bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 mortality and use of intensive care among ethnic minorities – a Danish register study
Authors: Nørredam M , Islamoska S , Holm Petersen J , Benifeld T 
Published: October 2023

Abstract

Background
Migrants and ethnic minorities are disproportionately affected by the Coronavirus Disease 2019 (COVID-19) pandemic compared to the majority population. Therefore, we studied mortality and use of mechanical ventilation (MV) by country of birth and migrant status in a nationwide cohort in Denmark.

Methods
Nationwide register data on all cases hospitalized for &gt; 24-hours with COVID-19 between February 2020 and March 2021. Main outcome measures were mortality and MV within 30 days of hospitalization for COVID-19. Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by region of origin and migrant status using logistic regression analyses, adjusting for age, sex, comorbidity and sociodemographic factors.

Results
Of 6,406 patients, 977 (15%) died and 342 (5%) were treated with mechanical ventilation. Immigrants (OR:0.55;95%CI: 0.44-0.70) and individuals of non-Western origin had a lower odds (OR: 0.49; 95% CI: 0.37-0.65) of death upon admission with COVID-19 compared to Danish born individuals. Immigrants and descendants (OR: 1.62; 95% CI: 1.22-2.15) as well as individuals of non-Western origin (OR: 1.83; 95% CI: 1.35-2.47) had a significantly higher odds of MV compared to Danish born individuals. Outcomes of individuals with Western origin did not differ.

Conclusions
Immigrants and individuals of non-Western origin had a significantly lower COVID-19 associated mortality compared to individuals of Danish origin after adjustment for sociodemographic factors and comorbidity. In contrast, the odds of MV was higher for immigrants and individuals of non-Western origin compared to individuals of Danish origin.

Key messages
• Immigrants and individuals of non-Western origin had a significantly lower COVID-19 associated mortality compared to individuals of Danish origin.
• Risk of technical ventilation was higher for immigrants and individuals of non-Western origin compared to individuals of Danish origin.
Assessment of Diet Quality and Associated Environmental Impacts in Ireland
Authors: Leydon C L , Harrington J M , McCarthy S N 
Published: October 2023

Abstract

Background
Suboptimal diets continue to be a major contributor to the global burden of disease, while food production contributes to climate change and environmental degradation. Food systems account for &gt;30% of anthropogenic global greenhouse gas emissions (GHGE), and around 70% of freshwater use. Research on healthier diets having lower environmental impacts has been inconsistent. This study aimed to explore the association between environmental footprints and diet quality among older Irish adults.

Methods
The Mitchelstown Cohort was a cross-sectional study conducted between 2010 and 2011 in County Cork, Ireland. Dietary data was available for 1,862 participants. Adherence to three a priori defined diet quality metrics (Dietary Approaches to Stop Hypertension (DASH), Mediterranean diet (MD), and the Healthy Eating Index 2015 (HEI-2015)) were measured. Those in quartile four (Q4) of each metric were the most adherent to the respective dietary recommendations. Environmental impact of foods was quantified by linking food items to GHGE and blue water (BW) use impact factors, based on life cycle assessment (LCA) literature.

Results
The median daily diet in Ireland was associated with 6.8 kg CO2-equivalents per day and 425.1 litres of blue water. Males had significantly higher dietary GHGE but a lower water footprint compared to females (P &lt; 0.001). Higher diet quality was inversely associated with GHGE according to the DASH and MD diet (adjusted for age, sex, and energy intake). Adherence to the DASH and MD diet was positively associated with BW use. No association between the HEI and GHGE and BW use was found in the adjusted model.

Conclusions
Irish dietary patterns are unhealthy and unsustainable. Higher quality diets reduced GHGE but increased water use. Future research must focus on identifying culturally-acceptable, optimised dietary patterns, where health and impact indicators align to curtail environmental burdens potentially transferring.

Key messages
• The healthiness of a diet is dependent in part on the constructs and scoring criteria of the diet quality metric used. The metrics have conceptual differences which may explain heterogeneous findings.
• The sustainability of diets is dependent on the environmental indicator(s) assessed. Future dietary patterns must be healthy, culturally-acceptable, equitable, and align across multiple indicators.
Validation of Globorisk in Turkish people and development of a new model for cardiovascular diseases
Authors: Emecen A N , Siyve N , Unal B 
Published: October 2023

Abstract

Background
Cardiovascular diseases (CVD) is a major cause of death globally, and accurate risk assessment is important for identifying high-risk individuals. This study aimed to validate the laboratory-based Globorisk score for predicting CVD in the Turkish population and to develop a Turkish population-specific model.

Methods
We analyzed data from Turkey's Chronic Diseases and Risk Factors study, which examined CVD incidence from 2011 until 2017. After excluding those with prior CVD history, a total of 7239 individuals aged 40 to 80 years were included in the analysis. The performance of Globorisk in predicting CVD was assessed using the C-index. With demographic, dietary, anthropometric and Globorisk variables; we used backward stepwise logistic regression to select the final model (Turkish CVD-TCVD). Lastly, the TCVD model was internally validated and calibrated with 200 bootstrap replicates.

Results
Out of 7239 participants (mean age: 53.9±10.3), women: 52.3%); 766 developed CVD within six years (cumulative incidence rate: 10.6%). The C-index of the Globorisk was 0.72 with sensitivity and specificity being 68.2% and 67.3%. In the final TCVD model, backward stepwise selection identified age (odds ratio-OR: 1.06, 95% Cl: 1.05-1.07), diabetes (OR:1.83, 1.47-2.28), body mass index (OR:1.02, 1.01-1.04), high waist-hip ratio (OR:1.37, 1.13-1.66) and systolic blood pressure (OR:1.01, 1.00-1.01) as significant predictors for CVD. C-index was 0.73 with sensitivity and specificity being 72.9%, and 62.9%. Examination of the calibration plot showed signs of overprediction when the actual CVD probability was &gt;20%.

Conclusions
Laboratory-based Globorisk score had a good fit in the Turkish population. TCVD model had better sensitivity than Globorisk. Adding of waist-hip ratio to the Globorisk score could improve predictive CVD models in the Turkish population.

Key messages
• External validation of laboratory-based Globorisk showed good predictive accuracy in the Turkish population.
• Although more challenging to measure, adding of waist-hip ratio to the laboratory-based Globorisk score could improve predictive cardiovascular disease models in the Turkish population.
Digital public health in Romania
Authors: Brînzac M 
Published: October 2023

Abstract
The Romanian digital public health story is far from the end or its highest point. As in all cases, the digital public health advancements were led by the COVID-19 pandemic and the need to move everything into a digital format. This came, of course, with its hiccups and trials and errors, but in the end, it all led to considerable advancements in the public health system. One of the most significant achievements in recent years is the settlement of telemedicine services for family doctors. Initially, this was approved for the duration of the lockdown as a measure to limit the spread of the virus. Still, this measure was extended after pressure from professional associations and civil society. Another national digital public health agenda point is using electronic health records. The project was launched several years ago with the National Health Insurance House insurance card. It was now continued, with the work underway for its development. This would be a significant achievement as it would alleviate the public health system quite a lot, and it would allow health surveillance for chronic conditions with longitudinal data. Additionally, it could potentially reduce health spending as it would reduce unnecessary or doubled investigations and tests. Romania presented numerous initiatives on digital public health, but unfortunately, many were limited or renounced. A characteristic of the Romanian digital public health ecosystem is the presence of grass-root initiatives led by innovators and system disruptors, small private entities with a strong desire to solve systemic issues. This presentation will highlight how the COVID-19 pandemic enabled Romania to move forward with its digitalization and will advocate for continuous and sustainable future development of the national digital public health system.
The challenges of measuring: mapping and understanding resilience metrics in the context of a climate change shock
Authors: Haywood P , Ginnane J , Zimmermann J , Levy N , Karanikolos M , Cylus J 
Published: October 2023

Abstract
During this presentation, discussion will be held around several of the decisions made for the sample climate change scenario, suggested indicators and their implications. This provides the audience with an example process of how to put together a shock scenario and prepare a resilience test given the tools and methodology the resilience testing project provides. There is increasing evidence of climate change and its associated health risks. Whilst resilience is required against a multitude of threats, resilience to climate change induced health risks will be essential for health systems in the future. This scenario focuses on a heat wave that is complicated by a follow-on shock, the collapse of the electrical grid. Deliberate choices were made to include two shocks, the integration of heat warning systems, suggestions to increase the demand for health services and how to include considerations of vulnerable groups. These will be discussed in the context of how to customise a scenario to a country context including the current functioning, replacing the shock mechanism of heat wave with other shocks such as flood or fires, and including the lessons of previous experience of environmental shocks. Resilience testing tools, such as the resilience testing manual, other sample scenarios and peer-to-peer scenario repository website will be demonstrated in practical application. This shock initially has an impact on the service delivery and resource generation functions of the health system performance assessment (HSPA) framework but the impacts flow into the other functions. The workshop will go through the combined framework, indicators that are useful to assess health systems resilience and questions that are proposed to the guide the discussion of the resilience testing exercise. From the discussion participants will be better prepared to implement resilience testing in their countries, understanding how to customise the shock of a heat wave to their local context.
The effects of a mindfulness-based programme on quality of life and social support in older people
Authors: Juraga D , Rukavina T , Marinović Glavić M , Roviš D , Bilajac L , Knežević M , Raat H , Vasiljev V 
Published: October 2023

Abstract

The importance of mindfulness in promoting mental health and well-being has been increasingly recognised in recent years. As a result, mindfulness-based interventions have been introduced to improve various aspects of life, including quality of life and social support. The aim of this study was to examine the effectiveness of a seven-week mindfulness-based workshop programme in improving quality of life and social support among participants in the intervention compared to a control group.
A total of 257 participants (65+) were recruited and assigned to either the intervention group, which participated in the seven-week mindfulness-based workshop programme, or the control group, which received no intervention. The workshop programme combined two evidence-based programmes: The Chronic Disease Self-Management Programme (CDSMP) and the Mindfulness-based Living Programme. Participants completed two questionnaires (EQ-5D-5L and OSSS-3) to assess quality of life and social support before and after the intervention. Data were analysed using appropriate statistical tests to compare pre- and post-intervention outcomes between groups. The intervention group showed significant improvement in quality of life (p&lt;.001) and social support scores (p = 0.002) after the seven-week mindfulness-based workshop programme. The control group, on the other hand, showed no significant changes in these measures. The significant improvement indicates the effectiveness of the mindfulness-based workshop programme. The results of this study show the positive effects of a seven-week mindfulness-based workshop programme on the quality of life and social support of older people. The results suggest that mindfulness-based interventions can be an effective tool for improving mental health and well-being by promoting quality of life and strengthening social support networks.

Key messages
• The seven-week mindfulness-based workshop programme improves the quality of life and social support of older people, which can have an impact on overall mental health and well-being in general.
• The results of this study can ensure a sustainable impact on achieving better health outcomes and saving resources in the health care system through reduced and more effective use of services.
Public food procurement as a tool for more sustainable and high quality food offer in public institutions
Authors: Gabrijelčič M , Fras N , Ožbolt P 
Published: October 2023

Abstract
As children spend almost a third of their day in kindergarten or school and consume a large part of their daily energy intake in educational environments, those environments are important factors in the development of healthy eating habits at one hand or unhealthy ones with possible consequence of childhood obesity on the other. Strong evidence of the importance of access to healthy and balanced nutrition in schools for children's health is available, and a nutritionally regulated school environment is associated with a lower risk of childhood obesity, which can also be facilitated by a transparent and quality-oriented procurement system. JRC has estimated the value of the European social food service market as sizeable in both reach and force of €82 billion. Progressive and targeted public procurement of food for health can reward food business operators who provide nutritionally balanced meals. According to the EU AP on childhood obesity 2014-2020, action such as use of nutritional criteria in food service procurement should be required in schools and kindergartens. JA Best-ReMaP situation analyses showed that current implementation of public food procurement across EU Member States differs substantially. Project activities aimed to support the establishment of the intersectoral working mechanisms (groups) for the public procurement of foods in participating MSs, to increase the understanding, knowledge and skills regarding public procurement of food/food products in public health and other selected public institutions, to pilot Slovene best practice tool for PFP as optional approach for implementation of the sustainable and high quality PFP procedures and to recommend further institutionalised implementation of the public procurement procedure for foods, based on quality standards, in the Member States and propose minimum criteria for sustainable public procurement, in line with the developments at the European Commission level.
Uptake of flu vaccination in Denmark: A comparison between Danish and migrant populations, 2015-2021
Authors: Deal A , Hayward S E , Langholz Kristensen K , Holm Petersen J , Valentiner-Branth P , Friedland J S , Hargreaves S , Norredam M 
Published: October 2023

Abstract

WHO's Immunisation Agenda 2030 emphasises vaccination across the life course, including among migrants who may be at-risk in terms of access and uptake. Despite availability of a vaccine, influenza remains a key contributor to winter excess mortality in Europe. We analysed national Danish Registry Data to determine how flu vaccine uptake varies by migration status. We carried out a retrospective cohort study (2015-2020) to determine flu vaccine uptake among migrants ≥65 years matched 1:6 on age and gender to Danish-born. We used a multivariate logistic regression model (in R v4.2.1), controlling for migrant status, time in Denmark and other socio-demographic variables (age, gender, nationality, urban/rural residence), to identify factors associated with uptake. 81,644 individuals were included in the analyses. The flu vaccine uptake across 6 flu seasons in Danish-born was 44.7%, compared with 34.7% in the migrants. Migrants were statistically significantly (OR:0.64; 95% CI:0.62-0.65) less likely to receive a flu vaccine across all seasons; the gap widened from 2015 (OR:0.76; 95% CI:0.72-0.80) to 2020 (OR:0.49; 95% CI:0.47-0.51). Those who arrived as family-reunified to Danish citizens (OR:0.51, 95% CI:0.45-0.58) or to immigrants (OR: 0.58, 95% CI:0.47-0.71) were statistically significantly less likely to receive the vaccine across the study period than asylum seekers and refugees. In 2015-2017 seasons, those residing in Denmark &gt;10 years were more likely (2015 OR:2.06, 95% CI:1.56-2.73; 2016 OR:2.35, 95% CI:1.75-3.15); 2017 OR:1.92, 95% CI:1.41-2.61) to receive a vaccine than those more recently arrived. Our data show that flu vaccine uptake was poor in all groups but that migrant groups have consistently lower uptake rates, particularly among family-reunified migrants and those more recently arrived. Migrant flu vaccination rates in migrants fell over a 6-year period. Going forward, developing tailored interventions in collaboration with communities will be key.

Key messages
• Migrant groups have consistently lower uptake rates of flu vaccination than Danish born.
• Newly arrived migrants are significantly less likely to get vaccinated, suggested targeted interventions may be needed.
The assessment of determinants of vaccine-related conspiracy beliefs in Polish society
Authors: Duplaga M , Wilk M , Zwierczyk U , Kowalska-Duplaga K 
Published: October 2023

Abstract

Background
The COVID-19 pandemic showed that health denialism and conspiracy beliefs may influence adherence to preventive measures. Many variables have been considered as determinants of conspiracist attitudes. This study aims to assess the determinants of conspiracy beliefs related to vaccination (Vaccine Conspiracy Beliefs Score, VCBS) in Polish society during the COVID-19 pandemic.

Methods
The analysis was based on data from the online survey conducted in November 2021 in a representative sample of adult Internet users. Uni- (ULR) and multivariable linear regression (MLR) models were developed for VCBS. The relationships of health literacy (HL), e-health literacy (eHL), future anxiety (FA), Internet (IU) and social media use (SMU), self-assessed health status (SAHS), and prevalence of chronic disease (CD) with VCBS were assessed after adjusting for sociodemographic variables and political sympathies. B coefficient (B) and 95% confidential intervals (95%CI) are reported here for MLR.

Results
The study sample of 2189 comprised 51.2% of women and 26.1% of persons with a University education. The mean age (standard deviation, SD) of respondents was 44.1 (15.25) years; VCBS - 3.77 (1.52), eHL score - 28.91 (10.63), and FA score 4.75 (1.27). MLR revealed that VCBS was significantly associated with HL but not eHL. VCBS was higher in persons with inadequate HL than those with sufficient HL (B; 95%CI: 0.66; 0.36 - 0.95). Greater FA was also associated with higher VCBS (0.08; 0.03 - 0.13). Interestingly, less duration of IU (the lowest vs. the highest use: 0.47; 0.08 - 0.85) but more intense SMU (frequent vs. infrequent use: 0.31; 0.11 - 0.51) predicted higher levels of VCBS. Finally, SAHS and CD were not significant predictors.

Conclusions
Health literacy remains a key modifiable determinant of the prevalence of conspiracy beliefs related to vaccination. Effective measures counteracting conspiracy beliefs should be considered in future public health challenges.

Key messages
• Developing adequate health literacy may be an efficient measure counteracting unfavorable impact of conspiracist thinking on the acceptance of vaccinations.
• Health denialism manifesting with conspiracy beliefs should be treated as a target for public health interventions during pandemics.
Methodological challenges in collecting and analysing data on child unintentional injuries: Insights from the CHILD Vigilance project (CHIVI) on parents’ attitudes and practices
Authors: Alves T , Papadakaki M , Silva S , Braz P , Vagionaki K 
Published: October 2023

Abstract
Injuries are among the top ten conditions affecting children according to WHO's latest evidence on years lived with disability. Despite this fact, EU countries are still missing strong information systems for enabling efficient response to the problem. Data on child unintentional injuries are still inconsistently collected in Europe due to substantial deficiencies in injury surveillance data as well as differences in coding systems and legal policies on reporting requirements. Apart from specific countries (e.g. Norway) there is no population-based monitoring of child unintentional injuries in Europe, while initiatives to collect EU-wide information on child unintentional injuries such as the Eurosafe study, seems to be scarce. Improving data availability will require greater investments in country health information systems, vital statistics systems, and household survey programmes. Technical advisory groups indicate the need to develop standard data collection procedures and ensure that indicators are harmonised across global initiatives. Building country capacity in collecting, analysing and increasing the use of child injury data for decision making at global, regional, and national levels, is important. The current presentation will discuss the methodological challenges identified in collecting and analysing data on child unintentional injuries based on the CHILD Vigilance project (CHIVI), which is being conducted in two countries (Portugal, Greece) under the umbrella of EUPHA INJ and aims at assessing parenting attitudes and supervision practices in children aged 0-14 years. Based on 577 valid responses, involving 890 children (53.1% male; 46.8% female) the study revealed major challenges in defining child unintentional injuries, identifying validated tools to accurately measure injuries and their impact on children as well as the challenges in defining the most appropriate determinants of child unintentional injuries.