bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational class difference in COVID-19 symptoms in France: contribution of work-related exposures
Authors: Ghoroubi N , Khlat M , Counil E
Published: October 2024

Background

The association between socio-occupational class and SARS-CoV-2 infection remains inconclusive and may depend on the setting and the pandemic stage. Our study aims to quantify self-reported COVID-19 symptoms by occupational class (OC) in spring 2020 in France and explain observed differences using work-related risk factors.

Methods

We analyzed data from the EpiCoV population-based cohort, comprising 46,849 active workers aged 18-64 in metropolitan France. COVID-19 symptoms were sudden loss of taste/smell, fever with cough, fever with shortness of breath, or fever with chest oppression. Separating regions highly affected by COVID-19 from other regions, we related OC with reporting of COVID-19 symptoms and assessed the mediation effect of work-related SARS-CoV-2 exposures (contact with the public, using public transportation, self-perceived exposure) using the Karlson-Holm-Breen mediation analysis method.

Results

During the study period, 7.1% of the workers reported COVID-19 symptoms. In both regions, work-related SARS-CoV-2 exposures were related to higher reporting of symptoms, and those exposures were more prevalent in the lowest than in the highest OCs. However, the association of OC with reporting symptoms was not the same in the two regions. In less affected regions, the lowest OC reported COVID-19 symptoms less often than the highest OC, whereas in highly affected regions, symptoms were more frequent in middle OCs, and this was partly explained by work-related SARS-CoV-2 exposures.

Conclusions

Different socio-occupational patterns of symptoms were observed in the two groups of regions. The situation in the less affected regions, with more reporting in the highest relative to the lowest classes, may be attributable to exposure factors playing a role opposite to that of work-related exposures. Further studies on OC disparities in COVID-19 severity are needed based on hospitalization and mortality.

Key messages

• During the early pandemic, in regions less affected by COVID-19, the upper occupational class reported more COVID-19 symptoms, whereas the middle class did so in highly affected regions.

• Work-related exposure to SARS-CoV-2 mediates the association between occupational class and reporting COVID-19 symptoms to some extent, even when the occupational gradient is reversed.
Do shift-working nurses’ work-life quality relate to their physical health and diet quality?
Authors: Yilmaz A , Esin M N
Published: October 2024

Background

Shift work negatively affects work-related quality of life and this situation causes significant labour force losses and decreased productivity in the society, especially health problems in nurses. This study was conducted to determine the relationship between work-related quality of life, physical health level and nutritional behaviours of nurses working in shifts.

Methods

This descriptive and relationship-seeking study was conducted with 312 nurses selected by quota sampling in Istanbul. Data were collected between December 2022 to July 2023 using the The Professional Quality of Life Scale (ProQOL), Physical Health Questionnaire and Food Consumption Frequency Questionnaire. Descriptive statistics and Pearson correlation tests were conducted on IBM SPSS 25.0. BeBIS 7.1 software were used for calculation diet index.

Results

Compassion Satisfaction (CS), Burnout (B) and Compassion Fatigue (CF) scores of nurses was examined, a relationship was found between CS score and B score (r=-0.39 p < 0.05) and between B score and CF score (r = 0.58 p < 0.05). CS score correlated with Cardiovascular Risk Level score (r=-0.15 p < 0.05) and diet index score (r = 0.15 p < 0.05). B score correlated with Gastrointestinal Risk Level score (r = 0.27 p < 0.05) and Cardiovascular Risk Level score (r = 0.38 p < 0.05). There was a correlation between the score of CF and Gastrointestinal Risk Level score (r = 0.25 p < 0.05) and Cardiovascular Risk Level score (r = 0.31 p < 0.05). Daily energy, fibre, vitamin B1 and C, folate, calcium and magnesium intakes of nurses were lower than the recommended.

Conclusions

Research results support that the gastrointestinal and cardiovascular systems have a direct relationship with stress and emotional states. In the policies to be developed within the scope of occupational health nursing practices, it is recommended to carry out studies to improve the physical health and nutritional behaviours of nurses in order to improve their work-related quality of life.

Key messages

• Nurses are a risky occupational group in terms of burnout. Protection studies should be prioritised to prevent burnout.

• Gastrointestinal and cardiovascular system complaints of nurses should be paid special attention during recruitment and periodic examinations.
Psychiatric comorbidity and hospitalization outcomes for AMI in portuguese public hospitals
Authors: Fonseca A , Perelman J , Roxo L
Published: October 2024

Background

Severe mental health disorders directly affect quality of life but may also indirectly relate to physical diseases and their prognosis. We test this hypothesis for the specific case of acute myocardial infarction (AMI), postulating a longer in-patient stay and an excess in-hospital mortality among patients suffering psychiatric comorbidities (PC).

Methods

A retrospective observational study was conducted using secondary data from public Portuguese hospitals, for all patients with a primary diagnosis of AMI (12,213 patients aged 18-80, for the years 2017-18). We used linear and logistic regression to model length of stay (LoS) and in-hospital mortality, respectively. Having at least one psychiatric comorbidity was the explanatory variable, and models were adjusted for age, sex, and the Charlson Comorbidity Index.

Results

The prevalence of PC was 12.95%. The in-hospital mortality rate was significantly higher in the group with PC (4.43%, OR = 1.372, 95%CI=1.041-1.784), than in the group without PC (3,38%). Stays were significantly longer among those with PC (mean=7.69 days), compared to those without PC (mean=6.87 days; adjusted β-coefficient=0.098, 95%CI=0.056-0.141).

Conclusions

Patients with AMI and comorbid mental disorders have poorer hospitalization outcomes than those without PC. This emphasizes the importance of promoting effective management strategies for comorbid psychiatric disorder, for instance, by improving the integration of mental health care in general hospitals, and empowering healthcare professionals to recognize and manage patients with PC.

Key messages

• Psychiatric comorbidity is related to longer inpatient stays and higher mortality risk among patients with AMI.

• Efforts to integrate mental health care in general hospitals should be maintained.
Epidemiological profile of patients consulting for smoking cessation in Tunisia from 2020 to 2023
Authors: Bebses K , Ayedi Y , Fitouri S , Skhiri A , Ben Aissa M , Fourati A , Nsiri Z , Hamdi R , Harizi C , Fakhfakh R
Published: October 2024

Background

Tobacco addiction poses a significant global health challenge, contributing to various diseases and premature mortality. The main objective of our work was to describe the epidemiological profile of smokers seeking assistance at the smoking cessation departement of the ‘Abderrahmane Mami’ hospital.

Methods

We conducted a retrospective study involving smokers who attended the smoking cessation department between January 2020 and December 2023. Data were collected from the consultants’ records. The descriptive study was conducted using IBM SPSS 25 software.

Results

The number of consultants was 440 during the years of the study. The study population was predominantly male (75.2%). The average age of the consultants was 45.41 ± 13.9 years [14-89 years]. The education level of the patients was predominantly university-level (42.4%), followed by secondary education (33.6%). Cardiovascular history was the most common (22.42%). More than half of the consultants (n = 279; 63.4%) had tried to quit smoking at least once. More than half of the smokers followed (57.9%) were highly dependent on nicotine (Fagestrom score ≥ 7). The mean score of the hospital anxiety and depression scale was 8.03 ± 5.398 for anxiety and 5.44 ± 5.185 for depression.

Conclusions

Our study provides informations about the epidemiological profile of individuals seeking tobacco cessation support during the study period. The findings underscore the diverse demographic and clinical characteristics of this population. Understanding these profiles can provide information for the development of effective anti-tobacco programs.

Key messages

• Tailored interventions are essential to meet the diverse needs of people seeking smoking cessation, optimizing the impact on public health.

• Understanding cessation seeker profiles crucial for effective strategies.
Loneliness in Baltic-Nordic Older Adults Amid COVID-19
Authors: Reine I , Miķelsone M , Tomsone S , Guðmundsson H , Ivanovs A , Guðmundsson H S , Koroļeva I
Published: October 2024

Background

The study investigates loneliness among older adults in the Baltic-Nordic region, particularly in the context of the COVID-19 pandemic. It aims to understand how loneliness varies across cultural and socio-economic contexts in these areas, which is critical for developing public health strategies tailored to the specific needs of older populations.

Methods

We employed a comprehensive comparative analysis, leveraging data from the Survey of Health, Ageing and Retirement in Europe (SHARE) and the HL20 study from Iceland, focusing on individuals aged 67 and above. The study encompassed a diverse sample from Sweden, Denmark, Estonia, Lithuania, Finland, Latvia, and Iceland, totaling 5,313 participants. This research is part of a bilateral EEA FM2021/23 initiative to enhance methodological approaches to analyzing older populations by coding and standardizing variables for comparability across different countries.

Results

Significant regional differences in loneliness were observed. The Baltic regions reported a higher prevalence of loneliness compared to the Nordic countries, which displayed lower levels, attributed to strong social welfare systems and community engagement. Factors such as employment, marital status, and educational attainment varied across regions, affecting loneliness levels.

Conclusions

The findings highlight the importance of considering regional cultural and social contexts in public health interventions aimed at reducing loneliness among older adults. The study underscores the need for targeted strategies that address the unique social dynamics of the Baltic and Nordic regions. Innovative public health actions, such as community engagement programs and policy development, are recommended to alleviate loneliness in these populations.

Key messages

• Significant regional differences in loneliness in the Baltic-Nordic region underscore the need for tailored public health interventions.

• Employment and social welfare are key factors in mitigating loneliness among older adults, highlighting the importance of socio-economic support systems.
A Qualitative Study Evaluating the Challenges of Orthopedists and Internists in the Earthquake Zone
Authors: Gemici E , Kaş D , Tosun F , Ertürk İ , Dural S , Ay P
Published: October 2024

Background

The earthquake centered in Kahramanmaras province, Turkey, on February 6, 2023, with a magnitude of 7.7, resulted in the loss of 53,537 lives and the injury of 107,213 people. This study was conducted to evaluate the challenges and experiences of physicians who provided post-disaster medical care.

Methods

We conducted a qualitative study with orthopedists and internists who had worked in the earthquake zone using in-depth interviews. Participants were selected through snowball sampling. Interviews explored challenges in the disaster zone, obstacles related to healthcare services, and disaster management. Thematic analysis was used.

Results

A total of 13 physicians participated in the study. Data revealed four main themes: disaster management, organizational deficiencies, challenges faced, and logistical issues. Participants indicated that the Ministry of Health didn’t have a priori operational emergency action plan, which led to problems in healthcare service delivery. Some physicians complained that they had to serve just as emergency consultants and were not able to carry out tasks compatible with their expertise. Some indicated that they organized the services rather than providing medical care. Almost all encountered a variety of interesting cases and evaluated their experience as significant. Logistical needs were met mostly with the support of non-governmental organizations.

Conclusions

We need to have a priori operational emergency action plan to ensure the effective delivery of healthcare services in the aftermath of a disaster. The Ministry of Health needs to allocate and coordinate healthcare personnel in line with their areas of expertise and prevent service disruptions.

Key messages

• There is a need to make an operational emergency action plan beforehand to deliver healthcare services effectively following a disaster.

• Physicians should be allocated in line with their specialty of expertise to efficiently address the healthcare needs.
Agricultural activities reduce the risk of requiring long-term care among older Japanese
Authors: Takase H , Arita M , Miyai N , Kashiba M , Yamasaki M , Shiwaku K
Published: October 2024

Introduction

Controlling the risks that lead to requiring long-term care for the older adults is a crucial medical and socio-economic issue. This study investigated the impact of agricultural activities (AAs) on the risk of requiring long-term care.

Methods

A 5-year follow-up was conducted on 1,009 healthy individuals aged 65-80 years (mean age 72 years; 44% men) living in a rural area (Wakayama, Japan). Requiring long-term care was assessed as requiring support or nursing care (RSNC) according to the Japanese criteria. Health status including frailty and metabolic syndrome were also assessed using Japanese criteria. Work status and lifestyle habits were assessed using self-administered questionnaires. The main outcome was the probability of RSNC. COX proportional hazards regressions were performed, stratified by occupation (agricultural worker or other) or frequency of AAs (none, less than or >150 days/year), adjusted for sex, age, frailty, metabolic syndrome and household as possible confounding factors.

Results

Approximately 35% of the participants were in agriculture, forestry, and fisheries as occupation, and 78% engaged in AAs. A total of 85 participants RSNC and 39 deaths were observed during the follow-up. The cumulative survival probability did not differ according to occupation or frequency of AAs, whereas the probability of RSNC was significantly lower in participants engaged in AAs (hazard ratio 0.37 [95% CI 0.22, 0.62]; <150 days/year, 0.29 [95% CI 0.17, 0.50]; >150 days/year). Participants engaged in AAs were significantly more likely to engage in low- and vigorous-intensity physical activity, and to participate in industry and community organizations and relating events.

Conclusions

These findings suggest that AAs may promote a physically and socially active lifestyle, independent of frailty or metabolic syndrome, and reduce the risk of RSNC.

Key messages

• Prevention of long-term care is important in the older population.

• A lifestyle associated with agricultural activities may contribute to healthy aging.
The impacts of UK coronavirus virus job retention (furlough) scheme on mental health
Authors: Akanni L , Deeming C , Adjei N , Wickham S , Taylor-Robinson D
Published: October 2024

Background

In March 2020, the UK government introduced the pandemic-induced job retention scheme, known as furlough. The scheme provided grants to employers, to retain their workforce by subsidizing up to 80% of wages. While the scheme was aimed at preventing unemployment during lockdowns, it also came with wage loss, with implications for mental health for affected workers, although evidence is limited. Therefore, we aimed to explore the impact of the furlough scheme on mental health in the UK

Methods

We explored longitudinal data from the UK’s Understanding Society Survey between 2019 and 2021, including nine COVID waves. We matched a sample of furloughed and non-furloughed workers using various covariates. Mental health was measured using General Health Questionnaire (GHQ-12, scored 0-36). We estimated difference-in-differences models to explore the heterogeneous causal effects on mental health of workers participation and exit from the furlough scheme. We further considered the effects of being furloughed contrasted with becoming unemployed during the pandemic

Results

The estimated average treatment effect (-0.53 [95% CI: -0.91 - -0.16]) suggests that being furloughed had significant positive impact on mental health, while exiting from furlough due to changes requiring workers to work minimum hours increased the incidence of poor mental health 0.41 [95% CI: -0.11 - 0.92]. However, compared to becoming unemployed, being furloughed improved mental health by around -0.42 [95% CI: -0.75 - -0.09] GHQ points.

Conclusions

Policies that mitigate the economic impact of the pandemic also had psychological effects on the population. Even though there were mixed effects of coronavirus-induced social restrictions and lockdowns. Furlough reduced the psychological risks associated with the pandemic job loss, while exiting the scheme increased the incidence of poor mental health. This could be explained by substantial decline in the generosity of the scheme by up to 40%.

Key messages

• Job loss during the pandemic had deteriorating mental health effects.

• Government contribution to furloughed workers’ wages minimizes the incidence of mental health distress.
Examining factors associated with cocaine use in late adolescence and early adulthood
Authors: Brennan M M , Cavallaro M , Mongan D , Millar S R , Galvin B , Ivers J H , Zgaga L , Smyth B , McCrory C , McCarthy N
Published: October 2024

Background

In 2022, cocaine was the leading problem drug for which individuals sought treatment in Ireland, overtaking opioids for the first time. Despite increasing concerns about cocaine, there is limited longitudinal research examining factors associated with cocaine use in the general youth population. We describe levels of use and associated factors at 17 and 20 years old

Methods

Past-year cocaine use was studied at age 17 (N = 5965) and 20 (N = 4679) in a nationally representative cohort. Individual, family, social and environmental exposure variables were selected a priori. Weighted logistic regression models were fitted using Generalised Estimating Equations to multiply imputed and complete case data.

Results

Cocaine use was reported by 220 (4%) at age 17, and 1072 (23%) at age 20. Both individual and community factors predict use. Earlier alcohol initiation and having friends who use cannabis were strongly associated with increased odds of cocaine use at both ages. Those with parents who reported that neighbourhood intoxication or drug-taking was common had elevated odds of cocaine use at age 17.

Conclusions

Past-year cocaine use at 20 years old in this cohort is substantially higher than other international cohort studies. Levels of cocaine use increase significantly between 17 and 20 years old.

Acknowledgement: Growing Up in Ireland (GUI) is funded by the Department of Children, Equality, Disability, Integration and Youth (DCEDIY). It is managed by DCEDIY in association with the Central Statistics Office (CSO). Results in this report are based on analyses of data from Research Microdata Files provided by the CSO. Neither the CSO nor DCEDIY take any responsibility for the views expressed or the outputs generated from these analyses.

Key messages

• Our study underscores significant cocaine use rates and correlations with early substance initiation and neighbourhood factors.

• This emphasizes the necessity of a comprehensive, multilevel strategy for preventing cocaine use.
Inclusive, needs-based research for addressing Health Literacy in Parents with immigrant backgrounds
Authors: Riiser K , Macintyre A , Haraldstad K , Hesselberg H , Helseth S
Published: October 2024

Research indicates that parental health literacy is associated with child health outcomes. A 2021 study by the Norwegian Public Health Department found that certain immigrant groups struggle with health literacy due to language barriers, cultural differences in understanding of health and illness, and unfamiliarity with the Norwegian health system and services. To reduce differences in health literacy and better support parents with immigrant backgrounds to make health promoting choices for their children, and navigate the Norwegian health and social systems effectively, we need knowledge about their resources, challenges, and needs. This knowledge makes it possible to design strategies to promote parental health literacy and make health services more responsive to the needs of the population. Optimising health literacy amongst parents with immigrant backgrounds (OPAL) is a research collaboration between Oslo Metropolitan University and the Bjerke City District, one of the most culturally and linguistically diverse districts in Oslo. Applying the Optimising Health Literacy and Access (Ophelia) process, parents health professionals, and researchers work systematically together to develop knowledge of parents’ health literacy, identify priority areas for research, design and implement effective solutions in primary health care. In this presentation, we will describe how OPAL is rooted in the strategic priorities of the city district, how the project applies methods for needs identification and involves users and stakeholders at all stages. We will share experiences from planning and conducting inclusive data collection, preliminary results and describe how results will be used in development of targeted health literacy actions.
Living conditions in Italian administrative detention centres for migrants: a scoping review
Authors: Mazzalai E , Caminada S , Giannini D , Marchetti G , Angelozzi A , Gatta A , De Marchi C , Turatto F , Declich S , Marceca M
Published: October 2024

Since 2011, Italy has experienced a growing flow of migrants, despite the implementation of restrictive and detention-oriented procedures. Detention facilities for migrants must provide health protection and general assistance to the person. Considering the critical state of the centres reported by various sources, this study gives an overview of the conditions in Italian detention facilities for migrants from a public health perspective. A scoping search of the peer-reviewed and grey literature was performed to investigate the public health standards currently in force in Italian detention facilities for migrants and refugees (Hotspot and CPR-Pre-removal Detention Centres). Articles published from 2009 to 2021 in English and Italian were included and qualitatively described in five categories: provision of healthcare, living conditions, protection of vulnerable detainees, access to legal advice, and the Covid-19 pandemic. 11 peer-reviewed studies and 24 grey documents were included. Guidelines on screening procedures for infectious diseases or vaccines appeared to be hastily followed; chronic and mental diseases were not appropriately addressed. The facilities were described as run-down, with scarce and poor-quality meals, and lacking of educational activities. A lack of protection for vulnerable categories was reported, including unaccompanied minors. The Covid-19 pandemic further exacerbated pre-existing issues, highlighting systemic weaknesses in preparedness and response. Life conditions within the centres for migrants in Italy fall significantly short of acceptable standards. The main problems are the unavailability of cultural mediation services and the insufficient protection of mental health. The overall conditions appeared to be not dignifying and violations of the law are, if not frequent, present and well recognised. Urgent reforms are warranted to address these shortcomings and ensure the humane treatment and protection of migrants within these facilities.

Key messages

• Italy is responding to the recent inflow of migrants with policies oriented to detention and repatriation. To this, it established de-facto detention centres for migrants, namely Hotspot and CPRs.

• The public health standards of migrants’ repatriation centres are poorly followed and life inside the centres appears misereble.
The impact of healthcare worker migration in source countries: Colombia, Indonesia, and Jordan
Authors: Sax dos Santos Gomes L , Efendi F , Putri N K , Bolivar-Vargas M , Saadeh R , Villarreal P A , Aye T T , De Allegri M , Lohmann J
Published: October 2024

Background

To address domestic shortages, high-income countries are increasingly recruiting healthcare workers from low- and middle-income countries. This practice is much debated, yet empirical evidence is rare. This study fills this knowledge gap by reporting high-level stakeholders’ perspectives on health system impacts of international migration and active recruitment of HCWs in Colombia, Indonesia, and Jordan.

Methods

We used a multiple case study methodology, based on qualitative methods integrated with information available in the published literature.

Results

All respondents decried a lack of robust and detailed data as a serious challenge in ascertaining their perspectives on impacts of healthcare workersmigration. Stakeholders described current emigration levels as not substantially aggravating existing healthcare workforce availability challenges. This is due to the fact that all three countries are faced with healthcare worker unemployment grounded in unwillingness to work in rural areas and/or overproduction of certain cadres. Respondents, however, pleaded against targeting very experienced and specialised individuals. While observing little harm of healthcare worker migration at present, stakeholders also noted few benefits such as brain gain, describing how various barriers to skill enhancement, return, and reintegration into the health system hamper in practice what may be possible in theory.

Conclusions

Improved availability of data on healthcare workers migration, including their potential return and reintegration into their country of origin’s health system, is urgently necessary to understand and monitor costs and benefits in dynamic national and international health labour markets. Our results imply that potential benefits of migration do not come into being automatically, but need in-country supportive policy, such as favourable reintegration policies or programs targeting engagement of the diaspora.
Mothers to Babies & Art of Creation: Canadian stakeholder engagement during intervention development
Authors: McKerracher L , Chin J , Sloboda D
Published: October 2024

Background

The 2021 British Medical Research Council framework, outline that effective development of interventions requires engagement of diverse stakeholders. In practice, however, engaging stakeholders in health intervention development often receives insufficient investment. The Mothers to Babies (M2B) Study and its linked Art of Creation (AoC) Intervention Project comprise a joint case study in prioritizing stakeholder engagement.

Methods

From 2016 to 2019, our M2B team dedicated its financial and personnel resources to assessing community health priorities for preventing non-communicable diseases (NCDs) in Hamilton, Canada. Motivated by a “first 1000 days” approach (i.e. health environments through pregnancy and infancy have outsized impacts on NCD risks across a child’s life), we worked with stakeholders to identify acceptable, feasible complex intervention strategies supportive of health behaviours among pregnant Hamiltonians. To this end, we surveyed 434 pregnant people of diverse backgrounds and ran focus groups, interviews, and meetings with 69 stakeholders with diverse orientations to pregnancy and family health provision.

Results

M2B’s work indicated two areas actionable through a complex, behavioural intervention: 1) lack of knowledge about the first 1000 days, and 2) need for platforms for peer support and empowerment. These themes were centred in the development and the stakeholder-engaged implementation/evaluation of the ongoing AoC intervention study. AoC uses outreach through local cultural institutions and arts-based workshops to facilitate understanding of the first 1000 days. AoC increases participants’ knowledge of the first 1000 days, supports social relationships among participants and is enjoyable and empowering.

Conclusions

Investing three years and dedicated personnel to stakeholder engagement by M2B yielded the development of AoC, a complex health promotion intervention that fits the diverse priorities of Hamilton communities.
A Process Evaluation in a Randomized Controlled Trial among Adults with Acetabular Dysplasia
Authors: Jacobsen J S , Evans R , Morgan K , Thorborg K , Oestergaard L G , Sørensen D
Published: October 2024

Introduction

The 2021 framework from the UK’s Medical Research Council defines evaluation as a theory-driven approach to examine how well an intervention works. However, the application of these guidelines can be challenging. Therefore, using a process evaluation case study on an exercise and patient education intervention for adults with acetabular dysplasia, we reflect on which specific aspects were relevant for the evaluation of the intervention and why. We focus on detailing methods to assess implementation (process, dose, reach), acceptability, mechanisms of change, and the impact of contextual factors.

Methods

Two hundred trial participants aged 18-50 years will be recruited from a University Hospital in Denmark and randomised to intervention and control groups. The process evaluation adopts a concurrent mixed-methods design involving self-report questionnaires at baseline and 6-month follow-up, training records and semi-structured focus groups with intervention providers (n = 10) and healthcare managers (n = 4-6). The mechanisms of change will be explored through semi-structured one-to-one interviews (at baseline and 6-month follow-up) with 15-20 purposefully sampled trial participants, and additionally, through exploratory examinations of associations between dose and change in health outcomes at 6-month follow-up), via simple linear regression models. The acceptability and contextual factors will be explored through one-to-one participant interviews, plus focus groups with 4-6 healthcare managers. Thematic analyses of the interviews will focus on expectations, experiences, events, personal understandings and interpersonal and organisational interactions.

Conclusions

The presentation will explore how the operational aspects of the intervention can be assessed through a process evaluation and how these findings may improve and expand any future implementation efforts.
5.F. Scientific session: Staying cool: innovative solutions for an ageing population in a warming Europe
Authors:   Organised by: DG SANTE European Commission
Published: October 2024

The EU is facing the dual challenge of climate change and rapid population ageing: temperatures in Europe are warming more rapidly than in the rest of the world and at the same time the number of those aged 85 years or more in the EU is projected to more than double by 2050. The increase of morbidity and mortality due to extreme heat is higher in older adults compared to the other age groups. During the workshop, we will first address the effect of heat waves and raising temperatures on older adults’ health and then present and discuss possible innovative tools and actions to minimise their impact on the EU ageing population.

Objectives

Emphasise the importance of addressing heat waves and raising temperatures including their impact on NCDs, with a focus on the implications for the ageing population; Present the reinforced activities of the Climate and Health Observatory, focusing on raising temperatures and heat waves; Discuss possible measures at EU level, multisectoral collaboration, the synergies and possible trade-offs between adaptation and mitigation measures; Discuss innovative solutions to minimise the impact of raising temperatures and heat waves on older adults.

Speakers/Panelists

• Projections of heat exposure of older adults and the consequences.

• The European Climate & Health Observatory – presentation of reinforced & broadened activities.

• Measures for adapting to and protecting against the effects of heat waves and warming.

• Tackling the problem at the source: mitigating the contribution of the healthcare sector to GHG emissions/climate change.
Emergency preparedness in healthcare systems: the “policy-effect” of COVID-19
Authors: Beccia F , Cacciuttolo M G , Farina S , Specchia M L , Damiani G
Published: October 2024

The COVID-19 pandemic has highlighted that health services preparedness is crucial. Indeed, effective planning enables streamline operations, optimized resource allocation, and transparent communication during crises. Within this context, our analysis aims to assess EU countries’ healthcare systems preparedness, by policies analysis and capacity factor analysis, and relationship with COVID-19. We reviewed policies regarding influenza, antimicrobial resistance (AMR), and climate change in EU countries, using a web-screening of national and international authorities and institutions. Furthermore, we performed a factor analysis on WHO’s States Party Self-Assessment Reporting (SPAR) and evaluated the results using an iterated principal factor analysis with promax rotation. Few countries updated their policies after the pandemic, particularly regarding influenza plans. Italy stands out as an exception, having updated its national plan in 2021, while other countries maintain pre-COVID plans. Regarding AMR, only few countries, including Sweden, Netherlands, Malta, Germany, Spain, Belgium, and France, updated their plans post-pandemic, while Estonia and Romania lack plans entirely. Addressing the climate crisis and its impacts on health and healthcare resilience, all EU countries aligned with the EC regulation on climate action through National Energy and Climate Plans in 2023. Moreover, EU countries had average preparedness level of 75.77 (SD: 8.23), calculated on SPAR 2022, with significant disparities. Three major factors contribute to preparedness levels: planning, service delivery, and specific subtopics (e.g. food safety, radiation, infectious diseases). Our findings reveal the complexity of preparedness, showing diverse approaches across countries, despite EU regulations and WHO guidelines. International collaboration is crucial to standardize policies and enable countries to leverage successful examples, improving public health outcomes.

Key messages

• Health services preparedness, underscored by the COVID-19 pandemic, is crucial for effective planning and crisis management.

• The analysis demonstrates varying levels of preparedness across EU countries, with differences in policy updates and adherence to international guidelines.
Slaintécare Healthy Communities: Engaging with evidenced based best practice to promote health literacy in Ireland
Authors: Carney M , Nyamakope T
Published: October 2024

This workshop will include a blend of presenters from both practice and research, with tangible examples of how the needs analysis was conducted, how meaningful partnerships were developed, and how we suggest these suggestions can be brought to life. This opening presentation will set the scene, detailing the role of Sláintecare Healthy Communities, the rationale for a focus on health literacy, the incredible value of adopting a meaningful participatory approach, and learnings from collaborating with a research team/project.
Capturing the health and well-being impact of climate change: a health impact assessment in Wales
Authors: Green L , Edmonds N
Published: October 2024

Climate change is one of the biggest threats to global health in the 21st century and is likely to impact on health through a range of factors (societal, economic or environmental). The need to take action on climate and nature emergencies in order to protect population health and well-being and prevent negative impacts are becoming more urgent. Public Health Wales carried out a comprehensive mixed-method Health Impact Assessment (HIA) of climate change in Wales. HIA is a systematic process which considers the impact of a policy on the health and well-being of a population. It appraised the potential impacts of climate change on health and inequalities in Wales. This involved participatory workshops, engagement with stakeholders, statistical data, systematic literature reviews and case studies. The HIA findings indicate significant potential impacts across the determinants of health and mental well-being. For example, air quality, flooding, economic productivity, working conditions, access to services and community resilience. Impacts were identified across population groups, settings, and areas including urban and rural contexts, outdoor workers, children and young people, older people, schools, hospitals and workplaces. These findings have been beneficial to inform decision-makers to prepare for climate change plans and policies using a preventative evidence-informed approach. The work has demonstrated the value of HIA for significant, complex policies by mobilising a range of evidence through a transparent process, resulting in government and organizational action and transferrable learning for others.

Key messages

• HIA is a beneficial tool to identify at a granular level the health impacts of climate change.

• The HIA has been used by the government of Wales and organisations to respond to and plan for climate change.
Impact of temperature and humidity on airway obstruction in a cohort of elderly women
Authors: Areal A , Singh N , Schikowski T
Published: October 2024

Background

Temperature and relative humidity (RH) impact human health. However, little is known about the combined association between temperature and RH on respiratory health in the elderly. In this study, we evaluated the interactive associations of temperature and RH on airway obstruction in elderly German women.

Methods

Using data from the second follow-up (2007-2010) of the German SALIA cohort study, we assessed the short-term (Lag0-8) combined association between maximum and minimum temperature (Tmax, Tmin) and RH on airway obstruction. Airway obstruction was defined as the ratio of first second of forced expiration (FEV1) / forced vital capacity (FVC) < 0.70. Multivariable logistic regression with a distributed lag non-linear model (DLNM) was constructed for the interaction between temperature and RH and adjusted for a single pollutant, location, socioeconomic status and smoking status.

Results

735 elderly women with an average (±SD) age of 73.46 (±3.09) years were included. Around 16.73% of them had airway obstruction. For non-linear antagonistic Tmax and RH interaction models, we found a U-shaped relationship from Lag 0-8, with an immediate adverse association from Lag0-1 and a significant delayed adverse association from Lag7-8. For non-linear antagonistic Tmin and RH interaction models, the relationship was U-shaped and showed an immediate adverse association from Lag0-1, while there was also a significant delayed association from Lag6-8.

Conclusions

Climate change increases the likelihood of exposure to adverse temperatures and weather conditions. Vulnerable populations like the elderly are more susceptible to the adverse associations of climate change. In this epidemiological study, we found that exposure to Tmax/Tmin and RH had immediate and delayed adverse associations by increasing respiratory obstruction in elderly women. Increasing public awareness of the danger of interactions between non-optimum temperature and RH on respiratory health is crucial.

Key messages

• Elderly women’s respiratory health is impacted by temperature and humidity interactions, requiring awareness and proactive measures.

• Climate change heightens risk for vulnerable groups, emphasising the need to address environmental impacts on health.
Family Vulnerability: From concept to a scale validity and application
Authors: Eshriqui I , de Almeida L Y , de Souza E L , Nascimento V E , de Mendonça JMT , Neto FTP , Rebustini F , de Medeiros E B , de Sousa AAF , Bonfim D
Published: October 2024

This activity will last 20 minutes. An interactive presentation will be structured at three steps. First, a debate will be facilitated to engage participants on the following questions: i. What is family vulnerability? ii. Why should we measure family vulnerability at the context of Primary Health Care (PHC)? Second, once concepts are aligned, a brief presentation about the Vulnerability Family Scale for Brazil (EVFAM-BR) will be performed. At this time, participants will have the opportunity to know about the process of development, validation and the final version of EVFAM-BR (Souza et al., 2023, available at https://doi.org/10.1371/journal.pone.0280857). Third, presenters will share step by step how EVFAM-BR can be implemented into PHC, considering two real-world experiences in Brazil, Southeast and North regions, and will discuss about possible strategies to tailor it at different cultural and geographic context, from settings with higher vulnerability and low resources to high technology settings.
6.E. Practice session: Using European environmental data in public health: datasets and applications
Authors:   Organised by: European Environment Agency,   Chair persons: Gerardo Sanchez Martinez (Denmark)
Published: October 2024

The European Environment Agency collects, quality-assures and quality-checks data on environment, climate and sustainability. It does so through its network and other institutional partners across 38 European countries. Most of these validated environmental data are publicly available and many can be used by practitioners to assess environmental risks to the health of their communities, as well as for designing and evaluating policies’ effectiveness. The objective of this workshop is to provide public health practitioners and scientists with an overview of the EEA data streams of public health relevance, including on air pollution, noise, water pollution, industrial emissions and climate impacts, among others. It will also highlight existing examples of local and national assessments and communication products based on these data, as well as demonstrating how specifically data on air pollution can be used for a quick health impact evaluation. The format of the workshop will be a practice session of 60 minutes with four presentations, the last being a live example demonstration, and an ample session of questions and answers.

Key messages

• The EEA collects and publishes large, validated datasets of public health from across 38 member countries, including on air and water pollution, industrial emissions, noise and climate change.

• These data can be directly used by practitioners to assess environmental risks to the health of their communities, and to design and evaluate policies, with publicly available models and tools.
Using EEA data to calculate health impacts of air pollution via the AirQ+ model: a practical example
Authors: Mudu Pierpaolo
Published: October 2024

The AirQ+ software tool for health risk assessment of air pollution, developed by the World Health Organization, helps quantify the effects of exposure to air pollution. Specifically, AirQ+ can estimate the effects of short-term changes in air pollution (based on risk estimates from time-series studies) and the effects of long-term exposures (using life-tables approach and based on risk estimates from cohort studies). AirQ+ is available in English, French, German and Russian. In this presentation, AirQ+ will be loaded with air pollution data from the European Environment Agency datasets for a quick evaluation of health effects from air pollution in an European city.
Health literacy from the perspectives of children and adolescents - a meta-ethnography
Authors: Sommer I , Seidl K , Affengruber L , Stauch L , Rojatz D , Wahl A , Gugglberger L , Okan O , Griebler U
Published: October 2024

Background

The current literature on health literacy rarely considers the views of children and adolescents. The aim of our qualitative evidence synthesis was therefore to develop a child- and adolescent-centered conceptualization of health literacy.

Methods

We conducted a meta-ethnography of qualitative studies. Our iterative literature search considered the literature up to November 2023. We dually screened 1596 abstracts and 97 full texts, assessed the methodological limitations of the 32 included studies, and considered 21 data-rich studies in the analysis. We extracted first- and second-order constructs, translated the studies into each other, and developed a coherent argumentation. We dually assessed the trustworthiness of the evidence.

Results

The resulting model comprises micro-, meso-, macro- and chronosystems. It highlights the influence of demographic, cognitive and psychological factors on the development of health literacy in children and adolescents at the micro level, the social environment, including family, friends, peers, teachers, and health professionals at the meso level, and the media and internet, the health and education system, the living environment, and the social narrative about health at the macro level. The chronosystem shows the impact of upbringing, development, and experience. Children absorb health information actively and passively, employing various strategies to evaluate its trustworthiness. They seek advice from their social environment, which acts as a source of information and influencing factor. Different types of information are weighed up and ranked before action is not taken.

Conclusions

Existing models of health literacy are too one-dimensional to be applied to children and adolescents and do not consider their social and living environment. The proposed model offers a comprehensive understanding of health literacy in children and adolescents. It can be used as a basis for future interventions to improve health literacy.

Key messages

• Health literacy of children and adolescents is significantly influenced by a combination of internal and external factors.

• By incorporating the perspectives of children and adolescents, we have developed a more inclusive and nuanced understanding of health literacy.