The InfAct proposal for a sustainable European health information infrastructure on population health: the Distributed Infrastructure on Population Health (DIPoH).

BACKGROUND: In Europe, data on population health is fragmented, difficult to access, project-based and prone to health information inequalities in terms of availability, accessibility and especially in quality between and within countries. This situation is further exacerbated and exposed by the recent COVID-19 pandemic. The Joint Action on Health Information (InfAct) that builds on previous works of the BRIDGE Health project, carried out collaborative action to set up a sustainable infrastructure for health information in the European Union (EU). The aim of this paper is to present InfAct's proposal for a sustainable research infrastructure, the Distributed Infrastructure on Population Health (DIPoH), which includes the setup of a Health Information Portal on population health to be maintained beyond InfAct's time span. METHODS: The strategy for the proposal was based on three components: scientific initiatives and proposals to improve Health Information Systems (HIS), exploration of technical acceptability and feasibility, and finally obtaining high-level political support.. The technical exploration (Technical Dialogues-TD) was assumed by technical experts proposed by the countries, and political guidance was provided by the Assembly of Members (AoM), which gathered representatives from Ministries of Health and Science of EU/EEA countries. The results from the AoM and the TD were integrated in the sustainability plan compiling all the major outputs of InfAct. RESULTS: The InfAct sustainability plan was organized in three main sections: a proposal of a new research infrastructure on population health (the DIPoH), new health information tools and innovative proposals for HIS, and a comprehensive capacity building programme. These activities were carried out in InfAct and are being further developed in the Population Health Information Research Infrastructure (PHIRI). PHIRI is a practical rollout of DIPoH facilitating and generating the best available evidence for research on health and wellbeing of populations as impacted by COVID-19. CONCLUSIONS: The sustainability plan received wide support from Member States and was recognized to have an added value at EU level. Nevertheless, there were several aspects which still need to be considered for the near future such as: (i) a commitment of stable financial and political support by Member States (MSs), (ii) the availability of resources at regional, national and European level to deal with innovations, and (iii) a more direct involvement from EU and international institutions such as the European Centre for Disease Prevention and Control (ECDC), the World Health Organization (WHO) and the Organisation for Economic Cooperation and Development OECD for providing support and sustainable contributions.

Comparison of metabolic syndrome prevalence using four different definitions - a population-based study in Finland.

BACKGROUND: Metabolic syndrome (MetS) is a public health problem in Europe, affecting all age groups. Several MetS definitions are available. The aim of this study was to compare four different MetS definitions in the Finnish adult population, to assess their agreement and to evaluate the impact of the choice of the definition on the prevalence of MetS. METHODS: Data from FinHealth 2017, a cross-sectional national population health survey, focusing on adults aged 25 years or older were used in the analysis (n=5687). Measured data on anthropometrics, blood pressure and biomarkers together with questionnaire data were used to classify the participants into the MetS categories according to the four definitions. The definitions chosen for the comparison were those by the World Health Organization (WHO) (1998), National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) (2004), International Diabetes Federation (IDF) (2005), and Joint Interim Statement (JIS) (2009). RESULTS: The four MetS definitions resulted in substantially different MetS prevalence: 17.7% by WHO, 33.3% by NCEP-ATP III, 41.5% by IDF, and 43.0% by JIS. Regardless of the definition used, the prevalence of MetS increased with age. The prevalence of the different components varied between the definitions, depending on the different cut-off points adopted. Out of all participants, only 13.6% were identified to have MetS according to all four definitions. Agreement between participants recognised by different MetS definitions, estimated through kappa coefficients, was almost perfect for IDF vs. JIS (0.97), strong for JIS vs. NCEP-ATP III (0.80), moderate for IDF vs. NCEP-ATP III (0.76) and weak for WHO vs. NCEP-ATP III (0.42), WHO vs. IDF (0.41) and WHO vs. JIS (0.40). CONCLUSIONS: Differences between observed prevalence of MetS in Finnish men and women using different MetS definitions were large. For cross-country comparisons, as well as for trend analyses within a country, it is essential to use the same MetS definition to avoid discrepancies in classification due to differences in used definitions.

Suicide. The post-COVID era: a time for action / Suicidio. La era post-COVID: tiempo para la acción

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Episodios de cefalea en ráfagas asociados a las fluctuaciones de temperatura en Bogotá 2009-2013 / Cluster headache attacks associated with temperature fluctuations in Bogotá 2009-2013

El calentamiento global, que conlleva un incremento en el promedio y la varianza de la temperatura a nivel mundial, se ha asociado a una gran variedad de efectos agudos y crónicos sobre la salud, los cuales han sido descritos en la ciudad de Bogotá. Este aumento de la temperatura podría estar asociado a una mayor frecuencia de eventos cardiovasculares, respiratorios y neurológicos, como la cefalea en ráfagas (CR). El objetivo de este estudio fue evaluar la asociación entre las variaciones de temperatura y la ocurrencia diaria de episodios de cefalea en ráfagas, a través del análisis ecológico de series de tiempo en el periodo comprendido entre 2009-2013 en Bogotá. Este diseño utilizó los datos diarios de consultas de urgencia por CR y su relación con los valores diarios de variables meteorológicas y contaminantes criterio durante 5 años. El análisis estadístico incluyó el resumen descriptivo de las variables, posteriormente el análisis bivariado con pruebas de correlación, autocorrelación y correlación cruzada y por último el análisis multivariado mediante una regresión dinámica de Poisson y el modelo no lineal de rezagos distribuidos. Se encontró una correlación con un comportamiento cíclico entre cefalea en ráfagas con amplitud térmica (Rho=0,054, p<0,05) y temperatura máxima (Rho=0,050, p<0,05). En el modelo multivariado, se observó una influencia alta tanto de la amplitud térmica (ß=0,11, IC95% 0,07 a 0,16), como de la temperatura máxima (ß=0,14, IC95% 0,08 a 0,20) en la incidencia de CR. La amplitud térmica y la temperatura máxima podrían ser un desencadenante de los episodios de cefalea en ráfagas, pero futuros estudios deben explorar la relación de las crisis de acuerdo a las islas de calor en Bogotá y explorar las asociaciones con estudios a nivel individual.

Global warming has been linked to the increase of both average and variance of temperature which has been associated with a variety of acute and chronic health effects and Bogotá has not been the exception. This temperature increase might be related to a greater incidence of cardiovascular, respiratory and neurological outcomes, as cluster headache. Aim of this study was to assess the association between temperature fluctuations and daily incidence of cluster headache, through a time series analysis of the cases from 2009 to 2013. An ecological design was carried out with daily emergency admissions of cluster headache and daily values of meteorological and pollutants in Bogota. Statistical analysis included a descriptive summary of variables, a bivariate analysis with correlation, crossed correlations and autocorrelations tests and multivariate analysis by Poisson regression models and distributed lag nonlinear models. A cyclic behavior was observed, with a correlation between cluster headache and thermal amplitude (Rho=0.054, p<0.05) and with maximum temperature Rho=0.050, p<0.05), which persisted in the multivariate analysis: thermal amplitude (ß=0.11, CI 95% 0.07 a 0.16), and maximum temperature (ß=0.14, IC95% 0, 08 a 0, 20). Thermal amplitude and maximum temperature might be a trigger of cluster headache, but future studies should explore +this association at individual level and in the urban heat islands.

Factores de riesgo para enfermedad respiratoria en población de 5 a 14 años de una Localidad de Bogotá, 2012-2013 / Respiratory disease risk factors in the 5-14 year-old population in an area of Bogota, 2012-2013

Objetivo Establecer la prevalencia de síntomas respiratorios, asma y rinitis, posiblemente asociados a la contaminación del aire en niños entre 5 y 14 años, en la localidad de Bosa, año 2012-2013. Métodos Se tomó una muestra de 553 niños residentes en la localidad de Bosa. Resultados Cuando el niño habita con personas que fuman tiene 1,5 veces más de riesgo de toser en la noche respecto a los niños cuyos contactos no fuman. Los niños que habitan en viviendas con chimeneas a menos de 100 m de distancia tienen 1,6 veces la probabilidad de presentar el síntoma. Quienes asisten al colegio de mayor exposición y además tienen edificaciones en construcción o vías en mal estado a menos de 100 m de sus viviendas, presentan 2,5 veces la posibilidad de manifestar el evento. En cuanto a presentar sibilancias en el último año, los niños que tienen humedades en su habitación presentan 4 veces la probabilidad de manifestarlas. Hay un incremento del riesgo de sibilancias en un 80 % cuando el niño vive a menos de 100 m de edificaciones en construcción o vías sin pavimentar y además asiste al colegio de mayor exposición. Conclusiones Son tan importantes las intervenciones gubernamentales para la modificación de los factores de riesgo extramurales asociados a la enfermedad respiratoria como las mejoras que deben llevarse a cabo extramuralmente.(AU)

Objective Establishing the prevalence of respiratory symptoms, asthma and rhinitis, possibly associated with air pollution, in 5- to 14-year-old children in Bosa (a conurbation of Bogota), between 2012 and 2013. Methods A sample was taken of 553 children living in the conurbation. Results The results indicated that when a child lives with people who smoke there was a 1.5 times risk of coughing at night (compared to living in a non-smoking home) such night-time coughing being different to that produced by respiratory infections such as colds, bronchitis and pneumonia. Children living in homes having fireplaces/open cooking areas located less than 100 m apart had 1.6 times greater probability of presenting symptoms. Children attending schools having greater PM10 exposure and living near buildings being constructed or having roads in a poor state of repair less than 100 meters from their homes were 2.5 times more likely to suffer respiratory disease. Children living in damp rooms were 4 times more likely to have wheezed during the past year. The risk of wheezing became increased by 80 % when a child lived within 100 meters of buildings being constructed or near unpaved roads and attended a school having greater exposure. Conclusion Government intervention is critical for changing respiratory disease-associated extramural risk factors, such as improvements benefitting children which should be carried out in urban areas.(AU)

[Respiratory disease risk factors in the 5-14 year-old population in an area of Bogota, 2012-2013]. / Factores de riesgo para enfermedad respiratoria en población de 5 a 14 años de una Localidad de Bogotá, 2012-2013.

OBJECTIVE: Establishing the prevalence of respiratory symptoms, asthma and rhinitis, possibly associated with air pollution, in 5- to 14-year-old children in Bosa (a conurbation of Bogota), between 2012 and 2013. METHODS: A sample was taken of 553 children living in the conurbation. RESULTS: The results indicated that when a child lives with people who smoke there was a 1.5 times risk of coughing at night (compared to living in a non-smoking home) such night-time coughing being different to that produced by respiratory infections such as colds, bronchitis and pneumonia. Children living in homes having fireplaces/open cooking areas located less than 100 m apart had 1.6 times greater probability of presenting symptoms. Children attending schools having greater PM10 exposure and living near buildings being constructed or having roads in a poor state of repair less than 100 meters from their homes were 2.5 times more likely to suffer respiratory disease. Children living in damp rooms were 4 times more likely to have wheezed during the past year. The risk of wheezing became increased by 80 % when a child lived within 100 meters of buildings being constructed or near unpaved roads and attended a school having greater exposure. CONCLUSION: Government intervention is critical for changing respiratory disease-associated extramural risk factors, such as improvements benefitting children which should be carried out in urban areas.