bluuebunny/crossref_metadata_2025_split huggingface dataset:
8.E. Skills building seminar: Methods for measuring the true health cost of pollution
Authors:   Organised by: BEST-COST, EUPHA-PHMR, -ECO,   Chair persons: Brecht Devleesschauwer (Belgium), Hanna Tolonen (EUPHA-PHMR)
Published: October 2024

Abstract

Healthy environments are essential for physical and mental wellbeing. Air pollution is considered to be one of the most significant environmental risk factors for ill health and premature death within the European Union. Poor air and noise quality have been linked to the exacerbation of symptoms, hospital admissions, and even premature deaths, especially for those with cardiorespiratory diseases. The associated medical costs and productivity losses therefore also impose a large economic cost. Exposure to environmental stressors disproportionately affects socially disadvantaged groups, and therefore contributes to the large socioeconomic inequities in health observed persistently in Europe. The EU has prioritised action on causes of pollution. For example, its Green Deal outlines ambitious plans to address climate challenges such as pollution and align air quality ambitions closer to the World Health Organization guidelines. Likewise, the European Environmental Agency routinely monitors the mortality burden associated with air pollution, while the impact of environmental noise on European citizens is examined through the Environmental Noise Directive. While in the political scene there is interest to advance the reduction of pollution, efforts are hindered by the lack of an harmonized methodology to quantify the socioeconomic cost of environmental stressors. Currently, researchers working with the burden of disease framework face many challenges in its application in the context of environmental stressors. Among others, these challenges include unmet data needs and major lack of transparency in methodological developments. In this skills-building seminar, we will outline an integrated approach for measuring the true health cost of pollution. This approach is currently being trialled in the EU-funded BEST-COST project, which sets out to improve methodologies for understanding the socioeconomic cost of environmental stressors, focusing on air and noise pollution. The project brings together a consortium of 17 partners from Europe and the USA, and is led by Sciensano, the Belgian institute for health. Through a synergy of theoretical outlines and real-life examples, seminar participants will gain methodological insights in the three key components of this integrated approach - i.e., the quantification of the health burden of environmental stressors via comparative risk assessment, the monetization of Disability-Adjusted Life Years to assess economic impact, and the quantification of environmental health inequalities via a novel area-level based framework.

Key messages
• There are significant unmet needs with respect to both data and methodologies for quantifying the socioeconomic cost of environmental stressors.
• We outline an integrated approach for measuring the true health cost of pollution, combining health burden, economic burden, and environmental health inequalities.
The German National Cohort (NAKO): Current state and further follow-up data collection
Authors: Greiser K , Hilger-Kolb J , Bohn B , Palm L , Panreck L , Breunig E , Lieb W , Pischon T , Schikowski T , Völzke H 
Published: October 2024

Abstract
The German National Cohort (NAKO) is a multidisciplinary, population-based cohort study that aims to investigate the development and aetiology of diseases, identify risk factors and enhance early detection and prevention of diseases. Between 2014 and 2019, a total of 205,415 subjects aged 20 -74 years were recruited and examined at 18 study centres across Germany. The baseline assessment included a face-to-face interview, self-administered questionnaires, a wide range of biomedical examinations and the collection of various bio samples. Furthermore, whole-body magnetic resonance imaging (MRI) was performed on 30,861 participants at 5 of the18 study centres. The first re-examination of study participants started in October 2018, and will be completed end of July 2024 aiming for at least 135, 000 participants. Until April 2024 134,428 participants completed their second examination, including 18,707 participants with additional MRI examination. The second re-examination will start in May 2024 and will last until April 2028 aiming to examine at least 85,000 participants for a third time. Besides the examinations at the study centres, participants receive written health questionnaires (GEFUs) 2-3 years after their last examination to get additional information on incident diseases and changes in exposures. The first GEFU questionnaire (GEFU-1) was conducted between October 2017 and May 2023 and was filled in by 171,181 participants. Since the start of GEFU-2 in March 2023 65,624 participants have answered the GEFU-2 questionnaire. Due to the longitudinal design, the large sample size and the broad examination programme, NAKO provides information on determinants of population health and disease. Thus, it is a valuable resource for researchers from different disciplines.
8.H. Scientific session: Coordinated actions to improve our response to Long COVID at EU and national levels
Authors:   Organised by: DG SANTE European Commission, NIVEL (Netherlands), EUPHA-HSR,   Chair persons: Stefan Schreck (Luxembourg), Johan Hansen (EUPHA-HSR)
Published: October 2024

Abstract

The COVID-19 pandemic still has very real and far-reaching consequences for European citizens, healthcare systems and economies. It has been estimated that approximately 10%-20% of people that were infected by SARS-CoV-2, develop Long COVID. Countries within the European Union and elsewhere have been responding to Long COVID in various ways. Some countries initiated a more extensive response to Long COVID, including the creation of multidisciplinary Long COVID clinics. In other counties, Long COVID should be addressed within existing infrastructures within the health care system, which can be hampered by the siloed approach of how services for people with chronic conditions is organised. Moreover, a coordinated and uniform response to Long COVID is complicated by the fact that there is a large variety of terms and definitions of Long COVID and the fact that long COVID symptom are often similar to symptoms of other diseases, thus hampering specific characterisation of patients. While substantial progress has been made in understanding Long COVID we still need more answers about its causes and the most effective treatments. It is also important to understand the impact that Long COVID has on individual lives of those who are being affected - and their families - as well as on societies as a whole. The session aims to take stock of a number of recent insights relating to Long COVID, also with the purpose to identify opportunities for a more coordinated and harmonized approach towards Long COVID at national and international levels. The session will provide room for discussions and engagement with the audience, allowing to help inform future policy agendas. As such, better ways to understand and address Long COVID can also be beneficial for health systems as a whole, given the parallels with how services are provided and policies are set up to address other chronic (non-communicable) diseases.

Key messages
• Long COVID is still poorly understood, in part relating to the complexity of the condition, also having considerable impacts on individuals and societies.
• A more harmonised response can help improve the manners to address it, this to support those still suffering from this long term impact of the COVID-19 pandemic.
Smoke-Free Policies and Cigarette Consumption Impact on Myocardial Infarction Mortality in Europe
Authors: Pastorino R , Sassano M , Mariani M , Boccia S 
Published: October 2024

Abstract

Background
Limited evidence exists on the association between smoke-free policies and per-capita cigarette consumption and mortality due to acute myocardial infarction (AMI) in Europe. Therefore, our study aimed to assess this association and evaluate influencing factors.

Methods
We conducted an interrupted time series analysis involving 27 European Union member states and the UK, examining per-capita cigarette consumption and AMI mortality. A multivariate meta-regression assessed potential influencing factors.

Results
Approximately half of introduced smoke-free policies were associated with level or slope changes, or both, in per-capita cigarette consumption and AMI mortality (17 of 35). Notably, the smoking ban in Poland in 2010 resulted in the most substantial level reduction in cigarette consumption (rate ratio (RR): 0.47; 95% CI: 0.41, 0.53), while the intervention in Bulgaria in 2012 led to the largest level reduction in AMI mortality (RR: 0.38; 95% CI: 0.34, 0.42). More recent policies or those from countries with lower human development indices were linked to greater decreases in cigarette consumption. Furthermore, smoking bans encompassing bars exhibited a stronger inverse association with both cigarette consumption and AMI mortality.

Conclusions
Our findings indicate the effectiveness of smoke-free policies in reducing per-capita cigarette consumption and AMI mortality. Continued monitoring and data collection on tobacco, prevalence, and consumption are crucial for concerted efforts to address its health impacts.

Key messages
• Smoke-free policies lower cigarette consumption, reducing heart attack deaths in Europe.
• Monitoring tobacco data crucial for health efforts: Study shows smoke-free policies save lives.
Sociodemographic, work- and health-factors predict rejection of vocational rehabilitation in Finland
Authors: Louhimo R , Hautamäki H , Airila A 
Published: October 2024

Abstract

Background
Vocational rehabilitation (VR) decreases the number of premature retirements. Pension insurance companies operate private sector employees’ VR in Finland. In 2022, some 15,500 individuals received rehabilitation in this earnings-related pension system. However, the rejection rate was 46%. Similar systems exist throughout OECD. VR facilitates finding suitable work despite an illness. A person is eligible if a threat of disability exists within the next few years and non-medical requirements are met. Currently VR is underused. Thus, it is important to understand which sociodemographic, work- and health-related factors predict a VR rejection.

Methods
We had full application data from a Finnish insurer for 2015-20. Our data cover roughly 40% of the 2.7M person Finnish working population. We excluded applicants with preceding VR and only included under 58-year-old applicants rejected due to ‘no risk for disability’. Our data comprised age, region of residence, salary, doctor’s assessment grades, diagnosis, industry, and data on preceding sickness, unemployment and rehabilitation benefits. For analysis, we used logistic regression.

Results
After adjustment, younger age and mental disorders showed largest effects on rejection. Features associated with a less severe medical condition as well as decreased employment were significantly connected to rejection. Industry and place of residence showed no effect. Of note, stable employment and higher pay predict entry possibly due to more possible rehabilitation options and better health in general. Interestingly, people with multiple diagnoses are more likely to be rejected.

Conclusions
The work-ability of aging European populations could benefit from vocational rehabilitation that better suits mental disorders and younger people.

Key messages
• Vocational rehabilitation (VR) is an underused method to maintain work ability.
• Our study identified groups that could benefit from tailored solutions in VR that decrease barriers to entry.
Innovative approaches to measuring and promoting employee vitality and sustainable employability
Authors: Houkes I , Hazelzet E , De Rijk A , Bosma H , Koep N 
Published: October 2024

Abstract

Background
Employers find it difficult to develop interventions for vitality and sustainable employability (SE), particularly for employees in low-skilled jobs. Measures based on the employee perspective on SE that would give direction to interventions fall short, and effective programs to improve vitality and SE in this group are lacking. This study aims (1) to get insight into the effect and implementation of an innovative organizational, dialogue-based approach ‘Healthy HR’ (HHR)* to promote job control and SE, and (2) to refine and further validate the Maastricht Instrument for SE (MAISE)-Easy (an HHR tool for needs assessment).

Methods
(1) An effect evaluation with a pretest-posttest design with a 1 year follow up (N = 71), and a mixed-methods process evaluation were conducted. Data were collected using questionnaires, interviews with employees and employers (N = 26), focus groups (N = 4) and logbooks. (2) A questionnaire containing the MAISE-Easy-items, proxy variables (health and vitality) and demographics was answered by 1223 employees from 7 organizations. Construct validity, reliability and criterion validity were tested through PCA, CFA, Cronbach’s alpha and correlations.

Results
(1) A higher dose of HHR resulted in better job control and SE (n.s.). HHR had a positive impact on the awareness level of vitality and healthy workplaces of all stakeholders. (2) Reliability, construct and criterion validity of the MAISE-Easy were good, and MAISE-Easy 2.0 was constructed. This tool consists of 8 scales and 20 items divided over 4 areas: (1) Level of SE; (2) Factors affecting my SE; (3) Overall responsibility for SE; and (4) Responsibility for factors affecting my SE.

Conclusions
MAISE-Easy 2.0 is a valuable, valid and reliable tool in HHR which serves as a needs assessment for SE interventions. The innovative participatory approach HHR can improve job control and SE of employees in low-skilled jobs by giving them an active voice.
*doi.org/10.1186/s12889-021-11278-7

Key messages
• Healthy HR (HHR) is an effective, organisational dialogue-based approach (online toolkit) to promote job control, vitality and sustainable employability (SE) of employees in low-skilled jobs.
• MAISE-Easy-2.0 (Maastricht Instrument for SE) is a new and thoroughly validated HHR tool for needs assessment, which measures SE and the responsibility for SE from the employee perspective.
Substance use and risk behaviour patterns among people who inject drugs
Authors: Jakubauskiene M , Pridotkiene E , Rasimaite B 
Published: October 2024

Abstract

Background
Substance use and injecting drug use in particular are related to health damages, reduced quality of life and life expectancy. Injecting drug use is a risk factor for acquiring infectious diseases among people who inject drugs (PWID). The aim of the study was to assess the risk behavior related to the use of intravenous psychoactive substances among PWID in Lithuania.

Methods
In 2023 a cross sectional study using respondent driven sampling (RDS) of active intravenous drug users (n = 370) was conducted in 5 different sites across Lithuania. RDS is a sampling methodology based on peer-referral in underserved populations that cannot be sampled randomly. Descriptive statistical and regression analyses were conducted using SPSS 23.0.

Results
78% of the sample were males, 22% - females. Age mean is 40.6 years, SD-7.7. The first injecting drug was used at the age of 18 (mode). 69% of PWID received drug dependance treatment at least once in life. 70% of the PWID in harm reduction services are also in the substitution therapy programmes. Fentanyl is the main substance for every second respondent which is injected 3 times a day and commonly used with alcohol (64%). 79% of PWID during the last injection used sterile needles and syringes. 45% of respondents reported overdosing during the last 12 months and half of all PWID had naloxone for death prevention. Nearly 70% were tested for TB and syphilis during the last 12 months.

Conclusions
PWID are mainly males who began injecting drugs at 18 years. Unsafe injecting behaviour (frequency and mode), using alcohol were related to lower participation in health care services for PWID.

Main messages
• Lower participation in health care services is related to behavioural risk factors.
• Ongoing research is needed to assess the factors determining engagement into healthcare of PWID.
Transferability of vaccination interventions from a community perspective: One size does not fit all
Authors: Schloemer T , Hecht H , Papaevgeniou N , Karnaki P , de Zeuw J , Ganczak M , Filakovska Bobakova D , Horstman K 
Published: October 2024

Abstract

Background
Removing health system barriers to childhood vaccination is an urgent matter in the migrant community in Greece, the Turkish and Moroccan communities in the Netherlands, the Ukrainian minority in Poland, and the marginalized Roma community in Slovakia. The objective of this study was to select and adapt potentially transferable evidence-based interventions for HPV and MMR vaccine uptake in partnership with the underserved communities.

Methods
Using a participatory approach, we assessed transferability of six pre-selected interventions with the Population, Intervention, Environment and Transfer (PIET-T) models: All countries investigated two interventions with trained community members to support vaccination as health promoters. Greece and the Netherlands included a school-based vaccination program. The Netherlands added two interventions addressing providers’ HPV vaccine communication, and Slovakia a multilevel intervention.

Results
We identified barriers and facilitators for successful intervention transfer in each of the target contexts. The transferability analysis showed that an intervention with health promoters is potentially transferable with adaptations in all countries. Principles of trust in the educator, tailored and trustworthy information, help in navigating the health system for vaccination and easy access at no cost are transferable key elements in all contexts. Adaptations refer to the intervention elements that need to be tailored to specific contextual needs. School-based vaccination was nowhere transferable. Health provider training needs to be culturally sensitive and adapted to the Dutch system. The multilevel intervention in Slovakia is not fully transferable.

Conclusions
Participatory transferability analysis was essential for decision-making and intervention adaptation. All countries independently selected a health promoter intervention as having potential to remove the identified health system barriers in the respective context.
Skills and competences of sexuality educators. Evidences from a qualitative research in Italy
Authors: Ubbiali M , Mortari L , Paparatto G 
Published: October 2024

Abstract

Background
The scientific literature recognizes the strategic role of educators in sexuality education projects in schools. If, however, there is often a discussion about the most effective professional figure (teachers, school experts or external experts), there is a little attention to the skills and competences that an educator should possess and to which he or she must be trained. Adopting a Comprehensive Sexuality Education (CSE) approach, which is evaluated as the most effective, it is necessary to consider a skill set for educators that should not be limited to the knowledge in the area of sexual health promotion and risk prevention.

Methods
In order to build evidence-based competencies and skills, a qualitative study was conducted. A total of 72 educators involved in school-based CSE interventions in 4 Italian Regions, in 24 middle and secondary schools (68 classes), during 2 consecutive school years were enrolled. Before, during, and after the activities in the classrooms, qualitative feedback was collected, through reflective journals written by educators themselves. These data were analyzed through a qualitative approach, according to the principles of empirical phenomenology.

Results
The phenomenological evidences confirm the need to overcome the conception of educator as instructor equipped only with knowledge in the field of sexual health. It is considered fundamental to possess and develop pedagogical competences and skills, such as: caring attitude, teaching skills, theoretical awareness, capacity to manage the unexpected. Moreover, educators reported the necessity of an initial and continuous training on these dimensions considered as the most challenging.

Conclusions
The research confirms the complexity of the competency profile of CSE educators. Therefore, their professional development should include tailored designed multi-disciplinary training programs, with particular attention to the pedagogical dimension.

Key messages
• Comprehensive sexuality education requires an adequate professional figure intended not as an instructor aimed only at risk prevention and health promotion, but as a real caring educator.
• Pedagogical skills and competences should be included in the training processes for sex educator, through adequate activities.
Individual fluidity of sexual identity in Stockholm County, 2010 to 2021
Authors: Zhang G , Tynelius P , Mathur M B , Brandén G , Liljeros F , Kosidou K 
Published: October 2024

Abstract

Background
Sexual fluidity is key to understanding the size of sexual minority populations and analyzing the socioeconomic disparities these populations face. This study explores the stability and changes in sexual identity over time, and identifies key demographic factors that predict shifts in sexual identity.

Methods
We analyzed longitudinal data from the Stockholm Public Health Cohort, following 36,398 participants from 2010 to 2021. Sexual identity was measured using a self-administered questionnaire in 2010, 2014, and 2021. Demographic data from 2010 were collected from the Swedish national registers. Multivariate Poisson regression with robust variance estimators was used to identify demographic factors that predicted identity changes. Results were presented as proportion or risk ratio (RR) with 95% confidence interval (CI).

Results
Overall, 12.1% (95% CI 11.8%-12.5%) changed sexual identity at least once in 2010-2021, including 10.4% (10.0%-10.7%) among those initially identifying as heterosexual in 2010, 41.3% (37.1%-45.6%) as homosexual, 59.6% (55.0%-64.0%) as bisexual, and 65.0% (59.4%-70.3%) as uncertain. Multivariate analyses showed that sexual minorities (homosexual: RR 5.00, 95% CI 4.45-5.61; bisexual: 6.68, 6.04-7.38; uncertain: 3.88, 3.30-4.55), females (1.28, 1.21-1.35), younger (18-29 years: 1.49, 1.30-1.70) and older ( &gt; =60 years: 2.07, 1.92-2.22) ages, born outside Sweden (Europe: 1.21, 1.11-1.32; Outside Europe: 2.90, 2.62-3.21), and lower education ( &lt; =9 years: 2.14, 1.98-2.31; 10-12 years: 1.43, 1.34-1.53) and income (100 SEK/year) ( &lt; =2,500: 1.83, 1.66-2.02; (2,500, 3,500]: 1.32, 1.19-1.46) independently predicted a higher probability of identity changes.

Conclusions
This study provides the first insights into sexual identity fluidity in a large general population sample in Sweden, highlighting its fluid nature. Future research is needed to unravel the intricate mechanisms underlying the demographic disparities in sexual identity fluidity.

Key messages
• This study provides the first insights into sexual identity fluidity in Sweden, highlighting its fluid nature.
• Future research is needed to unravel the intricate mechanisms underlying the demographic disparities in sexual identity fluidity.