bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health in All policies: what do we mean and where are we now?
Authors: Green L 
Published: October 2022

Abstract
This presentation sets what HiAP is and is not, and its evolution since it was conceived. It also addresses how HiAP can be mobilised in practice via the use of tools such as HIA and the key role that enabling structures and contexts - both politically strategic and locally operational- to ensure that health, wellbeing and equity is promoted in the European region. It discusses the enabling context of Wales, with the Future Generations (Wales) Act 2015, which provides political leverage for the implementation of HiAP in practical terms, enabling addressing health considerations intersectorially by non-health policies and projects. This Act along with supporting documents, guidance and legislation implicitly incorporates the principles of HiAP so the rest of non-health sector understand (and also have the statutory obligation) to address the health considerations of policies and plans. It does this by requiring all public bodies in Wales to strive to maximise 7 Well-being Goals - which include ‘A healthier Wales’, ‘A more equal Wales’ - and requires that they do so by working with other agencies in order to prevent negative impacts and promote participation, long-term thinking and integration to ensure that inequalities are minimised. These are key public health principles from which to have conversations. Wales also provides a good example with its advocacy and policy in respect to Economies of Wellbeing - a critical challenge for HIAP is that HiAP is, by its nature, political, and may challenge some policy proposals. Although the focus is on identifying ‘win:wins’ and co-benefits, sometimes there is a conflict between health and other outcomes. There may be a need to balance health gains against economic growth or other policy aims. The following debate intends to discuss the challenges and enablers to achieve that aim, and how public health can make its voice heard.
Economics and health economics as a major determinant towards HiAP
Authors: Santos J 
Published: October 2022

Abstract

COVID-19 pandemic response was an opportunity to advocate for HiAP as everyone developed opinions on how policies could affect the different dimensions, including health and economy. Health planning, from the local to the international level, is the main setting where we still need to advocate for the inclusion of all political sectors and actors in order to ensure an effective HiAP implementation. From a more technical perspective, there is still a lot to do when it comes to implementing and improving economic evaluations, including on data on costs, valuing benefits or using cost-effectiveness approaches.

Speakers/Panellists
Nikhil Gokani
EUPHA-LAW
School of Law, University of Essex, Essex, UK
A sport focus of ECEC centres appears especially health-promoting for boys from lower socio-economic background
Authors: Mayer A , Herr R , Wiedemann E , Diehl K , Blume M , Hoffmann S , Jepsen D , Sundmacher L , Schneider S 
Published: October 2022

Abstract

Background
Pediatric overweight is considered one of the 21st century's most serious public health challenges. Many studies investigated individual level determinants of children's body mass index (BMI), yet studies measuring determinants at the meso- level are sparse. As there is a lack of theoretical and empirical knowledge about the role of child care facilities, the aim was to examine the combined effects of family socio-economic position (SEP) and the meso-level variable early childhood education and care (ECEC) centre with sport focus on the BMI of pre-schoolers.

Methods
We used data from the German National Educational Panel Study (NEPS) and included 1,891 children from 224 ECEC centre groups. Multilevel mixed-effects linear regressions were applied to calculate the main association of ECEC centre focus and family SEP, as well as their interaction on children's BMI. All analyses were adjusted for age, migration background, number of siblings, and employment status of parents and were stratified by gender.

Results
Boys attending an ECEC centre with a sport focus have on average a lower BMI than boys from ECEC centres not having this focus. Interactive effects between family SEP and ECEC centre focus were found. Considering predictive margins, boys with low family SEP not attending a sport focused ECEC centre had the highest BMI while boys with low family SEP attending a sport focused ECEC centre had the lowest BMI. For girls, no association regarding ECEC centre focus or interactive effects emerged. Girls in the high family SEP tertile had the lowest BMI in both ECEC centre types.

Conclusions
Our analysis shows the social gradient towards a higher BMI for children from lower SEP families. Considering meso-level factors, we provide evidence for the relevance of ECEC centre characteristics for BMI in boys, whereas for girls the association of family SEP with BMI remains. The ECEC centre focus appears to lower the association of family SEP with BMI for boys.
A gamification-based intervention to encourage active travel
Authors: Harris M 
Published: October 2022

Abstract

Purpose
‘Beat the Street’ is a community-wide intervention which aims to increase active travel by turning an area into a 6-week game. Residents earn points and prizes by walking and cycling and tapping a smartcard on RFID readers called ‘Beat Boxes’ placed on lampposts at half-mile intervals. To-date, over 1 million people have taken part in the intervention, however, the impact of the program on adult active travel is yet to be explored.

Methods
In Autumn 2019, Beat the Street was delivered throughout the London Borough of Hounslow. Prior, and immediately following the intervention, residents were invited to complete a self-report questionnaire (Sport England Active Lives Survey-SF) to assess changes in physical activity. Time-stamp data generated through Beat Box activity provided an objective measure of intervention engagement and a traffic survey camera was used to measure the number of cars travelling along 1 target road between 1-week pre- and 1-week post-intervention.

Results
28,219 people took part in the six-week game. Between pre- and post-intervention there was 7% decrease in adults reporting less than 30mins of activity per week and a 13% rise in adults reporting 150+ mins (n = 346, p &lt; 0.01). Beat box data ascertained that 25% of total taps at all Beat Boxes were made between 08:00-08:59am and a further 28% were made between 3:00-3:59pm, typical travel to school/work periods. Further, traffic camera data showed that between the week before and week following Beat the Street, 1199 and 705 fewer cars and 130 and 36 fewer vans were observed travelling along Cambridge Road between 07:00-09:30am and 2:00-4:30pm, respectively.

Conclusions
These data sources, in combination, suggest gamification may be an encouraging approach to increasing levels of active travel at a community-wide level.

Key messages
• Gamification based intervention increases physical activity.
• Gamification encourages active travel to school and work.
A systematic review of randomized clinical trials on quadrivalent influenza vaccines for adults
Authors: Pellacchia A , Mannocci A , Millevolte R , Chiavarini M , de Waure C 
Published: October 2022

Abstract

Background
Vaccination is the most effective intervention to prevent influenza. Adults at risk of complications are among the targets of annual vaccination campaigns and can receive different types of quadrivalent influenza vaccines (QIV). To assess the immunogenicity of different QIVs we performed a systematic review of available randomized controlled trials (RCTs) with the aim of indirectly compare them through a network meta-analysis.

Methods
The systematic review was conducted in accordance with PRISMA-NMA guidelines. We systematically searched RCTs conducted in adults aged 18-64 years that assessed the immunogenicity, namely seroprotection and seroconversion rate (SPR and SCR), of any QIV compared to any comparator. The literature search was performed on three databases (Medline, Cochrane Library and Scopus) until March 30th, 2021.

Results
Twenty-four RCTs were included in the systematic review. A network meta-analysis was not possible: the assumption of transitivity was not satisfied. Therefore, we decided to combine data on immunogenicity and efficacy of each QIV through single meta-analyses in the presence of at least two studies. Live attenuated QIV showed the worst results in terms of both SCR and SPR. Standard dose egg based, low dose adjuvanted, cell based, recombinant and intradermal QIV showed similar SCR in respect to influenza strain A, whereas low dose adjuvanted QIV showed an overall better profile in respect to B lineages. Regarding SCR, the better results were issued by standard egg based, cell based, recombinant, and low dose adjuvanted QIVs.

Conclusions
Albeit an indirect comparison among different QIVs was not possible, the assessment of SCR and SPR provided an overview of their respective potentiality and criticality in adulthood. In particular attention should be paid to new generation influenza vaccines that can have an antigen sparing effect and to the collection of real world data to make comparison among different QIVs possible.

Key messages
• Available evidence does not allow to perform indirect comparison of the quadrivalent influenza vaccines for adults.
• Some QIVs, including new generation ones, elicit a better antibody response.
Self-cutting in bullying victimized adolescents is mediated by depression and dissociation
Authors: Hamal M , Kekkonen V , Kraav S-L , Kivimäki P , Rissanen M-L , Hintikka J , Tolmunen T 
Published: October 2022

Abstract

Background
Bullying victimization is a universal public health threat with numerous negative mental health consequences, including anxiety, depression, and dissociation.

Aims
We explored 1) firstly whether bullying victimization is associated with self-cutting in Finnish adolescent population and, 2) if the possible association is mediated by dissociation and/or depression.

Methods
We used cross-sectional questionnaire data from 13-18- year-old Finnish students (N = 4214; boys n = 1942; girls n = 2229).

Results
Bullying victimized adolescents were older, more likely to come from single-parent families and to take drugs and drink alcohol, had a poorer relationship with parents and siblings, as well as poorer school performance compared to non-bullied adolescents. According to logistic regression analysis the association between bullying and self-cutting remained significant despite adjustments for age, gender, fear of going to school, school performance, social network-related factors, family-related factors, lifestyle related factors, and dissociative symptoms, but not for depressive symptoms. In mediation analyses we found that both depression and dissociation mediated the effect of bullying victimization on self-cutting.

Conclusions
Self-cutting is more common in adolescents who have been bullying victimized. The association is mediated by depressive and dissociative symptoms. More studies are needed to clarify the exact mechanisms how of depressive and dissociative symptoms interact with the association between bullying and self-harm.

Key messages
• Bullying victimized adolescents are associated with self-cutting.
• Depression and dissociation mediate the mentioned association.
Low-quality employment trajectories and mental health disorders among Swedish and migrant workers
Authors: Pollack R , Kreshpaj B , Jonsson J , Bodin T , Gunn V , Orellana C , Östergren P , Muntaner C , Matilla-Santander N ,   PWR Consortium
Published: October 2022

Abstract

Aim
This study aims to examine the effects of low-quality employment trajectories on severe common mental disorders (CMD) according to Swedish and foreign background.

Methods
This is a longitudinal study based on Swedish population registries (N = 2,703,687). Low- and high-quality employment trajectories observed across five years (2005-2009) are the exposure with severe CMD as outcome (2010-2017). Adjusted hazard ratios (HR) were calculated using Cox regression stratified according to background (first-generation (i) EU migrants, (ii) non-EU migrants, (iii) second-generation migrants, (iv) Swedish-born with Swedish background) and sex. The reference group were Swedish-born with Swedish background in a Constant high-quality employment trajectory.

Results
Second-generation migrants had an increased risk of CMD compared to Swedish-born with Swedish background when following low-quality employment trajectories (e.g., male in Constant low-quality HR: 1.53, 95% CI: 1.41-1.68). Female migrant workers, especially first-generation from non-Western countries in low-quality employment trajectories (e.g., Constant low-quality HR: 1.65, 95% CI:1.46 - 1.87), had a higher risk of CMD compared to female Swedish-born with Swedish background. The confidence interval for CMD risk showed little differences between migrant groups (1st and 2nd generation) compared to the reference group.

Conclusions
Low-quality employment trajectories appear to be determinants of risk for CMD, having a differential impact according to background of origin and sex. We observe a higher risk for severe CMD across migrant groups, especially second-generation migrants, compared to Swedish-born with Swedish background. Further qualitative research is recommended to understand the mechanism behind the differential mental health impact of low-quality employment trajectories according to foreign background.

Key messages
• First and second-generation migrants in low quality employment have higher risk of severe common mental disorders compared to Swedish born with Swedish background workers in low quality employment.
• Policies targeting working conditions in low-quality employment and promoting workers mental well-being are essential to reduce this higher risk for developing CMD, especially for migrant populations.
9.Q. Skills building seminar: Redistribution of ill-defined deaths: a methodological conundrum
Authors:   Organised by: COST Action CA18218– European Burden of Disease Network,   Chair persons: Brecht Devleesschauwer (Belgium)
Published: October 2022

Abstract

Today, several countries are conducting national burden of disease (BOD) studies, calculating Disability-Adjusted Life Years (DALYs) for a variety of diseases, injuries and risk factors. The DALY metric is composed of a morbidity component, the Years Lived with Disability (YLDs), and a mortality component, the Years of Life Lost (YLLs). The calculation of YLLs typically starts from national cause of death data, which are coded using the International Statistical Classification of Diseases and Related Health Problems (ICD). National BOD studies however often follow (a modified version of) the cause hierarchy of the Global Burden of Disease (GBD) study, which applies coarser categories, and does not contain unknown or ill-defined causes. This implies that not all ICD codes can be mapped to one specific BOD cause, giving rise to so-called “ill-defined” or “garbage” codes. To include all deaths in a national BOD study, it is therefore necessary to redistribute the ill-defined deaths to specific BOD causes. Several methodological approaches exist for redistribution of ill-defined deaths, ranging from the use of fixed redistribution proportions to advanced redistribution algorithms based on multiple cause of death data. The choice of the methodology needs to depend on the nature of the available cause of death data, and as a consequence, methodologies are typically tailored to the specific data at hand. The absence of a single best methodology, and the methodological heterogeneity across applications, has made redistribution of ill-defined deaths into a methodological conundrum. This skills building workshop will present the redistribution methods applied in different national burden of disease studies, including a discussion of their strengths and weaknesses. By providing a step-by-step presentation of how the methods have been applied, attendees will gain unique insights in the different redistribution methods currently applied.

Key messages
• Redistribution of ill-defined deaths is an essential part of national burden of disease studies, but is methodologically challenging.
• Attendees will receive an overview of the redistribution methods applied in different national burden of disease studies, including a discussion of their strengths and weaknesses.
Primary health care reforms in Estonia: using financial incentives to encourage multidisciplinary care
Authors: Habicht T , Kasekamp K , Webb E 
Published: October 2022

Abstract
Estonia has a historical legacy of large hospital networks and municipality-owned specialist clinics, with a low emphasis on primary health care (PHC). Since the 1990s, a transition towards PHC has occurred, delivering PHC in family physician practices rather than in specialist clinics. The transition has been underpinned by a series of comprehensive healthcare system reforms starting in the late 1990s. The most recent reforms, although lacking a legal basis, have been accompanied by financial incentives including EU structural funds to encourage change. These financial incentives were designed to improve quality of care, encourage working in remote areas, and more. A key focus of PHC reforms has been an emphasis on multidisciplinary care, and the reforms have aimed at increasing the involvement of home nurses, midwives, and physiotherapists in PHC. The reforms have also prioritized PHC centres, with multiple practicing physicians, over single physician practices. Although EU structural funds have supported building the infrastructure for expanded scope of services at PHC level, the uncertainty of long-term funding of expanded services remained a key challenge limiting the success of the reform. Further, the supply of family physicians will be problematic in the future, as the number of permanently vacant positions has quadrupled in the last five years and almost half are 60 years of age or older. As the PHC reform process in Estonia continues until today, it can serve as a case study for other countries interested in strengthening their PHC systems.
10.C. Round table: Is public health just science?
Authors:   Organised by: UK Faculty of Public Health, EUPHA-ETH, EUPHA-PHPP,   Chair persons: Farhang Tahzib (EUPHA-ETH)
Published: October 2022

Abstract

Politicians and policy makers often assert that they are following the science and the evidence in their decision making. Public health is proud of its rigorous scientific and evidence-based approaches and providing the numbers and facts. It is clear though that such numbers and facts, as during the pandemic, have resulted in diverse policies in different countries. Some commentators have noted that public health has lost its way, arguing that its leadership is failing, lacks courage and not sufficiently concerned with issues about social reform and political accountability and change. Is providing facts and the science sufficient to fulfil our mandate and obligations in public health? What should be our role in advocacy and engagement in politics and policy-making to promote and protect the public's health and tackle health inequalities? The purpose of the roundtable is to explore questions of whether public health is “just science”: is it built merely on a scientific skillset; or is it about justice-promoting science? This question goes to the heart of public health's mandate, with direct implications for public health practice. The questions will be considered largely from the perspective and evidence from the Covid pandemic. There will be presentations by senior distinguished academics and public health practitioners and leaders who have been researching and advising policy makers on wide range of public health issues. They will share their research and experience in particular from membership of the UK Independent Scientific Advisory Group (Indie_ SAGE) for the pandemic and on the Pandemic Ethics Accelerator, as well as other groups advising the government and public organisations on the analysis and implementation of policy options during the pandemic. This will be followed by reflections and discussion with the workshop participants and their reflections and insights on these critical questions.

Key messages
• Public health is not merely a technical, scientific discipline; it incorporates norms and values, and operates in a political environment where value-judgments are fundamental to decision making.
• Public health practitioners and leaders need to consider advocacy and engagement, and the moral foundations of public health, as key to their mandate and professional obligations.

Speakers/Panellists
John Coggon
University of Bristol, Bristol, UK
Martin McKee
LSHTM, London, UK
Marleen Bekker
Wageningen University & Research, Wageningen, Netherlands
Farhang Tahzib
Faculty of Public Health, Haywards Heath, UK
Methodological considerations when assessing the Burden of Disease due to injuries
Authors: De Pauw R 
Published: October 2022

Abstract
Measuring the burden of disease due to injury is a similar process compared to the disease burden. However, burden calculations for injuries impose an extra complexity for the non-fatal burden, as it is important to consider both the ‘cause’ and the ‘nature’ of the injury. Cause of injury (e.g., road injuries, falls, drowning) have historically been used for assigning cause of death as opposed to the ‘nature’ of injury, which more directly specifies the pathology that resulted in death or disability. However, precisely estimating the disability as a result of an injury requires a mapping of, for example, individuals that have suffered a fracture hip (‘nature’ of the injury) because of falling (‘cause’ of the injury). This process would require a matrix of the nature-cause relation of injuries, which are only scarcely available, because they required dual-coded data registers. The presentation will zoom into the differences between disease and injury estimations and will appraise the methodological considerations for the estimations of injury-related burden of disease estimates.
References
James, S. L., Castle, C. D., Dingels, Z. V., Fox, J. T., Hamilton, E. B., Liu, Z., ... & Fomenkov, A. A. (2020). Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study. Injury Prevention, 26(Suppl 2), i125-i153.
Haagsma, J. A., James, S. L., Castle, C. D., Dingels, Z. V., Fox, J. T., Hamilton, E. B., ... & Mahotra, N. B. (2020). Burden of injury along the development spectrum: associations between the Socio-demographic Index and disability-adjusted life year estimates from the Global Burden of Disease Study 2017. Injury prevention, 26(Suppl 2), i12-i26.