bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing mental health from registry data: what is the best proxy?
Authors: Beerten S G , De Pauw R , Van Pottelbergh G , Casas L , Vaes B 
Published: October 2023

Abstract

Background
Medical registries frequently underestimate the prevalence of health problems compared with surveys. This study aimed to determine the registry variables that can serve as a proxy for variables studied in a mental health survey.

Methods
Prevalences of depressive symptoms and antidepressant use from the 2018 Belgian Health Interview Survey (HIS), stratified by sex and age, were compared with same-year prevalences from INTEGO, a Belgian primary care registry. Participants aged 15 and above were included. We assessed correlation and agreement using Spearman's rho (SR), the intraclass correlation coefficient (ICC) and the limits of agreement (LOAs).

Results
HIS questions about depressive symptoms were compared with the following variables from INTEGO: symptom codes (SR 0.763, ICC 0.026), diagnosis codes (SR 0.653, ICC 0.195), free text (SR 0.653, ICC 0.322), antidepressant prescriptions (SR 0.793, ICC 0.391) and the combinations symptom + diagnosis codes (SR 0.640, ICC 0.270) and symptom + diagnosis codes + free text (SR 0.653, ICC 0.386). LOAs varied from [-0.120, 0.021] for antidepressants to [-0.015, 0.061] for the full combination. HIS questions about antidepressant use were compared with prescription frequencies in INTEGO of at least once (SR 0.899, ICC 0.586) and at least three times yearly (SR 0.895, ICC 0.835). Corresponding LOAs were [-0.093, -0.008] and [-0.053, 0.007].

Conclusions
Correlation between the HIS and INTEGO was high, agreement fair to poor. Agreement increased by combining certain variables, by including free text, or by increasing the prescription frequency to resemble chronic use. Prevalences from INTEGO were mostly underestimates. A considerate choice of variables and prescription chronicity is needed to accurately use a registry as a surveillance tool for mental health.

Key messages
• The external validity of medical registries can be poor, especially compared with survey data.
• Researchers should be aware of the choice of variables when using registry data as a proxy for population measures.
Mental distress during the COVID-19 Infodemic in Ireland, a prospective national survey over time
Authors: Arnott J M , Joyce M , Corcoran P , Troya M I , Khashan A , Perry I , Arensman E 
Published: October 2023

Abstract

Background
The World Health Organisation (WHO) declared an ‘infodemic’ in 2020, that resulted in distrust in health authorities and impacted public mental health promoting confusion, worry, and fear. The aim of this study is to identify indicators associated with mental distress during the first year of the COVID-19 pandemic in Ireland.

Methods
A nationally representative cross-sectional telephone survey conducted data collection during 3 study periods: May, July, September 2020. Mental health outcomes were assessed by the Patient Health Questionnaire Anxiety Depression Scale (PHQ-ADS), mental distress defined as a score of 10 or more. Analysis included descriptive and logistic regression.

Results
Of the 2,914 participants, 27.6% experienced mental distress during 2020(n = 804). The prevalence of mental distress did not significantly change over time, from 28% in May2020 to 25.3% in Sept2020. Women were significantly more likely to experience mental distress than men; 34% compared to 21% (OR:1.91;95%CI:1.62-2.26). Mental distress was highest in the youngest age groups (43% in &lt; 30years,OR:3.24;95%CI:2.36-4.45), with a significant decreasing trend with increasing age. Mental distress was associated with trust in the pandemic response, those with the lowest levels of trust had the highest levels of mental distress at 37% (OR:1.84;95%CI:1.26-2.68), with a significant decreasing trend with increasing trust. During May2020, those experiencing mental distress were significantly less likely to seek healthcare when required, 41% compared to 21% (OR:2.59;95%CI:1.94-3.46). Education, employment and household income were also studied.

Conclusions
This study identified indicators associated with mental distress, such as trust and healthcare avoidance, which can inform future emergency management policy. The WHO recommends promoting the understanding of risk to mitigate harm to the public's mental and physical health, which could increase public trust and reduce mental distress.

Key messages
• The COVID-19 ‘infodemic’ impacted the public's mental health, with 27.6% of the study experiencing mental distress.
• Mental distress is associated with trust and healthcare avoidance which can inform future management strategies.
10.B. Workshop: Combatting AMR: European collaboration to ensure sustained access to effective antibiotics
Authors:   Organised by: European Observatory on Health Systems and Policies,   Chair persons: Dimitra Panteli (Belgium), Elias Mossialos (UK)
Published: October 2023

Abstract

Antimicrobial resistance (AMR) is one of the greatest public health threats facing the world today. The health and economic impacts of AMR are a major challenge for all healthcare systems and societies worldwide. It is estimated that antibiotic-resistant infections are responsible for a substantial number of deaths in Europe each year, with a health burden comparable to that of influenza, tuberculosis and HIV/AIDS combined and a cost of about €1.1 billion to the healthcare systems of EU/EEA countries. Holistic and multicomponent strategies in accordance with the ‘One Health’ perspective are key to curbing the development and spread of AMR. One crucial component of such strategies is ensuring broad and timely availability of effective antibiotics; this captures both investing in R&D for new antibiotics and safeguarding continued access to new and existing products. Scientific, economic, structural and regulatory barriers continue to limit the development of novel antibiotics with innovative characteristics despite intensified international efforts. Indeed, only a handful of new antibiotics have been developed and launched over the last few decades, and almost none have any innovative characteristics. This means that they are vulnerable to cross-resistance with existing antibiotics. At the same time, while ensuring timely access to new and existing antibiotics is critical, new antibiotics are often only launched in larger markets while supply-chain problems or withdrawals due to low profitability impact the availability of older antibiotics as well. This panel session aims to discuss the challenges facing health systems regarding how to foster research and development for new antibiotics and ensuring sustainable access to new and pre-existing antibiotics in the context of addressing AMR. In particular, it will aim to highlight avenues for collaboration and the potential role of the EU for addressing these challenges. Following a short presentation of the key findings of a policy brief published by the European Observatory on Health Systems and Policies at the request of the Swedish Presidency of the Council of the European Union, participants will hear reflections from the national and international levels and discuss potential implications and ways forward. Panelists will reflect on the relevant priorities of the upcoming Belgian Presidency of the Council of the European Union in the first half of 2024, as well as the WHO Regional Office for Europe's Regional Roadmap on AMR.

Key messages
• Fostering innovation and ensuring sustained access to effective antibiotics are paramount for addressing AMR.
• Collaboration across countries, supported by the EU and the WHO will be key to achieving these goals.
Partial substitution of red or processed meat with plant-based foods and colorectal cancer risk
Authors: Tammi R , Kaartinen N E , Harald K , Maukonen M , Tapanainen H , Pajari A M , Männistö S 
Published: October 2023

Abstract

Background
Consumption of plant-based foods, particularly whole grains, may decrease colorectal cancer (CRC) risk, while red and processed meat consumption increases it. Moreover, shifting to more plant-based diets promotes sustainable food systems. Yet, few studies have examined the impact of dietary shifts towards more plant-based diets on CRC risk. We modelled a partial substitution of red or processed meat with whole grains, vegetables or fruits in relation to CRC risk in Finnish adults.

Methods
Our data comprised 43 788 participants (79% men) aged ≥25 years from five Finnish cohorts. The median follow-up was 29 years, during which 1124 CRC cases were diagnosed. Diet was assessed by a validated food frequency questionnaire. We modelled substitutions of 100g/week of red meat or 50g/week of processed meat with an equivalent amount of plant-based foods. In a two-stage meta-analysis, cohort-specific hazard ratios (HR) were calculated using Cox proportional hazards model and pooled together. We adjusted the analyses for sex and other relevant confounders.

Results
We observed a small decrease in CRC risk when red or processed meat was partially substituted with vegetables (red meat: HR 0.97, 95% CI 0.94-0.99, P = 0.008; processed meat: 0.99, 0.98-1.00, P = 0.029) or fruits (red meat: 0.97, 0.94-0.99, P = 0.007; processed meat: 0.99, 0.98-1.00, P = 0.036). No association occurred between the partial substitution of red or processed meat with whole grains and CRC risk.

Conclusions
Our results suggested that already small and easily implemented substitutions of red or processed meat with vegetables or fruits could reduce CRC risk in Finnish adults. The findings highlight the need for effective nutrition policy actions to promote the shift towards more plant-based diets that would benefit both public health and sustainable food systems. Further research on similar substitutions in relation to CRC risk is required in different populations and real-life settings.

Key messages
• Already small and easily implemented substitutions of 100g/week of red meat or 50g/week of processed meat with vegetables or fruits could reduce colorectal cancer risk in Finnish adults.
• The findings highlight the need for effective nutrition policy actions to promote the shift towards more plant-based diets that would benefit both public health and the sustainability of food systems.
Impact of COVID-19 pandemic on health care attention on breast cancer patients
Authors: Bruning González P , Quintana M J , Requeijo C , Savall O , Bonfill X 
Published: October 2023

Abstract

Background
Health care in relation to breast cancer has been negatively affected by COVID-19 pandemic. This study aims to estimate the impact of the pandemic on health care related to breast cancer at Hospital de la Santa Creu i Sant Pau (HSCSP), Barcelona, Spain.

Methods
This retrospective cohort study estimated the impact of pandemic during its first year on patients diagnosed with breast cancer undergoing treatment, follow-up, and control at HSCSP, and performed a comparative analysis with patients diagnosed the previous year in relation to the clinical characteristics, the treatments and the health care received.

Results
Data from 408 patients were analyzed, 217 (53.19%) from the group diagnosed the year before the pandemic (GC) and 191 (48.81%) from the group diagnosed during the pandemic (GP). No differences (p &gt; 0.05) were found in clinical characteristics such as ECOG at diagnosis, histological type, presence of hormone receptors and HER2 receptors and prognostic stage. No significant differences (p &gt; 0.05) were found in relation to survival at year. Most patients were diagnosed in HSCSP in assistencial circuit, a decrease of 10.02% was observed in the number of diagnoses in screening program. A difference of 3 days (p = 0.047) in diagnostic delay was found in GP in HSCSP. 10.93% fewer surgeries (p = 0.021) were performed as first treatment in GP.

Conclusions
11.98% less breast cancer was diagnosed in HSCSP during COVID-19 pandemic. The difference in diagnostic delay was 3 days, with a scarce clinical relevance. A reduction of approximately 10% was found in patients diagnosed through the screening program, which could explain the lower number of surgeries performed as first treatment (91.7% patients diagnosed through screening have surgery as first treatment). No significant differences were found in the clinical characteristics, probably because the lockdown (3 months) was not enough, although studies with longer follow-up times are lacking.

Key messages
• During the COVID-19 pandemic, there were fewer breast cancer patients diagnosed through the screening program and fewer patients whose first treatment was surgical.
• A delay of a few weeks in the start of treatment could result in a significant increase in mortality, this study showed that health care in the HSCSP was not greatly affected by the COVID-19 pandemic.
Forecasting the future burden of disease in Scotland
Authors: Grant I , Fletcher E , Wyper G , Lakha F 
Published: October 2023

Abstract
Scotland is expected to see a rapidly ageing population within the context of an overall decrease in population. Public Health Scotland's Scottish Burden of Disease (SBoD) Study has recently been adapted to forecast how these demographic and population health trends are expected to combine, to anticipate the extent of future public health challenges. Our initial aim was to forecast the burden of disease for 12 disease groups, over the next two decades, based solely on projected changes in the population. Further work is underway looking at the additional impact of changing morbidity and mortality at individual disease level, using an age period-cohort approach, and the possible impact of disease treatment through scenario analyses. We sourced Disability-adjusted life years (DALY) rates for 12 disease groupings from the SBoD study for 2019. Age-sex specific disease burden rates were assumed to remain constant over the forecasting period, thus assuming no changes to the underlying epidemiological rates. Population projections at 5-year age group, separately for males and females, were sourced from National Records Scotland up until the year 2043. Despite a projected decrease in the Scottish population, the annual disease burden is forecast to increase 21% in the next 20 years. Absolute increases in annual disease burdens are forecast to be largest for cardiovascular diseases, cancers, and neurological diseases - together accounting for 68% of the total increase in forecasted disease burden. Forecasted relative increases in annual disease burdens highlight increases for common infectious diseases; unintentional injuries; diabetes and kidney diseases; and chronic respiratory diseases. By indicating how the changing demographic situation in Scotland will impact the causes of disease burden, these forecasts are useful to inform priorities for workforce and care service planning and redesign, and for prioritising areas for disease and injury prevention.
Incidence and persistence of psychotic experiences among young people
Authors: Staines L , Healy C , Cotter D , Cannon M 
Published: October 2023

Abstract

Background and Hypothesis
Psychotic experiences (PEs) are associated with increased risk for mental disorders, in particular persistent PEs. PEs therefore might be useful within intervention research. We sought to systematically determine the incidence and persistence of PEs in the general population. Study Design: A double-blind search of databases (Embase, Pubmed PMC, Psychinfo, Medline, and Web of Science) from inception to January 2023 and data extraction, were conducted. Study quality was assessed using the NIH assessment tool. Random effects models were conducted to calculate pooled incidence rate per personyear and proportion of persistent PEs per year. Age and study design were all examined using subgroup analyses. Demographic, risk factors, and outcomes for incidence and persistence of PEs were reported in a narrative synthesis.

Results
Using a double-blind screening method for abstract (k = 5763) and full text (k = 250) were screened. In total 91 samples from 71 studies were included, of which 39 were included in a meta-analysis (incidence: k = 17, n = 56 089; persistence: k = 22, n = 81 847). Incidence rate was 0.023 per person-year (95% CI [0.0129;0.0322]). That is, for every 100 people, 2 reported first onset PEs in a year. This was highest in adolescence at 5 per 100(13-17 years). The pooled persistence rate for PEs was 31.0% (95% CI [26.65,35.35]) This was highest in adolescence at 35.8%. Cannabis was particularly associated with incidence of PEs, and persistence of PEs were associated with multiple mental disorders.

Conclusions
Each year incidence of PEs is 2 of every 100 people, and persists each year in 31% of cases, this risk is highest in adolescents.
Human Dignity: Exploring the Implications of the Dying Patient Act in Home-Hospice Care
Authors: Yakov G , Spector-Mersel G , Halevi-Hochwald I 
Published: October 2023

Abstract

Background
Human dignity is a vital value in democratic countries, forming the foundation for essential values such as autonomy, informed consent and appropriate clinician-patient relationships. The Israeli Dying Patient Act of 2005 aims to balance the sanctity of life and patient autonomy by standardizing medical care for dying patients. The law mandates that clinicians respect dying patients’ wishes and not artificially prolong their lives, providing palliative care administered by a multi-professional team. This study explores the implications for the human dignity of dying patients in home hospice care in Israel.

Research Methodology
The study employs a qualitative approach, utilizing 17 semi-structured interviews with multi-professional team members working within a home hospice framework. The collected data was analyzed using a narrative analysis approach.

Results
The findings reveal a nuanced understanding of the challenges of implementing the human dignity value in the home hospice, based on the Dying Patient Act. The challenges include managing a care framework that is also the patient's home, dealing with the tension between patients’ wishes and those of their families, and managing patients’ changing wishes, such as when they initially wish to die at home but later ask to be taken to the hospital.

Conclusions
Clinicians should be trained in end-of-life communication to respect patients’ wishes at the home hospice under the spirit of the Dying Patient Act. Patients and families should be partners in addressing these challenges. Human dignity is essential in providing quality care. This study offers insights for policymakers and clinicians to improve end-of-life care in the home hospice setting.

Key messages
• In the home hospice, human dignity plays a crucial role in delivering quality and ethical care, especially when dealing with the balance between the Inconsistent wishes of patients and families.
• Clinicians should be trained in end-of-life communication to respect patients’ wishes, and patients and families should be partners in addressing the challenges to provide quality care.
Evaluation criteria of evidence-based practices in health and wellbeing promotion in Finland
Authors: Kylänen M , Kostiainen E 
Published: October 2023

Abstract
Decision makers and experts have a great need to receive independent and credible knowledge about the effectiveness of evidence-based practices (EBPs) for promoting health, wellbeing, and equity. Best practice portals that evaluate EBPs have developed for this need. However, the evaluation criteria by which the portals determine the degree of effectiveness, evidence, and practical applicability of EBPs may differ between portals and need further investigation. There do not exist a single framework for evaluation criteria. Although the randomised control trials may meet a gold standard, there are alternative approaches to evaluate EBPs, considering the complexity of health promotion and wellbeing interventions. The Finnish Institute for Health and Welfare started to develop the best practice portal in health and wellbeing promotion in 2019. In this workshop, we present the evaluation criteria of EBPs in Finland and how the approach may contribute to the evaluation of EBSs, knowledge base and management in health promotion and disease prevention policy. We will also reflect on the way we capture the complexity in our criteria.
Comparative study on school health promotion in Switzerland and Malaysia: qualitative evidence
Authors: Betschart S , Adams D , Sandmeier A , Skedsmo G 
Published: October 2023

Abstract

Background
The Ottawa Charter emphasized schools as a central location for health promotion. In particular, a holistic approach involving all members of a school and the school community is considered desirable for school health promotion (SHP). School principals are seen key players in SHP implementation, but little is known about how contextual factors such as the governance of health and education affect their roles. The project aims to study the governance mechanisms and contextual factors affecting SHP implementation in schools in two national contexts: in Malaysia and Switzerland.

Methods
18 principals were interviewed in expert interviews. The interviews were transcribed verbatim and analyzed with MAXQDA using qualitative content analysis with deductive and inductive categories.

Results
Results indicate that there are significant differences in how Malaysia and Switzerland govern SHP. In Malaysia, there are clear structures and responsibilities for SHP. The health and education sectors work closely together, with top-down decision-making on a national level. In contrast, Switzerland has no governmental policy regarding SHP for schools with SHP organized mainly by NGOs. It appears that in Switzerland, decisions regarding SHP are made more bottom-up and at the local level, typically by municipalities. Malaysia has a very distributed leadership model, with a school leader specifically responsible for student affairs and SHP at each school. Enablers of SHP include clear structures and well-defined responsibilities, while a lack of time and staff are among the primary barriers to successful implementation.

Conclusions
The governance and policies of SHP are very different in Malaysia and Switzerland. Clear structures and high centralization in Malaysia are contrasted by very high autonomy and a federal structure in Switzerland. Advantages and disadvantages of these differences in educational governance will be discussed within the presentation.