bluuebunny/crossref_metadata_2025 huggingface dataset:
Plant-based polyphenol-rich foods and beverages influence metabolic health in a Mediterranean cohort
Authors: Micek A , Currenti W , Godos J
Published: October 2021

Background

There is convincing evidence that a healthy diet may affect metabolic disorders and reduce the risk of chronic non-communicable diseases. Plant-based dietary patterns have been the focus of major interest for their potential in improving metabolic status of the general population. Besides their content in fiber, healthy fats, and antioxidant vitamins, also phytochemicals, such as polyphenols, have been called out as potential compounds driving the aforementioned benefits. This study aimed to explore the association between a plant-based foods and beverages rich in polyphenols and metabolic outcomes irrespectively of the role of the whole diet.

Methods

Demographic and dietary characteristics of 2044 adults living in southern Italy were analyzed. Multivariate logistic regression analyses were used to calculate odds ratios and 95% confidence intervals of the association between polyphenol-rich foods and beverage consumption and metabolic status, adjusted for adherence to the Mediterranean diet.

Results

Individuals with a higher total polyphenol-rich beverage intake (including coffee, tea, and red wine) had higher polyphenols intake and were less likely to have hypertension, type-2 diabetes, and dyslipidemia; however, when adjusted for potential confounding factors, only the association with hypertension remained significant (OR = 0.69, 95% CI: 0.50-0.94). Higher nut intake was inversely associated with occurrence of hypertension, type-2 diabetes, and dyslipidemia. However, the association did not remain significant for the latter after adjusting for the main background characteristics, while an inverse association was stably confirmed for hypertension (OR = 0.61, 95% CI: 0.46-0.80 and OR = 0.44, 95% CI: 0.26-0.74, respectively) even after adjusting for adherence to the Mediterranean diet.

Conclusions

Plant-based polyphenol-rich foods and beverages are major driver of metabolic benefits irrespectively of the overall adherence to the Mediterranean diet.

Key messages

Higher intake of plant-based polyphenol-rich foods may contribute to better metabolic health. Plant-based polyphenol-rich foods not characteristics of the Mediterranean diet could be underrated among individuals living in the Mediterranean area.
Lifecourse partnership breakups or years lived alone and low grade inflammation in middle-aged adults
Authors: Lund R , Davidsen K , Carstensen S , Kriegbaum M , Bruunsgaard H
Published: October 2021

Background

Divorce and living alone are associated with several adverse health outcomes. There is however very limited knowledge on the potential effects of exposure across the life course. The aim of this study is to investigate whether accumulated number of divorces/partnership breakups or years lived alone across 26 years of adult life, is associated with levels of low grade inflammation and if vulnerability with regards to gender or educational level can be identified.

Methods

4,835 participants from Copenhagen Aging and Midlife Biobank (CAMB) aged 48-62 were included. Accumulated number of partnership breakups and years living alone, were retrieved from a national standardized annual register. Inflammatory markers, Interleukin-6 (IL-6) and high sensitivity C-Reactive Protein (hsCRP), were measured in plasma samples. Multivariate linear regression analyses were adjusted for age, educational level, early major life events, BMI, chronic diseases, medicinal intake that affects inflammation, acute inflammation, and personality scores (neuroticism, agreeableness, conscientiousness).

Results

For men, two or more partnership breakups as well as living alone for 7+ years was associated with significantly higher levels of and inflammatory markers, i.e. 12-17% higher level of hsCRP and IL6 compared to the reference groups (no break-ups/0-1 years living alone) p-values <0.0001-0.024. No associations were found for women, and no joint effect of partnership breakups and educational level was found for either gender.

Conclusions

The findings suggest a strong association between accumulated number of partnership breakups or years lived alone across 26 year of adult life and low grade inflammation for middle-aged men but not for women. No specific vulnerability among the lower was identified. The findings points towards the importance of developing tailored preventive initiatives to males experiencing several partner-break-ups or who lives alone for many years.

Key messages

Two or more partnership breakups or 7+ years lived alone across 26 year of adult life is associated with increased low grade inflammation for middle-aged men but not for women. No increased vulnerability among the low educated was identified.
Country Experience with using the Country Assessment Tool (Lessons learned)
Authors: Nordström C
Published: October 2021

Difficulties in completing the CA concerned the availability of data and quality of data, also complicated by complex government structures. UK-level data are collected by various agencies and are often unavailable at Welsh level. Data on migrant health is not collected, apart from the Office of National Statistics scoping collection at UK level. There was no data available regarding refugees after they have been granted leave to remain, and the numbers in Wales not known. Research on migrant health is largely limited to people seeking sanctuary, and there is an ambitious cross-sector plan to make Wales the world's first Nation of Sanctuary. While there is limited visibility of migrants in health-related policies, rather references to ‘diverse communities' or ‘black and minority ethnic groups', Welsh policy in devolved areas e.g. Health are generally more inclusive of migrants than UK policy.

Lessons learned: It is difficult to retro fit data systems and trying to gather from mainstream information will vastly underestimate the underserved population groups such as migrants. Especially when sanctions against individuals and mistrust of officialdom may mean an unwillingness to engage. For asylum seekers these stakes are very high eg deportation. Hence specific bespoke systems of data capture are needed. Often using trusted others eg third sector organisations that support health, legal advocacy and other service reports are important.
Personality traits associated with Healthy Diet and Obesity: A systematic review
Authors: Diop M , Epstein D , Ruiz-Adame M
Published: October 2021

Objective

This study aimed to examine the association between personality traits and either dietary behaviour or weight-related outcomes.

Methods

A systematic review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement was conducted through Scopus, PubMed and PsychInfo databases. Studies were included if they used a facet of personality that we were confidently able to map to a Big Five dimension.

Results

A total of 21 studies were eligible for inclusion. Most studies that reported a measure of association found a result that was statistically insignificant at the 5% level. In studies where the result was statistically significant, Extraversion, Openness, Agreeableness and Conscientiousness were almost always positively associated with healthy dietary behaviour and negatively associated with fat consumption, eating problems, obesity and measures of unhealthy weight across all the populations. Four studies found statistically significant results in the opposite direction. Neuroticism was associated with unhealthy behaviours or weight problems.

Conclusions and Implications

The Big-Five-model is an adequate instrument to measure the relationship between personality and diet. Healthy dietary behaviour tends to be associated with more pro-social personality characteristics, whereas poor weight control could be linked with Neuroticism. These results suggest there may be some benefit from using psychological traits to personalise interventions aimed at improving nutrition.

Key messages

There may be some benefit from using psychological traits to personalise interventions aimed at improving nutrition. Another interesting line of research may take account of the role of peer-effects and role-models in promoting healthy or unhealthy behaviour across social networks.
Mediterranean Diet in Europe: how are mature adults and elderly moving closer to this diet pattern?
Authors: Alves R
Published: October 2021

Background

The decrease in Mediterranean Diet (MD) adherence during the last decades in Europe has been linked with changes to modern lifestyles, and more recently, to the Great Recession. However, new national efforts to improve dietary habits through fiscal and regulatory policies, and the economic improvement of the second half of the past decade (pre-covid 19 pandemic) might have led to a reversal in this trend. Our goal was to analyze the changes in MD adherence between 2013 and 2019 among a sample of European mature adults and the elderly.

Methods

Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) for adults over 50 years old, we design a longitudinal cohort study with a sample of participants from waves 5 (2013) and 8 (2019/20). Logistic regressions were used to model the consumption of MD adherence, meat/fish, fruit/vegetables, legumes/eggs and dairy products as function of the year. We stratified the analyses by educational level and age groups and for transitions in economic status, employed, and self-perceived health.

Results

There was in 2019/20 a significant increase in the MD adherence (10.8 v. 14.3%, OR = 1.377, P < 0.01). The rise is mainly related to the decrease of meat and fish (38.4 v. 30.5%, OR = 0,703, P < 0.01) and growth of legumes and eggs intake (36.3 v. 41.8%, OR = 1.260 P < 0.01). The results were consistent in all European regions and most sociodemographic groups. Younger people with higher income and education and overall better self-perceived health had a more prevalent rise in M.D adherence.

Conclusions

Our analysis shows a generalized growth in MD's adherence amongst mature adults and elderly population across Europe. This rise was observed across most socioeconomic subpopulations and European countries, suggesting a shift to healthier diet patterns. Yet, MD adherence increase was more noticeable amongst more affluent, educated and healthy responders, which may further entrench diet and health inequalities.

Key messages

Mediterranean Diet adherence has been increasing among mature adults and the elderly in Europe (2013-2019). The rise in Mediterranean Diet adherence was more evident amongst more affluent, educated and healthy responders, which may further entrench diet and health inequalities.
Global solidarity, justice and moral failures
Authors: Tahzib F
Published: October 2021

The WHO Director-General's in his opening remarks at 148th session of the Executive Board on 18th January 2021, warned of ‘catastrophic moral failure' if world leaders did not rise to the challenge of vaccine equity and subsequently referred to it as a test of character, with consequences. A moral failure is an act or thought which is carried out when one knows that it should not be carried out or conversely an act which is not carried out when one knows it should be carried out. Scholars in reviewing the responses to the pandemic have highlighted that “Nothing will fundamentally change unless we truly understand and appreciate the nature of the lessons we should learn from these outbreaks. Our past failures must be understood as moral failures that offer moral lessons. Yes, we can learn how to better curb the spread of outbreaks by using shiny new technologies,” it has been suggested, “but unless we appreciate that we have a defect in our collective moral attitude as a global community toward remediating the conditions that precipitate the emergence of outbreaks, we will never truly learn. The purpose of the presentation will be to reflect on the issues revealed by the pandemic, why they are referred to as “moral issues” and the societal moral distress resulting from our continued neglect to recognise and to address them. The individual, community and institutions which serve them are key protagonists and chief stewards for health and it is through their interactions and values that future emerges. The presentation will highlight the need for global solidarity, justice and empathy and the case to reimagine the earth as one country and humankind its citizens.
COVID-19 in patients receiving renal replacement therapy in the Russian Federation
Authors: Shilov EM , Rumiantseva EI , Shilova MM , Milchakov KS
Published: October 2021

Background

It is known that patients receiving renal replacement therapy (RRT) are at a risk for severe COVID-19. This study was the first to evaluate the epidemiology of COVID-19 in patients receiving RRT in the Russian Federation in 2020.

Methods

The research method was an Internet survey conducted among the main nephrologists of the subjects of the Russian Federation. Data were obtained from 82 out of 85 subjects of the Russian Federation. We evaluated the numerical changes in the population of patients treated with RRT from 01.01.2020 to 01.01.2021; the number of patients diagnosed COVID-19; total mortality and the proportion of deaths associated with COVID-19. The COVID-19 was diagnosed by a positive polymerase chain reaction, supplemented by lung CT results.

Results

The prevalence of COVID-19 among all 72,734 patients who were receiving different types of RRT was 13,585 (18.7%), which is significantly (p < 0.05) higher than the average in the Russian Federation. The prevalence of infection among patients with peritoneal dialysis (PD) and kidney transplantation (KT) was lower (12.6% and 11.6%, respectively) than among patients with hemodialysis (HD) (20.5%). This can be attributed to the self-isolation of patients with PD and KT, in contrast to patients on HD, which, on the contrary, increased the frequency of contacts between patients and medical staff. Among all patients observed during 2020, the average mortality rate was 22.1%, exceeding by 7.8% the average level of this indicator in 2018 (14.2%). Of these 22.1%, most (17.4%) were non-COVID-19-related deaths, and about 4.6% were COVID-19-related deaths. Among the 13,585 patients on RRT with COVID-19, the annual mortality rate was 24.4%.

Conclusions

The prevalence of COVID-19 and mortality rates among patients on RRT are higher than in the general population of the Russian Federation.

Key messages

In the Russian Federation patients receiving RRT are at a high risk of severe COVID-19. Mortality rates of COVID-19 are higher in patients receiving RRT than in general population of the Russian Federation.
What is a covid dashboard?
Authors: Riley N , Hansen J
Published: October 2021

Public Health Reporting has a long history (text here suddenly missing!)There is a long tradition of Public Health Reporting to support knowledge during public health crises. The Covid-19 pandemic has seen the unprecedented rapid demand for Public Health Reporting. The size, speed and scale of the pandemic led to governments, public health professionals, the media and citizens asking for up-to-date, accurate and accessible information and intelligence. One way that these demands were answered were through the creation and publication of Covid-19 dashboards to communicate to diverse audiences. Health Information Professionals were required to make significant decisions quickly. Which indicators to select? Which audiences to develop dashboards for? Which technologies to deploy? Decisions that would normally take a considerable length of time were abbreviated. There were no international standards and a variability of requirements for different commissioners of dashboards. Furthermore the public spotlight and ‘democratisation' of health information created additional pressure and a lack of situational control. Some of the choices made will have a consequential impact for shared Health Service and Population Health Research as the pandemic continues.

 

The purpose of this presentation is to

Discuss the need for rapid health reporting as a result of the Covid-19 pandemic Examine some of the choices faced by health information professionals in creating and sustaining public Covid-19 dashboards during the pandemic. Illustrate a variety of solutions that emerged internationally that were broadly trying to address the same need.
7.F. Workshop: Health literacy in the European Region: a summary of survey results and policy recommendations
Authors:   Organised by: GÖG (Austria),   Chair persons: Diane Levin-Zamir (Israel), Stephan Van Den Broucke (Belgium)
Published: October 2021

As the European Health Literacy Survey HLS-EU (2009-2012) and experience in many countries has shown, measuring population health literacy is important for putting health literacy on the agenda of health policy, practice and research and to inform health policy where there is specific need for improving health literacy by interventions. For the Health Literacy Survey 2019 of WHÓs Action network on Measuring Population and Organizational Health Literacy (M-POHL), the HLS19-Q12 instrument on measuring comprehensive general health literacy (HL) of general adult populations was developed, building on the HLS-EU instrument. Furthermore, specific instruments have been developed for measuring digital, communication, navigation, and vaccination health literacy. The survey was implemented in 17 countries in the European Regions of the World Health Organization with representative national samples of above 1000 respondents, between 2019 and 2021. This workshop with two presentations and 3 panelists will present methodology and main results of the European Health Literacy Survey 2019 and recommendations for health policy based on the results of the survey.

The first presentation “The European Health Literacy Survey 2019 of M-POHL: a summary of its main results” will focus on construction, validation, and distribution of the scores and categorial levels of the HLS19-Q12 instrument. Results social gradient and on selected determinants of HL measures and consequences of general HL in the areas of health behaviors and life stye, health status and healthcare utilization will be shown. Overall trends in HL in the participating countries and variation between these countries will be provided. The second presentation “Policy recommendations for improving health literacy: based on European Health Literacy Survey 2019” will present procedure and outcome of drafting recommendations for policy implementations in Europe based on the survey results by the M-POHL consortium.

Speakers/Panelists

Kristine Sørensen Global Health Literacy Academy, Health Literacy Europe, Aarhus, Denmark Miguel Arriaga Division of Literacy, Health and Well-being, Directorate-General on Health, Lisbon, Portugal Maria Lopatina National Medical Research Center for Therapy and Preventive, Ministry of Health of the Russian Federation, Moscow, Russia

Key messages

Measurement of health literacy of adult populations of 17 countries in the European region by the HLS19 study shows general trends and considerable variation by country. Results of the HLS19 study were a good basis for developing policy recommendations for improving health literacy in Europe.
Policy recommendations for improving health literacy: based on European Health Literacy Survey 2019
Authors: Dietscher C , Le C , Telo de Arriaga M , Schaeffer D , Drapkina O , De Gani S
Published: October 2021

The European network on Measuring Population and Organizational Health Literacy (M-POHL) was founded in 2018 under the umbrella of the European Health Information Initiative (EHII) of the World Health Organization - Regional Office for Europe. Health literacy (HL) is increasingly recognized as a critical determinant, mediator or moderator of health, and large parts of populations have been shown to have limited HL. Therefore, it is one of the aims of M-POHL to install international comparative population HL surveys at regular intervals. These can provide a valuable and valid basis for developing evidence-informed recommendations for policy, research and practice in the field of HL. To meet this purpose, M-POHL brings together experts from research and policy. Following up on the first European HL survey (HLS-EU), the first project of M-POHL was the international HLS19 survey, with 17 participating countries from the WHO European region. In addition to general population HL, the survey also covered specific HL's such as digital, communication, navigation, and vaccination HL. Despite the obstacles posed by the Corona pandemic, the survey could be administered, and an international comparative report was prepared by the HLS19 project consortium. On this basis, M-POHL will hold two workshops in June and August 2021 to develop resulting recommendations for policy and research in Europe. It is expected that these recommendations will a. o. focus on: population groups in most need of support in their HL; how to improve different dimensions of HL (such as finding, understanding, assessing, and applying relevant health information); HL as applied to health care, disease prevention, and health promotion; and aspects relating to the specific HL's measured. The presentation will describe the process of development, and give an overview of the M-POHL recommendations.
Influences on the use of digital tools in primary care to deliver physical activity advice
Authors: Bondaronek P , Singh Jennings S , Mallion V , Stefanidou C , Bhathal A , Simon C
Published: October 2021

Background

Increasing physical activity is a public health priority. The unique and critical role of healthcare professionals (HCPs) in primary care to help address physical inactivity is explicitly identified by various national physical activity (PA) frameworks. Yet, there may be various obstacles to the delivery of PA advice, such as lack of time, lack of confidence and lack of knowledge of where to refer people for further support. Digital technology provides new opportunities and has the potential to facilitate PA advice. However, it is unknown if and how digital tools are used within the context of primary care. The aim of the study was to understand the use of digital tools to support primary care consultations.

Methods

Twenty-five semi-structured interviews were conducted with HCPs in primary care. Data were analysed using thematic analysis to identify influences on the use of digital tools. Next, the themes were categorised using the COM-B model of behaviour to identify barriers and/or enablers to using digital tools to support the delivery of PA advice.

Results

The most prominent barriers and enablers related to included having the digital skills to use the systems, understanding of the PA assessment and advice, and the ability to tailor the tool to the HCPs needs. The opportunity factors included the limited digital resources available, organisational culture, and environmental stressors. The motivational influences included the level of familiarity with the tool, the confidence to use it, beliefs about a tool's usefulness, and professional identity.

Conclusions

A variety of influences were identified on the use of digital tools to support primary care consultations to deliver PA advice. These findings provide a foundation to design a system that addresses the barriers and leverages the facilitators to the efficient use of digital tools that support PA advice provision within the primary care context.

Key messages

There are various influences on the use of digital tools to support the provision of PA advice within primary care consultations, including skills, environmental and social factors, and motivation. The use of behaviour change theory allows us to systematically identify what barriers need to be addressed to assist HCPs in providing PA advice using efficient and flexible digital support tools.
Advances in real-time social listening for an adaptive public health response: WHO’s EARS platform
Authors: Mahajan A , Czerniak C , Lamichhane J , Phuong L , Purnat T , Nguyen T , Briand S
Published: October 2021

Background

COVID-19 pandemic was accompanied by an Infodemic (overabundance of information, including misinformation and disinformation, both online and offline); in response to this Infodemic, WHO launched the EARS platform (Early AI-assisted Response with Social Listening), showing real-time information about how people are talking about COVID-19 online. This information is intended to serve health information professionals to understand narratives and needs of the general public, in order to inform policy or communications decisions.

Methods

Data is collected daily from online conversations in publicly available sources, including Twitter, online forums, and blogs in English, French, Spanish and Portuguese, for 20 pilot countries. Once the data is collected, it is processed and classified into 39 categories, according to a set of pandemic public health taxonomy. The classification is made based on semi-supervised machine learning.

Results

Top 5 categories across regions are Covid-19 vaccine, Transmission settings, Personal measures, Testing and Industry (industry refers to the impact of the pandemic on the economy). We find that conversations around Covid-19 vaccines usually rank in the second or third position in all regions and represent 9%-12% of the conversation.

Conclusions

The configuration and application of the EARS platform has enabled progress towards more scalable and sustainable social listening to inform Infodemic management and response, compared to previous methods which were more manual, required data scientists in the team, or had fewer analytics capabilities. Future work will focus on gradually adding more data sources which can expand coverage and representativity.

Key messages

Discuss social listening methods for greater accountability to affected populations. Formulate insights into how digital media and information technology can be better utilized for more rapidly responding to the evolving needs of communities.
Modelling the impact of compliance fruit and vegetable intake recommendations on mortality in Russia
Authors: Mukaneeva D , Kontsevaya A , Karamnova N , Drapkina O
Published: October 2021

Background

Low fruit and vegetable intake is among the top ten selected risk factors for global mortality. The World Health Organization recommended daily fruit and vegetable intake is known to be 400 g/day. Despite strong evidence indicating that low fruit and vegetable intake relates to chronic diseases and mortality, most adults do not comply with dietary recommendations. According to the ESSE-RF epidemiological study, the prevalence of low fruit and vegetable consumption was 41.9%. The purpose of this study is to model the impact of following the national fruit and vegetables intake recommendations in decreasing N of death attributable to low fruit and vegetable intake.

Methods

A validated and transparent macrosimulation model, the PRIME (Preventable Risk Integrated ModEl) was used to estimate the cardiovascular and diet-related cancer death toll that could be prevented or delayed for the populations of Russia in a year. Data included in the model are a baseline scenario (actual F&V intake), a counterfactual scenario (recommended intake), and age-and sex-specific mortality for cardiovascular and diet-related cancer diseases, together with the total population risk of a specific year. Monte Carlo analyses with 5000 iterations were performed to produce the 95% uncertainty intervals.

Results

In 2018, an estimated 52 725 deaths (95% CI: 33 474, 69 837) could be averted or delayed if Russians adhered to dietary recommendations on fruit and vegetable intake. Cardiovascular disease accounted for 97.8% of these deaths. The modelled reduction in deaths for coronary heart disease was 43 530 (95%CI: 24 782, 60 168), for stroke 8 063 (95%CI: 5 252, 10 715). The modelled reduction in deaths for lung cancer was 1132 (95%CI: 484, 1731).

Conclusions

The modelling illustrates the potentially large social benefits of compliance with national fruit and vegetable intake recommendations.

Key messages

Despite strong evidence indicating that low fruit and vegetable intake relates to chronic diseases and mortality, most adults do not comply with dietary recommendations. The modelling illustrates the potentially large social benefits of compliance with national fruit and vegetable intake recommendations.
The role of Inclusionary Othering in Public Health
Authors: Akbulut N , Razum O
Published: October 2021

Inclusionary Othering has been established in public health literature, in addition to Exclusionary Othering. The concept of Inclusionary Othering was introduced by Mary Canales (2000, 2001, 2010). She developed this term in her doctoral thesis (1998), in which she dealt with the topic of Othering in the context of nursing care. Her conceptualization of Othering focuses primarily on approaches of Symbolic Interactionism. In particular, the theory of role-taking coined by George H. Mead (1962) plays an essential role in the rise of the notion of an ‘inclusive' potential of Othering. Theoretical approaches applied to conceptualize Inclusionary Othering, such as Goffman's stigmatization theory and Mead's theory of role-taking, have been explored in their explanatory power on Othering. Following this, in the context of which Othering emerged, the postcolonial theory was used to discuss whether Othering can have an ‘inclusive' impact in the context of public health. The Symbolic Interactionist approaches analyzed do not use the term Othering. Goffman's stigmatization approach is well suited to explain attribution processes that reduce the Other to a status of deviance. Stereotypical attributions are a necessary component of Othering. Mead's role theory, however, neglects the power asymmetry between the Other and the Non-Other. Accordingly, the hegemonic status of the Non-Other and the structural privileges he or she has remained untouched in the process of role-taking. Moreover, the approach focuses on an interactional level and does not consider the historical, discursive, and structural levels significant for Othering processes in health care settings. Othering already creates exclusion in the construction of Others and therefore cannot have any inclusive effects. In dealing with the consequences of Othering in health care, it is recommended to refer less to inclusion and, instead, to deconstructivist approaches such as critical whiteness.
The importance of personal attitude toward Health issues: the Covid 19 Vaccination attitude
Authors: Carbone AM , Mea C , Califano M , Califano R , Magri P , Iervolino A , Pacilio M , Scamardo MS , Buonomo B , Egidio R
Published: October 2021

The project realize an idea from students of Scientific High school involved in a multidisciplinary path focused on “ONE HEALTH” approach and “ENVIRONMENTAL EDUCATION” After skill buildings webinars the students decided to build a survey in order to

Raise awareness about how any individual behavior Underline the importance of information, even scientific, in order to take appropriate choices. Build confidence in the effectiveness of the vaccination interventions against COVID 19

 

The project has been done by the students on the basis of multimedia digital tools, exploiting some IT tools like Google forms, PPTs, Spreadsheet, Excel. Students carried out an online survey addressed to a sample of the adult population among students' friends. Observational questionnaire asked the participants their sharing about some issues or the ticking of one or more options from a list of default answers. The survey involved a sample of people between 500 and 1000 units from April 15th to May 30th 2021.After the collection, all the data have been processed through tables and graphs according to the following macro-themes:

Boundaries against vaccines Use of personal protective equipment The most feared pandemic risks and their environmental implications

The outcome of the survey mainly highlights the population ‘attitude to get vaccine together with the awareness of the necessity of herd immunity achievement, to overcome this pandemic. Students stand point is that personal attitude toward prevention and personal behavior may have impact either on health or into environmental goals.
Towards a Population Health Information Research Infrastructure
Authors: Bogaert P , Schutte N
Published: October 2021

Issue/Problem

Bringing Real World Evidence (RWE) and scientific consensus to the attention of policymakers is key in underpinning and supporting health policy decision making. Now more than ever, generating information on health and well-being of European populations as impacted by COVID-19 requires the full capacity of the European research community to generate evidence for better health system preparedness. Nevertheless, the necessary type of research input is not structurally and sufficiently available within the European research landscape.

Description of the problem

COVID-19 has clearly shown that a structured European mechanism to organize and share accurate information between countries is urgently needed, especially in the area of population health, to inform decision-makers, researchers and the public.

Results

The Population Health Information Research Infrastructure (PHIRI) offers a European mechanism for structured exchanges of population health data and information useful also in current and future epidemics or crises. The project improves population health information research at EU level, with services and tools necessary for researchers to find and access population health information data sources and to use Pan-European data for generating RWE, including an online Health Information Portal and the implementation of distributed analytical solutions to produce research outputs in a GDPR compliant, federated way. Finally, by means of EU-wide capacity building, PHIRI tackles health information inequalities.

Lessons

The support of exchange of knowledge and expertise across Europe is a key for driving the decision-making process, and facilitated by a European Health Information portal for COVID-19 embracing a federated infrastructure that overcomes data reuse and data sharing hindrances. This allows for a rapid and relevant policy response and analysis of knowledge gaps, while ensuring FAIR and ELSI principles.
The use of Real-World Data (RWD) by Health Technology Assessment (HTA) agencies
Authors: Karen K
Published: October 2021

Issue

There are divergent views between HTA bodies and pharmaceutical industry on the potential for RWD to inform determination of added benefit or value for money of new medicines. However, exploration of use of RWD is now essential as more high-cost innovative therapies come to market with short-term uncontrolled trials.

Description of problem

Payers are increasingly seeing use of RWD to fill evidence gaps in clinical development programmes, including external control arms or collection of RWD after initial assessment to determine real-life effectiveness or duration of benefit. An international multi-stakeholder initiative, RWE4Decisions, led by the Belgian Payer - RIZIV/INAMI - has explored these issues over the past few years. They have proposed that all stakeholders including industry, clinicians, regulators, patients and methodologists need to be involved to determine what questions can be answered by RWD and ensuring data is of sufficient quality to generate robust real-world evidence (RWE). Alongside this, the IMPACT HTA Project has reviewed use of RWD in specific rare disease case studies.

Results

Several HTA/Payers have implemented RWD collection schemes, but few have been successful in delivering sufficient evidence to enable re-assessment of treatment value. Italy is an exception, with a national web-based registry system. Other countries prefer to rely on secondary use of health system data and links to clinical registries, but curating and analysing these data can be complex. The case studies show how more recently some countries are overcoming these challenges by entering into more formal agreements with stakeholders to ensure purposive data collection.

Lessons

There is a need to publish protocols and reports related to RWD collection in an international portal. If possible, dialogues among bodies should happen in advance to align RWD collection requirements and facilitate data analysis.
Data availability for health system comparisons and assessments in the WHO African Region
Authors: Polin K , Webb E , Quentin W
Published: October 2021

Background

Describing and assessing health systems is a challenging but essential task for researchers and policy makers striving to perform cross-country comparisons and to ensure evidence-based global health policy. The European Observatory on Health Systems and Policies has developed a template for country health system reviews (HiT) to systematically describe and assess health systems. To date, the HiT template has been used for countries in Europe, Asia and North America. This study reviews to what extent data for the indicators in the HiT template are available for the 47 countries of the WHO African Region.

Methods

After identifying indicators in the HiT template, we explored the databases highlighted in the HiT template, as well as additional international and regional databases, to determine data availability. We extracted the country coverage and availability of indicators over time, noting gaps in data availability. Internationally available socio-demographic, macroeconomic, and mortality and health indicators were most frequently available for all 47 countries included in the study; data on the provision of services had the lowest availability. Data on human and physical resources and service provision had the most geographic and temporal variability. Information related to health system assessment, including issues around quality of care and access, if available, were geographically and temporally limited and found only in regional surveys or national sources.

Conclusions

This project provides a comprehensive overview of health system-related data availability for the African Region. Regional or country group databases with regular updates, such as those managed by OECD and Eurostat, are less common in the African region, leading to a dearth of information. More work is needed to determine the most appropriate indicators and data sources for health system comparisons and assessments in the region.

Key messages

We evaluated the data availability of health system indicators in the WHO African Region using indicators from the HiT template of the European Observatory on Health Systems and Policies. Socio-demographic, macroeconomic, and mortality indicators had highest availability for all 47 countries included in the study, while data on the provision of services had the lowest availability.
Non-adherence to COVID-19 guidelines on handwashing and social distancing on the island of Ireland
Authors: Darker C , O’Connell N , Graham CD , Nicolson G , Demster M
Published: October 2021

Background

COVID-19 public health measures like handwashing and social distancing can help stem the spread of the virus. Adherence to guidelines varies between individuals. This study aims to identify predictors of non-adherence to social distancing and handwashing guidelines.

Methods

A cross-sectional weekly telephone survey was conducted over eight weeks (11/06/2020-05/08/2020). The sample included adults resident on the island of Ireland (75:25 split between ROI and NI). Data were collected on demographics, threat perceptions, fear of COVID-19, response efficacy and self-efficacy, response cost and social norms, COVID-19 behaviours, mood, loneliness, and self-reported health.

Results

3011 participants were surveyed. Handwashing non-adherers were more likely to be male (OR: 5.2, 95% CI: 2.4 - 11.3), to have higher levels of loneliness (OR: 1.86, 95% CI: 1.1 - 3.1), and higher perceptions of handwashing costs (OR: 3.4, 95% CI: 2.2 - 5.2). Those reporting rarely engaging in social distancing were more likely to be members of lower socioeconomic groups, to be younger (OR: 0.97, 95% CI: 0.96 - 0.98), male (OR: 1.67, 95% CI: 1.1 - 2.5), healthcare workers (OR: 1.98, 95% CI: 1.1 - 3.4), to report lower mood (OR: 1.72, 95% CI: 1.3 - 2.2), were less likely to live in households with people aged under-18 (OR: 0.75, 95% CI: 0.6 - 0.9), and to have lower fear of COVID-19 (OR: 0.79, 95% CI: 0.6 - 0.9).

Conclusions

Non-adherers to handwashing differ from social distancing non-adherers. Public health messages should target specific demographic groups and different messages are necessary to improve adherence to each behaviour.
Changes In Psychosocial Status And Quality Of Life In Pediatric Patients With Cutaneous Leishmaniasis
Authors: Allahverdi S , Koruk I
Published: October 2021

Background

Leishmaniasis is a parasitic disease transmitted by the bite of sandflies that can affect different body systems. It is stated that 350 million people in the world are at risk of infection [1, 2]. Dermatological disorders as like cutaneous leishmaniasis are known to have negative effects on the psychosocial status and quality of life of children [3]. The aim of this study was to determine the psychosocial status and dermatological quality of life before and after treatment, the duration of positive changes after treatment, and other factors that affect the changes due to treatment in patients with cutaneous leishmaniasis(CL) aged 6-17 years.

Methods

This follow-up study was conducted at the Sanliurfa Cutaneous Leishmaniasis Diagnosis and Treatment Center(SCLDTC) between December 2019 and November 2020. The study included 48 children aged 6-17 years, who applied to the SCLDTC with the suspicion of CL, were diagnosed with CL, and who accepted intralesional treatment with pentavalent antimony compounds.

Results

The median age of the children participating in the study was 11.5(mean 11.4 ± 2.7) years. The lesions were present in the facial area in 41.7% of the patients. The families of 47.9% of the patients were seasonal agricultural workers. It was found that social anxiety score and dermatological quality of life score in children started to decrease at the end of the 3rd month after treatment and continued to decrease at the end of the 6th month after treatment. It was found that depression and stigma scores started to decrease at the end of the 3rd month after treatment and remained at the same level until the end of 6 months(p < 0.05).

Conclusions

It was observed that psychosocial status and quality of life, which were negatively affected by CL lesions in children, changed positively with treatment. Furthermore, it was found that this improvement lasted at least 6 months in different dimensions and at different rates.

Key messages

It was observed that the negative effects in social anxiety, depression, dermatological quality of life, and stigmatization scores, continued for 6 months despite the treatment. Children in the 7–11 age group and children of SAW families should be considered as a high-risk group in terms of psychosocial burden associated with the disease.
Gender minority youth: Shifting the paradigm from risk to resilience
Authors: Vaughan E , Költő A , Ravikumar D , Kelly C , Nic Gabhainn S
Published: October 2021

Background

Discourse on the lives, health, and well-being of transgender and other gender minority (TGM) youth frequently revolves around narratives of risk and victimisation. While TGM youth undeniably face many challenges, such singular discourses belie a more complex picture of TGM youth lives and problematically position them as passive victims rather than as social subjects with agency.

Methods

The “LGBTI+ Landscape and Knowledge Gap Analysis” aimed to systematically map research evidence on sexual and gender minority (SGM) youth in Ireland and other European countries. A scoping review methodology was employed in which the systematic concept searches were linked to the five outcomes of Ireland's Better Outcomes, Better Futures national youth policy framework, which in turn are aligned with the fifteen objectives of the Irish LGBTI+ National Youth Strategy.

Results

One hundred and twenty-six pieces of evidence were included in the final sample for analysis, which were mapped to the fifteen objectives of the National Youth Strategy. Particular attention was given to the positive aspects and protective factors identified throughout the literature. The evidence showed that while TGM youth disproportionately experience stigma, discrimination and unequal health outcomes, there were sources of resilience at the micro-, meso-, and macro- levels that serve as protective factors against health inequalities.

Conclusions

Discourse that focuses exclusively on the ‘at-riskness' of trans and gender minority young people presents a one-dimensional perspective that fails to capture the reality and richness of their lives. Over-emphasising individual risk factors may obscure the structural and social factors that underpin the health inequalities experienced by TGM youth.
A mixed methods study of lived experiences of homelessness in Wales and childhood adversity
Authors: Grey CNB , Woodfine L , Davies AR , Azam S
Published: October 2021

Background

Homelessness is a serious and complex societal and public health issue with multiple causes and solutions. Dealing with homelessness involves both supporting people at risk of homelessness and addressing personal and structural causes occurring through the life-course, including Adverse Childhood Experiences (ACEs). We examine the relationship between ACEs and homelessness in Wales, and consider priority areas for early intervention and prevention.

Methods

Data was retrospectively analysed from a 2017 cross-sectional national 2017 (n = 2452) of adults aged 16-69 years living in Wales using a stratified random probability sampling methodology. Outcome measures included number of ACEs, lifetime homelessness, and childhood resilience assets and were analysed using bivariate statistics. Pathways interviews with people experiencing homelessness (n = 27) and services (n = 16) explored experiences and views, and were analysed thematically.

Results

Homelessness affects 1 in 14 (7%) of the Welsh population in their lifetime. 87% of those with lived experience of homelessness had experienced at least one ACE compared with a Welsh average of 46%; and 50% of those with lived experience of homelessness had experienced 4+ ACEs, compared to 11% in the wider population. Compared with those with no ACEs, individuals with 4+ ACEs were 16 times more likely to report experiencing homelessness (95% CI 9.73,26.43), but Childhood Resilience Assets were protective reducing this by half (adjusted odds ratio 8.073, 95% CI 4.68,13.93). From interviews, early years/schools are critical in supporting children with ACEs, and services through the life-course need to be ACE-aware and better able to cope with impacts of ACEs.

Conclusions

A clear association is seen between ACEs and homelessness. Early intervention that prevents ACEs is needed, as well as better addressing support needs of both child and adult vulnerable populations to prevent homelessness and intervene earlier.

Key messages

In a national Welsh study, 87% of those reporting lived experience of homelessness had experienced at least one adverse childhood experience (ACE), and 50% reported four or more ACEs. Early intervention that prevents ACEs, combined with a trauma-informed approach that builds resilience in at-risk children and adults, is likely to contribute to reducing and preventing homelessness.