bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intermarriage and health: Mortality among Finnish migrants in Sweden by spousal country of birth
Authors: Östergren O , Korhonen K , Cederström A , Martikainen P 
Published: October 2023

Abstract

Background
Finnish migrants in Sweden experience a mortality disadvantage relative to the native population in part due to health behaviours. Interaction between migrants and natives may lead to a convergence of health behaviours and thereby mortality between the groups. Finnish migrants who are married to a native Swede may thus have mortality rates that are more similar to the Swedish population compared to those married to fellow Finns. Conversely, mortality rates of migrants married to a fellow Finn may more closely resemble those of the population in Finland.

Methods
We use register data to identify all Finnish migrants aged 40-64 in Sweden in 1999 who were married to a native Swede or a fellow Finn. We identify reference groups in both Sweden and Finland, using a combination of inverse probability weighting and direct matching to adjust for differences in sociodemographic characteristics between the groups. We analyse mortality from all causes, CVD, alcohol and smoking related causes during 2000-2017.

Results
Compared to Finnish migrant men married to a fellow Finn, migrant men who are married to a native Swede have lower mortality rates, closer to that of the native population of Sweden. This difference is largely explained by sociodemographic characteristics, although lower levels of all-cause and CVD mortality remain after adjustment. By contrast, migrant women married to a native Swede have higher smoking-related mortality, closer to that of native Swedish women. Migrant women married to a fellow Finn have lower smoking-related mortality, closer to that of Finnish-born women in Finland. This pattern is especially pronounced when adjusting for sociodemographic characteristics.

Conclusions
Being married to a native is associated with lower all-cause and CVD mortality for migrant men and higher smoking-related mortality for migrant women. Depending on gender and risk factor intermarriage can be either protective or detrimental for migrant health.

Key messages
• The mortality risk of Finnish migrants in Sweden vary by spousal country of birth but if intermarriage is protective or detrimental for health depends on gender and risk factor.
• Being married to a native Swede is associated with lower CVD mortality for Finnish migrant men and higher smoking-related mortality for Finnish migrant women.
Population size estimation of survivors of violence against women and girls in Tirana
Authors: Ylli A , Sant Fruchtman C , Shahu S , Sota M , Revenga Becedas R , Wallenborn J , Cobos Munoz D 
Published: October 2023

Abstract

Survivors of violence against women and girls (VAWG) are often stigmatized, resulting in unreported cases and missed opportunities for support services. In this analysis we aimed to estimate the real size of VAWG in Tirana district between 2019-2022. Size estimation was based on capture-recapture methodologies using two independent databases; from the Counselling Line for Women and Girls (CLWG), a non-governmental agency providing counselling to survivors of VAWG, and the Registry of Violence in Albania (REVALB), the official registry of VAWG. There were 155 and 895 cases respectively in CLWG and REVALB. 48 women were found in both registries. The first points of contact for survivors of VAWG were Police, Court/Judge and Municipality services while none of the women recorded in REVALB reported accessing health, education or NGO services. The estimated number of reportable VAWG cases in Tirana district between January 2019- August 2022 was 2890 (95% CI:2218-3562). The estimation is highest for 2021 with 1418 cases (95% CI:766-2069) and lowest for 2020 with 251 cases (95% CI:101-400). Real number of reportable survivors and victims of VAWG is at least 3 times higher than the cases officially registered in the national database in Tirana. The estimation for 2020 is highly affected by an important decrease in registration of cases during first year of COVID-19 pandemic. More efforts should be made, especially by the health services, to identify and refer as needed potential cases of VAWG.

Key messages
• Real number of reportable survivors and victims of VAWG is at least 3 times higher than the cases officially registered in the national database in Tirana
• ore efforts should be made, especially by the health services, to identify and refer as needed potential cases of VAWG.
Sudan: from a food basket to a pesticide sink
Authors: Noory B , Nuwayhid I , Habib R R 
Published: October 2023

Abstract

Background
Sudan, a country once referred to as ‘a food basket', had an agricultural sector employing 53% of the workforce (21.8% of the GDP) in 2019. However, intensive agricultural schemes and excessive use of pesticides have plagued this sector since colonial times, resulting in negative environmental health impacts. We analyzed relevant policies to identify deficiencies and improvement opportunities.

Methods
The National Pesticides and Pest Control Products Act (NPPCPA 1994), Environmental Health Act (EHA 2009), and the National Occupational Health Act (NOHA 1966) were analyzed.

Results
The laws governing pesticide handling and use are outdated. The NPPCPA (1994) does not capture recent regulations specified in international conventions. The EHA (2009) regulates the storage of vector-control pesticides, without referring to agricultural pesticides. NOHA was promulgated in 1966, yet the occupational health (OH) functions were formalized within the Federal Ministry of Health (FMOH) in 1968. The OH unit and functions in FMOH were fully dismantled in 1993-1994 and NOHA clauses were reduced to an administrative section in the 1997 Federal Labor Act with no specific mention of pesticide exposure. The NPPCPA 1994 act stipulates the development of a multi-stakeholder national committee, yet it works in a fragmented manner and conducts pesticide analysis on an ad hoc basis. The lack of a national agricultural policy for the safe use of pesticides, and the absence of an oversight agency to monitor, inspect, and enforce safety measures, have led to unsafe exposures and high residues in crops.

Conclusions
Laws and policies governing pesticide use are outdated and deficient in Sudan. They fail to regulate the use of pesticides and protect workers and consumers. Evidence-based and context-specific policies and regulations are needed. A successful implementation of regulations requires revisiting governance structures, in tandem with widescale capacity-building efforts.

Key messages
• Sudan’s economy relies heavily on agriculture, yet the laws governing this sector are outdated and deficient.
• There is a need for a national agricultural policy for the safe handling and use of pesticides.
Out-of-pocket expenditure at end-of-life among decedents from cardiovascular disease
Authors: Tur-Sinai A , Bentur N 
Published: October 2023

Abstract

Background
Most people who develop chronic diseases, including cardiovascular disease (CVD), live in their homes in the community in their last year of life. Since cost-sharing is common in most countries, including those with universal health insurance, these people incur out-of-pocket expenditures (OOPE). The study aims to identify the prevalence and measure the size of OOPE among CVD decedents at end-of-life (EOL) explore differences among countries in OOPE, and examine whether the decedents’ characteristics or their countries’ health policy affects OOPE more.

Methods
SHARE data among people aged 50+ from seven European countries (including Israel) who died from CVD are analyzed. Decedents’ family members are interviewed to learn about OOPE on their relatives’ accounts.

Results
We identified 1,335 individuals who had died from CVD (average age 80.8 years, 54% men). More than half of CVD-decedent people spend OOPE on community services at EOL and their expenditure varies widely among countries. About one-third of people in France and Spain had OOPE, rising to around two-thirds in Israel and Italy and almost all in Greece. The average OOPE is € 369.3, with wide variance across countries. Significant odds of OOPE exist in the country variable only, and significant differences exist in the amount of OOPE among countries and ages.

Conclusions
Since improving CVD care efficiency and effectiveness are key aims, healthcare policymakers should consider expanding public funding for community services in order to mitigate OOPE, alleviate the economic burden on households, mitigate forgoing of community services due to price, and reduce rehospitalization. The expansion of public funding of CVD community care may lower their OOP expenditure, mitigate the non-use of community services due to cost, and reduce hospital readmissions. This is important in all countries included in the study and especially so in those where OOP expenditure is highest.

Key messages
• More than half of CVD decedents spent out of pocket on community services in their last year of life.
• The expansion of public funding of CVD community care may reduce hospital readmissions.
A role of National Cancer Control Programme during COVID-19 pandemics - experience from Slovenia
Authors: Tomsic S , Duratovic Konjevic A , Plantosar K , Zadnik V 
Published: October 2023

Abstract

Issue
Cancer is a major public health issue. Countries should tackle it with setting up National Cancer Control Programmes (NCCP), which are especially important during extreme circumstances. In Slovenia, during the COVID-19 pandemic, we managed to follow the direction set out in the NCCP.

Description of the problem
Slovenia has had a NCCP since 2010. The program's activities are already yielding results at a national level. During the COVID-19 pandemic, oncology services in Slovenia were designated as an exception that should not be interrupted. However, the functioning of primary care level has been modified due to COVID-19 management. This reflected in the drop of new cancer diagnoses and temporary stop of cancer screening programmes.

Results
During pandemics timely monitoring of cancer care has been set up by Slovenian Cancer Registry. During the first wave more than 30% drop in new cancer diagnoses has been observed. The results have been presented to policy makers and general public. Appeals to the policy makers to resume cancer screening as soon as possible, communication campaigns urging people to see a doctor, if they notice any signs of cancer, and support for all providers to maintain cancer care uninterrupted have been initiated by the NCCP. These activities resulted in only 3 months stop of the three national cancer screening programmes, and enhanced activities after their restart; the cancer awareness was raised in the next COVID-19 waves, since the drop in the new cancer diagnoses during following waves (autumn 2020- spring 2021) reached to “only” 10%. And institutions related to cancer care have remained dedicated to cancer throughout the whole pandemic period.

Lessons
Coordinated national cancer strategy can have important influence on policy makers and general population, raising awareness and preventing major disruptions. Coordinated support for cancer care was crucial to avoid worse long-term cancer outcomes.

Key messages
• Strategic framework of activities through NCCP have important impacts on the provision of cancer care, especially during extreme circumstances, such was COVID-19, which diminish health care delivery.
• Strategic framework of activities through NCCP have important impacts on the provision of cancer care, especially during extreme circumstances, such was COVID-19, which diminish health care delivery.
From health in all policies to health for all policies with a focus on older people - climate, health and equity
Authors: Schmidt A , Lampl C , Aigner E , Haas W 
Published: October 2023

Abstract

Background
The climate crisis constitutes the largest threat to public health in the 21st century, from which severe health risks emerge that hit older age groups disproportionately. In addition, the health sector itself contributes to the climate crisis (up to 10% of national carbon emissions) and health inequity. We use the Health for all Policies paradigm and apply it to the links between equity, climate, and health in old-age. The paper develops a conceptual framework for strengthening interdisciplinary approaches toward a climate-resilient future for all age groups.

Methods
We conducted a systematic literature review for the analysis of the links between health, climate, and equity, by considering a health for all Policies (HfaP) paradigm and highlight results focusing on the living situation of vulnerable subgroups of older people in this presentation.

Results
The climate crisis with its pending health threats has multiple links with HfaP, and can be applied to an analysis for specific subgroups of older people, vulnerable due to intersectional and overlapping challenges related to their health status, economic situation, gender or race, specific living or family situation. An in-depth understanding of the equity-climate-health nexus helps avoid a low-carbon shift may become that is too narrow in its scope, compounding vulnerable groups's situations. At the interlinkages between health, climate and inequality multiple co-benefits (e. g. inclusive infrastructure for active mobility) can be achieved and trade-offs avoided.

Conclusions
Policymakers worldwide and in the EU take up the challenge to substantially reduce greenhouse gas emissions, but the complex interconnection of climate, health and equity has found very little attention, even less so applied to older people. Vulnerable subgroups of older people have limited resources for dealing with the severe impacts of climate change on health, calling for adaptation measures to be planned with an equity lens.
The ‘FFAB’ project: Lessons learned from an early health intervention for male sports bettors
Authors: Biggar B , Reith G , Wardle H 
Published: October 2023

Abstract

Background
Sports betting is a growth area for the gambling industry with football fans becoming a key target of advertising. This demographic is also one at elevated risk from gambling harm. This paper reflects on the NIHR-funded Football Fans and Betting project (FFAB) - an innovative early health intervention with football fans (aged 18-55) who gamble regularly to reduce their betting.

Methods
We will present findings from interviews and observations to reflect on the delivery of our 8-week intervention delivered by 4 clubs’ Community Trust Coaches - Leicester, Preston North End, Accrington Stanley, and Blackpool. Planned as a feasibility study and pilot RCT, FFAB's feasibility learnings led to the development of a different model than originally proposed.

Results
Preliminary findings suggest (1) there is a clear need for an early health intervention for men looking to reduce their betting. (2) Overcoming shame and stigma are significant barriers to recruitment in a study like this. (3) Conducting independent research with football clubs, given their complex sponsorship arrangements, presents multiple challenges. (4) relatedly, while recruitment was easier in smaller more locally rooted clubs, they faced more challenges for resources which led to difficulties with retention on the programme.

Conclusions
FFAB is the first intervention of its kind and has lessons for interventions with underserved groups more widely. We identified the need for more focused pre-recruitment work on changing understandings of gambling through public health-focused education. We believe more recognition and visibility of a public health approach to gambling in the wider population would help to de-stigmatise language and discussion of gambling and lessen the challenges of engaging our target group. We recommend a more grassroots, localised approach to future early health interventions of this nature. In doing so, we believe that we could minimise many of the challenges we faced in delivery.

Key messages
• There is a clear need for community-based interventions that aim to reduce gambling harm amongst the high-risk population of male sports bettors.
• Feasibility work suggests that refinements to our initial model, utilising more localised, grassroots approaches, are required to successfully engage with this target population.
Why is it important to address organisational vaccine literacy?
Authors: Aloise I 
Published: October 2023

Abstract
Starting with a quick recall from the definition of organizational HL and HL responsiveness, the concept of vaccine literacy will be unpacked. Individual vaccine literacy and organizational VL will be presented. In particular the new concept of organizational VL will be explained and opportunities for its application to the prison settings and to tailored healthcare approaches for migrant's health. We will remark that the suggested strategy by the two projects is provision of vaccine services, programs and information in ways that promote equitable access and engagement, that meet the diverse vaccine literacy needs and preferences of individuals, families and communities, and that support people to participate in decisions regarding their health. We need to move towards an organisation that takes charge of the complexity of needs and delivers the right performance/service not on the basis of differing accessibility (often determined by socio-economic variables that add discrimination and inequality to more or less well-expressed health needs), but on the correct assessment of the real socio-medical burden and, in so doing, contributes to reducing the gap that determinants such as citizenship or deprivation of liberty can so deeply produce.
Building a European One Health workforce for prevention and preparedness to health threats
Authors: Robbiati C , Milano A , Declich S , Riccardo F , Mancini L , Di Domenico Kevin , Scavia G , Dente M G 
Published: October 2023

Abstract

Background
The Quadripartite has elaborated the One Health Joint Plan of Action (2022-2026) (OH JPA) to promote health sustainably and prevent the next pandemic through the One Health (OH) approach. One of the action track of the OH JPA is to create a training program for environment, medical and veterinary sector professionals.

Objectives
The Italian National Institute of Health is developing a training curriculum about OH prevention and preparedness to health threats within the European Region to promote the OH workforce capacities and capabilities and to support the OH JPA execution. The training curriculum would be developed through a literature review and a stakeholder consultation process, validated by a steering committee and presented during a workshop.

Results
A modular training curriculum about OH prevention and preparedness to health threats within the European Region is developed and it includes modules to strengthen soft and hard skills around 5 OH domains (OH thinking, OH design, OH implementation, OH evaluation, OH cross-cutting competences) with case studies encompassing different threats. The curriculum would be further developed into a training hybrid course for National Public Health Institutes, decision and policy-makers at all level, International and European organizations and agencies, Academia, professionals working in the area of environmental and agricultural sciences, social sciences, human and animal health.

Conclusions
The training curriculum would contribute to build a European OH workforce by strengthening OH prevention and preparedness skills and competences and networking opportunities. It would support OH action and practice at national, regional and global level and the execution of the OH JPA.

Key messages
• A training curriculum for OH prevention and preparedness to health threats within Europe has been elaborated.
• The OH workforce, OH action, and the OH JPA execution are strengthened and supported.
Promoting primary healthcare services resilience with chronic disease management digitalization: a foresight study in the Lisbon health region
Authors: Peyroteo M , Maia M , Velez Lapão L 
Published: October 2023

Abstract

Background
Due to the pressure on health systems, the COVID-19 Pandemic forced administrators to rapidly harness and integrate existing technology to manage access of patients with chronic diseases to Primary Health Care (PHC) in Portugal. Studies show that one of the most important areas for improvement is the sustainability of artefacts after the implementation phase, which depends on the successful implementation of digital transformation. As such, this study aims to assess the impact and influence of digitalization of PHC to settle a set of actions to be taken so that implementation is carried out more effectively and to support evidence-based policy-making in a PHC Unit located in the peripheral area of Lisbon.

Methods
This study followed a collaborative foresight approach using a scenario development methodology proposed by Lapão and Thore, divided into three stages: understanding the context, developing scenarios, and their analysis. These steps were achieved by conducting focus groups using the thematic brainstorming approach to analyse strategic and operational scenarios within ten years (between 2022 and 2032).

Results
Considering the influence of digitalization of PHC in the next ten years, three relevant and plausible scenarios were developed: ‘Digital PHC and active patients’, ‘NHS transition’ and ‘Climate exigency’. Combining innovation skills to establish digital services with improved governance policies has shown significant benefits toward the goals of more patient-centred care.

Conclusions
The collaborative reflection process throughout the study made the different stakeholders identify and understand the impact of the essential measures to be taken in different scenarios, allowing the digitalization of PHCs to be implemented more effectively, enabling the sustainability of the National Health Service in the Lisbon region, which has only been discussed so far at a limited and theoretical level.