bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of the 50 biggest pharma companies: a review of Environmental report aspiring to NetZero
Authors: Di Russo M , Zjalic D , Lombardi G S , Perilli A , Congedo G , Daugbjerg S , Cadeddu C
Published: October 2023

Background

Pharmaceutical companies have a considerable environmental impact in terms of waste disposal, CO2 emissions, plastic usage, and air pollution, water and energy consumption (including those related to transportation and refrigeration of drugs). According to data from 2019, pharmacological firms’ CO2 emissions are 13% greater than those of the car industry. To follow a greener path, pharmaceutical companies should primarily invest in sustainable production and supply, standard criteria, rewards programs, and staff training. This review aims to examine how pharmaceutical businesses incorporate environmental sustainability concerns into their operations, regulations, and communications.

Methods

We selected the top 50 pharmaceutical companies by revenue using the drugdiscoverytrends.com database. We collected the 2021 ESG report for each company, examining the following aspects: the inclusion of a ‘sustainability’ section or a downloadable sustainability report; the disclosure of the company production and carbon footprint; the existence of concrete measures to limit CO2 emissions, save water and energy, and reduce the effect of transportation. Data were analyzed through descriptive statistics to assess the sustainability of companies.

Results

Preliminary results indicate that each organization has a different level of importance for the topic of sustainability. Companies focused on CO2 production, few on other areas such as water needs or impact on biodiversity. Logistics correspond to the most impactful carbon footprint. Future forecasts and the path to NetZero emissions will also be emphasized, possibly comparing them with upcoming ESG 2022 reports.

Conclusions

The first results of our review show that the 50 biggest pharmaceutical companies have a different kind of interest towards environmental-friendly actions. Those with the highest revenues seem to be more careful towards the green issues, but the route to NetZero is still far to be achieved.

Key messages

• The environmental impact of pharmaceutical companies is greater than other industries. They must balance their business goals with environmental sustainability to reach NetZero as soon as possible.

• The future goal of public health will be to monitor the environmental impact of drug production.
Co-benefiting people and planet: stewarding health resources to reduce waste and improve health
Authors: Aldrich R , Sykes S , Grenfell R
Published: October 2023

The health sector contributes 4-5% of global greenhouse emissions, with direct and indirect harms to people and the planet. Reducing health sector waste by stewarding health resources can reduce emissions, improve preventive and clinical services, reduce costs, and deliver numerous population health co-benefits. Sources of waste include overuse of energy and products (such as diagnostics, medications, consumables, devices), waste related to models of care (including over-diagnosis, unwarranted variation, and excess bed-days from avoidable admissions or not preventing disease or progression of disease), and human factors-related waste (such as duplication, delays, teamwork failure, adverse events and safety shortcuts). A health resource stewardship program commenced in our large regional referral health service (6500 staff) in Ballarat, Victoria, Australia in 2018. Staff commence training having identified a source of waste warranting attention, and receive mentoring over a four-month period to implement their solution; more than 300 have been trained to use improvement methods to reduce or eliminate wasteful practices. Successful initiatives include that removing a blood tube (for a test rarely required but often done) from a trolley halved its use and saved half the salary of the nurse who took the action. Training staff to recognise early sepsis halved admissions to the Intensive Care Unit and saved lives. Implementing pharmacist-led care via telehealth before a person's in-person cardiology appointment saved 16,275Kms and 4.5tonnes of carbon dioxide. People and the planet benefit from modest or broad action such as reducing printing, assuring prevention program quality and efficacy by co-designing with consumers, optimising effective screening in a high-risk population, and investment in programs such as telehealth or digital health records. Health resource stewardship can be done anywhere any day by anyone, and is a key climate action for health by the health sector.

Key messages

• The health sector produces greenhouse emissions which harm people and the planet.

• Stewarding health resources can reduce emissions, reduce costs, and deliver numerous population health co-benefits.
The impact of induced earthquakes on mental health: evidence from the Dutch Lifelines Cohort Study
Authors: Shui A , Mierau J , van den Berg G J , Viluma L
Published: October 2023

Background

A growing body of literature demonstrates that exposure to events, such as natural disasters, accidents, or adverse life events, may increase the risk of physical and psychological distress. Despite this understanding, little is known about the health consequences of consistent exposure to human-made crises. To address this issue, we examine the long-term health effects of mining-induced earthquakes in the Northern Netherlands and study the heterogeneity of the effect across socioeconomic status (SES).

Methods

Large-scale individual health data is from the Dutch Lifelines biobank and cohort study with 148,700 participants from the Northern Netherlands. Earthquake data is from Royal Netherlands Meteorological Institute. The main health outcomes are housing-related stress, depression, anxiety, and self-assessed health. The key independent variable is accumulated peak ground velocity. We use an individual-level fixed effects model to assess the health effects of induced earthquakes by controlling individual heterogeneity, especially migration preference. Further, we add the interaction terms of accumulated PGV and education level into the regression model to analyze the different effects of earthquakes across SES.

Results

We find an association between living in high-exposure areas and housing-related stress. The results also show that for each additional noticeable earthquake (PGV>0.5 cm/s), the probability of getting anxiety increases by 1.04% on average. Moreover, the number of noticeable earthquakes (PGV>0.5 cm/s) has an adverse impact on self-assessed health. After adding the interaction terms, considerable health effects disparities were observed between SES, with the highest health effects of earthquakes in the lowest SES groups.

Conclusions

Our results indicate that the long-run effects of sequences of small shocks are more significant than previously believed. The low SES group was the most vulnerable population to induced earthquakes.

Key messages

• This paper aims to estimate the causal effects of mining-induced earthquakes on health by employing large-scale panel data from the Lifelines biobank and cohort study in the Northern Netherlands.

• Our findings suggest that exposure to repeated earthquakes has a negative effect on housing-related stress, anxiety, and self-rated health.
Low-cost IoT sensors reveal adverse health outcomes associated with air pollution exposure
Authors: Salim S , Diallo G , Morita P
Published: October 2023

Background

Air pollution is a major public health threat and has been linked to various adverse health effects including respiratory and cardiovascular diseases. Fine particulate matter (PM2.5) and coarse particulate matter (PM10) are two major components of air pollution that are significant contributors to these health outcomes. With the advent of low-cost sensors, accurate measurement of exposure has become possible, allowing for better assessment of the impact of air pollution exposure on human health.

Methods

To investigate the association between air pollution exposure and illnesses resulting in hospital visits, IoT sensors were deployed in Ulaanbaatar, Mongolia, to measure PM2.5 and PM10 levels from 2018-2021. Health data was obtained from the Mongolian National Center for Public Health. Multivariable logistic regression models were used to estimate overall odds ratios for the associations between daily PM2.5 and PM10 exposure and the occurrence of illnesses, adjusting for age and sex.

Results

The unadjusted odds ratio for the association between PM10 exposure and acute respiratory illnesses was 1.3, while the unadjusted odds ratio for PM2.5 exposure was 1.2; decreasing to 1.2 and 1.1 respectively after adjusting for age and sex (p < 0.05). These findings are consistent with previous studies and highlight the significant impact of air pollution on the occurrence of acute respiratory illnesses. The use of IoT sensors allowed for accurate assessment of air pollution exposure in the study population.

Conclusions

This study provides further evidence of the detrimental effects of air pollution on human health, particularly on the occurrence of acute respiratory illnesses. These findings highlight the importance of continued efforts to reduce air pollution levels. Accurate measurement of exposure rates using IoT sensors can aid in identifying and addressing sources of air pollution to improve the quality of life for individuals and communities affected by this health threat.

Key messages

• This study shows the significant impact of air pollution on acute respiratory illnesses, highlighting the importance of reducing air pollution levels.

• Accurate measurement of air pollution exposure using IoT sensors can aid in identifying and addressing sources of air pollution to improve public health.
At-home thermal discomfort is associated with non-communicable chronic diseases
Authors: Sousa I , Candeias P , Capitão C , Virgolino A , Freitas S , Climaco N , Santos O
Published: October 2023

Background

Air temperature is a relevant environmental determinant of hospitalization and mortality. Less known is the prevalence of at-home thermal discomfort and its associations with health indicators. This work aimed to characterize the association between thermal discomfort and self-reported non-communicable chronic diseases in adults living in the municipality of Lisbon.

Methods

Observational cross-sectional study with data collected through individual telephone interviews, with a non-probabilistic stratified (by gender, age, education, and area of residence) sample. Logistic regression models were used to estimate effect sizes, controlling for age, gender, educational level, and morbidity indicators.

Results

Overall, 855 adults (25+ years old) living in the municipality of Lisbon participated in the study. Only respondents who reported to be 10+ hours per day at home were included in the analysis. The sample was balanced for genders (55,2% female), with an average age of 53,4 years (SD = 17,0; maximum age=93 years old), and 40,2% (n = 356) not having a higher-level education. About three-quarters (74,2%; n = 552) reported feeling thermal discomfort at home and 56,9% (n = 414) reported having at least one non-communicable disease diagnosed. When considering the sample's most prevalent self-reported chronic diseases, a significant association with thermal discomfort was found for asthma and hypercholesterolemia (chi-square=4,08; p=.004; and chi-square=4,87; p=.027, respectively). After adjusting for sex, age, educational level, area of residence, and other self-reported morbidities, asthma was found as a significant predictor of thermal discomfort (OR = 3,03; 95% CI: 1,03-8,90).

Conclusions

These preliminary results suggest that some chronic diseases may have an unequal impact on thermal regulation and comfort. This is an important message also for those responsible for the development of policies against energy poverty.

Key messages

• At-home thermal discomfort is a relevant indicator to consider when monitoring chronic diseases and urban health.

• Suffering from chronic diseases may have a relevant impact on thermal discomfort and this should be taken into account when defining policies against energy-poverty.
PM2.5 Air Quality Monitoring during COVID-19 Restrictions in Portugal: Key Findings
Authors: Lima L , Corda M , Viegas S , Martins C
Published: October 2023

Background

Particulate matter with or less 2.5 diameters (PM2.5) has deleterious health effects on humans. In 2020, exposure to levels of PM2.5 above World Health Organization Air Quality Guidelines (WHO AQG) caused 238,000 and 2,600 premature deaths in the European Union and Portugal, respectively. During the lockdowns and restrictions periods due to the COVID-19 pandemic, air quality was improved. The aim of this study was to assess the variation of PM2.5 concentrations in Portugal during the years 2020 and 2021, considering COVID-19 restrictions.

Methods

The daily average (24-hour) concentrations of PM2.5 were calculated based on the hourly values registered at the monitoring stations (Online Database on Air Quality of the Portuguese Environment Agency). Friedman tests were used for paired samples to assess differences between levels of PM2.5 in the months of total lockdown, partial restriction due to the COVID-19 pandemic and months without restrictions, considering a level of significance of 5%.

Results

The levels of PM2.5 had heterogeneous variation over the months of the two years. The higher levels of PM2.5 in 2020 and 2021 were 21 and 34 µg/m3 in March and February, respectively. Although 2020 did not exceed the EU Air Quality Directive 2008/50 (25 µg/m3), the levels of PM2.5 exceeded the current WHO Guideline (5 µg/m3) during the whole year. Levels of PM2.5 were statistically significant different between the months of lockdown, partial restrictions and without restrictions in the both years (p < 0,001).

Conclusions

Despite the evidence showing that the lockdown and restrictions due to COVID-19 minimized emissions from anthropogenic activities mainly related with mobility, Portugal still exceeded the WHO AQG highlighting the need for further measures to improve air quality accordingly with the international standards.

Acknowledgments

This work is funded by FCT/MCTES through national funds to PMCardImpact (EXPL/SAU-PUB/0944/2021).

Key messages

• Additional environmental policies are required to improve air quality in Portugal.

• Air monitoring is the first step to estimate the health impact of air pollution.
Risk communication during COVID-19 pandemic in Georgia
Authors: Skhvitaridze N , Gamkrelidze A , Topuridze M , Getsadze R
Published: October 2023

Risk communication during COVID-19 pandemic was essential to ensure community engagement. Providing accurate, timely, and reliable information about risks and preventive measures was important to reduce the likelihood of transmission. During COVID-pandemic Georgia developed Risk Communication and Public Engagement Strategy and provided easy-to-understand messages through credible channels to encourage two-way communication. Aim was to promote preparedness by developing a multi-level and multi-faceted communication system to respond emergency. In fact, several communication approaches were used for risk groups, and ethnical minorities. Additionally, stakeholders’ awareness rising was coordinated; relevant legislation was enforced; collection of a behavioral insight data (social listening and surveys) were ensured; system for analyzing misinformation, disinformation, infodemics and public views were developed, including fighting against panic and stress-management. Nonetheless, community engagement was critical for the successful implementation of measures. Given the various governmental activities to protect the public health, it was important regularly monitor the adherence to recommendations. Continuous assessment of new social norms implementation (mask wearing, social distancing, reduction of contacts) were also important. With support of the WHO Country office, Georgia introduced Knowledge-Attitude-Practice studies to identify the adherence to preventive measures and immunization across different groups. Notably, the majority of respondents follow the basic rules for infection prevention. The main preventive measures were implemented by most respondents. Indoor mask wearing and disinfecting hands remained the measures often applied in all risky situation. The attitude of the respondents toward the vaccine was not unconditional but depended on various rational factors.

Key messages

• Overall, the risk perception and knowledge about preventive strategies play a crucial role in limiting transmission.

• It is essential from health authorities to adopt risk communication, community engagement strategies and obtain regular feedback to reduce negative impact of public health emergency.
Smartphone Addiction among Syrian Medical Students
Authors: Alibrahim H , Bohsas H , Swed S , Abou Shaar B , Albakri K , Haj Saleh H , Sawaf B , Bakkour A , Hafez W , Cherrez-Ojeda I
Published: October 2023

Background

Smartphone use has increased and has become an essential part of daily life. This study aimed to assess the prevalence of smartphone addiction among medical students in Syria, investigate its potential effects on insomnia and sub-health.

Methods

This study was conducted in Syria from October 6th to November 12th, 2022. We included Syrian medical students across all Syrian medical colleges. The survey consisted of four questions, sociodemographic information, insomnia scale, Sub health status questionnaire (SHSQ-25), and Smartphone Addiction Scale (SAS). The data were analyzed using IBM SPSS Version 28.0.

Results

A total of 1437 participants completed the survey, and their mean age was 21.4 (SD = 1.8). Our analysis identified the prevalence of smartphone addiction, insomnia, and subhealth among medical students as 62.5%, 23.7%, and 28.4%, respectively. The mean hours number of smartphones used daily was (6±2.8). About half of the respondents use their phones for more than six hours a day (50.2%), and over half of the participants (52.8%) consider themselves addicted to their smartphones. Among students diagnosed with smartphone addiction, 43.2% reported using their phones for more than six hours daily, and 41.1% perceived themselves as smartphone addictive. Students residing in the city's outskirts exhibit a higher likelihood of addiction than their urban counterparts (OR = 1.5, P value < 0.05). Furthermore, individuals who avoid using their smartphones before bedtime exhibit a lower propensity towards developing smartphone addiction than those who do (OR = 2.7, P value < 0.05). As well, we defined a significant inverse correlation between the smartphone addiction score and the SHS (r2= -0.114, P value< 0.001).

Conclusions

We indicate that smartphone addiction negatively affects the sleep quality and subhealth of medical students, particularly among those who use their smartphones before sleeping and those who consider themselves smartphone addicts.

Key messages

• We indicate that smartphone addiction has detrimental impacts on the quality of sleep and subhealth of medical students, particularly those who use their smartphones before sleeping.

• It is suggested that medical institutions conduct educational initiatives regarding the negative consequences of smartphone addiction, including its potential long-term impact on mental health.
Patients’ suitability for digital health - what should be evaluated by health care professionals?
Authors: Kaihlanen A-M , Virtanen L , Kainiemi E , Heponiemi T
Published: October 2023

Background

The need to optimize health care services by utilizing digital technologies has been recognized worldwide to respond to the population's growing care needs. However, not everyone can benefit from digital solutions. Health care professionals have a crucial role in evaluating whether their patients could utilize digital health. This requires identifying the key factors to be evaluated. We carried out a scoping literature review to identify factors that professionals should consider when evaluating the patient's suitability for utilizing digital health.

Methods

Searches were conducted in four databases to identify studies that addressed instruments suitable for professionals to assess patient suitability for utilizing digital health. Two reviewers performed the abstract and full-text screening. The individual domains of the instruments were extracted and synthesized qualitatively.

Results

The review included 19 articles with 12 instruments. A total of 59 domains were found, which embodied multiple perspectives for evaluating patient suitability. Their main unifying factor was a focus on skills, such as the ability to apply digital health information and communicate online, and technical skills. Many domains also contained the ability to take care of own health, such as self-care activity, social support, and knowledge of the health system. There were fewer domains that covered attitudes and experiences with digital services, including comfort, motivation, and trust. Only a few domains considered the technology and facilities required to use digital health.

Conclusions

Based on the variety of instruments and the domains they measure, there is a lack of a systematic and comprehensive way of evaluating patient's potential for utilizing digital health. Professionals need quick and easy-to-use evaluation tools that cover multiple aspects of suitability, as well as instructions on how to use the information obtained when promoting the patients’ use of digital health.

Key messages

• Healthcare professionals need to consider the required skills, attitudes, health behavior and available technology of their patients to increase the utilization of digital health.

• Professionals need evaluation tools suitable for busy clinical work, as well as instructions on how to use the information obtained in the planning and implementation of the patient's individual care.
Digital health literacy – an evolving concept
Authors: Juvalta S , Feer S , Dratva J
Published: October 2023

Digital technologies are changing our health system, health information and health communication, and digital health literacy is becoming increasingly important to ensure equitable access to health. Digital health literacy applies to all contexts of health and healthcare, such as health information seeking behavior, navigation of healthcare systems, and healthcare access. However, the concept of digital health literacy is constantly evolving due to continuous technological developments and their adoption in society and health system. One of the first to define ehealth were Norman and Skinner. Their concept is based on the concept of health literacy, to seek, understand, critically evaluate, and apply information. The talk will outline the development of the digital health literacy concept since Norman and Skinners’ definition in 2006 to the current understanding of digital health literacy in 2023. The technological changes and the increasingly digitalized societies have led not only to an expansion, but also higher specificity of the literacies embedded in the digital health literacy concept. Aim of the talk is to raise the understanding for the complexity and the relevance of digital health literacy in children and adolescents by exemplifying digital health literacy in the context of child and adolescent lives and health needs. The concept, however, is not without critique, which will be addressed and discussed with the audience.
The increasing use of digital therapeutics of insomnia and other sleep disorders: a systematic review
Authors: Madeo G , Sanna A , Golinelli D , Foggi A , Cocchi F , Nante N
Published: October 2023

Background

Chronic insomnia is a significant public health problem affecting 15% of the adult population worldwide. There have been few research trials on digital therapeutics (Dtx) for insomnia and other sleep initiation and maintenance disorders (ISMD), and even less real world evaluations of their efficacy. The aim of this review is to describe the digital therapeutic (Dtx) solutions that have been reported in the scientific literature to mitigate the impact of ISMD on individuals.

Methods

We conducted a systematic review of Dtx and insomnia-related literature (with no time limits) by searching MEDLINE/Pubmed and Scopus with appropriate terms to find relevant articles. We included only primary studies and exluded those on patients with diseases other than ISMD. We extracted study characteristics such as the paper title, journal, and publication year, and we categorized them by setting of the study, type of technology/device, type of treatment provided, primary outcome, and clinical results of the Dtx use for ISMD.

Results

The search identified 129 articles, of which 15 full-text articles were assessed and included in the review after duplicate removal and screening. Most of the selected articles were randomized controlled trials (RTCs 60%) and real-world studies (40%) published between 2016 and 2023, and using the following types of digital technologies: mobile apps (66%), web-based programs (7%), and mixed solutions (27%). We report that these digital solutions provide digital-Cognitive Behavioural Therapy (d-CBT 67%), mindfullness (13%) and other treatments (20%). Many scientific contributions use the Insomnia Severity Index (47%) and sleep latency (20%) as primary outcomes, and all the included studies report significant improvements in ISMD control.

Conclusions

Both evidence resulting from controlled trials and real-world data suggest that digital therapeutics can result in relatively high levels of engagement and clinically meaningful sleep improvements.

Key messages

• This review demonstrate that both RCTs and real-world evidence support the efficacy of digitally-provided treatments for mitigating the impact and improve outcomes of patients with insomnia.

• In a ever evolving scenario, where new digital solutions and therapeutics continuously enter the market, it is mandatory to constantly monitor the efficacy and safety of such innovations.
Measuring digital health literacy in children and adolescents
Authors: Feer S , Juvalta S , Dratva J
Published: October 2023

The talk will address the different digital health literacy instruments currently existing and present their advantages and limitations. The rapid growth in access and use of digital (health) information resources in our society can also be observed among adolescents and children. However, to date no instrument exists that was specifically designed to measure how children and adolescents find, understand, appraise, and use such digital health information and services. The aim of the talk is to provide an overview of digital literacy instruments and present strengths and limitations of existing instruments. One limitation, the self-reported nature of digital health literacy, will be addressed and potential solutions discussed with the audience. The talk will demonstrate the current lack of instruments to measure digital health literacy in children and adolescents, and what this means for child and adolescent public health and the promotion of digital health literacy.
eHealth profile of patients with diabetes
Authors: Jendly M , Santschi V , Tancredi S , Konzelmann I , Raboud L , Chiolero Arnaud
Published: October 2023

Background

Digital health technology can be useful to improve the health of patients with diabetes, to support patient-centered care, and self-management. In this cross-sectional study, we described the eHealth profile of patients with diabetes, based on their use of digital health technology, and its association with sociodemographic characteristics.

Methods

We used data from the “Qualité Diabète Valais” cohort study, conducted in one region of Switzerland (Canton Valais) since 2020. Participants with type 1 or type 2 diabetes completed questionnaires on sociodemographic characteristics and on the use of digital health technology. We defined eHealth profiles based on three features, i.e., ownership or use of 1) internet-connected devices (smartphone, tablet, or computer), 2) mHealth applications, and 3) connected health tools (activity sensor, smart weight scale, or connected blood glucose meter). We assessed the association between sociodemographic characteristics and participants’ eHealth profiles using stratified analyses and logistic regression models.

Results

398 participants (38% women) with a mean age of 65 years were included. The vast majority (94%) were Swiss citizens or bi-national; 14% had a primary level education, 51% a secondary level, and 32% a tertiary level. Some 75% of participants had type 2 diabetes. Some 90% of the participants owned internet-connected devices, 43% used mHealth applications, and 44% owned a connected health tool. Older age and a lower educational level were associated with lower odds of all features of the eHealth profile.

Conclusions

While most participants owned internet-connected devices, only about half of them used mHealth applications or owned connected health tools. Older participants and those with a lower educational level were less likely to use digital health technology. eHealth implementation strategies need to consider these sociodemographic patterns among patients with diabetes.

Key messages

• eHealth use among patients with diabetes was associated with younger age and higher education.

• eHealth strategies need to consider that patients at higher risk of complications are those who use eHealth the least.
Digital health literacy in schools: new tools, empirical findings and implications for interventions
Authors: Okan O , Stauch L , Rangnow P , Renninger D , Hartmann A , Fischer L , Dadaczynski K
Published: October 2023

Children and youth are important populations to receive education and training on digital health literacy, while digital health literacy has recently increased attention as an important determinant of child and adolescent health. Albeit schools are the best equipped settings to enhance health-related competencies and digital literacy capacities of children and adolescents, the uptake of digital health literacy by European schools is still in its infancy and progresses somewhat slowly. Reasons are that digital health literacy is a relatively new topic in education, an overcrowded curriculum, lacking training opportunities for teachers on the subject, economic constraints and poor digital health policies for the education sector, and limited knowledge about the digital health literacy needs of schoolchildren, teachers, and schools, as well as missing evidence needed to inform these issues. A new project on digital health literacy in schools in Germany seeks out to close some of these gaps by conducting two large-scale surveys among secondary schoolchildren and teachers. New measurement tools have been developed and used to generate first time data on digital health literacy in schools, not only assessing personal capacities of schoolchildren and teachers but of learning opportunities and instructions concerning digital health literacy teaching and learning provided in schools. These findings will inform future tailored educational programs, public health interventions, and health and education policies in order to enable the uptake of digital health literacy in education, schools, and teacher training.
Innovative online portal to support persons with obesity: STOP Project RCT
Authors: Moorhead A , Zheng H , Engel F , Vu B , Hemmje M , Lynch L , Bond R , Wang H , McTear M
Published: October 2023

Background

This research is part of the STOP project, a H2020 RISE project funded by European Commission (GA No 823978) to address the challenge of preventing obesity in Europe. The interdisciplinary European STOP project aims to establish a data and knowledge ecosystem as a basis for the STOP Portal to enable healthcare professionals in decision support, and persons with obesity in analysis and feedback of health information to optimise healthy nutrition. The aim of this current randomised controlled trial (RCT) was to determine the effectiveness of the newly developed system for adults with overweight and obesity to lose weight.

Methods

This was a pilot two-arm RCT: 1. intervention (n = 15) and 2. control (n = 15). All the participants were adults with overweight or obesity. The intervention group used the STOP Portal, while the control group did not use this system, no intervention. Participants were randomised into one of the two groups using a computer randomised programme. The primary outcome was percentage reported weight loss, by three months. Four data collection points for both the intervention and control groups at 1. baseline (month 0); 2. month 1; 3. month 2; and 4. month 3. The STOP Portal collects the following data: physiological data, knowledge resources, biomedical data, self-reporting activity and food data. Ethical approval was obtained.

Results

A total of 30 adults registered for this pilot RCT and participated up to three months. The results clearly indicated that adults (18 years+) who were overweight or obese and were in the intervention group and using the STOP Portal significantly (P < 0.001) lost body weight (kg; % weight loss; BMI). Thus the STOP Portal was significantly effective for participants losing body weight.

Conclusions

Overall, the STOP Portal is easy to use, fit for purpose and is significantly effective for adults with overweight and obesity to lose weight.

Key messages

• Innovative online portal, STOP Portal, is significantly effective for adults with overweight and obesity to lose weight.

• This project addresses obesity management and prevention through the foundation of an innovative platform to support persons with obesity with a better nutrition.
Investigating the gendered nature of new parents’ digital technology use for health information
Authors: Hiebert B , Donelle L , Hall J , Facca D
Published: October 2023

Background

Parenting is marked by intense emotional and health information needs for individuals and families. Understanding how digital technologies are used by new parents may allow public health organizations to tailor digital health information resources and delivery methods to better meet needs.

Methods

A qualitative descriptive study was conducted to understand new parents’ experiences with digital technology during their transition to parenting. Individuals in Ontario, Canada who had become a parent in the past 24 months were recruited to participate in a focus group. Participants were asked to describe the technologies used to support their parenting and how they were used to support self and family health. Focus group data were subjected to thematic analysis using inductive coding.

Results

Focus groups were conducted with 26 heterosexual female participants. Participants primarily used digital technologies (smartphone, social media) to seek information on maternal, foetal, and infant health and establish social and emotional supports. Parental health information work was gendered and categorized by 2 dominant themes. First, “‘Let me know when I'm needed'” typifies fathers’ limited health information seeking and reinforces mothers as lay information mediaries. Second, “Information Curation” captures participants’ belief that gender biases built-in to digital parenting resources reified the gendered nature of health information work for new parents.

Conclusions

While parents regularly use digital resources for health information seeking, the gendered nature of such digital resources reinforces gendered divisions of health work.

Key messages

• Digital technologies tailored to new parents actively reinforces gender norms.

• Public health organizations have an opportunity to engage with new parents to identify how digital information resources can be created that support equitable division of health information work.
Association between sleep duration and high blood pressure in Lithuanian adolescents
Authors: Stankute I , Kuciene R , Dulskiene V , Medzioniene J
Published: October 2023

Background

Sufficient sleep duration in children plays an essential role in physical, mental, and emotional development. High blood pressure (HBP) is growing public health problem in youth. The aim of this study was to evaluate the association between short sleep duration (SSD) and HBP in Lithuanian adolescents aged 11-18 years.

Methods

The cross-sectional study was conducted from 2019 to 2020 in Kaunas district, Lithuania. HBP was defined according to the 2017 AAP guidelines. Sleep duration was calculated from the time of going to bed to the time of waking up. SSD was defined as sleeping <8 h/day. Multivariate logistic regression was used to calculate aORs and 95% CI.

Results

The present analysis included 1368 subjects (723 boys and 645 girls) with a mean age of 13.96±1.76 years. Overall, the prevalence of HBP was 43.6% (51.3% for boys and 34.9% for girls). Overall, 21.7% of the subjects reported sleep duration of 7- < 8 h/day, and 11.3% - <7 h/day. In the total sample, after adjustment for sex, BMI, breakfast consumption, and parental smoking, significant associations were found between SSDs and HBP (7-<8 h/day: aOR=1.47; 95% CI, 1.12-1.95; P = 0.006, and <7 h/day: aOR=1.52; 95% CI, 1.05-2.20; P = 0.025), compared to subjects who were sleeping ≥8 h/day. In boys, after adjustment for potential confounders, SSDs were associated with higher odds of HBP (7-<8 h/day: aOR=1.94; 95% CI, 1.30-2.89; P = 0.001, and <7 h/day: aOR=2.35; 95% CI, 1.35-4.12; P = 0.003). There was no significant association between SSD and HBP among girls.

Conclusions

Our study showed that SSD was significantly associated with increased odds of HBP in Lithuanian adolescents, especially in boys. Public health strategies should focus more on prevention of modifiable cardiovascular disease risk factors.

Key messages

• Sufficient sleep duration is important for adolescents’ health and may contribute to reduce the risk of cardiovascular disease.

• Future prospective studies are needed to confirm these findings.
Changing inequalities in life-expectancy by income in Finland 1997-2020
Authors: Tarkiainen L , Martikainen P , Junna L , Remes H
Published: October 2023

Background

Previous studies show that in recent decades the changes in mortality disparities between income groups in Finland have been driven by alcohol- and smoking-related causes of death. The gap between the extreme income quintiles narrowed in 2008-14 particularly due to the declining alcohol-related mortality. We analysed the most recent changes in mortality disparities and the causes of deaths behind them.

Methods

We used register based individual level total population data for ages 30-95+ and yearly follow-up for mortality in 1996-2020 including information on disposable household income quintile in the previous year. Preston method was used for assessing the impact of smoking on mortality. We calculated trends in life expectancy (LE) at age 30 for three-year periods in 1997-2020 and then conducted an Arriaga cause of death decomposition of the gap between highest and lowest quintiles and changes in LE for each quintile from 2015-17 to 2018-20.

Results

We observed an increasing gap in LE by income due to stagnating LE in the lowest income quintile from 2015 onward among both men and women. Among men the stagnation was observed even after eliminating smoking- and alcohol-related mortality and among women the LE slightly increased after accounting for smoking and alcohol but the gap to the highest quintile increased clearly. Decomposing the change in LE from 2015-17 to 2018-2020 by causes of death showed no specific causes of death behind the stagnation and the widening gap. Among both men and women mortality due to circulatory diseases showed a substantial decline in the lowest quintile whereas in all other causes mortality increased or declined only slightly.

Conclusions

Inequalities in LE by income are widening again in Finland due to stagnation in the lowest income quintile. Contrary to the prior decades the increasing disparities are not attributable to smoking and alcohol-related deaths but occur in the majority of causes of death.

Key messages

• After nearly a decade of narrowing mortality inequalities we observed an increasing gap in life expectancy by income mainly due to stagnation in the lowest income quintile.

• Contrary to the prior decades the increasing disparities and stagnation of the lowest income quintile are not explained by smoking and alcohol-related deaths but occur in majority of causes of death.
A conceptual framework for early life determinants of future multimorbidity
Authors: Stannard S , Berrington A , Paranjothy S , Owen R , Fraser SDS , Hoyle R B , Batchelor S , Welch J , Alwan N A
Published: October 2023

Background

Social, biological and environmental factors in early life, defined as the period from preconception until age 18, play a role in shaping the risk of Multiple Long-Term Condition Multimorbidity (MLTC-M). There is a need for conceptual framing of these factors to inform and shape future research on aetiology and for modelling prevention scenarios of MLTC-M. We developed a conceptual framework to characterise early life determinants of future MLTC-M risk.

Methods

The conceptualisation of determinant domains was shaped by reviewing existing research evidence and policy, and co-produced with public contributors living in the UK via two workshops, one with 8 contributors age 18-30 regardless of MLTC-M status, and one with 12 contributors age 40-65 who all self-reported MLTC-M.

Results

Domains included: 1.Prenatal, antenatal, neonatal and birth; 2.Adverse childhood experiences; 3.Child health, check-ups and screening; 4.Developmental attributes; 5.Child education and health literacy; 6.Demographics; 7. Parent health and health behaviours; 8.Socioeconomics; 9.Parental family factors; 10.Neighbourhood, physical environment and health care systems; 11.Health behaviours and diet; 12.Religion, spirituality and culture. Some domains identified by the public contributors, such as religion, health screening, check-ups, and diet, were not well represented within the research evidence or policy documents.

Conclusions

This co-produced conceptualisation can inform research to investigate the early life characteristics of population groups at risk of future MLTC-M, as well as policy directions towards prevention of early-onset MLTC-M. Additionally, it can shape the direction of further data collection, particularly with respect to the understudied domains identified by our public contributors.

Key messages

• We developed a conceptual framework to characterise early life determinants of multimorbidity.

• This conceptualisation can inform future research and policy directions towards prevention of multimorbidity.
Enacting multisectoral service chains and packages in the health and social care regions in Finland
Authors: Liukko E , Muurinen H
Published: October 2023

Several studies have concluded that about 10% of the users of the health care and social services use most services and produce about 80% of the costs of care. However, this client group and their needs for services, which are often complex and multisectoral, are poorly characterized. The new Act on Organizing Health and Social Care Services in Finland obliges the health and social care regions to identify the client groups who need integrated services and to define the multisectoral service chains and packages for these clients. The assumption is that an individual client's personal service path can be planned and enacted by utilizing the pre-defined service chains and packages. This study aimed at studying the definition, development and enactment of the service chains and packages. The study was based on a survey which was carried out in the 22 health and social care regions in spring 2023 for analyzing 1) to which client groups the service chains and packages are defined, 2) what needs there are in the background of defining service chains and packages, 3) what kind of goals are defined for the service chains and packages, 4) what the current developmental state of the service chains and packages is and how they manage to cross the sectoral and disciplinary boundaries, and 5) what successes and challenges there are in defining, developing and enacting the service chains and packages. The survey was the first part of a study which focuses on the development and enactment of service chains and packages in the health and social care regions. The survey results showed that most of the development activities were in the definition phase. The survey gives perspective and background knowledge to the second part of the study which focuses on one specific client group, the children with neuropsychiatric symptoms, and on the definition and enactment of their service chains and packages within three regions.
Psychoactive substances use among Tunisian adolescents: Trend analysis 2013-2021
Authors: Zribi M , Rejaibi S , Zid M , Silini A , Zoghlami N , Mallekh R , Ben Slama I , Ben Youssef S , Ben Salah N , Aounallah-Skhiri H
Published: October 2023

Introduction

Psychoactive substances (PAS) use among adolescents has been a growing concern in Tunisia in recent years. Their use can have a serious impact on the physical and mental health of young people, leading to addiction, academic difficulties and a range of social problems. We aimed to study the prevalence of PAS use among Tunisian high school adolescents and assess significant trends from 2013 to 2021.

Methods

Pooled data from Mediterranean school surveys on PAS conducted in 2013, 2017, and 2021 were used. Based on three-stage stratification sampling method, first and second grade secondary education students were enrolled. Were not included students enrolled in vocational training centers and out-of-school adolescents. Self-administered standardized questionnaire was used in data collection. We studied weighted lifetime prevalence of PAS use (cigarettes, alcohol, cannabis, cocaine and ecstasy) and performed global trend analysis. STATA software was used for statistical analysis.

Results

A total of 14,723 students were enrolled with sex ratio (M/F) equal to 0.61 and mean age of 16.2±0.8 years. The prevalence of cigarettes use increased from 22.6%, to 25.1% then to 30.7% for 2013, 2017 and 2021 respectively (p < 10-3). Trend analysis concluded to significant increase in alcohol use (5.8%, 6,3% and 8% respectively in the three years) (p < 10-3). The greatest increase was in cannabis use (1.5% in 2013, 3.0% in 2017 and 7.9% in 2021) (p < 10-3). However, there was no significant change in cocaine and ecstasy use (p < 0.05).

Conclusions

Although restrictive legislative measures have been reinforced, there has been a significant increase in the use of PAS among high school adolescents in Tunisia. Thus, it is crucial to delve deeper into this issue and its potential risk factors. The findings can help shed light on the scope of the problem and guide targeted efforts to mitigate the harm caused by these substances.

Key messages

• Trend analysis confirmed the significant increase in psychoactive substances use in high school adolescents in Tunisia.

• This alarming public health issue requires urgent legislation review and close multisectoral collaboration to reduce the impact of this phenomenon.