bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continuous perinatal health monitoring and analysis in Europe based on a federated analytic approach: a proof of concept study
Authors: Philibert M , Amyx M , Durox M , Dimnjakovic J , Thissen M , Estupiñán-Romero F , Berna E , Zeitlin J 
Published: October 2022

Abstract

Background
International comparisons of population indicators of maternal and newborn health are valuable for guiding health policy and practice. The Covid-19 pandemic revealed the difficulties of compiling comparable, timely data in Europe. As part of the PHIRI (Population Health Information Research Infrastructure) project, we developed a protocol to facilitate the exchange and analysis of population birth data in Europe.

Methods
The Euro-Peristat network, which includes experts from 31 European countries, developed a common data model and R scripts to facilitate rapid exchange of anonymised aggregate tables (https://zenodo.org/record/5148032#.YmlUttpBxPY). These tables were used to compile comparable perinatal health indicators from routine population-based sources for the years 2015 to 2020. We assessed the feasibility of this approach and the availability, quality and comparability of the data.

Results
Building on previous Euro-Peristat recommendations and a structured consensus process, the network defined a common data model including 22 variables for the testing phase. 17 additional variables were considered important and feasible for a second phase. 25 countries created patient-level data files. Most countries had 20 or more of the data items, whereas 1 had 18, 3 had 16 and 2 had 15 variables. Limiting factors included not having all data in a single database, most often the case for neonatal and infant mortality or vital statistics versus healthcare data, and the diversity or absence of data on socioeconomic status. Setting up the model was time consuming, but once established, running the R scripts was easy and quick (&lt;15 min). The protocol requires the active participation of each country to ensure it is correctly applied.

Conclusions
We illustrated the feasibility of using a common data model with open source scripts to facilitate rapid production of data and analysis on key perinatal health indicators in European countries
Socioeconomic differences in perinatal health outcomes: perinatal health surveillance through a health-equity prism
Authors: Smith L , Farr A , Zurriaga O , Cuttini M , Verdenik I , Vidal Benedé MJ , Kearns K , Sakkeus L , Kyprianou T , Barros H 
Published: October 2022

Abstract

Background
Socioeconomic status (SES) is strongly associated with perinatal health outcomes, perpetuating intergenerational health inequalities. Our aim was to assess the utility of population data in Europe to monitor social inequalities in key perinatal health indicators.

Methods
Using the PHIRI federated analysis protocol to aggregate routine birth data from across Europe, we collected data on selected perinatal health indicators by SES from 2015 to 2020. Mothers’ education level (primary/lower secondary; upper secondary; postsecondary) was the preferred SES indicator; if unavailable, parents’ occupation or area-based deprivation scores were provided. The International Standard Classification of Occupations was used to group parents’ occupations into 4 categories, while area-based deprivation scores were measured in quintiles. For each country, we calculated risk ratios (RR) for preterm birth, stillbirth, neonatal death and caesarean delivery (CD) comparing the most with the least disadvantaged group

Results
17 countries provided data on maternal education, 5 on area-based deprivation, 1 on parents’ occupation and 2 could not provide data. For preterm birth, stillbirth and neonatal death, lower SES was associated with worse outcomes with most RR between lowest and highest groups in the range of 1.5 to 3.0. In contrast, in some countries, such as Croatia, Latvia, Lithuania and Spain, CD rates were higher for socially advantaged groups whereas the gradient was reversed in others (Denmark, Luxembourg, the Netherlands and Italy).

Conclusions
European countries can provide perinatal health indicators by SES, revealing marked socioeconomic inequalities in perinatal health. The differing SES gradient between countries for CD raise questions about care organization and clinical practice. Further exploration of the harmonization of differing SES measure across countries is required, while countries that do not monitor SES data should aim to improve existing systems.
Achieving more with less: lessons from country-level analyses of caesarean delivery and perinatal outcomes in Europe
Authors: Zeitlin J , Mortensen L , Nijhuis JG , Recio Alcaide A , Velebil P , Tica V , Mierzejewska E , Klungsoyr K , Donati S , Macfarlane A 
Published: October 2022

Abstract

Background
There is consensus that caesarean delivery (CD) is a lifesaving procedure for both mother and child in emergency situations and that CD without medical indication should be avoided. However, the rate that optimally balances the risks and benefits of CD is unresolved. In 1985, the World Health Organization concluded that the CD rate should be no more than 10-15%; subsequent reviews relating CD rates to infant mortality show no benefits at the country-level for rates higher than 15-19%. However, stillbirth has not been investigated because comparable international stillbirth data are not readily available.

Methods
We conducted an ecological study in 25 European countries from 2015 to 2019 utilizing data from routine birth data sources aggregated using the Euro-Peristat PHIRI federated data analysis protocol. We assessed country-level associations between CD rates and perinatal outcomes (singleton preterm birth, stillbirth at ≤ 24 weeks’ gestational age, neonatal death) for all years using Pearson correlations, adjusted for clustering of years within country. Correlations were also estimated between linear trends over time in the indicators.

Results
The median [range] of CD rates was 23.1% [16.2 to 56.9] in 21 participating countries, while these were 6.9% [5.3 to 11.9] for preterm birth, 3.3 per 1000 total births [1.8 to 7.6] for stillbirth and 1.9 per 1000 live births [0.7 to 6.1] for neonatal mortality. The CD rate was not associated with the stillbirth rate (cluster-adjusted rho: -.01, P=.94) or with the neonatal mortality rate (rho:.27, P=.27). However, there was a strong positive correlation with the preterm birth rate (rho:.81, P&lt;.001). Results were similar in time trend analyses.

Conclusions
Higher CD rates were not associated with lower stillbirth or neonatal mortality rates, but were strongly correlated with higher preterm birth rates. This study suggests no benefits and indicates potential harms for higher CD rates in Europe.
Meeting the health needs of forcibly displaced populations: translating evidence into implementation via the WHO global research agenda on migration and health
Authors: Orcutt M 
Published: October 2022

Abstract
In this presentation, Dr Orcutt, will outline the health system responses needed to respond effectively to the health needs of forcibly displaced populations - from initial health assessments to the longer term - and the role that research can play in ensuring evidence-informed policies and practice. She will present the main areas of the WHO's new global research agenda on migration and health and outline how translating evidence into implementation is essential to improve the health of migrants.
Strengthening implementation of catch-up vaccination and multi-disease screening for new migrants
Authors: Hargreaves S 
Published: October 2022

Abstract
Dr Hargreaves will discuss the current guidance for EU/EEA countries on public health considerations for newly arrived migrants, with a specific focus on catch-up vaccination delivery across the life course in mobile populations. She will explore current initiatives and best practices to ensure child, adolescent and adult refugees and migrants are included in catch-up planning and delivery for missed vaccines and missed doses and to align them with the host country vaccine schedule.
Health care provision to migrants: what did we learn from the Ukraine, Afghan, and Syrian crises?
Authors: Veizis A 
Published: October 2022

Abstract
Dr Veizis was involved in the immediate health care provision to Ukrainian people fleeing to neighbouring countries including Poland and Moldova, as well as health care provision to Syrian people residing in Greece, working for the non-governmental organisation INTERSOS and previously MSF. He will discuss his experiences to date in terms of immediate and long-term provision to these groups and the role of both NGOs and mainstream health services in meeting the needs of forcibly displaced migrants to Europe.
2.P. Round table: Covid-19 pandemic: the rise or downfall of public health
Authors:   Organised by: EUPHA,   Chair persons: Iveta Nagyova (EUPHA), Marieke Verschuuren (EUPHA)
Published: October 2022

Abstract

This year, we are celebrating 30 years of the European Public Health Association. But celebrating this after over two years of COVID-19 and the Russian reinvasion of Ukraine, invites us all to reflect on the use, misuse and non-use of public health. Over the years, our approach to public health has evolved. At the start of the 20th century, public health emphasized the inequalities created by the environments in which people lived, including housing, sanitation, and nutrition. By the end of the century, this extended to the political and commercial determinants of health and the concept of planetary health, which would later be encapsulated by the 2016 Vienna Declaration on Public Health. Given this comprehensive approach, supported by a much greater body of knowledge produced by many disciplines, public health should have been in the driver's seat when the world was hit with COVID-19. But it was not. Its expertise was often absent from COVID-19 response teams. Policies were often driven by panic in the face of visions of overwhelmed hospitals. Restrictions on mixing were essential until more was known about this new virus but there were failures to appreciate the impact that these measures would have on those already disadvantaged, many in precarious employment in public-facing jobs and overcrowded accommodation. As a consequence, existing health inequalities deepened. It seemed that much that had been learned over the preceding decades had been forgotten. In this roundtable, we seek to explain why, and what needs to change in order to refocus the centrality of public health on supporting and creating fair societies as a prerequisite for health for all.
So, is COVID-19 the downfall or the new rise of public health? In this Round Table, we will discuss the questions as follows.
1. Where was public health during COVID-19?
2. Why were social factors ignored during COVID-19?
3. Why has public health not used/is not using the momentum created by COVID-19?
4. And the main question: How can we create a fair society?

Key messages
• Public health needs to strengthen its core activities.
• Advocacy is a key role for public health.

Speakers/Panellists
Martin McKee
LSHTM, London, UK
Natasha Azzopardi Muscat
WHO, Msida, Malta
Dineke Zeegers Paget
EUPHA
Klaus D Pluemer
Independent Public Health & Health Promotion Consultant, Duesseldorf, Germany
Caroline Costongs
EuroHealthNet, Brussels, Belgium
FRESHER: Challenges and opportunities for building Health/Healthy futures
Authors: Giuffrè G , Giesecke S 
Published: October 2022

Abstract

Background
FRESHER (2016-2018) Foresight and modelling for European health policy and regulation - is a H2020 project that aimed at representing alternative health Scenarios to test future policies for tacking Non-Communicable Diseases (NCDs). The key added-value consists in the combination of qualitative foresight and quantitative forecast approaches: a micro-simulation model, specifically developed by the project, computed the health outcomes of the four FRESHER Scenarios.

Methods
The Scenarios building activities involved overall more than four-hundred experts and stakeholders, with different backgrounds within and beyond health fields, throughout all the steps of the process, in two surveys and nine workshops. The horizon scanning phase led to identify a wide range of societal trends that impact health and NCDs. Considering a long-term horizon at 2050, eight trends were then selected and ranked according to their importance and uncertainty.

Results
In the Scenario Building phase, the combination of different evolutions of the selected trends resulted in four alternative futures: a Business as Usual Scenario, “The rich get healthier”, two response Scenarios, “We will Health you” and “Healthy together”, and a worst case Scenario “Desolation Health”. The scenarios imagine different futures and depict how health would subsequently change in such worlds.

Conclusions
Given the increasing need to put health at the centre of all policies, it is necessary to make more evident the relationship between societal trends and their impact on health, specifically for NCDs. The translation of trends, and their evolutions, into changes of risk factors is a viable option to assess the impact of public health policy. FRESHER aimed to trigger a dialogue across different scientific and policy communities outside the health sector in order to define innovative strategies and identify disruptive innovations.
Sources of bias in COVID-19 infection fatality rate estimation
Authors: Pezzullo AM 
Published: October 2022

Abstract
Since the beginning of the devastating COVID-19 pandemic, there has been a great debate about various public health relevant parameters such as the number of people infected with SARS-CoV-2, the number of deaths from COVID-19, and the resulting infection fatality rate (IFR), calculated as a ratio of the number of deaths from COVID-19 and the number of people infected with SARS-CoV-2. Among people dying from COVID-19, the largest burden is carried by the elderly, and locations with an older population will have a higher average IFR. Drawing from a project on the estimation of age-stratified IFR at an international level, in this methodological presentation, I will review the considered sources of bias for COVID-19 IFR calculation and interpretation. Both numerator and denominator can be overestimated or underestimated leading to biased estimates, while different locations can present sources of true variability. The estimation of the number of people infected with SARS-CoV-2 (the denominator of the IFR) presents several challenges. Relying on testing is inadequate due to a substantial undiagnosed proportion, and seroprevalence studies have been used to estimate the number of people infected with COVID-19, but selection bias can arise when the examined population might have a lower or higher risk than the target population. This can be the case when factors such as ethnicity, working status, and comorbidity are not considered in the recruitment. Information bias can result from suboptimal test performance and seroreversion. The number of deaths can be underestimated in situations where testing is not widely available and overestimated by the attribution of COVID-19 deaths to patients that have died with COVID-19 but not from it. Sources of true variability between locations are the population age distribution, protection of the vulnerable populations, as well as the presence of a prepared and efficient healthcare system.
Public Health Ethics and ‘the Science’ in Public Decision-Making
Authors: Coggon J 
Published: October 2022

Abstract
In this presentation, I aim to complement the ideas presented by the other speakers by raising questions about ethics and (different senses of) integrity. In particular, against the pressures of providing evidence bases for governmental decision-making during the COVID-19 pandemic, I ask critically whether, or to what extent, we find harmony between the integrity of science, scientists, and democratic decision-makers. The potential for tensions is explained through consideration of public communication, pluralism in scientific knowledge bases, basic uncertainty, and fundamental principles such as transparency in political decisions. The reality of the tensions is found by considering some limits of ‘the science’ as it has been used in political turns of phrases such as ‘we are following the science’. The tensions are particularly evident where there are gaps given expedited methodologies, when we explore how ‘the science’ actually represents a plural concept, and where we acknowledge that science even broadly conceived is not able to be all that leads decision-making. And they are compounded by factors that might motivate silence or simplification in public communication, such as the apparent appeal of making ‘the science’ seem clearer or more uniformly agreed than may be the case, or by using ‘the science’ to avoid or obfuscate discussion of value judgments. The complexities of these ethical points provide their own important context for evaluating evidence-based policy within and beyond the pandemic.
Current gaps in data and health information system in the European Region
Authors: Davia S 
Published: October 2022

Abstract
When the SDGs were adopted in 2015, it was already clear that major issues regarding data availability would need to be tackled to enable comprehensive and policy-relevant monitoring and reporting. The SDG Report 2019 found that most MS were still not regularly collecting data for more than half of the global indicators. The measurement framework (MF) of the EPW builds on the SDGs. Also here, important data gaps for the included health-related SDG indicators exist. These gaps relate, e.g., to coverage of treatment for substance use disorders and the proportion of women with satisfied family planning needs. In addition, the MF exposed data gaps for several other areas that are highly relevant for the WHO European Region, such as health inequalities, intersectoral action for health, ageing populations and mental health. To help overcome these gaps, the EPW MF includes a development list. This list contains 20 indicator areas for which either no well-defined measures have yet been included in Region-wide international data collections or where data are available only for a limited number of MS. It will serve as a priority list for developmental work on indicators in the European Region in the coming years. Data gaps as described above are not stand-alone problems but are linked to wider issues with the functioning of HISs. In the European Region, the main HIS challenges relate to limited resources and capacity; insufficient coordination and collaboration, leading to fragmentation and problems with interoperability; lack of central governance; and limited use of health information for decision-making. In this presentation, we will give an overview of the main gaps in data and HISs in the European Region and explain the roadmap for the implementation of the EPW MF, which will be an important tool to achieve sustainable improvement of data availability and quality for key indicators. Tools to improve HIS performance overall will be addressed in the next presentation.
Highlighting the ‘public ‘in digital public health – a critical reflection
Authors: Zeeb H , Schüz B , Pigeot I 
Published: October 2022

Abstract
What is the appropriate differentiation of digital public health versus digital health - or is there none? This is an essential question when pondering digitalisation and public health, especially with a view to the potential development of the field. Digital health seems to be a general term related to information and communication technology in health care. Putting a public health lens on this general descriptive term can be done by simply expanding it towards public health as a population science and practice field, rather than the narrow medical and health care arena. However, a more specific approach towards outlining similarities and differences will also focus on digital technologies and their challenges in the core areas of prevention and health promotion. Considering the leading public health functions, their relationship with digitalisation and their specific requirements towards digitalisation can be a valuable path to describe and discuss what digital public health is all about. We will also highlight where interfaces and interrelations with digital health need to be considered for research and practice. This contribution will aim to provide such a perspective.
A framework for developing and evaluating digital and public health tools
Authors: Schüz B , Müllmann S , Pan C-C , Jahnel T , Forberger S , Jürgens D , Pedros Barnils N , Gerhardus A 
Published: October 2022

Abstract
To paraphrase a classic, evaluating digital technologies in health is a bit like eating spinach - no one is against it in principle because it is good for you. However, no one would do it unless being asked to. In recent years, the sheer number of digital health technologies that potentially fulfil public health purposes has increased tremendously. The basis for evaluating such tools for public health purposes however has not met this pace, and in particular frameworks for the systematic development and evaluation of digital technologies in public health are rare. Existing frameworks for digital technologies focus on clinical aspects of digital health applications (e.g., NICE Evidence standards framework for digital health technologies), thus lacking both a population and prevention focus. Generic frameworks such as the Health Technology Assessment (HTA) methodology do not contain items specific to digital technologies and public health purposes. Here, we describe the process of developing a framework specific for the development and evaluation of digital public health technologies based on the core HTA model. We conduct a scoping review of frameworks for the development and the evaluation of technologies in public health and digital health, following PRISMA-SCR guidelines. The identified frameworks are then mapped onto the core HTA model to develop additional items specific for the development and the evaluation of digital technologies in public health. These additional items can be used to integrate the development and evaluation of digital technologies for public health purposes within the wider HTA context, making this process both transferable and scalable.
Implementing a digital public health project - lessons learned?
Authors: Buttigieg S , Agius Muscat H , Ebejer J-P 
Published: October 2022

Abstract
The demand for the digitalisation of public health has been ongoing for more than a decade. The COVID-19 pandemic was the tipping point that accelerated the ideation, implementation, and scale-up of such public health projects. Despite the well-needed push, the same challenges that face every similar implementation will nonetheless be the same if not accentuated. The scope of the presentation is to highlight the difficulties and facilitators that such implementations and evaluations bring forward. We will also see what we can learn as public health professionals to ensure that present and future information systems are well-planned. We have to ensure that they do not succumb to the pressure of well-intended stakeholders who are yearning for such solutions to help their business workflows. This presentation will be enhanced with the lessons learned from implementing, monitoring, and following up on Malta's national contact tracing app and Customer Relationship Management systems based on Microsoft Dynamics 365 technologies that tackled the Test, Track and Trace workflows that were integral to the COVID response in Malta.