bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comorbidity of substance use and mental disorders in Europe
Authors: Montanari L 
Published: October 2024

Abstract
‘Comorbidity of substance use and mental disorders’ refers to the co-occurrence of a substance use disorder (SUD) and another mental disorder (MHD) in the same individual: mental disorders can be a risk factor for SUD and SUD may affect the occurrence of MHD. The relevance of the mental health disorders among people who use substances is related not only to its high prevalence, but also to its difficult assessment, diagnosis, and management. The EUDA is the European Drug Agency (EUDA), a decentralised agency of the European Commission with the purpose to support the European member States to monitor, respond and be prepared to the challenges posed by the drug phenomenon, including the link between SUD and MHD. In 2015 the agency has published an overview on comorbidity of SUD and MHD where it discusses several issues regarding dual disorders, including: theoretical concepts and mechanisms of actions, tools for screening and clinical diagnosis, epidemiology and interventions available to address comorbidity in the European countries (EMCDDA, 2015). The European strategic policy documents in the drug area stress the importance of considering mental health in monitoring, evidence-based responses and training for professionals in the drug field (EC, 2021). During the COVID19 pandemic, due to the overall increased concern on mental health in the population, the EUDA conducted an ad-hoc study to its the impact on substance use and mental health, especially in people who use illicit drugs. Recent work has been done to improve the available epidemiological data on comorbidity in the current European drug monitoring tools and to describe models of care for the treatment of dual disorders in Europe. Further steps are being taken with the development of the recent new agency’s mandate.
References: EMCDDA (2015), Comorbidity of substance use and mental disorders in Europe; Council of the European Union (2020), EU Drugs Strategy 2021-2025
HIV-1 transmission clusters and drug resistance in men who have sex with men in Portugal
Authors: Abrantes R , Pimentel V , Miranda M , Cruz S , Best-Hope S G , Seabra S , Martins MRO , Gomes P , Pingarilho M , Abecasis A B 
Published: October 2024

Abstract

Introduction
In 2022, 45.8% of diagnoses in the EU/EEA with known route of transmission were in Men who have Sex with Men (MSM). We aim to characterise HIV transmission clusters and transmission of drug resistance (TDR), as well as its determinants, using integrated sociodemographic, behavioural, clinical, and viral genomic data of MSMs newly diagnosed in Portugal between 2014 and 2019.

Methods
This study included data from 340 MSM who were diagnosed with HIV-1 infection. These individuals were newly diagnosed at 17 hospitals in Portugal between September 2014 and December 2019. Phylogenies were constructed and transmission clusters were identified with branch support ≥ 90% and 1.5% genetic distance. Logistic regression models were computed to examine the factors associated with clusters of transmission and with the presence of TDR.

Results
We identified 38 transmission clusters with 104 MSM, which included 26.6% of the total 305 MSM from our database used for cluster analysis. The overall prevalence of TDR was 8.2%. Only subtype C was significantly associated with TDR. 10.5% of the clusters had at least 1 drug resistance mutation (K103N, L90M or N88S). There was no significant difference in the prevalence of TDR between MSM inside and outside clusters. 50% of the clusters were composed of portuguese native MSM only, whereas 16% had exclusively migrant MSMs. No significant difference was found in the proportion of portuguese and migrant MSM inside and outside clusters. Factors associated with HIV-1 transmission clusters were age at diagnosis, district of residence, unprotected anal or vaginal sex with a woman, HIV testing frequency, presenter status and subtype. 87% of men engaged in sexual activity only with other men, while 13% with both men and women.

Conclusions
Specific subgroups of MSM are contributing to HIV dissemination in Portugal. Direct and precise prevention measures based on molecular epidemiology should be developed.

Key messages
• Specific subgroups of MSM are contributing to HIV dissemination in Portugal.
• Direct and precise prevention measures based on molecular epidemiology should be developed.
Assessing Health Gains: A Cost-Utility Analysis
Authors: Guarducci G , Siragusa C , Gurnari J , Gentile A M , Nante N 
Published: October 2024

Abstract

Background
With the increase in life expectancy and the consequent shift in the epidemiology of chronic diseases, the need to enhance and measure the population’s health status is even more imperative. The aim of this study is to assess health gains and their associated costs provided by an Italian clinic.

Methods
A retrospective study was conducted on 129 patients admitted for short-term planned hospitalization from June 2020 to August 2023. At both admission and discharge, these patients completed the EQ-5D-5L questionnaire. Quality-Adjusted Life Years (QALYs) were calculated from the difference in EQ-5D-5L scores between discharge and admission, assuming that health gains (discounted at a rate of 3.5%) accumulate up to two years after discharge. Cost-utility analysis was performed using QALYs and invoices issued by the clinic (cost of hospital stay: 250 Euro/day). Patients were stratified by gender, age (geriatric and non-geriatric), and length of stay (LoS). Descriptive statistics (median and interquartile range) and statistical analysis (Mann-Whitney test) were conducted using STATA software.

Results
The sample comprised 129 patients (55% female) with a median age of 81 [11] years and a median LoS of 16 [16] days. The median QALY gained was 0.33 [0.38], higher for males (0.35 [0.34]) than females (0.29 [0.45]). Patients younger than 65 years old experienced a greater gain in QALY (0.41 [0.42]) than geriatric patients (0.32 [0.38]) (p &gt; 0.05). Patients with a longer LoS had a greater gain in QALY (0.35 [0.42]) than those with a shorter LoS (0.23 [0.29]) (p &lt; 0.05). The median cost per QALY gained was 14,337 Euro, lower for males (13,803 Euro), non-geriatric patients (13,743 Euro), and those with a shorter LoS (10,670 Euro) (p &gt; 0.05).

Conclusions
Despite disparities in QALY gains between groups, the median cost per QALY gained remained relatively constant. These findings underscore the importance of tailored interventions for effective resource allocation.

Key messages
• Differences in QALYs indicate the need for personalized healthcare strategies to optimize patient outcomes.
• The constant cost per QALY underlines the importance of effective and efficient allocation of resources.
Having paid work 1 year after disability claim in different types of mental and behavioural disorders
Authors: Ziech MLW , Hoekstra T , Boersema H J , Brouwer S 
Published: October 2024

Abstract

Background
The majority of claimants diagnosed with a mental and/or behavioral disorder have residual work capacity, however, the chance of actual (return to) work after a disability claim assessment may differ within this diagnosis group depending on the specific type of disease. The aim of this study is to examine the associations of different mental and behavioural diseases with having paid employment one year after the claim assessment.

Methods
This longitudinal register based cohort study included all work disability applicants with mental and behavioural disorders assessed with residual work capacity in the Netherlands in 2016. Data were derived from the Dutch Social Security Institute (UWV) and were linked to register data on paid employment. ICD codes were used to categorize 11 disease groups (mental retardation, autism spectrum disorders, ADHD, somatoform disorders, adjustment disorders, PTSS, anxiety, personality disorders, mood affective disorders, addictions and delusional disorders. Multivariable logistic regression analyses were conducted separately for applicants who work and not work at time of the claim assessment.

Results
A total of 8544 claimants (mean age 45, 56% female; n = 1915 work at baseline) were included. In the working group being diagnosed with ADHD (OR 3.05, CI 1.08-8.61) or PTSS (OR 1.45, CI 1.04-2.02) was associated with paid work, and adjustment disorder was negatively associated (OR 0.74, CI 0.56-0.97). In the not-working group, autism spectrum disorder (OR 1.51, CI 1.02-2.22), personality disorder (OR 1.36, CI 1.02-1.81) and addiction (OR 1.94, CI 1.32-2.86) was associated with return to work, and somatoform (OR 0.51, CI 0.31-0.84) disorders and mood affective disorders (OR 0.83, CI 0.70-0.99) were negatively associated.

Conclusions
The findings of this study show different associations between type of mental and behavioural disease groups and paid employment one year after the claim assessment.

Key messages
• The association of either remaining at work or return to work is different among mental and behavioural diagnosis groups, therefore a different approach is indicated.
• Active interventions to facilitate return to or remain at work might be indicated in specific diagnosis groups.
Quantifying Cardiovascular Disease Burden and Quality of Care Index across Four Visegrád Countries
Authors: Merzah M , Fiatal S , Sándor J 
Published: October 2024

Abstract

Background
Cardiovascular diseases (CVDs) have surged to become the leading cause of premature death in Europe. Yet, analyses examining the Quality of Care Index (QCI) and CVD burden within the 4-Visegrád (4V) nations remain notably sparse. This study aims to address this gap by comprehensively assessing both the QCI and CVDs burden across these countries.

Methods
The burden of CVDs was assessed using data extracted from the GBD-study 2019. We employed min-max normalization to standardize each health indicator, including Mortality-to-Incidence Rate, Prevalence-to-Incidence Rate, Disability-Adjusted Life Years-to-Prevalence rate, and Years of Life Lost-to-Years Lived with Disability. Subsequently, we utilized a weighted sum approach to aggregate the normalized values of the health indicators. The QCI was then derived as the sum of the products of normalized values and their corresponding weights.

Results
In 2019, age-standardized rates (per 100,000) significantly decreased compared to those in 1990. Ischemic heart disease remained the primary cause of death in all 4V countries, followed by stroke. Czechia exhibited the most substantial reduction in 2019 compared to the rates in 1990, with incidence and mortality rates decreasing by -252.55 and -308.95, respectively. Poland demonstrated the highest reduction, compared to the Central European average rates, in both incidence (-113.73; 95% CI: -125.08_-103.79) and death rates (-74.79; 95% CI: -73.53_-75.31) in 1990, and in 2019 (-175.22; 95% CI: -169.52_-178.29 and -41.55; 95% CI: -40.12_-40.64, respectively). Poland scored highest in QCI among the 4V countries, with Czechia scoring the lowest.

Conclusions
The findings underscore the imperative for continued efforts to boost cardiovascular healthcare and outcomes in the region. While the reduced ratio signals improvement, there remain avenues for refining disease management, prevention strategies, and access to care to further enhance patient outcomes.

Key messages
• Our study on 4V nations’ QCI and CVD burden underscores urgent need for sustained efforts in cardiovascular healthcare, with notable rate reductions since 1990.
• Challenges persist in managing heart disease and stroke in the 4-Visegrád (4V) countries.
Health mediation for promoting cancer screening and vaccination in deprived neighbourhoods in France
Authors: Legendre E , Kelly D , Franke F , Ménager C , Ramalli L , Dutrey Kaiser A , Attalah Y , Gaudart J , Chaud P , Rebaudet S 
Published: October 2024

Abstract

Social inequalities in health affect access to healthcare and prevention. In Marseille, these inequalities are pronounced, with 26% of the population below the poverty line. In September 2022, a health mediation and outreach program was launched in deprived neighbourhoods to promote cancer screening and vaccination by going towards populations and providing information and orientation adapted to individuals’ health literacy and autonomy. We aimed to evaluate the effectiveness of this intervention. A repeated cross-sectional study compared knowledge, attitudes and practices about cancer screening and vaccination before and after health mediation interventions and between control and intervention neighbourhoods. Trained investigators administered a questionnaire door-to-door to individuals aged 18-74 years in randomly selected households. A first T0 survey was conducted in September 2022, and a second T1 survey is underway in May 2024, in 13 intervention and 26 control neighbourhoods. We compared the before-and-after participation rates and associated risk factors for cancer screening and vaccination between both areas using mixed regression models. Of the 2,647 respondents at T0, 61% were women, 43% non-native French speakers, 40% unemployed, and 53% had public health insurance. Survey respondents were socially deprived and had lower participation rates in cancer screening and vaccination compared to national levels. At T0, the cancer screening participation rate was 31% for colorectal cancer, 51% for breast cancer, and 68% for cervical cancer. Factors associated with non-participation were not believing in the effectiveness of cancer screening, not being aware of its existence or not speaking French. At T0, only 54% knew about human papillomavirus vaccine and only 35% of eligible women were vaccinated. A comparison of these T0 results with results of the ongoing T1 survey will be presented, in order to assess the effectiveness of this health mediation intervention.

Key messages
• Health mediation promotes cancer screening and vaccination by going towards populations in deprived neighbourhoods and providing information adapted to individuals’ health literacy and autonomy.
• Survey respondents were socially deprived and had lower participation rates in cancer screening and vaccination compared to national levels.
The role of interoception in lifestyle factors: a systematic review
Authors: Mulder J , Boelens M , Van der Velde L A , Brust M , Kiefte-de Jong J C 
Published: October 2024

Abstract

Interoception, the perception of the internal state of the body, has been shown to play an important role in various conditions. A clear overview of the relationship between interoception and lifestyle factors has to the best of our knowledge not yet been presented. This systematic review aims to provide insight into the current state of evidence about the role of interoception in lifestyle factors. A protocol for this systematic review was registered in PROSPERO (CRD42023465957). A systematic search conducted in PubMed, Embase, and Web of Science databases included terms such as interoception (accuracy, attention, awareness, sensitivity, or sensibility), as well as lifestyle factors (alcohol consumption, cognitive leisure and relaxation activities, eating behavior, exercise, sleep, or smoking). Studies written in English, using qualitative data, including adults, using at least one measure of interoception, and using at least on measure of a lifestyle factor were included. The review included 68 studies, in which 47 measures of interoceptive accuracy and 34 measures of interoceptive attention were identified. Six studies quantified interoceptive awareness (e.g., the interaction between interoceptive accuracy and attention). 12 studies focused on alcohol consumption, 22 studies on cognitive leisure and relaxation activities, 19 studies on eating behavior, 9 studies on exercise, 4 studies on sleep, and 5 studies on smoking. Generally, cognitive leisure and relaxation activities, eating behavior, and fasting showed positive relations with interoception. Conflicting evidence on the relation between exercise and some interoceptive domains, and moderate evidence on the positive relation with other interoceptive domains was found. Greater sleep difficulties were related to enhanced interoception scores and alcohol consumption was negatively related with interoception, while results on the relation between interoception and smoking behavior showed varying results.

Key messages
• Some lifestyle factors positively influence interoception and vice versa, while for other factors the results are varying or conflicting.
• The role of interoceptive skills in lifestyle factors is important for lifestyle and health management.
Improving physical healthcare for people experiencing mental illness: The COMITMENT project
Authors: Schiffler T , Kainzbauer L , Tupy C , Lehner L , Eitenberger M , Grabovac I 
Published: October 2024

Abstract

Background
People experiencing mental illness (PMI) face significant challenges in accessing and using somatic healthcare services, reducing their overall life expectancy by up to 20 years. The COMITMENT project aimed to identify barriers and facilitators in accessing and using somatic healthcare services for PMI and co-design strategies that could address existing challenges.

Methods
This study employed a qualitative participatory approach, involving a “trialogic” steering group composed of a person with lived experience of mental illness, a family member and caregiver of PMI, as well as a health professional. Two co-design workshops were conducted with members of each trialogic group, based on “World Café” methodology, facilitating open discussion between and among the three perspectives. Data was gathered through participant observations and systematically collecting participants’ workshop contributions, and analyzed thematically.

Results
Overall, 52 people participated in the two workshops. Findings identified six overarching themes regarding challenges in somatic healthcare access/use for PMI: (1) accessibility and facility design, (2) support and bureaucracy, (3) awareness among healthcare professionals, (4) societal awareness, (5) structural diversity of services, and (6) lack of networking abilities. Notable insights include inclusivity design requirements for healthcare facilities and the importance of integrating lived experiences of PMI into the training of healthcare professionals to reduce stigma.

Conclusions
This study underscores the critical need for systemic changes to improve somatic care for PMI. It suggests that greater awareness among healthcare professionals, coupled with more inclusive service design and enhanced networking abilities, could substantially improve the quality of healthcare for PMI. The COMITMENT project provides robust and co-designed results for social, systemic, and political reforms aimed at reducing healthcare inequity.

Key messages
• This study shows how direct involvement of relevant stakeholders improves the design of interventions that truly meet the needs of people with mental illness regarding somatic healthcare services.
• To improve healthcare access and treatment for people experiencing mental illness, systemic social, design, educational, and political changes and adaptations are required.
Evaluation of a public health workplace staff psychosocial risk assessment and wellbeing initiative
Authors: Ryan L , Cooney F 
Published: October 2024

Abstract

Adverse psychosocial work environments can have a detrimental effect on staff wellbeing causing chronic stress leading to burnout. Despite legislation mandating regular risk assessments, only one third of workplaces assess psychosocial risks. A 2020 European report identified one of the main barriers being a reluctance to talk openly about psychosocial issues. This paper describes an evaluation of a staff psychosocial risk assessment and wellbeing initiative in a Public Health Department in Ireland. The initiative commenced in October 2022 during a period of major health service organisational change. Informed by positive organisational psychology conceptual frameworks, guided by the European Psychosocial risk assessment framework (PRIMA-EF) and utilising the HSE Work Positive (CI) survey tool it was possible to constructively identify and categorise psychosocial risks across the Public Health team. In the evaluation, a mixed methods approach was used based on Donabedian’s structures, processes and outcomes overarching framework and Nielsen’s Model of Process Evaluation Framework. The first three iterative quality improvement cycles of the intervention were reviewed. The evaluation demonstrated that all of Nielson’s three indicators for a successful organisational level staff wellbeing intervention had been met: there was evidence of improvement in both working conditions and staff wellbeing; iterative quality improvement cycles including appreciative inquiry staff collaborative engagement ensured staff views and key learning was captured; new organisational structures within the Department enabled the sustainability of this process. The evaluation indicates that the staff psychosocial risk assessment process is beneficial for staff wellbeing and that the methods used are appropriate. The resources used in this process continue to be readily available within the health service organisation. The evaluation supports continuation of this process in its present form.

Key messages
• This evaluation supports staff psychosocial risk assessment and mitigation processes and provides a framework for healthcare managers to implement such processes and comply with legislation.
• This evaluation indicates that effective and sustainable collaborative staff engagement can be achieved using a positive focus which builds on team strengths and harnesses collective wisdom.
Leveraging epidemiological data for the development of interventions to promote healthy nutrition and physical activity among adolescents from disadvantaged backgrounds
Authors: Schmengler Heiko 
Published: October 2024

Abstract
ePro-Schools is a public health initiative designed to promote healthy nutrition and physical activity among adolescents from socially disadvantaged backgrounds using a targeted e-health intervention to be deployed in the school context. A central theme of ePro-Schools is its robust cross-sectoral collaboration, involving stakeholders from academia, healthcare, education, and local communities. This cooperative approach not only enhances the intervention’s relevance and efficacy but also ensures its cultural, social, and economic adaptability to the needs of the target population. The project embodies a truly interdisciplinary effort, integrating insights from epidemiology, behavioural science, public health, and digital technology to innovate and improve health promotion strategies. This presentation will explore how data from epidemiological studies, such as the Health Behaviour in School-aged Children (HBSC) study, are used to support the development of the ePro-Schools intervention. Utilizing high-quality epidemiological data, the project identifies key determinants of physical activity, dietary habits, and sedentary behaviour amongst adolescents growing up in low-SES contexts, allowing to craft tailored strategies to promote healthier lifestyles within this vulnerable population.