bluuebunny/crossref_metadata_2025 huggingface dataset:
Forecasting of COVID-19 spread in Poland as part of health needs mapping
Authors: Witczak K , Raczyńska M , Kozioł-Rostkowska M , Śmiglewska A
Published: October 2023

The development of a robust model for COVID-19 forecasting was a crucial task undertaken by the Ministry of Health of the Republic of Poland in response to the pandemic. High-quality forecasting rendered the inclusion of COVID-19 modelling in health needs assessment indispensable at the regional as well as country level. The model served as a basis for data-driven policy-making, such as the introduction or lifting of non-pharmaceutical interventions and the management of hospital resource allocation. The proposed model draws upon the population-adjusted infection fatality rates, vaccine-induced immunity, reported test positivity rates, and COVID-19-related mortality to infer the dark figure of cases. The estimates of the true number of infections lay the foundations for the computation of variant-dependent effective reproduction numbers, which constitute the workhorse of the model. The algorithm utilises the Bayesian prediction of those metrics along with the estimation of hybrid immunity levels to arrive at a short-term forecast of the course of the pandemic. The implemented model yields reliable results throughout the outbreak, allowing for the assessment of the strain of consecutive epidemic waves on the healthcare system.

Key messages

• Forecasting of COVID-19 spread is vital for health needs assessment and health crisis management policy-making.

• Short-term forecasting of COVID-19 spread using effective reproduction numbers yields high-quality results.
Implementation of COVID-19 measures for Dutch nursing home staff and their insights
Authors: van Dijk Y , van Tol L S , Achterberg W P , Zuidema S U , Janus SIM
Published: October 2023

Background

Measures against COVID-19 in nursing homes impacted both clients and staff, yet the importance of measures from the staff's perspective remain underexplored. This study examined measures related to staff during the COVID-19 pandemic, staff perspectives of their importance and the involvement of staff in deciding these measures.

Methods

In this qualitative study, the minutes of 41 nursing home outbreak teams in the period March to November 2020 were analyzed and 4 group meetings were conducted between June-November 2020. Qualitative content analysis was used for the minutes data, whereas reflexive thematic analysis was used for the group meeting data.

Results

Measures implemented for staff focused on prevention of COVID-19 transmission, (suspension of) educational activities, testing, additional tasks and staffing capacity, promoting well-being, and other means of support. The results showed overlap between the implemented measures and the measures considered important by staff, except for measures on decision-making support and communication, which were considered important by staff but not listed among the implemented measures. Measures were prioritized by staff because they affected their well-being, workforce scheduling, decision making, or preventing infections. Furthermore, the group meetings revealed that decision making shifted from mainly implementing national guidelines to more context -adjusted decision making in the staff's or clients’ situation.

Conclusions

Although there was overlap regarding measures taken, our findings suggest that organizations should be encouraged to explore ways of timely involvement of staff in decision making when implementing measures in future pandemics. During the COVID-19 pandemic, information about the pandemic response strategies and policies were shared with policymakers and nursing home organizations to learn from each other and make more informed decisions about how to respond to the pandemic.

Key messages

• The information gained through the group meetings can lead to an improved fit between implemented measures and staffs’ working procedures during future pandemics.

• Decision making support and communication should receive more attention according to staff during future pandemics.
COVID-19 vaccine hesitancy among healthcare workers and its associated factors: A systematic review
Authors: Fakih L , Copas A
Published: October 2023

Background

The COVID-19 pandemic is considered one of the most significant public health crises in the 21st century. Healthcare workers (HCWs) as frontliners are at a greater risk of infection compared to the general population. HCWs can influence the general public's decisions when it comes to their health, particularly vaccination. Vaccine hesitancy can be a threat to controlling pandemics, at times when timely interventions are needed to save lives and reduce the burden on healthcare systems. Understanding vaccine hesitancy among HCWs can inform policy change and better pandemic preparedness.

Methods

This systematic review investigated vaccine hesitancy and its associated factors among HCWs following the approval of the first COVID-19 vaccine. Searches were run in three databases on eligible studies published between December 2, 2020, and June 15, 2022.

Results

We included 24 studies with a total of 74,739 [241- 12,610] HCWs from 12 countries including the United States, China, Germany, Belgium, Switzerland, and Greece. Most studies were conducted shortly after vaccine approval. The average prevalence of vaccine hesitancy across the studies was 24%. Factors associated with vaccine hesitancy among HCWs were classified using a five categories ‘5C model': confidence, complacency, convenience, communication, and context. Age, gender, healthcare profession, a history of flu vaccination, a positive history of COVID-19 infection, and confidence in COVID-19 vaccine safety were the most commonly identified factors associated with vaccine hesitancy.

Conclusions

This review suggests that the reasons underlying vaccine hesitancy among HCWs are multifactorial and might be unrelated to vaccine availability. Future studies could study vaccine hesitancy on a wider timeline following vaccines approval, to understand whether low uptake reflects hesitancy or a delay in vaccination. Understanding vaccine hesitancy among HCWs is crucial for pandemic preparedness and control.

Key messages

• Understanding vaccine hesitancy among healthcare workers and its underlying factors is crucial for pandemic preparedness and response.

• Vaccine hesitancy among healthcare workers is multifactorial and may be unrelated to the availability of vaccines. Future research should expand on this topic to understand factors underlying it.
Encouraging the planetary health diet via food taxes and subsidies: a model concept
Authors: Mészáros A , Vokó Z
Published: October 2023

Background

Several studies simulated the effect of food taxes and subsidies on health and environmental outcomes, but they are diverse and rarely model both health and the environment. Incomplete models’ estimates can be misleading: outcomes can be detrimental in a topic that was not included in the model. The aim of this study is to map the important areas affected by planetary food taxes and subsidies and to build a comprehensive model concept.

Methods

A systematic literature search database was used to map the areas. An initial model concept was then iteratively redesigned and finalized.

Results

The main included outcome areas are health, dietary, financial, and environmental outcomes, the latter assessed in diverse areas, like freshwater use, land use, and biodiversity loss. The elements which can greatly influence the model estimates should be carefully assessed, like consumption change, which lies in a central part of the model: included complementary and substitution foods, and consumed diet mass stability is assumed to be more accurate. Health outcomes include the health effects of climate outcomes, affecting not just the modeled region but the whole world population. The input data is scarce, especially reliable price elasticity estimates, and the health effects of climate change.

Conclusions

The stability of consumed diet mass is still not agreed upon but leads to a biologically more accurate outcome. The inclusion of the health effects of climate outcomes can broaden the picture and emphasize the global nature of our food choices. Input data for building a comprehensive model is currently not optimal, more data are needed on consumption change and the health effects of climate change. The next step for public health could be to model food taxes and subsidies for Europe and to compare the estimates with previous models, also to map the stakeholders’ impressions regarding such a tax and subsidy.

Key messages

• We need comprehensive models of food taxes and planetary health to make responsible decisions.

• A model concept was made which includes important areas and relations between them.
Association between metals and metalloids with cognitive status in Mild Cognitive Impairment subjects
Authors: Urbano T , Filippini T , Carbone C , Chiari A , Marti A , Zamboni G , Michalke B , Vinceti M
Published: October 2023

Mild Cognitive Impairment (MCI) is regarded as a transitional state between normal aging and dementia. Several risk factors have been related to MCI and dementia vulnerability. Among these, metals and metalloids have been hypothesized to affect dementia risk. Our objective was to study the associations between metals and metalloids (cadmium, copper, iron, manganese, selenium, zinc) concentrations in serum and cerebrospinal fluid (CSF) with cognitive impairment status of MCI subjects. 144 individuals newly diagnosed with MCI were recruited at Neurology Memory Clinics at Modena and Reggio Emilia Hospitals (Italy) in the period 2019-2022. The concentrations of elements in paired serum/CSF were determined using inductively coupled plasma mass spectrometry. Participants’ global cognitive status was assessed using the Mini-Mental State Examination (MMSE). Muti-adjusted spline regression analyses were performed to assess the relation between the serum/CSF concentrations and MMSE. Median serum and CSF concentrations were generally higher in men than women, except copper in serum and iron in CSF demonstrating higher concentrations in women. A positive linear association emerged between serum iron concentrations and MMSE, while a slight negative one emerged for serum selenium levels. Cadmium in serum was positively associated with MMSE until 0.2 µg/L and then the association became null, while in CSF a U-shaped relation emerged. A U-shaped relation was also observed for serum copper and CSF iron and manganese levels. CSF selenium concentrations were inversely related to MMSE, although above 5 µg/L the curve flattened. Zinc exhibited the same pattern of association in both serum and CSF, i.e., an inverted U-shaped one. These findings suggest that CSF and serum content of the investigated elements may be differently related with global cognitive status in MCI subjects. Higher levels of selenium and zinc, in particular, are associated with lower MMSE score.

Key messages

• Heavy metals and metalloids display different pattern of association with global cognitive status.

• High levels of selenium and zinc are inversely related with global cognitive status in MCI subjects.
Plant-based foods on the Portuguese market: a salutary alternative to animal-origin counterparts?
Authors: Brazão R , Fernandes P , Lopes A , Dias M G
Published: October 2023

Background

The consumption of animal-origin products (AOP) has been linked to an increased risk of heart disease, diabetes and cancer and significant environmental issues. The growing interest for plant-based foods (PBF) have been raising important questions about their overall healthiness. In this context, this study aims to assess the nutritional quality of PBF available in the Portuguese market, analyzing their nutrient profiles and comparing them with AOP and nutrient reference values established. Evaluating if PBF are a salutary viable alternative, we expect to contribute to the promotion of healthier and more sustainable food choices and help inform public health policies.

Methods

Collection and comparison of the nutritional information of PB burgers, sausages and breaded food products and their AOP equivalents and with the reference values of the Integrated Strategy for the Promotion of Healthy Eating (EIPAS) and of the Directorate-General of Health Label Decoder.

Results

A cross-sectional survey of nutrients was conducted on 207 PBF and 253 AOP equivalents. When compared, all PBF categories had higher energy, carbohydrate and sugars. The PB burgers had lower levels of fat, saturates and protein but higher salt content. The PB sausages had lower levels of saturates and salt but higher fat and protein contents. The PB breaded food products had higher levels of fat, saturates, protein and salt. When jointly evaluated sugars and salt, 99.5% of all PBF did not meet EIPAS reference values.

Conclusions

The nutritional composition of the PBF studied vary widely. Although some presented lower saturates levels others had higher fat, sugars and salt compared to AOP, with 99.5% not meeting EIPAS sugars and salt reference values. In this context, public health actions to address the nutritional quality of PBF, normally perceived as healthier, are needed, namely food literacy initiatives and legislative measures concerning the labeling and reformulation of PBF products.

Key messages

• The nutritional quality of PBF available in Portugal varies widely. Although some have a better nutrient profile compared to AOP equivalents, others are high in fat, sugars and salt.

• Public health actions are needed to promote healthier and more sustainable food choices, including food literacy initiatives and legislative measures concerning PBF labeling and reformulation.
Healthy dietary patterns and cognitive status in Mild Cognitive Impairment subjects
Authors: Urbano T , Filippini T , Carbone C , Malavolti M , Marti A , Agnoli C , Sieri S , Chiari A , Zamboni G , Vinceti M
Published: October 2023

Mild Cognitive Impairment (MCI) may be a prodromal condition of clinically overt dementia. Several risk factors have been investigated for their possible role in dementia etiology. Among these, higher adherence to healthy dietary habits, such as the Mediterranean-type diets, has been hypothesized to decrease dementia risk. Our objective was to study the associations between adherence to four dietary patterns (Dietary Approach to Stopping Hypertension-DASH, Mediterranean and Mediterranean-DASH Intervention for Neurodegenerative Delay-MIND) with cognitive impairment status of MCI subjects. In 2019-2023, 144 MCI subjects were recruited at Neurology Memory Clinics at Modena and Reggio Emilia Hospitals and completed a validated semi-quantitative food frequency questionnaire (FFQ) developed within the EPIC project. Through the EPIC-FFQ, we estimated adherence to the DASH diet (range 8-40), the Greek Mediterranean Index-GMI (range 0-9), the Italian Mediterranean Index-IMI (range 0-11), and the MIND diet (range 0-15), the higher scores indicating higher adherence. Participants’ global cognitive status was assessed using the Mini-Mental State Examination (MMSE). Muti-adjusted spline regression analyses were performed to assess non-linear associations between the variables. Median and interquartile range (IQR) levels of adherence were 24 (21-27) for the DASH diet, 4 (3-6) for the GMI, 4 (3-5) for the IMI and 7 (6.5-8.5) for the MIND diet. A U-shaped relation was observed for the DASH and Mediterranean diets with MMSE score. At levels of adherence below the median, the association was negative, while it became positive at higher adherence scores (> 25 for the DASH diet and >5 for the GMI and IMI). A positive and almost linear relation emerged between the MIND diet and MMSE. These findings suggest that higher adherence to healthy dietary patterns, particularly the MIND diet, is related to better global cognitive status in MCI subjects.

Key messages

• Healthy dietary patterns are positively associated with higher global cognitive status.

• Higher MIND diet scores are associated with better global cognitive status.
Economic impacts and mitigation strategies of African Swine Fever in China: a systematic review
Authors: Wu Z , Zhang Y
Published: October 2023

Background

African Swine Fever (ASF) and food safety issues present significant challenges to the global food industry. The Food and Agriculture Organization (FAO) notes that food safety issues can result in economic losses in the food industry. The impact of ASF has been particularly harsh, affecting over half of China's provinces. However, few study has examined its specific economic impact on China. This study aims to explore ASF's economic impacts from 2018 to 2022 and analyze existing mitigation strategies in China.

Methods

This study used a systematic review methodology to synthesize journal articles published in English between 2018 and 2022 from four databases (Pubmed, Web of Science, Scopus, Embase). Journals are included in the study if they discuss the economic impact of ASF in China or provide strategies for mitigation.

Results

Our search yielded 49 results, with 11 papers included in the final review. On average, ASF causes about 108 billion losses in 2018, and this figure is increasing to 127 billion in 2019. Current interventions are divided into three types: reforming food manufacturing companies (n = 5), promoting advanced agricultural techniques like vertical farming (n = 4), and adopting a new food supervision system (n = 2). Although these strategies have provided relief, the effectiveness of these strategies remain to be investigated in the future.

Conclusions

ASF's economic loss is substantial and increasing. The study concludes three main strategies for addressing food safety concerns: reforming food manufacturing companies, promoting advanced agricultural techniques like vertical farming, and adopting a new food supervision system. However, future studies should focus on the effectiveness analysis regarding these strategies.

Key messages

• This study highlights the need for a comprehensive approach to address global food safety issues.

• Implementing the proposed strategies can promote a healthier and more sustainable food system.
Nutrition knowledge and practices in children under two years of age in Huila, Angola
Authors: Veloso-Fraigola M , Martín-Cañavate R , Aguado I , Ramirez-Viaplana F , Faria M L , Da Silva Gerardo A , Iraizoz E , Trigo E , Custodio E , Romay-Barja M
Published: October 2023

Background

The 2021 UN report indicated 149 million children under 5 years suffering malnutrition. African continent has the highest prevalence of stunting. Angola has a persistent nutritional crisis. Improving child-feeding practices is essential to ensure good nutrition. This is the preliminary analysis of baseline data of MuCCUA trial aimed to study household Caregiver's (C) knowledge and practices regarding nutrition of children under two years of age in two communes of Huila, Jamba and Libongue. 381 caregivers were interviewed. A bivariate analysis of the sociodemographic variables was carried out and differences between communes were evaluated with a Chi-square test. To identify socioeconomic factors associated with good knowledge and practices we did forward logistic regressions. Poisson regressions with robust variance were performed to calculate the incidence ratio and 95% confidence intervals.

Results

98.2% C. were women, 69.6% were 20-39 years old and 45% had no education. In Libongue the caregivers had a lower educational level (p < 0.05) and a lower socioeconomic level (p < 0.05) compared to Jamba. Only 27% of households had a drinking water tap and only 20% had latrine. 36.2% had high nutrition knowledge and 37% had good practices. 50% caregivers considered important to breastfeed immediately after birth but only 36% breastfed immediately after birth. In Jamba, 48% of the children stopped being breastfed within a year, vs 23% in Libongue (p < 0.05). The number of people in the house (RI 1.167 CI: 1.167-1.276) and high level of knowledge (RI 2.02 CI: 1.3-3.1) were factors associated with good practices.

Conclusions

The percentages of good knowledge and practices in nutrition have been low. However, Knowledge was a predictor of good practices in these communes. It is necessary to improve caregiver nutrition knowledge if we want to improve child-feeding practices in Huila, Angola.

Key messages

• The percentages of good knowledge and good practices in nutrition have been low.

• Knowledge was a predictor of good practices in these communes. It is necessary to improve caregiver nutrition knowledge if we want to improve child-feeding practices in Huila, Angola.
Impact of universal free school meals on health and equity: international policy scoping review
Authors: Silva L , Malcolm A , Cooklin Urbano S , Couzens L , Clark E , Dyakova M
Published: October 2023

Issue

Every child should have access to healthy foods, engagement with peers, and thrive in educational environments. Universal free school meal policies can address health inequalities and the wider determinants of health. Such policies can impact economic development, community well-being, gender equity, and environmental sustainability.

Description

The World Health Organization Collaborating Centre on Investment for Health and Well-being undertook an international scoping policy review to identify examples of universal free school meals policy and practice. Resources, including government, public health, and non-governmental organisational websites, were reviewed. Data were extracted on delivery models and outcomes including health, equity, sustainability, and economic well-being. Best practices were summarised. The findings were shared with key Government stakeholders to provide high level overview of the impact of school food programmes and procurement practices on health and wellbeing, wider determinants and social outcomes to inform local policy and practice decisions.

Results

The report provides evidence on the impacts of universal free school meal programmes as well as promising practices to improve health, equity and well-being. Outcomes explored within the report include inter alia: health and well-being (nutrition, physical health), wider determinants (inequities, educational attainment, poverty, food insecurity) and social outcomes (stigma, social skills, uptake of school food programmes). Taking a global perspective, the report summarises international evidence to support inclusive, sustainable, and equitable solutions, such as improving economic well-being, promoting sustainable procurement practices, and maximising social return on investment.

Lessons

Mobilising and sharing international evidence and best practice supports equitable, long-term action to improve the health and well-being of children, local economies, and the climate.

Key messages

• International learning provides key insights to support innovative, equitable and effective policies.

• Sustainable policies should address health and social outcomes, and support children and the environment.
Knowledge, attitudes, and barriers of dietitians toward screening patients for food insecurity
Authors: Kaufman-Shriqui V , Factor H , Perets O
Published: October 2023

Background

Global food insecurity (FI) prevalence in 2020 was 30.4%. In Israel, in 2021, it was 16.2%. FI is associated with a high prevalence of chronic diseases, more hospital admissions and visits, and a shorter lifespan. Screening for FI in the health setting is less common, despite recommendations.

Methods

Between July 2022 - February 2023, a mixed-methods study distributed an online survey and a request for qualitative interviews among a convenience sample of registered dietitians (RDs). The survey obtained sociodemographic characteristics and information on work experience, knowledge, attitudes, and barriers toward screening for FI. Sixty-one questions were modified from existing questionnaires. An expert committee reviewed the questions. Later, the questionnaire was pilot-tested by ten RDs and amended according to their comments on the clarity.

Results

Overall, 140 RDs were surveyed, and 7 RDs were interviewed. 96.7% of the participants were female, with a mean of 13.36±9.9 years of experience. 97% of RDs didn't screen for FI. 65.5% didn't know the percentage of households living with FI in Israel, and 72.1% of RDs didn't know where to refer food-insecure patients for additional assistance. Positive attitudes toward screening and treating FI were documented. About 80% of RDs indicated that FI is relevant to their patients and are willing to screen for FI. Religious and traditional RDs had 10.08 times and 4.46 times, respectively, greater odds of having positive attitudes toward screening and treating food-insecure patients. The main barriers identified were a lack of time, knowledge of screening tools, and missing information on appropriate treatment and referral.

Conclusions

Further education and training in screening FI should be implemented among RDs. System barriers should be addressed to allow RDs routine screening for FI. Additional research is needed to explore healthcare providers’ attitudes and barriers toward screening and treating FI.

Key messages

• Most registered dietitians had a low level of knowledge and did not screen routinely for food insecurity.

• The majority were positive towards screening, highlighting system and training barriers.
Member States’ preparedness in joining the European Health Data Space
Authors: Kesisoglou I , Abboud L
Published: October 2023

The third presentation will focus on the findings of the TEHDAS country visits carried out between December 2021-December 2022, which mapped 12 countries’ health data management systems and preparedness to join the European Health Data Space (EHDS) for secondary use (for research and policy making). The presentation will cover the methodology used, based on the WHO tool for health information system assessment, adapted to the specific focus of secondary use of health data. The presentation will outline the key findings from the TEHDAS country visits. In general, countries recognise the benefits of the EHDS and the potential it provides for improvements at national level. The presentation will focus on overarching findings across countries, with a particular focus on preparedness for the EHDS, and the needs and concerns raised by countries.
Piloting a branded food database for reformulation monitoring in Ireland
Authors: O'Mahony S , Pravst I , Hribar M , Collins N , Doyle G , Gibney E R
Published: October 2023

Branded food databases (BFDs) are used to monitor changes in nutrition composition as a result of reformulation and innovation of pre-packed foods. There is no established BFD with market wide coverage of pre-packed foods within and across food categories in Ireland. To address this gap, we aimed to pilot a BFD for reformulation monitoring in Ireland. In 2020, a review of existing BFDs was complete and the Nutrition Composition and Labelling Information System (CLAS) developed by the Nutrition Institute in Ljubljana, Slovenia was identified and a partnership established. The CLAS tool and data collection methodology were translated, tested and adopted for use. CLAS-IRE was deployed to collect nutrition composition of seven food categories in December 2021-February 2022. The mean (SD) nutrition composition per food category (100g) was calculated using IBM SPSS V27 and sugar is presented here as an example. The review identified BFDs using different methods to collect nutrition composition of foods e.g. in-store, web-scraping and crowd-sourcing. A tool for instore collection was selected as 40% (n = 2) of Irish grocery retailers had online stores in 2020. CLAS-IRE was used to collect n = 2256 food products (biscuits n = 181, breakfast cereal n = 188, yogurt n = 297, carbonated sugar-sweetened beverages n = 132, confectionary n = 980, cakes n = 180 and savoury snacks n = 298). The average sugar content per food category was: biscuits 31.7g (9.4), breakfast cereals 15.8g (8.9), yogurt 9g (4), carbonated sugar-sweetened beverages 6.8 (3.6), confectionary 51.58g (10.7), cakes 33.5g (13.8) and savoury snacks 4.9g (9.3). Taking a partnership approach to piloting a branded food database for reformulation monitoring in Ireland allowed for a fast and cost-effective solution. This approach will enable cross country comparative analysis of nutrition composition of food products sold in both countries. The CLAS - IRE tool is established and available for nutrition research in Ireland.

Key messages

• Pre-packed foods are widely available in Ireland. The CLAS – IRE tool is established and available for nutrition research on pre-packed foods.

• A branded food database can support the implementation, monitoring and evaluation of nutrition related policies and strategies in Ireland, including food reformulation.
Food for thought: a look at the food industry’s corporate political activity in Portugal
Authors: Baptista A C , Ramalho C M , Lopes D C , Valente F P , Pereira S C
Published: October 2023

Background

Corporate political activity (CPA) stands for the strategies used by industries to attempt at influencing government policymaking in ways that are beneficial to the company. In the food industry context, these often collide with public health concerns, constituting a major barrier to noncommunicable diseases (NCDs) prevention efforts. This study aimed to characterise the CPA activity of the food industry in the Portuguese context.

Methods

The methodology conceptualised by Mialon et al. (2015) to identify and monitor the CPA activity of the food industry concerning public health was used in this study. Prominent food industry actors were selected, including processed food and non-alcoholic beverage manufacturers, fast food companies, and food retailers. To depict current practices, publicly available information from 2019 onwards was collected from the 7 selected food industry actors’ websites. A thematic qualitative analysis was performed by classifying the retrieved content according to the 6 CPA framework categories and subcategories.

Results

Collected data indicate that out of the 151 analysed written records, nearly half were information and messaging CPA strategies that mostly frame the debate on diet and public health-related issues. Constituency building through seeking community involvement was the second most represented category. Policy substitution was barely present, whereas financial incentive, legal, and opposition fragmentation and destabilisation strategies were not identified. Most of the coded content was retrieved from McDonald's and the Dairy Industry National Association websites.

Conclusions

Recognising the CPA strategies used by the food industry will enable more targeted and informed decisions at the public health intervention and policy levels. Notably, more attention should be paid to the way the food industry frames the diet and public health debate to avoid misinformation among consumers.

Key messages

• Addressing the global burden of noncommunicable diseases implies recognising corporate political activity strategies used by the food industry that counteract NCDs prevention efforts.

• The way the food industry frames the diet and public health debate should be of concern to public health professionals and policymakers to prevent misinformation among consumers.
Social gastronomy initiatives in Copenhagen, Denmark for food security, sustainability and health
Authors: Siiger C
Published: October 2023

Issue/problem

Social gastronomy addresses the inclusion of socially marginalized communities in using food-related activities to improve the food system and nutrition. In Denmark, the project Green Sustainable Communities in a housing area in Copenhagen, aimed to develop social gastronomy methods, promote sustainable meals while empowering lower socio-economic households with sustainable, healthy, and affordable cooking practices. Interventions included community-based solutions e.g. meals, gardening, and food courses.

Description of the problem

Promoting sustainable diets with a low environmental impact contribute to food security and health for present and future generations (FAO, 2010). More households in affluent countries like Denmark are faced with food security challenges due to poverty and increasing expenses. Diabetes and marginalization are prevalent. The project engaged residents in food related activities to promote social wellbeing and sustainable meals. The project addressed food and garden activities relevant for specific groups of residents and ways of integrating sustainable cooking practices into community food practices.

Results

Solutions were local food initiatives to promote affordable, climate friendly and healthy diets using surplus food from retailers specifically fruits and vegetables combined with affordable legumes. Initiatives integrated community meals, food courses and urban gardening, increasing social wellbeing and improving nutrition.

Lessons

Combining people's own recipes with sustainable ones empowers and recognizes food cultures and skills related to sustainable meals. We used innovative collaboration between a housing organization and a nutrition education, where students collaborated with residents to create sustainable food practices.

Key messages

• Social gastronomy activities can inspire and increase access to healthy, sustainable, and affordable meals amongst low-income households.

• Combining different food initiatives appeal to different target groups and inspire more sustainable and nutritious meals.
Inadequate WASH access and risk for non-partner sexual violence in low- and middle-income countries
Authors: Chi H
Published: October 2023

Background

Globally, 6% of women and girls have ever experienced non-partner sexual violence (NPSV) at least once in their lifetime. Prior literature suggests that inadequate access to water, sanitation and hygiene (WASH) facilities can exacerbate the vulnerability to NPSV against women and girls, especially in low- and middle-income countries (LMICs). Nevertheless, quantitative evidence on the association between NPSV and inadequate WASH access is still limited.

Methods

Demographic and Health Surveys from 27 LMICs were used for the analysis of 237,324 women aged 15-49 years. Experience of NPSV was defined as an event within 12 months preceding the survey. Explanatory variables included type of sources for drinking water (private, public, and open source) and toilet facilities (private, shared, and open type). Multivariable three-level random effects logistic regressions were conducted.

Results

Overall, 6.6% of women were getting water from open sources such as river and 19.9% were openly defecating. 0.5% of the study sample had recent experience of NPSV. After adjusting for demographic and socioeconomic covariates, having to use public or open source for drinking water was associated with 26% and 37% greater likelihood of experiencing NPSV, respectively (OR: 1.26, 95% CI: 1.04-1.51 for public; OR: 1.37, 95% CI: 1.01-1.84). Using shared toilets and practicing open defecation were also associated with 16% and 39% greater risk for NPSV (OR: 1.16, 95% CI: 1.00-1.34 for shared; OR: 1.39, 95% CI: 1.16-1.68 for open).

Conclusions

To prevent the victimization of women with disadvantaged WASH infrastructures and achieve Target 5 from the Sustainable Development Goals, which envisions to eliminate all forms of violence against all women and girls by 2030, it is essential to secure private water sources and toilet facilities via multinational official development assistance as well as country-level policies alongside with ensuring gender equality.

Key messages

• One out of 200 women in low- and middle-income countries has experienced non-partner sexual violence within a year.

• Risk for such non-partner sexual violence was positively associated with inadequate access to water and sanitation facilities, particularly in low-resource settings.
Canadian Adolescents Perceptions of Survey Questions about Climate Emotions and Coping Strategies
Authors: Cosma A , Roswell T , Treble M , Martin G
Published: October 2023

Background

Globally, there is increased research and media attention about how young people are experiencing climate change. Much of this attention is about the worry and concern young people feel about climate change, with recent survey research finding that the majority of young people are at least moderately worried about climate change.

Objectives

To examine the perceptions that Canadian adolescents have about survey measures that have been used to study climate emotions and the coping strategies they use.

Methods

Seven online focus groups occurred in December 2022 with Canadian adolescents aged 15-18. The focus groups began with a brainstorming activity followed by a semi-structured discussion about climate emotion survey questions that have been used in previous surveys. Data were analyzed using rapid thematic analysis.

Results

Overall, Canadian adolescents showed a preference for questions that allowed for more nuance in their response. Questions that were seen to allow for a variety of perspectives were also favored.

Conclusions

Findings from this study can be used to guide survey item development/adaptation in this emerging field of inquiry.

Key messages

• Participants indicated a preference for multi-item questions in relation to climate emotions.

• Focusing on coping items was deemed a priority.
Addressing health equity within the implementation of health system reforms: A scoping review
Authors: Bouckley T , Peiris D , Nambiar D , Mishra S , Sood T , Schierhout G
Published: October 2023

Background

Health equity is a commonly asserted goal of health systems. However, there is limited understanding on appropriate equity-promoting strategies within system reform initiatives. To address this knowledge gap, we conducted a scoping review to (1) identify and characterise strategies that promote health equity during the implementation of health reform initiatives; and (2) reflect on implications for reform implementation and research.

Methods

Using scoping review methodology, we systematically searched peer-reviewed literature from 2013-2022. A comprehensive search strategy captured literature inclusive of four domains: (1) health equity; (2) implementation; (3) health system; and (4) reform, policy, or theories. Thematic analysis was conducted, and findings reported according to the PRISMA checklist.

Results

Of 10,999 identified articles after duplicates were removed, 69 articles met the inclusion criteria. A vast number of health equity promoting themes derived from individual strategies was identified, with a median of 10 strategies (interquartile range 7, 15) per article. Two a priori conditions were observed: (1) the need for health equity promoting strategies to be made explicit, and (2) the need for alignment and complementarity of strategies at community, regional, state, and national health system levels. Themes identified, such as accountability, leadership commitment, shared power, adaptability, and trust, present opportunities to support strategy selection and alignment across health system levels. Underpinning strategies were present across a range of governance domains, although emphasis varied by health system level.

Conclusions

The review recognises that different strategies may be applicable in different contexts; however, it may help to be explicit toward health equity strategies and align across health system levels. In future, reform implementation reporting should be made more consistent to promote a shared language.

Key messages

• A comprehensive review identified two a priori conditions to support equity promoting strategies within reform implementation; being explicit towards equity, and alignment across system levels.

• Our research identified health equity-promoting strategies within health reform implementation. Common across system levels included accountability, leadership commitment, shared power and monitoring.
European Hub for Planetary Health – Policy Engagement Working Group vision mission and priorities
Authors: de Heer P , Queralt Bassa A , Voss M , Jevtic M , Rochfortt A , Hämäläinen R M
Published: October 2023

In September 2022, the European Hub for Planetary Health (EHPH) was established with the aim of coordinating a movement to promote leadership across multidisciplinary communities in Europe towards a synergistic approach to planetary health. www.planetaryhealth.eu The vision of the Policy Engagement Working Group (PEWG) of the EHPH is that Planetary Health should be the central mindset of everyday life for all people, for the purpose of safeguarding a liveable planet for future generations. It is necessary to apply scientific insights to promote Planetary Health-based policies whilst being mindful of the social and economic pressures on populations to ensure that such policies are actionable. The mission of the Policy Engagement Working Group is to build bridges between researchers and policy makers in Europe (on local, regional, national, and EU levels), to promote Planetary Health as a central line of thought for policy making. The PEWG aims to be an interface between views and insights of the members of the Planetary Health European Hub and governments, academia, and other relevant actors in European policy, to move the evidence-base for Planetary Health higher on the political agenda so it is integrated into policies, strategies, and policy agendas. We want to support enhanced policy coherence and vertical coordination in support of Planetary Health and sustainability at international, national, regional, and local levels. The priorities of the Policy Engagement Working Group include knowledge translation; awareness raising by dissemination of information and signposting to reliable sources that can be for the benefit of policy makers and the public on the concept of Planetary Health; policy dissemination and analysis; policy advice and advocacy to European health services and governments; capacity building and development of operational methodologies for national, regional and local Planetary Health Operations.
Stakeholders’ perceptions of factors influencing uptake, delivery, and commissioning of health checks
Authors: Sommer I , Harlfinger J , Toromanova A , Dobrescu A , Affengruber L , Klerings I , Griebler U , Kien C
Published: October 2023

Background

General health checks are offered through national programs and commercial providers in many healthcare systems. Despite their popularity, it has been argued that health checks have little or no impact on population morbidity and mortality. The aim of the qualitative evidence synthesis was to identify factors that influence the uptake, delivery, and commissioning of general health checks from the perspective of stakeholders.

Methods

We searched Medline and CINAHL for relevant studies up to 20 January 2022. We dually selected abstracts and fulltexts according to predefined criteria and sampled studies using a maximum variation. We developed a logical model representing individual, intervention, and contextual factors which guided data extraction and synthesis.

Results

A total of 110 studies met the inclusion criteria, and we selected 37 as sample. Individual factors identified were awareness of the existence of general health checks, personal risk perception, social factors, patient-doctor relationship, financial and time resources, experience during examination and fears regarding outcomes, feedback on health status as impetus for lifestyle changes. Intervention factors included information and invitation systems, discussions about the components and impact of general health checks, modalities of follow-up care, staff qualifications, framework conditions, logistical aspects, and setting. The contextual factors included cultural differences in the perception of disease and prevention, effects of general health checks on morbidity, mortality and social inequality, accessibility, and political climate.

Conclusions

The results show a variety of perceptions regarding factors that influence the uptake, delivery, and commissioning of general health checks. They shed light on the debate about general health checks as a preventive measure in the health care system and highlight the limitations of the evidence regarding effectiveness.

Key messages

• Clients, providers and commissioners may define the “effectiveness” of general health checks not merely on the grounds of population-wide morbidity and mortality reduction.

• Clients, providers and commissioners might seek in general health checks the fulfillment of individual needs that are context dependent.
Experiences with a patient-oriented navigation program in Germany from the navigators' perspectives
Authors: Fuegemann H , Goedde K , Goerling U , Rieckmann N , Holmberg C
Published: October 2023

Background

The German healthcare system has a distinct separation of outpatient and inpatient care, with no coordination along a patient's care trajectory between these sectors. Additionally, support offers are often unknown by patients and providers. To address these barriers, we developed a patient-oriented navigation program for people with chronic conditions in Germany, which mainly focus on the patients' individual needs.

Methods

In a mixed methods study our navigation program for people with lung cancer and stroke is being evaluated in the German healthcare context. Patient navigators support study participants in their individual healthcare organization and coordination for 13 months. Qualitative interviews are conducted regularly with the navigators to capture their experiences with the navigation program.

Results

In our study, three navigators support a total of 122 study participants. Their activities include emotional support, help with bureaucratic matters, organizing outpatient care and gathering specialized information. There is a high overlap in navigation tasks between the two groups of patients. Interviews show that the navigators perceive their work as meaningful and find the exchange within the team and the offer of supervision very important.

Conclusions

For navigation of chronic conditions that require complex care, such as lung cancer and stroke, it appears important to ensure that patients' emotional, social and coordination needs are met in a way that suits their individual wishes. The experiences of the navigators as providers of the navigation intervention can be used for a practice-oriented optimization of the navigation program.

Key messages

• Navigation tasks overlap to a large extent in both groups of patients despite the differences in disease trajectories.

• We suggest that a patient-oriented navigation program focusing on social and coordination needs does not have to be disease-specific but can cover general needs of people with complex care situations.