bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resilience and optimism associated with mental health to subjective well-being in older adults 65+ during pandemic outbreak
Authors: Lee S 
Published: October 2021

Abstract

Background
During the ongoing COVID-19 pandemic, older adults are more likely to experience limitations in activities for daily living and social isolation and thus at greater risk for decline in mental and cognitive health. The current study examined how older adults' resilience and optimism affected mental and emotional well-being in the midst of pandemic crisis.

Methods
The study used data sampled from two waves of the Eurofound COVID-19 survey collected from 27 European countries in April, during the first lockdown, and July 2020 when restrictions and measures were mildly lifted-up. The first round sample included 11,211 older adults (Mean age = 69.71 ± 5.15, 70% females, 86% retired) and second round sample included 4,424 (Mean age = 69.93 ± 4.47, 61% females). Analysis focused on resilience, optimism, WHO Well-being Index, psychological distress, and subjective well-being (self-rated health, life satisfaction, happiness). Covariates included socio-demographic information and financial and health care situations since pandemic crisis.

Results
Mental health, subjective well-being, and psychological distress in older adults tended to change over time, while resilience and optimism were relatively stable. Regression analysis indicated that older adults who scored higher for resilience and optimism reported greater life satisfaction and happiness, better health perception, higher levels of mental health, and lower psychological distress when controlled for socio-demographic variables and adversities related to pandemic outbreak.

Conclusions
Resilience and optimism might have a potential to help older adults cope with exposure to stressful life events and later life adversity, but inconclusive. Future studies should more precisely examine the role of resilience and optimism in promoting mental health in older adults, its formation and protective mechanism, to better incorporate these factors into life-long education and interventions for older adults.
The impact of parental migration background on cardiometabolic health in European children
Authors: Lindblad A , Ahrens W , Winkler V , Lissner L , Mehlig K 
Published: October 2021

Abstract

Background
There is accumulating evidence that children from migrant families have higher risk of developing overweight and obesity than their peers in the host population. This study aims to investigate the association between parental migration and cardiometabolic health, including the metabolic score and its components, in children and adolescents in Europe.

Methods
Data was collected from 8,828 children (aged 2-17) in eight European countries included in the multicentre IDEFICS/I.Family cohort. Multilevel linear regression models were used (accounting for correlations between siblings) to investigate the association between parental migration background (one or two migrant parent(s) vs native parents) and the cardiometabolic health outcomes body mass index (BMI), metabolic score and its individual components. Outcome variables were parametrized as age and sex-specific z-scores. We controlled for socioeconomic indicators, maternal weight status, as well as lifestyle and dietary patterns.

Results
We found a higher mean BMI z-score (+0.24 SD, p &lt; 0.001) and overall metabolic z-score (+0.28 SD, p &lt; 0.001) among children with two migrant parents in comparison to children with two native parents. No differences could be seen between children with one versus no migrant parent. The effects were attenuated when controlling for maternal weight status and levels of sport club activity. Parental education modified the associations for some health outcomes (BMI and waist circumference) such that they were more pronounced in children with low parental education.

Conclusions
European children and adolescents with two-parent migration background seem to be at higher risk of developing adverse cardiometabolic health than their peers. Children with one migrant parent seem to have similar risk as children with native parents. Maternal BMI and levels of physical activity partly explained the higher risk, a risk which was more prevalent in families with lower education level.

Key messages
European children and adolescents with two-parent migration background have higher risks of developing adverse cardiometabolic health than their peers with one or two native parents. The higher risk of being overweight and having cardiometabolic risk factors among children with two-parent migration background was most pronounced in families with low level of education.
The impact of the epidemiology of multimorbidity on health policy across settings and countries
Authors: Nicholson K , Stranges S 
Published: October 2021

Abstract

Issue/Problem
The epidemiology of multiple health conditions (also known as multimorbidity) is increasingly being studied across many settings and countries around the world. More specifically, prevalence and predictors of multimorbidity are being explored among clinical and population-based samples from high-, middle- and low-income countries in rural and urban settings. While the prevalence of multimorbidity tends to increase among ageing populations, a growing proportion of adults under the age of 65 years are also living with multimorbidity, indicating a need for effective interventions.

Description of Problem
There is a need to identify consistent and distinct epidemiological patterns of multimorbidity across different settings and countries. More specifically, the prevalence and consequence of multimorbidity may have different implications in high-, middle- and low-income countries, as well as between rural and urban settings. This understanding can be informed by extracting information from relevant publications and conducting a survey of multimorbidity researchers on the impact of this research on subsequent health policy priorities and decisions in their specific setting or country.

Intended Results
The responses and insights provided by multimorbidity researchers from the completion of the survey (consisting of both open- and closed-ended questions) will be presented, including how the epidemiology of multimorbidity has been conducted to date and how this research may or may not be informing policy priorities and decisions in their respective countries. As well, the focus of interventions to prevent multimorbidity occurrence will be explored across settings.

Lessons
Overall, this presentation will aim to summarize key patterns in both epidemiology and policy responses to multimorbidity occurrence and implications across settings and countries. This work will also aim to create a more formal community of multimorbidity researchers around the world.
Multimorbidity and Health Systems: Challenges and Priorities
Authors: van den Akker Marjan 
Published: October 2021

Abstract
Older patients, suffering from numerous diseases and taking multiple medications are the rule rather than the exception in primary care. A manifold of medical conditions are often associated with poor outcomes, and their multiple medications raise additional risks of polypharmacy. Such patients account for most healthcare expenditures. Effective approaches are needed to manage such complex patients in primary care. The paper will discuss different models of care as well as major health care challenges in the management of multimorbidity in primary care with focus on interactions (disease-disease, treatment-treatment, and treatment-disease) extrapolated from (disease specific) guidelines and the feasibility to apply these guidelines for and with patients who have multimorbidity.
Chronic disease prevalence and patterns of comorbidities in people with intellectual disabilities
Authors: van den Bemd M , Schalk B , Bischoff EWMA , Cuypers M , Leusink GL 
Published: October 2021

Abstract
This study aims to examine chronic chronic disease prevalence in people with ID compared to those without ID in primary care settings and comorbidity patterns accompanying chronic diseases, by focusing on age and sex differences. With a focus on the four highest-impact chronic diseases worldwide and individually, ischemic heart disease, cerebrovascular disease, diabetes mellitus, and chronic obstructive pulmonary disease (COPD), it is assessed to what extent these diseases affect people with ID. Two databases are linked, that of Nivel Primary Care Database, a large representative sample of Dutch citizens registered in general practices, and non-public microdata from Statistics Netherlands, containing information on indication of long-term care or supportive services for people with ID. With prevalence rates and odds ratios chronic disease prevalence and comorbidity patterns were established by total groups of people with and without ID and by sex and age groups. Results displayed differences in chronic disease prevalence in people with and without ID: cardiovascular diseases were less prevalent, and diabetes mellitus more prevalent in people with ID. At relatively young age (&lt;50 years), people with ID not only had more chronic diseases, but also more often had multiple comorbidities compared to those without ID. The most common comorbidity in all chronic diseases was hypertension, while diabetes mellitus as comorbidity also occurred often. This study is the first to present chronic disease prevalence and comorbidity patterns across the groups of people with and without ID and by sex and age groups. It can therefore be used as source of accurate information on the health prevalence and patterns of people with ID compared to the general populations, and provides a novel insight into differences in the group of people with ID.
Mental health care for adults with mild intellectual disabilities: A retrospective database study
Authors: Pouls K , Cuypers M , Mastebroek M , Koks-Leensen M , Wieland J , Leusink GL , Assendelft P 
Published: October 2021

Abstract
People with mild ID suffer more mental health disorders (MHD) than people without ID. Practitioners working in mental health services (MHS) indicate limited knowledge and experience to provide the care needed. Besides diagnosing MHD, identification of the ID itself is a challenge and not all people with a ID are recorded in the MHS as such. These factors contribute to insufficient care and can result in chronic, more difficult to treat MHD. For this study, all adult users of Dutch MHS between 2015 and 2017 were enrolled in MHS databases of Statistics Netherlands. Presence of mild ID was established by linking MHS data with social services and chronic care databases. Characteristics of new cases of MHC were analyzed and compared between patients with and without mild ID. Linking databases identified 11,374 MHC patients with mild ID, and 525,162 patients without ID. A substantial proportion of patients with mild ID did not have this characteristic noted in their MHS records (60.6%). Preliminary results showed people with mild ID were younger, were more often man, had different diagnostic profiles, required more crisis interventions, and more psychiatric hospital admissions compared to people without ID. In addition, people with a mild ID and no ID record in MHS received less treatment compared to both people with mild ID and a ID record, and people with no ID. According to these findings, the prevalence of MHD and provided care between people with and without a mild ID, in MHS deviated. The Mild ID is potentially under recognized among MHS patients. The findings are a first step towards improving mental healthcare for patients with ID.
Is outsourcing healthcare to private providers associated with higher mortality rates in NHS England?
Authors: Goodair B , Reeves A , Rahal C 
Published: October 2021

Abstract

Background
Outsourcing services to for-profit organisations within a publicly funded healthcare service which runs parallel to private provision in a ‘two-tier' system aims to increase the competition between healthcare providers, driving up their performance. However, some worry that contracting out health services to for-profit providers may lead to cost-cutting and poorer outcomes for patients. We aim to assess whether increased outsourcing to the private sector is associated with changes to treatable mortality rates, and, therefore, with the quality of healthcare.

Methods
We construct a novel database compiling every procurement contract over 7 years (n = 646,938, total value = £204.1bn) across England's Clinical Commissioning Groups (regional health boards). We identify institutions registered on the Companies House registry which supply regional commissioners in England's NHS, and then aggregate this annually with local mortality data. By exploiting the commissioners' variation in spend on private sector providers, we estimate the association between outsourcing and treatable mortality rates in the following year. We account for year and individual fixed effects and control for multiple covariates, including average household income, Local Authority spending, and population size.

Results
Our sample comprised 173 Clinical Commissioning Groups between 2013 and 2020. In general, outsourcing increased over this period, but the extent of change varied substantially. Some areas, like East Riding of Yorkshire, saw very large increases but others saw reductions. We find an annual increase of one percentage point of outsourcing to the private sector corresponds with an annual increase in treatable mortality of 0.34% (95% CI 0·10% to 0·58%) in the following year.

Conclusions
The incorporation of private sector providers into England's NHS appears to be corresponding with a decline in the quality of healthcare services.

Key messages
The private provision of healthcare services has generally increased across England's NHS since 2013. Increased outsourcing of services to private sector providers is associated with increased treatable mortality rates.
Food industry shaping of the principles of scientific integrity
Authors: Mialon M , Ho M , Carriedo A , Ruskins G , Crosbie E 
Published: October 2021

Abstract

Background
There is evidence that food industry actors try to shape science on nutrition and physical activity. But they are also involved in the influence of scientific integrity principles. Our research objective was to study the extent of that involvement, with a case study of ILSI as a key actor in that space.

Methods
We conducted a qualitative document analysis, triangulating data from an existing scoping review, publicly available information, internal industry documents, and existing freedom of information requests.

Results
Food companies have joined forces through ILSI to shape the development of scientific integrity principles. These activities started in 2007, in direct response to the growing criticism of the food industry's funding of research. ILSI first built a niche literature on conflicts of interest (COI) in food science and nutrition at the individual and study levels. Because the literature was scarce on that topic, these publications were used and cited in ILSI's and others' further work on COI, scientific integrity, and PPP, beyond the fields of nutrition and food science. In the past few years, ILSI started to shape the very principles of scientific integrity then and to propose that government agencies, professional associations, non-for-profits, and others, adopt these principles. In the process, ILSI built a reputation in the scientific integrity space. ILSI's work on scientific integrity ignores the risks of accepting corporate funding and fails to provide guidelines to protect from these risks.

Conclusions
The activities developed by ILSI on scientific integrity principles are part of a broader set of political practices of corporations to influence public health policy, research, and practice. It is important to learn about and counter these practices as they risk shaping scientific standards to suit corporate interests rather than public health ones.

Key messages
ILSI, a group funded by corporations, shaped the very principles of scientific integrity. ILSI built a reputation in the scientific integrity space.
Hospital-level risk factors for healthcare-associated infections: insight from the Italian PPS Study
Authors: Garlasco J , Vicentini C , D'Ambrosio A , Quattrocolo F , Zotti CM 
Published: October 2021

Abstract

Background
In 2016-2017, a Point Prevalence Survey (PPS) was conducted by the European Centre for Disease Prevention and Control (ECDC) in 29 European countries to investigate healthcare-associated infections (HAIs) and antimicrobial use. The aim of this study was to identify significant determinants of HAIs at a hospital level according to Italian data.

Methods
Among variables considered by the ECDC Protocol for the PPS, those with most plausible relationship with HAI occurrence according to the literature were a priori selected. Hence, conceptual causal models were built for each reference variable, by adjusting for an established set of confounders (geographical region, hospital type and number of beds), and also considering the possible interaction of the number of blood cultures per 100 patient-days (a proxy of how thoroughly HAIs are searched). Direct effects were estimated in the form of risk ratios through multivariable log-binomial regression models.

Results
Data were available for 135 Italian hospitals participating in the survey. Factors with significant impact on HAIs resulted to be: percentage of single rooms (RR = 0.91 for every 5% increase, p = 0.013), presence of a plan for infection prevention and control (IPC, RR = 0.51, p = 0.007), routine production of an IPC report (RR = 0.50, p = 0.001), adoption of measures for HAI prevention (RR = 0.21, p = 0.002) and antimicrobial stewardship (RR = 0.50, p = 0.015). The interaction of the number of blood cultures was significant for the effect of IPC report (p = 0.038), number of measures for HAI prevention (p = 0.037) and antimicrobial stewardship (p = 0.02).

Conclusions
The results confirm the importance of HAI prevention and antimicrobial stewardship as means of lowering the occurrence of HAIs. Therefore, investigating, testing and correctly reporting the onset and evolution of HAIs is paramount to ensure better understanding of the phenomenon and to provide useful insights to create a safer background for clinical practice.

Key messages
Adopting preventive measures and antimicrobial stewardship is crucial in lowering the occurrence of HAIs and ensuring safer care. Investigating, testing and correctly reporting the onset and evolution of HAIs is paramount to ensure better understanding of the phenomenon and to enable effective HAI prevention.
Gender inequality and population-level health outcomes: Panel data analysis of OECD countries
Authors: Veas C , Crispi F , Cuadrado C 
Published: October 2021

Abstract

Background
Gender plays a well-recognized role in many health inequalities. However, the population-level health consequences of gender inequalities have not been measured comprehensively. The goal of this study, therefore, was to evaluate associations between gender inequality and health indicators in OECD countries.

Methods
Ecological study based on 1990-2017 panel data for Organisation for Economic Co-operation and Development (OECD) member countries. Gender inequality was measured using the Gender Inequality Index (GII). The population health parameters evaluated were: life expectancy (LE), healthy life expectancy (HALE), years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALYs), and specific-cause mortality. Two way fixed-effects linear models were developed to assess the relationship between gender inequality and health outcomes. Models included potential mediating and confounding factors such as health spending, political model, and economic inequities.

Results
Greater gender inequality was associated with lower LE (-0·49%; CI95 -0·63%- -0·31%; p-value &lt;0·0001) and HALE (-0·47%; CI95 -0·63%- -0·31%; p-value &lt;0·0001) as well as less-favorable figures for YLL (6·82%; CI95 3·63%-10·75%; p-value &lt;0·0001), DALYs (1·50%; CI95 0·48%-2·46%; p-value=0·0028), and YLD (2·59%; CI95 0·67%-4·77%; p-value=0·0063). The sensitivity analysis indicated that the results were robust to the various specifications of the causal models.

Conclusions
Our results suggest that gender inequality has a negative impact on the health of the population. Promoting gender equality as part of policy-making is vital for optimizing health on a population scale

Key messages
Reduce gender inequality can advance health outcomes on a population scale, resulting in increased LE and HALE and decreasing YLL, YLD, and DALY, in the general population, and in men as well as women. This information supports the need to develop gender-sensitive public policies, for the benefit of society as a whole.
Asylum seekers’ experiences with quarantine after arriving in Germany during the COVID-19 pandemic
Authors: Rast E , Perplies C , Biddle L , Bozorgmehr K 
Published: October 2021

Abstract

Background
During the COVID-19 pandemic, newly arriving asylum seekers undergo mandatory quarantine in many European countries. Quarantine is likely to amplify pre-existing strains associated with asylum seeking, including limited autonomy and barriers for care-seeking. Our objectives were a) to elicit asylum seekers’ experiences with quarantine regarding their mental health and needs and b) to explore how they assess the measure.

Methods
We conducted 9 semi-structured interviews with asylum seekers in a German reception centre (July-December 2020). Individuals with quarantine experience who spoke German, English or French were invited to participate. The interviews were recorded, transcribed and analysed thematically with an inductive-deductive approach. Funding: German Federal Agency for Health Education (BZgA).

Results
The participants (2 women, 6 men and a couple from Syria, Algeria, Yemen, Bangladesh and Cameroon) experienced the quarantine as a difficult situation and described feeling locked-in and bored. Obsessive thinking, loneliness, sleeping problems and feelings of abandonment were repeatedly reported. Unmet basic needs (e.g. special foods, cleaning tools, shampoo, Wi-Fi) and unclarity about access to social or emergency help further impaired wellbeing in some cases. In view of negative PCR test results, the rationale of mandatory quarantine was questioned by some. Assessments of the quarantine varied: Some favoured individual responsibility, physical distancing and hygiene measures over quarantine, while others considered it necessary for health protection despite the strains entailed.

Conclusions
Quarantine can be a considerable stressor for asylum seekers. In this explorative study, shortcomings in the provision of daily necessities and information were visible. Potential adverse impacts of quarantine on wellbeing should be minimised through ensuring its comprehensibility, the supply of daily needs and low-threshold access to psychosocial support.

Key messages
Quarantine can be a significant stressor for newly arriving asylum seekers. Quarantine-induced stress should be minimised through appropriate information, the provision of daily necessities and psychosocial support.