bluuebunny/crossref_metadata_2025_split huggingface dataset:
Experiences of discrimination in Finnish healthcare services
Authors: Klemettilä K-L , García Velázquez R , Skogberg N , Castaneda A E , Eid M , Kuusio H 
Published: October 2024

Abstract

Background
It has been found that foreign-born people report more discrimination than the general population. This study examines experiences of discrimination in Finnish healthcare, with a focus on individuals with a foreign background.

Methods
Two nationally representative cross-sectional data sets were used: MoniSuomi (n = 7838; response rate 44.1%) and Healthy Finland Surveys (n = 28154; response rate 46.3%). The outcome variable, experiences of discrimination, was predicted by means of stepwise logistic regression models covering (1) socioeconomic factors, (2) factors related to healthcare service need and use, and (3) migration-related factors.

Results
In healthcare services, migrants experienced discrimination more than twice as frequently as the general population (8.9% versus 3.6%, 95% CI = 8.0-9.8, 3.2-4.1). According to regression models, relevant factors were insufficient income, being female, studying as the main occupation and poor mental and physical health. Foreign background was not independently associated with discrimination. However, higher educational attainment, chronic disease, and use of occupational healthcare services increased the likelihood of experiencing discrimination only among those of foreign background and showed the opposite trend for the general population. All migration-related factors increased the risk of discrimination.

Conclusions
The findings underline the need for training on explaining the service system, overcoming language barriers, and working with forced migrants. The occupational healthcare workforce would particularly benefit from these interventions. The results inform the development of professionals’ training.

Key messages
• Migrants experience higher levels of discrimination in healthcare compared to the general population. Multiple factors explain this difference.
• Healthcare professionals require training to better inform patients about the service system, to improve communication and to address the situation of forced migrants.
Child COVID-19 rates and migrant status: A quantitative study in the Lisbon area (Mar 2020-Jun 2022)
Authors: Banha Alves I , Becker Loesch R , Neto Conceição M , Carmezim Pereira S , Carlos Silva A , Oliveira Martins M R 
Published: October 2024

Abstract

Introduction
According to OECD data, immigrant children were over-represented among COVID-19 cases compared to non-immigrant children. However, evidence is missing on whether their migrant status is associated with testing positive for COVID-19. Therefore, we aimed to estimate COVID-19 positivity rates among children residing in five municipalities of the Lisbon metropolitan area, Portugal, and to analyze migrant status as a determinant of health.

Methods
We conducted a prospective cross-sequential cohort study with 989 children born in 2015, 2018, and 2020 (48.5% non-immigrants; 51.5% immigrants). Sociodemographic data were collected through interview-based questionnaires, and the child’s birth weight and gestational age were obtained from the primary health center’s information system (SClinico). COVID-19 test results (conducted between March 2020 and June 2022) were obtained from the national surveillance system (SINAVE Lab) and categorized into two primary outcomes: ever positive for COVID-19 (yes/no) and positivity frequency for COVID-19 (count). Robust and standard Poisson regressions were used to estimate the association between primary outcomes and demographic, socioeconomic, and clinical variables. We estimate relative risks (RR) and prevalence ratios (PR) with 95% confidence intervals.

Results
The positivity rate is lower for immigrant children (12% vs 17%). Compared with non-immigrant, and adjusting for other factors, immigrant children are 52% less likely to be ever positive for COVID-19 (PR = 0.482; IC 95%: 0.392-0.594), and the estimated number of positive tests is 54% lower (RR = 0.456; IC 95%: 0.362-0.574).

Conclusions
Being an immigrant is a protective factor against testing positive for COVID-19, aligning with the well-known immigrant paradox. These results underscore the need for further research into the immunological profiles of this population and are crucial for guiding strategies to manage emerging public health crises.

Key messages
• Immigrant children living in the Lisbon metropolitan area may have a protective factor against testing positive for COVID-19, consistent with the well-known immigrant paradox.
• Understanding COVID-19 positivity rates and associated factors in children is crucial for guiding effective strategies to manage and mitigate emerging public health crises.
Meaning-making of mental health among reception center clients in Finland
Authors: Mankinen K , Nordberg C , Skogberg N 
Published: October 2024

Abstract

Introduction
Asylum seekers and refugees face significant challenges, including high rates of mental health issues, as they navigate unfamiliar societal systems and norms. However, little is known about their subjective experiences of mental health and the mental health support in everyday social encounters. This study aims to explore the meaning-making of mental health and the experiences of receiving mental health support among clients of Finnish reception centers (FRCs).

Methods
Semi-structured individual in-person interviews were conducted with 11 reception center clients from various locations in Finland, with an interpreter present in four interviews. Interviews lasted approximately 60-90 minutes. Thematic analysis was employed to identify recurring themes and subthemes.

Results
Preliminary findings indicate a diversity in the meaning-making of mental health among participants. While some discussed mental health in terms of stress, others approached the topic analytically, while some avoided it altogether. Participants highlighted the importance of access to external resources, such as schools, language courses, and employment, for enhancing overall well-being. Trust in FRC staff emerged as a crucial factor in seeking and receiving assistance for mental health concerns. Additionally, participants exhibited resilience, suggesting benefits of empowering them during this challenging period.

Conclusions
Adopting a holistic approach to mental health care within FRCs is imperative. Understanding how clients construct meaning around mental health is particularly relevant for training FRC staff, who serve as primary points of contact for asylum seekers and refugees in Finland. Moreover, amplifying the voices of reception center clients can contribute to improving services and enhancing the health and well-being of this population in Finland.

Key messages
• It is necessary to adopt a holistic approach to mental health care within reception centers, one that addresses broader social determinants of mental health.
• Trust in the staff of Finnish reception centers is a critical factor in facilitating the seeking and receiving of assistance for mental health concerns among asylum seekers and refugees.
Long COVID Prevalence and Factors Among ethnically Diverse UK Healthcare Workers
Authors: Al-Oraibi A , Martin CAA , Woolf K , Bryant L , Nellums L B , Tarrant C , Khunti K , Pareek M 
Published: October 2024

Abstract

Background
Long COVID (LC), characterised by persistent symptoms post-acute COVID-19 infection, presents a growing public health concern. Data on prevalence among healthcare workers (HCWs) are lacking. Our study aimed to establish the proportion of UK HCWs with symptoms lasting beyond five weeks and identify factors associated with LC in a diverse cohort.

Methods
We conducted a cross-sectional analysis from December 2020 to March 2021. The main outcome was LC in relation to self-reported ethnicity. Univariable and multivariable logistic regression identified associations. Odds ratios (ORs) and adjusted odds ratios (aORs) were calculated with 95% confidence intervals (95%CIs). The multivariate analysis adjusted for demographic information, job role, household factors, health status, and existing long-term conditions. Missing data were imputed via chained equations.

Results
From 11,513 HCWs, 2,331 (20.2%) reported COVID-19, with 525 (22.5%) experiencing LC. 80.0% of those reporting LC were female, compared to 74.3% without LC were female. Participants with LC (median age 46 [IQR 36-54)]) were slightly older than those without LC (median age 41 [IQR 31-52]). In multivariable analyses of those who reported having had COVID-19, HCWs in nursing/midwifery roles (aOR 1.76, 95% CI 1.26-2.46, p = 0.001) and allied health professions (aOR 1.42, 95% CI 1.05-1.93, p = 0.023) had higher odds of reporting LC compared to those in medical roles. Significant associations were also found with self-reported depression, anxiety, and asthma. There was no significant association between ethnicity and experiencing LC.

Conclusions
In this large ethnically diverse cohort study, there is a substantial burden of LC among UK HCWs. Further research and collaborative efforts are urgently needed to address these factors effectively, develop targeted public health interventions, and understand the temporal and longitudinal dynamics of the condition.

Key messages
• One in five UK healthcare workers reported long COVID, indicating critical needs for targeted public health interventions.
• Our study highlights urgent public health responses to address long COVID among healthcare professionals.
From crisis to chronic: a comparative analysis of Long COVID impact in Italy and the United States
Authors: Nurchis M C , Heidar Alizadeh A , Garlasco J , Mhmoued Abdo Elhadidy H Safwat , Raspolini G M , Gianino M M , Damiani G 
Published: October 2024

Abstract

Background
The aftermath of COVID-19 is bringing about socio-economic consequences, such as diminished quality of life (QoL), decreased productivity, and considerable healthcare expenditures. Despite the emerging acknowledgment of a clinical syndrome following COVID-19 disease, known as Long COVID (LC), notable research gaps persist. This study aims to assess the epidemiological and economic impact of LC in both Italy and the United States (US).

Methods
This ecological analysis comprises epidemiologic and economic data from 2020 to January 2023, regarding working-age individuals (18-64 years). An Italy/US incidence rate ratio (eIRR) was estimated to compute LC cases in each country. The product between the value of a year spent in good health, individual Quality-Adjusted Life Year (QALY) loss, and LC cases yielded total lost QoL. Temporary productivity loss (TPL) was calculated through the Human Capital Approach. All estimates were deemed significant at a p-value less than 0.05.

Results
Up to date, the eIRR was 0.78 [0.43 - 0.91] implying 22% fewer LC cases in Italy with respect to the US. Total LC cases were 11 [8.7 - 13.5] and 1.8 [0.9 - 2.1] million in the US and Italy, respectively. The relative QALYs loss was 1.5 [0.8 - 3.1] and 0.2 [0.1 - 0.9] million. Reduced QoL cost roughly $189 [164 - 214] billion in the US and €6 [1 - 11] billion in Italy. TPL amounted to $37 [21 - 57] billion in the US and €2.8 [1.2 - 7.4] billion in Italy. Americans aged 30-39 years showed the largest income loss (26.6%), while in Italy it occurred in the age group 50-64 years (38%).

Conclusions
LC places a substantial burden in Italy and the US, impacting both the productivity of the working-age population and influencing the younger generation, who constitute the future workforce. Our study underpins the necessity for comprehensive health policies, programs, and interventions alongside effective tertiary prevention strategies to tackle the challenges posed by LC.

Key messages
• According to this analysis, both countries show significant productivity and quality-adjusted life years loss due to LC among working age individuals.
• Steering the formulation of evidence-based sounding health policies to address LC burden, among working age individuals, both in Italy and in the US.
Health Impacts of Disasters and Social Indicators: An Ecological Study
Authors: Özden M , Paksoy Erbaydar N 
Published: October 2024

Abstract

The objective of this study is to investigate the correlation between certain social indicators and the mortality and morbidity in disasters recorded in the EM-DAT database within countries in the last decade. The correlation between the mortality and morbidity in disasters recorded in the EM-DAT database between March 1, 2014-2024 and the most recent data on Human Development Index (HDI), Gender Inequality Index (GII), Gini Coefficient (GC), Government Health Expenditure as a share of GDP (GHE/GDP) and Corruption Perception Index (CPI) were analyzed. During the period of the study, disasters from a total of 207 countries/regions were recorded in the database. The median (IQR) values of countries in disasters were found to be 35.1 (67.5) for death per million and 76.3 (783.0) for injury per million. The most frequent types of disasters, the most frequent cause of mortality and the most frequent cause of injury in each country were found to be floods, extreme temperatures, and epidemics, respectively. While there was no significant difference between the social indicators analyzed and the total number of deaths, there was a negative correlation between the number of injuries and the HDI, CPI, GHE/GDP values of the countries, and a positive correlation between the GC and GII values (for all tests, Spearman correlation test, p &lt; 0.001). The correlation coefficient was interpreted as ‘weak’ in all other pairwise analyses except for the GHE/GDP value (moderate). Countries with social indicators closer to the positive threshold have been found to have less injuries in disasters. The possible reason for the insignificant correlation with the mortality is thought to be the difficulties in detecting mortality, especially in ‘extreme temperatures’, and the fact that it is mostly recorded in countries where social indicators are relatively more advanced. More research is needed to investigate the relationality between social indicators and disaster harms.

Key messages
• Disasters are critical mediators between social determinants and health. Addressing and reducing inequalities should remain on the public health agenda to prevent disasters and protect health.
• Analysis of disasters shows that ‘extreme temperatures’, which cause the most deaths in some countries, are barely detected in developing countries. Disaster recording systems need to be strengthened.
Non-medical use of tranquilizers and sedatives by 15-16-year-old adolescents in Estonia, 2003–2019
Authors: Veskimäe L , Vorobjov S , Pärna K 
Published: October 2024

Abstract

Background
Non-medical use of prescription drugs has become a global concern in recent decades. This study aimed to explore trends in non-medical tranquilizers and sedatives use (NTSU) among adolescents in Estonia from 2003 to 2019.

Methods
Utilizing data from the cross-sectional European School Survey Project on Alcohol and Other Drugs (ESPAD) conducted in 2003-2019, study included 15-16-year-old Estonian schoolchildren (n = 11,328; 48.6% boys). Cochran-Armitage test was employed to assess changes in NTSU trends, with statistical significance set at p &lt; 0.05. Prevalence rates and 95% CIs used as outcome measures.

Results
From 2003 to 2019, the lifetime prevalence of NTSU significantly increased for both genders, with girls consistently showing higher rates. Among boys, NTSU rose from 5.0% (95% CI 3.8-6.5) to 11.3% (95% CI 9.6-13.3), particularly among those reporting NTSU 1-2 times, from 3.0% (95% CI 2.1-4.2) to 8.2% (95% CI 6.7-9.9), p &lt; 0.001. Similarly, for girls, NTSU rose from 12.6% (95% CI 10.7-14.7) to 17.5% (95% CI 15.4-19.7), p &lt; 0.001. There was an increase among girls reporting NTSU 1-2 times from 7.5% (95% CI 6.0-9.2) to 10.6% (95% CI 9.0-12.4), p &lt; 0.001, and those reporting NTSU three or more times, from 5.1% (95% CI 3.9-6.6) to 6.9% (95% CI 5.6-8.4), p = 0.017. Among boys reporting medical tranquilizers and sedatives use (MTSU), NTSU rose from 21.1% (95% CI 13.9 to 30.0) in 2003 to 41.4% (95% CI 32.3 to 50.9) in 2019, p = 0.006. However, there was no statistically significant change in NTSU among girls reporting MTSU, remaining at 44.1% (95% CI 36.0 to 52.4) in 2019, p = 0.951.

Conclusions
Study reveals a significant increase in lifetime NTSU from 2003 to 2019, with girls consistently showing higher prevalence. Targeted interventions are needed to address adolescent non-medical prescription drug use, particularly among girls. Moreover, substantial NTSU among those reporting MTSU highlights the need to monitor and address non-medical usage in this subgroup.

Key messages
• Estonian adolescent non-medical tranquilizers and sedatives use surged from 2003 to 2019, particularly among girls, highlighting the need for targeted interventions.
• The high prevalence of non-medical tranquilizer and sedative use among those reporting medical tranquilizer and sedative use underscores the necessity for vigilant monitoring.
Characteristics of web-based and paper-based respondents in The Danish Capital Region Health Survey
Authors: Grønkjær M S , Eliasen M H , Elsborg P , Andreasen A H 
Published: October 2024

Abstract

Background and aim
This study aims to investigate the potential impact of adopting web-only surveys on the representativeness of survey participants by examining the sociodemographic characteristics of participants in the Danish Capital Region Health Survey (DCRHS) who respond online versus those who respond using a paper-based questionnaire.

Methods
The study utilizes data from the DCRHS including participants invited by a mixed-mode approach and given the choice to respond to a web-based or paper-based questionnaire in 2021 (N = 53,874) and 2017 (N = 51,902). Information on age and sex was obtained from national registers.

Results
The proportion of paper respondents decreased significantly from 18% in 2017 to 16% in 2021. In both years, women had higher odds of responding on paper compared with men (OR = 1.20; 95% CI: 1.16-1.24). In 2017, the highest prevalence of paper respondents was observed among participants aged ≥80 (29%) and 16-24 years (21%). In 2021, the highest prevalence was likewise observed among participants aged ≥80 (28%) but with the second highest among the 65-79 years age group (17%). The decrease in paper responses from 2017 to 2021 varied across age groups, with a greater decrease among younger participants than among older participants.

Conclusions
This study highlights the potential risk of excluding a significant proportion of elderly citizens from large population surveys if the web-based response option is the only option provided. Elderly individuals are less likely than younger individuals to switch to digital responses, emphasizing the importance of considering alternative modes of data collection to ensure representativeness in survey samples.

Key messages
• The use of web-only surveys has increased; however, we risk excluding a significant proportion of elderly citizens from large population surveys if only the web-based response option is provided.
• Elderly individuals are less likely to switch to digital responses, emphasizing the importance of considering alternative modes of data collection to ensure representativeness in survey samples.
4.F. Scientific session: Progress in assessing climate change risks to health and implementation in UK and Europe
Authors:   Organised by: NIHR Health Protection Research Unit in Environmental Change and Health (UK), EUPHA-ENV,   Chair persons: Marija Jevtic (EUPHA-ENV), Grace Turner (UK)
Published: October 2024

Abstract

Climate change poses one of the greatest threats to health security. Climate change is increasing the frequency and intensity of environmental health threats like flooding and heatwaves and is creating conditions which heighten the risks from infectious diseases. Whilst everyone will be at some risk from adverse health impacts from climate change, the impacts will vary at individual level and the most disadvantaged both here in the UK and around the world will be disproportionately affected. Many of the anticipated adverse health impacts of climate change in the UK are still avoidable through mitigation and adaptation and that there are other benefits to health to be gained, therefore rapid action is critical to avoid the most severe potential scenarios. The Health Protection Research Unit in Environmental Change and Health, funded by the National Institute of Health Research, provides multi-disciplinary research to support decision-making relating to the impacts and responses to environmental changes that affect human health and well-being in the UK and beyond. In this workshop we present the results of recent research on the progress in assessing climate change risk factors on health in the UK and review the evidence on implementation of mitigation and adaptation measures in Europe. The workshop aims to support evidence translation for climate action that prioritises health protection and equity. The workshop will include presentations on reviewing risk assessment methods for quantifying health impacts across Europe as well as analysing the effects of fuel poverty on cold-related mortality. We present results from an analysis of primary care data to identify individual level characteristics associated with increased risk of mortality during heatwaves. Furthermore, we review national food-based dietary guidelines across Europe and South America to determine how environmental sustainability is being integrated to benefit health. The workshop will comprise 4 -5 oral presentations and we will then open the floor to have a wider facilitated discussion about what are the evidence needs for UK and European policy to further address climate risks to health.

Key messages
• The progress in assessment and understanding of risks from climate change on health is improving.
• The health risks we face from climate change will not be distributed equally across the UK and Europe.