bluuebunny/crossref_metadata_2025_split huggingface dataset:
6.D. Workshop: Climate change, energy issues and air pollution – as a triad of health priorities
Authors:   Organised by: EUPHA Environment and health section,   Chair persons: Peter Van Den Hazel – EUPHA-ENV, Marija Jevtic - EUPHA -ENV
Published: October 2020

Abstract
As well known, climate change changes weather patterns, producing far-reaching effects on the environment, the economy and society as a whole, endangering global livelihoods, health, food and energy security, and water resources.
Climate change, although globally threating to the human population and biocenosis, yet has some positive sides if the unity achieved through the Green Deal (GD) can be named so.
It is difficult to prioritize among many present-day challenges and many health threats. This document strongly confirms the path to be navigated. What is the role of health professionals and what is the possible contribution of public health?
This European Commission document envisages Europe as the first climate-neutral continent while strengthening its economy, taking care of and improving its inhabitants' health. The GD insists on the care for nature and a clear view that no one should be left out and left behind.
This workshop points out that, even we have large regulatory framework on clean air, air pollution in the European Union continues to be the top environmental threat to health, leading to approx. 400,000 early deaths annually and high health costs. Over 20 of the 27 EU countries fail to keep air quality standards, which for key pollutants are already less strict than what the World Health Organization (WHO) recommends.
There were several possible scenarios, out of which two were considered: one based on collaboration and the other, on conflict. Several dimensions were examined to address both cooperation instruments and the consequences of non-cooperation: Energy production (e.g., conventional versus renewable) and use; water resources and food security; the environment (air quality) and the impact on health; Population and migration flow.
The Energy issues in the world demand new innovative ways of providing us with energy. Innovations sometimes go faster than the health sector can study the disadvantages for health. The burden of disease might change due to new forms of energy.
It is important to note that health sector has an opportunity to not only prevent further damage from the air pollution and climate crises, but also to improve health outcomes by decarbonizing, building climate resilience, and amplifying the message around the interdependency between climate change and human health. This workshop will present a framework, co-developed by WHO and Health Care Without Harm, for climate-resilient, sustainable health facilities.

Key messages
The public health sector should consider the GD as an argument for achieving goals at national levels, and align national public health policies with the goals of this document. Achieving goals requires the education process for healthcare professionals covering all of topics of climate change, energy and air pollution to a much greater extent than before.
Food industry influence on public health policy, research and practice in Latin America
Authors: Mialon M , Perez E , Corvalan C , Monteiro C , Jaime P , Baeza Scagliusi F 
Published: October 2020

Abstract
One of the key barriers to the development of public health policies, such as restrictions on marketing of unhealthy foods to children, is the influence of corporations, also known as corporate political activity' (CPA). This project aimed to identify the CPA of the food industry in Brazil, Colombia and Chile, over a 2-year period.
This research consisted of a document analysis of publicly available information triangulated with interviews. It contributed to, and was based on methods developed by INFORMAS (International Network for Food and Obesity / non-communicable Diseases Research, Monitoring and Action Support), which aims to monitor food environments.
In all three countries, the food industry lobbied against public health policies and had direct access to high ranking officials and policy makers. It also shifted the blame away from its products in the obesity and non-communicable diseases epidemic onto individuals and their lack of education. In Brazil, the food industry was active against a new front-of-pack labeling, setting up its own website to promote an alternative model and self-regulation. In Colombia, the food industry captured the media and had strong ties with the government, including through nutrition programmes. Public health advocates felt unsafe when speaking against the industry or its products. In Chile, despite advances with the introduction of public health policies to limit the sales and marketing of unhealthy products, the food industry, including the sweeteners industry, which was not affected by the recent legislation, was still influencing policy, research and practice.
Food industry actors, including local companies and transnationals, used several CPA strategies in Latin America to try and influence public health policy, research and practice. It is urgent that policy makers, academics and other individuals in public health are aware of these practices and equipped with solutions to address undue influence by the food industry

Key messages
In Latin America, the food industry used several CPA practices, which collectively could have a negative influence on public health policy, research and practice. These practices could delay efforts to protect and promote public health in the region.
Media's mixed messages on trans fat and sodium reductions during the policy making process
Authors: James L 
Published: October 2020

Abstract

Background
During the mid-2000's, reductions in the population intake of trans fat and sodium were commitments of the Government of Canada to reduce population risk for chronic disease. During the policy making process, various stakeholders interpreted and applied evidence in a range of ways to suit their interests. Media as a stakeholder has a powerful role in shaping both political will and public opinion.

Methods
A media analysis was conducted from 2004 - 2013 to access how trans fats and sodium reduction was portrayed in the Canadian media. Qualitative thematic analysis captured key subject areas including political ideology, personal responsibility/freedoms, industry tactics, evidence updates/disputes and health harms. Overall tone was assessed to be neutral, opposed or in favour of policy regulation. The number of quotes from key stakeholders contributed to the tone classification. Quantitative assessments compared the tone between trans fat and sodium cases.

Results
Trans fat and sodium were portrayed very differently by the media. Preliminary results show that trans fat was depicted as a harmful industry ingredient, used to extend profits at the expense of public health. On the other hand, communications around sodium research and evidence was not consistent. Media often pitted members of the scientific community against each other and reported on new studies that were outliers to the evidence base.

Conclusions
The media has an important role to play in shaping public perspectives on nutrition issues and related policy development. The media's mixed messages on sodium reduction may have contributed to the lack of political will and government's policy inaction. Public health practitioners and researchers should consider building in knowledge translation strategies into nutrition advocacy campaigns and research releases. Without these important strategies, the media's framing of nutrition issues could be counter-intuitive to public health aims.

Key messages
Media seems to have played a key factor in the the development of both trans fat and sodium reduction policies in Canada. Framing of nutrition research results and advocacy messages should align with public health policy goals.
Public acceptability of a sugar-sweetened beverages tax and its associated factors in the Netherlands
Authors: Eykelenboom M , van Stralen M M , Olthof M R , Renders C M , Steenhuis I H M 
Published: October 2020

Abstract

Background
Public acceptability of a sugar-sweetened beverages (SSBs) tax is important for governments in the decision-making process. Therefore, the aim of the present study was to investigate the level of public acceptability of an SSBs tax and its associated factors.

Methods
Dutch adults representative of the Dutch population for age, sex, educational level and location (n = 500) completed an online self-administered questionnaire. The acceptability of an SSBs tax was measured on a 7-point Likert scale. Associations between acceptability and sociodemographic factors, body mass index, SSB consumption, and beliefs about effectiveness (9 items, e.g. 'An SSBs tax would reduce people's SSB consumption'), appropriateness (7 items), socioeconomic and economic benefit (5 items), implementation (1 item) and trust (3 items) were assessed using multivariable linear regression analyses.

Results
Of the participants, 40% supported and 43% opposed an SSBs tax in general. Moreover, 42% supported (43% opposed) an SSBs tax as a strategy to reduce overweight and 55% supported (32% opposed) an SSBs tax if revenue is used for health initiatives. Participants with a low educational level (B=-0.82;95%CI = [-1.31,-0.32]), overweight (B=-0.49;95%CI = [-0.89,-0.09]), moderate or high SSB consumption (B=-0.86;95%CI = [-1.30,-0.43] and B=-1.01;95%CI = [-1.47,-0.56], respectively) and households with adolescents (B=-0.57;95%CI = [-1.09,-0.05]) reported lower acceptability of an SSBs tax than their counterparts. Beliefs about effectiveness, appropriateness, socioeconomic and economic benefit, implementation and trust were associated with acceptability (P &lt; 0.001).

Conclusions
Public acceptability of an SSBs tax tends to be higher if revenue is used for health initiatives. Sociodemographic factors, body mass index, SSB consumption and several beliefs about effectiveness, appropriateness, socioeconomic and economic benefit, implementation and trust are associated with acceptability.

Key messages
It should be considered to include a recommendation to use revenue for health initiatives in global guidelines for SSBs taxes. Targeting population subgroups with low levels of support might be an effective strategy for communication campaigns.
Forecasting health prior to state pension age – projections for the Netherlands 2040
Authors: van der Noordt M , Polder J J , Plasmans M H D , Hilderink H B M , Deeg D J H , van der Lucht F 
Published: October 2020

Abstract

Objectives
In many Western societies, the state pension age is being raised to stimulate prolonged working. In the Netherlands, the raise of the state pension age is linked to the remaining life expectancy at age 65 with a factor of 2/3rd, and is expected to be 68 years in 2040. It is not yet well understood whether health of the 60+ permits this increase. In this study, health of Dutch adults aged 60 to 68 is forecasted up to 2040.

Methods
Data are from the Dutch Health Interview Survey (HIS) 1990-2017 (N≈280.000) and the Dutch Public Health Monitor (PHM) 2016 (N≈460.000). Health is operationalized using binomial scores of 1) self-rated health and 2) limitations in hearing, seeing or mobility. Categories are: good health (healthy on both items), moderate health (healthy on one item) and poor health (unhealthy on both items). First, based on the HIS, health status in 5-year age categories was modelled up to 2040 using logistic regression analysis in R. Second, the growth factor from 2016 to 2040 was applied to the health level from the PHM 2016.

Results
In 2016, 63% of men aged 60-65 had good health, 25% had moderate health and 12% had poor health. Among women, this distribution was 64%, 22% and 14%, respectively. In 2040, the health distribution among men aged 60-68 is estimated to be 63-71% in good health, 17-28% in moderate health and 9-12% in poor health. Among women this is estimated to be 64-69%, 17-24% and 12-14%, respectively.

Conclusions
Health of Dutch cohorts nearing the state pension age in the future is estimated to remain the same or improve up to 2040. This development in health is not an obstacle to raising the state pension age. However, due to the increasing state pension age and the baby boom generation reaching age 60+ in the coming years, the absolute number of people aged 60+ in poor and moderate health that participates in labor will increase. Policy aiming at sustainable employability will therefore become increasingly important.

Key messages
Health of Dutch cohorts nearing the state pension age is estimated to remain the same or improve in the future. The development in health is not an obstacle to raising the state pension age. Although health is estimated to remain the same or improve, the absolute number of people aged 60+ in poor and moderate health that participate in labor will increase due to an aging population.
Belgian population norms for the EQ-5D-5L, 2013 and 2018
Authors: Van Wilder L , De Smedt D , Beutels P , Cleemput I , Bilcke J , Speybroeck N , Van der Heyden J , Van Oyen H , Charaffedine R , Devleesschauwer B 
Published: October 2020

Abstract

Background
Health-related quality of life outcomes are increasingly used to monitor population health and health inequalities, and to assess the (cost-)effectiveness of health interventions. The EQ-5D-5L has been included in the Belgian Health Interview Survey (BHIS), providing a new source of population-based self-perceived health status information. The aim of this study is to estimate Belgian population norms for the EQ-5D-5L by sex, age, and region, and to analyse its association with educational attainment.

Methods
The BHIS 2013 and 2018 provided EQ-5D-5L data for a nationally representative sample of the Belgian population. The dimension scores and index values were analysed using logistic regression and linear regression, respectively, taking into account the survey design.

Results
The majority of respondents reported problems of pain/discomfort, while over a quarter reported problems of anxiety/depression in both surveys. The average index value was 0.81 in 2013 and decreased significantly to 0.79 in 2018. Women reported more problems on the dimensions, but particularly on anxiety/depression and pain/discomfort, resulting in significantly lower index values. Problems with mobility, self-care, and usual activities showed a sharp increase after the age of 80 years. Consequently, index values decreased significantly by age. Lower education was associated with a higher prevalence of problems for all dimensions except pain/discomfort in 2013 and anxiety/depression in 2018, and with a significantly lower index value.

Conclusions
This paper presents the first nationally representative Belgian population norms using the EQ-5D-5L. Inclusion of the EQ-5D in future surveys will allow monitoring over time of self-reported health, disease burden, and health inequalities.

Key messages
This study is the first to provide Belgian population norms for the EQ-5D-5L and consequently increases the evidence base regarding country-specific population norms. Our results help policy makers in understanding and monitoring the self-perceived health status of the Belgian population according to age, gender, and educational attainment.
Using AI for Mental Health Analysis and Prediction in School Surveys
Authors: Adnan H S , Srsic A , Venticich P M , Townend D M R 
Published: October 2020

Abstract

Background
Childhood and adolescence are critical stages of life for mental health and well-being. Schools are a key setting for mental health promotion and illness prevention. One in five children and adolescents have a mental disorder, about half of mental disorders beginning before the age of 14. Beneficial and explainable artificial intelligence can replace current paper-based and online approaches to school mental health surveys. This can enhance data acquisition, interoperability, data-driven analysis, trust and compliance. This paper presents a model for using chatbots for non-obtrusive data collection and supervised machine learning models for data analysis; and discusses ethical considerations pertaining to the use of these models.

Methods
For data acquisition, the proposed model uses chatbots which interact with students. The conversation log acts as the source of raw data for the machine learning. Pre-processing of the data is automated by filtering for keywords and phrases. Existing survey results, obtained through current paper-based data collection methods, are evaluated by domain experts (health professionals). These can be used to create a test dataset to validate the machine learning models. Supervised learning can then be deployed to classify specific behaviour and mental health patterns.

Results
We present a model that can be used to improve upon current paper-based data collection and manual data analysis methods. An open-source GitHub repository contains necessary tools and components of this model. Privacy is respected through rigorous observance of confidentiality and data protection requirements. Critical reflection on these ethics and law aspects is included in the project.

Conclusions
This model strengthens mental health surveillance in schools. The same tools and components could be applied to other public health data. Future extensions of this model could also incorporate unsupervised learning to find clusters and patterns of unknown effects.

Key messages
This model uses artificial intelligence to improve mental health surveillance and evaluation in school settings. Artificial intelligence can be applied more broadly in public health to harness the potential of predictive models.
Graduate students’ mental health: Exploring experiences of isolation and loneliness
Authors: Kalubi J , Bertrand Y , Dagenais B , Houde R , Marcoux S , Bujold M 
Published: October 2020

Abstract

Background
A student psychological health survey, conducted in 2015-2016 among over 10,000 students at the University of Montreal (UdeM), gives an alarming picture of psychological distress associated to feelings of loneliness. The objective of this phenomenological study is to better understand the experience of isolation from the perspective of UdeM graduate students.

Methods
As part of a qualitative methods course, five semi-directed interviews and a focus group (n = 8) were conducted with graduate students and a psychologist from UdeM. Hybrid thematic analysis of verbatim and inter-rater debriefing were conducted using NVivo 11 software.

Results
Thematic analysis illustrates that most graduate students feel isolated at some point during their studies, but also that the impact and the meaning of this loneliness feeling is variable. It can be perceived positively when it is sought, temporary and/or allows one to be more productive. It can be perceived negatively when it is involuntary, constant over time and/or does not improve academic effectiveness. Personality, academic and social contexts, as well as support by peers and supervisors appear to modify feelings of isolation.

Conclusions
This study demonstrates the importance of context for graduate students' feelings of isolation. Further research is needed to move towards saturation of perspectives around this phenomenon.

Key messages
Graduate students reported that the experience and the repercussions of isolation may differ in whether it is sought or involuntary. Factors that seem to influence the feeling of loneliness include academic context and supervisor support. Further research is needed to discriminate the impact of these different contextual factors.
The reliability of the Study burnout inventory among Medical students
Authors: Todorovic J , Terzic-Supic Z , Divjak J , Kocic S , Radovic S , Ukropina S , Mijatovic-Jovanovic V , Mirkovic M 
Published: October 2020

Abstract

Background
The burnout syndrome is increasingly recognized as the factor compromising the mental health of health-care workers. The demands of higher education were reported to influence the development of burnout syndrome among students. Medical students are a significant population as both future health care workers and students with high academic demands. The burnout among medical students has been studied using different questionnaires. The aim of this study was to assess the psychometric characteristics of the Study Burnout inventory for the assessment of burnout among medical students.

Methods
The cross-sectional study was conducted during December of 2019 among the fifth year Medical students at the five Universities in Serbia (University of Belgrade, Novi Sad, Kragujevac, Nis, and Kosovska Mitrovica). The questionnaire used was the Study Burnout Inventory, nine-item scale, measuring three dimensions of burnout (exhaustion from studying- EXH; cynicism toward the meaningfulness of studying-CYN; the sense of inadequacy as a student-INAD). Answers were given on a six-point Lickert scale. The assessment of psychometric characteristics of the questionnaire was done using the reliability analysis (Cronbach alpha-α) and test-retest reliability (intra-class coefficient-ICC). Sensitivity and specificity were assessed using the Receiver operation curves (ROC) compared to the total burnout assessed by the Copenhagen burnout inventory.

Results
A total of 493 students filled-in the questionnaire. The mean score was 28.95±8.87/54. The Cronbach alpha for the total scale was α = 0.839, for the EXH scale was α = 0.724, for the CYN scale was α = 0.767, and for the INAD scale was α = 0.431. The test-retest reliability was ICC=0.750. The total area under the curve was 0.756 (95% CI: 0.711-0.800).

Conclusions
The Study Burnout Inventory has good reliability and can be used for rapid assessment of burnout among Medical students, as this scale is short and convenient for the participants.

Key messages
The Study burnout inventory has a good reliability as a total scale. This short scale is convenient for the participants and can be used for assessment of burnout.