bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal Oral Health and Global Oral Health: Policy Perspective
Authors: Ramphoma K , Lee H 
Published: October 2022

Abstract

Background and problems
The findings of the last South African National Children Oral Health Survey conducted between 1999 and 2002 indicated a national prevalence of dental caries at 60% among 6-year-olds, with over 80% of untreated caries. Various studies have shown that one of the successful strategies in preventing dental caries is intervention during pregnancy by providing prenatal oral health education.

Importance and opportunities
To successfully mitigate the challenge of ECC, South Africa needs a holistic approach strategy that will integrate oral health services into existing general health programmes, especially into antenatal care (ANC). South Africa National Oral Health Policy and Strategy states that “Integrate oral health strategy elements and strategies into programmes and policies of all sectors that impact community health like maternal and women's health.” All government health care facilities offer free essential ANC services, identifying risk factors relating to poor maternal and birth outcomes. This existing infrastructure can be utilized to deliver oral health education and care for expecting mothers as essential ANC services.

Solution
The Public Oral Health Forum, a non-profit organization in South Africa, seeks to develop maternal and oral health policies that can be aligned with its research and policy development strategy. It proposes maternal oral health policy and strategies, which could be applicable in the South African context: Education of pregnant women, prenatal providers, and dental and medical students about perinatal and infant oral health, integration of oral health in primary health care services, interprofessional workforce development and research to improve oral health and access to dental care among pregnant women and new mothers. This presentation will demonstrate how such maternal oral health policy and strategy are developed, aligning with existing policy and infrastructure in South Africa.
4.P. Workshop: Health promotion policy implementation evaluation: tools, challenges and futures directions
Authors:   Organised by: University of Limerick (Ireland),   Chair persons: Aurélie Van Hoye (Ireland), Catherine Woods (Ireland)
Published: October 2022

Abstract

Background
Public policies can enhance opportunities for the whole populations to be more health promoting. They are important tools as they tackle the upstream component of health promotion behaviours to influence the environment and opportunities for the general population. Research has focused on policy development and content, but less on its implementation process and s evaluation. These latter steps are necessary for policy accountability, would serve policy-making process and strengthen policy impact for real change.

Objectives
The objectives of the workshop are to present different methods and toolkits allowing the evaluation of policy implementation at national level.

Workshop format
The workshop will include 4 presentations, with two systematic reviews and two tool presentation, to offer opportunities to the audience to understand both theoretical and methodological perspective and applied process in regard to health promotion policy evaluation and implementation evaluation. First, a systematic literature review considering the fitting framework for implementation of policies promoting health nutrition and physically active lifestyle will describe the components and scope of 18 policy implementation frameworks. Second, a systematic literature review on methods of physical activity policy monitoring will help us to learn from the analysis of 112 studies on research-driven, government-driven or co-production approaches, their strengths and weaknesses. The third presentation will introduce the Physical Activity Environment Policy Index, a tool to monitor and benchmark policies to improve the healthiness of physical activity policy environment, as well as provide guidance on how to use it. The fourth presentation will present the health promoting sports clubs national audit tool, aimed at reviewing policy supporting sports clubs to promote health, and present preliminary results from its use in Ireland. During the presentation we will pose questions to the audience, encouraging them to apply the theory/tools to their own context, and to spark conversation and interaction as part of the workshop. After the presentations, questions from the audience will be discussed with each presenter, and a discussion will be open in terms of future challenges for health promotion policies implementation evaluation.

Key messages
• Guidance is needed to evaluate health promotion policies implementation to improve practice, as well as development of framework and methods to build toolkits.
• Policy implementation evaluation is key for improving policy making process.
Impact of COVID-19 on hospitalisation for diverse conditions in European countries
Authors: Lyons RA , Schmidt AE , Aldridge S , Mathis-Edenhofer S , Estupiñán-Romero F , Thissen M , Gissler M , Palmieri L , Majek O 
Published: October 2022

Abstract

Background
The COVID-19 pandemic has had an unprecedented impact on Europe. Health systems came under strain, with non-urgent treatments postponed and resources reserved for treatment of COVID-19 patients. Delayed care seeking has been reported, for fear of infection with SARS-CoV2. Yet, the scale of this impact remains under researched. This study aims to compare indirect effects of the pandemic in a European cross-country study aiming to highlight the potential of Population Health Information Research Infrastructures (www.phiri.eu).

Methods
Focusing on (i) major vascular events (MVE) and (ii) elective surgery for joint replacements (ESJR) as well as (iii) serious trauma this study analyses individual level hospital data in a standardised harmonised data model. We compared pre-pandemic incidence rates (2018-2019) with rates for 2020 and 2021. Analyses are systematically contrasted with SARS CoV2 incidence rates, and policy measures taken based on the OxCGRT index.

Results
A drop in hospital discharge rates was observed during the pandemic in all countries but differing by condition and month. Socio-economic differences also varied by condition. Our evidence suggests that periods of more severe policy measures also correlated with more dramatic drops in regular hospital activities.

Conclusions
Our findings provide new insights on the dramatic level of de-prioritisation of essential services faced by non-COVID-19 patients in Europe. From a public health perspective, hospital escalation plans should be developed early on to avoid negative mid and long-term health and financial consequences of indirect effects. The study demonstrates the tremendous potential in exploiting health information systems in a systematic way across countries and the value of the PHIRI system. Further research should investigate policy trade-offs involved in severe lockdown measures during a pandemic and variations in health service resilience for future pandemic preparedness.
Impact of the COVID-19 pandemic on perinatal health and perinatal health inequalities in Europe
Authors: Zeitlin J , Philibert M , Rihs TA , Draušnik Ž , Gatt M , Engiom HM , Recape J , Szamotulska K , Barros H , Gissler M 
Published: October 2022

Abstract

Background
The COVID-19 pandemic and lockdowns may adversely affect pregnancy outcomes due to disrupted healthcare provision and increased stress, anxiety and economic hardship. We assessed changes in perinatal outcomes in 2020 using population birth data in Europe.

Methods
25 Countries in the Euro-Peristat Network implemented a federated analysis using routine national data. Countries generated anonymised aggregate data files using R scripts from individual-level data formatted to a common data model with 22 variables. We compared preterm birth, stillbirth, neonatal death and caesarean delivery rates in 2020 to 2015-2019 for 2 periods: full-year (FY) and pandemic (March-September [MS]). Data from October onward were not included in the MS period because potentially declining pandemic-related fertility may affect perinatal indicators. Country-specific relative risks (RR) for the periods, adjusted for linear trends, overall and by socio-economic (SES) group, were calculated and pooled using random effects meta-analysis.

Results
Preterm birth rates decreased slightly (pooled RR: 0.97FY [95% confidence interval (CI) 0.95-0.99]; 0.98MS [0.96-1.00]) in 2020. Heterogeneity was high (I2FY=85%; I2MS=70%), with 5 countries experiencing significant declines. Neonatal mortality rates were unchanged (0.97FY [0.92-1.01]) while stillbirth rates were higher (1.05FY [1.01; 1.09]; 1.10MS [1.02; 1.19]). Caesarean rates were slightly raised (1.02FY [1.00-1.03]; 1.02MS [0.99-1.04], 5 countries had significant increases). Increases for stillbirth were more pronounced in the lowest (1.08FY [0.99-1.16]) versus highest SES group (1.05 FY [0.93-1.17]).

Conclusions
In 2020, there was an unexpected decline in preterm birth in some countries, while increases in stillbirths and caesarean occurred in others. High country-level heterogeneity suggests that some government policies to mitigate the pandemic might have been more protective of pregnant women and newborns than others.
Policy to cover perinatal care costs: a quasi-experimental study on adverse newborn health outcomes
Authors: Epure AM , Courtin E , Wanner P , Chiolero A , Cullati S 
Published: October 2022

Abstract

Background
Low birth weight (LBW) and preterm birth are associated with an increased risk of neonatal death and chronic conditions across the life course. Reducing LBW is a global public health priority and requires strategies to improve healthcare during pregnancy. We aimed to assess the effect of a health policy providing full coverage of illness-related costs from 13 weeks of gestation through 8 weeks postpartum on birth outcomes and neonatal mortality in Switzerland.

Methods
We applied a regression discontinuity design to administrative data gathered as part of a Swiss research program (NCCR on the Move). We included all children (N = 166,709) born between March 1, 2013 and February 28, 2015. The outcomes were birth weight (BW), gestational age (GA), LBW (&lt;2,500 g) and very low birth weight (VLBW; &lt;1,500 g), preterm (&lt;37 weeks of gestation), and extremely preterm (&lt;28 weeks), and neonatal (≤ 28 days) death. Children were exposed to the policy if they were born from March 1, 2014 onwards. We estimated the intention-to-treat effect of the policy using parametric regression models.

Results
Children had a mean BW of 3,291 g and mean GA of 275 days. The prevalence of LBW was 6.4%, VLBW 1%, preterm 7.2%, and extremely preterm 0.4%, respectively. Some 0.3% newborn died within one month. The policy increased BW (mean difference =13 g [95% confidence interval (CI): 1, 25]) and decreased the risk of LBW (odds ratio [OR]=0.89; 95% CI: 0.82, 0.98) and VLBW (OR = 0.81; 95% CI: 0.64, 1.01). Additionally, the policy slightly decreased the risk of preterm birth (OR = 0.94; 95% CI: 0.87, 1.03), while it did not affect GA. Effect estimates for extremely preterm and neonatal mortality were imprecise and inconclusive.

Conclusions
This quasi-experimental and population based-study of 166,709 live births between 2013 and 2015 in Switzerland provides evidence of a reduction in the risk of LBW, VLBW and preterm birth thanks to a health policy that fully covered healthcare services during maternity.

Key messages
• Free access to healthcare during pregnancy may mitigate adverse newborn health outcomes.
• A Swiss health policy that fully covered healthcare services during pregnancy reduced the risk of low birth weight and preterm births.
Monitoring the reproduction number of COVID-19 in France: estimates compared from 3 datasets
Authors: Bonaldi C , Fouillet A , Sommen C , Lévy-Bruhl D , Paireau J 
Published: October 2022

Abstract

Background
The effective reproduction number (Rt) represents the average number of secondary cases generated by an infected person. During an outbreak, near-real-time monitoring of Rt constitutes a key indicator for detecting changes in disease transmission and assessing the effectiveness of interventions. The estimation of Rt usually requires identifying infected cases in the population which is in practice challenging from available data. The purpose of this study was to compare Rt estimates for COVID-19 surveillance in France based on three data sources of different sensitivity and specificity for identifying infected cases.

Methods
By applying a statistical method developed by Cori et al., we estimated Rt using (1) confirmed cases identified from positive virological tests among the tested population (2) suspected cases recorded by a national network of emergency departments (3) hospital admissions for COVID-19 recorded by a national administrative system to manage hospital's organization.

Results
From June 2020 to March 2022, the estimates of Rt in France showed similar temporal trends regardless of the dataset. Estimates based on the daily number of confirmed cases provided an earlier signal that the two other sources, with a lag of 3 and 6 days compared to estimates based on emergency department visits and hospital admissions, respectively.

Conclusions
The COVID-19 experience has proven that monitoring temporal changes in Rt was a key indicator to help public health authorities controlling the outbreak in real time. Having data on infected people in the population to estimate the Rt is not straightforward in practice. As this study has shown, the opportunity of using more readily available data, provided that it is highly correlated with the spread of infection, gives a practical solution for monitoring the COVID-19 epidemic and any epidemic in general.

Key messages
• The effective reproduction number (Rt) is a key parameter to monitor transmission during epidemics but its estimation from available data is often a critical issue.
• Based on COVID-19 experience, data sufficiently correlated with the spread of infection may be appropriate to estimate Rt and monitor its temporal trend.
Establishing intersectoral ‘Schools Teams’ to mitigate SARS-CoV-2 school transmission, 2020/2021
Authors: Kelly C , Naughton P , Kennedy E , Ward M 
Published: October 2022

Abstract

The SARS-CoV-2 pandemic disrupted the lives of up to 100,000 school-going children in Ireland. Consequently, intersectoral ‘Schools Teams’ were established for the 2020/2021 school year to reduce SARS-CoV-2 transmission in school settings. This novel public health intervention provides learning to inform future cross-sectoral collaborative work in Public Health in responding to infectious disease threats. For the 2020/2021 school year in Ireland, intersectoral Schools Teams were formed within each of eight regional Departments of Public Health to manage mitigation of SARS-CoV-2 transmission in school settings. These teams comprised of staff from Departments of Public Health and redeployed staff from the Department of Education. A nationally agreed schools process was followed by Schools Teams to manage SARS-CoV-2 cases and outbreaks in schools. Relevant cases were referred to the regional Schools Team for a public health risk assessment (PHRA). Close contacts were determined using appropriate definitions of close contact within a school setting through the PHRA. This model with centralised procedures and linked health/education teams was novel and adaptable to additional settings. Results from the East region of Ireland showed testing of close contacts of COVID-19 was conducted in 71.8% (676/942) of schools, with 43881 tests completed. Most Schools Team members reported efficient communication within the team (88.7%), a positive team culture (96.3%) and feeling comfortable in their roles following training (82.7%). The majority of members felt the team was able to effectively support schools to reduce COVID-19 transmission (92.5%). Lessons learnt include the synergistic working of educational and health professionals towards a common goal, maximising the skills of all, ensuring a better outcome for school children. Involving educational teams in active contact tracing of COVID-19 cases in schools maximised engagement of the educational sector in the COVID-19 response.

Key messages
• Establishing intersectoral ‘Schools Teams’ pooled skills, resources and expertise, enabling development of synergistic solutions to a complex problem.
• This exemplifies a large national cross-sectoral collaborative working process involving education and public health sectors, providing a model for future responses to infectious disease threats.
Risk of SARS-CoV-2 reinfection 18 months after first infection: population-level observational study
Authors: Flacco ME , Acuti Martellucci C , Soldato G , Di Martino G , Carota R , Caponetti A , Manzoli L 
Published: October 2022

Abstract

Background
Current data suggest that SARS-CoV-2 reinfections are rare. Uncertainties remain, however, on the duration of the natural immunity, its protection against Omicron variant, and on the impact of vaccination to reduce reinfection rates.

Methods
In this retrospective cohort analysis of the entire population of an Italian Region, we followed 1,293,941 subjects from the beginning of the pandemic to the current scenario of Omicron predominance (up to mid-February 2022). We assessed the proportion of reinfections overall, and by demographic and clinical characteristics, time after primary infection, and predominant circulating variant. Cox proportional hazard analysis was used to compute the relative hazards of reinfection.

Results
After an average of 277 days, we recorded 729 reinfections among 119,266 previously infected subjects (overall rate: 6.1‰), eight COVID-19-related hospitalizations (7/100,000), and two deaths. Importantly, the incidence of reinfection did not vary substantially over time: after 18-22 months from the primary infection, the reinfection rate was still 6.7‰, suggesting that protection conferred by natural immunity may last beyond 12 months. The risk of reinfection was significantly higher among females, unvaccinated subjects, and during the Omicron wave.

Conclusions
This study confirms and expands previous findings reporting a low risk of SARS-CoV-2 reinfection, and a very low risk of severe or lethal COVID-19 for those who recovered from primary infection, suggesting that the protection conferred by the natural immunity lasts beyond 12 months. Although the marked increase of the reinfection rates during the Omicron wave is concerning, the risk of a secondary severe disease or death remained close to zero. Vaccines were able to significantly reduce the likelihood of reinfection in both pre-Omicron and Omicron waves, although the risk-benefit profile of multiple vaccine doses for this population should be carefully evaluated.

Key messages
• After primary infection, the risk of SARS-CoV-2 reinfection and of severe/lethal COVID-19 was low, suggesting that natural immunity lasts beyond 12 months.
• Despite increasing reinfection rates with Omicron, the risk of a secondary severe/lethal disease was close to zero, and vaccines reduced the likelihood of reinfection before and during Omicron waves.
Health, Architecture and Wellbeing: building bridges between health and the design of living spaces
Authors: Leão T , Neiva A 
Published: October 2022

Abstract

Background
Health is determined by where we live. Nevertheless, medical and architecture students often ignore the relation between health, housing and urban planning. In order to bridge these areas, we designed an interdisciplinary course for students of University of Porto Medical and Architecture schools, winning a 2021 Pedagogic Innovation courses call.

Objectives
”Health, Architecture and Wellbeing” aimed to explore the effect of living spaces in health, combining the health and architecture perspectives in the analysis of case studies, and discussing strategies to improve health and wellbeing of the population. By exposing students to tools for designing healthy, sustainable, efficient and accessible spaces, and to public participation strategies, we aimed to foster awareness and share knowledge among complementary scientific fields.

Results
Students were exposed to theoretical and practical sessions with experts from the medical, architecture, landscape architecture, and geography areas, as well as to field visits in social neighbourhoods, collective housing, and green spaces. Besides introducing students to concepts, as health needs and determinants, and to healthy and accessible design methods, students interacted with inhabitants, gathering experiences on how they lived in those spaces, understanding its impact on their wellbeing, while exploring the enablers and barriers of participation strategies. Students were encouraged to complement technical architecture competences with public health evidence, and social participation leading to the development of design proposals improving the existing living environments.

Conclusions
“Health, Architecture and Wellbeing” interdisciplinary course connected public health expertise with architecture, promoting knowledge dissemination and awareness among health and architecture students. This experience may be reproduced in other countries, as health continues to be determined by living and public spaces.

Key messages
• Bridging public health with other disciplines is fundamental to understand the origin of health issues, namely living conditions, and maximise the opportunities of acting near their root causes.
• This course allowed architecture and medical students to gain awareness about the impact of housing and urban design on people’s health, and to learn how to propose and design healthier environments.