bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-COVID in Italy: a country perspective
Authors: Onder G , Floridia M , Giuliano M , Silenzi A , Castriotta L , Pricci F , Grisetti T , Grassi T , Tiple D , Villa M , Brusaferro S
Published: October 2023

Introduction

In 2021 the Italian Ministry of Health, recognizing the need to improve knowledge and standardise the approach to Long-COVID nationwide, funded a project, led by the Italian National Institute of Health, with the following objectives: 1) to define the magnitude and impact of Long-COVID; 2) to identify and assess Long-COVID services nationwide; 3) to define Good Clinical Practices for the management of Long-COVID.

Methods

For objective 1, data of 3 Regions (Friuli Venezia Giulia, Tuscany and Apulia), covering a population of about 9 million people, were analysed, comparing service utilization in patients with previous COVID-19 over six months (from end of acute phase) and in controls matched for age, gender and comorbidities. For objective 2, a national survey was performed to map and characterize Long-COVID care services. For objective 3, an expert panel was appointed to produce good practice recommendations.

Results

In objective 1, COVID-19 was associated with higher rates of specialist visits (Incidence Rate Ratio, IRR: 1.88, 95% CI 1.65-2.13), hospitalizations (IRR 1.98, 95% CI 1.66-2.36), and instrumental diagnostic procedures (IRR 2.70, 95% CI 2.28-3.19) in the 6 months after acute infection. This association was stronger in individuals with infection causing hospital and/or ICU admission. For objective 2, 124 Long-COVID care centres were identified nationwide, with a high heterogeneity in services provision and organization. For objective 3, the panel issued National Good Practice Recommendations for Long-COVID, with 17 statements that provide key principles on services organization and patient management.

Conclusions

Results of this project can be used nationally to put in place appropriate measures targeting Long-COVID. Additional ongoing activities include the implementation of a surveillance system for Long-COVID and the development of activities aimed at increasing awareness and knowledge of citizens and health professionals about Long-COVID.
Changes in care utilization by patients in low-income neighborhoods during two Covid-19 waves
Authors: Kocken P L , Sana S , Van Pelt S , Denktaş S
Published: October 2023

Background

During the COVID-19 pandemic, general practitioners’ face-to-face consultations were replaced by remote (telephone or digital) consultations. This study aims to gain insight into the impact of the COVID-19 pandemic on GP care and the suitability of remote GP care for patients living in low-income neighborhoods.

Methods

A follow-up study of GP patients in disadvantaged neighborhoods of Rotterdam, using questionnaires at T1, the outbreak of COVID-19 (N = 213) and T2, after one year with gradual easing of COVID-19 measures (N = 133). At T1 and T2, 56% and 61% respectively were female, 61% and 65% 50 years and over, 48% and 53% had low health literacy.

Results

The proportion of patients who used remote or other care, i.e. face-to-face care or contact with assistant (56% and 44% respectively) was at T2 similar to T1. A positive attitude toward remote care declined from T1 to T2 from 71% to 58%. At T1 use of remote care was associated with sex and age, with significantly more females using remote care (OR = 3.22, 95% C.I. 1.57 - 6.59) and less respondents 50 years and over using remote care (OR = 0.46, 95% C.I. 0.22 - 0.97). At T2, remote care use was associated with having a migration background (OR = 2.18, 95% 1.00 - 4.74), financial difficulties (OR = 0.30, 95% 0.11 - 0.81), lack of digital skills (OR = 2.73, 95% 1.19 - 6.26) and a chronic disease (OR = 0.40, 95% 0.19 - 0.87). At multivariate level, the associations of age and digital skills with remote care at both time points T1 and T2, compared to remote care only at T1 or T2 or no remote care, were confounded by chronic disease, with lower remote care use by those with a chronic disease (OR = 0.33, 95% 0.13 - 0.87).

Conclusions

The COVID-19 pandemic rapidly accelerated the use of remote care in Dutch general practices. Experience after one year showed provision of GP remote care should be advised selectively for patients showing vulnerability, such as financial difficulties, low digital skills and chronic diseases.

Key messages

• At the start of the COVID-19 pandemic, patients were willing to receive GP care remotely and provision was depending on general characteristics sex and age.

• Remote GP care is less suitable for vulnerable older patients, patients with financial difficulties and those with low digital skills or chronic diseases living in low-income neighborhoods.
Screen Sustenance: Representations of Food and Drink in Film and Media
Authors: O'Brien D
Published: October 2023

This ten-minute video essay will blend together a range of clips from classic and contemporary films (documentary and fiction), as well as television, social media and computer gaming, to consider how food and drink is represented on screen. From early subliminal messaging in movie theatres to “drink Coca Cola” (a practice now illegal) to the modern social status of the ‘viral’ energy/hydration drink, Prime, promoted by YouTubers, food and drink has had a significant relationship upon a range of screen media. In computer gaming it is often synonymous with restoring an avatar's health, while in film and popular programming it can offer a gustatory sensation to viewers through a process of synaesthesia as taste is conveyed through sound and vision. The video essay will consider all of these angles, showcasing the palatable as well as the unsavoury through a range of examples which includes films such as Peter Strickland's Flux Gourmet (2022), Morgan Spurlock's Super-Size Me (2004) and Andrea Arnold's Cow (2021).Fusing a range of gaming, television and social media ingredients together, the video essay is served to help think about the role food and drinks has, and continues to play, within film and screen culture.
COVID-19 impact on pathological cancer diagnoses in Netherlands, Aotearoa New Zealand, & N. Ireland
Authors: Mitchell H , McLean J , Gavin A T , Visser O , Millar E , Luff T , Bennett D
Published: October 2023

Background

The COVID-19 pandemic was managed in Aotearoa New Zealand (NZ) by a COVID-19 elimination policy, involving border closure and an initial national lockdown. This was different to most other countries including Northern Ireland (NI) and the Netherlands (NED). We quantify the effect of these policies on the diagnosis of three major cancers comparing NZ with these two European countries.

Methods

Data from NED, NZ and NI population-based cancer registries were used to assess trends in all pathologically diagnosed (PD) lung, breast, and colorectal cancers from March to December 2020 (COVID period) and compared to the similar pre-pandemic period 2017-2019. Trend data were also collated on COVID-19 cases and deaths per 100,000 in each population.

Results

Comparing the pre-pandemic period to the COVID-19 period there were statistically significant reductions in numbers of lung (↓23%) and colorectal (↓15%) PD cancers in NI and numbers of breast (↓18%) and colorectal cancer (↓18.5%) diagnosed in the NED. In NZ there was no significant change in the number of lung (↑10%) or breast cancers (↑0.2%) but a statistically significant increase in numbers of colorectal cancer diagnosed (↑5%).

Conclusions

The impact of COVID-19 on cancer services was mitigated in NZ as services continued as usual reflecting minimal healthcare disruption and protected cancer services linked with the elimination approach adopted. The reduction in PD cases diagnosed in NED and NI were linked with higher COVID-19 rates and reflect societal restrictions which resulted in delayed patient presentation to primary and secondary care, disruption to screening and healthcare services because of COVID-19 infections on staff and the need to shift intensive care to COVID-19 patients.

Key messages

• Reductions in PD cancers in NI and the NED and in particularly lung cancers in NI, highlight the need for targeted public health campaigns to identify and treat ‘missing’ patients.

• Protecting cancer services should be a priority in any future pandemic or systemic healthcare system disruption.
A review of implementation and evaluation frameworks for public health to inform co-creation
Authors: Longworth G R , Goh K , Agnello D M , Messiha K , Beeckman M , Zapata-Restrepo J R , Cardon G , Chastin S , Giné-Garriga M
Published: October 2023

Background

Co-creation is a promising approach attempting to bridge the knowledge translation gap between research and practice to tackle complex and wicked public health problems. While implementation and evaluation frameworks for public health interventions are numerous and include relevant elements, recommendations are lacking on how to apply them specifically to the context of co-creation. This systematic review identifies and analyses existing implementation and evaluation frameworks for public health interventions and formulates key recommendations for professional stakeholders and researchers wanting to adopt a co-creation approach to intervention.

Methods

PubMed and CINAHL databases were screened for articles introducing original implementation and evaluation frameworks for public health interventions. Backward snowballing techniques were applied to the included papers. Identified frameworks were classified and the content of the recognized frameworks extracted and analysed through deductive thematic analysis.

Results

Thirty frameworks were identified, classified according to most recent literature and prominent concepts and steps extracted. Recommendations around the use of identified frameworks for the context of co-creation were included.

Conclusions

When engaging in co-creation, we recommend including implementation considerations from an early stage and suggest adopting a systems thinking as a way to explore multiple levels of influence, contextual settings and systems from an early planning stage. We suggest applying an evaluation design that is formative and iterative, which, along with effectiveness, pays particular attention to the process evaluation and experience of the engaged co-creators.

Key messages

• When adopting co-creation for public health, we recommend repositioning implementation and evaluation considerations.

• When adopting co-creation for public health, we suggest applying a formative and iterative evaluation, which, along with effectiveness, pays attention to process and experience.
Design of a school-based stroke preparedness intervention: challenges in acute diseases recognition
Authors: Volevach E , Schneider F , Maršálková H , Mikulík R
Published: October 2023

Background

Timely activation of emergency medical services (EMS) by bystanders is important and it can improve outcomes of acute diseases such as stroke in Europe. Since there are no effective interventions addressing the complexity of help-seeking behaviour in the event of stroke, this study describes the development of the Czech “HOBIT” programme, which educates secondary school children to correctly activate the EMS.

Methods

Intervention Mapping was used to guide the development of the intervention using theory and evidence, as well as principles of co-creation. A needs assessment was completed by reviewing the evidence and interviewing stroke survivors. It identified sub-behaviours and their determinants. The information obtained was utilised to select the methods of behaviour change and their practical applications. In the last phase, the intervention tools were created.

Results

The needs assessment revealed stroke recognition and assessment as well as ambulance call as the main behaviours that must be done for EMS activation. Risk perception, outcome expectations, social influences, knowledge, and skills were revealed as important determinants of above behaviours. Modelling was selected as a method for the behaviour change. Based on discussions with 157 children aged 11-15, the format of an entertainment-education video was chosen. Incorporation of the modelling parameters (engagement, transplantation, identification) into the video was assessed during discussions with 15 children (scored >4 on the 5-point scale). As a result, a 5-minute entertainment video, modelling an acute stroke with a child as the main bystander was created.

Conclusions

The innovative educational video teaches children to correctly activate the EMS in stroke by modelling a real-life situation. Our results enable future projects to build on our findings to create the intervention for supporting behaviours in acute events that cannot be trained by direct experience.

Key messages

• Using the systematic approach built on co-creation with stakeholders is a significant foundation for the development of an effective intervention to improve timely activation of the EMS in stroke.

• The current paper provides a comprehensive roadmap to help health promoters approach structured planning for behaviour change in acute diseases response.
Effectiveness of health literacy interventions on the health outcomes of higher education students
Authors: Rosário J , Raposo B , Santos E , Dias S , Pedro A R
Published: October 2023

Background

Health literacy is relevant to the empowerment process of higher education students. It reduces their vulnerability in health decision making. Higher education institutions are planning, implementing, and evaluating health literacy interventions on a variety of topics and using a variety of methodologies in order to achieve health benefits for their participants. Benefits in disease prevention, health promotion and health care have been associated with health literacy interventions. A review was conducted to identify and synthesise evidence on the effectiveness of health literacy interventions delivered in academic settings on the health outcomes of higher education students.

Methods

A systematic review of the literature was conducted with research on the EBSCO Host-Research Databases platform. The methodology followed the PRISMA guidelines, and the protocol was registered with PROSPERO. Methodological appraisal of the studies was carried out according to the Joanna Briggs Institute appraisal tool. A thematic and narrative synthesis was carried out for literature synthesis.

Results

This review included 9 articles out of 154 identified. The health gains of health literacy interventions in academic settings were positive changes in mental health; attitudes, norms, and self-efficacy for condom use; emotional, social, and psychological wellbeing; subjective sleep quality, sleep latency, and habitual sleep efficiency; physical activity; and self-reported servings of fried foods. The educational or motivational health literacy interventions contributed to health promotion, disease prevention or healthcare.

Conclusions

The variety of health literacy interventions that are delivered in an academic setting contributes to positive changes in the health outcomes of students in higher education. Investing in the design and delivery of health literacy interventions is one way to reduce their health vulnerability and protect them from the threats.

Key messages

• When planning health literacy interventions, it is important to know what health benefits they bring.

• Health literacy interventions in an academic setting are important for health outcomes.
Cystic echinococcosis in humans and ruminants in Portugal: a one health approach
Authors: Alho A M , Canhão-Dias M , Cardo M , Aguiar P , Madeira de Carvalho L M
Published: October 2023

Background

Cystic echinococcosis or hydatid disease is an important parasitic zoonosis for public health, although neglected. Despite being a mandatory notification disease both in humans and animals, data in Portugal are almost absent. A collaborative One Health retrospective nationwide study was conducted, bringing together the expertise of public health doctors, veterinarians and epidemiologists.

Methods

Human hospitalizations caused by cystic echinococcosis and slaughterhouse records of echinococcosis from bovine, ovine and caprine species were obtained. Poisson loglinear regression model was used. Occurrence maps were generated combining animal and human cases.

Results

From 2008 to 2022, 298 cases of echinococcosis were identified in post-mortem inspection in Portuguese slaughterhouses (bovines n = 125, ovines=288 cases, caprines n = 14). Between 2008 and 2018, cystic echinococcosis caused 582 hospitalizations in Portuguese public hospital, with an average length of 11 (± 15.66) days, resulting in 13 deaths (2.23%). Alentejo was the region with the highest hospitalizations. For every infected animal, a 7% increase in the incidence rate of human hospitalization was found (p = 0.002, Exp(B)=1.070, 95% CI: 1.025 - 1.117). Residing in the Alentejo increased the incidence rate of human hospitalizations by 5.3 times when compared to other regions (p = 0.000, Exp(B)=5.290, 95% CI: 3.835 - 7.296). For every 100,000 person-years, there was a total of 0.528 hospitalizations and the risk of death from echinococcosis was 8 times higher for those living in the Alentejo (p < 0.001, Exp(B)=8.259, 95% CI: 2.427 - 28.106).

Conclusions

Living in the Alentejo region has shown to be a high-risk factor for echinococcosis. This work gives an accurate recognition of the situation in Portugal, allowing the development of effective health control and education programs to face an important but neglected zoonotic disease under a One Health approach.

Key messages

• Considering that echinococcosis is still one of the 20 neglected tropical diseases of global health importance, is critical to map and monitor its prevalence and trends.

• This study highlights the impact of this neglected zoonosis in humans and livestock, allowing the identification of the most problematic areas for echinococcosis in Portugal.
Indicators used in policy monitoring documents and decision tools assessing the impact of COVID-19
Authors: Garriga C , Valero Gaspar T , Misins J , Vuković J , Díaz A , Palmieri L , Saso M , Rodríguez-Blázquez C , Forjaz M J ,   PHIRI WP5 surveys collaboration group
Published: October 2023

Background

The aim of this study is to present a synthesis of health indicators implemented in policy documents and decision tools to tackle the impact of COVID-19 pandemic across Europe.

Methods

Two surveys were conducted to collect information on indicators monitoring the COVID-19 pandemic. Data source, strength and limitations of the indicators were described. Public health experts from 28 European countries were asked to identify documents and tools from their countries that included impact indicators to measure the direct impact (survey conducted in October 2022) and indirect impact (March 2023) of COVID-19. Experts classified the documents and tools according to their nature: a) promotion, b) prevention or c) health care.

Results

Thirty-one surveys were completed related to direct impact of COVID-19 from experts of 22 countries. Most of the documents/tools were related to ‘prevention and care’ (38.7%), ‘promotion, prevention and care’ (25.8%) and ‘prevention’ (22.6%). Almost all contributions came from primary sources of information (93.5%) The quality of data collection was the most reported strength for the creation of indicators of direct impact (71.0%) The missing values and diagnoses of SARS-CoV-2 not well defined were the limitations to construct direct impact indicators (19.4%, in both cases).

Concerning the indirect impact documents/tools, 15 surveys were completed by 7 experts. Documents/tools with indirect impact indicators mainly covered “promotion and prevention” (46.7%) and prevention (13.3%). Primary and secondary sources of information were evenly used to get indicators of indirect impact (66.7%). A large sample size was mainly reported as strength for indicators of indirect impact (60.0%).

Conclusions

The indicators collated will be useful to assess the impact of future pandemics. It is crucial to harmonise their calculation to allow for comparisons between settings, countries and different populations.

Key messages

• The characteristics of direct and indirect impact indicators collated allow to obtain a better understanding of how the COVID-19 pandemic was assessed.

• Key indicators could be chosen according to their identified strengths and limitations to be truly informative for policymakers.
Voluntary private health insurance and management of frailty in European Health Systems: a longitudinal analysis
Authors: Palladino R
Published: October 2023

Frailty is a major health concern associated with aging. It is a state of multisystem physiological decline and inability to maintain homeostasis, gradually leading to an increased risk of multiple adverse outcomes, such as falls, hospitalizations, and death. The prevalence of frailty in community-dwelling older Europeans (65 years and older) varies between 5.8% and 27.3%; in addition, between 34.6% and 50.9% are classified as ‘pre-frail’. In the face of the rapid population ageing occurring in Western societies, frailty is set to reach epidemic proportions over the next few decades. Although most European health care system offer essential treatment free of charge, voluntary private health insurances (VPHI) are becoming more common. Their coverage can be complementary or supplementary including access, faster treatment, waiting list avoidance, and out-of-pocket refund. A growing body of evidence is showing that there is erosion of the universal health coverage in European Health Systems and accessing VPHI might impact quality of care, especially for complex conditions i.e. Frailty. Using European data from the 2013 to 2011 we will assess trends of VPHI in individuals 65 years and older and whether accessing VPHI impacts frailty management and quality of life for elderly Europeans who are frail. These findings will help assessing quality of frailty management in European Health Systems and identify possible inequalities in accessing health services.
Building an infodemic management network in Serbia: Insights from public health practitioners
Authors: Stevanović A , Mandić-Rajčević S
Published: October 2023

Background

Vaccine coverage against COVID-19 in Serbia remains suboptimal, although COVID-19 vaccines became available to the public early during the pandemic. The presence of the infodemic, an overabundance of false, harmful, or outdated information, is one of the root causes of stagnation in vaccine demand. The Laboratory for infodemiology and infodemic management has been established at the Faculty of Medicine, University of Belgrade, to coordinate the efforts and mitigate the harmful impact of the infodemic.

Methods

Training for public health (PH) professionals, civil society organizations (CSOs), and academia was conducted in three Institutes of Public Health in different regions of Serbia. The training included an introduction to infodemic management and social listening, followed by group discussions. A questionnaire was given to all participants to share their experience about the infodemic sources, effects, and needs of the populations they serve.

Results

A total of 36 PH professionals, CSO representatives, and academics filled out the questionnaire. Over half of them (52.8%) had a primary affiliation in a public health institution and over 15 years of work experience. Although 83.3% of the participants stated that the infodemic presents a major public health issue in Serbia, only 16.7% were satisfied with current infodemic management activities in Serbia. Participants identify family members, doctors, and personal reasoning as the top three factors influencing health behavior. Participants identify the lack of institutional trust as the most important problem in infodemic management.

Conclusions

Insights from public health professionals, CSOs, and academia point to infodemic management being one of the main priorities in future public health activities. A stronger collaboration of experts of different backgrounds is needed to mitigate the complex nature of the infodemic.

Key messages

• Public health practitioners recognize the importance of the infodemic and search for adequate response.

• The lack of institutional trust is one of the main obstacles to effective infodemic management.
Environmental, climatic, anthropogenic features of Filoviruses Disease Outbreak: a systematic review
Authors: Valz Gris A , Regazzi L , Farina A , Campo E , Solimene V , De Maio L , Ricciardi W , Gualano M R
Published: October 2023

Background

Filoviruses, including Ebola and Marburg viruses, are a threat to global public health due to their transmission and mortality rates. Despite recent advances in forecasting infectious disease limited knowledge of the ecological niche of Filoviruses still hinders research progress. Studying the ecological context of Filoviruses can provide important information for the development of international preparedness and surveillance systems.

Methods

We conducted a systematic literature review according to the PRISMA 2020 checklist. A search of relevant articles was performed in PubMed, Scopus, and Web of Science databases. Eligible articles were any type of publication, published in English between 2013 and 2023, discussing environmental, climatic and anthropogenic risk factors of Filovirus disease outbreaks.

Results

A total of 5818 records were screened, and 41 articles were included. Of the 41 studies analyzed, 21 reported an analysis of risk factors related to Ebola Viruses, 8 of Marburg Virus, and 12 analyzed multiple species of Filoviruses. Of the 41 studies analyzed, 16 also developed risk prediction models aimed at stratifying geographic areas. We collected a total of 19 risk factors divided in 4 categories: environmental risk factors (e.g., forest coverage, cropland coverage), climate risk factors (e.g., annual temperature range, seasonal temporal frequency) population risk factors (e.g., human population density, urban population increase), cultural and behavioral risk factors (e.g., bushmeat trade, use of traditional burial practice). The analyzed models primarily use climate and environmental data, with population and cultural factors being considered to a lesser extent.

Conclusions

The identification of potential predictors of Filovirus disease outbreak is crucial for geographic mapping of high-risk areas. A multidisciplinary Planetary Health approach is needed to advance research and to develop targeted surveillance systems to prevent pandemic outbreaks.

Key messages

• Environmental and climate factors play a crucial role in filovirus spillover events, but population and cultural factors should also be considered in future research and risk prediction models.

• To improve prediction of pandemic outbreaks more research on disease emergence and transmission dynamics, better surveillance of disease in humans and animals, and better access to data are required.
Association of eating behavior with body mass index and waist circumference in university students
Authors: Gazibara T , Aleksic V , Maksimovic N , Dotlic J , Stevanovic J , Milic M
Published: October 2023

Background

University students often change their eating habits in favor of snacking and intake of calorie-dense food while studying. This study aimed to examine whether the consumption of specific foods is associated with a higher body mass index (BMI) and waist circumference.

Methods

This research was conducted at the University of Pristina temporarily seated in Kosovska Mitrovica, Kosovo, Serbia, from November 2018 to March 2019. In this cross-section study participants completed a socio-demographic and behavioral questionnaire, the Perceived Stress Scale (PSS), the Beck's Anxiety Inventory (BAI) and the Beck's Depression Inventory (BDI). All students were measured for body weight, height, and waist circumference. A linear regression model was adjusted for age, gender, smoking, alcohol intake, physical activity, number of daily hours spent sitting, having chronic diseases, PSS, BAI and BDI.

Results

The study sample consisted of 534 students. Overall, the average BMI was 23.7 ± 4.5. The adjusted model showed that neither the number of fruit and vegetable portions nor the frequency of eating meat, fish and seafood were associated with a lower BMI. The same model confirmed that neither the number of fruit and vegetable portions per day nor the frequency of eating meat, fish and seafood were associated with a lower waist circumference. However, a regular intake of breakfast was associated with a lower waist circumference (B -1.882; 95% confidence interval -3.59, -0.17; p = 0.031).

Conclusions

Regular intake of breakfast is associated with a lower waist circumference among health sciences students in Northern Kosovo. Providing opportunities for breakfast intake on the school campus should be one of the main goals of the school authorities.

Key messages

• Regular intake of breakfast may help health sciences students have a lower waist circumference.

• Prioritizing breakfast intake can be beneficial for students’ health.
Rapid review of evidence to inform the Northern Ireland Obesity Prevention Strategy 2023-33
Authors: Reynolds CME , Mack J B , McAvoy H
Published: October 2023

Background

The Department of Health in Northern Ireland is leading on the development of a 10-year strategy on obesity prevention (2023-33). The Institute of Public Health conducted a rapid review to identify international policies relating to obesity prevention to populate a ‘policy options matrix’ and support obesity policy development.

Methods

A rapid review was conducted on nine policy measures. The search was conducted in May 2022 and included any systematic review published in the English language in the last ten years available on PubMed and had no conflicts of interest declared. Where no systematic review evidence was available the criteria were expanded to include any type of review level evidence. The search was conducted by two researchers who assessed returned articles in a two-stage screening process.

Results

51 review articles (48 systematic reviews, two scoping and one narrative review) met all inclusion criteria. The articles were summarised into a policy options matrix under the headings; author/year, aim, country/countries, type of evidence, evidence quality, target population, results, equity impact and unintended consequences. The findings were summarised and categorised as follows: food labelling, food packaging, food reformulation, taxation/subsidies, advertising, marketing and sponsorship, food and physical activity environment, and target population policy measures including socially disadvantaged groups and indigenous groups.

Conclusions

The majority of review articles reported low to moderate evidence quality. The most consistent evidence was for policies that aimed to make healthier options the most accessible, cheapest, and appealing and in policies which reduced access to and/or increased the prices of food and drinks high in fat, salt or sugar.

Key messages

• The most effective policies are those improve the food and physical activity environment in which people are born, live, and learn.

• Evidence also supports policies which target specific population groups.
LIFE Climate Smart Chefs; qualitative insights for a sustainable food service
Authors: Martin S , O'Brien K , Nicholson W , Magnani A , Antonelli M , Castaldi S , Kirwan L B
Published: October 2023

Innovative technologies can accelerate the transition to sustainable business practices in the hospitality and food service (HaFS) sector. In order for technologies to be adopted, challenges and opportunities need to be evaluated in order to ensure an effective implementation across the sector from operators and catering staff. Virtual roundtable discussions were held as semi-structured focus groups to identify challenges and opportunities related to technology use in the HaFS sector under three themes; business and economic, functional, and political challenges. 61 participants registered for the “Technology Tools for Chefs” sessions online. Feedback was transcribed and analysed. Challenges identified included a lack of knowledge and disinterest in technology, financial concerns, and a lack of government support. Opportunities included waste management, improved recipe and menu engineering, and showcasing sustainable practices. Business and economic opportunities include efficient time management, integrating sustainable practices, and using technology to predict consumer demands. Political opportunities included more accessible grants, clearer regulation guidance, and facilitating a transition towards sustainable practices. Qualitative research is crucial for identifying and providing solutions to challenges in transitioning to sustainable business practices. Solutions identified include staff training, improved accessibility of funding, and collaboration between businesses, officials, and stakeholders. Promoting sustainability through innovative technology in the food industry requires collaboration between businesses, government officials, and stakeholders to overcome the challenges and achieve sustainable development goals. Overall, the roundtable discussion provided valuable insight on pathways to a sustainable food sector.

Key messages

• Qualitative research provides an evidence base to support a transition to sustainable business practices.

• Incentives included education, improved resources, accessibility of funding, and collaboration.
Geospatial mapping of food advertisements in three low-income communities in Cape Town, South Africa
Authors: Wentzel A , Eichinger M , Hill J , von Philipsborn P , Holliday N , Delobelle P , Mchiza Z
Published: October 2023

Background

The South African food environment is characterized by pervasive marketing on television and in print media of unhealthy food and beverages. Little is known about the extent of outdoor food and beverage marketing (product, spatial advertising, branding) at transport interchange areas, community food outlets, and schools. Our study aimed to map outdoor food and beverage marketing within the vicinities of these areas in three low-income communities in Cape Town.

Methods

Data on food and beverage-related branding, product type, placement, pictures, and Global Positioning System coordinates were captured using a web-based questionnaire. Geographic Information System software was used to delimit the target communities and areas, geospatially map the physical food environment, and perform spatial analysis of the data.

Results

Overall, 986 food and beverage advertisement entries were observed. Preliminary results depicted trends of advertisements clustering around retailers. Spatial trends depicted that fast food and sugar-sweetened beverage (SSB) advertisements were likely to collocate around transport interchange areas, while SSB advertisements were more likely to collocate near schools. The spatial trend for alcohol advertisements indicated a clustering near main roads. Spatial trends for product types varied by location. Few advertisements for fruit and vegetables were captured. Further spatial analysis is underway to assess advertisement density and proximity to youth-related areas, food outlets, and transport interchange areas.

Conclusions

Low-income communities, commuters, and schoolchildren in South Africa are targeted by advertisements for unhealthy foods and SSBs, indicating the need for policy intervention to regulate food marketing.

Key messages

• Geospatial mapping of food and beverage advertisements indicated the promotion of unhealthy products in low-income communities in South Africa.

• Food and beverage adverts target school children and commuters using public transport in poorer communities.
Socioeconomic and health predictors for food insecurity during the COVID-19 pandemic in Czechia
Authors: Ohno M , Vávra J , Jehlicka P
Published: October 2023

Background

COVID-19 impacted people disproportionately and exacerbated preexisting social and health inequalities. The aim of this study was to understand how socioeconomic and health conditions affected food security in Czechia during the pandemic.

Methods

Data on a representative panel of Czech adults from a longitudinal survey, Life During the Pandemic collected in October 2022 as part of a Czech longitudinal survey were analyzed. Binary logistic regression was performed to evaluate whether food insecurity during the pandemic was associated with socioeconomic factors (sex, age, education, income, number of children) and health factors (BMI and comorbidity). The association between food insecurity and growing own food such as fruits and vegetables was also explored.

Results

Younger people aged 20-34 years, lower education attainment, and people with underlying health condition(s) had a higher likelihood of reporting food insecurity. The lowest income group was associated with a 13 times higher likelihood of reporting food insecurity as compared to the high income group (95% CI 6.55, 27.44). Those who grew own food had a 37% decrease in the odds of reporting food insecurity. The number of children in a household was not a predictor for food insecurity.

Conclusions

Our study suggests that younger people and socially, economically vulnerable groups of people were more likely to experience food insecurity. Policies that support these groups and reduce inequality in education and income are needed to reduce food insecurity. Growing own food may reduce impacts of food insecurity. Encouraging people to grow own food either in their own garden or in allotments may prepare us for unprecedented food insecurity.

Key messages

• Our results highlight food insecurity was associated with younger people, people with underlying health condition(s), low-income and lower education attainment.

• Growing own food may reduce impact of food insecurity.
Food security and Mediterranean diet in five countries: the DELICIOUS project
Authors: Godos J , Guerrera I , Laudani S , Mata A , Pardo M I , Busó P , Grosso G
Published: October 2023

Food security is a universal need assuring access to healthy diet in both developing and developed countries. The aim of this study was to investigate the association between factors related to food security and adherence to the Mediterranean diet in 5 Mediterranean countries (Italy, Spain, Portugal, Egypt, and Lebanon) participating to the EU funded project DELICIOUS (UnDErstanding consumer food choices & promotion of healthy and sustainable Mediterranean diet and LIfestyle in Children and adolescents through behavIOUral change actionS). Data were retrieved from a survey involving 2011 parents of children and adolescents aged 6-17 years old. The KIDMED score was used to assess the level of adherence to the Mediterranean diet. Information regarding easiness to retrieve foods characteristic of the Mediterranean diet, working status, economic allowance, and place of living were collected. The association with adherence to the Mediterranean diet were investigated by performing logistic regressions. The analyses revealed that individuals living in rural areas and reporting difficulty to retrieve all food items explored were less likely to have higher adherence to the Mediterranean diet. Moreover, higher adherence was also associated with household income higher than €3,500. No associations with family status nor working situation were found. There were no evident differences across countries, although there was nearly an inverse trend toward lack of association between economic allowance and higher adherence to the Mediterranean diet in Italy. In conclusion, the progressive abandonment of traditional dietary patterns, such as the Mediterranean diet, may not just depend on a cultural shift toward unhealthier industrial alternatives, but also on family budget and easiness to retrieve food stuff.

Key messages

• Food security may play a role in adherence to the Mediterranean diet.

• The food market may be responsible for changes in cultural culinary habits.
Mapping of surveillance systems for health crisis preparedness and response in Member States
Authors: Cosgrove S
Published: October 2023

The Health Emergency Preparedness and Response Authority (HERA) was established by the European Commission in the aftermath of the COVID-19 pandemic to improve EU preparedness and response to cross-border health threats. The HERA IT platform for intelligence gathering and threat assessment is being developed to support HERA's activities through collection of data from relevant sources at European and national level. In this regard the EU-HIP project is collaborating with HERA to map surveillance systems for health crisis preparedness and response in different European countries, focusing on how to ensure interoperability between these systems and HERA's IT platform for intelligence gathering and threat assessment. The methodology to be used will be based on best practice from previous assessments, incorporating assessment indicators relevant to health emergency preparedness and data flows. During the presentation, initial results from the first countries analyzed will be presented, covering the identified digital infrastructures and systems, stakeholder networks and pertinent legislative aspects for threat assessment and response.
Training for the qualification of care management for high-risk pregnant women in Amazon, Brazil
Authors: Shimocomaqui G , Sampaio J O , Silva AAB , Ribeiro SSC , Oliveira MMB , Moreira NRA , Morais TLM , Farias LNG , Souza I S ,   I Eshriqui
Published: October 2023

Background

Maternal care is a worldwide concern, especially at vulnerable settings, as Amazonas, Brazil, where insufficiency of training institutions and professionals and environmental issues are challenges for vulnerable pregnant women care, including indigenous and riverside population. PlanificaSUS project, which is developed nationwide aiming to support and integrate of Specialized Outpatient Care (SOC) and Primary Health Care (PHC).

Objectives

Between September 2022 and January 2023, the PlanificaSUS developed a training in 2 Amazonas’ municipalities to qualify work practices at PHC and SOC aiming integrality and equitable care for pregnant women. Target audience was health professionals and managers. The following care management tools were used as didactic materials: i. Clinical Guideline for Pregnancy, Childbirth and Puerperium; ii. Risk Stratification Form; iii. Care Sharing Form; and iv. Care Plan. The training last 4 hours, with 3 levels of cognitive process as learning objectives. Activity 1 (understanding): consisted of handling the presented tools and reflections based on the local reality. Activity 2 (application): participants groups simulated the use of tools in clinical cases. Activity 3 (analysis): planning actions to implement tools in local work process after training.

Results

48 professionals and managers participated in the training. It was verified that participants did not know the care management tools. Preliminary 2-month results indicate that the tools were incorporated into work process of 5 PHC units. Among 167 pregnant women previously registered, 72% had been stratified using the clinical guideline and the risk stratification form. Of those, 17% were at high risk, among which 38% had the care plan and the form to share care with SOC prepared by PHC team.

Conclusions

The training supports care management based on population needs, allowing care qualification and greater systemic rationality, despite vulnerability and low resources.

Key messages

• The training enabled health professionals and managers to understand the real health needs of the population and to qualify their care practices for vulnerable pregnant women in Amazon, Brazil.

• The training contributed to qualify the access and care of high-risk pregnant women and those in vulnerable situations to the specialized outpatient care integrated with the PHC in Amazon, Brazil.
Overall effectiveness of PRALIMAP-INES in reducing adolescents’ nutritional and weight inequalities
Authors: Dosda A , Manneville F , Omorou A
Published: October 2023

Background

The PRALIMAP-INES trial was effective in reducing weight social inequalities among adolescents with overweight or obesity. Nevertheless, the question of its overall effectiveness on weight status and nutritional behaviours (NB) remains unclear. This study aims to evaluate the overall effect of the PRALIMAP-INES trial on weight status and NB among adolescents with overweight or obesity .

Methods

Generalized Pairwise Comparison was used to evaluate the overall benefit by prioritising outcomes comparing two groups of intervention: Advantaged with standard intervention (AS) and Less Advantaged with standard intervention and strengthened care (LASS). We used the following order: corpulence, vigorous physical activity (PA), fruits and vegetables consumption (FV), sedentary time (ST), sweetened products and beverages consumption (SPB), moderate PA and walking time (WT). This approach provided for each outcome the net benefit in favour of LASS (δ) and the overall net benefit (Δ) as their sum. Net benefit was define as the probability for an adolescent of LASS group to have favourable outcome as compared to AS group.

Results

We included 1223 (AS: n = 808; LASS: n = 415) adolescents (mean aged= 15.37 ± 0.72 years; 45.05% girls). The overall net benefit was estimated at 11.13% [4.15 - 18.06%; p < 0.001] meaning that an adolescent form LASS group had 11.13% higher probability to have favourable change in all weight and NB outcomes than an adolescent from AS group. For each outcome this net benefit was estimated as follow: corpulence (δ = 4.22%), vigorous PA (δ = 4.14%), FV (δ = 3.09%), ST (δ = 0.42%), SPB (δ=-0.71%), moderate PA (δ= -0.02%) and WT (δ= -0.03%).

Conclusions

Beyond corpulence, changes in NB in the PRALIMAP-INES trial show an overall favourable effect for adolescents in the LASS group. The overall net benefit in favour of LASS, confirm a short-term effectiveness of the trial to reduce weight social inequalities and suggests a long-term could be expected.

Key messages

• In the PRALIMAP-INES trial, adolescents who did not change their corpulence may have initiated changes in lifestyle behaviours.

• A benefit of the PRALIMAP-INES trial could be expected in the long-term.