bluuebunny/crossref_metadata_2025 huggingface dataset:
Participative development of a culture-sensitive instrument to measure substance use in Syrian refugees
Authors: Behr K , Lindert J
Published: October 2024

Background

Rarely assessment instruments have been developed with end users such as refugees or those suffering from mental health conditions. Refugees’ experiences pre-, during, and post-flight are associated with various mental health problems including substance use disorders. Systematic reviews on the prevalence of substance use disorders in refugees worldwide show heterogeneous results. To address possible misclassification due to the lack of refugee-sensitive instruments we aimed to develop a refugee-sensitive instrument.

Methods

We applied a three-step triangulation study design. First, we conducted a three-stage delphi-process in 2019 and 2020. We recruited Syrian medical doctors for the study. Second, we conducted six focus group discussions with Syrian refugees and medical doctors. Third, we conducted expert checks with medical doctors and professionals providing psycho-social services for refugees. For all focus group discussions, audio recordings were translated and transcribed. Computer-assisted thematic analysis was performed applying a deductive approach with semantic coding.

Results

The refugee-sensitive instrument consists of seven domains of substance use: lifetime use of relevant types of substances, frequency, intensity, self-perception of, and situations posing a risk for substance use, ability to perform, craving, tolerance, and intentions to reduce or quit substance use.

Discussion

The instrument has been developed qualitatively, however, a limitation is that it could not be validated in a quantitative large sample of refugees. In spite of this limitation, this is - to the best of our knowledge - the first instrument that has been developed in a participatory approach together with end-users.

Outlook

The study suggests that developing assessment instruments in a participatory approach is feasible. Participatory development of assessment instruments is in line with the new paradigm of co-creation of mental health conditions management.
Exploring the mental health impact of asylum-seeking of sexual minority men: a qualitative study
Authors: Gottvall M , Isaac R , Carlsson T
Published: October 2024

Background

Sexual minority individuals, often called LGBTQ+, encounter significant danger and violence in some countries worldwide. This forces many to seek asylum in a range of European countries. The study aimed to explore the experiences of seeking asylum and its implications for the mental health of sexual minority forced migrant men in Sweden.

Methods

An exploratory qualitative approach was used, and 15 adult gay and bisexual cisgender men were interviewed individually. Participants were recruited through a combination of purposeful, convenience, and snowball sampling. Systematic text condensation was used to analyze data. The analysis was conducted in close collaboration with three migrants with lived experience.

Results

The asylum-seeking process proved emotionally challenging, involving procedures with negative impacts on mental health. Challenges included disclosing intimate information during asylum interviews and enduring long periods of uncertainty with limited information on asylum case progress. Fundamental to participants’ experiences were the behaviors and attitudes of the professionals involved in legal procedures. Disrespectful and homophobic conduct during asylum interviews, enacted by interpreters and caseworkers, had been experienced by participants. The accuracy of interpretation emerged as crucial, possibly influencing the outcome of asylum claims as well as participants’ comfort in sharing information.

Conclusions

Sexual minority men seeking asylum in Sweden find themselves in an unfamiliar and emotionally challenging position. The challenges highlighted in this study implicates that the stressful asylum process may lead to health burdens among this population. The study emphasizes the critical role of a safe, affirming and supportive environment for asylum seekers. Further research is needed to develop effective support methods to ensure the health and well-being of sexual minority forced migrant populations during the asylum process.

Key messages

• The stressful asylum process may lead to health burdens among forced migrant sexual minority men.

• There is a need for public health action to develop effective support methods addressing the mental health challenges faced by sexual minority forced migrants during their asylum process.
8.P. Scientific session: Lessons-learned from recent foresight studies to support policy making?
Authors:   Organised by: EUPHA-FS, RIVM (Netherlands), Instituto Superior Técnico (Portugal), RAND Europe,   Chair persons: Henk Hilderink (EUPHA-FS), Ana Vieira (EUPHA-FS)
Published: October 2024

Though foresight is still relative new regarding applications to public health, their number is rapidly growing. Recently, several foresight studies have been published with different health angles. These foresight studies have in general the purpose to support and improve the policy making process. Policy making that is foresight-informed, e.g. policies that account for possible futures and the uncertainty they encompass, will hopefully be better in achieving policy goals than without foresight. However, policy makers in general have a relatively short time horizon, may not welcome uncertainty and have many other aspects to account for when developing their policies. In this workshop, the link of foresight studies with policy making, also referred to as knowledge translation will be the focal point. The workshop will start with and interactive Mentimeter session to get a better view on how the audience is familiar with foresight and knowledge translation. Then, a brief presentation is given as introduction to foresight and a systematic way of doing knowledge translation, applied to foresight, explaining the basic concepts to level understanding of the audience. This is followed by three presentations of foresight studies on specific topics (Screening, AMR, Substance use) focussing on their link withing policy making. Next, two broader foresight studies will be presented (i.e. Dutch PHFS 2024 and the future of public health in Europe). These provide good examples on how broad future public health are analyzed and can be linked to public health policy making. The workshop will be concluded with a discussion with presenters on the lessons learned regarding foresight and the link to policy making.

Key messages

• Foresight studies in the field of health are maturing by a stronger link to policy making.

• We can learn from recent foresight studies how to do better knowledge translation regarding foresight.
Applying foresight methods at the national level in the field of substance use: Experience from the DRUG-PREP project
Authors: Cosgrove S , Hauspie B
Published: October 2024

This presentation will focus on the experience from the DRUG-PREP project. While foresight has been used in other sectors, its implementation in the drugs field has previously remained relatively limited. The application of foresight to the drugs sphere is important in recognition of the fast-changing and intersectional nature of drugs and addiction. At the European level, a futures exercise was organized by the EMCDDA (as of July 2024 the European Union Drugs Agency, EUDA) to explore the future of drugs at the European level until 2030. In this landscape, the DRUG-PREP project implemented foresight approaches at the national level, to support preparedness of national drug monitoring and response systems. The DRUG-PREP partners carried out individual national exercises in six countries: Belgium, Czechia, Finland, Ireland, the Netherlands, and Portugal. The link to policy was a key aspect of the project, with each country organising a national dialogue to directly engage policymakers. The presentation will focus on the Belgian research. Horizon Scanning was performed to identify trends and megatrends with potential implications on the national drugs ecosystem, through a literature review. An expert workshop was organized to validate the trends and explore their implications. Subsequently, a small scenario building exercise was organised to explore the consequences of a clearly defined ‘disruptor’: the ban on opium production in Afghanistan. Finally, a national dialogue allowed discussion with stakeholders on how foresight can be integrated more structurally in the drugs field in Belgium. A summary of the results will be presented. Policymakers across all levels (local, regional, federal) have been active participants in the foresight activities and workshops. The link to policymaking has been crystallized in the integration of foresight into the new Belgian National Drugs Strategy 2024-2025.
An automated approach to health misinformation monitoring on YouTube
Authors: Zakir Hussain I , Kaur N , Oetomo A , Chen L , Morita P P , Hanjahanja-Phiri T , Kaur J
Published: October 2024

Background

YouTube is a social media platform associated with large viewership but little research into its role in the propagation of online health misinformation. This study proposes an automated pipeline to facilitate the collection and analysis of health misinformation on YouTube.

Methods

The pipeline relies on Python and the Youtube Data API. A preliminary test of the proposed pipeline was conducted using two videos from the channel “@BobbyParrish” (5.55M subscribers, 1.5K videos). The pipeline was used to extract two videos with large view counts and comparable like and comment counts. This extraction includes the transcript of the respective videos and engagement metrics. All the comment threads under the videos are also collected with the reply structure preserved. Then, the pipeline employs NLTK’s SentimentIntensityAnalyzer to score each comment for sentiment polarity and classify into positive, negative, or neutral. The pipeline generates visualizations of the sentiment distribution and a frequency-based word cloud of emojis extracted from the text.

Results

The proposed pipeline passed the test satisfactorily. It was able to retrieve channel statistics and metrics associated with the videos on the channel. It also successfully extracted the transcript and complete comments of the videos while preserving the integrity of the reply structure found on YouTube. Automated analyses of the data resulted in comprehensive and accessible visualizations.

Conclusions

The proposed work has the potential to facilitate large-scale studies into the propagation of health misinformation on YouTube. Moreover, it can be used by public health officials to rapidly address viral videos spreading health misinformation through social inoculation. Future work includes integrating topic modelling and automatic classification of health misinformation in the analysis portion of the pipeline.

Key messages

• The pipeline offers public health officials and researchers a rapid tool to identify and analyze health misinformation on YouTube, facilitating timely interventions.

• The pipeline enhances the ability to monitor and respond to evolving public health misinformation trends, by automating the extraction and sentiment analysis of YouTube data.
How likely are Eastern European and Central Asian Countries to Achieve Global NCD Targets?
Authors: Dumcheva A , Nevalainen J , Laatikainen T , Nuorti P
Published: October 2024

Background

In Europe, premature deaths from noncommunicable diseases (NCDs) have declined significantly, except in twelve countries of Eastern Europe and Central Asia (EECA), namely Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. Analyses of the long-term trends of NCD premature mortality in EECA are limited making it hard to know what to expect over the next years.

Methods

We used the 1990-2019 Global Burden of Disease database to analyze NCD trends and identify country-specific change points by using piecewise linear regression. We assessed the likelihood of achieving NCD global targets (GTs) to reduce premature mortality among persons 30-69 years old from four NCDs: cardiovascular diseases (CVD), cancers, diabetes mellitus (DM) and chronic respiratory diseases (CRD) by 25% from 2010 to 2025 (WHO25X25 target) and by 33% from 2015 to 2030 (SDG 3.4.1).

Results

Only Kazakhstan and Russia are likely to achieve NCD-GTs. For Kazakhstan, WHO25X25 and SDG 3.4.1 GTs mortality rates were 494.3 and 374.8 per 100,000 population respectively; the corresponding predicted values (PVs) were 360.6 [CI 260.1-461.1] and 245.1 [CI 113.4-376.8]. For Russia, WHO25X25 and SDG 3.4.1 GTs were 560.5 and 442.8 per 100,000 population respectively; the corresponding PVs were 427.7 [CI 270.3-585.1] and 311.0 [CI 102.8-519.1]. Achieving NCD-GTs is also possible for Kyrgyzstan. For the rest of EECA countries achieving NCD-GTs is unlikely. All EECA countries have increasing premature mortality from DM, eleven - from CRD and cancers, and six - from CVD. Most EECA countries have higher NCD rates and slower progress among men compared with women.

Conclusions

In most EECA countries the trend towards achieving NCD-GTs is slow or reversed. Further quantitative and qualitative research is needed to understand the underlying reasons. Separate indicators are needed to monitor countries’ progress for cancers, DM and CRDs.

Key messages

• Most EECA countries have slow or reversed trend in achieving NCD-GTs. All EECA have increasing premature mortality from DM, eleven – from CRD and cancers, and six – from CVD.

• Further research is needed to understand the underlying reasons for slow progress towards NCD-GTs in EECA. Separate indicators are needed to monitor progress for cancers, DM and CRDs.
Evolution and future prospects in quantifying the chemical burden in Portugal
Authors: Assunção R , Martins C
Published: October 2024

The quantification of the burden associated with chemicals is essential for comprehending their impact on public health and implementing effective risk management strategies. This presentation underscores the significance of conducting such assessments at both national and local levels, taking into account the exposures and vulnerabilities of those populations. Our objective is to provide an overview of past burden quantification exercises in the Portuguese context while identifying ongoing and future initiatives. Drawing from past experiences, we have initially characterized the burden of the Portuguese population’s exposure to mycotoxins through food consumption, particularly aflatoxins, and the consequent health burden. This laid the groundwork for discussing the potential consequences of climate change in this context and the associated burden. Subsequently, various exercises have been undertaken, incorporating diverse data sources, including human biomonitoring. Currently, several exercises are ongoing or planned, addressing different chemicals and contexts. These include arsenic and its association with various types of cancer, mercury and lead linked to cognitive impairment, and air pollution (e.g., PM2.5 and NO2) and its impact on health (e.g., cardiovascular diseases, lung cancer, asthma). Given the evolving challenges posed by climate change and emerging contaminants, understanding the burden of chemicals assumes increased importance, reinforcing the role of these assessments in safeguarding public health, guiding policy decisions, and highlighting the necessity of prioritizing research and surveillance efforts to protect human health and mitigate the adverse effects of chemical exposures.
Healthy design strategies to promote Urban Public Mental Health, according to the contemporary cities’ climate resilience and the SDGs’ challenges
Authors: Capolongo S , Rebecchi A
Published: October 2024

According to the “Urban Health Rome Declaration” at European meeting “G7 Health” that defines the strategic aspects and actions to improve Public Health into the cities, and referring to the Agenda 2030 in which the 11th SDG argue about “Sustainable Cities and Communities. Make cities and human settlements inclusive, safe, resilient and sustainable”, one of the most expressive syntheses of the challenging relationship between urban planning and Public Health is stated by WHO (2016): “Health is the precondition of urban sustainable development and the first priority for urban planners”. Referring to the Healthy Cities & Urban Health definitions, we can consider Public Health not merely an aspect of health protection and promotion, but an individual and collective condition, strongly influenced by the environmental context and by the strategies implemented by local Governments. The “Health in All Policies” strategy, clearly underlines how health doesn’t depend only on the supply of healthcare services, but also, on the quality of outdoor and indoor living environments. Aim of the Presentation 3 is the share the findings of a literature review about the link between the urban contexts’ morphological and functional features; the results are divided into: 14 Health Outcomes, representing the main Non-Communicable Diseases (NCDs) whose come from the urban environment’s quality and by the adoption of healthy lifestyles; 8 types of Environmental Risk Factors (Urban Heat Island Effect; soil/air/acoustic/light pollution; vehicular traffic; Safety & Security; weak attractiveness of places); and 14 Healthy Urban Planning Strategies (green/blue/grey infrastructures; biodiversity protection; adverse meteoric events management; public transport systems; vehicular traffic reduction; pedestrian and cycling paths; social and functional mix; urban solid waste’s management; renewable energy and efficiency; outdoor spaces lighting; Design for All).
Exposure to food additive mixtures and type 2 diabetes risk in the NutriNet-Santé cohort
Authors: Payen de la Garanderie M , Deschamp N , Hasenböhler A , Javaux G , Szabo de Edelenyi F , Agaësse C , De Sa A , Deschasaux-Tanguy M , Srour B , Touvier M
Published: October 2024

Background

So far, the safety evaluation of food additives has been performed substance by substance, while in real life, millions of individuals are exposed to mixtures of food additives daily. According to preliminary experimental data, some of these chemicals, alone and/or in synergy are suspected to impact metabolic health. The objective of this study was to investigate for the first time the associations between exposure to mixtures of food additives and type 2 diabetes (T2D) risk in a large prospective cohort of French adults.

Methods

Participants (n = 108,783, 79.2% women, mean age=42.4 years, SD = 14.6) from the NutriNet-Santé cohort (2009-2024) completed repeated 24h-dietary records, detailing industrial product brands. Additive exposure was assessed using composition databases and laboratory assays. Five mixtures of additives were identified through non-negative matrix factorisation (NMF). Associations between these mixtures and the risk of T2D were characterised using multivariable proportional hazards Cox models adjusted for known risk factors.

Findings

1115 participants were identified with T2D during follow-up. Two additive mixtures were associated with increased T2D risk. The first mixture included higher exposure to modified starches E14xx, pectins E440, guar gum E412, carrageenan E407, and polyphosphates E452 (HRper 1SD increment=1.11 [1.05-1.18]), p < 0.0001). The second mixture comprised citric acid E330, sodium citrates E331, phosphoric acid E338, sulphite ammonia caramel E150d, acesulfame-K E950, aspartame E951, sucralose E955 and arabic gum E414 (HR1SD=1.13 [1.08-1.18]), p < 0.0001).

Interpretation

This large prospective cohort study revealed direct associations between T2D risk and exposure to two food additive mixtures. Molecular epidemiology and experimental studies will be necessary to depict underlying mechanisms and potential cocktail effects.

Key messages

• Consumed together, widely used food additives may contribute to T2D aetiology, shedding light on the detrimental impact of highly processed foods on metabolic health.

• This study highlights positives associations between T2D risk and exposure to two food additive mixtures.
What is driving food insecurity risks in UK households with children?
Authors: Arnold R , Taylor-Robinson D , Hargreaves D , Loopstra R
Published: October 2024

Background

Food insecurity is a global public health issue, disproportionately affecting households with children in the UK. Despite increased research attention, there remains a gap in understanding why prevalence of food insecurity is higher in this demographic. This study aims to address this gap.

Methods

Utilising data from the 2021/22 and 2022/23 Family Resources Survey, an UK annual cross-sectional survey, we investigate the association between sociodemographic and economic factors, and the risk of food insecurity among households with children. Logistic regression analysis was used, with food security treated as a binary outcome variable. Control variables included receiving means-tested benefits, disabilities in a household, region within the UK, and the ethnicity, highest education level and marital status of the household reference person. A total of 41127 households were included, with 10137 being households with children.

Results

Our preliminary findings reveal stark inequalities, with 12.0% of households with children experiencing food insecurity, compared to 6.4% of households without children (p-value for comparison <0.0001). After adjusting for control variables, the odds of food insecurity among households with children was 1.40 (95% CI: 1.27, 1.54) compared to households without children. Adding equivalised household income after housing costs attenuated the relationship but households with children remained at significantly higher odds of food insecurity (OR: 1.32 (1.20, 1.45)).

Conclusions

This preliminary analysis demonstrates that, after adjusting for control variables and equivalised household income after housing costs, having children in a household is still associated with a higher risk of food insecurity. This underscores the need to understand the mechanisms underlying this relationship further. Such insights are essential for informing targeted policies and interventions aimed at mitigating food insecurity among households with children.

Key messages

• Having children independently increases the risk of food insecurity in households in the UK.

• Moving forward, our aim is to understand the mechanisms underlying the relationship between households with children and food insecurity.
Navigating the infodemic through digital health literacy education in schools
Authors: Renninger D , Stauch L , Fischer L , Hartmann A , Rangnow P , Dadaczynski K , Okan O
Published: October 2024

Background

High digital health literacy (DHL) can help to navigate the internet’s vast information landscape. This research explores the impact of learning DHL in schools on students’ DHL, and how it might mitigates confusion surrounding health-related information. Moreover, this research sheds light on how learning DHL in schools influences students’ inclinations towards specific sources of health information.

Methods

1448 secondary school students aged 9-18 years participated in face-to-face interviews. Associations between learning digital health literacy (DHL) and students’ DHL, comprehension of health information, sense of being informed on health topics, and utilization of diverse health information sources were evaluated using the chi-squared test.

Results

The learning of DHL within school settings demonstrated a significant correlation with students’ overall DHL (X2 (6) = 120.99, p < .001). Those reporting high levels of DHL learning exhibited reduced confusion regarding health information (X2 (4) = 16.65, p = .002) and felt notably more informed (X2 (4) = 231.06, p < .001). Contrasted with peers who reported insufficient learning of DHL, students with high learning reported learning more about health from parents (X2 (2) = 55.28, p < .001), peer interactions (X2 (2) = 214.51, p < .001), online sources (X2 (2) = 78.54, p < .001), influencer content (X2 (2) = 68.46, p < .001), offline literature (X2 (2) = 24.32, p < .001), television (X2 (2) = 140.36, p < .001), and in school (X2 (2) = 205.53, p < .001). However, they were less reliant on physicians for health information (X2 (2) = 53.62, p < .001).

Conclusions

Integrating DHL into school curricula holds promise for enhancing students’ DHL and alleviating apprehensions regarding health-related information. Moreover, such educational initiatives have the potential to expand students’ repertoire of resources for accessing health information, encompassing both digital and non-digital sources.
A behavioural perspective on pandemic preparedness
Authors: Euser S , van Dijk M , Dekker R , de Bruin M , Mehra S , Sanders J , Kroese F
Published: October 2024

Driven by lessons learned from the COVID-19 pandemic, the RIVM Behavioural Unit is working on the preparedness of social and behavioural sciences. This includes establishing and maintaining a stakeholder network and a knowledge base on pandemic preparedness and behaviour. Using the socio-ecological model and the emergency management cycle, we propose a conceptual framework for a behavioural perspective on pandemic preparedness. The multilevel (individual, community, organisational, national and supra-national), time-dependent (cold, acute, recovery phase) structure of the framework can be helpful in explicating who has to do what, when. In addition, to explain and understand what different actors require for those behaviours prior to or during a pandemic, we propose an adapted version of the COM-B model (Michie et al., 2011), including determinants of behaviour related to motivation, capabilities and opportunities. Based on these frameworks, various monitoring tools are developed. Here we present the Pandemic Preparedness and Behaviour (PPb) survey aimed at cold phase monitoring behaviour on an individual level (i.e. hygiene behaviours, social activity, preparedness behaviours) and their determinants. With this survey we will obtain baseline measurements ahead of a possible future pandemic and will have developed the appropriate tools to be used in a hot phase for as much as possible. In addition, results on cold phase determinants can help to identify where communities, organisations and governments can provide support to improve pandemic preparedness. In this presentation, the proposed conceptual framework and the PPb survey will be discussed, together with their relevance for preparedness of the social and behavioural sciences.
2.X.2. Cancer Screening Across the Life Course and Surveillance Bias
Authors:   Organised by: #PopHealthLab University of Fribourg (Switzerland), Western University (Canada), EUPHA-CHR,   Chair persons: Arnaud Chiolero (Switzerland), Saverio Stranges (EUPHA-CHR)
Published: October 2024

The proposed workshop organized by the Chronic Disease EPH section will start with an overview of the impact of a life course perspective on cancer prevention and screening strategies, in the context of aging populations and fear of increasing health inequity. It will be followed by three presentations to address issues of cancer screening inequalities, low-value cancer screening, and cancer surveillance bias due to screening.

Key messages

• Due to population aging, the burden of cancer increases and calls for new cancer prevention and screening strategies.

• Cancer screening strategies must be adapted among older adults and designed to prevent inequities.
3.Y.1. Genomics in EU Health Systems: Navigating the Opportunities and Challenges for Personalized Health
Authors:   Organised by: EUPHA-PHG, -EPI,   Chair persons: Roberta Pastorino (EUPHA-PHG), Péter Pikó (EUPHA-PHG)
Published: October 2024

The rapid advancements in genomics research offer significant promise for revolutionizing healthcare, potentially reshaping how we approach disease prevention, diagnosis, and treatment. However, unlocking the full potential of genomics requires more than just scientific breakthroughs-it necessitates translating these discoveries into clinical practice. This involves bridging the gap between research and healthcare implementation, addressing challenges such as technical infrastructure, ethical and legal frameworks, healthcare professional competencies, and citizen engagement. As we navigate the evolving landscape of individualized patient care, it becomes increasingly crucial to implement effective risk stratification methodologies and personalized preventive measures. Among these methodologies, polygenic risk scores are gaining prominence. However, the adoption of these innovations necessitates careful consideration of their clinical utility, including their feasibility, cost-effectiveness, and acceptability in diverse healthcare settings. Validating these approaches from multiple perspectives is essential to ensure their effectiveness in real-world clinical practice. Integrating genomic sequencing data with health records presents an invaluable resource that can enhance patient outcomes and drive further research. The creation of infrastructures and initiatives such as those carried out by projects like the European Health Data Space and Genomic Data Infrastructure are fundamental to unleash the enormous potential of data-driven innovation. To date, the implementation of genomics in medical practice varies across European countries, with discrepancies in adoption levels across different aspects of healthcare, including prevention, diagnosis, and personalized treatment. Addressing these disparities and promoting standardized approaches to genomic medicine implementation are crucial steps toward ensuring equitable access and maximizing the benefits of genomics for all individuals across Europe. This workshop aims to provide decision-makers, healthcare professionals and researchers with a comprehensive overview of the state-of-the-art for the adoption of personalized approaches, and of the maturity of genomic medicine practices within different healthcare systems as well outlining the benefits of data accessibility for research. The speakers are coordinators and partners of EU projects as B1MG (Beyond One Million Genomes), Prophet (A PeRsOnalized Prevention roadmap for the future Healthcare), EHDS (European Health Data Space), GDI (European Genomic Data Infrastructure), GoE (Genome of Europe) and CanHeal.

Key messages

• Genomics has the potential to improve health outcomes.

• Equal access to genomic medicine critical for personalized health. Ensuring equity, while considering feasibility.
Risk communication with migrants: Lessons learned from the COVID-19 Pandemic experience in Malmö
Authors: Svensson P
Published: October 2024

Background

During the COVID-19 pandemic, many migrants faced challenges in accessing, comprehending and implementing information, leading to mis- and disinformation and distrust. The pandemic underscored the importance of effective risk communication (RC) and community engagement (CE) that reaches all segments of society, both for managing health effects and preventing the reinforcement of discrimination and stigmatization. This study aims to describe the experience of RCCE targeting migrants in Malmö, Sweden, from an expert perspective. Further, to gain an in-depth understanding of the requirements for inclusive RCCE actions and to identify alternative or complementary strategies based on good local practices.

Methods

Individual interviews were conducted with experts representing civil society and public authorities who were purposely sampled based on their engagement with RCCE targeting migrants. The interview guide was based on a review of international guidelines addressing aspects of RCCE, and analysed with content analysis.

Results

Three key organisations working towards undocumented migrants; unaccompanied minors; and newly arrived refugees, respectively, were included. Findings are synthesized into three key insights: a) RC through trusted sources in safe spaces; b) Understanding migrant living conditions c) Promoting intersectoral collaboration and feedback loops. Experts underscored the importance of cultivating sustainable and relationships with migrant communities to effectively communicate, aiding in compliance and counter distrust. The significance of intersectoral collaboration and communication pathways was highlighted for assessing migrant specific needs and designing appropriate interventions.

Conclusions

Long-term trusting relationship facilitate RC. Embedding sustainability within intersectoral collaboration structures is imperative to facilitate swift mobilization during health crises, foster resilience, and counter health inequities.
Alarm fatigue and sleep quality in healthcare workers
Authors: Rypicz L , Witczak I , Supinova M , Salehi H P , Jarabicova O
Published: October 2024

Background

Alarm fatigue, a prevalent issue in medical settings, arises when healthcare professionals are exposed to an overwhelming number of clinical alarms, leading to desensitization and decreased responsiveness. The constant alertness required due to medical device alarms in hospitals can severely disrupt the quality of sleep for medical personnel. This study aims to demonstrate whether there is a relationship between alarm fatigue and sleep quality in medical staff. For the research project, it was decided to carry out the study in three European neighbouring countries: Poland, Slovakia and the Czech Republic

Methods

The the survey was carried out in three European countries: Poland, Slovakia, and the Czechia from June to July 2023. The study was attended by a total of 756 participants. The study used: a socio-demographic metric; Alarm Fatigue Assessment Questionnaire and The Pittsburgh Sleep Quality Index to evaluates sleep quality.

Results

Among the 756 survey participants, 603 (79.76%) had poor sleep quality (6-21 PSQI points), 147 (19.44%) had good sleep quality (0-5 PSQI points), and 6 (0.79%) did not answer. The analysis of sleep quality scores for participating countries shows that sleep problems were significantly higher in Slovakia and Poland than in the Czech Republic. Alarm fatigue levels were determined for respondents in every country in this study. The statistical difference between countries is significant. In Slovakia and Poland, the levels of alarm fatigue caused by medical devices were significantly higher than in the Czech Republic. With regards to sleep quality, there is a positive correlation between alarm fatigue and sleep problems. A statistically significant positive correlation was obtained for all three countries.

Conclusions

The study found that workers in the health system are exposed to alarm fatigue, and that this in turn can reduce sleep quality. The consequences of this may be reflected in patient safety.

Key messages

• The results of the study clearly indicate that quality of work should be ensured by developing protocols for managing medical device alarms.

•  Combatting alarm fatigue among medical personnel is vital for public health as it reduces medical errors caused by sleep deprivation.
Sickness absence patterns during the COVID-19 pandemic among Finnish public sector employees
Authors: Haukka E , Joensuu M , Kausto J , Oksanen T , Vahtera J , Kivimäki M , Ervasti J
Published: October 2024

Background

The patterns of sickness absence (SA), that is, the clustering of differing lengths of episodes and total number of days absent, have not been examined. We examined these SA patterns and factors associated with the patterns during the COVID-19 pandemic.

Methods

We used survey data from employees of four large Finnish cities in 2020 linked with SA data in 2021 retrieved from employer registers (n = 39 791). SA patterns were defined through cluster analysis (K-means) including number of SA days, short (1-9 days), and long (10-365 days) SA episodes within one year. The associations of employee and work characteristics in 2020 with SA clusters in 2021 were analysed with multinomial regression.

Results

Four SA patterns (=clusters) were identified: 1) Optimal SA pattern (n = 31 320, 79%), 2) Recurring short SA episodes (n = 5149, 13%), 3) Recurring long SA episodes (n = 2964, 7%), and 4) Very high levels of SA with long episodes (n = 358, 1%). Compared to optimal SA pattern, female gender, higher body mass index, former smoking, abstinence from alcohol, not being in high occupational socioeconomic position, on-site work during COVID-19, and COVID-19 infection were associated with all suboptimal SA patterns. Recurring short SA episodes were more likely in younger employees (odds ratio=0.98, 95% confidence interval 0.97-0.98), those with a temporary job (1.10, 1.00-1.20), current smokers (1.34, 1.21-1.48), those using passive commute modes (1.03, 1.01-1.05 [car]; 1.02, 1.00-1.04 [public transport]), and those who had experienced a team reorganization due to COVID-19 (1.27, 1.10-1.46). The two most adverse SA patterns were more likely among older employees, and less likely among those cycling to work (0.91, 0.84-0.98; 0.97, 0.95-0.99).

Conclusions

We identified three differential suboptimal SA patterns. Compared to the optimal SA pattern, several individual-level risk factors, but also some COVID-19 related factors were found to associate with suboptimal SA patterns.

Key messages

• We identified three suboptimal sickness absence patterns during COVID-19 pandemic.

• Individual characteristics, but also COVID-19 related factors were associated with the observed sickness absence patterns.
The health of older caregivers in Spain: a matter of age or a matter of care?
Authors: Bernal-Alonso A , Rodríguez-Blázquez C , Ayala A , Mateo-Abad M , Calderón-Larrañaga A , Forjaz M J
Published: October 2024

Introduction

Informal care is crucial in Spain’s care system, with a rising number of caregivers aged 75 or older, yet studies on its health effects are lacking. This study aims to determine the differential impact of age and care-related variables on the health of older caregivers.

Materials and methods

This is a cross-sectional, national study with a sample of 3,870 informal caregivers from the Spanish 2020 Disability, Personal Autonomy and Dependency Survey. We performed a logistic regression where self-reported deterioration in caregiver health due to caregiving was the dependent variable and age (<75 vs. ≥ 75) was the independent variable. Caregivers’ sex, educational level (primary and lower or secondary and higher), income (<1,150 euros per month vs. ≥ 1,150), severe functional limitation of caregivers and care-receptors (yes or no), duration of care (< 8 years vs. ≥ 8 years), and daily hours of care were used as covariates.

Results

One in 6 caregivers was 75 or older (16,1%). Caregivers’ mean age was 58.4, and care-receptors’ 66.6 years. Women represented 63.0% of caregivers, and 42.8% of care-receptors. Up to 4.6% of caregivers had a severe limitation, and 43.7% of caregivers reported deterioration of their health due to caregiving. A greater perception of deterioration in caregiver health due to caregiving was associated with being 75 years or older (β = 0.34, p = 0.009). Covariates associated with caregivers’ health deterioration were being a woman (β = 0.77, p < 0.001), presence of severe limitation of care receptors (β = 0.58, p < 0.001), and increased daily hours of care (β = 0.01, p = 0.013). Caregivers’ severe limitation, level of education, income and years of care did not show a significant association with perception of health deterioration.

Discussion

Caregivers older than 75 years in Spain experience a key deterioration in their health associated with caregiving. This vulnerable population must be prioritized in health and social policies.

Key messages

• One out of 6 caregivers in Spain is aged 75 years or older. Caregiving impacts greatly in their health status.

• Older caregivers is a vulnerable population that must be a priority for health and social services.
The effects of hypothetical psychological interventions on alcohol use in European young adults
Authors: Do S , Börnhorst C , Didelez V , Ahrens W , Hebestreit A ,   I IDEFICS/I.Family consortia
Published: October 2024

Background

Low psychosocial well-being (PWB) and high emotion-driven impulsiveness (EDI) are associated with alcohol. Yet, it is unclear whether a hypothetical intervention targeting one or the other in adolescence might be more effective in reducing alcohol consumption (AC) in young adulthood. Therefore, we aimed to compare the separate causal effects of PWB and EDI in adolescence on AC in young adulthood.

Methods

We included 505 European young adults from the IDEFICS/I.Family cohort (mean age: 20.2 years; age range: 18.2-23.5 years) who did not drink alcohol at study entry. AC was operationalized as the amount of weekly consumed alcoholic beverages (mean: 4.2 drinks per week; range: 0.3-70 drinks per week). EDI was assessed using the negative urgency subscale from the UPPS-P Impulsive Behaviour Scale. PWB was assessed using the KINDLR Health-Related Quality of Life Questionnaire. Following the principles of target trial emulation, we estimated, separately, the average causal effects of PWB and EDI on AC accounting for relevant confounders and applying a semi-parametric doubly robust method (targeted maximum likelihood estimation). We stratified the results by sex and parental education.

Results

If all adolescents, hypothetically, had high levels of PWB, compared to low levels, we estimated a decrease in the average amount of alcoholic beverages in young adulthood by 0.1 drinks per week [95%-confidence interval: -2.3; 2.1]. Furthermore, if all adolescents had low levels of EDI, compared to high levels, we estimated an increase in alcoholic beverages in young adulthood by 1.5 drinks per week [0.1; 2.9]. Different effects for sex and parental education groups were found.

Conclusions

Hypothetical interventions targeting PWB in adolescents were not found to have effects on reducing AC in young adulthood. Interventions targeting EDI, however, would lead to an increase in AC. This may be due to unmeasured confounding and the missing distinction between drinking motives.

Key messages

• We demonstrate that causal inference methods, compared to traditional ones, improve the robustness of estimated effect measures and address important sources of bias in European cohort data.

• To inform public health interventions on reducing alcohol consumption, future research should investigate different drinking motives, e.g. alleviating negative emotions or enhancing positive emotions.
A comparative study of how teachers communicate in deaf education classrooms
Authors: Holcomb Leala , Dostal Hannah , Wolbers Kimberly
Published: October 2024

This study investigates the communication practices of four teachers in 3rd to 6th grade classrooms with 9 deaf students with limited language proficiency and in stages of emergent writing development. Analyzing language modalities, utterance types, and class interactivity, we found that teachers using American sign language used student-centered approaches, generating a greater number of directives and responsive utterances. They persevered in increasing students’ engagement and were successful in clarifying misunderstandings. Teachers using spoken English used teacher-centered approaches, making general comments directed at the whole class, which consequently reduced student participation and responsiveness. They also largely avoided repairing communication breakdowns with emergent writers, focusing instead on those with greater auditory and speaking abilities. These patterns reveal disparities in classroom communication that can affect student learning. Our findings highlight the need for teacher preparation programs to equip teachers with skill sets to employ accessible and effective communication during instruction, especially with deaf students who are still developing foundational language and writing skills.
Kendra’s journey: an intrinsic case study of a deaf autistic child
Authors: Gosselin Hills Jennifer , Bowen Sandy K
Published: October 2024

This study used an intrinsic case study to investigate how interventions from applied behavior analysis impacted language development, academic progress, and the reduction of severe challenging behaviors for an 8-year-old child who is Deaf and autistic. 3 main themes were identified: language acquisition, behavioral change strategies, and academic performance. Additionally, 2 common threads wove in and out of each and connected all 3 themes: language access and qualified providers, including Deaf professionals. This study expands the literature about using behavioral strategies with children who are Deaf and autistic and discusses implications for clinical and educational practice.
Plant cell wall structure and dynamics in plant–pathogen interactions and pathogen defence
Authors: Munzert Kristina S , Engelsdorf Timo
Published: October 2024

Plant cell walls delimit cells from their environment and provide mechanical stability to withstand internal turgor pressure as well as external influences. Environmental factors can be beneficial or harmful for plants and vary substantially depending on prevailing combinations of climate conditions and stress exposure. Consequently, the physicochemical properties of plant cell walls need to be adaptive, and their functional integrity needs to be monitored by the plant. One major threat to plants is posed by phytopathogens, which employ a diversity of infection strategies and lifestyles to colonize host tissues. During these interactions, the plant cell wall represents a barrier that impedes the colonization of host tissues and pathogen spread. In a competition for maintenance and breakdown, plant cell walls can be rapidly and efficiently remodelled by enzymatic activities of plant and pathogen origin, heavily influencing the outcome of plant–pathogen interactions. We review the role of locally and systemically induced cell wall remodelling and the importance of tissue-dependent cell wall properties for the interaction with pathogens. Furthermore, we discuss the importance of cell wall-dependent signalling for defence response induction and the influence of abiotic factors on cell wall integrity and cell wall-associated pathogen resistance mechanisms.
RNA-directed peptide synthesis across a nicked loop
Authors: Su Meng , Roberts Samuel J , Sutherland John D
Published: October 2024

Ribosomal translation at the origin of life requires controlled aminoacylation to produce mono-aminoacyl esters of tRNAs. Herein, we show that transient annealing of short RNA oligo:amino acid mixed anhydrides to an acceptor strand enables the sequential transfer of aminoacyl residues to the diol of an overhang, first forming aminoacyl esters then peptidyl esters. Using N-protected aminoacyl esters prevents unwanted peptidyl ester formation in this manner. However, N-acyl-aminoacyl transfer is not stereoselective.