bluuebunny/crossref_metadata_2025_split huggingface dataset:
Framework for federated causal inference based on real-world observational data sources (BY-COVID)
Authors: Meurisse M , Estupiñán-Romero F , Van Goethem N , González-Galindo J , Bernal-Delgado E 
Published: October 2023

Abstract

Background
Causal inference techniques help researchers and policy-makers to evaluate public health interventions. Approaching causal inference by re-using routinely collected observational data across different regions is challenging and guidance is currently lacking. With the aim of filling this gap and allowing a rapid response in the case of a next pandemic, a methodological framework to estimate causal effects in a federated research infrastructure is showcased in the baseline use case of the European BY-COVID project.

Methods
A framework, implementing existing methodologies and expertise, is proposed, enabling federated research based on routinely collected sensitive individual-level data. The framework includes step-by-step guidelines, from defining a research question, to establishing a causal model, identifying and specifying data requirements in a data model, and developing an interoperable and reproducible analytical pipeline for distributed deployment. Using open-source software, a complete workflow implementing federated causal inference was prototyped to assess the real-world effectiveness of SARS-CoV-2 primary vaccination in preventing infection in populations spanning different countries, integrating a data quality assessment, imputation of missing values, matching of exposed to unexposed based on identified confounders and a survival analysis within the matched population.

Results
The proposed methodological framework was successfully demonstrated within the BY-COVID use case, illustrating its feasibility and value. Different Findable, Accessible, Interoperable and Reusable (FAIR) research objects were produced, such as a study protocol, a data management plan, data model and interoperable analytical pipeline.

Conclusions
The framework provides a systematic approach to address policy-relevant causal research questions in a privacy-preserving way. The methodology and derived research objects can be re-used and contribute to pandemic preparedness.

Key messages
• Estimating causal effects using observational data in a privacy-preserving way was demonstrated to be achievable and can help policy-makers to evaluate public health interventions.
• The methodology, constituted of Findable, Accessible, Interoperable and Reusable (FAIR) research objects, is generalizable to other research questions and contributes to pandemic preparedness.
What Works overviews: Opportunities and Challenges
Authors: Van Dale D , Leenaars K 
Published: October 2023

Abstract
In the Netherlands in 2007 the RIVM established a good practice portal for Health promotion and Disease prevention. In this portal we present the effectiveness, quality and feasibility of programmes or interventions with all the material needed for implementation. However, evaluation and usability studies showed that health promotion practitioners and decision makers needed not only practices but also overviews of options for evidence based actions for health topics and specific target groups in diverse settings for their policy plans.
In 2016 we started to develop What works overviews for several topics The What works overviews consist of:
• A report of a systematic review for a specific topic, target group and setting, e.g., Alcohol prevention for children aged from 12-18 years.
• Overview of the results on the website of Healthy Living website (loketgezondleven.nl) with
- An overview of recommendations: what works, what doesn’t work and what is still uncertain?
- Overview of integrated policy actions
- Good practices or examples of municipalities and schools preferable from our portal
In this workshop we will show how we develop the What Works overview, the results of a usability study and the challenges we have with the dissemination, keeping up the data and funding.
Access Game
Authors: Paiva Neto F 
Published: October 2023

Abstract
This activity will last 40 minutes. The Access game and easy to play and aims to discuss and trigger reflections about the path of people with mental care needs seeking access and integrality of care in health system. Histories of three characters who represent people seeking access to mental health care in Primary health care (PHC) will be presented. The board game will be set up on the floor, allowing participants to walk around the board, which will represent the path do access PHC. During the game, participants will find figures that illustrate and trigger discussions about the barriers of access to mental health care, as well as PHC's strengths and strategies to overcome these barriers and guarantee integrality of care. Figures that illustrate PHC strengths and strategies (ex: community health worker, collaborative care, and intersectionality) make the player move forward, while those that represent characters’ access barriers to the service [eg: stigma, low professionals’ skills and supply-based management (and not on the population needs)] make the player return some squares. Also, players will be invited to share examples of their professional experiences, pointing out what barriers were identified and strategies that contributed to overcome it. By sharing their experiences, participants will advance a few more spaces. Game's components are: 1 board, 1 dice, 3 characters that represent people who use the health service, and cards with illustrations and explanatory texts. The winner will be the one with the character that manages to overcome the barriers and improve access based on the strengths PHC elements, arriving first at the end of the journey, which is represented by access to integrality of care. Participants will have the opportunity to recognize which strategies contribute to overcome mental health care access barriers. Thus, even if there is only a winner, everyone wins, taking the knowledge acquired in the discussions to their professional practices.
8.B. Workshop: Fit for purpose surveillance - strategies to implement effective surveillance systems in EU/EEA countries under the new Serious Cross Border Health Threats Regulation (2022/2371)
Authors:   Organised by: HaDEA, European Commission,   Chair persons: Isabel de la Mata (European Commission - DG Sante)
Published: October 2023

Abstract

Background
As part of the European Health Union package, the EU Regulation 2022/2371 on serious cross-border threats to health has entered into force on 26 December 2022. Chapter III (Articles 13-17) of this Regulation provide new provisions for Epidemiological surveillance, the Digital platform for surveillance, and EU reference laboratories.

Methods
Several Implementing Acts are currently in preparation, which will define in more detail the concrete implementation of these provisions, such as the list of communicable diseases, case definitions, procedures for the operation of the epidemiological network for epidemiological surveillance, the specifications of the digital platform for surveillance and its specific rules for functioning, as well as to designate EU reference laboratories. Via the EU4Health Programme, the European Commission is furthermore providing funding for Integrated Surveillance, Surveillance capacity building

Results
The workshop will inform on the current state of implementation, on the results of the preparatory works carried out so far as well as on an outlook to the short and longer term plans for the implementation of the regulation on serious cross-border threats to health. Furthermore, it will inform on a funding mechanism for the improvement of EU Surveillance Systems as one of the central lessons learnt from the COVID-19 pandemic and showcase a good national practice.

Conclusions
The COVID-19 pandemic has clearly illustrated that the creation and further development of sound, reliable, integrated and real-time digital surveillance systems are a very crucial component for preparedness against serious cross border health threats. The current work under the new regulation is a valuable opportunity for public health practitioners to improve surveillance at EU, national and regional level.
The workshop will host panel presentations followed by a round-table discussion.
What's Next and the Quest for 2030 SDG Attainment
Authors: Lyshol Heidi 
Published: October 2023

Abstract

Time is running out to achieve the 2030 SDGs. Data are lacking for many SDG indicators, and data are often outdated or presented with a time lag. The WHO European Region is comprised of 53 countries whose health systems and priorities differ; devising a perfect common indicator framework is difficult. The European Programme of Work Measurement Framework is a set of 26 indicators chosen for data availability. The EPWMF reports on the SDG indicators most relevant to the Region. All indicators can be sourced from existing data collections, presenting no extra burden to Member States (MS). WHO proposes two key processes: 1) develop a European Region Health Information Network with membership from all MS and WHO collaborating centers, research institutions, and international organizations. This will improve the quality of health information through international cooperation and knowledge exchange. As the three country stories have shown, we have much to learn from each other. 2) develop a list of SDG indicator areas for which limited data exist across the Region. Main principles: (1) Organize development work as a long-term, institutionalized activity embedded in regular structures and processes of WHO/Europe; (2) Ensure strong involvement of MS so indicators reflect their priorities and any adaptations to data collections are feasible and agreed upon; (3) Ensure strong involvement of international organizations to prevent duplication of work and increased reporting burden; (4) Align development with policy processes to ensure coherence between WHO policy, monitoring and evaluation frameworks and (5) Create flexible structures bringing together relevant experience through working in topic-specific expert groups, utilizing lessons learned from HIS assessments to create realistic indicators that can measure progress. Thus, we will move towards 2030 with a clear plan for developing concrete indicators to ensure all MS can report on the SDGs.

Speakers/Panelists
Heidi Lyshol
Norwegian Institute of Public Health, Oslo, Norway
“The worst has already happened”: communicating sensitively with bereaved survey participants
Authors: O'Ceallaigh D , Verling A M , Marley E , Mason T , Tuohy E , Rohde D 
Published: October 2023

Abstract

Issue
The National Care Experience Programme asks people about their experiences of health and social care services, including maternity bereavement and end-of-life care. The surveys aim to identify areas of good experience, as well as areas requiring improvement. Implementing surveys on sensitive topics involves a duty of care to participants to ensure the highest ethical standards and sensitive communication with bereaved parents and relatives.

Description of the problem
Under General Data Protection Regulation, there is an obligation to be transparent with people in the event that they are invited to participate in a survey. This must be balanced with sensitive and respectful communication with those who have experienced a loss. The mode of contact and timing of surveys requires careful consideration.

Results
Bereaved parents and relatives, support organisations and subject matter experts were engaged with extensively to inform the National End of Life Survey and National Maternity Bereavement Experience Survey, including the mode of contact with eligible parents and relatives and the timing of surveys. A detailed communications plan was developed to share information across social media platforms, radio and relevant websites. Communication about the survey balanced key messages on the aims, methods and eligibility criteria with a sensitive and time-appropriate delivery.

Lessons
Both surveys asked about the lived experiences of significant, traumatic life events. Participation had the potential to place an emotional burden on participants, who had to relive their experiences of loss. In order to limit the potential harm, bereaved parents and relatives were involved in all stages of the survey development process. Information on support services was included with all survey invitations and documentation. Strong response rates highlight a willingness amongst bereaved parents and families to share their experiences to inform improvements to care.
Generating actionable evidence from free-text feedback to improve maternity and acute hospital experiences: A computational text analytics & predictive modelling approach
Authors: Ojo A , Rizun N , Isazad Mashinchi M , Walsh G S , Gruda D , Narayana Rao M , Venosa M , Foley C , Rohde D , Flynn R 
Published: October 2023

Abstract

Background
Patient experience surveys are a key source of evidence for supporting decision-making and quality improvement in healthcare services. These surveys contain two main types of questions: closed and open-ended, asking about patients’ care experiences. Apart from the knowledge obtained from analysing closed-ended questions, invaluable insights can be gleaned from free-text data. Advanced analytics techniques are increasingly used to harness free-text data, yet existing approaches do not offer the rigour required to support formal decision-making through free-text.

Methods
This study addresses the challenge of effectively and rigorously analysing patients’ free-text feedback to improve maternity and acute hospital services in Ireland. Aspects of healthcare services (i.e. themes) that could be improved were determined using computational text analytics and predictive modelling. Themes extracted from comments were prioritised based on volume, the intensity of negative affect expressed in the texts, and the estimated influence of the themes on overall patient satisfaction.

Results
Results demonstrate the viability of producing rigorous evidence for prioritising interventions to improve healthcare services based on free-text feedback. Specifically, consistency in advice and support in breastfeeding were among the most important issues for maternity services. For acute hospital services, meals quality and access, A&E waiting time, ward hygiene and communication at discharge were among the most important issues. Women also wanted more emphasis on prior birth experience and complications in future maternity care surveys.

Conclusions
Advances in computational text modelling enable the extraction of concrete and actionable insights from the analysis of free-text data. This approach also allows decision-makers to prioritise emergent themes and inform actions that will positively impact overall patient satisfaction.
Subtle industry interference in public health: the case of the alcohol industry
Authors: Ghandour L 
Published: October 2023

Abstract
Upstream drivers of alcohol consumption forcing people to consume alcohol frequently and excessively and experience alcohol-related harms are in fact all industry-related factors: easy physical access to alcohol, cheap alcohol beverage pricing, and heavy alcohol advertising and promotion. Unequivocal evidence exists on how these visible industry tactics effectively allow the infiltration of alcohol products into the market, targeting specific subgroups (women, youth), increase total per capita consumption and subsequently alcohol-related morbidity and mortality. This presentation will highlight using country cases and various examples the more subtle mechanisms in which the industry has successfully been interfering with nations’ progress in alcohol policy (e.g., NoLo beverages, interfering with WHO definitions, using SDGs to foster partnerships). Using the whole-of-government whole-of-society approaches, the presentation will also present evidence-based multi-sectoral actions (their facilitators and barriers) for more effective national alcohol policy. Given that alcohol is no ordinary commodity, the presentation will end with implications for policy to counterbalance global alcohol industry interference and support national actions.
Cancer risk according to fasting blood glucose trajectories: a population-based cohort study
Authors: Khong T , Oh J-K , Bui T , Kang H-Y , Park E 
Published: October 2023

Abstract

Background
Diabetes mellitus is known to increase the risk of cancer. Fasting blood glucose (FBG) levels can be changed over time. However, the association between FBG trajectory and cancer risk has been insufficiently studied. This research aims to examine the relationship between FBG trajectories and cancer risk in the Korean population.

Methods
We analyzed data from National Health Insurance Service-National Health Screening Cohort collected between 2002 and 2015. Group-based trajectory modeling was performed on 256,271 Koreans aged 40 to 79 who had participated in national health examinations at least three times from 2002 to 2007. After excluding patients with cancer history before 2008, we constructed a cancer-free cohort. The Cox proportional hazards model was applied to examine the association between FBG trajectories and cancer incidence, after adjusting covariates. Cancer case was defined as a person who was an outpatient thrice or was hospitalized once or more with a cancer diagnosis code within the first year of the claim.

Results
During the follow-up time (2008-2015), 18,991 cancer cases were identified. Four glucose trajectories were found: low-stable (mean of FBG at each wave &lt;100 mg/dL), elevated-stable (113-124mg/dL), elevated-high (104-166mg/dL), and high-stable (&gt;177mg/dL). The high-stable group had elevated risks in multiple myeloma, liver and gastrointestinal cancer, with hazard ratio (HR): 4.09 (95% confidence interval (CI): 1.40-11.95), HR: 1.68 (95%CI: 1.25-2.26) and HR: 1.27 (95%CI: 1.11-1.45) respectively. In elevated-stable group, the risk increased for all cancer (HR: 1.08, 95%CI: 1.02-1.16) and stomach cancer (HR: 1.24, 95%CI: 1.07-1.43). Significant associations were also found in the elevated-high group with oral (HR: 2.13, 95%CI: 1.01-4.47), liver (HR:1.50, 95%CI: 1.08-2.08) and pancreatic cancer (HR:1.99, 95%CI: 1.20-3.30).

Conclusions
Our study highlights that the uncontrolled high glucose level for many years may increase cancer risk.

Key messages
• Individuals in the prediabetes stage may be at an increased risk of developing cancer.
• Fasting blood glucose trajectories may be a predictive factor for the development of digestive cancer.
Factors linked to future care conversations with others in Ireland: Age and gender differences
Authors: Pilch M , Wards M , Doyle F , Thomas S , Kenny R A , May P , Hayes C 
Published: October 2023

Abstract

Background
Ireland needs evidence-based strategies for meaningful engagement in ACP activities. This study aimed to identify factors associated with conversations with trusted others among older adults in Ireland.

Methods
Data from the Irish Longitudinal Study on Ageing (TILDA), a nationally representative study of community-dwellers (≥50 years old), was used. Participants who consistently reported ACP conversations with trusted others at Waves 4 and 6 (n = 2764) were included. Binary logistic regression was carried out using these conversations as a dependent variable (categorised as engagement/non-engagement). The results of a mixed-research synthesis informed selection of explanatory variables; including age, gender, education, health literacy, pain, making a will, religiosity, wish to die, and marital status. Data were stratified by gender and aged groups.

Results
Although men (n = 1242) were 58% less likely to engage in conversations with trusted others, there was a 4% increase in odds of their engagement per year older. Younger participants (≤64) who made a will were 99% more likely to report ACP conversations. Those who were ≤74 years old and reported pain were 42% more likely to engage. Men and younger participants (50-64) who ever experienced a wish to die were over twice as likely to report ACP. Similarly, men and those &gt;74 years old with a third level education were twice as likely to engage. For every additional score on the health literacy scale, women were 56% more likely to report ACP. Younger participants (50-64) for whom religion was somewhat important were 36% less likely to engage. While single women were 49% less likely to engage, separated, divorced, or widowed women were 43% more likely to report ACP.

Conclusions
This study identified theoretically important factors associated with ACP conversations with loved ones in Ireland and highlighted gender and age groups differentials. These findings will inform policy and ACP intervention development.

Key messages
• Increasing age, female gender, third level education, health literacy, having a will, pain, and a wish to die facilitate ACP conversations. Religiosity and being single impede these conversations.
• The findings should inform the design of local ACP interventions. They suggest the need to tailor future ACP strategies to the requirements of specific gender and age groups.
Leisure activities and mental well-being among adolescents across Norwegian municipalities
Authors: Myhr A , Haugan T 
Published: October 2023

Abstract

Background
Engagement in organized leisure activities (OLAs) may benefit health and well-being in adolescents. The social inequalities in OLA participation, and growing share of non-participants, is a public health concern in Norway. Thus, the present study aims to examine the association between OLA participation and mental health outcomes, and the interaction effect of overall share of adolescents participating in OLAs at municipal level.

Methods
This study, based on the nationwide Ungdata survey, includes 342,161 adolescents attending lower and upper secondary education in 276 municipalities in Norway between 2019 and 2022. A series of two-level random intercept models were fitted to distinguish the individual and municipality sources of variation in adolescents’ mental well-being measured by depression symptom scores and quality of life.

Results
Adolescents’ participation in OLAs varied considerably between Norwegian municipalities from lowest 33 % to highest 88 %. Being female, increase in age and decrease in family affluence level was negatively associated with both OLA participation and mental wellbeing. Overall, and particularly among girls and the least affluence adolescents, participation in OLAs was associated with higher quality of life and lower depressive symptoms. Among girls, the positive association between OLA participation (at individual level) and mental well-being was most evident in municipalities with high share of adolescents participating in OLAs. The overall share of OLA participants in municipality of residence had no or little impact on boys’ mental wellbeing.

Conclusions
Both the personal leisure involvement and the overall share of individuals participating in OLAs at local community level may impact adolescents mental well-being. Ensuring that all adolescents, regardless of family affluence level and gender, are able to participate in OLAs may promote adolescent's mental well-being that benefits the local public health.

Key messages
• Participation in leisure activities was associated with higher mental well-being in boys and girls, and across the socioeconomic spectrum.
• In girls, highest mental wellbeing was observed among individuals living in municipalities with high share of leisure activity participating, and particularly for those who participates themselves.