bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social differences in 20-year trends in daily smoking among Lithuanian adult population
Authors: Petkeviciene J , Kriaucioniene V , Raskiliene A 
Published: October 2020

Abstract

Background
Tobacco control measures carried out in the countries can affect social inequalities in the smoking habit. This study aimed to examine the 20-year trends in social patterning of daily smoking in Lithuania.

Methods
The data were obtained from 11 biannual cross-sectional postal surveys of Lithuanian Health Behaviour Monitoring, beginning in 1994. Each survey used a randomly selected nationally representative independent sample of 3000-4000 inhabitants aged 20-64 drawn from the population register. In total, 8738 men and 11822 women participated in the surveys. The analysis of daily smoking involved the respondents who had smoked daily for at least one year.

Results
The prevalence of daily smoking was increasing up to the year 2000, especially among women, while a decreasing trend in men and levelling off a trend in women was observed afterwards. In the last survey, 33.3% of men and 12.5% of women were daily smokers. The proportion of daily smokers was higher among younger than older participants; however, the age difference in smoking decreased over time. The highly educated men and women smoked less than those with low education. The odds ratio (OR) of smoking in men with university versus lower education was 0.42 (95% CI 0.37-0.47) and in women - 0.68 (95% CI 0.60-0.78). The proportion of smoking men decreased in all educational groups; however, the differences in the smoking prevalence remained. Since 2000, the educational gradient in smoking among women was increasing due to a decline in smoking prevalence among women with university education. More women living in big cities than in non-urban areas were daily smokers (OR 1.29; 95% CI 1.15-1.44). Over 20 years, no consistent difference in the smoking trends by place of residence was found in both genders.

Conclusions
The 20-year trends in social patterning of daily smoking differed between men and women. Inequalities in daily smoking by age and education remained in both genders.

Key messages
In Lithuania, the trends and social differences in daily smoking were related to gender. Comprehensive tobacco control measures targeting young and lower educated groups should be implemented aiming to reduce social inequalities in smoking.
Association between smoking cessation and quality of life among patients with COPD in Tunisia
Authors: Dardouri M , Limam M , Ajmi T , Mtiraoui A , Zedini C , Mallouli M 
Published: October 2020

Abstract

Introduction
Smoking cessation is the most important step to limit the complications of chronic obstructive pulmonary disease (COPD). Outcomes from studies that assessed the association between health-related quality of life (HRQL) and smoking cessation have been controversial. This study aimed to assess the relationship between HRQL and smoking cessation in patients with COPD in Tunisia.

Methods
A cross-sectional study was carried out in the two main primary care centers in the center of Tunisia over a period of three months (April-June 2016). Clinic and socio-demographic data were collected from patients' records. HRQL was assessed by the Medical Outcomes Study Short-form 36 (SF-36). This instrument is composed of two dimensions: physical and mental components. The questionnaire outcomes were described as means and standard deviation. T-test was performed to assess the statistical difference between the dependent and categorical variables.

Results
A total of 249 COPD patients participated in the study with a mean age of 67.77±11.13. Of this sample, 169 (67.9%) ceased smoking. The average period of smoking cessation was 10 years. The mean of total HRQL score in patients who ceased smoking was lower in comparison to patients who did not quit smoking (40.65±24.49, 43.37±24.49; respectively). The T-test reported a significant difference between the physical component of HRQL and smoking status. Patients with current smoking status had a better physical component score in comparison with patients who quit smoking (43.76±22.62, 37,86±18.21, p = 0.04, respectively). No significant differences were found between smoking cessation, mental component, and HRQL total score (p = 0.89, p = 0.39; respectively).

Conclusions
This study revealed that smoking cessation was associated with the physical component of HRQL. The smoking dependence in patients with COPD could explain this finding. Health care professionals should work harder on effective smoking cessation strategies.

Key messages
These findings suggested that HRQL was better among patients who did not quit smoking. Patients who did not cease smoking reported better physical status and poorer mental status in comparison with patients who quit smoking.
Opportunities for achieving the sustainable development goals through assessing health in environmental assessments
Authors: Nowacki J , Mekel O , Martin-Olmedo P , Cave B 
Published: October 2020

Abstract
The 2030 Agenda for Sustainable Development calls for tackling environmental risks at their root, that is, through a shift towards primary preventive actions and the promotion of healthy choices. Reducing the 13 million deaths resulting from environmental risks each year requires efficient scale-up of primary preventive action involving all key stakeholders, across all sectors. Decisions taken on the drivers of health risks should have the attainment and protection of good health as an explicit aim in key sectors such as energy, transport, housing, labour, industry, food systems and agriculture, water and sanitation, and urban planning. A key tool for such actions can be seen in Health Impact Assessments (HIAs) and an enhanced integration of health assessments into environmental impact assessments (EIA).
In many countries worldwide, legally binding instruments exist which are concerned with assessing the impacts of policies, programmes, plans and projects on the environment to contributes to a high level of protection of the environment and human health. Within the European Union (EU) the EIA Directive 2014/52/EU names human health among the topics to be addressed when conducting an EIA. The amended EIA Directive also includes issues that are relevant to human health, for example, climate change and vulnerability (exposure and resilience) to major accidents and/or disasters. These amendments are relevant also beyond EU borders through, for example, the policies of the European Investment Bank. A paper recently developed by IAIA and EUPHA provides insights to the EIA Directive to raise awareness among health authorities and public health professionals on the potential for primary preventive actions and promotion of healthy choices outside the health sector. Key messages will be presented and further discussed with the audience on how achieving the 2030 Agenda can be supported through impact assessments and the enhanced involvement of health authorities.
Fostering methodological advances and technical capacity building
Authors: Grant I , Plass D , von der Lippe E , Lesnik T , Idavain J 
Published: October 2020

Abstract
Countries all over the world, and especially in Europe, are increasingly using the burden of disease approach to assess the health status of populations and to identify the main drivers of ill health. Thus, there is an increasing need for equitable capacity building on the one hand (including an improved understanding of the complex methods behind global and national burden estimates), and harmonization of methods on the other hand to keep the results comparable. Furthermore, involved researchers also strive for a platform to exchange experiences and foster collaboration.
To address the current challenges in burden of disease research, our COST Action CA18218-European Burden of Disease Network will build strongly on the COST mechanisms, such as short-term scientific missions and training schools to foster and increase capacity building activities across Europe. Our Action will also serve as a technical platform where knowledge and expertise can be shared among experienced and less experienced researchers. Collaboratively, the technical platform will provide unique opportunities for developing a joint research agenda in the domain of burden of disease, for fostering methodological developments, and for developing new collaborative research.
With this presentation, we aim to show how the COST Action is fostering methodological advances and technical capacity building, focusing on 1) the role and aim of short-term scientific missions including real case examples; 2) the concept and structure of the Action's training schools; and 3) examples of specific methodological activities underway as part of the Action. The session will conclude with an interaction with the audience during which the needs and expectations of the attendees will be elicited.
Recommendations for a Health literacy Policy Plan for Belgium: Learning from experiences of other countries
Authors: Van Den Broucke S , Rondia K , Adriaenssens J , Kohn L 
Published: October 2020

Abstract

Background
In Belgium, the past decade has seen a large number of initiatives by various stakeholders to address health literacy (HL) at different levels, but an encompassing policy plan to coordinate efforts across sectors is missing. The Belgian Federal Public Service of Health, Food Chain Safety and Environment commissioned a study to investigate HL policy plans of other countries, with the intention to make recommendations for the development of a Belgian National Health Literacy Plan (NHLP).

Methods
To identify elements and criteria for a NHLP, a transversal analysis was performed of HL policies in Australia, Austria, Ireland, The Netherlands, Portugal, and Scotland, following a preliminary scoping review regarding the availability of relevant information. Information about HL policies was analysed using a combination of document analysis and key informant approach, structured by means of an analytical grid specifying methods, resources, goals, actors, beneficiaries, actions, timing, opportunities, threats, evaluation, monitoring and impact.

Results
Policy approaches and action plans on HL vary widely in scope, focus and depth. Three pathways to developing a national HL plan were identified: (1) a conceptual approach whereby targets are formulated at the national or federal level, showing the country's determination to improve HL throughout its political system, but with a weak leverage for action (A, AUS, P); (2) a pragmatic approach targeting the healthcare sector first but progressively broadening the scope towards other sectors (SCOT); (3) a delegated approach whereby the authorities delegate the initiatives regarding HL to an active and dynamic civil society (NL, IRL).

Conclusions
There is no single best way to coordinate efforts to address HL across sectors. Policy makers should consider the strengths and weaknesses within their country to develop a substantiated HL approach that best fits the country's situation.
What can everyone do about it? Sustainable individual choices that contribute to the SDGs
Authors: Vareda R 
Published: October 2020

Abstract

Background
The Sustainable Development Goals (SDG) aim to solve the world's most wicked problems, which requires global partnership. That means governments, national and international organizations and worldwide leaders working together, but it also implies individuals, families and communities, which make up most of the world, must contribute.
Households, schools, the health system and others have a responsibility in the consumption and demand for energy and resources of our planet and contribute largely to climate change. Awareness and population education are essential to promote action on an individual level.

Objective
This presentation is part of a workshop on how individuals and public health (PH) can create a more sustainable world. It aims to present the science and challenges behind changing and creating new habits, and examples of individual habits and choices everyone can make in order to contribute to the SDG and to sustainable health prevention. This presentation is based on the United Nation (UN) available material for the SDG, as well as other independent research on the subject.

Results
Sustainable individual actions can be divided in 3 different main themes:
Food and Water - Examples. Eat a more plant-based diet; use apps like Too Good To Go®; reutilize the water from your shower...
Energy - Examples. Plug all appliances into a power strip and turn them off completely when not in use; adjust your fridge and home thermostat to winter and summer temperatures; use energy efficient light bulbs; fill your house with rugs...
Resources - Examples. Pay your bills online; delete your spam email; compost your food; choose a better diaper option; shop second-hand clothes...

Conclusions
There are a lot of habits and small choices everyone can adopt in order to contribute to a more sustainable world and to promote healthy habits. These changes may seem trivial on an individual level, but they add up to millions of resources saved for the planet at a global scale.
31.E. Workshop: Food processing in the modern era: implication for public health
Authors:   Organised by: EUPHA Food and nutrition section, EUPHA Chronic diseases section,   Chair persons: Giuseppe Grosso – EUPHA-FN
Published: October 2020

Abstract
Current scientific evidence and reports from governmental organizations agree that healthy nutrition represents a key factor to prevent death and disability from major nutrition-related chronic diseases. For many years, the essential goal of healthy dietary recommendations included eating nutrient dense foods and limiting consumption of foods high in energy (sugar, starch and/or fat) to maintain a healthy weight. However, the scientific community abandoned the more simplistic approach of energy balance between calorie in and out, shifting into investigation of the whole diet quality as main determinant of health. With development of new technologies and globalization of the markets, the food availability improved worldwide, often in spite of (nutritional) quality and loss of local products production/consumption. As a result, there is an industry-supported wide spread of “non-traditional” foods, including processed foods characterized by various ingredients, added sugars, and additives that are highly influencing consumers' behaviors and, only recently, questioned for their role on general public health. This workshop aims to provide insights on consumption of ultra-processed foods up to the extreme processing of dietary supplements and their use and misuse, emphasizing on their potential impact on traditional dietary patterns.
The objectives of the present workshop are the following: To provide a science-based definition of processed and ultra-processed foods; To explore current evidence of the association between ultra-processed foods and risk of chronic non-communicable diseases and mortality; To explore current evidence of the association between dietary supplements and human health; To discuss whether introduction of non-traditional foods may affect the relation between traditional dietary patterns and health.
Given the novelty of the topic, it is crucial to summarize current evidence from lead experts on this field of research and sharing opinions with the audience in light of the presented results. The conclusions might have crucial implications for potential policy and research outcomes.

Key messages
Uncontrolled consumption of ultra-processed foods and dietary supplements represent a potential threat for general public health. The inclusion of ultra-processed foods into traditional healthy dietary patterns may affect their efficacy in preventing chronic non-communicable diseases.
Ultra-processed/Ultra-formulated foods: association with chronic disease risk
Authors: Touvier M 
Published: October 2020

Abstract
During the past decades, diets have shifted towards an important increase in the degree of food processing and formulation. “Ultra-processed foods” (UPF) now represent more than 50% of energy intakes in several Western countries. In the very last years, an impressive accumulation of evidence from large-scale epidemiological studies linked regular UPF consumption to diverse adverse health outcomes. In this framework, our team of conducted pioneer studies within the prospective e-cohort NutriNet-Santé (n = 170 000) launched in 2009 in France. Dietary intakes were collected using repeated and validated 24-hour dietary records, covering &gt;3,500 food items, which have been categorized using the NOVA classification according to their degree of processing. These analyses highlighted robust significant associations between the consumption of UPF and increased risks of overall and breast cancers, cardiovascular, cerebrovascular, and coronary heart diseases, mortality, type 2-diabetes, overweight, obesity and weight gain, depressive symptoms, and gastro-intestinal disorders. Research perspectives now consist in elucidating the potential mechanisms that underlie these associations. Our team is launching an Europe-funded project built as a combination of epidemiological studies and in-vitro/in-vivo experiments, in order to shed light on individual exposure to food additive 'cocktails' in relation to human health. Meanwhile and even if further studies are needed to better understand the relative contributions of these factors, public health authorities in several countries have recently started to promote unprocessed or minimally processed foods and to recommend limiting the consumption of ultra-processed foods.
Working toward a common HSPA framework
Authors: Figueras J 
Published: October 2020

Abstract
HSPA has been viewed by international organisations, including the WHO, as primarily a country-specific process for which there is no single accepted template. As a result, while HSPA efforts generally agree on the basics, the practice of their application for assessing health systems varies depending on the methodology of a specific approach, capacity to conduct a comprehensive evaluation, as well as on county context.
The UHC2030 Technical Working Group sought to examine the similarities and differences across various tools used to carry out health system assessment to make use of the information they collect in a more harmonised and performance-focussed way. This was done through a rigorous review of existing tools and frameworks, as well as through conceptual work on further development of HSPA process to link health system functions and sub-functions to performance across specific assessment areas, intermediate health system objectives and final goals.
This presentation will provide an overview of the approach taken to harmonise the existing tools, which led to the creation of the HSPA framework for UHC. It will introduce the methodology and the basic analytical framework, and put this work into a wider context of the role of health systems.
Testing the framework in real life – application for country HSPA process
Authors: Lai T 
Published: October 2020

Abstract
The ability to use the existing health system assessment tools, HSPA processes and widely available indicators is an important, although not exhaustive, part of the practical application of the framework. With this in mind, we created an annotated template that can be used along with HSPA framework for UHC to facilitate information collection and harmonisation.
This annotated template was tested for Estonia and Azerbaijan with the aim to help with evaluating the transferability of HSPA information between existing approaches and in different settings. More specifically, we tested the extent to which information on assessment areas of the framework can be extracted from the existing sources; the ease of use and clarity of the annotated template; and how the information collected through the annotated template can be combined into a meaningful health system performance assessment, in line with health system goals.
The test showed that the information for Estonia and Azerbaijan could be obtained to complete much of the template. This can be done through a country-led performance assessment process that ensures that the indicative measures in the annotated template are relevant to the country context. The information collected also needs to be assessed in the context of policy priorities of the national health systems. Thus, more detailed guidance on the use of the framework can help to streamline such national processes and clarify the linkages between performance of specific functions and overall health system performance.
Reliability of studies published as SR/MA on nutrition in cancer prevention - a systematic survey
Authors: Storman D , Bala M M , Koperny M , Zajac J , Tobola P , Swierz M , Staskiewicz W , Gorecka M , Skuza A , Johnston B 
Published: October 2020

Abstract

Background
In several fields of medicine, the quality of studies published as systematic reviews/meta-analyses (SR/MAs) is low. Similar problems may exist for SR/MA on nutrition in cancer prevention. We aimed to assess overall quality and risk of bias (RoB) of studies published as SR/MA on nutritional interventions in cancer prevention with two instruments: AMSTAR 2 ('a measurement tool to assess systematic review 2') and ROBIS ('Risk of Bias in Systematic Reviews') respectively.

Methods
Following a systematic search in 3 databases we included studies identified as SR/MA published between 2010 and 2018 assessing any nutritional interventions in cancer prevention in the general population or among people with cancer risk (Protocol in PROSPERO CRD42019121116). All the steps of study selection and data extraction were done by two independent reviewers with conflicts solved by discussion or by the third reviewer.

Results
We focused on a subsample of 101 SR/MA randomly selected from 737 included SR/MA. Included SR/MA on average searched 2 databases with Medline in 98% and included cohort studies (93%). They focused on specific food (36%), specific nutrients (27%) or beverages (24%, mostly tea and coffee). The assessment using AMSTAR 2 tool indicated that 93% of SR/MA had no pre-specified methodology, in 77% - research questions and inclusion criteria did not include the components of PICO, RoB assessment of primary studies was not used or did not contain all elements (87%) and RoB was not accounted for in the interpretation of the results (75%). Overall, the quality of 97% of studies was assessed as critically low. In the ROBIS tool for 97% of included studies, the overall high risk of bias was detected. The most important methodological flaws in ROBIS were similar to identified in AMSTAR tool.

Conclusions
Poor quality of SR/MA due to flawed methodology may lead to many concerns and mislead public media and consumers.

Key messages
Poor quality of SR/MA due to flawed methodology may lead to many concerns and mislead public media and consumers. The studies published as SR/MAs addressing nutrition for cancer prevention have major flaws, which limit the reliability of their conclusions.