bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantifying the burden of disease in Scotland in 2018: a Scottish Burden of Disease study
Authors: Fletcher E , Wyper GMA , Grant I , de Haro Moro MT , McCartney G , Stockton DL 
Published: October 2021

Abstract

Background
The Scottish Burden of Disease (SBoD) Study monitors the contribution of over 100 diseases and injuries to the population health in Scotland. Providing robust estimates of the burden is important as recent evidence has highlighted stalling life expectancy and worsening trends in self-assessed general health and understanding the burden of disease is the first step in identifying areas of prevention which could have the biggest impact on health. Our aim was to estimate disability-adjusted life years (DALYs) for 2018, for all causes of disease and injury.

Methods
The SBoD 2016 study estimated the burden for 132 causes of injury and disease using routine data and patient-level record linkage. For this update, years lived with disability were estimated using 2016 age-sex-deprivation specific rates, assuming no change in disease prevalence from 2016, but taking account of changes to the population structure. Years of life lost were calculated from 2018 observed deaths and the application of the Global Burden of Disease aspirational life table.

Results
In 2018 the leading causes of burden were ischaemic heart disease, Alzheimer's/other dementias, lung cancer, drug-use disorders and cerebrovascular disease, representing over a quarter (27%) of the total DALYs in Scotland. Of the 10 leading causes of disease burden, four are wholly attributable to ill-health, demonstrating the added-value of considering DALYs in conjunction with traditional measures of mortality and morbidity.

Conclusions
Ischaemic heart disease continues to be the leading cause of burden of disease in Scotland, however recent years show an increase in burden of social causes and diseases primarily affecting the ageing population. These changes in leading causes demonstrate the importance of continuing to monitor the burden of disease in Scotland, to provide robust evidence for planning of local and national services.

Key messages
The study demonstrates the added-value of considering the burden of disease, in conjunction with traditional measures of morbidity and mortality. Ischaemic heart disease continues to be the leading cause of burden of disease in Scotland.
Mobilizing human resources
Authors: Williams G , Karanikolos M 
Published: October 2021

Abstract
The COVID-19 pandemic has confronted health systems with extraordinary changes in demand for health services, which magnified underlying disparities in the health workforce. Initial health workforce capacities were critical, as health systems only have two options to increase workforce level: increasing capacity among the existing workforce or mobilising/recruiting additional personnel. Workforce capacity became a limiting factor in an effective pandemic response, particularly in countries with acute workforce shortages. Countries in Europe have pursued various strategies to rapidly surge the numbers of health workers and using their existing human resources differently, including by introducing or expanding on alternative and flexible approaches such as task shifting and other skill-mix changes. The pressure to provide services across the continuum of care, from prevention and vaccination to specialist and inpatient care, led several countries to re-evaluate the distribution of tasks among the health workforce. In the best cases, multidisciplinary team-based staffing models combined the skills of multiple health professionals, enabling provision of the right care at the right time. This presentation will provide an overview of strategies to increase capacity for surges in human resources requirements, as well as supporting measures that help recognise the key role of health workers in the pandemic response. A brief overview of key metrics to assess resilience in the area of human resources will also be provided.
Delivering public health interventions
Authors: Karanikolos M 
Published: October 2021

Abstract
Public health has faced unprecedented pressures from the dual demands of responding to the COVID-19 pandemic while maintaining delivery of essential public health services such as screening and vaccinations. At the beginning of the pandemic, public health efforts turned towards implementing appropriate preventative health measures to control or mitigate transmission, while the rollout of COVID-19 vaccines has started since late 2020. Preventative public health measures to control or mitigate transmission include observing hygiene guidelines; using personal protective equipment (such as masks); limiting contact through physical distancing measures, curfews, bans on non-essential persons' movement and closing schools, businesses, as well as regional and national borders. All these measures have been supported, with Find, Test, Trace, Isolate, and Support (FTTIS) services, but many countries have struggled to implement these successfully, even months into the pandemic. While organisations such as the ECDC have issued guidance on implementing such interventions depending on the epidemiological situation, national strategies have ultimately depended on the countries' priorities, political realities and weighing the benefits against the potential adverse effects (such as mental health, economic and social impacts) and there has been little coordination among the countries. International coordination in the area of vaccines has also not always worked effectively. This presentation will provide an overview of strategies on implementing effective public health measures, including FTTIS systems and COVID-19 vaccinations. A brief overview of key metrics to assess resilience in the area of public health delivery will also be provided.
The role of the teacher in identifying (non-Western) children in need for psychosocial care
Authors: Eijgermans DGM , Raat H , Jansen PW , Blok E , Hillegers MHJ , Jansen W 
Published: October 2021

Abstract

Background
The prevalence of mental health problems in Europe is higher among children with a non-Western than a Western background. Nevertheless, non-Western children use less psychosocial care. A possible explanation is the differences in parents' perceived need for care. Non-Western parents generally have a lower perceived need, which calls for other significant adults in the children's life to identify this need. This study investigates whether teachers could fulfil a role in identifying mental problems, especially in non-Western children, to improve the access to care.

Methods
The study sample of 9-year-old children was retrieved from the Generation R Study (N = 3,084), a population-based cohort of children born in Rotterdam, the Netherlands. Teacher- and mother-reported problems were measured at 6 years via questionnaires. Psychosocial care use was mother-reported at the research centre at 9 years (8.1% used care).

Results
Our findings showed that, among children who used care, elevated problem levels at 6 years were reported for 10% by mothers and teachers, for 16% by mothers only and for 22% by teachers only. Hierarchical logistic regressions showed that having teacher-reported problems was associated with psychosocial care use (OR:3.06, p&lt;.05), also after adjusting for mother-reported problems (OR:2.83, p&lt;.05). Ethnic background did not moderate this association. Nonetheless, non-Western children did use significantly less care than Western children (OR:.58, p&lt;.05), irrespective of their problem level.

Conclusions
The association between teacher-reported problems and psychosocial care use suggests that teachers can play a role in identifying mental problems in children, in addition to parents. The role of the teacher might be particularly important for non-Western children in Western countries as their parents report on average a lower need for care, irrespective of the actual need. This calls for prevention strategies that focus on the teacher's unique position.

Key messages
Teachers have an important role in the identification of mental health problems and access to psychosocial care for children. The signalling function of teachers is extra important for children with a non-Western migrant background as this group uses less care, irrespective of their problem level.
Developing an Ethical Model of Care for People with a Variation of Sex Development in Switzerland
Authors: Kraus C , Meyrat BL 
Published: October 2021

Abstract

Background
What constitutes best practice in the area of intersex, renamed Disorders/differences of sex development (DSD/dsd) or even variations of sex development (VDS) after the “Chicago consensus”? What kind of model of care would meet the requirements of an ethical management of intersex/dsd/VDS?

Methods
In 2005, we launched an interdisciplinary SHS and gender medicine project to improve the standards of care for persons with intersex/dsd/VDS. Abroad, this project, initiated in Lausanne, has sometimes been called the “Swiss Model”. It includes the development of an interdisciplinary team, based at the University hospital CHUV, who takes care of persons born with intersex/dsd/VDS and also teaches an ethical model of care to students at the Medical School of the University of Lausanne. The “Swiss Model” is centered on the children's fundamental rights to bodily integrity, self-determination and genital autonomy. We describe our 10 years' experience, the reasons, goals and development modalities of our team and model of care.

Results
We have developed a medical ethics “from below” to overcome the lack of ethical recommendations, as it was the case until 2012 in Switzerland. During this period of time, genital surgeries and other non-vital medical treatments have been postponed until the child could fully participate in the medical decisions and give one's informed assent or consent. Only one family did not follow our recommendations.

Conclusions
The Lausanne experience testifies to the possibility of changing the so-called Johns Hopkins paradigm in actual practice. The model of care we have implemented can define best practice as it is scientifically grounded, medically reasonable, and ethically consistent.
5.C. Workshop: COVID-19 response in Europe one year on: a tale of five countries
Authors:   Organised by: EUPHA-IDC,   Chair persons: Michael Edelstein (EUPHA-IDC), Aura Timen (Netherlands)
Published: October 2021

Abstract

In November 2021 it will have been almost two years since the emergence of the COVID19 outbreak. The scale, duration and impact of the pandemic was unforeseen and unprecedented, with Europe being among the hardest hit regions. Within the region, individual countries have taken very different approaches to pandemic management and have achieved very different results. There are therefore wide variation in terms of diseases incidence and mortality within the region. The availability of vaccination has again widened differences with large differences between countries in term of vaccine access, and vaccination behaviour and coverage. At the World Congress of Public Health in November 2020, we compared and contrasted the situation and response in five countries in the European region: The UK, Italy, Poland, Portugal and Sweden. These countries were selected based on their very different approaches to managing the crisis and wide differences in terms of the epidemiology of COVID19 in country. Since then the pandemic has expanded more than 60 times in terms of number of cases, most countries experience serial lockdowns, and vaccines became available, which countries adopted at very different rates. In this interactive workshop we will invite representatives from those same five countries to discuss how and why their countries' situation evolved the way it did, and how policy choices in the last year have impacted on their national epidemiological situation. The session will go beyond simple description and will enable each country to reflect on different components of their management approach such as case identification, contact tracing, testing, social distancing, mask use, communication, travel restrictions, and vaccination, and contrast it with others. We plan to have short and effective 5 min presentations followed by a longer and constructive thought-provoking moderated discussion. Importantly, the five European case studies will offer ground to discuss issues such as balancing public health with other imperatives such as economic ones, equity and the pros and cons of a national vs a regional approach to pandemic management. The audience will be engaged through a Q&A session.

Key messages
Balancing public health with other imperatives is a challenge to which no universally agreed approach exists. The lack of a unified approach to pandemic management has led to wide inequalities within the region.
A Tale of 5 countries- the UK perspective
Jamie Lopez Bernal Public Health England, London, UK
A Tale of 5 countries- the Sweden perspective
Sara Byfors Public Health Agency of Sweden, Stockholm, Sweden
A Tale of 5 countries- the Portugal perspective
Ricardo Mexia Ministry of Health, Lisbon, Portugal
A Tale of 5 countries- the Poland perspective
Maria Ganczak University of Zielona Gora, Zielona Gora, Poland
A Tale of 5 countries- the Italy perspective
Anna Odone University of Pavia, Pavia, Italy
Anthropometric indicators and diabetes incidence: results from a national cohort study, Turkey
Authors: Emli Alpay E , Unal B , Ergor G , Dinc Horasan G , Sozmen K , Ekinci B , Sakarya S 
Published: October 2021

Abstract

Background
Anthropometric indicators such as Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and Body Shape Index (ABSI) are used globally to evaluate the risk of type 2 diabetes (T2DM). Our study aimed to investigate associations between different anthropometric indicators and the risk of T2DM using data from a national cohort.

Methods
The data on anthropometric measures and other risk factors of diabetes were obtained from Turkey Chronic Diseases and Risk Factors Survey in 2011 (n = 18,477). Disease information for the years 2012-2017 of the cohort has been reached through electronic health records and DM was ascertained by standard ICD-10 Codes. Four logistic regression models were generated based on different groups of confounders: unmodifiable risk factors, behavioral risk factors, comorbidities and socioeconomic variables. Categorical BMI, WC, WHR, WHtR, and ABSI values were used and adjusted RRs (95% CIs) of measurements were computed for men and women separately.

Results
Median follow-up year (IQR) was 6,46 (0,06). Between 2012 and 2017, 540 people were diagnosed with new diabetes. All anthropometric measurements except ABSI were associated with T2DM risk in all models. Among the anthropometric measures, BMI showed the strongest effect on incident diabetes, both in men (BMI ≥30; RRadj: 3.06, 95% CI 1.93-4.86) and women (BMI ≥30; RRadj: 2.58; 95%CI 1.73-3.85) in model 4 (adjusting for all confounding factors). WHtR provided the second strongest association with a RRadj of 2.57 in men (95% CI 1.78-3.71) and 2.55 in women (95%CI 1.87-3.47).

Conclusions
Independent of other risk factors, individuals with high BMI, WHR, WHtR and WC are at higher risk of developing T2DM. Public health strategies aimed at prevention of weight gain and obesity will probably be the most effective way to struggle with diabetes.

Key messages
There is a strong association between anthropometric measurements and type 2 diabetes incidence. Anthropometric indicators can be used to predict the risk of type 2 diabetes in males and females by clinicians and public health practitioners.
Adaptation and learning processes of stroke survivors and family carers: a scoping review
Authors: Moura A , Castanheira Pais S , Magalhães P , Alves E 
Published: October 2021

Abstract

Background
Knowledge on the processes of adaptation and learning after stroke are scarce, hindering the development of evidence-based public health strategies to promote survivors and family carers' health and wellbeing, across the post stroke trajectory. This study aims to assess the available evidence on the processes of adaptation and learning after stroke, by mapping the main barriers and enablers according to the perspectives of stroke survivors and family carers.

Methods
A scoping review was performed, following PRISMA-ScR guidelines. The electronic databases PubMed, ISI Web of Science, PsycINFO and SciELO were searched for empirical, peer-reviewed, original, and full-length studies on the processes of adaptation and learning of stroke survivors and family carers, in March 2021. Eligibility and data extraction were conducted by two independent researchers. The main qualitative data were explored by thematic content analysis and quantitative findings were synthesized.

Results
The included studies, 29 qualitative and 1 quantitative, were published between 1994 and 2019. Most of the studies were carried out with small samples and without a specific focus on the adaptation and learning processes after stroke. Barriers and enablers to stroke adaptation and learning processes were influenced by physical, psychological and social characteristics. The poor physical and functional status of survivors, the inability to maintaining the Activities of Daily Living, emotional disturbances, lack of support and information, and changes in roles, were identify as main barriers to stroke adaptation. Using coping strategies and having psychological, educational, and financial support were described as enablers.

Conclusions
Public health policies and practices should consider the physical, psychological and social barriers and enablers to the stroke adaptation and learning processes to ensure a high-quality long-term care centred on survivors and family carers.

Key messages
Robust theoretical and methodological studies, specifically designed to deeply explore and describe the post stroke adaptation and learning processes, are needed. Understand the main barriers and enablers to adaptation and learning after stroke may be useful for developing health education interventions centred on survivors and carers preferences and needs.
5.G. Skills building seminar: How to organise and benefit from a public health week in your country, region or continent
Authors:   Organised by: EUPHA,   Chair persons: Debora Miranda (European Observatory), Maaike Droogers (EUPHA)
Published: October 2021

Abstract

The European Public Health Week (EUPHW) is an annual activity by the European Public Health Association (EUPHA) that began in 2019, inspired by similar initiatives organised in Austria and the USA. This session aims to inspire and guide individuals and institutions to organise a public health day, week or month in a new city, country, region or continent. Having taken place both before and during the COVID-19 pandemic, the EUPHW has demonstrated that public health professionals, institutions and citizens across Europe are strongly committed to deliver its goals: to make the case for public health, amplify existing messages about important health topics, and create innovative ways of collaboration among all professionals contributing to public health - from local to international level. With a rich portfolio, the three editions of EUPHW recorded approximately 400 online and in-person activities hosted by more than 40 countries in multiple languages. In this skills-building seminar we will share examples, tips, best practices and lessons learned. This will be an interactive session combining group dynamics and Q&A to and from the audience, allowing participants to provide suggestions for improvement and share their experiences and perceptions as event hosts, disseminators or participants of past editions. The topics to be covered include governance, choice of themes and key messages, logistics, target audiences, communication, partnerships, stakeholder engagement, involvement types and evaluation, as well as concrete ways of applying the motto of EUPHW: “Joining forces for healthier populations”. Panellists will bring the perspective of organising a public health week at both national and European levels, including the day-to-day coordination work. They will also explain how we can engage with the future generation of public health professionals (EUPHAnxt) and build continuity and sustainable partnerships.
The EUPHW is an initiative by the European Public Health Association (EUPHA), receives co-funding under an operating grant from the European Union's Health Programme and is supported by the WHO Regional Office for Europe.

Speakers/Panelists
Dineke Zeegers Paget EUPHA Thomas Dorner Austrian Public Health Association, Vienna, Austria Marie Guichardon EUPHA Monica Brinzac Cluj School of Public Health, Cluj Napoca, Romania

Key messages
The European Public Health Week is a unique opportunity to make the case for public health, raise awareness about important health themes and promote collaboration among the public health community. This seminar aims to inspire individuals and institutions to organise a public health awareness day, week or month in their own local community, country or even continent.
Predictors of ER access of frail elderly: a way to fighting the COVID-19 outbreak
Authors: Gentili S , Terracciano E , Liotta G 
Published: October 2021

Abstract

Background
The overcrowding of the Emergency Room (ER) by the elderly is still a focus of public health policies, also due to the recent COVID-19 outbreak. Health policies have tried to mitigate the high use of ER by implementing community care on health demand in the absence of a plan to manage the increasing request of out-of-hospital care. This study aimed to investigate the predictors of Emergency Room Access (ERA) and No-Urgent Emergency Room Access (NUERA) of community-dwelling frail older adults.

Methods
An observational longitudinal cohort study was carried out. The cohort was made up of 1246 community-dwelling frail older adults (over 64) residents into the Latium Region. The ER admission rate was assessed over three years from the baseline administration of the Functional Geriatric Evaluation questionnaire to evaluate Bio-Psycho-Social Frailty. The GENLIN ordinal regression model was used to identify the predictors of ERA and NUERA.

Results
Mean age was 73.6 (SD ± 7.1) years, and 53.4% were female. The sample was stratified in Robust (43.5%), Pre-frail (35.8%), Frail (14.0%), and Very Frail (7.3%). The ordinal logistic regression model highlighted the predictive role of comorbidity (OR = 1.13, p &lt; 0.001) and frailty level (OR = 1.29, p &lt; 0.001) for ERA. With regard to NUERA, the predictors were social network (OR 0.54, P-value = 0.015) and) and a medium score of pulmo-cardio-vascular function (OR 1.50, P-value = 0.006).

Conclusions
Comorbidity and lack of social support impacted ER access and the overcrowding of the emergency department. Overall bio-psycho-social frailty represents an indicator of the frequency of ER accesses. This study could support policymakers and public health professionals in implementing community health care and defining and meeting the demand for care of non-frail individuals.

Key messages
The overcrowding of the Emergency Room (ER) by the elderly is still a focus of public health policies, also due to the recent COVID-19 outbreak. Comorbidity and lack of social support impacted ER access and the overcrowding of the emergency department.