bluuebunny/crossref_metadata_2025_split huggingface dataset:
Molecular transmission clusters in newly HIV-1 diagnosed migrants in Portugal from 2014 to 2019
Authors: Pingarilho M , Videira A , Miranda M , Sebastião C ,   BH BEST-HOPE study group, Seabra S , Oliveira Martins M R , Gomes P , Pimentel V , Barroso Abecasis A 
Published: October 2024

Abstract

Background
Portugal has an important HIV burden with a total of 804 diagnosed cases in 2022. Migrants remain a significant source of HIV infections, with 45% of newly reported cases. We aimed to evaluate the characteristics of HIV-1 molecular transmission clusters (MTCs) among migrants followed in Portugal, diagnosed between 2014 and 2019.

Methods
265 migrants, newly HIV-1 diagnosed were included in the BESTHOPE project with clinical, socio-behavioral and genomic data. Pol nucleotide-based phylogenetic analyses were used to infer HIV-1 MTC. Those were constructed using ClusterPickerGUI_1.2.3 considering SH-aLRT higher than 90 of branch support and a pairwise genetic distance of ≤ 4.5. Logistic regression analyses were used to examine the relationship between the sociodemographic and clinical data associated with HIV-1 clustering.

Results
66.8% of the migrants included in the study were males with a median age at diagnosis of 36.0 years old (IQR:29-45). Most migrants were from African countries (50.6%) followed by Brazil (39.6%). Sixty-eight (33%) of the migrants were included in clusters. Being in cluster was significantly associated with region of origin, with individuals from South America more likely to be in cluster (OR = 14.85, 95%CI:1.52-144.79), compared to individuals from Africa; with transmission route, with men who have sex with men (MSM) more likely to be in cluster (OR = 23.52, 95%CI:2.35-235.10), compared to the heterosexuals and with subtype, with subtypes B less likely to be in cluster (OR = 0,017, 95%CI:0,001-0,254) compared with subtype non-B.

Conclusions
Migrants HIV transmission clusters in Portugal are associated with specific health determinants, such as region of origin, transmission route and subtype. Targeted prevention health strategies are needed to mitigate transmission of HIV within this population. Funded by FCT to GHTM - UID/04413/2020 and LA-REAL - LA/P/0117/2020; BESTHOPE (HIVERA:249697); and MARVEL (PTDC/SAU-PUB/4018/2021).

Key messages
• HIV transmission clusters in migrant are associated with their region of origin, transmission route and subtype.
• Targeted prevention health strategies are needed for the migrant population.
Health disparities among in multicultural and non-multicultural families in South Korea
Authors: Song K S , Lee E J , Lee J H 
Published: October 2024

Abstract

South Korea has experienced significant immigrant growth, with international marriages playing a key role in this demographic change. In 2019, international marriages accounted for 10.3% of all marriages, increasing the number of multicultural households. Multicultural families in Korea faced controversies over accepting new members in a society traditionally considered racially and ethnically homogenous. In rural areas, where patriarchal and conservative values prevail, there is greater discrimination and negative perception towards foreigners compared to urban areas, impacting access to healthcare. This potentially adversely affects the health of married immigrants. However, research on this issue is limited. This study aims to examine the differences in health behaviors, access to care, and health status between multicultural and non-multicultural families in rural and urban areas. Using a cross-sectional study design based on the 2023 Community Health Survey, the sample included 228,216 adults from non-multicultural families and 3,373 adults from multicultural families. Adjusted differences in outcome were estimated using regression models, including linear probability and logistic models. Overall, there were minimal or no differences in health behaviors and health status between adults from multicultural and non-multicultural families. However, significant differences were observed in access to care, such as annual health check-ups (0.72 [0.64, 0.81]) and vaccinations (0.84 [0.76, 0.94]). Non-multicultural families showed regional differences in all outcomes, whereas multicultural families exhibited minimal or no regional differences. These findings suggest that multicultural families may face barriers beyond regional environments, limiting their access to care and potentially leading to long-term negative health outcomes. Targeted policy development for multicultural families in Korea is necessary to address this issue.

Key messages
• Access to health care may vary for individual and local factors, especially for people with different ethnicities or cultures.
• Multicultural families may encounter greater barriers than individual and regional characteristics, requiring the development of tailored policies for immigrants and multicultural families.
Mortality in migrants with dementia living in the Lazio region, Italy
Authors: Acampora A , Angelici L , Cascini S , Cacciani L , Canevelli M , Cova I , Contoli B , Pomati S , Bellomo G , Bargagli A M 
Published: October 2024

Abstract

Background
Dementia is a major cause of disability and death among older people. Older migrants living in Italy are increasing and the prevalence of dementia is expected to rise in this population. Nevertheless, there is lack of real-world information concerning their health outcomes. The aim of this work was to analyse mortality in migrants with dementia living in Lazio, Italy (IMMIDEM project, GR-2021-12372081)

Methods
In a retrospective cohort study, people with dementia aged ≥50 living in Lazio on 31st December 2018 were selected using Health Information Systems (HIS) and followed-up for 5 years. The migrant status was defined according to the Country of birth as native Italians, people from High Migratory Pressure Countries (HMPC) or Highly Developed Countries (HDC). Age-standardized mortality rate (SMR) was estimated overall and by migrant status. Time to event analysis was performed using Kaplan-Meier curves, log-rank tests, and multivariate Cox regression.

Results
On 31st December 2018, 38,835 individuals with dementia were living in Lazio, 2.1% from HMPC and 0.9% from HDC. Natives and HDC were older than HPMC, while migrants showed a higher proportion of female. The SMR was lower in migrants from HPMC (42.2%; CI95% 37.0%-48.1%) and from HDC (33.2%; CI95% 25.4%-43.4%) than among natives (52.4%; CI95% 50.7%-54.1%). The age-adjusted mortality hazard ratio (HR) was lower in migrants (HDCs HR = 0.76, CI95%:0.66-0.89; HMPC HR = 0.88, CI95%:0.80-0.97) than natives.

Conclusions
The study showed a lower mortality rate among migrants with dementia compared to native Italians. Under-diagnosis, the “salmon bias”, and the “‘healthy migrant effect” could explain this apparent paradox, consistently with available literature. In addition, following-up migrants in the HIS may be difficult and underestimation may occur. Enhancing the comprehension of this phenomenon could allow the formulation of more effective, diversity-sensitive policies and practices for the management of dementia.

Key messages
• The mortality rate among migrants with dementia was found lower than that among native Italians.
• Understanding the morbidity and mortality patterns in migrants with dementia is important to develop practice to adequately respond to their health needs and diversity-sensitive polices.
Validity of the Multigroup Ethnic Identity Measure for Māori, Pacific, Asian & European adolescents
Authors: Neumann D , Yao E , Feng L , Taufa S , Liang R , Kingi T K , Atatoa Carr P , Fenaughty J , Paine S J 
Published: October 2024

Abstract

Background
Ethnic identity is important for positive health and wellbeing outcomes, especially for Indigenous youth and adolescents from minoritised ethnic groups. The Multigroup Ethnic Identity Measure (MEIM) is widely used to examine ethnic identity as a general phenomenon across ethnic groups. However, evidence regarding its validity for adolescents from different ethnic backgrounds is mainly limited to the US context. This study investigated psychometric properties of the MEIM, for the first time, within a large ethnically diverse population-based sample in New Zealand.

Methods
We used data from the Growing Up in New Zealand study. Participants were 4500 12-year-olds and included 22.4% Māori (the Indigenous people of New Zealand), 16.7% Pacific, 14.8% Asian and 51.9% European young people. 45.7% were cisgender boy, 37.4% were cisgender girl, and 16.4% were non-binary, trans or unsure. We conducted factor analysis for the 12-item MEIM.

Results
Confirmatory factor analysis model fit tended to be best for a solution with two factors representing two ethnic identity subcomponents of Exploration and Affirmation/Belonging. A single ‘ethnic identity’ factor showed a slightly weaker model fit. Exploratory factor analysis revealed a 2-factor structure with a slightly different item composition as compared to the original MEIM subscales. The findings were largely comparable across ethnic groups.

Conclusions
The MEIM appears to be a valid measure for Māori, Pacific, Asian and European young people. However, nuances may exist due to unique contexts including structural factors, societal norms and challenges, opportunities and access to cultural engagement. Ethnic identity is strongly linked to health and wellbeing including quality of life, self-esteem and life satisfaction. Therefore, we recommend acknowledging nuances of ethnic identity during an important time of development within diverse cultural contexts, by applying subscales and subgroup analyses where possible.

Key messages
• The Multigroup Ethnic Identity Measure is valid and appropriate to use at age 12-years among diverse ethnic groups including Māori, Pacific, Asian and European.
• Nuances of ethnic identity should be acknowledged as an important factor for health and wellbeing, especially during critical times of transition for adolescents within diverse cultural contexts.
Promoting vaccination for newly arrived migrants: a multistakeholder collaboration pilot
Authors: Russo M L , Tosti M E , Marchetti G , Bellini A , Ferrari C , Napoli P A , Trani F , Coraci B , Rusi E , Declich S 
Published: October 2024

Abstract

Access to vaccinations for Newly Arrived Migrants (NAMs) is a critical public health issue. In the context of the project ‘Increased Access for Newly Arrived Migrants-AcToVax4NAM’ (Grant No. 101018349, 3rd EU Health Program), DPHID-SAP and GLOB-ISS conducted a pilot aimed at developing and testing a system pathway to promote and vaccinate NAMs. The pilot began with the creation of a team between researchers from DPHID-SAP and GLOB-ISS, professionals from two services of the Local Health Authority and from a first reception centre (CAS) in Rome area. An integrated knowledge translation approach was used, which facilitated the collaborative development of strategies and actions of the pilot. The team then reached out to other ‘professionals FOR health’ involved in the vaccination process of NAMs, i.e. physicians from Temporarily Present Foreigners (STP) outpatient clinics, General Practitioners and Pediatricians. Between July 2023 and April 2024, four actions were developed. 1) analysis of the current access of NAMs to vaccination services and the subsequent development of a contextualized pathway to facilitate vaccinations for NAMs, including catch-up strategies; 2) identification of informed consent and other materials needed to be included in the pathway; subsequently, translated in 10 languages; 3) implementation of vaccine literacy session for CAS staff and NAMs; 4) improvement of immunization information flows to enable assessment of vaccination coverage of NAMs. To evaluate the pilot, the vaccination rate observed during the pilot (January-April 2024) was compared to that occurring in 2023, showing a 36.5-fold increase in the vaccination rate (4 x 100 person-year in 2023 and 155 x 100 p/y in 2024; RR = 36.5 (95%CI 14.6-117.6). The pilot highlighted that a research collaborative approach among various actors facilitated the access to vaccination for NAMs and was an opportunity to turn knowledge into action.

Key messages
• It is essential to ensure equitable vaccination coverage to reduce under-immunized groups.
• Access to vaccination is a key element of the right to health and for collective health protection and it should be a shared responsibility.
Ethnic disparities in clinical severity of COVID-19 as predictor of long COVID
Authors: Goldschmidt M , Benfield T , Nørredam M 
Published: October 2024

Abstract

Background
Recent studies from Europe have shown a higher incidence of long COVID among ethnic minorities compared to the majority population. Little is known of these disparities, but they might be related to factors such as COVID-19 disease severity, barriers in access to health and individual factors such as working and living conditions. This study will elucidate possible predictors of long COVID related to COVID-19 disease severity in an ethnic diverse hospitalised cohort.

Methods
A retrospective cohort study of 1648 patients admitted with COVID-19 at three hospitals in Copenhagen, Denmark, between 1st February 2020 and 31st May 2022. Clinical data was extracted from health care records, and subsequently linked to data from Statistics Denmark on long COVID diagnosis (ICD-10 “DB948A”) as well as migration status.

Results
1361 patients were discharged alive and of those, 113 (8,3%) patients got a long COVID diagnosis. Preliminary analyses show no excess risk of getting a long COVID diagnosis as a migrant compared to patients of Danish origin (RR = 1,20, p = 0,35). Some ethnic disparities are seen in disease severity among all patients discharged alive. Patients with migrant background were admitted to the hospital later (6,8 vs 5,6 days, p &lt; 0,0001), and at a greater risk of needing high flow oxygen administration upon admission (RR = 1,46, p = 0,0012) compared to patients of Danish origin. Furthermore, a higher degree of systemic inflammation is seen among migrants with regards to lactate dehydrogenase (LDH) compared to patients of Danish origin (349,7 vs 317,2 U/L, p = 0,0014). No significant differences in c-reactive protein (CRP) levels (92,8 vs 85,9 mg/L, p = 0,11).

Conclusions
Preliminary analyses indicates possible ethnic disparities in COVID-19 disease severity among patients discharged alive possibly playing a role as predictors of long COVID. Low health literacy or language barriers might partly explain this. Further analyses are needed.

Key messages
• In preliminary analyses of 1381 patients previously admitted with COVID-19, we find no excess risk of a long COVID diagnosis (DB 948B) among patients with migrant background.
• Preliminary analyses show some ethnic disparities in COVID-19 disease severity that might act as possible predictors of long COVID.
Digital Literacy Among Migrants in Portugal: Access, Usage, and Trust in Health Information
Authors: Hamwi S , Marques M J , Dias S 
Published: October 2024

Abstract

Background
Digital literacy is crucial for effective utilization of health-related services and information. This study evaluates digital literacy among migrants in Portugal, focusing on three key components: access to digital services, usage of these services for health information, and trust in online health resources.

Methods
A cross-sectional survey was conducted to assess migrants’ access to digital devices such as smartphones and computers, their ability to use these devices for health-related purposes, and their perceptions of the credibility of online health information. Data were analyzed across various sociodemographic and migration-related factors.

Results
1,048 migrants were included, of which 90.3% had access to digital services, and 64.9% reported ease in using these services to obtain health information. Despite widespread access and usability, about 45.6% of migrants doubted the reliability of online health information. Access and usage varied significantly with age, education, income, employment status, and region of origin. Older, less educated, lower-income, and African migrants faced more significant challenges in access and usage. Additionally, trust issues were predominantly reported by females, those with lower education levels, recent arrivals, and non-Portuguese speakers.

Conclusions
The study highlights significant disparities in digital literacy among migrants, influenced by socio-economic and demographic factors. While access to digital tools is high, challenges in usage and trust present barriers to effective health communication.

Key messages
• High access to digital services among migrants, yet significant disparities affect older, less educated, and lower-income groups.
• Usage difficulties combined with low trust in online health info highlight the need for targeted digital literacy interventions.
Are post-communist countries paying increased healthcare costs because of risky behaviour?
Authors: Zimmermannova J , Helman K , Hajek M 
Published: October 2024

Abstract

Background
Based on the annual Country Health Profiles, we can see the difference in population behaviour across EU countries and the associated health risks. At first glance, the so-called post-communist countries are characterised by above-average per-capita harmful consumption of sin goods, alcohol and tobacco. Is this harmful consumption associated with increased healthcare costs?

Methods
The idea of the study is based on balanced panel-data published in Country Health Profiles. The member countries were divided into groups based on their health risk scores - high risk (above average), and low risk (below average). The group of countries with high risk is mostly composed of post-communist countries. The detailed per-capita annual data for the period 2013-2021 was collected, such as GDP, consumption of sin goods, alcohol, and tobacco. The analysis is based on fixed-effects linear regression models, following recent recommendations on suppressing the excessive role of statistical-inference tools.

Results
We built various models for different groups of countries, and in this abstract, we present results for the group of post-communist countries - a simple model of harmful consumption (sin goods, GDP) and a more complex model (alcohol, tobacco, GDP). The results show that in the case of the post-communist countries group, for a fixed level of GDP per capita, higher consumption of sin goods by EUR 1 per capita corresponds with total healthcare expenditures higher by EUR 0.244 per capita. For a fixed level of GDP per capita and tobacco consumption per capita, higher consumption of alcohol by EUR 1 per capita corresponds with total healthcare expenditures higher by EUR 1.367 per capita.

Conclusions
Harmful consumption has a multiplier effect in the health sector; besides direct impact, it influences an increase in healthcare expenditures. More emphasis should be placed on prevention and awareness of consumers to reduce harmful consumption.

Key messages
• For fixed GDP per capita, higher harmful consumption corresponds with higher healthcare costs in post-communist countries.
• For fixed GDP per capita and tobacco consumption per capita, a €1 higher alcohol consumption corresponds with more than €1 higher healthcare expenditure in the post-communist countries.
Public health and broader economic benefit of treating autoimmune and respiratory diseases in Greece
Authors: Stratopoulos A , Rigopoulos P , Kougioumtzoglou I , Chatzigeorgiou L , Kotsopoulos N , Kapaki V , Lagiou A 
Published: October 2024

Abstract

Background
The increasing prevalence and incidence of autoimmune and respiratory diseases is a leading public health concern. This study aims to quantify the public health and broader economic gains from treating autoimmune and respiratory diseases in Greece.

Methods
A decision-analytic model was constructed evaluating the socioeconomic and fiscal gains of established standard of care treatments against 4 autoimmune disorders namely, rheumatoid arthritis, psoriatic arthritis, psoriasis, ankylosing spondylitis and against the respiratory diseases of asthma, and COPD. Morbidity reductions from treatment were translated into averted loss of income and absenteeism and averted tax revenue loss and prevented disability pensions. Targeted literature reviews were conducted to obtain the effectiveness of treatments on productivity-related outcomes. Economic data were obtained from official sources.

Results
Treating 1,000 patients for the autoimmune and respiratory conditions is estimated to generate annual gains of 196.3 productive life years (PLYs), to avert 48,547 absenteeism days and to prevent 1.2 disabilities. The annual socioeconomic and fiscal gains of treatments against autoimmune disorders are estimated at €6.5 million and €1.3 million, respectively. Preventing asthma and COPD-related morbidity, among 1,000 patients, is estimated to yield annual socioeconomic gains of €1.2 million and fiscal gains of €0.4 million.

Conclusions
Effective treatment of autoimmune and respiratory diseases may generate substantial public health, socioeconomic and fiscal gains, simultaneously promoting population’s health and the sustainability of the healthcare system.

Key messages
• It is the first study carried out in Greece aimed to assess the positive impact on public health and the broader economic value of treating autoimmune and respiratory diseases.
• Therapeutic value of pharmacological interventions transcends the potential benefits to patients and public health.
Health economics and services research in symbiosis: STREAMLINEing mental health services in Austria
Authors: Simon J ,   on behalf of STREAMLINE Consortium
Published: October 2024

Abstract

Objectives
The cost of mental diseases exceeds 4% of GDP in Europe. In Austria, every 5th person lives with mental ill-health (MIH). Ongoing epidemiological, demographic and societal changes increase the need for easily accessible, better integrated and good value services. In STREAMLINE, we combine, harmonize and implement the latest methods in human service mapping and economic costing to optimize future service provision and financing for MIH in Austria.

Methods
We comprehensively assess the availability, activity and affordability of human services targeting MIH in Vienna within the health and social care, education, labour and justice sectors based on a conceptual mind map. We identify services through extensive literature, document and web searches plus expert consultations. Services are mapped and costed according to the European PECUNIA methods: classification of the main service types using the international DESDE taxonomy of human services; development of Reference Unit Costs using the PECUNIA RUC templates with primary data; validation of the results with secondary data; compilation of a comprehensive multi-sectoral service catalogue; and synthesis for spatial and policy analyses.

Results
We identified 756 sources, 75% individual organisations, 5% multi-organisations and 20% existing provider lists. 84% relate to health and social care, 10% labour, and 3% education and justice sectors each. 58% deliver care to adults, 37% to children & adolescents, and 5% support carers. Further service mapping and RUCs will be presented.

Discussion
STREAMLINE pioneers in coordinated public mental health services and economics research at scale. Assessed levels of fragmentation call for better integration, improved transition, reduced spatial inequity and increased support for carers. Results increase the feasibility of service evaluations from a societal perspective. Planned public service atlas facilitates information and access for service users and carers. Funding: WWTF

Key messages
• New methods for harmonized health services and economics research allow comprehensive information for optimized future mental health service planning and financing.
• Assessed levels of fragmentation highlight the need for better integration, improved transition, reduced spatial inequity and increased support for carers.