerabilities as well as infectious and chronic diseases. The electronic system is compliant with the EU-GDPR and includes validated tools such as the WHO (Five) WBI, the EASO tool for special needs identification, the Italian guidelines on Border health checks and the Italian protocol for the unaccompanied minors' age assessment.

Results
The system is being implemented in 4 Italian Regions, where over 28,000 migrants are hosted in reception structures and is expected to be used in the whole Italian reception system. The migrant person is also given the opportunity to save, store and use his health records even in case of relocation to another country.

Lessons
SAVe is turning out as an innovative tool to evaluate vulnerabilities and health of M&Rs who are present in Italy. The use of validated and evidence-based tools improves the confidence of doctors in detecting vulnerabilities and social determinants of health. Its spread at National level is expected to guarantee the continuity of care. Further, the interoperation between SAVe and the National Health File would allow health data collection from the first arrival of migrant until its full integration in the country.

Key messages
SAVe is designed to evaluate comprehensively the health of M&Rs, increase the continuity of care and optimize the healthcare resources. Its socio-health and evidence based approach encourages the use as a benchmark for health data collection and health information sharing.
Barriers and facilitators to genetic testing amongst Black African women in the UK
Authors: Kabeya V , Puthussery S , Furmanski A 
Published: October 2021

Abstract

Background
Black African women have the lowest attendance of genetic testing services and the highest mortality rate of breast and ovarian cancer amongst women from ethnic minority groups in the UK. Therefore, this study aimed to identify the barriers and facilitators to genetic testing to enable these women to make informed choices if found eligible.

Methods
A qualitative approach was used to explore the perceptions surrounding genetic testing amongst Twenty-four women aged 23-57 Black African women in Luton. Purposive sampling combined with snowballing sampling was used as a recruitment technique.

Results
The findings revealed that most of the participants had no awareness or knowledge of genetic testing and limited knowledge of their family medical history for eligibility to attend genetic testing services. Facilitators including family member's health, funding by the National Health services and accessibility and awareness and education on genetic testing were identified.

Conclusions
This study sought to explore the perceptions of Black African women on barriers and facilitators to genetic testing to enable researchers to implement efficient intervention that would increase genetic testing attendance whilst addressing the other barriers and facilitators to alter Black African's women health seeking behaviours.

Key messages
Identify barriers and facilitators to genetic testing amongst Black African women in the UK. This study highlights the need for further research into health seeking behaviour among Black women that could contribute to the low uptake of genetic testing.
11.B. Workshop: COPERS - an international longitudinal study on coping and resilience during the COVID-19 pandemic
Authors:   Organised by: EUPHA-PMH,   Chair persons: Ledia Lazeri (Hungary), Jutta Lindert (EUPHA-PMH)
Published: October 2021

Abstract

Background
Mental health and resilience during the COVID-19 pandemic is a challenge for all indivduals. While evidence is emerging that the COVID pandemic has affected mental health of everybody, at this point, no comparable data about the extent of the COVID-19 pandemic impact on mental health and resilience on citizens in Europe are available. We aim to fill this gap in knowledge.

Methods
We conducted a longitudinal study in eight European countries including 18+ year old individuals using mixed methods sampling (e.g. convenience sampling, panel data sampling). Main outcomes were depression, anxiety, post-traumatic symptoms and resilience. Depression was assessed with the PHQ-9, anxiety with the GAD-7, substance use with the Audit, resilience with the BRS and the CD-RISK, stress symptoms with the Impact of Event Scale (IES-R). We assessed as potentially influencing factors socio-demographic factors (location, age, gender, education, profession, living situation), and COVID-19 specific factors, furthermore we investigated social support, social capital, loneliness, and domestic violence and alcohol consumption (AUDIT). We analyze every measurement point, starting from the baseline data, cross-sectional and longitudinally. For the longitudinal analyses, multiple linear regression analyses, simple logistic regression analyses, and multinomial logistic regression analyses are conducted to examine resilience trajectories. Furthermore, to simultaneously control for many variables that potentially confound the relationship between a mental health and resilience, propensity score matching is applied.

Results
In total as of 30. April. 2,442 individuals participated (female: n = 1,582 (64.8%), male: n = 672 (27.5%), diverse: n = 5 (0.2%), missing: n = 183 (7.5%) as well as an age bias (Median=33, Mean=36.30, SD = 14,46, age range=18years-80 years. Mental health outcomes varied widely within and between countries. In this panel European and country specific data will be presented and discussed. We present the data on behalf of the COPERS consortium, other members of the consortium will be present at the discussion.

Speakers/Panelists
Jutta Lindert Hochschule Emden-Leer, Emden, Germany Marija Jakubauskiene Vilnius University, Vilnius, Lithuania Marija Jevtic Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia Edvaldo Begotaraj Department of Social and Developmental Psychology, Sapienza University, Rome, Italy Alessandro Morganti Politecnico di Milano, Milano, Italy

Key messages
To the best of our knowledge, no comparable multinational data about the impact of the COVID-19 pandemic impact on mental conditions and resilience on citizens in Europe are available. Scope and extent of mental conditions during the COVID pandemic vary; country specific most vulnerbale groups are identified.
Inequalities in COVID-19’s collateral public health damage in Vienna
Authors: Oberndorfer M , Dorner TE 
Published: October 2021

Abstract

Background
Although lockdown measures are effective in containing the spread of COVID-19, such societal shutdowns may be accompanied by collateral public health damage. We aimed to assess potential inequalities in the distribution of adverse health-related and socioeconomic outcomes related to this pandemic for an urban Central European context.

Methods
Using a stratified random sample of 1004 participants living in Vienna, the capital of Austria with approximately 2 million inhabitants, this study analysed the distribution of 10 adverse health-related and socioeconomic outcomes attributable to the COVID-19 pandemic across socioeconomic strata. Data were collected between April, 27th and May, 17th 2020. Outcomes comprised a worsened economic situation, worsened self-reported mental and physical health, and a suspected or diagnosed infection with COVID-19 of the participant or someone close. Socioeconomic position (SEP) was indicated by income, education, and household overcrowding. We estimated differences in the incidence rates of our 10 outcomes by SEP using zero-inflated Poisson and logistic regression models adjusted for age and gender.

Results
Analysing the total number of experienced adverse outcomes, participants in the lowest and second lowest SEP category experienced a higher incidence rate (IRR=1.333[95%CI: 1.079 - 1.639] and IRR=1.447[95%CI: 1.190 - 1.760] respectively) compared to participants in the highest SEP category. Inequalities were highest for the outcomes job loss, worsened financial situation, and worse mental health. Different measurements of SEP yielded similar results, however, inequalities were most visible across income groups.

Conclusions
These results add to the rapidly accumulating evidence on the unequally distributed burden of the COVID-19 pandemic. Increased awareness about effect heterogeneity across SEP indicators will help to identify those in most urgent need of supportive policies.

Key messages
During the early phase of the COVID-19 pandemic in Vienna, its health-related and socioeconomic burden has been disproportionately carried by people in low socioeconomic positions. Inequalities in the incidence rate of adverse COVID-19-related outcomes were highest across income groups and for the outcomes job loss, worse financial situation, and worse mental health.