bluuebunny/crossref_metadata_2025_split huggingface dataset:
Contribution of compositional changes in the workforce to sickness absence trends in Finland
Authors: Leinonen T , Hartikainen E , Salonen L , Viikari-Juntura E , Solovieva S 
Published: October 2022

Abstract

Background
Information on factors driving work disability trends helps to evaluate the potential of interventions to improve the health and work ability of the workforce. We assessed whether the long-term decrease in sickness absences in Finland is explained by observed and unobserved compositional changes in the workforce.

Methods
Utilising register-based panel data on Finnish private and public sector employees aged 30-62, we examined the annual onset of compensated full sickness absence (granted after 10 working days) in the period 2005-2016. We applied random effects models adjusting for changes in observed sociodemographic factors of the study population. We also applied fixed effects models, with corrections of the estimates for cohort ageing, to additionally account for unobserved time-invariant characteristics of the study population over the years.

Results
Of the observed factors, increases in educational level partly explained the decreasing trend in sickness absences, and more so among women than men and among private than public sector employees. Changes in occupational class and industrial sector played little role in the public sector and only slightly further explained the sickness absence trend in the private sector. The decreasing trend in sickness absences appeared to be largely explained by unobserved time-invariant individual characteristics.

Conclusions
The decrease in sickness absences appeared to be more strongly influenced by compositional changes in factors that are established before fully entering the labour market - such as educational level as well as unmeasured individual characteristics that remain unchanged after childhood and early adulthood - than in the work environment or other factors contributing at working age. Attempts to improve the health and work ability of the workforce should not only rely on interventions directed at the working age population, but also on those carried out early during the life course.

Key messages
• Compositional changes in the workforce should be taken into account when assessing sickness absence trends.
• Interventions aiming to improve the health and work ability of the workforce should be implemented already early in the life course and not only in working age.
Excess costs of multiple sclerosis: A register-based study in Sweden
Authors: Murley C , Tinghög P , Sebsibe Teni FS , Machado A , Alexanderson K , Hillert J , Karampampa K , Friberg E 
Published: October 2022

Abstract

Background and Objective
Population-based estimates of the socioeconomic burden of multiple sclerosis (MS) are limited, especially regarding primary healthcare. This study aimed to estimate the excess costs of people with MS that could be attributed to MS, including primary healthcare.

Methods
An observational study was conducted of the 2806 working-aged people with MS in Stockholm, Sweden and 28,060 propensity score matched references without MS. Register-based resource use was quantified for 2018. Annual healthcare costs (primary, specialised outpatient, and inpatient healthcare visits along with prescribed drugs) and productivity losses (operationalised by sickness absence and disability pension days) were quantified using bottom-up costing. Costs were compared between the people with MS and references with independent t-tests with bootstrapped 95% confidence intervals (CIs) to isolate the excess costs of MS.

Results
The mean annual excess costs of MS for healthcare were €7381 (95% CI: 6991-7816) per person with MS with disease modifying therapies as the largest component (€4262, 95% CI: 4026-4497). There was a mean annual excess cost for primary healthcare of €695 (95% CI: 585-832) per person with MS, comprising 9.4% of the excess healthcare costs of MS. The mean annual excess costs of MS for productivity losses were €13,173 (95% CI: 12,325-14,019) per person with MS, predominately from disability pension (79.3%).

Conclusions
The socioeconomic burden of MS in Sweden from healthcare consumption and productivity losses was quantified, updating knowledge on the cost structure of the substantial excess costs of MS.

Key messages
• Primary healthcare contributes around a tenth of the excess healthcare costs of MS in Sweden, primarily owing to contacts with healthcare professionals other than physicians.
• Overall, the excess costs of MS in Sweden from lost production are larger in magnitude than the excess costs for healthcare consumption.
Networking experiences for promoting HIA implementation in Andalusia
Authors: Martin-Olmedo P , Moya Ruano L , Martin Verdugo E , Rodríguez Rasero FJ , Martín-Jiménez JL , Marchena FJ 
Published: October 2022

Abstract

The Health Impact Assessment (HIA) is a useful tool that allows policymakers and project developers to predict and control the consequences of their proposals on the health and equity of the affected population. The existence of a legislative framework for the institutionalization of HIA has been proposed as a critical factor in providing permanent rules and in legitimizing HIA within the decision-making process. In Andalusia (Southern Spain), the HIA is legally binding after the approval of the Public Health Act 16/2011 and Decree 169/2014, which establishes the HIA procedure in the Andalusian context. This new legal framework made necessary to promote capacity-building programs in HIA, but also to develop an online platform that would allow sharing experiences and knowledge among all those public health professionals involved in the review and approval of HIA reports submitted by the developers of proposals. These tasks were addressed by a leading group of the HIA network made up of officials from the Regional Ministry of Health and experts from the Andalusian School of Public Health (EASP). The platform, set up in 2018, integrates around 90 professionals from different administrative bodies according to the proposal's scope (local, regional), covering the great geographical dispersion of Andalusia, and allowing to evaluate more than 2400 proposals in 4 years. The platform also facilitates the traceability of files (both for improving internal management and in responding to external queries), and acts as a source of relevant evidence, supporting the work of professionals involved in HIA. The platform allows extracting data and generating figures, showing information on the number of files created and resolved by different periods, provinces, type of proposals, etc. This tool has been very useful for the continuous training of professionals involved in HIA in Andalusia, following a coaching approach.

Speakers/Panellists
Robert Otok
ASPHER, Brussels, Belgium
Enablers and barriers associated with high MMR uptake among the Finnish Somali population
Authors: Hussein I 
Published: October 2022

Abstract

Introduction
In Finland, the Somali-speaking community is the fourth largest migrant group after Russian, Estonian, and Arabic-speaking communities. Finland is home to 21,000 Somali-speaking individuals, with around 70 % of them living in the capital region. Even though vaccine uptake in most ethnic minority communities is usually lower, MMR coverage in Finnish Somali children is partly higher than that of ethnic Finns.

Methods
We interviewed 30 Somali-origin mothers living in the capital region of Finland in terms of childhood vaccination acceptance, and in specific, issues affecting their children's MMR vaccine uptake. All interviews were conducted by a Somali researcher either in Somali or Finnish language. The interviews were recorded, transcribed, translated, and analysed using thematic analysis of the transcripts. To understand the enablers presented by the health care system in Finland, 10-15 public health nurses working in maternal and child health clinics in the capital region will be interviewed.

Results and discussion
Preliminary results show that trust in the health care system is the main enabler of high MMR vaccine coverage in the Somali population - even when mother's knowledge of the vaccine was very limited. In terms of information sources, mothers indicated that they ask, and trust maternal and child health clinics in all vaccine-related information- often more than any other source, including the internet.

Conclusions
This study enhances our understanding of system level enablers in the Finnish Somali community regarding MMR vaccination. The results of this study are applicable to improve vaccine uptake in other underserved minority communities throughout Europe.
Reported Barriers and Enablers to Undertaking Childhood Vaccinations by Bangladeshi Parents in East London
Authors: Ali I 
Published: October 2022

Abstract

Introduction
The Bangladeshi community living in the East London borough of Tower Hamlets is one of the UK's most socioeconomically deprived communities. Despite being a highly disadvantaged ethnic group with suboptimal health, the data suggests the uptake of several childhood vaccinations including the MMR vaccine is notably higher amongst this group, relative to other ethnic groups in Tower Hamlets.

Methods
This study employs a qualitative research design. One-to-one, semi-structured interviews will be conducted with Bangladeshi parents, alongside relevant healthcare and public health professionals involved in vaccination delivery in Tower Hamlets to understand the barriers and enablers to childhood vaccinations. Interviews will be conducted in English by the researcher or in Bengali/Sylheti using an interpreter. Interviews will be audio-recorded, transcribed, translated and analysed using a thematic analysis. The socioecological model will be utilised as a theoretical framework to guide the data collection and analysis.

Results and discussion
The preliminary results indicate parental trust in the safety of vaccinations, perceived health importance of childhood vaccinations, ease in accessibility and positive attitudes towards vaccinations within the community are notable enablers. Regarding barriers, parents have expressed reluctance on religious grounds towards childhood vaccinations which contain animal derivatives. The data also suggests differences exist between immigrant and non-immigrant parents in the decision-making process to undertake the vaccinations, with non-immigrant parents demonstrating a higher level of agency in their decision-making.

Conclusions
The study provides valuable insight into the barriers and enablers for childhood vaccinations amongst the Bangladeshi community in Tower Hamlets. This data may inform tailored initiatives to improve childhood vaccination uptake amongst other underserved communities with suboptimal uptake.
Setting targets for population health improvements: Trends in perinatal health in Europe over the past five years
Authors: Szamotulska K , Loghi M , Weber G , Heller G , Zile-Velika I , Isakova J , Monteath K , Jané Checa M , Zhang WH , Gissler M 
Published: October 2022

Abstract

Background
The Euro-Peristat network documented disparities in perinatal outcomes between countries in Europe in its reports published every 5 years, but trend analyses were limited because data were not collected annually.

Methods
Using the Euro-Peristat PHIRI protocol, we estimated rates and assessed trends between 2015 and 2019 for preterm birth, stillbirth, neonatal mortality and caesarean delivery. Country-specific relative risks (RR) for year, modelled as a continuous variable, were estimated and random effects meta-analysis used to generate pooled RRs. Heterogeneity was measured with the I2 statistic (percentage of variability in estimates due to heterogeneity rather than sampling error).

Results
Stillbirth rates ≥24 weeks of gestational age (GA) varied in 2019 from &lt;2.5 per 1000 births in Denmark, Estonia, Finland and Slovenia to over 4 per 1000 in Belgium, Cyprus, UK Wales and Lithuania. Preterm birth rates ranged from &lt;6% in Lithuania, Finland, Latvia, Estonia and Denmark to 8% or more in Portugal, Belgium, UK Scotland and Cyprus. Fewer than 20% of births were by caesarean in Norway, the Netherlands, Finland, Estonia in comparison to one-third in Cyprus, Ireland, Italy, UK Scotland. Trends over time differed between countries and were not related to the level of the indicator: the pooled RR by year for preterm birth was 0.99 [0.99; 1.00] with five countries having significant decreases and three countries having increases. Caesarean section rates were stable overall (RR: 1.00 [0.99; 1.01]RR:1.00, 95% CI: 0.99-1.01), but with high heterogeneity (I2=99%); in six countries rates increased significantly, whereas in nine rates decreased between 2015 and 2019.

Conclusions
European countries have varying rates and trends of the principal perinatal health indicators. Investigation of policies in high-performing countries could provide guidance for improvement elsewhere.
The inseparable relation between foresight and uncertainty
Authors: Hilderink H , Moye Holz D 
Published: October 2022

Abstract

This presentation starts with an interactive mentimeter poll to involve the audience. They will be asked several questions about what they find important in dealing with uncertainty in public health foresight studies.

Background
The future is per definition uncertain. Our knowledge about the future is obviously limited, especially when we look further into the future. Next to limited knowledge, people also have different ideas about what they consider a desirable future. All these aspects of uncertainty play a role when doing a foresight study. One of the challenges when doing a foresight study is to address these uncertainties in a systematic manner.

Methods
The cognitive uncertainty addresses the lack of knowledge, which can easily be extended to the information that can be inaccurate or unreliable. These cognitive uncertainties can vary widely, and can be classified according to location, level and nature of the uncertainty. Especially in foresight studies with a strong quantitative character, the cognitive uncertainties can be crucial and can form the basis of developing scenarios. Next to the cognitive uncertainties, normative uncertainties can be distinguished which address desirable futures. These represent the obvious differences in norms and values that people have when valuing health. There are several examples of public health foresight studies that include a proper consideration of uncertainties involved.

Conclusions
Applications of foresight studies in the field of public health are still limited. However, the recent years we see a broadening of initiatives of doing a foresight study, including addressing uncertainty in an more systematic way. Especially in public health, the normative uncertainty might play a rather relevant role.
Normative uncertainties in public health foresight
Authors: Den Hertog F , Ruiter H , Hilderink H 
Published: October 2022

Abstract

Background
People value health differently, based on the norms and values. This is important when looking into the future trends in health and health care., and the perception of challenges they may arise from these trends.

Methods
Together with stakeholders from a broad range of health-related professions, we identified several challenges for public health and healthy environments. Professionals working on these subjects came up with different goals and different ways to achieve them. These normative goals in health policies provide uncertainties in foresight, because they can be either synergetic or conflicting.

Results
In the Dutch Public Health foresight study of 2014 four societal challenges for public health and healthcare were identified and formulated, as follows: (1) to keep people healthy as long as possible and cure illness promptly; (2) to support vulnerable people and enable social participation’ (3) to promote individual autonomy and freedom of choice; and (4) to keep healthcare affordable. In 2022 we will update and deepen these perspectives on public health and at the same time we will broaden the usability of working with this method by focussing on environmental health.

Conclusions
To explicitly distinguish different perspectives on health leads to a better understanding and dealing with normative uncertainties by taking into account the trade-offs between competing interests and values. The challenge then is to identify policy options that have positive effect from different perspective, the win-wins.
3.B. Workshop: Quality of COVID-19 science: meta-research and the ethical implications for public health
Authors:   Organised by: EUPHA-EPI, EUPHA Research Pillar, EUPHA-ETH, EUPHA-PHG, EUPHA-HTA, UK Faculty of Public Health,   Chair persons: Stefania Boccia (EUPHA-EPI), Alastair Leyland (EUPHA)
Published: October 2022

Abstract

Since the beginning of the COVID-19 pandemic, scientific researchers have had to balance the need to disseminate information rapidly while still maintaining high-quality standards of research design and reporting. Early meta-research efforts comparing the methodological quality of COVID-19 research with pre-pandemic medical research found a higher prevalence of observational studies with a shorter time from submission to acceptance, lower methodological quality scores, higher risk of bias, and lower number of participants. This workshop is intended to showcase some public health relevant meta-research that has assessed COVID-19 study quality during later phases of the COVID-19 pandemic, analysed transparency and integrity indicators, and revisited earlier studies in the light of stronger evidence. After three more technical presentations that will examine the role of meta-research in addressing some of the COVID-19 pandemic research challenges, an ethical overview of the concept of “the science” as an idea used in public decision-making and policy will be given.

Key messages
• Meta-research role of scrutinizing evidence as it is produced is even more important when scientific information is diffused at an expedited rate.
• Ethical questions might be as relevant as epidemiological ones when science is not able to be all that leads decision-making.
Quality of COVID-19 research: An overview of large-scale assessments and a case study on excess mortality estimates
Authors: Belbasis L 
Published: October 2022

Abstract
COVID-19 is an ongoing public health emergency, which affected individual and population health, whereas it disrupted social and economic activities for more than 2 years. High-quality research evidence, which is published without delays in the peer-review and publication pipeline, is the most powerful tool for evidence-based decision-making by physicians, public health and health policy specialists, and politicians. However, from the early stages of the pandemic till now, there is a debate on the quality of COVID-19 research, whereas it has been observed that the decrease in the time from submission to publication was accompanied by a decrease in research quality. This presentation discusses the findings and main conclusions from two research projects. The first part focuses on a systematic review of published large-scale qualitative evaluations of COVID-19 research. By taking advantage of these large-scale assessments, we will provide a bird's eye view on the quality of COVID-19 research done so far. The second part focuses on a case study describing the methodological quality of studies calculating excess mortality estimates during COVID-19 pandemic. Excess mortality estimates depend on important choices about the pre-pandemic reference period, the pandemic period of interest, and the modelling of the comparison between these two periods. Such an assessment has not been done yet although there is an abundance of published approaches to estimate excess mortality during the COVID-19 pandemic. Overall, these two projects highlight the importance of meta-research in the time of pandemic by scrutinizing and assessing scientific evidence while deriving recommendations for improvement of future research. This presentation concludes with a summary of the implications of low-quality COVID-19 research in decision-making and some general considerations to improve research quality and integrity in the case of future pandemics.
Main findings of the European Health Report 2021
Authors: Zelviene A 
Published: October 2022

Abstract
The EHR2021 examines the WHO European Region's progress towards the health-related SDGs, the impact of the COVID-19 pandemic on population health, and approaches to build back better from 2022 onwards. It provides insight into the main challenges related to the 3 core priorities of the EPW, which are moving towards UHC, protecting people better against health emergencies, and ensuring healthy lives and well-being for all at all ages. In this presentation, we will have look at these 3 core priorities in more detail. Although the European Region is making good progress for some of the SDG targets, challenges and delays exist across the core priorities. For example, the incidence of catastrophic health spending ranges from 1% to 19% across countries, and the European Region is one of two global regions where the overall number of new HIV infections is increasing. One year into the pandemic, 29% of health services were still at least partially disrupted in the Region. The impact of the pandemic aggravates the effort Member States will have to make to reach the health-related SDGs by 2030. Furthermore, there are large and persistent differences between Member States. The COVID-19 pandemic has exacerbated existing health inequalities by impacting vulnerable groups most severely. To build back after the COVID-19 crisis, the EPW will be the leading policy framework for the coming years to take on the challenges identified. The report shows that the evidence base for supporting the policy efforts that Member States will have to make for reaching the SDGs and working on the EPW core priorities is suboptimal. While the COVID-19 pandemic has emphasized the importance of health information and sparked innovative ways of data collection and processing, there are still data gaps for key indicators and operational challenges in HISs. Overcoming these issues in health information is critical for improving the health of the people in the WHO European Region.
The importance of digitalisation and data science for HIS strengthening
Authors: Novillo D 
Published: October 2022

Abstract
The COVID-19 (coronavirus disease 2019) pandemic has underscored the critical need for all countries to strengthen their health data and information systems and ensure the routes the data travel, from submission to use, are unobstructed. Timely, credible, reliable, and actionable data are key to ensuring that political decisions are data driven and facilitate understanding, monitoring, and forecasting. To ensure that critical decisions related to the wider health and socioeconomic effects of this pandemic are data driven, each country needs to develop or enhance a national data governance plan that includes a clear coordination mechanism, well-defined and documented data processes (manual or electronic), the exchange of data, and a data culture to empower users. In addition, countries should now more than ever invest and enhance their data and health information systems to ensure that all decisions are data driven and that they are prepared for what is next. Furthermore, strong enabling environments and advanced and digitized health information systems are vital to controlling epidemics. Sustainable finance and government support are required for the continued implementation and enhancement of HIS. It is important to promote digital solutions beyond the COVID-19 pandemic. Now is the time to discuss potential solutions to obtain timely, accurate, and reliable health information and steer policy-making while protecting privacy rights and meeting the highest ethical standards.