bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mind the gap: from real-world policies to health impact assessment modelling
Authors: Croes S , Devleesschauwer B , Gorasso V 
Published: October 2024

Abstract
When conducting health impact assessments (HIA), researchers often face the challenges of trying to align as closely as possible with policy scenarios. This phase concerns the translation of real-world policies into estimates usable in models. Most of the time, researchers need to address a policy-impact gap between what is needed by the policymakers and what is believed to be reliable data fitted for the model. These mismatches can stem from differences in how exposure and outcomes are studied compared to the policy plan. By looking at a case study of the planned Belgian policy to reduce tobacco selling points, challenges during the pre-modelling phase were identified. The question of what an effect size should be and its importance in the HIA process were considered fundamental for the analysis. In particular, literature on exposure to tobacco sales points differed in outcomes, as it would target proximity to someone’s home, while the policy itself focuses on the reduction of points of sale of a specific store type. Similarly, smoking behaviour can be measured in various ways, such as initiation, cessation, relapse rates, or overall smoking prevalence. The policies’ effect on these various outcomes differed significantly. In this presentation, the discussion will focus on the alignment of the existing literature with the specific details outlined in the policy. We will explore the challenges that arose when existing research criteria and assumptions did not fully match the policy, taking the new Belgian tobacco plan as an example. Lastly, we will highlight the opportunity to set up monitoring systems to evaluate tobacco interventions to extract reliable estimates for HIA and strengthen evidence-based tobacco policies in the future.
How are the three environmental threats challenging health systems’ resilience?
Authors: Viegas S 
Published: October 2024

Abstract

Background
Known avoidable environmental risks cause about one quarter of all deaths and disease burden worldwide, amounting to at least a steady 13 million deaths each year. Indeed, diseases caused by the environment weigh heavily on health systems. These not only harm directly human health increasing the burden of disease but also potentiate other threats, by acting as drivers (e.g. pandemics, antimicrobial resistance). In addition, the increased burden due to these environmental threats also put in risk the capacity of health systems to adapt to the new healthcare needs and to provide a proper answer to the diseases caused by other health determinants.

Methods
Based on a review of the literature, the presentation addresses the question of potential options in public health climate action at the interface of environmental sustainability and health systems sustainability and resilience. It identifies possible priority areas in order to guarantee environmental and healthcare sustainability.

Results
Approaches that focus on treatment of individual diseases rather than improvement of environmental determinants of health will be insufficient to tackle the triple environmental crises of climate change, biodiversity loss and pollution. Single-determinant approaches are unlikely to achieve expected improvements, given the complex interaction of environmental factors.

Conclusions
Approaches that are more integrated are required to address the root causes of disease and guarantee health systems sustainability, which are often defined by policies in key sectors other than health, such as the environment. Multi-sectoral actions are needed to prevent and mitigate the threats to human health from the ongoing and interconnected environmental crises of climate change, biodiversity loss and pollution, contributing to a Planetary Health perspective on health systems’ resilience.
Cross-country price comparison of institutional long-term care: In search of suitable data
Authors: Brzozowska Z , Zuba M , Gredinger G 
Published: October 2024

Abstract

Background
In European ageing societies, the national expenditure on institutional long-term care (LTC) has been growing for decades, currently exceeding 1% of the GDP in many countries. At the same time, however, comparative analyses of (day) prices in the nursing and residential care facilities (NRCFs) are still lacking. The data reported by international databases vary substantially in the services they cover which makes cross-country comparisons very difficult.

Methods
We combine publicly available data from Eurostat (System of Health Accounts), OECD and national sources on the number of recipients of LTC in NRCFs, the number of beds in NRCFs and the expenditure on LTC in NRCFs in over 20 European countries. Our aim is to compute internationally comparable daily prices of LTC in NRCFs using gross-costing approach. We first validate the data by cross-checking and documenting which health care functions and providers are reported by each country. Second, based on that we identify countries with comparable data and, third, perform a cross-country comparison of the daily spending on LTC in NRCFs.

Results
The reported data vary substantially with respect to their coverage. For instance, while some countries include NRCFs for all disabled people at all ages, others focus only on the NRCFs for the elderly. The ways the beds and the recipients are counted also show substantial variation. Moreover, we found inconsistencies in the reported numbers not only between but also within countries.

Conclusions
The considerable cross-country diversity in the LTC provision within the NRCFs poses inevitable challenges to international standardised reporting. Our analysis shows, however, that at least some of the challenges can be overcome by, e.g. improving the consistency of the reported numbers at the country level.

Key messages
• A consistent definition application markedly improves the comparability of data on LTC in NRCFs.
• Given the rising demand for and economic importance of the LTC sector standardised data on NRCF services are greatly needed.
Employees’ work ability during returning to work with common mental disorders: a mixed methods study
Authors: Sikora A , Stegmann R , Schröder U B , Schulz I L , Wegewitz U , Bültmann U 
Published: October 2024

Abstract

Background
A main goal during the return to work (RTW) process after a long-term sickness absence due to common mental disorders (CMDs), is to restore and maintain an employees’ work ability to enable sustained work participation. To date, surprisingly little research has examined the concept of work ability during the RTW process with CMDs. To better understand how to restore employees’ work ability during RTW with CMDs, both quantitative and qualitative research is needed. The goal of this mixed methods study is to expand the understanding of restoring work ability during the RTW process with CMDs.

Methods
In this mixed methods follow-up study of N = 286 participants, work ability was quantitatively assessed with the Work Ability Score (WAS, range 0-10) at five measurement points (0, 6, 12, 18 and 30 months) during 30 months of follow-up. In a sub-sample, the qualitative work ability experiences of N = 32 participants were jointly analysed with their quantitative work ability ratings at 6 and 12 months.

Results
In the joint analysis, three groups of qualitative work ability experiences together with their respective quantitative work ability ratings emerged: Employees with (1) poor work ability (WAS 0-3), who did not RTW yet and described great difficulties in coping with everyday life; (2) moderate work ability (WAS 4-6), who mainly did RTW, but still showed a certain level of fragility; and (3) good to very good work ability (WAS 7-10), who mainly returned within 12 months and reported many individual and work accommodations to restore and maintain their work ability.

Conclusions
The joint evaluation of work ability ratings and experiences allowed a deeper understanding of restoring work ability during the RTW process. This knowledge may help occupational health professionals and other key RTW stakeholders to provide more tailored support during the RTW process and to promote a sustainable RTW for employees with CMDs.

Key messages
• Restoring and maintaining the work ability of employees with common mental disorders during the return to work process is crucial for their sustained work participation.
• Achieving a good to very good work ability helps returning employees with common mental disorders to ‘stay and thrive’ at work again.
Labor market participation in people with intellectual disability – a follow-up study in Sweden
Authors: Staland-Nyman C , Tideman M , Luthra R 
Published: October 2024

Abstract

Background
Work is vital to people’s health and quality of life. The Convention on the Rights of Persons with Disabilities affirms the right to work on an equal basis with others including an opportunity to earn a living by work, but evidence shows that people with intellectual disability (ID) are at greater risk of unemployment and social exclusion. Due to the lack of comprehensive data for longitudinal follow-ups, information on long-term labor market participation (LLMP) in people with ID is scarce. This study aimed to investigate factors of importance for LLMP in individuals with ID in Sweden.

Methods
The study was based on data from the upper secondary school for pupils with ID between 2001 and 2020 (N = 26,905) and from the longitudinal integrated database for health insurance and labor market studies. A sample of gainfully employed in 2011 (n = 2,719), was followed with respect to LLMP until 2020. Odds ratios (ORs) with 95% confidence intervals (CI) for associations between educational, sociodemographic, and work factors and LLMP (i.e. gainful employment throughout the follow-up), were estimated stratified on sex.

Results
LLMP was twice as likely in men compared with women, OR 2.06 (1.78-2.58) as was work in the private sector. Factors of significance for LLMP in men and women alike were: completed national education program, OR 3.40 (3.06-3.86) and OR 2.91 (2.40-3.54), parents’ education; compulsory school in mothers’, OR 1.22 (1.06-1.41) and 1.24 (1.00-1.55) and in fathers’ OR 1.35 (1.17-1.56) and 1.49 (1.20-1.85), while municipality of residence was significant only in men, OR 1.30 (1.10-1.56).

Conclusions
Public health prevention for disadvantaged groups requires accurate and up-to-date knowledge. Using unique register-based data, this is the first study on LLMP in people with ID in Sweden. Knowledge on what social determinants may strengthen LLMP is important since limited LLMP increases the risk of missing out on health benefits that employment may offer.

Key messages
• There was a significant gender difference in long-term labor market participation in people with intellectual disability in Sweden.
• There is a need for increased knowledge on what social determinants may strengthen long-term labor market participation in people with intellectual disability.
Risk of death after type of intimate partner violence (IPV) involvement
Authors: Urquia M , Trask B , Scatliff N , Au W 
Published: October 2024

Abstract

Background
Most studies have focused on women’s intimate partner violence (IPV) victimization but perpetration and bi-directional violence remain understudied.

Methods
Using linked criminal justice and population registers in Manitoba, Canada, we assessed the risk of death according to the role in IPV incidents (accused-only, victim-only, bidirectional, none). In this retrospective matched cohort study, we assembled a cohort of 212,068 adults who were followed from April 2004 to March 2023 to assess IPV incidents and subsequent death. Those involved in an IPV incident were 1:3 matched to persons with no history of IPV based on birth year, sex and marital status at the time of the incident.

Results
Men comprised 85% of accused-only, 21% of victim-only, and 50-51% in the other two groups. Overall, compared to those without IPV involvement, the adjusted Hazard Ratios for all-cause mortality were 1.38 [95% Confidence Intervals (CI): 1.28, 1.49] for accused-only, 1.39 (1.29, 1.50) for victim-only and 1.45 (1.19, 1.77) for bidirectional IPV. The associations were stronger among women, particularly that of bidirectional violence [1.24 (0.97, 1.60) among men and 1.92 (1.39, 2.66) among women]. Similar patterns were found for intentional mortality [0.96 (0.56, 1.64) among men and 2.43 (1.27, 4.65) among women].

Conclusions
There are clear sex inequities in IPV involvement. Any type IPV involvement is associated with higher risk of death, particularly among women, who comprise most of the victims.

Key messages
•  Any type IPV involvement is associated with higher risk of death, particularly among women, who comprise most of the victim.
• Use of linked criminal justice data allows studying the consequences of IPV victimization, perpetration and bidirectional violence and monitor gender inequities over time.
Signal detection and assessment supporting syndromic surveillance during the UEFA EURO 2024
Authors: Schranz M , Estupinan Mendez J , Schlump C , Markus I , Heese H , Charfeddine N , Diercke M , Ullrich A 
Published: October 2024

Abstract

Background
Mass gatherings like the UEFA European Football Championship in Germany pose a challenge for public health, elevating the risk of infectious disease outbreaks. The Robert Koch Institute (RKI) is performing intensified surveillance during this event, including data from emergency departments (ED). So far, no standardised process for signal detection, their assessment and communication exists for ED surveillance.

Methods
We reviewed the literature to identify an appropriate signal detection method for ED surveillance. We tested different aggregation levels of the ED data, to ensure sufficient quality with sparse categories. After consulting with international experts, we defined a standardized process for signal assessment. We developed an interactive dashboard to investigate anomalies by further analysing the ED data.

Results
We used the Farrington Flexible algorithm, but expanded its functionality to perform daily instead of weekly monitoring. Aggregating to federal state level or in five age categories provided enough daily data for the algorithm. During the assessment, identified signals will be automatically scored based on pre-defined criteria (e.g. excess number of cases, reoccurrence in previous days). Signals with a high score will be forwarded to an epidemiological assessment, where they are manually evaluated based on standardised questions (e.g. expected seasonality, disease severity). Surveillance experts at RKI discuss them further and decide the course of communication and possible further measures. We developed an interactive dashboard in which signal detection and assessment is visualized.

Conclusions
Syndromic surveillance using ED data is used as an information source for early warning during a mass sporting event in Germany. Signal detection enables the identification of potential outbreaks, while the standardized assessment process ensures an efficient way to prioritize and steer communication efforts across public health services.

Key messages
• Syndromic surveillance using signal detection has previously proven valuable to detect potential outbreaks of infectious diseases during mass gatherings.
• A standardised signal assessment process including an automatic and manual component ensures a sustainable and efficient way to prioritize possible incidents and steer public health communication.
Parental childhood vaccine hesitancy and the National Vaccination Programme, in Portugal
Authors: Gomes F , Soares P , Goes A R , Santos A J 
Published: October 2024

Abstract

Background
Despite the invaluable contribution of vaccination to Public Health, vaccine hesitancy is increasing in the European Union. Several factors are associated with parental childhood vaccine hesitancy (PCVH). In Portugal, there are no known studies specifically addressing vaccine delay in infants.

Objectives
We aimed to estimate the proportion of parental childhood vaccine hesitancy (PCVH) up to 12 months of age in Portugal, and to determine vaccination (confidence and information) and National Vaccination Programme (NVP) associated factors.

Methods
We performed a cross-sectional study on a convenience sample, using an anonymous online questionnaire directed to parents of children up to 17 months old, living in Portugal. We performed an exploratory factor analysis, followed by logistic regression. We obtained crude (OR) and parental vaccination status’ adjusted odds ratios (aOR).

Results
PCVH proportion was estimated at 1.8% (95%CI: 1.0%-3.0%; n = 790). The exploratory factor analysis resulted in five dimensions: 1. vaccine confidence; 2. access to enough/reliable information about vaccines; 3. access to NVP; 4. vaccination schedule; 5. trust in healthcare professionals’ information about vaccines. Vaccine confidence (aOR=0.29, 95%CI: 0.14-0.54), vaccination schedule (aOR=0.31, 95%CI: 0.15-0.58) and trust in information about vaccines provided by health professionals (aOR=0.30, 95%CI: 0.16-0.53) were protective dimensions of PCVH.

Conclusions
The low proportion of PCVH observed is consistent with the high immunisation coverage in Portugal. Vaccination schedule, trust in vaccines, and in the information provided by healthcare professionals are factors associated with lower vaccine hesitancy. This highlights the importance of trust and healthcare professionals in maintaining high vaccination coverage in Portugal.

Key messages
• Parental childhood vaccine hesitancy (PCVH) proportion was 1.8%. Vaccine confidence, vaccination schedule and trust in information provided by health professionals were protective factors of PCVH.
• Trust in vaccines and in healthcare professionals seem to play a key role in keeping a high immunisation coverage in Portugal.
The information layer: shaping data into meaning with interactive tools
Authors: Schmidt M , Gorasso V , Van den Borre L , Scohy A , Devleesschauwer B , De Pauw R 
Published: October 2024

Abstract
Valorization and interpretation of health data are contingent upon a robust analytical framework. This framework encompasses essential processes such as data cleaning, validation, and the critical evaluation of bias and missing data. A nuanced understanding of these factors is crucial for contextualizing data through stratification, developing comprehensive analysis plans, and addressing interactions, covariates, and confounders. Such meticulous methodologies guard against ‘data fishing expeditions’ that could otherwise lead to erroneous conclusions. Healthybelgium.be exemplifies our approach for deciding on appropriate levels of data aggregation and stratification. This study serves as a foundation for deriving conclusions and formulating hypotheses regarding the health status of the national and various sub-populations. Our discussion will cover the limitations of the questions that can be answered with the available data, the resulting opportunities for data enhancement, and the subsequent valorization of findings for knowledge advancement. Furthermore, we will present the interactive tools (through the use of R Shiny) developed by Sciensano to disseminate information broadly, making it accessible and comprehensible to diverse audiences. These tools embody a balance of strength and limitation, facilitating an informed dialogue among stakeholders. The ongoing refinement of these tools, influenced by continuous learning and insights, exemplifies our commitment to evolving public health intelligence.
The social gradient in institutional trust from 2011–2019 in the general population in Norway
Authors: Ihlebaek C , Stenmarch C , Nordboe ECA , Skipstein A 
Published: October 2024

Abstract

Background
Trust is described as the glue of healthy societies. Although Norway is among the countries with the highest levels of trust in public institutions, the increasing socioeconomic differences observed may threaten levels of institutional trust. Therefore, we aimed to investigate such differences in the general population between 2011 and 2019.

Methods
A repeated cross-sectional study was conducted using data on the general population in Østfold county from 2011 (N = 16673) and 2019 (N = 15935). Differences in trust toward five public institutions (healthcare system, school system, labour and welfare administration (NAV), police, and municipal council) by educational level were investigated with Chi-square tests. Logbinomial regression analyses were used to examine potential changes in high trust over time. Gender and age were included in the analyses as control variables.

Results
A relatively high proportion of the general population reported high levels of trust to the health care system (2011: 71%; 2019:80%), police (2011: 73%; 2019:77%), and the school system (2011: 64%; 2019:66%), whereas a lower proportion reported high levels of trust to NAV (2011: 37%; 2019:41%) and the municipal council (2011: 45%; 2019:36%). Both in 2011 and 2019 a clear social gradient in institutional trust was found for all institutions (p &lt; 0.05). There was a significant increase in the level of trust in the health care system (low education:RR=1,10; middle:RR=1,12; high:RR=1.06) and a significant decrease in trust in the community council (low:RR=0,77; middle:RR=0,80; high:RR=0,83) in all educational groups from 2011 to 2019. The level of trust in NAV increased significantly in the highest education groups, while a non-significant decrease was shown in the low educational group.

Conclusions
The persisting social gradient in institutional trust is worrying as trust is an important factor in ensuring inclusion, social capital, democracy, and health and wellbeing.

Key messages
• Institutional trust is an important factor in ensuring inclusion, social capital, democracy, and health and wellbeing.
• The lower levels of institutional trust found in low educational groups could be of particular concern as these groups might be more dependent on the different parts of the welfare system.