bluuebunny/crossref_metadata_2025_split huggingface dataset:
Policies out of sync – are healthy ageing agendas fit for the future?
Authors: Mavrodaris A , Lafortune L , Brayne C 
Published: October 2022

Abstract

Background
In both scale and impact, population ageing has far reaching implications for our planet, not least as a major driver of population growth and the ever-increasing human demands on natural resources and ecosystems. This fundamentally impacts sustainable development efforts to eradicate poverty, achieve food security, build inclusive and resilient communities, and ensure sustainable consumption. The overarching connections between global ageing and sustainability are clear: a focus on sustainable healthy ageing is fundamental to a healthy planet. Our responses to date have however largely been disconnected. To progress this dual agenda, our work aims to i) assess whether current national/international strategies addressing healthy ageing include a strategic focus on sustainability; ii) present the evidence for such alignments; and iii) develop a framework of sustainable actions and aligned policy.

Methods
A mixed-methods approach using content and applied thematic analysis was utilised to examine strategy documents, and develop an analytical framework derived from relevant theory to guide quantitative and qualitative analysis of the resultant data. Evidence themes were developed iteratively during analytical phases. Findings informed the development of the framework.

Results
We identified and analysed 36 strategies published from 2000 to 2021 containing over 600 wide-ranging policies. No strategies and only a minority of policies included a strategic sustainability focus. A larger subset made reference to links between ageing and sustainability or environmental elements yet these were largely theoretical and not carried through in the key strategic approaches or resulting polices.

Conclusions
This work provides valuable insights into strategic approaches to foster sustainable healthy ageing and identifies levers for greater alignment and sustainable action. The recently declared 2021-30 UN Decade of Healthy Ageing provides an ideal platform for action.

Key messages
• While the evidence for strong alignment is unequivocal, global healthy ageing and sustainability agendas are largely disconnected.
• By strengthening the links between healthy ageing and sustainability agendas, stakeholders across sectors can reinforce and design approaches that meet human needs while protecting our planet.
Identifying cross-sectoral cooperation for urban health
Authors: Matinheikki K , Liinamo A 
Published: October 2022

Abstract

Empirical evidence for collaborative health promotion practices is still limited. The Cross-Sectoral Cooperation Self-Assessment Tool (CroCo SA) presented here provides a tool for cities to assess their current commitment to promote urban health and well-being across sectors. The SA tool was validated by co-operating with 9 pilot cities and seven countries in the framework of the Healthy Boost project funded by Interreg Baltic Sea Region (2019-2022). Addressing the current complexity, interdependence and emerging challenges of health promotion requires cross-sectoral cooperation and tools to assess cross-sectoral processes and make their impact visible. A digitized CroCo SA tool was developed and validated. An SA evaluation matrix was created, including 162 cells of options for reflective and guiding responses according to 6 scale x 27 items used in the SA tool. After submission of the electronic form, respondents can view anonymized results in a digital form on the Healthy Boost platform. The feedback report summarizes the results for respondents and provides, both numerical and descriptive, verbal feedback on the state of the assessed city's capacity for cross-sectoral cooperation, based on each assessment. The steps the respondents could take in their respective cities to improve cross-sectoral cooperation are outlined. Recommendations are based on the evidence found to be the prerequisites for effective cross-sectoral work for health promotion. SA can be conducted in many languages offered by the Google translation programme. Guiding feedback of CroCo SA defines areas for improvement in strategies and actions, allowing respondents also to do benchmarking and learn from other cities and countries. Self-assessment itself is a learning process.

Key messages
• The CroCo SA tool offers a method for gathering information about the state of cross-sectoral cooperation for urban health promotion.
• By identifying strengths and weaknesses in cooperation, the city can build capacity for cross-sectoral cooperation.
Alternative routes to HiAP implementation
Authors: Bekker M 
Published: October 2022

Abstract
From a public health political science perspective there are alternative routes to HiAP. Besides the ‘classic’ HiAP approach seeking government internal departmental alignments, facilitating and rewarding bottom up social initiatives by communities, or marketed health innovations by commercial health-related consultancies and enterprises, and regional (socio-) economic innovation networks that after a developmental stage can start to pressure multi-level governments for action. A final route lies along the litigation path (Think of climate agreements and governments being held accountable by the judiciary to comply with agreed emissions reductions etc.)
Impact of sepses caused by three Multi-Drug Resistant bacteria in a tertiary hospital in 2018-2020
Authors: Garlasco J , Beqiraj I , Bolla C , Marino EMI , Zanelli C , Rocchetti A , Gianino MM 
Published: October 2022

Abstract

Background
Healthcare-associated infections represent a major health issue, particularly if caused by multi-drug resistant (MDR) microorganisms, with additional hospitalisation days and relevant costs besides illness and deaths. This study aimed at evaluating the economic impact of healthcare-related sepses caused by three MDR Gram-negative bacteria (Acinetobacter baumannii, Klebsiella pneumoniae and Pseudomonas aeruginosa) in a tertiary hospital.

Methods
An observational, retrospective-cohort analysis was based on data related to patients admitted to the “SS. Antonio e Biagio e Cesare Arrigo” Hospital in Alessandria (Italy) between 2018 and 2020. Starting from the microbiology laboratory database, the set of patients developing sepses from the examined species was selected, by also checking that the relevant antibiogram provided evidence of resistance to ≥ 2 antimicrobial classes indicated by the European Centre for Disease Prevention and Control. Data were retrieved from patients’ medical records and from the hospital's computer-based application.

Results
In years 2018-2020, 174 patients developed septic infections from the examined species, the majority of which (88, i.e. 50.6%) in 2020 only. Altogether, these cases were responsible for 3,295 additional hospitalisation days (median 14 days, mean 19 days), with 901 imaging and 7,365 laboratory exams being reasonably ascribable to the septic episodes. Sepsis-related costs could be estimated in around 3 million Euros, about 85% of which (≈2.5 million Euros) were due to the actual cost of extra hospital stay. Specific antimicrobial therapy accounted for around 11.2% of the total (≈336,000 €).

Conclusions
The results of this study pointed out that MDR sepses were responsible for conspicuous costs, largely grounded on the extra length of hospital stays but also due to the use of highly-expensive new-generation antimicrobials. Further research is needed to explore costs of septic episodes in different contexts.

Key messages
• MDR sepses entailed high costs (around 3 million Euros in three years only in a single hospital), due to extra length of hospital stays and use of highly-expensive new-generation antimicrobials.
• In order to provide wider-scale estimates of the economic impact of sepses, further research is needed to explore costs of septic episodes in different sanitary systems and contexts.
Trends in mortality associated with surgical site infections: a cohort study in Italy, 2009-2019
Authors: Paladini G , Elhadidy HSMA , Cornio AR , Bordino V , Vicentini C , Zotti CM 
Published: October 2022

Abstract

Background
Surveillance programs have proven to be effective in reducing surgical site infection (SSI) rates. In 2008 Piedmont joined the Italian national surveillance system. The aim of this study was to evaluate mortality rates and trends associated with SSIs in Piedmont from 2009 to 2019 for the two most frequently performed surgical procedures, hip arthroplasty (HPRO) and colon surgery (COLO).

Methods
Data were collected through the national surveillance system, which includes 42 hospitals in Piedmont who participated in the surveillance program from 2009 to 2019. Procedure-specific SSI rates, overall mortality rates and case fatality rates (CFR) associated with SSIs were calculated, overall and per year. Trends were evaluated using the chi-squared test for trends. Analyses were performed using Epi Info v. 7.2.

Results
A total of 33438 surgical procedures (21645 HPRO, 11793 COLO) were monitored over the study period from the hospitals participating in the network. 1215 SSIs (293 HPRO, 922 COLO) were observed and 617 deaths were registered (222 HPRO, 395 COLO). For HPRO procedures, an overall SSI rate of 1.35% was found, with an overall mortality of 1.03% and a CFR of 3.75%. No significant trend was observed. Considering COLO interventions, an overall SSI rate of 7.82% was found, with an overall mortality of 3.35% and a CFR of 6.94%. There was a statistically significant downward trend in SSI and overall mortality rates (p = 0.046 and 0.005, respectively).

Conclusions
Considering HPRO, it is possible that the lack of significant trends could be due to the already low SSI and overall mortality rates, with the protective effect of surveillance having reached a plateau. Regarding COLO procedures, a significant reduction in SSI and overall mortality rates was observed during the study period. The reduction in mortality could be due to the decrease in SSI rates, however other factors not analysed in our study could have contributed.

Key messages
• This study brings further evidence to the protective effect of surveillance, attributable to an improvement in healthcare quality and patients’ safety.
• A significant decrease in COLO mortality rates was observed, which could be due to the decreasing trend in SSI rates.
Aetiology of influenza-like illnesses in the pre-COVID-19 season 2019-2020: role of coronaviruses
Authors: Amoruso I , Fonzo M , Bertoncello C , Baldo V , Baldovin T 
Published: October 2022

Abstract

Background
Only a proportion of seasonal influenza-like illnesses (ILIs) can de facto be attributed to influenza viruses. This study investigated the aetiology of ILIs to estimate the prevalence of human coronaviruses (CoVs) and to analyse their clinical-epidemiological traits.

Methods
A sample of 613 outpatients (253 adults, 360 children) with ILI in Veneto Region, Italy, was included. ILI was defined according with the EU Decision 2018/945. Sigma-Virocult nasopharyngeal swab were used. Nucleic acids were extracted with the QiaAmp Viral RNA Mini Kit (Qiagen). Molecular detection of respiratory viruses was performed with commercial One-step RT qPCR reagents (Allplex® Respiratory Panels, Seegene). Information on age, sex, symptoms, co-infections and comorbidities was collected.

Results
CoVs were the 3rd most frequent pathogen in adults (7.5%, after influenza and rhinovirus) and the 4th in children (4.7%, after influenza, rhino- and adenovirus). Subtype distribution was similar, with OC43 the most frequent. Probability of CoV involvement was twice in males (AOR=2.16; 95%CI: 1.05-4.39), whereas no association with age was noted. Co-infection with other viruses was frequent in children (65% of cases). CoV symptoms were not peculiar, although respiratory tract involvement was less likely than influenza (AOR=0.13; 95%CI: 0.04-0.41). Among CoV outpatients, 36% had one or more chronic diseases, compared with 5.6% among influenza (p = 0.001).

Conclusions
Even before the COVID-19 pandemic, CoVs had a substantial role in ILI aetiology: 1 case of CoV every 3 influenza infections in adults. The higher prevalence of comorbidities among CoV positives compared to influenza indirectly shows the benefits of flu vaccines in individuals at higher risk. Careful surveillance of the viruses responsible for ILI continues to be desirable, including, but not limited to, detecting a possible change in the aetiology of ILI after the administration of SARS-CoV-2 vaccines in the population.

Key messages
• Pre-pandemic virological surveillance of influenza-like illnesses (ILIs) reveals how seasonal coronaviruses were the third most frequent respiratory pathogen in adults.
• Prevalence of comorbidities was significantly higher in patients with a coronavirus-related ILI compared to influenza, supporting the benefits of flu vaccination for high risk groups.
Toward a digital child health booklet
Authors: Dratva J , Stronski S 
Published: October 2022

Abstract
Public health, paediatrics as well as other health professionals share the interest in providing services and improving conditions to ensure life-long health and well-being of children and adolescents. In this interprofessional setting and aim, parents are central partners, as are adolescents when they take over the responsibility of their own health. Ensuring the availability of health data for parents and adolescents at any given time and place is a key factor to empower and improve health management and literacy, providing continuity of health information along the care chain, and analysing health data of healthy and sick children is of high importance. The digital booklet will have a positive impact on sharing of health information among care professionals, thus ensuring continuity of care and limiting redundancy of investigation, and in addition provide data for public health research and monitoring of health and determinants. The Swiss Society of Paediatrics, the ZHAW/Institute of Public Health and the Kollegium of Hausarztmedizin (general practices) founded an association to digitalize the current paper child and adolescent health booklet with the aims:
1. Empower parents as ‘owners’ of health data to take responsibility and have greater autonomy in managing their child's health and illness
2. Provide a digital infrastructure for
– low-threshold and reliable source of advice
– easy update of data/information, digital communication with parents
– sharing of data with professionals and non-professionals involved in care of child.
3. Monitoring of children's health data (parental consent provided)
The speakers with present their collaboration and project, its current status, as well challenges and solutions found.
Which effects had the pandemic in migrants’ health and well-being? A mixed-methods approach
Authors: Gama A , Marques MJ , Pedro AR , Hoffmeister LV , Rodrigues F , Ribeiro JS , Dias S 
Published: October 2022

Abstract

Background
The COVID-19 pandemic affected populations’ health, with a disproportionate impact on those most socially vulnerable such as migrants. The way these populations experienced the pandemic lockdowns and its effects on daily life are yet to be known. This study aimed to understand the effects of the pandemic on health and well-being of migrants in Portugal.

Methods
In a mixed-methods approach, a survey was conducted with a community-based sample of 1126 migrants in the Lisbon Metropolitan Area, assessing sociodemographics, migration-related characteristics and the perceived impact of the pandemic on health. In addition, n = 12 migrants purposively recruited were invited to participate in a photovoice study, sharing photographs about their daily life during the lockdowns. Following semi-structured interviews were conducted. Quantitative data were analysed using multivariable analysis and qualitative data were analysed through content analysis.

Results
A fifth of the participants perceived having worse health condition since the pandemic, which was more likely among women (OR = 1.58, CI95% 1.13-2.20), those &gt;45 years old (OR = 1.78, CI95% 1.02-3.16), with lower education (Basic education: OR = 1.57, CI95% 1.01-2.47) and with lower monthly income (&lt;EUR 650: OR = 1.69, CI95% 1.18-2.44). Two themes emerged from the photovoice: effects of the pandemic lockdowns on daily life (routines, social relations, work) and on health and well-being (eating habits, physical exercise, leisure). Strategies to cope with the adverse effects included social activation and changes in lifestyles.

Conclusions
The pandemic had disproportionate effects on some migrant groups, intensifying social and health inequalities, with consequences for their well-being. Participatory methods can contribute to further understand migrants’ experiences while involving and empowering them for health promotion.

Key messages
• The pandemic had adverse effects on migrants’ health and well-being, disproportionately affecting most socially vulnerable migrant groups.
• Participatory research methods as photovoice are valuable to gain access to individual experiences and perspectives, while involving and empowering participants.
Femicides in Turkey: Analysis of the last two decades’ cases
Authors: Erbaydar NP , Muharremoğlu ZD , Mutlu DA 
Published: October 2022

Abstract

Aim
Femicide is the women's murder by men for misogynistic reasons. This research aims to determine the characteristics of femicides in Turkey.

Methods
In this cross-sectional study, 13 news sites were scanned using keywords related to femicides between 2000-2019, and 1744 cases were included. In the study, the murdered women, the perpetrators’, and the femicides’ characteristics were determined and the percentages, central tendency, and distribution measures were calculated.

Results
The mean age of the murdered women was 33.2 (SD = ±13.2); 55.5% who were married or cohabitated had at least one child (Mean=2.2±1.4), and 977 children lost their mothers due to femicide. Of the women killed, 19.1% of them filed for divorce, 10.0% of them applied to law enforcement before, and 4.5% were pregnant. Of the perpetrators, 53.1% were husbands/ex-husbands. The mean age of perpetrators was 38.3±13.4 and 10.8% had criminal records. Of the perpetrators, 12.1% had threatened the women before, and 6.2% of them had been detained. Of the femicides, 80.4% were committed in urban areas. According to the news, 34.7% of the perpetrators were in the prosecution and detention process, 25.6% were on trial, 16.2% committed suicide. Of those whose sentences have been finalized, 26.6% of them were given aggravated life imprisonment and 36.3% of them to life imprisonment. Sudden quarrels, desire for divorce, jealousy, and honor/custom were the most cited reasons. Firearms or sharps were the most frequently used weapons.

Conclusions
Women were killed by men who were close to them. Women's desires for separation/divorce or to make their own decisions for their lives posed a threat to traditional masculinity. The fact that one out of every ten perpetrators had a criminal record in femicides showed that violence was a way of life for some men. In addition, the ease of access to firearms led to their frequent use in femicides.

Key messages
• Improve gender equality.
• Access to firearms should prevented.
Redistribution of ill-defined deaths: the Scottish Burden of Disease approach
Authors: Fletcher E , Grant I , Wyper G , McCartney G , Thrower M , Stockton D 
Published: October 2022

Abstract
Burden of disease (BoD) studies are an established method of quantifying health loss across - and within - a population. They aim to combine the impact of living with, and dying from, various health conditions to allow for comparability of conditions in an equitable manner. A key component of this is the calculation of the loss of years of life arising from premature death (Years of Life Lost (YLL)). Most high-income nations have robust death registration systems which ensure that deaths are routinely recorded, the causes are medically certified and the age at death is accurate. However, even in these situations the recording of ill-defined death (IDD) causes remains widespread and to some extent unavoidable, in that it is not always appropriate to undertake extensive investigation to establish an exact cause of death or the cause of death recorded does not map directly to disease groupings used routinely in BoD studies. The Scottish Burden of Disease (SBoD) uses cause of death data from the National Records of Scotland. These patient-level records include one underlying cause of death and up to 10 supplementary causes of death, all coded using ICD classifications. Around 12% of these deaths do not map directly to a BoD cause group and could therefore be considered ill-defined. The SBoD study have developed a 9-step hierarchical methodology for the redistribution of ill-defined deaths, utilising uses a mix of fixed and proportional redistribution and focusses on exploiting the data recorded on the death certificate at both an individual and population level. In this presentation we will describe the methodology used to redistribute ill-defined deaths in the Scottish study - the development, the application and the strengths and weaknesses of our approach. We will also discuss the example of COVID-19 and how competition between the underlying cause of death is likely to impact how we need to approach IDDs in the future.
Primary health care reforms in Poland: ambitions versus reality
Authors: Sagan A , Badora-Musiała K , Domagałaa A , Kowalska-Bobkoa I 
Published: October 2022

Abstract
Poland, like many other former eastern bloc countries, inherited a health system dominated by narrow medical specialties, a large number of hospital beds and relatively weak primary health care (PHC). Since early 1990s, efforts have been made to strengthen the role of PHC, starting with the introduction of specialization training in family medicine. With privatization of PHC practices the standard of PHC care has improved. However, national audits have repeatedly found PHC to still be inadequate, with the key weaknesses including shortages of family medicine specialists, insufficient provision of preventive services, and limited use of diagnostics, which led to inappropriate referrals and long waiting times for specialist consultations. Between mid-2018 and the end of 2021, a new model of PHC organization was piloted in around 40 PHC practices across Poland that met the model's requirements. The pilot, supported by the World Bank, put much emphasis on health promotion and disease prevention by including health educators and dieticians in PHC teams and by introducing periodic check-ups. It also aimed to reduce referrals to specialist care by allowing PHC doctors to order extensive diagnostic and laboratory tests and, if needed, consult with a range of cooperating specialists. It also sought to increase the role of PHC doctors in the management of chronic conditions by introducing disease management programmes (DMPs) for 11 most prevalent conditions. PHC teams were made responsible for coordinating patients’ care pathways, including post-hospital treatment, and a new role of care coordinator was introduced to that end. After the pilot was concluded, all PHC practices were mandated to hire care coordinators. Implementation of other solutions tested in the pilot remains uncertain, mainly due to the lack of financial and human resources, and the dominance of small PHC practices that struggle to meet the ambitious requirements set out in the new model.