bluuebunny/crossref_metadata_2025 huggingface dataset:
Interobserver Reliability of the Nancy Index for Ulcerative Colitis: An Assessment of the Practicability and Ease of Use in a Single-Centre Real-World Setting
Authors: Le Huy Duc , Pflaum Theresa , Labrenz Johannes , Sari Soner , Bretschneider Fabienne , Tran Florian , Lassen Arne , Nikolaus Susanna , Szymczak Silke , Kormilez Diana , Rosenstiel Philip , Schreiber Stefan , Aden Konrad , Röcken Christoph
Published: October 2022

Background

Histological disease severity assessment in ulcerative colitis [UC] has become a mainstay in the definition of clinical endpoints [‘histological remission’] in clinical trials of UC. Several scores have been established in the microscopic assessment of disease activity, but the Nancy index [NI] stands out as being the histological index with the fewest scoring items. To what extent histological assessment using the NI is affected by interobserver reliability in a real-word setting is poorly understood. We therefore performed a single-centre retrospective analysis of NI assessment in patients with UC.

Methods

We retrospectively evaluated the NI in two independent cohorts [total: 1085 biopsies, 547 UC patients] of clinically diagnosed UC patients, who underwent colonoscopy between 2007 and 2020. Cohort #1 consisted of 637 biopsies from 312 patients, while Cohort #2 consisted of 448 biopsies from 235 patients. Two blinded pathologists with different levels of expertise scored all biopsies from each cohort. A consensus conference was held for cases with discrepant scoring results. Finally, an overall consensus scoring was obtained from both cohorts.

Results

The interobserver agreement of the NI was substantial after the assessment of 1085 biopsy samples (κ = 0.796 [95% confidence interval, CI: 0.771–0.820]). An improvement of the interobserver agreement was found with increasing numbers of samples evaluated by both observers (Cohort #1: κ = 0.772 [95% CI: 0.739–0.805]; Cohort #2: κ = 0.829 [95% CI: 0.793–0.864]). Interobserver discordance was highest in NI grade 1 [observer 1: n = 128; observer 2: n = 236]. Interobserver discordance was lowest in NI grades 0 [observer 1: n = 504; observer 2: n = 479] and 3 [observer 1: n = 71; observer 2: n = 66].

Conclusion

The NI is an easy-to-use index with high interobserver reliability for assessment of the histological disease activity of UC patients in a real-world setting. While NI grades 0 and 3 had a high level of agreement between observers, NI grade 1 had a poorer level of agreement. This highlights the clinical need to specify histological characteristics leading to NI grade 1.
Digitalisation in the area of alcohol, drug, and tobacco during the COVID-19-pandemic: supporting the drive towards an equitable health?
Authors: Jonsson F , Schimmer R
Published: October 2022

Background and objectives

The COVID-19 pandemic has posed challenges for traditional public health practice. In the area of alcohol, drugs, and tobacco, local and regional actors have largely moved from physical to digital solutions to handle the barriers imposed by the pandemic. To strengthen the knowledge base in the area, this project aimed to explore how the local transition to, and management of, digital solutions within alcohol, drugs, and tobacco prevention might support the policy drive in Sweden towards equity in health.

Methods

This was a qualitative study where 13 local coordinators from 7 municipalities participated. Data were collected through 9 individual and 2 group interviews (semi-structured). The analysis was inductive and followed a thematic analysis approach to identify, analyse, and present patterns (themes) in the data.

Results

Three themes were developed illustrating how the local implementation of digital solutions in the area of alcohol, drugs, doping, and tobacco prevention might support the transition towards equity in health by ‘making time and resources available for development and innovation’, ‘improving the ability to reach and engage with vulnerable groups’, and ‘(re)shape initiatives to act inclusively’.

Conclusions

As illustrated by experiences of the local coordinators, the municipalities seemed to have managed the challenges of the pandemic in a good way. To a large extent, they appeared to have adapted their work to remain operational by transitioning into digital solutions. Considering that the pandemic has been challenging in various ways, the finding of ensuring operations were running should not be underestimated. However, besides being able to largely maintain a “status quo” in a time when traditional modes of working were inadequate or inappropriate, the results illustrated how the municipalities have added numerous (digital) tools to their toolbox for use in the continuing drive towards good and equitable health.
What are the tools provided by the EU to support health and care improvement?
Authors: Mauer N
Published: October 2022

Improving health and care systems is primarily the responsibility of Member States within the EU. Nevertheless, the EU provides a lot of potential support to Member States that can help to improve health systems. However, the range of EU tools that can help to strengthen health systems has grown up over decades across different policy fields, and most potential EU support is incorporated within instruments that have wider objectives. This can make it challenging to identify and optimise the use of the different instruments, as well as to create synergies across tools as part of an overall process of improving a health system. For example, the EU's wide-ranging support across diverse instruments and policy areas has contributed towards improving the prevention, monitoring, and management of cancer, as well as modernising dedicated health infrastructure and developing common cancer policy guidance in Europe over several decades. This presentation will help with understanding what different tools can be used for, showcasing content from the policy brief and how it can be helpful with addressing the challenges faced by health policy makers. Using concrete case studies, it will illustrate how different instruments might be combined in pursuit of a specific process of health system strengthening and transformation.
Impact of climate change on food systems – the One Health approach
Authors: Assunção R
Published: October 2022

In recent decades, changes in climate have caused impacts on natural and human systems on all continents and across the oceans. Climate change has become one of the most critical issues for the sustainable development of human societies and the functioning of ecosystems on Earth. In one hand, climate change threatens our ability to ensure global food security, eradicate poverty and achieve sustainable development. Agriculture and animal production are affected by changing rainfall patterns, drought, flooding and the geographical redistribution of pests and diseases, with consequent implications in the food availability, a key requirement for food security. On the other hand, despite less debated, climate change could also affect food safety, impacting the occurrence of food safety hazards at various stages of food chain, from “farm to fork”. The tendency to increase the use of agrochemicals to balance the effects of more frequent extreme weather events and water scarcity in some regions could become more frequent. In addition to pesticide residues, both chemical and microbiological risks are expected to impair food and feed safety as a consequence of climate change: in particular mycotoxins, marine biotoxins (phycotoxins), trace metals, among others. Humans, animals and the environment are/will be affected by the consequences of climate change, with an expected impact on the food systems. Thus, a One Health perspective, representing a holistic view of the problems, defining and establishing adequate strategies to tackle these challenges, is more than needed. On this presentation, main issues relating the impact of climate change on health of humans, animals and environment and how a One Health perspective, as a holistic approach, represent a key contribution to the definition of proper policies to ensure the public health will be approached and debated.
Intensive animal production as driver of biodiversity loss and pandemics
Authors: Viegas S
Published: October 2022

Pandemics have their origin in diverse microbes carried by animal hosts, but their emergence is entirely driven by human activities. These include deforestation, land- and sea-use change, agricultural expansion and intensification, and wildlife trade and consumption. These activities bring wildlife, livestock, and people into closer contact, allowing animal microbes to spillover into people and causing infections, sometimes outbreaks, and more rarely epidemics and pandemics. Domestic animals and peri-domestic wildlife also have a role in creating bridges for the emergence of human diseases, since this can happen in an evolutionary sense, or the animal could serve as a physical transmitter. The most important reservoirs of pathogens with pandemic potential are mammals (in particular bats, rodents and primates) and some birds, as well as livestock (e.g. pigs, mink, poultry). In fact, intensive animal production is also considered one of the drivers for biodiversity loss and potentially for future pandemics. As an example, intensive poultry farming not only poses a significant risk to workers, but can also act as a potential public health menace evidencing the One health approach to tackle all the menaces in this particular setting.
Biodiversity and Health
Authors: Viegas S
Published: October 2022

Biodiversity underpins all life on Earth, and refers to biological variety in all its forms, from the genetic makeup of plants and animals to cultural diversity. Human health depends upon ecosystem products and services (e.g. availability of fresh water, food and fuel sources) which are requisite for human and animal health. Biodiversity loss can have significant direct human health impacts if ecosystem services are degraded and not able to guarantee social needs. The ecosystems also control disease and stabilize the climate. However, biodiversity loss is occurring at unprecedented rates, impacting human health worldwide, according to the report jointly published by the Convention on Biological Diversity (CBD) and the World Health Organization (WHO). In this report, awareness is provided to the need to promote integrated approaches to biodiversity and health by highlighting that biodiversity contributes to human health and wellbeing, and emphasizing also that biodiversity needs protection for development to be sustainable. Indirectly, changes in ecosystem services affect livelihoods, income, local migration and, on occasion, may even cause or exacerbate political conflict. Some features will be presented and discussed to describe in detail the most relevant impact that biodiversity has in human health and wellbeing and how the loss of biodiversity can imply risk for animal and human health.
Getting started with Podcasts
Authors: Buttigieg S
Published: October 2022

There are a world of opportunities waiting for public health professionals to get started with a regular audio-visual communication channel. The barrier of entry to start creating your very own podcast has been reduced to a bare minimum. This presentation intends to cover the basics to get started with your own podcast and intends to share the lessons from the author's involvement as a co-host of “The Digital Health Voice” podcast.
The German National Cohort (NAKO): Overview and Current State
Authors: Greiser KH , Bohn B , Panreck L , Breunig E , Lieb W , Pischon T , Schikowski T , Völzke H
Published: October 2022

The presentation aims to give an overview of design, methods and first results of the German National Cohort (NAKO), the largest cohort study in Germany. NAKO is a multidisciplinary, population-based cohort study that provides a central resource for population-based epidemiologic research. NAKO aims to investigate the development and aetiology of diseases, identify risk factors and enhance early detection and prevention of diseases with a focus on diabetes, cancer, cardiovascular, pulmonary, neuropsychiatric and infectious diseases. Between 2014 and 2019, a total of 205,415 persons aged 20 - 74 years were recruited and examined at 18 study centres across Germany. The participants were invited to their local study centre to participate in a face-to-face interview, complete self-administered computer-based questionnaires, undergo a battery of biomedical examinations, and provide various biosamples. In addition, whole-body Magnet Resonance Imaging (MRI) was performed in 30,861 participants on dedicated 3 Tesla MRI scanners at 5 study centres. In 4-5 year intervals, all study participants are re-invited for examinations at the study centres. The programme for the first re-examination (including MRI scanning) was similar to the baseline programme. Thereby, longitudinal information on changes in risk factor profiles and in vascular, cardiac, metabolic, neurocognitive, pulmonary and sensory function is collected. During the COVID-19 pandemic, questions on pandemic-related aspects including the history of infection, severity and long-term health impacts of COVID-19 were added to the examination programme. Since October 2018, 77,896 participants have been re-examined, including 11,382 with additional MRI examination. A supplemental COVID-19 questionnaire was completed by 161,849 participants of NAKO during the first COVID-19-related lockdown in Spring 2020.
Evaluation of Factors Associated with Dual Use of E-Cigarettes in University Students
Authors: Öznur Muz FN , Metintaş S , Önsüz MF , Aydoğan Gedik S , Mutlu A , Arslan Torba T
Published: October 2022

Background

The World Health Organization defined smoking as the fastest spreading and longest lasting epidemic globally. It has been reported that two-thirds of all tobacco consumption in the world is in developing countries, and with today's technology, the use of electronic cigarettes (e-cigarettes) has increased rapidly among young people and adults, especially in recent years. The study aimed to evaluate the factors associated with dual use of e-cigarettes (e-cigarette plus one of the tobacco products) in university students.

Methods

This study was carried out with the participation of 2477 students at Eskişehir Osmangazi University in the 2019-2020 academic year, and it was designed as a nested case-control study from a study in which 49 were determined to be dual smokers. A randomized 1:3 for age and gender with 147 non-smokers (NS) and 147 classic cigarette smokers (CSS) selected by the propensity score matching method was performed, with the final sample consisting of 343 participants. Chi-square and multinomial logistic regression analyzes were used in the study.

Results

In the multinomial logistic regression, the belief that e-cigarettes do not help quit classical cigarette smoking was 4.0 (95% CI; 1.7 - 9.6) times higher in NS and 4.1 (1.6 - 10.0) times higher in CCS compared to dual smokers, while the belief that e-cigarettes may suppress the desire to smoke was 4.4 (1.7 - 11.2) times higher in NS and 6.8 (2.6 - 17.6) times higher in CCS.

Conclusions

The study determined that dual smokers were less likely to believe that e-cigarettes are more innocent than other tobacco products. While dual smokers believed that e-cigarettes might not suppress the desire to smoke, CCS believed e-cigarettes could even increase classical cigarette smoking.

Key messages

• Since the effects of e-cigarette use on human health are controversial, it is still a significant public health problem in developing countries.

• Although it was initially marketed to help quit or reduce the use of classical cigarettes, it should be noted that e-cigarettes are also a type of tobacco product addiction.
Investing in the health workforce, protecting mental health: policy and action taken by WHO
Authors: Zapata T , Langins M
Published: October 2022

Background

The COVID-19 pandemic and the current war in Ukraine have presented opportunities to increase national leadership on mental health, including support health and care workers. Member States across the region have worked closely with the WHO to strengthen their policy levers to support the mental health and occupational safety policies for the workforce at various levels including government, organization and local service levels. To complement these policies, the WHO will launch the WHO Global Health and Care Compact at the Seventy-fifth World Health Assembly in May 2022.

Methods

The WHO has convened Member States to discuss the policy levers that can support the mental health of health and care workers. These include online multistakeholder webinar series, national policy dialogs, ministerial discussions during the Regional Committee, preparatory consultations for the World Health Assembly to discuss priority areas and policy. More recently with the crisis in Ukraine, the WHO has been working closely with the UN Interagency Steering Committee (IASC) Reference Group on Mental Health and Psychosocial Support in Emergency Settings rolling out services for refugees, including health workers in these settings.

Results

A number of important policy recommendations are emerging from this work: (1) strengthening national and political leadership; (2) adopting stepped approaches; (3) facilitating collaboration across professions, sectors and levels of syste for more effective responses; (4) strengthening capacity and expertise; (5) monitoring effectiveness for continuous improvement; (6) ensuring acceptability and accessibility.

Conclusions

Promoting health and well-being and mental health support to the health and care workforce has become a key priority for health systems to enable sustainable national health workforces. WHO will prioritize country support on this area and the development of regional guidance.
COVID-19 vaccination uptake in Belgium: socioeconomic and sociodemographic disparities
Authors: Cavillot L , Van Loenhout J , Catteau L , Van den Borre L , De Pauw R , Blot K , Speybroeck N , Devleesschauwer B , Hubin P
Published: October 2022

Background

Recent studies have identified important social inequalities in SARS-CoV-2 infection and related COVID-19 outcomes in the Belgian population. This study aims to investigate socioeconomic and -demographic characteristics associated with the uptake of COVID-19 vaccine in Belgium.

Methods

We conducted a retrospective analysis of the uptake of the first dose of COVID-19 vaccine among 5,341,584 adults (≥ 18 years) tested for COVID-19 in Belgium until August 31, 2021. We integrated four national data sources: the Belgian vaccine registry (vaccination status), COVID-19 Healthdata (laboratory test results), STATBEL (socioeconomic/-demographic data) and the Common Base Registry for HealthCare Actors (people licensed to practice a healthcare profession in Belgium). Unvaccinated and vaccinated people (with at least one dose) were compared using multivariate logistic regression analysis.

Results

During the study period, 53,887 people (10%) did not receive the first COVID-19 vaccine dose in Belgium. Migrant background was associated with vaccine uptake (e.g., non-Europeans were almost three times [2.96-3.00] more likely to be unvaccinated compared to Belgian nationals). Single parents (OR 1.27 [1.26-1.28]) and people living alone (OR 1.18 [1.17-1.19]) were more likely to be unvaccinated compared to couples with children. Having a low or moderate education level (OR 1.36 [1.35-1.38] for low; OR 1.30 [1.29-1.32] for moderate) and income (OR 2.36 [2.34-2.38] for low; OR 1.54 [1.52-1.55] for moderate), being unemployed, (OR 1.50 [1.49-1.51), and having low health literacy (OR 1.41 [1.39-1.43]) led to a greater likelihood of being unvaccinated.

Conclusions

Migrants, people living alone, single parents or socioeconomically disadvantaged groups have lower uptake of COVID-19 vaccine in Belgium. The identification of these socioeconomic and -demographic disparities is critical to develop strategies guaranteeing a more equitable COVID-19 vaccination coverage in Belgium.

Key messages

• The study highlight important determinants in the uptake of the first dose of COVID-19 vaccine in Belgium.

• These results highlight the importance to focus efforts on socioeconomically disadvantaged groups currently under-represented in COVID-19 vaccination uptake in Belgium.
Conceptual views of mental health among adolescents in Sweden
Authors: Durbeej N , Karlsson AC , Sarkadi A
Published: October 2022

Background

Lay and professional people may use terms for mental health and mental health problems differently, causing difficulties in adequately addressing associated needs. Despite the public health issue of increased mental health problems among adolescents, there is limited research on perceptions of mental health concepts among young people. This study aimed to explore conceptual views of mental health and mental health problems among adolescents.

Methods

During October and November 2020, a total of 32 adolescents (15-18 years old) living on Sweden's largest island Gotland were interviewed in focus groups or individual interviews. The interviews were semi-structured and audio recorded. Data were analysed thematically according to Systematic Text Condensation.

Results

Three themes emerged from the analysis: Mental health is about how we feel; One's mental health depends on one's situation, thoughts and ways of coping; and Mental health problems should be taken seriously and can get severe. The adolescents described mental health as an overarching concept encompassing both positive mental health and mental health problems. Mental health problems were perceived as something other than normal challenges in life, however ranging from minor problems to severe illness. Good mental health was understood as a condition with absence of mental health problems and presence of symptoms of positive mental health.

Conclusions

The adolescents’ had a complex and holistic understanding of mental health concepts, consistent with definitions used by the World Health Organization and Swedish authorities. They suggested both positive mental health and mental health problems to be considered when assessing and discussing their mental health. Further, the results highlight the need of support for young people on how to cope with difficulties in life and support for those suffering from minor mental health problems.

Key messages

• The adolescents’ understanding of mental health and mental health problems were highly consistent with current accepted definitions of the concepts.

• According to the participants, both positive mental health and mental health problems should be considered simultaneously to understand and address adolescents’ mental health.
Help-seeking behaviors among survivors of intimate partner violence during pregnancy in 54 LMICs
Authors: Stiller M , Wilson ML , Bärnighausen T , Adedimeji AA , Lewis ER , Abio A
Published: October 2022

Background

Intimate partner violence (IPV) experienced by pregnant women is pervasive worldwide. As survivors rarely seek help, there exists a paucity of research on their help-seeking behaviors. The present study provides a multi-national perspective into the nature of help-seeking behaviors among survivors of IPV during pregnancy.

Methods

Population-based data from 54 LMICs were abstracted from the Demographic and Health Surveys Program between 2005 and 2020 (N = 359,027). Bivariate and multivariable logistic regression were used to analyze the extent to which - and from whom - survivors of IPV during pregnancy sought help and assess associated factors.

Results

Half of respondents (51.87%) sought help following IPV while pregnant (ranging from 39.02% in Asia and Oceania to 63.18% in sub-Saharan Africa). Support was primarily obtained from informal contacts (44.02%), such as family, neighbors, and friends, and rarely from formal institutions (10.45%), such as law enforcement, social and medical services. Help-seeking behaviors were positively associated with higher education, employment, earnings exceeding that of their spouse, exposure to mass media, intimate partner's alcohol consumption, fear of their intimate partner, parental violence, richer wealth status, partner's controlling behaviors, and facing barriers to access health care. Conversely, being married, and justifying wife beating were negatively associated with help-seeking.

Conclusions

The research findings highlight the need for interventions, ranging in scope from the individual to familial and societal levels, to increase and improve help-seeking opportunities for IPV survivors. Efforts should be made on strengthening women's decision-making capacity, reducing poverty, ensuring educational attainment, improving employment opportunities, disseminating information about help sources, IPV screening within health care, and promoting the diffusion of gender equality by engaging communities as a whole.

Key messages

• IPV during pregnancy is still pervasive in LMICs, and only half of survivors seek help. Women’s individual, partner’s/family’s, and community’s factors are associated with IPV survivors’ help-seeking.

• The research findings highlight the need for interventions, ranging in scope from the individual to familial and societal levels, to increase and improve help-seeking opportunities for IPV survivors.
Intervention research in health promotion: policy issues, the example of the ten-year cancer strategy in France
Authors: Foucaud J
Published: October 2022

Prevention research covers a wide domain of studies, including identification of unknown risk factors for certain cancers, for example prostate cancer; or health promotion with approaches by population, by living environment or by territory. This research focuses in particular on identified carcinogenic factors (e.g. tobacco, alcohol, certain pesticides) but also on the causes of the prevalence of these factors in certain populations. PHIR makes it possible to meet these challenges. In 2010, the French National Cancer Institute was a pioneer in the development of PHIR in France and decided in 2021 to make it one of the spearheads of its ten-year strategy. This presentation will aim to give an account of this policy of developing RISP as a relevant tool for thinking about health promotion policies and actions, by targeting the issue of inequalities as one of the priority research objects as well as certain audiences (young people, vulnerable populations). The presentation will discuss four challenges for the implementation of this research policy: the development of the French scientific community in order to be able to respond to priority issues; the structuring and animation of this community; the evaluation of research projects and the mobilisation of a still timid global community; the articulation of academic and concrete/experiential knowledge. Through a concrete example of a national research development policy, the aim of this presentation is to help participants understand the challenges of RISP (its obstacles and levers, not limited to financial issues), the organisation of research, and the links between the actors involved (researchers and field workers, beneficiaries, health professionals). The first part will focus on identifying the participants’ representations of the obstacles to the development of RISP. The second part will be an interactive presentation of 12 minutes, the last 2-3 minutes will be devoted to final questions.
The city of proximity (accessible, inclusive, sustainable, healthy & salutogenic): the case of Brussels Bourse, Grand-Place station
Authors: Micic G , Jevtic M
Published: October 2022

The ecological dimension is expressed, among other things, in the matter of movement and the process of appropriation of local spaces. The creation of public space is oriented towards centralising and bringing exchanges closer together. It is a recognition of the ways of life of the individual who has become aware of the other essentials for human well-being. How does the proximity of multimodality and culture strengthen the urbanity? And how does it influence urban intensity, livability, health & the salutogenic approach of public space? The study investigates the quality of public mobility spaces through design, multimodality and sustainable planning by surveying the case of Bourse-Grand-Place station in Brussels. This transformation project is the subject of an empirical method using the material of recent research on urban design and professional practice. Falling within the scope of the “Cities for People” vision of the future, the design of this project integrates socio-cultural activities around the idea of “Station for People”. A concept based on universal accessibility ensures that all individuals can access it. Thereafter, an evolving social economy programme promoted cycling through equipment, maintenance, recycling, training, innovation and the encouragement of cycling culture. The breakthrough of the innovative multimodal design process based on multidisciplinarity could become a helpful urban strategy, oriented toward making proximate neighbourhoods both residentially and practically attractive. The present article carries out an enquiry of how design and urban activities take part in strategies to improve the quality of the public spaces. It reveals some hints that could help urban practitioners when making decisions regarding the quality of an urban place and ‘living together’ oriented developments. With a contribution to climate change issues, this article demonstrates how urban design can contribute to the quality of life of users and citizens.
Life events as predictors of unsustainable working life trajectories from a life course perspective
Authors: Wang M , Raza A , Narusyte J , Silventoinen K , Böckerman P , Svedberg P , Ropponen A
Published: October 2022

Background

The association between family-related life events (e.g., getting married or having children) and unsustainable working life in terms of unemployment, sickness absence and disability pension (SA/DP) are rarely studied from a life-course perspective although having public health importance. We investigated trajectories of unsustainable working life, and the associations between change in family-related life events and unsustainable working life trajectories by controlling for familial factors.

Methods

This is a prospective cohort study of 37,867 Swedish twins aged between 20-40 years on 31st December 1994. Data on trajectories of annual unemployment, SA/DP, and a combined measure of unsustainable working life months was collected from the Swedish national registers. The trajectories over a 23-year period were analysed by group-based trajectory modelling. Associations of change in family-related life events with trajectory groups in the whole sample were estimated by multinomial logistic regression and in discordant twin pairs (n = 4,647 pairs) with conditional models.

Results

Most participants had no or low levels of unemployment, SA/DP or combined unsustainable working life during 1994-2016. Individuals who were stably married or changed from being single living without children to married living with children had a decreased risk of unsustainable working life compared to individuals with stable family-related life events. The risk of unsustainable working life months over time was higher among individuals who changed from married to single status regardless of having children (range of HRs:1.31-4.44).

Conclusions

Family-related life events such as maintaining the relationship or getting married and having children decreases the risk of unsustainable working life while divorce is a risk factor for unsustainable working life. From a public health perspective, actions to support family formation or life would consequently promote a sustainable working life.

Key messages

• Unsustainable working life was less likely among married and among those who changed from single living without children to married with children compared to those with stable family life events.

• Individuals who changed from being married to divorced status had an increased risk of unsustainable working life over time and therefore being potentially an important group for public health.
Driving HIA implementation in Ireland: The role of academia and public health institutions
Authors: O'Mullane M
Published: October 2022

Over the past decades public health research has presented compelling evidence that health is socially determined. To address structural inequalities and inequities in health, public policies require intersectoral development and implementation. Health Impact Assessment (HIA) is an established tool for analysing potentially detrimental health outcomes of policies, programmes and projects. In Ireland, we are presented with a unique opportunity to examine HIA implementation by capitalising on the synergy of recent policy commitments driving HIA implementation. Specifically, the national public health framework Healthy Ireland 2013-2025, and the newly developed all-island Institute of Public Health HIA guidance (2021), have coalesced in steering the strategic direction of HIA. This presentation outlines the current synergistic policy context on the island of Ireland, including the publication of new HIA guidance, which opens opportunities and new possibilities for implementing HIA. Reflections will be made on the potential and reality of current HIA training programmes in Ireland. Learning from the lessons of a dearth of HIA implementation at varying time periods since 2000, this presentation discusses the mechanisms in place, such as the successful World Health organization-led healthy cities projects in Ireland, such as Cork Healthy Cities, and those key drivers that are required to capture policy synergy for meaningful HIA implementation.
2.M. Workshop: Empowering examples of high vaccination in minorities: learning from three underserved communities
Authors:   Organised by: RIVER-EU Project,   Chair persons: Michael Edelstein (Israel), Danielle Jansen (EUPHA-CAPH)
Published: October 2022

Childhood vaccine uptake in most minority or ethnic communities in Europe is typically substantially and unacceptably lower compared to the general population. Ethnic, religious, or cultural minorities are more likely to encounter health system barriers to accessing health care services which are a major contributor to comparatively low vaccine uptake among these disadvantaged communities. Despite these challenges, some minority communities manage to achieve high uptake for childhood immunization sometimes higher than the general population in their respective countries. We have called these populations “empowering examples”. As part of RIVER-EU (Reducing Inequalities in Vaccine uptake in the European region - Engaging Underserved communities) an EU funded project aiming to improve access to vaccine services for children and youth, reducing inequality and improving vaccine uptake of HPV and MMR vaccination in underserved communities in Europe, we collected evidence on health system barriers and enablers to vaccination among underserved communities, including three empowering examples of underserved minority communities that achieve high vaccine uptake: the Somali community in Finland, the Arab community in Israel, and the Bangladeshi community in the United Kingdom. Understanding enablers to vaccination in these populations will help generate knowledge that will be translated to other populations in order to facilitate similar enablers, thus improving vaccine uptake. The main objective of this workshop is to share and discuss the preliminary findings related to health system enablers from these three “empowering examples.” The workshop will be structured in 3 presentations of 12 minutes each. Each empowering example will present preliminary findings from interviews and focus group sessions conducted with each minority community. Presentations will be followed by a moderated questions and answers session that will help the audience understand what factors have contributed high vaccine uptake in these populations and how they can be applied to others. Participants will be invited to share experiences from their own countries.

Key messages

• Accessibility, trust in the health care system, and perceived vaccine safety, were found to be powerful health system enablers to HPV and MMR vaccination among three underserved populations studied.

• Normalizing vaccination as “just something you do” seems to be a common approach among the highly vaccinated minorities.
2.O. Workshop: Initial health assessments and catch-up vaccination for forcibly displaced migrants to Europe
Authors:   Organised by: St George's, Lancet Migration European Hub, ESGITM,   Chair persons: Sally Hargreaves (UK), Ana Requena Mendez (Spain)
Published: October 2022

Objectives

Recent crises in Ukraine, Afghanistan, Syria and other countries have, again, resulted in large populations of asylum seekers and other migrant groups arriving in Europe. However, European countries still grapple with questions about what level of health care should be offered to forcibly displaced people (emergency care, preventative care, multi-disease screening and catch-up vaccination?), and when and where in the migration trajectory provision should be made (should it be at borders, reception centres, once settled via the national health system, via specialist or routine services, or left to non-governmental organisations?), and what their subsequent level of right to access the mainstream health-care system should be. Countries do not have a uniform approach to the provision of health care for these populations, with some countries more inclusive than others, and wide discrepancies between evidence and implementation in policy and practice. In this workshop we will discuss current approaches, implementation, research and policy gaps, and models of good practice from the clinic to the community to ensure both the immediate and long-term health needs of these diverse mobile populations are met.

Workshop plan

The workshop will start with 10-minute presentations by each of the 4 speakers (to include a short Q&A after each talk). This will then move into a 20-minute audience discussion centred seeking specific feedback on examples of successful interventions, good practice, and lessons learned across EU/EEA countries in delivering multi-disease and catch-up vaccination and holistic and inclusive healthcare approaches.

Key messages

• Governments should develop clear short-term and long-term policy and evidence-led research strategies to ensure the equitable provision of health services.

• Strategies must include multi-disease and catch-up vaccination approaches, alongside meaningful access to mainstream health systems.
Community engagement to co-design and deliver public health interventions in newly arrived migrants
Authors: Crawshaw A
Published: October 2022

Alison Crawshaw will talk about her participatory research that uses design thinking to develop community-based strategies to improve health outcomes in migrant populations. She will summarise the benefits of using community-based approaches and co-designing public health initiatives with affected migrant communities, bringing in lessons learned from a recent project with the Congolese community in London.
How can policymakers incorporate uncertainty (as modelled through foresight) into policy evaluation?
Authors: Bana e Costa CA , Oliveira MD , Rodrigues TC , Vieira A
Published: October 2022

Background

Using a robust policy evaluation framework is critical to inform policymakers about the relevance of a policy in a structured way, clarifying its implications and providing arguments and criteria to compare competing options and decide which policy should be prioritised. In the current context of complex societal, environmental and public health challenges, decision-makers demand tools that allow a comparative assessment of the effectiveness of multisectoral policies and their comparison under different scenarios.

Methods

This presentation will detail a socio-technical “desirability-doability” framework (2xD). In 2xD, an additive value model is constructed to measure the desirability of public policies, and their doability is appraised under two contrasted scenarios. For these purposes, the MACBETH approach is used in developing the three group modelling phases of 2xD: (I) Structuring facilitated workshops, (II) Evaluation decision conference, and (III) Desirability-doability decision conference. Tailor-made interactive protocols or questioning procedures are used to elicit group judgements, based on which objective-specific value scores are assigned to the policies, and the objectives are weighted (in II). Finally, we elicit doability scores for the policies under each scenario (in III).

Results

We present how the 2xD framework was applied in Lisbon's urban health policymaking setting and discuss case insights regarding the role of scenario analysis in the appraisal and selection of policies.

Conclusions

The 2xD framework advances knowledge on how to assist policymakers in evaluating and selecting policies and contributes to the literature on overall policy formulation and evaluation. Specifically, the framework enabled a group of policymakers to balance (multicriteria) desirability versus doability of policies under the light of two contrasting scenarios, therefore incorporating uncertainty in their decision-making process.
Lessons learned from automated screening of COVID-19 preprints
Authors: Weissgerber T , Riedel N , Kilicoglu H , Labbe C , Eckmann P , ter Riet G , Byrne J , Cabanac G , Capes-Davis A , Bandrowski A
Published: October 2022

Preprints occupied the spotlight early in the pandemic, as scientists, the media and the public sought information on the evolving pandemic. While some in the scientific community embraced this shift, others were concerned about the quality of these papers, which had not yet undergone peer review. Furthermore, the flood of COVID-19 preprints quickly overwhelmed the scientific community's ability to monitor and assess new preprints. Automated screening tools that detect beneficial practices, or common problems, in preprints are one potential solution to this problem. These tools could potentially provide individualized feedback, allowing authors to improve their manuscripts prior to publication in a peer-reviewed journal. We have combined many tools into a single pipeline, called ScreenIT. ScreenIT assess factors such as open data and open code, blinding, randomization, power calculations, limitations sections, and data visualization problems. Since June 2020, we have used ScreenIT to screen and post daily reports on more than 23,000 new COVID-19 preprints deposited on bioRxiv and medRxiv. Results show that practices such as sharing data and code are relatively uncommon. Sample size calculations, blinding and randomization are rarely reported and most papers do not report the sex of participants, animals or samples. This work demonstrates the feasibility of using automated tools to rapidly screen many preprints in real time, and provide authors and readers with rapid feedback. However, this approach has important limitations. Automated screening tools can make mistakes. Tools can't always determine whether an item is relevant to a particular manuscript. Further studies are needed to determine whether feedback from automated tools is effective in encouraging authors to improve reporting.
Planetary health education: a cornerstone for international sustainable public health deals
Authors: Cadeddu C , Pivor J , Jevtic M , Faerron C , Zjalic D , Lombardi GS , Myers SS , Ricciardi W
Published: October 2022

As stated in The Lancet Public Health editorial, “No public health without planetary health”, the future health of the planet and human health are inextricably linked. For this reason, global citizens, practitioners, and professionals, especially those involved in Public Health, must be equipped to address and understand the field of Planetary Health (PH), which looks at the complex connections associated with disruptions to natural systems and resulting impacts on human health. Strategies aimed at incorporating PH education into high schools and academic curricula are required to build capacity for future national and local PH leadership. One of the most relevant tools used to achieve these goals is the PH Education Framework, designed by the Planetary Health Alliance (PHA). This framework considers five foundational domains as essential for PH knowledge, values, and practice, and has been currently applied by different institutions involved in PH. The Italian Institute for PH (IIPH) applied this framework to a school-based project for education in urban health, which will be better described in the workshop presentation. The PH Education Framework domains were used for the development of four interactive sessions oriented to raise students’ interest on the topic and stimulate active participation during and after the intervention, also with simple pro-environmental behaviours. The experience was shown to be fruitful for Public Health residents as well, who were deeply involved in and led the interactive sessions held in the high school. By means of a qualitative assessment, residents demonstrated to have increased their self-confidence, knowledge and leadership skills in PH. Further research and applications of the PH Education Framework are needed in order to increase evidence and awareness in PH and strengthen PH collaboration in Europe and beyond.
Health Experts’ voice for Healthier Choice – a call for Zero Air Pollution in the Western Balkans
Authors: Jevtic M , Matkovic V
Published: October 2022

In 2019, the European Environment Agency has shown that the fine particulate matter PM2.5 caused more than 25 000 premature deaths in six Western Balkans countries alone, namely Albania 4 000, Bosnia and Herzegovina 5 900, Kosovo* 2 800, Montenegro 900, North Macedonia 3 400 and Serbia 11 400. In the same year, more than 2 200 lives were lost due to nitrogen dioxide (NO2) and ozone (O3) pollution. Air pollution and climate change are major health problems in the region. Health experts in the Western Balkans region have joined forces to highlight the importance of air quality actions and achieving zero air pollution as a prevention intervention for public health. We brought together a call for the Western Balkans policy-makers to invite them to commit to full alignment of all national air quality standards with the World Health Organization guidelines, to establish regional intersectoral cooperation to accelerate the moving to zero pollution, to including health authorities, public health institutes, and medical societies, patient representative and all health care experts and providers; to end direct or indirect public subsidies of polluting processes, especially fossil fuel activities such as coal power plants; to finalise the process of the ratification of the Convention on Long-range Transboundary Air Pollution and its protocols; to support modelling to establish economy-wide emission reduction commitments for the five main pollutants; to develop and implement Air Quality Strategies; to increase the uptake of Best Available Technologies (BAT) in accordance with the Industrial Emissions Directive; to establish an adequate air quality monitoring system, and to including through accreditation of air quality monitoring networks. Public health experts from the WB, united in the regional call, highlight the urgent need for improvements in air quality in the region together with a zero air pollution objective and a timeline to reach it.