bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clustering of unhealthy behaviours and subsequent sickness absence among Finnish municipal employees
Authors: Salmela J , Lahti J , Kanerva N , Rahkonen O , Kouvonen A , Lallukka T 
Published: October 2022

Abstract

Background
Unhealthy behaviours are associated with increased sickness absence (SA), but few studies have explored these associations using person-oriented approach. We aimed to identify latent classes of unhealthy behaviours among female and male employees and examined their associations with subsequent SA.

Methods
Health behaviours (leisure-time physical activity, sedentary behaviour, fruit and vegetable [F&V] consumption, sleep, binge drinking, and use of tobacco products) were derived from the Helsinki Health Study questionnaire survey, collected in 2017 among 19-39-year-old employees of the City of Helsinki, Finland. The questionnaire data were linked to employer's SA register. Latent class analysis was used to identify underlying profiles of unhealthy behaviours and negative binomial regression was used to examine their associations with subsequent SA (≤7 days, &gt;7 days, and all lengths) among 3228 women and 771 men. The mean follow-up time was 2.1 years.

Results
Among women, we identified 3 latent classes: 1) healthy behaviours (81% of women), 2) binge drinking and tobacco use (12%), and 3) inadequate F&V consumption and insufficient sleep (7%). Classes 2 and 3 showed increased rates for subsequent SA compared to class 1, regardless of the length of SA spells (age-adjusted rate ratios [RR] 1.37-1.42 and 1.35-1.64, respectively). Among men, we identified 3 latent classes: 1) healthy behaviours (51% of men), 2) binge drinking and tobacco use (19%), and 3) inadequate F&V consumption, binge drinking and tobacco use (30%). While classes 1 and 2 were not different in terms of subsequent SA, class 3 had increased rates of subsequent, particularly short-term SA (RR 1.24, 95% CI 1.03-1.48).

Conclusions
Preventive actions should consider simultaneously several unhealthy behaviours while aiming to reduce employees’ SA. These actions might benefit from regarding potential gender differences in the clustering of unhealthy behaviours and their associations with SA.

Key messages
• Preventive actions to reduce sickness absence should consider clustering of unhealthy behaviours among employees.
• Potential gender differences need to be regarded in these actions.
What do employees on long-term sick leave experience, as barriers for returning to work?
Authors: Strømstad K , Skarpaas LS , Wiik SE , Haslerud SI , Aas RW 
Published: October 2022

Abstract

Background
The financial burden long-term sick leave places on society are immense and amounted to an annual cost of 180 billion NOK in Norway. Epidemiological and sociodemographic risk factors related to sickness absence and return to work (RTW) are well studied, less is known regarding self-perceived biopsychosocial barriers for RTW. The aim of this study was to investigate the diversity of barriers for RTW as experienced by long term sick listed employees.

Methods
The study is a large-scale qualitative interview study (n = 85), using semi-structured telephone interviews. Participants were eligible to participate if they had received sick leave benefits &gt;6 months and &lt;1,5 years at the time of recruitment, for at least 50% of their employed work hours. The data was analysed with a directed qualitative content analysis combined with a summative approach. A deductive approach, guided by the theoretical framework provided in Model of Human Occupation (MoHO) were used in the analysis process. In MoHO, the main categories are person specific components and environmental components.

Results
The study generated 952 coded meaning units describing barriers for RTW. Of these, we were able to deductively code 917 within the framework of MoHO. In the person specific concept, performance capacity barriers were dominant (n = 530). Volitional barriers (n = 164) were related to personal causation, hereunder self-efficacy (n = 24), and one's sense of capacity (n = 91). Barriers related to habituation (n = 64) was expressed as habits, both necessary habits and undesirable habits. Barriers related to the environmental component amounted to 388. The majority was linked to occupational environment (n = 217), including availability of adequate work tasks and barriers related to the healthcare system.

Conclusions
The experienced RTW-barriers extended beyond health-related barriers, for most of the participants the barriers were related to both person specific components and environmental components.

Key messages
• By gaining a greater understanding of the experienced RTW-barriers we could possibly provide more tailored RTW-services and help sick listed to a safe and sustainable return to work.
• The experienced RTW barriers for long term sick listed were primarily related to person specific and environmental components, and thus extended beyond health-related barriers.
Mental health impact and mental health care among first responders following the Paris terror attacks in November 2015
Authors: Motreff Y , Pirard P , Vuillermoz C , Rabet G , Petitclerc M , Stene L , Baubet T , Vandentorren S 
Published: October 2022

Abstract

Introduction
During the evening of 13 November 2015, a terror attack occurred in France in the Paris area. Overall, 130 people were killed, 643 were injured and several thousands were psychologically impacted. Thousands of first responders (FRs), including health professionals, firefighters, affiliated volunteers and police officers were mobilized that night and during the subsequent weeks. The aims of our study were to measure the psychological impact on FRs, and its associated factors 12 months after the 13 November 2015 terrorist attacks, as well as their engagement in mental health care and its associated factors.

Methods
FRs who had intervened during the night and/or the aftermath of the terror attacks had the possibility of answering a web-based study 8-12 months after the attacks. They satisfied criterion A of the DSM 5 definition of Post Traumatic Stress Disorder (PTSD). PTSD and partial PTSD were measured using the PTSD checklist for DSM-5 (PCL-5) and depression with the hospital anxiety and depression (HAD) scale.

Results
Overall, 663 FRs were included in the analysis. Prevalence of PTSD in our sample went from 3.4% among firefighters to 9.5% among police officers. Low educational level, social isolation, intervention on unsecured crime scenes and lack of training were associated with PTSD. Among FRs with PTSD, partial PTSD or depression, 38% sought mental health care. Mental health care engagement was associated with a history of mental health care, post-immediate support and the presence of PTSD, partial PTSD or depression.

Conclusions
Our results highlight that improving access to mental health care for FRs after terror attacks is needed. Efforts should be made before and after potentially traumatic events to ensure mental health education for FRs. Special attention should be given to FRs living in social isolation, those with low educational levels and those who intervene in unsecured crime scenes.
Do regional characteristics predict developmental delay? Analyses of German school entry examination
Authors: Hoffmann S , Tschorn M , Michalski N , Hoebel J , Förstner BR , Rapp MA , Spallek J 
Published: October 2022

Abstract

Background
Children's health and development are strongly linked to their living situation, including their family's socioeconomic position (SEP) and living region. However, research on the impact of the living region on children's development beyond family SEP is scarce. This study evaluated whether rurality and regional socioeconomic deprivation (DEP) are associated with children's development independently of family SEP.

Methods
The study used population-based data of 5-6.5 years old children (n = 22,801) from mandatory school entry examinations (SEE) in the German federal state of Brandenburg, which were examined in 2018/2019. The SEE data have been linked with data on i. rurality that was defined by an inverted population density and ii. regional DEP that were provided by the German Index of Socioeconomic Deprivation. By binary multilevel models, the predictive values of rurality and regional DEP for global developmental delay (GDD) were evaluated, while adjusting for family SEP.

Results
Children with high family SEP showed reduced odds for GDD compared to medium family SEP (female: OR = 4.26, CI95=3.14-5.79, male: OR = 3.46, CI95=2.83-4.22) and low family SEP (female: OR = 16.58, CI95=11.90-23.09, male: OR = 12.79, CI95=10.13-16.16). Regional DEP additionally predicted GDD, with higher odds for children from more deprived regions (female: OR = 1.35, CI95=1.13-1.62, male: OR = 1.20, CI95=1.05-1.39). Rurality did not predict GDD beyond family SEP and regional DEP.

Conclusions
In addition to family SEP, the regional DEP has an effect on children's developmental delay. Hence, Public Health should take into account regional socioeconomic conditions as determinant of health over the life course in addition to family SEP.

Key messages
• Regional socioeconomic deprivation contributes to inequalities in children's development and health.
• Besides family SEP, regional socioeconomic circumstances are of particular interest to promote health over the life course.
6.A. Workshop: Strategies to build up health system resilience: Legacy of the COVID-19 pandemic
Authors:   Organised by: Finnish Institute for Health and Welfare, Tampere University, Trinity College Dublin, University of Copenhagen, EUPHA-HSR,   Chair persons: Ilmo Keskimäki (Finland), Johan Hansen (EUPHA-HSR)
Published: October 2022

Abstract

Health systems are the central part of infrastructure in societies and their smooth operation is important for the continuation of a wide range of critical operations in any country. The COVID-19 pandemic has actualised questions on health system resilience defined as the system's ability to prepare for, manage (absorb, adapt and transform) and learn from external shocks.. However, economic recessions as well as long- and short-term stresses related to aging, climate change and migration, and most recently a war have underlined that also in Europe the governments need to prepare their health systems to face different types of threats in order to guarantee effective protection to population health in their countries. The importance of the task to strengthen health system resilience has been comprehended at national and international level. International actors including WHO, OECD and World Bank have designed policy advice on strengthening health systems against external shocks, the European Union has launched programmes for preparing for future health emergencies, and individual countries are designing policy and system reforms allowing for health crises. In the workshop we address policies to strengthen health system resilience drawing on the experiences in three countries: Ireland which entered the COVID-19 pandemic with a legacy of the recent economic crisis hitting hard health care financing, Finland which has been implementing a major health care reform concomitantly with the pandemic, and Denmark which offers a case study on organisational learning from the pandemic within the hospital sector and chronic patient care. Based on these three case studies the workshop also contemplates whether learning from shocks is always helpful in terms of system transformation or whether they can also create path dependencies that weaken the systems’ ability to prepare for unknown threats. The workshop will broaden the view by discussing the trends of health system reforms in European countries and considering international advice on system and policy reforms to strengthen health system resilience.

Key messages
• Shocks create opportunities for reform and better performance and challenges through overloaded systems and fast decision-making.
• Assuming all shocks are like the last weakens preparedness and adaptability.
Strategies for developing preparedness and building legacy – learning from the experience of building Health System Resilience in Ireland
Authors: Thomas S , Fleming P , O'Donoghue C , Almirall-Sanchez A 
Published: October 2022

Abstract
Health system resilience to shocks is perhaps the biggest global challenge facing health systems in the 21st Century. Health systems face an increasing prevalence and likelihood of a broad range of shocks (including economic crises, pandemics, climate-related events, political upheavals, mass migration, conflicts and cyberterrorism) that can each undermine the ability of a health system to function well. In particular, the twin processes of dealing with the legacy of a health system shock and preparing for the next shock are distinct but related challenges that face policy makers today. In this presentation the authors will present key findings on improving preparedness and building a constructive legacy drawing from:
• the results of a recent systematic review on how health system resilience has been measured in high income countries over the last twenty years;
• the results of a recent realist review exploring the legacy of the economic crisis for the resilience of the response of the health system to COVID-19, and
• analysis of interviews with Irish policy makers, managers and analysts as they reflect on the different shocks encountered by the Irish system over the last fourteen years.
Triangulating these findings, the authors will reflect on the merits and challenges of measuring resilience and what the focus should be moving forward. Key strategies and approaches will be outlined to best prepare a system for a shock and to leave a positive legacy for the future.
Nutritional and non-nutritional dietary factors affecting obesity and chronic related disorders
Authors: Grosso G , Bonaccio M 
Published: October 2022

Abstract
There is convincing evidence that diet quality represents one of the most important public health targets to prevent non-communicable diseases. Dietary risks alone have been estimated to be responsible for about 10 million deaths due to cardiovascular diseases, metabolic disorders, and certain cancers worldwide, with trends not expected to decrease. Results from meta-reviews and expert assessments are quite in line with robust key messages to deliver to the general public. From a nutritional point of view, lack of fibre, vitamins and antioxidants, and unsaturated fatty acids together with high content in free added sugars, sodium, and saturated/trans fats represent key features for unhealthy dietary patterns and are responsible for most diet-related non-communicable diseases. While the role of animal-derived foods is still controversial due to the registered excess consumption and the environmental impact, a general low intake of plant-derived foods remains a major detrimental factor for health. The concept of diet quality should thus overcome the over simplistic calorie-count when coming to prevent obesity and related non-communicable diseases, while an adequate communication on this matter to the public is highly warrant. Together with these general dietary recommendations relying on nutritional aspects affecting human health, emerging evidence is now also exploring the role of non-nutritional dietary factors. The level of processing, the alteration of the food matrix, the presence of additives (such as flavor enhancers, colorants, emulsifiers, artificial sweeteners, thickeners, foaming/anti-foaming agents, and preservatives) have been demonstrated to play a role in metabolic health and inflammatory-related disorders. These aspects are currently under investigation, but they might represent an underrated concern for public health due to the food market drive and a perfect fit into the obesogenic modern society.
Health literate settings in Austria
Authors: Gugglberger L 
Published: October 2022

Abstract

Issue/problem
Health literacy (HL) depends largely on how easy or difficult it is in a given situation to find, understand, evaluate and apply health-related information. HL is thus an interplay between personal skills and organisational requirements.

Description of the problem
In 2018 the Austrian platform for HL initiated the focal point ‘organisational framework conditions for strengthening health literacy’. Since then the needs of organisations are being assessed regularly and several strategies and initiatives have been launched to support organisational HL.

Results
To support organisations and settings with the implementation of HL a “starter kit” consisting of a general practical guide and several settings specific self-assessment tools (SAT) has been developed. SAT currently exist for hospitals, primary care units, businesses, open youth work, schools and municipalities. For the settings of primary care units as well as open youth work certification processes have been developed, based on the SAT, distribution of high-quality health information and proof of communication trainings. Currently tools for general practitioners are being developed.

Lessons
Experiences from workshops and pilot testing have shown that organisations need a variety of different tools and measures to help with the implementation of HL. Any type of support needs to be flexible and customisable to different needs and have a low threshold. What is needed most - apart from financial incentives - are settings-based workshops and personal consultation to raise awareness of what health literate organisations can achieve.
Main messages: Settings and organisations are important to increase HL in the population. Several settings in Austria have started to implement HL and are at different implementation statuses.
Burden of infectious diseases in prison settings and services offered
Authors: Alves da Costa F 
Published: October 2022

Abstract

Introduction
The WHO Prison Health Framework was developed to assess prison health system performance and support Member States (MS) in improving their prison health systems. Moreover, it shall enhance MS capacity to evaluate: the impact of changes in governance models, progress in service provision and improvements of the health status of people in prison (PiP).

Methods
The framework informed the 2021 data collection round of the Health In Prisons European Database Survey. Invitations were sent to all 53 MS of the WHO European Region. Those MS nominating a focal point and providing valid answers were included in the analysis.

Results
Answers were obtained from 36 MS, representing a total of 613,497 PiP. Access to immunization was very good across all MS, with the highest for COVID-19 (90% of MS provide it in all prisons). Vaccination against HBV was only available in all prisons of 25 MS. Access in all prisons to HIV post and PrEP were reported, respectively, by 78% and 58% of MS. Screening for diseases at entrance was common for HIV, HCV and HBV. In all prisons of 35 MS soap was provided for free, while needles & syringes and lubricants were only provided free of charge, respectively, in 3 and 4 MS. 5 MS did not have therapeutic spaces to tackle drug problems in any prison, in 73% of those having, accessibility was restricted to some prisons. HIV prevalence ranged from 0-16% and treatment was accessible to 55-100% of those diagnosed. Prevalence of HCV ranged from 0-34%, with access to treatment ranging from 0-91%. The most common format of health records in European prisons was paper based (44%).

Conclusions
Prison-based data collection systems resulted in limited capacity for extraction so that some countries were unable to provide any data on disease prevalence or treatments offered. Given the scarcity of data on this topic obtained from real-world and not from ad-hoc studies, this snapshot provides an important contribution to public health.
Health equity and worker justice: the food supply chain during the COVID-19 pandemic
Authors: Forst L 
Published: October 2022

Abstract
The COVID-19 pandemic has brought into stark relief the health, safety and security threats facing people in the US and around the globe. As stay-at-home orders were instituted, most economic activities closed or required work from home; however, companies in the Food Supply Chain (FSC) continued to operate, considered “essential businesses.” The meatpacking and agriculture sectors in Illinois - 79,000 and 55,000 workers, respectively - are largely populated by (im)migrant workers, some on short-term work visas and many of whom are part of the informal (cash) economy. Only a tiny percentage of meatpacking and no agriculture businesses are unionized in Illinois or most of the USA. Initially, FSC workplaces were not re-configured for social distancing; sanitation and entry procedures were not instituted; workers were not offered personal protective equipment (PPE); and no plans were made for quarantine of infected workers or isolation of COVID-exposed workers. Lack of paid sick leave for these workers, who earn subsistence wages and whose employment is extremely precarious due to immigration status, added pressure for them to continue to work while infectious. Investigation and enforcement of health and safety was taken on by local health departments rather than the occupational safety and health enforcement agency. Finally, these workers, who live in congregate housing and share transportation, carried the virus from work to community and community to work. We review US laws related to immigration, labor, and occupational health and safety before and during the pandemic, as well as epidemiological data. We will highlight the changes required to address “work” in the web of contagion during an infectious disease epidemic. Protection of workers’ rights, as well as a clearer understanding of the integral connection between workplace and community, will be a likely “side effect” of these efforts.
7.C. Workshop: Towards a true European Health Union: milestones, drivers and barriers
Authors:   Organised by: European Observatory on Health Systems and Policies,   Chair persons: Matthias Wismar (European Observatory)
Published: October 2022

Abstract

European health system responses to the COVID-19 pandemic have also demonstrated that European integration in health and health systems add value beyond what individual Member States can do: ranging from the joint purchase of medicines to providing large budgets for building back better. With a true European Health Union we will strengthen our health systems beyond crisis preparedness and response, which is necessary as we are facing the evolving perma-crisis, We will need to strengthen our health systems in general always with a view to Universal Health Coverage and improving health system performance. The European Health Union can work to help strengthen health systems, which may include support for Member States research, learning from best practices, investment but also common solutions including new or extended EU mandates, new arms-length bodies, as well as more coordination or harmonization. It has also taught us that we cannot wait to strengthen our health systems as we are in Europe in a perma-crisis.
The panel will address the following questions:
• Where are we with our progress towards a true European Health Union?
• What policy change is needed to create a true European Health Union?
• What would be the role of the true European Health Union strengthening and supporting Member States?
We will zoom in on the 1) existing public health mandate of the EU, 2) the impact of other EU-policies on health and health systems, 3) the new economic governance and, 4) the role of the EU in global public health

Key messages
• A true European Health Union will strengthen universal health coverage and health system performance.
• A true European Health Union goes beyond crisis-preparedness and respons.

Speakers/Panellists
Scott Greer
University of Michigan, European Observatory on Health Systems and Policies, Ann Arbor, USA
Anniek de Ruijter
University of Amsterdam, Amsterdam, Netherlands
Eleanor Brooks
University of Edinburgh, Edinburgh, UK
Thibaud Deruelle
University of Lausanne, Lausanne, Switzerland