bluuebunny/crossref_metadata_2025_split huggingface dataset:
Digital health literacy in schools: empirically navigating novel data from students and teachers
Authors: Okan O , Renninger D , Stauch L , Dadaczynski K 
Published: October 2024

Abstract
With the introduction of the Digital Competence Framework (DigComp+) by the European Commission, European schools have committed to promoting digital and media literacy systematically. DigComp+ shares several intersections with health literacy, e.g., information management, using digital tools, and taking action on the digital and commercial determinants of health, making it an ideal curriculum to teach digital health literacy in schools. However, internationally, not much is known about digital health literacy in schools. The aim of this study is to present data from a representative school study of students and teachers in 16 federal states in Germany. Data was collected using an online survey from a representative sample of N = 1,448 students (9-18 years) and a convenient sample of N = 1,600 teachers. With SPSS, descriptive statistics, chi-square tests, and internal consistency were calculated. Cronbach’s alpha indicated good internal consistency for both tools. Low digital health literacy was reported by 52,9 of students and ∼39,3% of teachers. In students, low digital health literacy linked with younger age (X2 (2)=34.69, p = &lt;.001), family affluence (X2 (4)=24.16, p = &lt;.001), and parental education (X2 (2)=8.26, p=.016). In teachers, it was linked to age (p &lt; .048), school position (p &lt; .001), and their own digital health literacy DHL (p &lt; .001). More than 45% of teachers reported not teaching digital health literacy in schools, while on average, 55% of students indicated they would not learn it in schools. Based on the first digital health literacy in schools study, results suggest DigComp+ is almost not used to teach digital health literacy and both students and teachers have significant deficits in their digital health literacy. Teachers should be trained in digital health literacy so that they can include it in their classroom teachings to promote the digital health literacy of students.
9.D. Practice session: Luton, a Marmot town – Lessons from using a whole-system approach to tackle health equity
Authors:   Organised by: Luton Borough Council (UK),   Chair persons: Laura Austin-Croft (UK), Jessica Allen (UK)
Published: October 2024

Abstract

Objective
To share learnings from our Health Equity Town journey, including opportunities and challenges. To allow stimulating discussion on whole system approaches to health inequalities and the social determinants of health. To include discussion on where and how public health influences or leads, the importance of impact measures, and of shared vision.

Added value
Luton’s 2040 strategy, and being a health equity town, are long term visions. It has been 18 months since we launched Luton’s health equity ambition, and during that time we have taken great strides forward in how we deliver against the Marmot principles and create a movement around health equity in Luton. Organisations nationally and internationally are grappling with approaches to doing this. This workshop will provide an opportunity to discuss some of the key learnings, challenges and opportunities so far in taking this approach, and how to continue to maintain momentum and buy in across sectors at local level.
The workshop will include discussion on the following: 1. Taking a whole-system approach to health inequalities - working across system leaders and strategic partners including health, care, voluntary sector, businesses, housing, police and others, as well as across the local authority departments. This takes clear articulation of the problem and actions, as well as clarity on where public health professionals are most effective to support, influence, and lead. 2. There is increasing recognition of the building blocks of health and the importance of ensuring action to improve health outcomes is taken across the whole system to tackle health inequalities - including employment, education, and housing. Discussion on specific actions being taken in some of these areas to tackle health inequalities as part of the health equity town approach. 3. Working with the community to understand health inequalities. 4. How we will measure progress. 5. The concept of proportionate universalism is now well known, however making this a reality is a challenge. 6. East London Foundation Trust, the mental health provider in Luton, is also embedding Marmot Policy objectives across the Trust, and is a key partner in Luton. Work is underway to establish projects with joint aims such as skills passport to increase employment in mental health service users.

Format
Presentation followed by opportunity for question and answer and discussion with panel.

Key messages
• Whole system approaches to tackling health equity are possible through shared vision and coordinated approach.
• Action across the building blocks of health is vital, the complex and long term nature is challenging.
Changes in opinions on health insurance benefits deservingness in the Netherlands between 2013-2023
Authors: Meijer M A , Brabers AEM , De Jong J D 
Published: October 2024

Abstract

Background
In many European countries, including the Netherlands, the healthcare system is financed according to the principles of solidarity. Although people are generally highly supportive of collectively financed healthcare services, some groups are considered more deserving of health insurance benefits than others. Increasing knowledge of the health risks of certain lifestyle choices and pressure on healthcare systems may result in changing opinions on the allocation of resources. Our study looks into changes in citizen’s opinions on the deservingness of different groups between 2013 and 2023.

Methods
Questionnaires were sent out to samples of 1.500 members of the Dutch Health Care Consumer Panel in 2013, 2015, 2017, 2019, 2021, and 2023. Response rates varied between 42% (2015) and 56% (2021). Deservingness was studied by asking respondents about their opinions on the amount of health insurance premium for different, opposing groups, for example older and younger people and those with a healthy and unhealthy lifestyle (group A should pay more, both groups should pay the same amount, or group B should pay more). Multinominal logistic regression models were used to examine changes in deservingness opinions over time.

Results
Our study showed year-to-year fluctuations in opinions on the premium amount for health insurance for different, opposing groups. However, no distinct increases or decreases were observed over the whole time period. This applies to both the general population and to people who do and do not belong to the different groups.

Conclusions
Although there are differences in the degree to which groups are considered deserving of health insurance benefits, deservingness opinions were found to be fairly stable in the Netherlands between 2013 and 2023. Our results do not point to increasing support for premium differentiation based on personal characteristics. This suggests that support for solidarity in healthcare financing is not in decline.

Key messages
• Opinions on the deservingness of health insurance benefits of different groups were found to be fairly stable in the Netherlands between 2013 and 2023.
• No evidence of increasing support for premium differentiation based on personal characteristics was found.
Work resumption and economic independence among women with paid employment one year after childbirth
Authors: Bertens LCM , Mohabier KSC , van der Meer L , Waelput AJM , Burdorf A , Steegers EAP 
Published: October 2024

Abstract

Background
In Europe, women are more likely to be unemployed compared to men. Also, they more often hold part-time employment. After pregnancy and childbirth, women often reduce their working hours further or even exit the workforce altogether. This not only impacts their individual career, financial stability, and economic independence, but also their own health and well-being and that of their offspring.

Objectives
We aim to study the patterns of women’s work resumption in the first year after childbirth, and if sick leave during pregnancy and birth outcomes small for gestational age (SGA) and preterm birth play a role in this. Data from Statistics Netherlands and the Dutch Perinatal Registry from 114,722 Dutch pregnant women in paid employment (2016) were used for the analyses. Next to descriptive analyses, multivariate regression was used to assess which factors contribute to economic independence one year after childbirth.

Results
After pregnancy, over 50% of women reduced their working hours, and 12% became unemployed. The largest reduction was found in the group working fulltime (from 31 to 11%), in contrast, the group working 20-25 hours per week increased from 19 to 28% one year after childbirth. Among the women with sick leave during pregnancy (11%), the decrease in working hours was more pronounced and almost 40% of them became unemployed. The percentage of women being economically independent changed from 88% at the onset of pregnancy to 78% one year after childbirth. Next to employment factors (working hours and contract type), migration background and lower education were associated with lower odds of economic independence. Moreover, sick leave during pregnancy and having a SGA baby also reduced the odds of economic independence.

Conclusions
After pregnancy, women tend to work less than before, or even exit the workforce, with considerable impact on their economic independence. This is even more pronounced in the group with sick leave during pregnancy.

Key messages
• Despite paid maternity leave, pregnancy and childbirth negatively impact work force participation in women.
• The need for sick leave during pregnancy is predictive of reduced work resumption and economic independence one year after pregnancy.
Sickness absence due to mental and somatic diagnoses by occupational class in Finland, 2011–2021
Authors: Blomgren J , Perhoniemi R 
Published: October 2024

Abstract

Background
Sickness absence (SA) due to mental disorders has strongly increased in Finland during recent years while sickness absence due to somatic diagnoses has continued to decrease. Research is lacking on recent trends in SA by occupational class, especially during years of increasing mental disorders. The aim of the study is to analyze these trends during 2011-2021.

Methods
National register data from the Social Insurance Institution of Finland (Kela), Statistics Finland and Finnish Centre for Pensions were linked for all employed Finns aged 25-64 for years 2011-2021 (yearly N about 2 million). SA was measured by sickness allowance, compensated by Kela after 10 days of absence. Age-standardized yearly prevalences of SA due to different diagnoses were calculated for women and men in four occupational classes over 2011-2021. Logistic regression was used to assess differences between occupational classes adjusted for age, marital status, education and region of residence.

Results
SA due to mental disorders has greatly increased in all occupational classes in Finland after year 2016 among both women and men, while SA due to musculoskeletal and other somatic diagnoses has continued to decrease. Increase in SA due to mental disorders has been largest among lower non-manual employees, especially among women, whereby also overall SA prevalence among female lower non-manual employees has reached the level of manual workers. Men show broadly similar trends but manual workers still have the highest overall SA prevalence. Relative adjusted differences between occupational classes decreased slightly between 2011 and 2021.

Conclusions
Clear occupational class differences persisted in diagnosis-specific SA throughout 2011-2021. However, the magnitude and order of the class differences changed along with increasing SA due to mental disorders. Occupational class differences should be taken into account when aiming to prevent further increases in SA due to mental disorders.

Key messages
• Sickness absence (SA) due to mental disorders has increased in all occupational classes in Finland after year 2016, while SA due to somatic diagnoses has continued to decrease.
• Increase in SA due to mental disorders has changed the overall occupational class differences in SA in Finland largely because the increase has been strongest among lower non-manual employees.
Ultra-processed food consumption and risk of coronary heart diseases: UK Whitehall II cohort study
Authors: Wang M E , LIewellyn C , Kastoulis M , Britton A 
Published: October 2024

Abstract

In recent decades, ultra-processed foods (UPFs) intake has increased drastically, sparking concerns about their potential impact on cardiometabolic diseases. However, large-scale cohort studies tracking UPF consumption at multiple time points remain limited. This study explores the prospective association between repeated measures of UPF intake and the risk of coronary heart disease (CHD), along with its secondary endpoints, within the UK Whitehall II study. The analytical sample tracked 7,138 midlife British participants without CHD from baseline. UPF consumption was measured using validated food frequency questionnaire (127 items) and classified by the NOVA system during three phases: 1991/1994 (phase 3), 1997/1999 (phase 5), and 2002/2003 (phase 7). This study assessed the onset of CHD and its secondary endpoints, including CHD and all-cause mortality, through medical exams and hospital records up to 2016 and 2021, respectively. Cox proportional hazards regression models adjusted for socio-demographics, lifestyle factors and total energy intake were used to explore the prospective association between cumulative average UPF intake (in quintiles) and CHD outcomes. During a median follow-up of 13 and 19 years, 589 cases and 1,314 deaths were documented. In multivariable adjusted cox models, the highest UPF consumption quintile versus the lowest quintile was associated with higher CHD incidence [HR:1.26; 95% Confidence Interval (CI): 1.02-1.55; p = 0.03]. Additional adjustment of total energy intake increased the CHD risk by 28% [HR:1.28; 95% CI: 1.03-1.58; p = 0.02]. No significant relationships were found between cumulative average UPF intake and CHD or all-cause mortality. In UK midlife adults, higher UPF intake is prospective associated with increased CHD risk. Although additional research is warranted, these findings emphasize the importance of public awareness and food policy interventions to reduce UPF intake for alleviating the population burden of CVD.

Key messages
• Our study suggests the need for increased efforts to implement population wide strategies on regulating food processing, such as taxation and front of package warning labelling of UPF.
• Our study emphasizes UPF’s role in cardiovascular prevention, highlighting the need for nutrition counseling on UPF consumption for those at risk of CVD.
Eating jetlag and risk of cardiovascular disease: prospective study of the NutriNet-Santé cohort
Authors: Le Folcalvez X , Obeid E , Palomar-Cros A , Bellicha A , Péneau S , Deschasaux-Tanguy M , Touvier M , Andreeva V A , Jacobi D , Srour B 
Published: October 2024

Abstract

Background
Social jetlag corresponds to the misalignment between biological circadian rhythms and the social rhythm imposed by society, resulting in discrepant activity/sleep schedules during work and free days. It has been associated with worsened biological parameters such as BMI or glycemic control. Eating jetlag is a related yet emerging concept defined as the difference of meal timing between free and work days. However, it has been little explored. This study aims to evaluate the association between eating jetlag and the risk of cardiovascular disease (CVD).

Methods
Dietary, anthropometric, socio-demographic and health data of 104,837 participants (79% women, mean age=42.7 years (14.6 SD)) were collected from the NutriNet-Santé cohort. Eating jetlag was calculated using time of first and last meals on weekdays and weekends, from repeated 24 dietary records, averaged during the 2 first years. It was assessed as a continuous variable or as 3 categories: ‘Advance’, ‘Maintenance’, ‘Delay’, compared to work days. CVD was self-reported and validated against medical records. The associations between eating jetlag and CVD risk were assessed through adjusted Cox models.

Results
During a median follow-up time of 8.1 years, 2,368 CVD cases were diagnosed. Eating jetlag showed a U-shaped association with CVD risk (HR Advance vs. Maintenance=1.05(95% CI: 0.87-1.26); HR Delay vs. Maintenance=1.08(0.96-1.21)). When the absolute value of eating jetlag was considered, there was a linear association with CVD risk (HR per 1-hour increase=1.05(1.00-1.12)). These linear trends were confirmed in categorial models (Low: ≤1h; Moderate: 1h&lt; to ≤ 2h; High: &gt;2h): HR Moderate vs. Low=1.05(0.94-1.18), and HR High vs. Low=1.13(0.94-1.37); however, statistical significance was not reached.

Conclusions
Our results suggest a potential role for meal timing regularity between free and work days in CVD etiology. They need to be replicated in other studies and mechanisms are yet to be fully understood.

Key messages
• Adopting regular meal timing schemes on work and free days could be associated with a lower risk of cardiovascular diseases.
• Meal regularity between work and free days could play a role in cardiovascular health and should be further investigated.
Temporal trends 1990-2020 in youth suicide: a global analysis based on the WHO Mortality Database
Authors: Bertuccio P , Amerio A , Grande E , La Vecchia C , Aguglia A , Berardelli I , Serafini G , Amore M , Pompili M , Odone A 
Published: October 2024

Abstract

Suicide is a serious but preventable public health issue globally, with substantial geographical disparities. Although mortality from suicide is higher in older age groups, it ranks as the fourth leading cause of death among youth. This study analysed global suicide trends for the age group 10-24, from 1990 to 2020. Using data on certified deaths from suicide (codes ICD-9: E950-959; ICD-10: X60-X84, Y87.0) and population from the WHO mortality database for 52 countries with valid data, age-standardised suicide rates (ASR) were computed (by sex, country, and calendar year) and joinpoint regression analyses were carried out to identify significant changes in trends. High variability in suicide rates and trends was observed, with male-to-female ratios ranging from two to five. From 1990 to 2020, most European countries reported declining suicide trends, with some exceptions. Particularly concerning trends emerged in the United Kingdom, with increases of 2.5% per year among males since 2005 and 8.5% among females since 2012. Southern Europe exhibited the most favourable trends and lowest suicide rates, with 3.1/100,000 males in Italy (2020) and 3.5/100,000 males in Spain (2021), and 0.9/100,000 females in Italy (2020) and 1.1/100,000 females in Romania (2019) among females. Conversely, Central-Eastern Europe showed the highest rates, with 10.2/100,000 males in the Russian Federation (2019) and 10.0/100,000 males in Poland (2002). Non-European areas reported higher suicide rates and significant increases. The highest ASR was 15.5/100,000 males in the United States of America, with an increase of 3.8% per year among males from 2009 to 2020 and 6.7% among females from 2007 to 2017, followed by a levelling off. Youth suicide rates and trends vary widely globally. Interpretation of temporal and geographical comparisons in suicide mortality should be approached cautiously due to potential misclassification or under-reporting of suicide deaths in some countries.

Key messages
• Albeit data on suicide mortality should be interpreted with caution, the study reveals high variability in suicide rates and trends among youths aged 10-24 across different countries worldwide.
• Timely and accurate monitoring of epidemiological trends should support the planning, implementation, and evaluation of setting-specific health promotion strategies in mental health.
Empowering youths through citizen science to address health inequalities in adolescence
Authors: Arevalo Lourdes Cantarero 
Published: October 2024

Abstract
Citizen Science (CS) stands as a beacon of hope in the fight against inequalities in adolescent health, revolutionizing scientific research by involving individuals from diverse backgrounds. Unlike traditional methods, CS transcends academic boundaries, fostering inclusivity and collaboration irrespective of age, nationality, or social status. This approach has gained momentum in adolescent health research, empowering young people as co-researchers from project inception, thereby reducing disparities in health knowledge and access. Studies demonstrate its efficacy in enhancing empowerment and health literacy among participants. YouthChronic is an example of how CS can mitigate health inequalities among adolescents. The project ensures active participation in every research stage by engaging adolescents with chronic conditions as citizen scientists. Open-ended questions facilitate detailed responses, while participation in analysis and dissemination enhances their research involvement and sense of ownership. Through initiatives like YouthChronic, CS is reshaping the research landscape, making it more relevant and impactful to bridge the inequality gap. Young Citizen Scientists’ views on their participation: “As part of YouthChronic, we felt like our experiences with chronic conditions were finally being heard. The researchers were cool-they listened to us, let us be flexible with our participation, and even taught us some research skills. Learning from other peers’ experiences made us feel less alone and gave us new insights. But it’s frustrating that we’re limited by resources. We have big ideas, like running an advocacy campaign, but we need funding to make them happen”. In conclusion, by actively involving adolescents in the scientific process through CS initiatives like YouthChronic, we can reduce inequalities in adolescent health, empower marginalized voices, and pave the way for a brighter, more inclusive future in scientific exploration and discovery.