bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers to resilience among healthcare staff in Ireland in the post-austerity period
Authors: Almirall Sanchez A
Published: October 2023

Background

The health workforce is the motor of any health system. Although the focus of health systems has been on increasing the availability of health workers, less attention has been devoted to exploring the factors associated with the satisfaction/dissatisfaction of the existing workforce or how to improve it. Objective: To assess job satisfaction among Irish healthcare workers and to model the association between psychological, sociodemographic, and work-related factors and the satisfaction of the health staff.

Methodology

A secondary data analysis and subgroup analysis were carried out utilising the data collected in the waves (2016, 2018) of the Irish Staff Survey “Your Opinion Counts”. Descriptive statistics were used to describe the baseline characteristics of the participants. Post-stratification weights were generated to decrease the bias associated with the representativeness of the sample. Ordinal logistic regression was utilised for determining associations between job satisfaction and work-related, sociodemographic, and psychological state variables.

Results

Just over half of the health staff were satisfied with their organisation (52.1%). At country and organisational levels, the communication within the organisation and the possibilities of training and career progression showed the greatest percentage of dissatisfaction within the participants. At the individual level, being a woman, experiencing bullying or discrimination, working in the National Ambulance Service or being a doctor/dentist were the variables highly correlated with dissatisfaction of health staff.

Conclusions

The results highlighted the dissatisfaction experienced by many healthcare workers. Therefore, understanding and addressing their concerns is crucial for policy makers developing national strategies and knowledge-based interventions.
1.O. Workshop: Caesarean section in Europe: Are women and babies receiving evidence-based obstetric care?
Authors:   Organised by: Euro-Peristat Network,   Chair persons: Serena Donati (Italy), Michael Robson (Ireland)
Published: October 2023

Every year in Europe, over 1.5 million women have a caesarean section (CS). The use of this surgical procedure is increasing globally, leading to concerns about a caesarean “epidemic”. While CS is a lifesaving procedure for mothers and babies with complications during pregnancy or labour, national variations in CS rates suggest the absence of standardised indications: in Europe rates vary from lows of 16% (Nordic countries, the Netherlands) to over 40% (Poland, Romania, Greece, Cyprus). Worldwide, the gap between low and high CS countries is even greater. To assess the magnitude of the variations in CS in terms of numbers of women experiencing the procedure in Europe, the Euro-Peristat network calculated that there would be 500,000 fewer CS if all countries had the rates in the lowest CS country. There is uncertainty about what the “optimal” CS rate should be and how this might differ in relation to the health of the childbearing population. CS risk is associated with characteristics of the childbearing population, such as older maternal age, nulliparity, higher body mass index and maternal chronic conditions. The optimal CS rate may also differ depending on the organisation and capacity of the health system. European countries provide a unique context for exploring these questions they have similar standards of living and access to advanced medicine, but differ greatly in the organisation of their health systems and CS practices. In this session, we will present three studies reporting recent data on CS variations and trends in Europe from the Euro-Peristat network to shed light on these questions. The presentations will be followed by a round table discussion about the next steps for evaluating the reasons as well as the health impact of varying practices in order to ensure that European women receive evidence-based obstetric care.

Key messages

• The persisting variation in the use of caesarean section between European countries raises questions about whether pregnant women and babies are receiving evidence-based care.

• Europe provides a unique context for exploring these variations because despite high standards of living and access to medical care, marked differences persist between countries.
1.Q. Workshop: Work, health, and migration: understanding the health impacts of precarious and exploitative work
Authors:   Organised by: St George's University of London (UK), Lancet Migration European Regional Hub (UK), EUPHA-MIG,   Chair persons: Sally Hargreaves (UK), Cathy Zimmerman (UK)
Published: October 2023

The ILO estimates that of the 169 international migrant workers globally, the largest share resides in Europe, where increasing numbers are at substantial risk of precarious, exploitative, and hazardous work conditions. While the right to health and decent work of migrants is recognised by European member states, COVID-19 has exposed how some low-wage migrant workers are compelled to accept exploitative and precarious employment terms and conditions, with implications for their health. The vulnerability of migrants to labour exploitation is influenced by both personal factors (such as age and gender) as well as situational factors (such as risk environments across the migration journey and national legislation). Hazardous, precarious, and exploitative work is an entrenched driver of poor health. Data show that low-wage migrant workers have higher injury and mortality rates compared to host workers and face barriers to occupational and mainstream health and vaccination systems. In this workshop, we will discuss the patterns of precarious work and labour exploitation in migrants residing in Europe, physical and mental health effects of labour exploitation, research and policy gaps, and models of good practice to ensure that the health and rights of migrant workers are protected.

Workshop plan

The workshop will start with 10-minute presentations by each of the 4 speakers (including a short Q&A after each talk). This will then move into a 20-minute audience discussion centred around exploring how to foster intersectoral collaboration across the work, migration, and health research communities to begin addressing some of the evidence and policy gaps in the European region.

Key messages

• Migrant workers have worse health outcomes than native workers, including higher rates of occupational injury and deaths.

• Labour exploitation is an important social determinant of health among migrants which requires greater recognition in research and practice.
Do migrant workers have a higher risk of death and injury than the host population in high-income settings?
Authors: Lau K
Published: October 2023

Karen Lau will describe the current situation in European policy and practice with respect to migrant workers in precious, exploitative or hazardous occupations. She will presenting findings from a recent systematic review on the mortality risk of migrant workers and previous work exploring health and wellbeing of migrant workers in high-income settings and the link between exploitative work and health. Given that existing research on the mortality of migrant workers remains limited and inconclusive, the aim of this study was to review and synthesise available mortality data on international migrant workers. This presentation will focus on findings relevant to migrant workers at risk of labour exploitation in the European region, including migrant worker characteristics and mortality risk estimates. The presentation will define challenges and opportunities in the study of comparative mortality of migrant workers in Europe and beyond.
Media representations of food
Authors: Robbins D
Published: October 2023

This presentation will discuss preliminary findings of a media content analysis focused on how the news media have represented food policy and different food movements, such as slow food, veganism and vegetarianism, and climate-friendly diets. Ireland will be presented as a case study, and the presentation will explore the use of framing theory as a lens through which media representations can be understood.
Too influential to be overlooked: How a Social Practice View of Health Literacy and Health Promotion is Transforming Research and Intervention
Authors: Harsch S
Published: October 2023

Introduction

The history of public health shows that our conceptualization of a study object (e.g. sustainability) influences how researchers perceive, explore, assess, and derive insights from it. Thus, a sound conceptualization is essential. Much debate has raged about the proper conceptualization of health literacy (HL). With the increasing focus on HL intervention research, a conceptualization grounded in practice is irreplaceable and needs to be reflected theoretically. This presentation will discuss the conceptualization of HL as situational social practice and the implications for HL research and interventions, based on ethnographic data of an educational settings, language courses. These courses are well suited to explore practices around HL, as their purpose is not to impart information but to promote competences and communicative skills in the life domain of health.

Methods

Ethnographic research including textbook analysis and participant observation in two second language courses in Germany (100 hours) explored the role, manifestation, and promotion of health and HL. Then practice-oriented evidence-informed interventions were developed and general insights derived.

Results

We identified more than 500 events for engaging with health information, utterly rich and complex and characterized by specific linguistic, situational, social, practice-related, and contextual features. Despite the same cultural portrayal and contextual influences, the learners’ and teachers’ practices proved to be diverse, varied from imitating to changing to creating. We developed complex interventions that provided teachers with both a social-practice-view on HL, the skills to purposefully promote it, and materials.

Discussion

Any use of HL is a situational social practice, and consciously taking this perspective allows us to better understand, explore the spaces and constraints for action, and develop more targeted interventions towards sustainability.
Public Health, Health Promotion and the Problem of Positivism
Authors: Bittlingmayer U H , Bitzer E
Published: October 2023

Introduction

Even though in public health and health promotion (HP) the most fundamental concepts refer to philosophical notions like equality, equity, fairness, justice or well-being, the practice of empirical research in HP is dominated by quantitative and standardized measures (seen widely on Health Literacy studies). Most of the quantitative empirical research has hardly any contact to these notions above referred. Public health and HP concepts shared by the WHO, UNESCO, UNHCR (asf. charters and declarations) deserve to be better explored.

Development

It is argued that there are several reasons that reproduce the domination of numbers in the field of public health and HP, rather than the insightful and transformative thoughts of theoretical developments. One reason is the power from medicine and similar disciplines that use their statistical and evidence-based methods as standard rules of evaluation. A second reason is the promise of public health and HP to make things better. A third reason is that in public health-related study programs very little attention is given to philosophy or sociological insights, although these are basic foundations of public health and HP. Explore some problems and shortages of a positivistic understanding of public health and HP, i.e. the scientific practice that overwhelms the reality by its methods and sees only what can be seen through the lens of the used methods, is needed to reflect on sustainability of human action.

Discussion

Public health and HP both refer immanently to - although contested - concepts and theories of democracy, freedom and justice. These concepts and theories are resistant against a pure mathematization and cannot be operationalized fully by quantitative numbers. There is a normative surplus in the subject of public health and HP that needs to be addressed differently. Finally, the relationship between empirical research and theory building in public health and HP is a quest yet to be firmly rooted.
Symptom patterns and triggers of Long Covid: findings from a longitudinal online survey
Authors: Ziauddeen N A , Pantelic M , O'hara M E , Hastie C , Alwan N A
Published: October 2023

Background

Long Covid (LC) is a multi-system often disabling condition that develops following a SARSCoV2 infection. We aimed to characterise the pattern and triggers of LC symptoms.

Methods

Data from a one-year follow-up of an online survey originally conducted in November 2020 were used. Respondents were adults with LC following confirmed or probable COVID-19 who were not hospitalised in the first two weeks of illness. The baseline survey recruited mostly from support groups using convenience non-probability sampling. The content of both the baseline and follow-up surveys was co-produced with people living with LC.

Results

1153 participants described their current health in the 1-year follow-up survey in November 2021 (530 with established clinical diagnosis of LC). The mean age was 47.7 years (standard deviation 10.6) with 84% females, 83% UK-based, 78% university-qualified and 90% reporting good to excellent health before SARSCoV2 infection. Only 5% of participants reported full recovery, and 45% reported a constant pattern of illness compared to 17% at baseline.

Out of 637 participants reporting fluctuating or relapsing pattern, 40% reported that their illness was usually triggered by an identifiable factor. A further 30% reported that their illness generally followed a set/cyclical pattern but was occasionally triggered by something, and 10% reported that they had been unable to identify a trigger. Common triggers were physical activity (44%), stress (40%), cognitive effort (27%), social effort (25%), and work (22%). 96% of participants reported getting vaccinated, with 22% reporting improvement, 17% worsening, and 50% no change in illness after vaccination.

Conclusions

Needing to avoid activities that trigger symptoms means that individuals will have to adapt life routines. This has the potential to widen health inequalities and increase hardship in individuals whose life circumstances and job types may not allow them to make necessary adaptations.

Key messages

• Symptoms pattern in Long Covid can be constant or fluctuating/relapsing triggered by certain activities.

• Having LC often means adapting daily activities to reduce the chance of triggering symptoms.
Long-term health consequences in persons with and without SARS-CoV-2 infection in Germany
Authors: Heidemann C , Sarganas G , Du Y , Gaertner B , Poethko-Müller C , Cohrdes C , Schmidt S , Schlaud M , Scheidt-Nave C
Published: October 2023

Background

So far, few population-based studies comprehensively examined health consequences of COVID-19 including a control group not exposed to SARS-CoV-2 infection and a long-term follow-up. This cohort study of 4817 adults from four municipalities in Germany examined health consequences among individuals more than one year after SARS-CoV-2 infection compared with non-infected individuals.

Methods

Exposure was the SARS-CoV-2 infection status (based on IgG antibodies, PCR test, or physician-diagnosis of COVID-19) at baseline (04/2020 to 12/2020). Outcomes assessed at follow-up (10/2021 to 01/2022) included recurrent or persistent health complaints, incident diseases, health-related quality of life (PROMIS-29), subjective health and subjective memory impairment. Regression models were adjusted for socio-demographic and lifestyle characteristics, pre-existing health conditions and follow-up time.

Results

Overall, 350 participants had a SARS-CoV-2 infection at baseline and 4467 had no infection at baseline or during follow-up. Individuals with an infection reported more often 7 out of 18 recurrent or persistent health complaints at follow-up: smell/taste disorders (OR 4.1, 95%−CI 2.8-6.0), shortness of breath (3.5, 2.6-4.7), pain when breathing (2.4, 1.3-4.2), fatigue (1.8, 1.4-2.2), weakness in legs (1.9, 1.3-2.8), myalgia/joint pain (1.5, 1.2-2.0) and cough (1.3, 1.0-1.7) and 3 out of 6 groups of incident diseases: liver/kidney (3.7, 1.7-8.1), lung (3.5, 1.7-7.1) and cardiovascular/metabolic (1.7, 1.0-2.7) diseases. Participants with an infection were significantly more likely to report poor subjective health, memory impairment and worse mean scores on fatigue and physical function domains of PROMIS-29 than non-infected.

Conclusions

Results of this population-based controlled study point to a considerable impact of SARS-CoV-2 infection on health and well-being among adults with a mainly mild course of acute infection even more than one year after infection.

Key messages

• After one year, individuals with SARS-CoV-2 infection showed increased risks of various health complaints, functional limitations and worse subjective health compared to those without an infection.

• Long-term health consequences after a SARS-CoV-2 infection is a relevant public health concern.
2.F. Workshop: Innovations for chronic diseases management: complementing usual care with digital therapeutics
Authors:   Organised by: EUPHA-CHR, EUPHA-DH,   Chair persons: Saverio Stranges (EUPHA-CHR), Stefan Buttigieg (EUPHA-DH)
Published: October 2023

The management of chronic non-communicable diseases (NCDs), including both physical and mental disorders, remains a pressing global health challenge in high-income countries and low-resource settings. Digital health technology, also known as eHealth, could help improve the management of chronic diseases, in the post-pandemic era, by facilitating data exchange between patients and health professionals. Specifically, digital therapeutics, which utilize technology to deliver evidence-based interventions, have demonstrated potential to complement traditional care approaches and improve outcomes for patients with chronic NCDs. The proposed joint workshop, organized by two EPH sections (chronic disease and digital health and communication), will provide four presentations on innovative approaches to improve the management of major chronic disease, with focus on digital health technologies, which can provide alternative cost-effective options in both high-income countries and low-resource settings. The workshop will explore how digital therapeutics can enhance the management of chronic NCDs, such as diabetes and common mental disorders among others, by complementing existing healthcare practices. The selected speakers are international leaders in the field and will represent different geographic contexts within Europe (Malta, Italy, and Switzerland) and North America (Canada).

Key messages

• Digital health technologies can provide alternative cost-effective options in chronic disease management.

• Digital therapeutics can enhance the management of chronic NCDs by complementing existing healthcare practices.
Evaluating Gamification of Antimicrobial Resistance as an Educational Tool: A Systematic Review
Authors: Nowbuth A A , Asombang A W , Alaboud K , Souque C , Dahu B M , Pather K , Mwanza M M , Lotfi S , Parmar V
Published: October 2023

Background

Antimicrobial resistance (AMR) poses a serious threat to global healthcare, and inadequate education has been identified as a major challenge by the World Health Organization. Gamification has emerged as an innovative tool to improve knowledge and change behaviours at the grassroots level. This scoping review provides an overview of existing games in prescribers’ education across the One Health sectors, with a particular focus on the impact of gamification in learning.

Methods

Using the PRISMA guidelines, we searched Cochrane, PubMed, Scopus, and Google Scholar for articles related to gamification for future prescribers’ of AMR until March 28, 2023. Retrieval and screening of articles was done using a structured search protocol with strict inclusion/exclusion criteria.

Results

A total of 120 articles were retrieved, of which 6 articles met the inclusion criteria for final analysis. Brazil, UK and France were the sites of almost all the gamification trials, with an additional global study incorporating low-middle income countries. All studies were tested in the human healthcare sector only. Board and card games were the most common types of games, with scoring and point systems as the most common game elements. All games focused on improving knowledge and prescribing behaviours of undergraduate students, with bacteria or antibiotics being the only content. Many studies highlight the significant role gamification can play in mitigating AMR, promoting antimicrobial stewardship (AMS), and improving retention of information compared to conventional lectures.

Conclusions

Our review highlights a lack of standardised content and gameplay across games addressing AMR for future prescribers of antibiotics, and a gap in assessing gamification of AMR as a tool to promote AMS across all three sectors. Our findings will guide the development of a game in the next phase of the project, as a longitudinal study across Norway and Zambia, focused on the One Health approach.

Key messages

• Tackling AMR requires improved education and awareness of healthcare workers, veterinarians, and agriculture workers around AMR stewardship issues.

• The One Health approach is necessary to mitigate AMR, and the foundation of future prescribers’ is vital. Innovative learning tools like gamification can play a pivotal role in this fight.
The Effectiveness of a Novel Public Health Campaign to Reduce Parental Provision of Alcohol
Authors: Booth L , McCausland T , Keric D , Stafford J , Samsa H , Akesson G , Pettigrew S
Published: October 2023

Background

Parental provision of alcohol to children is common despite being associated with negative outcomes, including earlier initiation of alcohol use and riskier drinking behaviours. Parental provision can be particularly problematic because it suggests to children that their parents have permissive attitudes to underage alcohol use. This study evaluated the ‘I need you to say no’ mass media public health campaign implemented by the Mental Health Commission in Western Australia (Nov 2018 - Feb 2022). The campaign adopted a novel approach by depicting adolescent children asking their parents to say ‘no’ if they ask for alcohol, alongside information challenging beliefs that provision behaviours are safe and commonplace.

Methods

Parents in Western Australia (n = 297) were surveyed in March 2022 to examine campaign recognition, perceptions of the campaign, and behaviours enacted due to seeing the campaign. Descriptive analyses were conducted. Two generalised linear models were also run to identify variables associated with positive campaign perceptions and behaviours enacted due to the campaign.

Results

The campaign was recognised by 4 in 5 parents and was rated by 70+% as being clear, memorable, and believable. Two-thirds of parents reported that the campaign made them concerned about underage drinking and less likely to supply alcohol to minors. Half the sample reported talking to their children about alcohol as a result of seeing the campaign. Perceptions of the campaign did not differ according to demographic characteristics, suggesting the campaign achieved widespread approval across demographic subgroups. Positive perceptions of the campaign were associated with enacting more of the examined harm reduction behaviours (B = .43, p = .002).

Conclusions

A novel campaign discouraging parental provision of alcohol resonated with parents and motivated harm reduction behaviours. Such campaigns have the potential to reduce alcohol-related harms among underage people.

Key messages

• A campaign advising parents to not provide alcohol to children was well received.

• Such campaigns can challenge permissive attitudes to parental alcohol provision and promote harm-reduction behaviours.
Training of women as promoters of social and emotional health in children and adolescents
Authors: Castro Ramírez C , Sierra Delgadillo V , Ruiz González L , Acosta Fajardo L , Piratova López D , Fonseca Zamora F , Romero Correa J
Published: October 2023

Background

Since the COVID-19 pandemic, the ‘silent pandemics’ associated with mental health became more visible; likewise, the confinement made us reflect on the importance of family environments for health promotion. On the other hand, child and adolescent suicide increases alarmingly; a context that highlights the need to consolidate health promotion actions from the emotional and social dimensions based on educational strategies with the community, be women, key to strengthen the community health system.

Objectives

To train 46 women as social and emotional health promoters in children and adolescents through the gamification methodology; 9 training sessions were held, developing the modules: a) Definition of social health and emotional health and play and gamification tools, b) Social health, c) Emotional health and d) Proposal for health promotion.

Results

Community mothers and women caregivers succeeded: a) Identification and application of the gamification methodology for the formulation of health promotion actions based on the projects implemented, such as: ‘I take care of myself to care for another', ‘Run with My Emotions', ‘Take Care of Myself and Be Happy', ‘Educational Mental Health', ‘Happy Explorers', ‘Active Squad'; b) Recognition of social and emotional health as well as personal and context risk factors; and c) Benefit your 46 families, an average of 5 persons per household, serving 230 persons in the community and 475 children and adolescents belonging to 36 community homes involved in the process.

Conclusions

Installed capacity was generated by certifying 46 women in the course: Gamification, play and playful, fundamental axes in the promotion of social and emotional health in children and adolescents; evidencing the strengthening of social and family ties based on the personal growth of trained women and the recognition of the role of participating women as multipliers and health promoters in their communities.

Key messages

• Gamification as a methodology for health education evidence significant learning in women and in their transfer of knowledge to children and adolescents.

• Training women as health promoters makes it possible to strengthen the community health system, recognizing the educational role they have in their families and communities to be multipliers.
Waste-pathogen combinations from land-spreading for a farm-to-fork QMRA of public health in Ireland
Authors: McCarthy J , Frias J , Hynds P , Bolton D
Published: October 2023

Recent reports highlight the importance of assessing public health and food safety risks via land-spreading of organic wastes (i.e., biofertilisers) in Ireland. Accordingly, this study established a modular framework for farm-to-fork quantitative microbial risk assessment (QMRA) of targeted waste-pathogen combinations (W-PCs) due to land-spreading. Assessments will also consider resultant cross-contamination of soil, livestock, water, and crops (i.e., One Health approach). A scoping review of the scientific literature was undertaken, employing search strings of relevant terms relating to enteric pathogens in land-spread animal manures and biosolids. The primary eligibility criterion was “spatial relevance” (i.e., Ireland and western Europe). Directed graphical model chains were developed, incorporating both stochastic model parameters and inherent uncertainty and variability associated with model inputs. Mixed effects meta-analyses, likelihood ratio testing, and stepwise multivariate regression were used to pool estimates from extracted farm-level datasets (i.e., harmonisation, weighting, and density function fitting for target pathogen prevalence and concentration). Identified priority W-PCs based on Irish environmental prevalence and epidemiological data were: bovine slurry (BS)-STEC O157/O26, BS-Cryptosporidium parvum, biosolids-noroviruses GI and GII, and broiler litter-Campylobacter jejuni. All distributed baseline prevalence meta-models included: pooled estimates ranging 0.13-0.43, SE ranging 0.04-0.06 (for p ranging <0.0001-0.009, respectively), and bioclimatic indicators, temperature and precipitation seasonality (for p ranging <0.0001-0.01, respectively), explaining 34.91%-54.75% of heterogeneity (system variance). The directed graphical model chains, pooled analyses, and fitted distributions for identified W-PCs provide the first modular framework for spatially explicit QMRA of land-spreading in the Republic of Ireland.

Acknowledgements DAFM R2021453

Key messages

• The modular framework provides the tools to assess the public health and food safety risks of land-spread biofertilisers in Ireland.

• This is the first modular framework for spatially explicit QMRA of land-spreading in the Republic of Ireland.
Polystyrene nanoplastics mediate ROS production and apoptosis in A549 cell line
Authors: Milillo C , Pesce M , Patruno A , Aruffo E , Di Carlo P , di Giacomo V , Marinelli L , Miscia G , Reale M , Ballerini P
Published: October 2023

Background

The ubiquity of single-use plastics has led to a global plastic pollution challenge with significant environmental and health consequences. Physical, chemical, and biological processes such as erosion, photo-oxidation, and biodegradation cause the plastic to erode, eventually forming debris in the size range from micro-plastics (MP) to nano-plastics (NP). Although NP has been extensively studied as a pollutant in marine and water environments, its potential detrimental effects, when present in the atmosphere, are still poorly investigated. In this study, we used polystyrene NP (PS-NP) in evaluating their potential toxic effects on the A549 cell line as a representative in vitro model of human lung epithelial cells.

Methods

The A549 cells were treated with concentrations of PS-NP (800 nm diameter) in the range of 10-500 mg/ml and for different time intervals up to 96 h. Cell viability, oxidative stress and senescence, were evaluated by commercially available kits, apoptosis was assessed by cytofluorimetric assay. Their capability to cross physiological barriers was assessed by Parallel Artificial Membrane Permeability Assay (PAMPA) and Caco-2 cell monolayer.

Results

PS-NP reduced cell vitality after 72 h of treatment at all the concentrations used. They also induced a marked increase in reactive oxygen species (ROS) production in a dose-dependent manner. Accordingly, PS-NP upregulated ROS-related genes evaluated by qPCR. PS-NP induced apoptosis after 96 h of treatment, whereas they were unable to induce senescence at the size and concentrations used. As expected, PAMPA results revealed no passive diffusion of PS-NP after 3 and 18 h, caco-2 assay excluded additional permeation mechanisms within 24h.

Conclusions

This study showed that atmospheric PS-NPs can represent a hazard to human lung health once inhaled. They cannot be degraded; thus they can be continuously accumulated and able to worsen pre-existing disease states or increase sensitivity to them.

Key messages

• The results indicated a significant effect of polystyrene nanoplastics on airway cell viability, ROS formation, and apoptosis.

• The study helps define the harmful effects of exposure to airborne polystyrene nanoplastics on human health at the respiratory system level.
Potential zoonotic agents in sea turtles: Chlamydia species and Listeria monocytogenes
Authors: Barsi F , Baruffaldi M , Vicari N , Taddei R , Sampieri M , Di Donato A , Savini F , Prandini L , Giacometti F , Rubini S
Published: October 2023

Background

Sea turtles are well recognized sentinels of marine environment as well as carrier of pathogens and contaminants. Chlamydial species have been described in reptiles, but scarce data regarding sea turtles are available in literature (Pace et al., 2022). Hitherto, only one case of listeriosis has been described in marine reptiles (Di Renzo et al., 2022). This study reports the detection of Chlamydia species and Listeria monocytogenes in loggerhead sea turtles (Caretta caretta), suggesting the role of these animals as carriers of potential zoonotic agents.

Methods

In 2022, a total of 11 sea turtles found stranded along Emilia-Romagna coast, Northwestern Adriatic Sea, were subjected to post mortem investigation. Cloacal swabs were collected from 10 of the investigated animals and screened for Chlamydiaceae family by qPCR targeting 23S rRNA gene, followed by confirmation via 16S rRNA fragment sequencing. For positive samples, Chlamydia species identification was performed by species-specific qPCR for C. abortus, C. pneumoniae, C. pecorum, C. psittaci. One subject showed internal organs disseminated with multiple nodular lesions that were sampled for histopathology analyses, alongside microbiological examination. The cultured isolates were identified by MALDI-TOF (MALDI Biotyper; Bruker Daltonics Inc).

Results

In six out of 10 cloacal swabs Chlamydiaceae DNA was demonstrated by qPCR and confirmed by sequencing of 16S rRNA, but species identification was not achieved. In the turtle with nodular lesions, histopathology revealed the presence of granulomas: the Ziehl-Neelsen stain was negative for acid-fast organisms. L. monocytogenes was isolated from heart and liver and listeriosis was diagnosed.

Conclusions

The results highlight how sea turtles can be carriers, symptomatic or not, of pathogens relevant for public health. Given the zoonotic potential of these microorganisms, particular precautions are recommended especially for professionals handling these animals.

Key messages

• Sea turtles can play an active role as carriers of possibly pathogenetic microorganisms.

• Further studies of molecular identification of Chlamydia spp. from sea turtles are needed in atypical strains.
The next-generation tools for risk assessment and precision food safety in the One Health continuum
Authors: Macori G , Fanning S
Published: October 2023

Sequencing technologies and bioinformatics are transforming microbiology and their applications, including aspects of food quality and precision food safety and description of microbial communities in the One Health context. The use of these protocols includes, among others, a deep understanding of the genomes of microorganisms in pure culture using whole genome sequencing and importantly, metagenomics has allowed the extensive comprehension of the microbiota and microbiome of samples. Microbial communities from different sources (clinical samples, environment, food-producing animals) have increasingly been studied to describe the genetic diversity, functionality, and succession of food-borne pathogens and for studying functional microorganisms used for producing novel foods and also using fermentation. This study presents the methods used for the description of microbial communities in a model fermented food, including culturing with a novel in situ culturing approach, full-length 16S rRNA gene sequencing, and shotgun metagenomic sequencing with computational enrichment. Several microorganisms were identified both in culture and as high-quality metagenome-assembled genomes and included prominent probiotic species of the genus Gluconobacter, Liquorilactobacillus, Lactiplantibacillus, Lentilactobacillus and Lacticaseibacillus that have potential health benefits and applications in food production and environment health enhancement. These tools can revolutionise risk assessment approaches, allowing for the pinpointing of contamination events, pathogens, antimicrobial resistance spread, and description of unknown beneficial microorganisms, as in this model study. The integration of these methods in the One Health continuum will allow the precise connection of samples from clinical settings, animals, plants, and their shared environment, achieving a holistic approach to food safety and public health.

Key messages

• technologies are changing food safety by enabling comprehensive analysis of microbiome. This can aid in identifying contamination events, pathogens, and AMR spread, and promote One Health integration.

• Use of sequencing in foods, enables the identification of novel microbial species, providing valuable insights into the functional microorganisms for production and their potential health benefits.
Post-covid policy responses to health workforce capacities: comparing health system resilience
Authors: Burau V , Falkenbach M , Fehsenfeld M , Kotoreva Z , Mejsner S B , Neri S , Wallenburg I , Kuhlmann E
Published: October 2023

Background

Post-Covid health policies seek to adapt to the ‘new normal'. Their success depends on the capacities of healthcare workforce (HCWF). Policies need to tackle rapidly growing shortages, high levels of stress and increases in violence against the HCWF. We lack more systematic comparisons of how countries respond, also across different sectors. Our study analyses policy responses in six European countries in relation to hospitals and ambulatory care, to provide in-depth insights into on how health system resilience is created, maintained and transformed.

Methods

We used a framework which considers the relationships between health system prerequisites, health workforce capacities, and health system resilience as flexible. We selected Austria, the Czech Republic, Denmark, Germany, Italy, and the Netherlands for our comparative analysis. We collected data in 2022 and prepared descriptive country cases, based on expert information and written secondary and primary research.

Results

Across our countries, the focus of national policy responses tends to be on hospitals and governments are often limited in developing HWCF capacity in ambulatory care. There are also variations in how fast national governments are moving to post-pandemic policy responses. Policy responses at sub-national levels have a broader focus on HWCF capacity, reflecting decentralisation as well as greater proximity to the consequences of increasing demands and greater shortages in the HWCF. At all levels, medical interests continue to be more influential compared to those of other health workers. Only few countries have adopted major transformative policy responses and capitalised on the possibilities offered by the EU Next Generation programmme.

Conclusions

Considering the scale of the post-Covid challenges, policy responses remain fragmented and often patchy. Securing health system resilience requires more concerted policies directed at the capacities of the entire HCWF.

Key messages

• Success of post-Covid health policies depends on the capacities of the HCWF and needs to tackle growing shortages, high levels of stress and increases in violence against health workers.

• Our comparison analysis shows that policy responses remain patchy and are fragmented across national and local levels, hospitals and ambulatory care, as well as different groups of the HCWF.
Decision-making, training and support:Lessons from public health response to COVID-19 in Ireland
Authors: Kennedy C , Conyard K F , Codd M
Published: October 2023

Background

The COVID-19 pandemic exposed the critical need for a rapid and effective public health emergency response to such crises. This study investigates the public health response to COVID-19 in Ireland, focusing on decision-making, recruitment, training, and specialised support for emergency responders.

Methods

Using a mixed-methods approach, we analysed data from surveys of volunteer contact tracers recruited in the early days of the pandemic, from government reports, and from the Health Service Executive (HSE) COVID-19 Contact Management Programme work instructions that evolved over the course of the pandemic response.

Results

Our findings reveal that the public health response in Ireland was moderately rapid and decisive with innovative recruitment strategies, targeted training programmes and the development of specialised support for frontline responders. While volunteer contact tracers were quickly upskilled, they required ongoing expert support on an evolving IT system and for effective clinical and public health responses. We highlight key lessons learned, including the need for interdisciplinary collaboration, ongoing training and support, and effective communication strategies.

Conclusions

Our study has important policy implications for public health emergency preparedness and response, which include the need for greater investment in training and support for public health professionals, the development of effective communication channels, and the establishment of a coordinated national response system. By implementing these recommendations policymakers can better prepare for, and respond to, future public health emergencies ultimately improving the health and wellbeing of the population. The key lessons presented from this analysis point to the importance of forward planning for early intervention, rather than reactive responses in times of crises.

Key messages

• Improving emergency preparedness by investing in training for public health professionals, developing effective communication channels, and establishing a coordinated national response system.

• The key lessons presented from this analysis point to the importance of forward planning for early intervention, rather than reactive responses in times of crises.
Hungry and warm; cold and fed? The intersection of food and fuel poverty
Authors: Champagne S N , Macdiarmid J I , Phimister E , Guntupalli A M
Published: October 2023

Background

The UK news has been increasingly reporting of people forced to choose between “heating and eating.” The (self-)rationing of food and fuel has harmful health repercussions, yet the intersection food poverty and fuel (or energy) poverty has been largely neglected in academic literature. This study looks to triangulate reports from the UK news and stakeholders in food and fuel poverty (FFP) mitigation to determine and compare how FFP is framed relationally between the sources.

Methods

Using the Nexis Lexis database, we searched for UK news articles on FFP, published between January 2010 and April 2022. Stakeholders in the FFP mitigation space, identified via hand-searching grey literature and snowball sampling, were interviewed between April and June 2023. Twenty interviews were conducted, and 185 news articles were included. Relying on framing analysis, extracted news data fragments and interview transcripts were thematically coded, analysed, and triangulated.

Results

Three descriptive frames of FFP were inductively identified across both data sources: 1) FFP is experienced as “trade-off” - a choice between heating and eating; 2) FFP is experienced as “mutual cutbacks” - an effort to reduce both necessities; 3) FFP is “not distinct” - the problem is income poverty. A fourth frame, that FFP is “situational” - it does not involve decisions but is a situation people find themselves in, only emerged from interviews. The UK news most prominently framed FFP as a “trade-off” (70%), followed by as a “mutual cutback” (29%), and rarely as “not distinct” (1%). Whereas stakeholders largely framed the issue as “mutual cutbacks” (45%), followed by as a “trade off” (30%), as “not distinct” (25%) and as “situational” (10%).

Conclusions

The varied and mismatched framings between the news and stakeholders suggests that FFP is complex and potentially poorly understood. Centring the framing of people with lived FFP experience may help towards meaningfully tackling FFP.

Key messages

• Food and fuel poverty (FFP) is largely framed differently between the UK news and FFP mitigation stakeholders.

• Centring the framing(s) of people with lived experience may help towards tackling FFP.
Nutritional status assessment using anthropometry and evaluation of school canteen menus in Tanzania
Authors: Callegaro D , Biasini B , Scazzina F
Published: October 2023

Background

According to the FAO, an estimated 767.9 million people faced hungry in 2021. To improve food sovereignty, it is necessary to investigate eating habits and assess the actual level of malnutrition. The study took place in two private schools, one primary and one secondary school in the Rukwa region, one of the poorest in Tanzania, with a human development index of 0.467.

Methods

Height and weight were measured from March to June 2022 on a sample of 235 students (52% male, age 9.9 ± 2.6) from the primary school and 297 (61% male, age 16.9 ± 2.8) from the secondary school. The menus of the canteens were evaluated by weighing the ingredients cooked for one week and dividing the estimated nutrients for each student attending the canteen, then comparing them with the EFSA Dietary Reference Values.

Results

The BMI by age of children from 5 to 19 years was compared with the WHO reference data for growth. 72.7% of primary school students were in the 50th percentile and 27.7% in the 15th percentile, while 68.7% of secondary school students were in the 50th percentile and 25.4% in the 15th percentile. The menu evaluation showed that carbohydrates provide 79.6% of the diet's energy, while lipids only 10.58%. Vitamin intake was particularly low for B7 (3.05μg), B12 (0.155μg), A (149.21μg), D (0.04μg) and K (0.57μg). Among the minerals, the greatest deficiencies are Calcium (290mg), Magnesium (39.95mg) Iodine (18.63µg), Copper (0.20mg), Selenium (1.38µg) and Manganese (0.46mg).

Conclusions

The results show that children and adolescents are growing less than recommended and malnutrition affects the youngest. The meals in the two canteens show a shortage of several nutrients, easily attributable to the low consumption of fruit and animal products. Although the situation appears critical, it should be emphasised that the schools surveyed were private, while in public schools the catering service does not exist, often condemning students to a single evening meal.

Key messages

• In a rural context of Tanzania, children and adolescents are growing less than recommended and malnutrition affects the youngest.

• A low intake of vitamins and minerals was detected in two school canteens in Tanzania.