bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the COVID-19 related knowledge and its association with perceived worries of COVID-19 infection and severe illness among higher education students in 26 countries: A cross-sectional study
Authors: Berhe N , Van De Velde S , Van Hal G 
Published: October 2021

Abstract

Background
During COVID-19, various public health measures such as physical distancing and distance learning are being implemented. As a consequence, higher education (HE) students face social as well as mental trauma at a crucial developmental stage in their lives. Having inadequate COVID-19 related knowledge can lead to an exaggerated worrying as well as to negative COVID-19 outcomes. Our study aims to assess COVID-19 related knowledge and its association with perceived worries among HE students.

Methods
Between April 27 & July 7, 2020, a cross sectional survey, called COVID-19 International Students Well-being Study (C19 ISWS) was conducted in HE institutions in 26 countries. A stratified convenience sampling technique was used to select HE institutions. An online questionnaire was distributed to HE students to investigate behaviour and mental well-being. Descriptive, bivariate and mixed effect logistic regression analysis were conducted using R software. Perceived worries of COVID-19 infection as well as of severe COVID-19 illness (outcome measures) were studied.

Results
Over 127,000 students from more than 100 HE institutions in 26 countries filled out the questionnaire. 97,495 (76.5%) respondents have never acquired COVID-19 (our study population). 70,365 (72.1%) of these respondents were female. The most frequent correct response to COVID-19 related knowledge questions among respondents was observed about having the virus without having symptoms (94.3%). The odds of being worried of contracting severe COVID-19 illness among respondents with poor knowledge is 1.15 (95%CI:1.11,1.18).

Conclusions
COVID related knowledge was independently associated with perceived worries of contracting severe COVID-19 illness. We recommend scaling up of awareness creation campaigns to increase the comprehensive and timely COVID-19 related knowledge in order to tackle exaggerated perceived worries of severe COVID-19 illness among HE students.
Sustainable dietetic models in Europe: the Mediterranean diet as case study
Authors: Scazzina F 
Published: October 2021

Abstract
More than five years since the global commitment to the 2030 Agenda for Sustainable Development, 690 million people lack sufficient food and economic projections suggest that the COVID-19 pandemic may add an additional 83 to 132 million people to the ranks of the undernourished. Meanwhile, 1.3 billion tons of food are wasted globally each year, utilizing 38% of total energy consumption in the global food system. Child and adult overweight and obesity are increasing in almost all countries, and on a global level the cost of a healthy diet is 60% higher than the cost of a nutrient adequate diet, and almost 5 times the cost of an energy sufficient diet. The Mediterranean Diet is one of the recognized models of healthy and sustainable diets. This model has proven to promote longevity and well-being, not only by considering specific food items and dietary patterns, but also taking into account the culture and the history of populations living in that region, as well as social aspects such as tradition and conviviality. Moreover, it is strongly tied to a gastronomic background that links health with enjoyment. This may be extremely important for the implementation of feasible programs for the prevention of chronic non communicable diseases. In fact, long lasting lifestyle changes are difficult to achieve and, although health motivations may lead to satisfactory dietary compliance in the short term, pleasure remains an important determinant of any dietary change that is intended to last. While keeping traditional dietary habits at European level, the main principles of the Mediterranean diet could be taken into account to identify key features that ensure both health benefits and sustainable impact on environment. Assessing the sustainability of these products can be an effective operational approach for preserving and promoting a Mediterranean-type dietary pattern in the European region.
Preparing the public health workforce for digital health futures: the case for digital Health training & capacity building
Authors: Wong B , Buttigieg S , Vital Brito D 
Published: October 2021

Abstract
Digital technologies are rapidly being integrated into a wide range of health fields, public health in particular. While ‘digital health' has the potential to significantly improve population health and well-being outcomes, its effective implementation and responsible use are contingent on building a public health workforce with a sufficient level of knowledge and skills to effectively navigate the digital transformations in health. In particular, the next generation of public health professionals-namely youth-must be adequately prepared to maximise the potential of these digital transformations. This presentation will highlight three key priority areas which should be prioritised in digital health education in public health to fully harness the potential benefits of digital health: capacity building, opportunities for youth, and an ethics-driven approach. It will also present applications of digital health (technologies) and best practices for public health education.
Exploring gendered practices by social position in epidemiology: the gender score applied to Germany
Authors: Wandschneider L , Sauzet O , Razum O , Miani C 
Published: October 2021

Abstract

Background
Gender as a relational concept is rarely taken into account in epidemiology, yet an in-depth reflection on gender conceptualisation and operationalisation can advance gender analysis in quantitative health research, allowing for more valid evidence to support public health interventions. We constructed a context-specific gender score to assess how its discriminatory power differed in sub-groups defined by social positions investigated in intersectional analyses, i.e. sex/gender, race, class, age and sexual orientation.

Methods
We created a gender score based on gendered social practices on a masculinity-femininity continuum (ranging from 0-1) using data of the German Socioeconomic Panel. With density plots, we exploratively compared distributions of gendered social practices and their variation across social groups.

Results
We included 13 gender-related variables to define a gender score in our sample (n = 20,767). Variables on family and household structures presented with the highest weight for the gender score. Calculating tertiles, the score ranged between 0.01 and 0.68, 0.69 and 0.93 and 0.94 to 1 in women and 0 and 0.18, 0.19 and 0.40 and 0.41 to 1 in men, showing that the distribution for women is more skewed than for men. Comparing social groups, we saw that young individuals, those without children, not living with a partner or currently living in a same-sex/gender partnership, showed more overlap between feminine/masculine social practices among men and women.

Conclusions
Our explorative findings showed that the distribution of gendered social practices differed among social groups, which empirically backed up the theoretical notion of gender being a context-specific construct. Economic participation and household structures remain essential drivers of heterogeneity in practices among women and men in most social positions. Concerted efforts must continue to overcome these gender (in)equalities - which are important determinants of health inequalities.

Key messages
Family and household structures are crucial to constructing the gender score, indicating that interpersonal relationships are key determinants of gendered social practices. Including gendered practices in representative health monitoring data could allow for differentiation of biological sex and socially constructed gendered practices that drive health inequalities.
Intersectional inequalities in physical and mental health by sex, gender and immigration in Germany
Authors: Wandschneider L , Miani C , Razum O 
Published: October 2021

Abstract

Background
The mapping of migration-related health inequalities remains challenging, since immigrant populations constitute a heterogenous socially constructed group whose health experiences differ by social determinants of health. In spite of the increasing awareness that population mobility and its effects on health are highly gendered, an explicit gender perspective in epidemiology is often lacking or limited.

Methods
To map health inequalities in Germany at the intersection of sex, gender and immigration status, we used data from the German Socioeconomic Panel (SOEP) and applied an intercategorical intersectional approach conducting multilevel linear regression models. We differentiated between sex (male/female) as reported in the survey and gendered social practices, quantified through a gender score (femininity-masculinity continuum).

Results
We included 20,897 participants in our analyses. We saw an intersectional gradient for physical and mental health. Compared to the reference group, i.e. non-immigrant men with masculine gendered practices, physical and mental health steadily decreased in the intersectional groups that did not embody one or more of these social positions. The highest decreases in health were observed in the intersectional group of immigrant women with feminine gendered practices for physical health (-1.54 CI -2.41;-0.79) and among non-immigrant women with feminine practices for mental health (-2.71 CI -3.19;-2.14).

Conclusions
We saw differentiated patterns of physical and mental health along the intersectional axes of sex, gender and immigration status, both for physical and mental health. These findings highlight the relevance of these intersections in describing population health statuses and emphasise the need to take them into account when designing public health policies aiming at effectively reducing health inequalities.

Key messages
Being a man and having masculine gendered practices were associated with higher mental and physical health scores, for both immigrants and non-immigrants. Adopting an intersectional perspective, which takes into account social positions (e.g. gender, immigration status) and their impact on health inequalities, can help to target public health policies.
Socioeconomic inequalities in COVID-19 DALYs in Scotland, 2020
Authors: Wyper GMA , Fletcher E , Grant I , McCartney G , Harding O , de Haro Moro MT , Stockton DL 
Published: October 2021

Abstract

Aim
Our aim was to estimate the overall, and inequalities in the, population health impact of COVID-19 in Scotland, measured by disability-adjusted life years (DALYs) in 2020.

Methods
National deaths and daily case data were input into the consensus model outlined by the European Burden of Disease Network, to estimate DALYs. Total Years of Life Lost (YLL) were estimated, and for each deprivation quintile of the Scottish population. Years Lived with Disability (2% of all DALYs) were proportionately distributed to deprivation quintiles, based on YLL estimates. Socioeconomic inequalities were measured by the Relative Index of Inequality (RII), Slope Index of Inequality (SII), and attributable DALYs were estimated by using the least deprived quintile as a reference. Results were presented as a range, using a sensitivity based on YLL estimates using: cause-specific; and COVID-19 related deaths.

Results
COVID-19 DALYs ranged from 96,500 to 108,200 in 2020, representing the second leading cause of disease/injury in Scotland, in 2020. Marked socioeconomic inequalities were observed across several measures. The difference between the most and least deprived areas, measured by SII, was 2,048 to 2,289 DALYs per 100,000. The RII was 1.16, meaning that the rate in the most deprived areas was around 58% higher than the mean rate of the population. DALYs attributable to differences in socioeconomic status accounted for 40% of total COVID-19 DALYs.

Conclusions
The direct population health impact of COVID-19 in 2020 was substantial. Despite unprecedented mitigation efforts, in Scotland, a single case in early 2020 developed to having an impact second only to ischaemic heart disease. This impact was not shared equally, and socioeconomically deprived areas were hit hardest, a result confirmed across all measures of inequality. DALY estimation on both the ongoing direct, and indirect, pandemic harms will evidence the extent of impact on overall, and inequalities in, population health.

Key messages
The population impact of COVID-19 has been highly damaging. When measured by DALYs, the population health impact of COVID-19 in Scotland, during 2020, was second only to ischaemic heart disease. The population health impact of COVID-19 has not been shared equally, a result confirmed across all measures of socioeconomic inequality.
Are children at schools registered to The Daily Mile™ more physically active?
Authors: Venkatraman T , Honeyford K , van Sluijs EMF , Costelloe C , Saxena S 
Published: October 2021

Abstract

Background
The Daily Mile (TDM) is among the most popular school-based running programmes recommended globally by governments and the WHO to meet the shortfalls in children's physical activity. In England, it has been adopted by 1 in 5 primary schools. However, its impact on children's physical activity has not been assessed at scale. We aimed to compare a)minutes (mins) of moderate to vigorous physical activity (MVPA) in and outside school hours and b)meeting physical activity guidelines in primary school children in England, comparing those in schools registered with TDM with those that were not.

Methods
This was a cross-sectional study. We used self-reported data of 49,561 English primary school children(5-11 years) from the Active Lives Children and Young People Survey and TDM registration data of their school. We compared mins of MVPA in and outside school hours between children in TDM-registered and non-registered schools using a multilevel zero-inflated negative binomial model; and the differences in the likelihood of meeting physical activity guidelines based on TDM registration with a multilevel logistic regression model. All models included a random effect for school and adjusted for potential confounders.

Results
Children attending TDM-registered schools reported an extra 36 mins of MVPA a week overall, including 10 additional mins (95%CI:3,16) MVPA/week during school hours and 26 additional (95%CI:4,44) mins MVPA/week outside school hours. Children in TDM-registered schools were 6% more likely to meet physical activity guidelines compared to those who were not(RR:1.06 (95%CI:1.02,1.11)).

Conclusions
Children in primary schools registered to TDM report more physical activity that is not compensated for outside school hours. However, the absolute differences fall considerably short of international guidelines across the whole child population. Therefore, a whole school and systems-based approach is required, embedding school-based running programmes.

Key messages
Children in schools registered to TDM report more MVPA overall, inside, and outside school hours; suggesting no compensation of activity in those who are registered. TDM is a potential solution to increase children’s physical activity during the school day.
Global health from home - results from a German student-led online lecture series during COVID-19
Authors: Gepp S , Gök S , Jung L , Kreitlow A , Machleid F , Nordmann K , Weber L 
Published: October 2021

Abstract

Background
The COVID-19 pandemic calls for a skilled health workforce, yet global health is largely missing in the medical curriculum in Germany. The interdisciplinary national student “Global Health Network” therefore initiated an online lecture series. “Global Health - perspectives, opportunities and challenges” included 14 lectures on a range of topics held by German and international academics from October 2020 to January 2021.

Methods
Evaluations were performed prior to, at midterm and after the series, including 5-point likert scales and open questions. Using quantitative and qualitative approaches, participants' motivation and learning outcomes of global health education were analysed.

Results
A total of 1393 students registered for the series. Individual lectures attracted on average 400 participants, mainly female medical students between 20-25 years, but also a variety of ages, genders and disciplines. Main reasons for participation included interest in COVID-19-related developments, learning about global health-specific topics, and professional development. More than 40% of participants reported to know little about global health before attending; after the lecture series, only 10% made this statement. In addition, 90% of participants perceived an increase of motivation to learn more about the topics, while about 40% gained motivation to become practically involved in the field. The lecture series was accredited in the curriculum at some universities, thus innovating the curriculum and enabling formal credits.

Conclusions
The new model of student-led online teaching proved to be feasible and demonstrated students' interest and positive impact on global health knowledge. Further institutional change and inclusion of global health in the curricula have to follow.

Key messages
Students need global health education to respond to global health-related challenges. Volunteer student-led initiatives can increase knowledge and interest and be an important driver for change towards improving global health education.
Evaluation of the impact of the European Code against Cancer on awareness and attitudes towards cancer prevention at the population and health promoters’ levels
Authors: Ritchie D 
Published: October 2021

Abstract

Introduction
The European Code against Cancer (ECAC) informs the public on steps to take to reduce their cancer risk. Despite over three decades of promotion, no systematic evaluation of its impact has yet been carried out. This study aimed to address the gap in knowledge regarding the impact of the ECAC.

Methods
An online survey targeting adults in the general population was conducted and analysed by age, gender, and country, both descriptive and mutually adjusted in logistic regression analyses. Additionally, semi-structured interviews with health promotion professionals from not-for-profit organisations in Europe were conducted and a qualitative thematic analysis was carried out for each interview.

Results
8171 people from eight European countries responded to the survey. Although 70 % of respondents were aware of cancer prevention guidance, a low percentage of participants had previously heard about the ECAC (2% in UK to 21 % in Hungary and Poland). Females were more likely to make lifestyle changes to reduce their risk of cancer (odds ratio = 1.17; 95 % confidence interval: 1.05-1.29). Twenty-eight online semi-structured interviews with professionals were conducted covering 25 countries. Regional variation in the methods and target groups of the promotion and dissemination of the ECAC was reported.

Conclusions
Whilst familiarity with the ECAC in the general public is low, professionals frequently use it as a basis for informing population-level actions. Future editions should be accompanied by a systematic evaluation of the ECAC investigating the impact upon society.
Better communication with migrant communities during COVID-19 pandemic:a portuguese experience
Authors: Neto J , Carvalho C , Letras S 
Published: October 2021

Abstract

Odemira, in the southeast litoral of Portugal, has 33% of migrant citizens, mostly from Southeast Asia, going up to 50% counting transient citizens. Most of them do not speak English, making communication with health services difficult. They tend to live in overcrowded houses with unsanitary conditions. With the emergence of the COVID-19 pandemic, all the above resulted in high incidence and ineffective contact tracing (CT), testing and isolation by the public health teams. It was essential to develop strategies to manage and control outbreaks, and also to achieve health equity. Our experience can be useful for other countries in dealing with their multicultural communities. This intervention started in march 2020 and is still ongoing. The aims were to improve the accuracy of epidemiological surveys (ES) and CT, to more easily stop transmission, to develop the communication skills of health professionals and to improve migrant's healthcare access. For this, the focus was on digital written communication tools (Whatsapp, translation apps). It was created a toolkit to guide ES and CT tailored to the migrant population, with tips and best practices, and used translated information materials about preventive COVID-19 measures. Workshops were led with health professionals. It was stablished work with local NGOs, creating social media campaigns during crucial events (Holi holliday). As results. it was achieved a better ES output, more accurate CT and better transmission control, with noticeable differences between march 2020 and now. The relationship with this community improved, having better access to services and their needs met. Health professionals reported being more at ease dealing with these patients. Our experience shows it's possible to communicate effectively despite language and cultural barriers, that cultural knowledge is important in advancing public health goals and that multidisciplinary and intersectoral work is essential to effective interventions.

Key messages
This intervention allowed us to achieve a better output of epidemiological surveys, more accurate contact tracing and were more effective in breaking transmission chains and controlling outbreaks. It was achieved a better understanding and relationship with this community, with better ability to respond to their needs and promoting their access to healthcare.