bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the transition to retirement on alcohol consumption: a longitudinal analysis within SHARE
Authors: Vigezzi G P , Bertuccio P , Mosconi G , Fanucchi T , Gallus S , Odone A 
Published: October 2024

Abstract

In an ageing society, the impact of retirement on behavioural risk factors and health status needs to be carefully assessed. Evidence on the short-term and long-term effects of retirement on alcohol consumption are contrasting and inconsistent. A longitudinal study was conducted based on data from the Survey on Health, Ageing and Retirement (SHARE) collected between 2004 and 2020 in 27 European countries and Israel. A repeated measure generalised estimating equation (GEE) model was fitted to estimate the relative risks (RR) and corresponding 95% confidence intervals (CI) of alcohol consumption (frequency, quantity, and binge drinking) at different time periods before and after retirement. We selected a cohort of 8,998 individuals who were employed at baseline and retired during follow-up (median follow-up: 9 years; maximum: 16 years). Compared to the year of retirement, the RR for habitual daily or near-daily drinking was 0.88 (95%CI 0.76-1.02) 10 years before retirement and 0.92 (95%CI 0.83-1.02). This pattern reversed post-retirement with a RR of 1.12 (95%CI 1.01-1.23) 3-4 years after retirement and 1.28 (95%CI 1.11-1.48) 10 years or more after retirement. No significant changes in the consumption of high volumes (more than 8 units of alcohol) were observed: while the frequency of regular drinking might increase post-retirement, the instances of heavy episodic drinking do not necessarily rise. Additionally, a reduction in occasional heavy drinking episodes was noted both before (RR 0.86; 95%CI 0.77-0.95, 5-9 years prior) and after retirement (RR 0.78; 95%CI 0.66-0.93, more than 10 years after). These findings underscore the complexity of alcohol use behaviours in the context of retirement. The increase in regular drinking post-retirement might be attributed to changes in daily structure, social interactions, or coping mechanisms for life transitions. The decline in binge drinking suggests a shift towards more moderated consumption patterns as individuals age.

Speakers/Panelists
Licia Iacoviello
University of Insubria, Varese, Italy
João Vasco Santos
University of Porto, CINTESIS, ARS Norte, Porto, Portugal
Considerations for coping with loneliness from the perspective of young people
Authors: Verity L 
Published: October 2024

Abstract
Adolescence is a time characterized by high friendship instability. Adolescents have to navigate changes to their social worlds alongside developmental challenges such as identity formation. It makes sense then, that loneliness is a common experience during adolescence. For most, loneliness is transient and can be adaptive; it motivates individuals to strengthen their social relationships by seeking connection and evaluating existing relationships. For some, loneliness becomes chronic leading to heightened risk of additional mental health issues such as depression and anxiety, and physical health issues such as cardiovascular disease. Extant interventions to help youth cope with loneliness have been developed based on quantitative research and may be missing qualitative insights that can expand our understanding by identifying the decisions made by young people when determining how to cope. Exploring the lived experience of adolescents who are navigating loneliness can complement quantitative work by identifying preferred coping strategies, and barriers to coping adaptively. This presentation will focus on qualitative research with adolescents highlighting factors that influence their approach to coping. Drawing from insights gathered from 13 focus groups with young people aged 8-24 years in the UK, the presentation will discuss key themes developed to describe the process by which youth determine how to cope, the influence of their underlying reasons for feeling lonely, coping strategies that help to alleviate loneliness, and strategies which are counterproductive.
Machine Learning Approach to Injury Monitoring in Children and Adolescents
Authors: Feer S , Zysset A , Saaro M F , Bächli M , Niemann S , Meier D , Seiler M , Bogojeska J , Dratva J 
Published: October 2024

Abstract
Pediatric injuries are common and associated with individual suffering and costs for the healthcare systems and society. The incidence of injuries among children in Switzerland has so far been insufficiently monitored. Emergency department patient records can be a valuable database to assess medically relevant injuries and gain information for monitoring and evidence-based prevention. The talk will outline our stepwise development of a machine-learning program for a pediatric injury monitoring system and lessons learnt. In this feasibility study we draw on electronic case histories of children treated for injuries between 2018 and 2022 at the University Children’s Hospital Zürich emergency department (N= to 30’884). The ML- approach follows different steps: step 1. utility evaluation of electronic pediatric patient records regarding ML and injury monitoring and prevention requirements in a test-sample of 100 electronic pediatric case histories; step 2. choice/adaptation of coding tree; step 3. coder training and inter-coder reliability testing; step 4. manual annotation of a sub-sample (n 1000) of the electronic pediatric patient records, step 5. design and testing of the ML program in an iterative process, and step 6. performance testing in a random sample of pediatric patient records. First lessons learnt indicate that electronic case history data contain relevant data and fulfill requirements for monitoring and prevention purposes. The IDB coding system proved too complex and detailed for the pediatric data base, providing too few examples for the ML-learning process, and needed to be adapted. Initial data analyses indicate the majority of cases are classified as less severe (73%) and only few (&lt;1%) as very severe but the later provide the most detailed data. ML is a promising approach and makes use of hospital data for a national monitoring of pediatric injuries in Switzerland.
Long-term disability following childhood injury: an imperative to monitor and address the continuum of trauma care
Authors: Ameratunga S , Harrison J E , Cameron P , Ponsford J , Reeder S , Lyons R A , Teague W , Nunn A , Gabbe B 
Published: October 2024

Abstract

Background
While injuries remain a leading cause of childhood death, increasing proportions of children survive life-threatening injuries. However, robust epidemiological data on their risks of long-term disability are scant, undermining comprehensive injury control efforts. This population-based prospective cohort study investigated the functional status and health-related quality of life of seriously injured Australian children over a 5-year period.

Methods
Patients aged &lt;18 years hospitalised for major trauma (Injury Severity Score &gt;12) in the State of Victoria over a 12-month period were followed-up at 6, 12, 24, 36, 48 and 60-months post-injury. Primary outcomes were assessed using the PedsQL, King’s Outcome Scale for Childhood Head Injury and the Glasgow Outcome Scale-Extended. Multivariable regression models investigated factors associated with outcomes.

Results
Of the 186 participants, 71% were retained to 60 months post-injury. At five years post-injury, only 39% had fully recovered while 39% experienced moderate to severe disability. Despite gains in functional status across the five years, psychosocial recovery lagged improvements in physical health. Factors associated with adverse outcomes included older age at injury, female sex, socio-economic disadvantage, remote/regional (versus urban) residence, pre-existing comorbidities, and injuries deemed compensable, intentional, or involving head trauma.

Implications
The high risks of long-term disability following serious childhood injury highlight the need for robust injury control efforts that monitor and address the inequitable burden of childhood injury, including the social determinants influencing the occurrence as well as sequelae following injury.
Gender identity differences in age of first mental health diagnosis: A population-based study of childhood and adolescence
Authors: Bränström R , Pachankis J E 
Published: October 2024

Abstract

Introduction
Gender minority (GM; i.e., trans, non-binary, and other gender diverse) individuals have an increased risk of mental health disorders, but few studies have explored disparities using population-based samples or the age of onset of this risk.

Objectives
The aim of the current study was to identify the age at which the gender identity disparity in physician-assessed psychiatric diagnosis and treatment for common mental health disorders can be first identified in a population-based sample linked to national health care registries.

Methods
All individuals aged 16 to 25 (n = 18,793) participating in the nationwide probability-based Swedish National Public Health Survey in 2018, 2020, or 2021 were included in the analyses. This sample could be linked to mental health care treatment history data in nationally comprehensive health care registries starting at age 8 years old.

Results
Individuals reporting a GM identity in adulthood were seven times more likely to having been diagnosed with depression and/or anxiety and about five times more likely to having been diagnosed with a neurodevelopmental disorder during childhood or adolescence compared to individuals with a cisgender identity. GM individuals’ increased likelihood of being diagnosed with depression and/or anxiety was significantly elevated from age 13, while their neurodevelopmental disorder diagnosis risk was significantly elevated from age 10, compared to cisgender individuals.

Conclusions
The results from this study are the first population-based evidence to show that GM individuals are more likely to be diagnosed and treated for mental health disorders early during childhood and adolescence compared to cisgender individuals. The early emergence of this increased risk requires further inquiry into causes of these early disparities. It also suggests a potential benefit of interventions that facilitate social belonging and inclusion and reduce stressors related to societal expectations of gender.
Disparities in Mental Health and the Social Determinants of Health Among Privately Insured Transgender Patients in the United States
Authors: Gonzales G , Wilder J , Tran N 
Published: October 2024

Abstract

Objectives
The purpose of this study was to examine disparities in mental health and the social determinants of health (SDoH) among privately insured transgender and gender minority (TGM) patients in the United States.

Methods
Data came from FAIR Health, a repository of private health insurance claims data covering over 150 million individuals in the United States. TGM patients (n = 274,479) were identified with medical claims that included a diagnosis for gender dysphoria or gender identity disorder. A random 5% selection of cisgender patients (n = 7,456,823) was used as a comparison group. We estimated descriptive statistics and used multivariable logistic regression models to compare health outcomes between TGM and cisgender patients.

Results
TGM patients were more likely to have anxiety (odds ratio [OR]=7.02; 95% confidence interval [CI]=6.94-7.09), depression (OR = 9.27; 95% CI = 9.16-9.37), post-traumatic stress disorder (OR = 9.03; 95% CI = 8.86-9.21), and substance use disorder (OR = 2.93; 95% CI = 2.86-3.00) compared to their cisgender peers. TGM patients were also more likely to have problems with education and literacy (OR = 5.95; 95% CI = 5.64-6.28), employment (OR = 3.67; 95% CI = 3.44-3.92), economic circumstances (OR = 5.74; 95% CI = 5.39-6.12), and social exclusion (OR = 7.35; 95% CI = 6.91-7.81). Compared to TGM patients living in states with transphobic policy environments, TGM patients in states with comprehensive protections from discrimination fared better.

Conclusions
We found wide disparities in mental health and the SDoH among privately insured TGM. More research is critically needed to better understand the health and social needs of TGM populations. Meanwhile, policymakers should consider enacting policies that would prohibit discrimination against TGM people throughout the SDoH -- or the conditions where we live, learn, work, play, and age. Health care providers should also receive education on the unique health needs of TGM patients to advance health equity.
Development of a first intervention for tobacco cessation for sexual and gender minority individuals in Romania
Authors: Lelutiu-Weinberger C , Matthews P , Zavodszky A , Hightow-Weidman L 
Published: October 2024

Abstract

Background
Data on tobacco use among SGM in Romania indicate high use rates, yet tailored smoking cessation efforts do not exist. We collected data from SGM individuals in Romania on tobacco use and cessation attitudes, facilitators and barriers to quitting, and intervention components acceptability to inform the first smoking cessation intervention for SGM in Romania, adapted from a U.S.-based intervention with mobile app support.

Methods
SGM individuals (≥ 18 years old, current smokers) recruited through community outreach in March 2024 completed a brief assessment and participated in a focus group regarding tobacco use, attitudes, norms, risks knowledge, facilitators and barriers to quitting, and intervention acceptability.

Results
Focus groups were held with 36 participants characterized as 45% cis male, 40% gender-diverse, 15% cis female; 40% gay, 33% bisexual, 10% queer, 8% pansexual; 6% lesbian, 3% heterosexual; M age=27, SD = 7.62. 70% smoked daily; median age of first cigarette was 17. Participants reported smoking up to 2 packs a day, with 50%-98% of people in their circles being smokers. Common reasons for smoking included to alleviate stress and “fit in.” Most did not receive support to quit from their social circles or within healthcare. While smoking was communal, quitting was individual and siloed, suggesting a preference for a group-based intervention, along with robust strategies to replace the function of smoking with adaptive habits. The app was evaluated positively, especially for its daily smoking tracking, reminders for alternative healthy activities, positive achievements, and forum for support.

Conclusions
Findings provide a solid platform for creating a first smoking cessation intervention for SGM individuals in Romania. Next steps include iterative testing of the mobile app to examine comprehension, usability, and satisfaction with content and functionality, in preparation for a randomized controlled trial testing the intervention’s efficacy.
Territorial health inequalities in breast cancer mortality across France from 1968 to 2017
Authors: Lucio Garcia C A , Grimaud O , Leyland A H , Le Meur N 
Published: October 2024

Abstract

Background
Territorial health inequalities are of growing concern in countries with universal health systems. From 2003, three successive national cancer plans were launched in France, aiming to improve prevention and treatment. Regions in France are responsible for strategic and financial management of healthcare within their boundaries, which, until 2016, included up to 8 departments. In this study, we analyze the evolution of between and within-region territorial inequalities in breast cancer mortality over 50 years.

Methods
We used direct and indirect standardization to analyze trends in breast cancer mortality for women aged 25 to 74 years between 1968 and 2017 in each department of metropolitan France. We analyzed the evolution of relative inequalities over time using standard errors of age-adjusted rates. We used multilevel Poisson regression to estimate how much the regional level contributed to territorial variation.

Results
Over the period 1968 to 1992, breast cancer standardized mortality ratios (SMRs) increased (+16%) while relative territorial inequalities decreased (-21%). After 1997, SMRs decreased (-23%) but territorial inequalities remained unchanged. In 18 out of 22 regions, inequalities were lower at the end than at the start of the study period. Period proved to be the most important determinant of variation in mortality. However, multilevel models also suggested that the regional level explained most of the remaining variation in each period (from 50% to over 80%).

Conclusions
Over the study period in most French regions, breast cancer mortality has decreased, and so have relative inequalities. Nevertheless, there is evidence that regions have performed differently. The proportion of variation explained by the regional level suggests the continued relevance of the health system on breast cancer mortality.

Key messages
• Territorial inequality in breast cancer mortality has decreased in France over the 1968-2017 period.
• In most regions, disparities between departments have decreased.
Socioeconomic inequalities in avoidable mortality: results from the Italian nationwide cohort
Authors: Ventura M , Petrelli A , Di Napoli A , Pappagallo M , Simeoni S , Frova L 
Published: October 2024

Abstract

Background
Inequalities in avoidable mortality have been well evaluated in many European countries. We aimed to assess the association between socioeconomic status and avoidable mortality in Italy.

Methods
The nationwide closed cohort of the 2011 Census of Population and Housing was followed up for 2012- 2019 mortality. Outcomes of preventable and of treatable mortality were evaluated among people aged 30-74. Exposures were education level and residence macro area (North-West, North-East, Center, South-Islands). Adjusted mortality rate ratios (MRRs) were estimated through multivariate quasi-Poisson regression models, by sex and group of causes, taking into account age at death and macro area of residence. Relative index of inequalities (RII) was estimated for preventable, treatable, and non-avoidable mortality and for some specific causes.

Results
The cohort consisted of 35,708,459 residents (48.8% men, 17.5% aged 65-74), 34% with a high school diploma, 33.5% living in the South-Islands; 1,127,760 deaths were observed, of which 65.2% for avoidable causes (40.4% preventable and 24.9% treatable). Inverse trends between education level and mortality were observed for all causes; comparing the least with the most educated groups, a strong association was observed for preventable (males MRR = 2.39; females MRR = 1.65) and for treatable causes of death (males MRR = 1.93; females MRR = 1.45). Highest RII were observed for HIV/AIDS and alcohol-related diseases (both sexes), drug-related diseases and tuberculosis (males), and diabetes mellitus, cardiovascular diseases, and renal failure (females). Higher risks of preventable and of treatable mortality were found for those living in the South-Islands.

Conclusions
We documented relevant socioeconomic inequalities in avoidable mortality in Italy, especially in the Southern regions. They represent a possible missed gain in health and suggest a reassessment of priorities and definition of health targets with the lens of equity.

Key messages
• An inverse socioeconomic gradient in avoidable mortality was observed in Italy, both for preventable and for treatable mortality, with geographical heterogeneity.
• Greatest social disparities were found in mortality for causes strongly associated with risk behavior and for which it is possible to identify risk factors on which to intervene.
Are health inequalities decreasing in Sweden?
Authors: Engström K , Fritzell S , Hemström Ö , Källberg H 
Published: October 2024

Abstract

Background
The overarching national goal for the Swedish public health policy is to create societal conditions for good and equitable health for all and to eliminate avoidable inequalities within a generation (until 2048). To know whether we are heading towards the public health policy goal, a surveillance system which follows a combination of several inequality measures over time, is needed.

Methods
All-cause mortality in age 25-64 and life expectancy at age 30, in the total population of Sweden, were used as measures of health and followed 2006-2022. Education (low, middle, high) was used to measure socioeconomic position. Both absolute and relative, and both simple and complex measures were used to analyse inequalities in mortality: rate difference (RD), relative risk (RR), population attributable fraction (PAF) and population attributable number (PIN). Life expectancy was analysed as absolute and relative difference in remaining number of years.

Results
Life expectancy has increased and mortality in age 25-64 have decreased in the Swedish general population. Comparing those with low and high education, both absolute and relative inequalities have increased, e.g. differences in life expectancy increased to &gt; 6 years among men and almost 7 years among women, and relative inequality in mortality in age 25-64 increased to &gt; 3 times higher risk (RR 3.1; CI 3.0-3.3). Inequality, measured with regard to all groups in the population, showed no noticeable changes over time.

Conclusions
The results show that Sweden is facing a challenge in achieving the public health goal to eliminate avoidable inequalities by 2048, with regard to life expectancy and mortality in age 25-64. To use a combination of health inequality measures strengthens the surveillance system and gives a more nuanced picture of the development. It enables, in parallel with universal health improving efforts, focus on the groups with the poorest health, where efforts have the greatest effect.

Key messages
• Sweden is facing a challenge in achieving the public health goal to eliminate avoidable inequalities by 2048, with regard to life expectancy and mortality in age 25–64.
• A more nuanced picture of inequalities is crucial to be able to parallel universal health-improving efforts with a focus on the groups with the poorest health, where efforts have the greatest effect.
Hospital design and planning in the line of foresight of health needs
Authors: Jevtic M , Bouland C , Polic D 
Published: October 2024

Abstract
The health needs of the population are increasingly difficult to plan and predict. Technological progress, artificial intelligence, new medicines, but also ecological disasters, humanitarian crises, energy crisis and other challenges (as a Covid 19 pandemic) represent the image of our time. New design of hospitals should be able to respond to the challenges of the future: comprehensive provision of health services taking into account the patient’s needs, working conditions taking into account the hospital staff, energy efficiency and construction in accordance with high standards and reduction of CO2 emissions (green hospitals), to ensure alternative sources of electricity and water supply bearing in mind potential emergencies. The big challenge of long-term construction in which advanced technologies and new procedures cannot simply fit into a rigid building structure that is several decades old (example Serbia), so it is necessary to apply precise planning and efficient and high-quality construction in the next generation hospitals, taking into account current modern equipment and that which will appear in the future. Designing hospitals involves anticipating future healthcare challenges, technological advancements, demographic shifts, and changes in patient expectations. Hospitals emphasis on patient-centered design principles, creating environments that prioritize comfort, privacy, and dignity for patients and their families, accessibility and inclusivity, infection control and prevention, sustainability and resilience. Modern hospitals should create collaborative spaces for interdisciplinary teamwork and communication among healthcare providers, research and innovation units, but also community engagement and health promotion activities. Future hospital design requires strong multidisciplinary and cross-sectional cooperation, in which priority is given to architects dedicated to this field and their cooperation with public health and health management experts.