bluuebunny/crossref_metadata_2025_split huggingface dataset:
National implementation of telehealth in Denmark: A case study
Authors: Bollerup S , Jensen L G , Jacobsen C B , Nielsen C P 
Published: October 2024

Abstract

Background
With a growing number of chronic patients and a shortage of healthcare professionals, modern health systems face mounting economic pressures. Telehealth has emerged as a promising solution to address these challenges and is considered a critical component of future healthcare provision. However, implementing telehealth on a large scale is complex and challenging. To fully grasp these challenges, it is essential to look beyond the technology and delve into the processes and actors involved in its implementation. Actors on a political-administrative level are pivotal in large-scale implementation, yet this level remains understudied. Thus, this study investigates the dynamics of large-scale implementation at a political-administrative level through a case study of the national implementation of TeleCOPD in Denmark - a home-monitoring intervention targeting patients with Chronic Obstructive Pulmonary Disease (COPD).

Methods
An in-depth qualitative study of the implementation process at the political-administrative level was undertaken. Data consisted of comprehensive documentary material, including policy documents and meeting minutes and 12 semi-structured interviews with 16 key stakeholders across all levels of the implementation process. Data was analysed in accordance with thematic analysis using an abductive strategy.

Results
The analysis shows that large-scale implementation of telehealth is a profoundly complex process, necessitating the collaboration of various stakeholders across organisational hierarchies. Substantial translational work is required at the political-administrative level to implement telehealth across diverse organisational contexts. Moreover, understanding the role of context in this translation process is essential.

Conclusions
This study generates valuable knowledge about large-scale implementation of telemedicine in addition to insights into the role of the political-administrative level in the implementation process.

Key messages
• Implementing telehealth nationally involves intricate translation processes at multiple levels.
• Balancing local adjustments with degrees of fidelity is crucial in large-scale implementation.
Inferring diagnoses from prescription data: a machine-learning approach
Authors: Pinto A S , Perfeito L , Miranda T , Mesquita S , Pereira N , Gonçalves-Sá J 
Published: October 2024

Abstract

Estimating disease prevalence is a fundamental while challenging public-health goal: in the absence of solid diagnostic data, it typically requires expensive and time intensive studies. Analyzing existing medical records is an alternative, complementary approach. In particular, prescription records offer a glimpse into the health status of populations, prescribing patterns, and operational dynamics. We asked whether these could be used to infer diagnostics and, therefore, estimate disease prevalence. We used the Portuguese electronic medical prescriptions dataset (ADD NUMBERS) and trained a machine learning model that captures the probability that specific drugs are prescribed for the same or related medical conditions. We 1) constructed a manually-curated dataset of diseases and associated medications; 2) used this dataset to train embeddings models; 3) tested these models against human-classified data; 4) used the trained/tested model to uncover comorbidities associated with a) antibiotic prescription (to validate the model), and b) the impact of COVID-19 in prescription patterns of chronic-diseases. The model was able to accurately identify drugs used for targeting ten specific diseases, with few false positives and false negatives. Our analysis showed that the COVID-19 pandemic had almost no effect on the number of prescriptions for some chronic diseases (such as diabetes and depression), but, importantly, had a strong impact on the number of new diagnoses, with new users of diabetes medication in 2019 dropping by more than 16.8% in 2020. Medical prescriptions offer a promising tool to quickly assess disease prevalence, underdiagnosis, and allow a broad overview of the medical status of the population, especially in the face of health emergencies that strongly pressure the medical system.

Key messages
• We propose a new approach to infer diagnostics from prescription data with several promising applications.
• We propose a new approach to infer diagnostics from prescription data with several promising applications.
What works in global health partnerships? Reflections on a Nigerian-German project collaboration
Authors: Okoroafor C , Haderer F , Terpase Dooga J , Zocher U , Okafor O , Okwor T 
Published: October 2024

Abstract

Background
Global health partnerships for project implementation is a frequent way to address health challenges. Bringing stakeholders from different disciplines, professions, settings and countries together provides opportunity to look at health challenges from different perspectives, develop suitable ideas to tackle them and leverage diverse capacities.

Problem
In such diverse partnerships, cultural norms, practical realities and institutional practices create challenges for the development of good and equitable relationships.

Methods
In our project collaboration between the Nigerian Centre for Disease Control and Prevention and the German Robert Koch Institute on developing and implementing trainings in infection prevention and control, we demonstrated how a partnership can function. The collaboration followed a participatory approach and was informed by the following principles: - Plan, revise, adapt and implement all project activities as well as its contents participatorily; - A well-coordinated teamwork is key to facilitate operational performance; - Consider everyone as expert in its own domain of influence; - Constant and inclusive communication: maintaining transparency on all aspects and steps both in contents and organization and applying non-violent communication and active listening; - Provide space for reflection on roles and functions and for open discussion on needs and misunderstandings; - Appreciate team work as constantly evolving process of interaction and learning.

Results
We built a strong resilient team and could leverage team diversity to deliver on project objectives with exceptional quality, adaptability in a highly complex and frequently changing implementation setting.

Lessons
Working across cultures, disciplines, professions and countries means to develop a joint communication language and an understanding of the other. It is challenging and dynamic, requires additional space/time and attention, but offers personal growth and self-realization.

Key messages
• Using a participatory approach in teams can leverage team diversity to deliver on project objectives and bring about a high professional and personal self-realization.
• There are concrete implementable ways of teamwork in international interdisciplinary global health collaborations that enhance quality of results in complex implementation settings.
A monitoring framework for reinforcing policies against antimicrobial resistance in Europe
Authors: Dates M , Davies M 
Published: October 2024

Abstract

In an attempt to overcome barriers to the effective implementation of policies against antimicrobial resistance (AMR) in the EU Member States, Norway and Iceland, One Health national action plans (NAPs) need to show improvements in both their formulation and their implementation. Research conducted by Tetra Tech, funded by the EU4Health Programme, has identified shortcomings to One Health national policies across all countries, such as limited political focus and awareness of the challenges brought by AMR; lack of operational plans for delivering on the NAPs; and lack of harmonised indicators and inadequate information systems for monitoring the implementation of plans. On this last issue, subsequent reseach by Tetra Tech has supported the design and development of monitoring indicators for reinforcing the expected improvements of NAPs and the implementation of policies aimed at EU Member States in the 2023 “Council Recommendation on stepping up EU actions to combat antimicrobial resistance in a One Health approach”. While drawing on existing data sources at EU and global level, the study has also worked with Member States representatives in identifying indicators for the monitoring framework and proposed new data collection activities at the national level.

Key messages
• EU countries face common barriers to the effective implementation of One health policies against AMR, and need to reinforce their national action plans.
• Stepping up the fight against AMR in the EU requires a strong monitoring framework for following up on EU recommendations.
2.Q. Skills building seminar: Publishing and disseminating your research: How to get published, and what then?
Authors:   Organised by: EUPHA,   Chair persons: Monica Brînzac (EUPHAnxt)
Published: October 2024

Abstract

Getting your public health research published can be a real challenge, and the publishing process is not always clear. Often it takes a lot of time, effort and perseverance. In this skills building workshop, participants will be able to learn the ropes from the Editor-in-Chief and the Publisher (OUP) of the European Journal of Public Health (EJPH), EUPHA’s scientific Journal. The EJPH is a well-established multidisciplinary, Open Access journal that covers a broad scope of public health topics. It’s current impact factor is 4.4. The workshop will have the format of an interactive clinic and will start with short presentations by the Editor-in-Chief of the EJPH and the Publisher on how to write, how to disseminate your findings, and tools the publisher has for helping promote your research for the best impact. The Editor-in-Chief will focus on what makes manuscripts attractive to editors and reviewers, while the publisher will give an overview of the publishing process, important aspects of the wider publishing industry (including how to publish your work Open Access) and give authors tips of how to promote their articles post-publication. After that, there will be ample time for participants to ask their questions to the panellists. This skills-building workshop will be of interest to anyone who would like to increase their chances of getting published and who would like to learn more about creating impact with their publications. The session should in particular be helpful for young researchers who do not have a lot of publishing experience yet.

Key messages
• Think about relevance to public health, and what your research adds to science and policy.
• Think about what tools you can use to disseminate your findings.

Speakers/Panelists
Peter Allebeck
Karolinska Institute, Department of Global Public Health, Stockholm, Sweden
Rachel Moriarty
Oxford University Press, Oxford, UK
Developing an infodemic management toolkit for immunization: An iterative consultation process
Authors: White B , Menning L , Orbina J R , Abeyesekera S , Purnat T , Von Harbou K , Emiroglu N , Varaidzo Machiri S , Yau B 
Published: October 2024

Abstract

Issue
An infodemic is an overwhelming amount of information, accurate and otherwise, that accompanies health emergencies such as outbreaks and other health crises. Infodemic management work is done by people from different positions and professions, with differing resources at their disposal, and applied to a range of health issues. An infodemic insights report can help identify questions, concerns, information voids and circulating mis- disinformation to help inform an emergency response. Health issue specific guidance can be useful for those who may have infodemic management as part of their regular work but want to identify infodemic insights and contextualize these insights in relation to other programme data.

Description
The WHO and UNICEF ‘how to build an infodemic insights report in 6 steps’ document provides general guidance. A more immunization specific document, with practical and specific tools in standalone short focus areas was developed to guide infodemic managers or those working on vaccine demand and acceptance, and by vaccination field workers. The toolkit is intended for vaccines across the life course, including for children, adolescents, pregnant people, adults, and people with pre-existing conditions or have other vulnerabilities.

Results
Rounds of iteration with experts both internal and external to WHO provided useful feedback, review and suggestions. The toolkit provides information targeted at different resource and capacity levels.

Lessons
The consultative process resulted in a toolkit informed by experts and those who are likely end-users of the document. The consultations sought to align the toolkit with immunization programme processes and with other tools and interventions for improving vaccine uptake. Having health issue specific guidance is a useful addition to the infodemic manager toolbox and tools such as these can be an important component of community resilience and health security initiatives.

Key messages
• For immunization, infodemic management can support programme activities to build vaccine confidence and improve uptake, and manage vaccine-related events.
• Expert informed guidance on health topic specific areas can be a useful addition to the infodemic manager toolbox.
Temporal Analysis of Sanitation and Water Development Indicators in Tunisia: 2012-2023
Authors: Fitouri S , Harizi C , Ayedi Y , Skhiri A , Besbes K , Fakhfakh R 
Published: October 2024

Abstract

Background
Access to sanitation and water resources is a cornerstone of the ‘One Health’ approach, which encompasses the holistic integration of human, animal and environmental health considerations. We aimed to elucidate the temporal trajectory of sanitation and water resource development in Tunisia across successive years.

Methods
Data from the Multiple Indicator Cluster Survey in Tunisia, a UNICEF-conducted repeated cross-sectional survey, was used to compare trends in access to improved water sources, utilization of improved sanitation facilities, and handwashing practices across 2012, 2018, and 2023.

Results
In 2023, we observed that 20.9% of households did not have access to drinking water on site, compared with 12.7% in 2018 (p = 0.15). The availability of drinking water in sufficient quantity was 69.8% in 2023 and 80.6% in 2018 (p = 0.37). In 2023, 78.1% of the population had access to an improved water source, compared with 86.3% in 2018 and 95.7% in 2012 (p = 0.4), 80% in urban areas and 73% in rural areas (p = 0.57). In 2023, 12.5% of the population consumed water from sources contaminated with Escherichia coli, compared with 20.5% in 2018 (p = 0.16). Disparities in Escherichia coli detection were observed between rural (21%) and urban (8.3%) areas (p = 0.01). In 2023, 92.1% of households had access to handwashing facilities equipped with soap and water, compared with 89.9% in 2018 and 91.5% in 2012 (p = 0.98). The breakdown between urban and rural areas was 95.1% and 86.4% respectively (p = 0.51).

Conclusions
Access to improved water sources, sanitation, and handwashing practices remains high over time, but regional disparities persist. Improved water quality directly reduces the transmission of waterborne pathogens, emphasizing the need to address regional disparities and socio-economic inequalities to promote public health nationwide.

Key messages
• Challenges persist in tunisia regarding sanitation and access to water.
• Regional disparities threaten public health.
Health literacy of pregnant women in Hungary
Authors: Molnárné Grestyák A , Ratkó T , Barabás Á , Takács P , Jávorné Erdei R 
Published: October 2024

Abstract

Health literacy determines our state of health and through this our quality of life. The health behavior of women of reproductive age should be treated with priority, since the lifestyle of pregnant women shows a correlation with the occurrence of premature birth and intrauterine development, and also between fetal development and the occurrence of chronic diseases in adulthood. The aim of our research is to explore the factors influencing the health behavior of pregnant women, to analyze regional differences, and to identify the causes of regional differences and inequalities. During a prospective, cross-sectional study, the health behavior of pregnant women living in Hungary was assessed using a questionnaire. In the course of our research, we examined health literacy using two measuring instruments, the Chew questionnaire and The Newest Vital Sign test. A total of 2,000 questionnaires were distributed of which 1,655 evaluable questionnaires were returned, the willingness to answer was 75%. The most people considered their own health to be good or very good (59.7%). 59.5% of the respondents changed their health behavior because of their pregnancy, mainly for the sake of the health of the fetus. 18.1% of pregnant women most likely have insufficient, 15.0% probably limited and 48.1% most likely have adequate functional health literacy. Age, education, place of residence and financial situation of pregnant women show a significant correlation with health literacy. Our results confirmed that sociodemographic factors, especially age and education, significantly influence the health literacy, perceived health status and health behavior of pregnant women. The two health literacy questionnaires we use can be combined well with each other and complement each other. The results greatly contribute to the development of health literacy, and thus to the development of individual and community-level strategies for improving health behavior in the field of pregnant women’s care.

Key messages
• Health literacy of pregnant women in Hungary.
• Health literacy in health promotion.
Impact of spilanthol supplementation with balance training on neuromuscular performance
Authors: Mishra K G , Patnaik N , Pradhan N R 
Published: October 2024

Abstract

Background
Age-related reductions in muscle mass, muscle contraction power, force, and coordination contribute to an elevated risk of falls and associated consequences. Research suggests that the enhancement of neuromuscular function is attainable through a regimen of targeted exercises and the strategic inclusion of certain supplements like spilanthol. This randomized controlled trial investigated the effect of resistance exercise with either spilanthol plus coordination/ balance training (BAL) or BAL-alone on neuromuscular function (countermovement jump, multiple one-leg hopping, and sit-to-stand test).

Materials and methods
In the course of this study, a cohort of 68 healthy male participants, aged 40 to 50 years, completed a rigorous 6-month intervention, from the initial 75 recruits. In the spilanthol-plus-BAL group, participants engaged in 30 minutes of resistance exercise sessions four times a week, complemented by daily supplementation of 17.5 mg of spilanthol.

Results
The analysis of the results showed significant improvements in the spilanthol-plus-BAL group, particularly evident in the peak countermovement power (p &lt; 0.01). The mean effect size for this parameter was a + 1.5[0.9 to 2.1] W/kg greater change in spilanthol-plus-BAL group than BAL-alone group after six months. Moreover, multiple one-leg hopping performance showed significant enhancement in the spilanthol-plus-BAL group post-intervention. The parameters of sit-to-stand duration (1.04 s vs. 1.95 s; p = 0.03) and average acceleration (1.54 g vs. 1.06 g; p = 0.04) both exhibited substantial improvements in the spilanthol-plus-BAL group compared to the BAL-alone group.

Conclusions
The findings of this investigation contribute empirical evidence supporting the proposition that spilanthol supplementation, when integrated with BAL training, can exert a more pronounced impact on select facets of neuromuscular function.

Key messages
• Spilanthol supplementation with balance training can exert a pronounced impact on neuromuscular function.
• Spilanthol supplementation with balance training demonstrates potential in mitigating sarcopenia and other degenerative conditions.
The association between trajectories of structural disadvantage and mental wellbeing for Māori youth
Authors: Neumann D , Paine S J , Yao E 
Published: October 2024

Abstract

Background
Youth mental health is a major global concern with substantial inequities for Indigenous and other young people from minoritised ethnic groups. In New Zealand, Māori, the Indigenous people, experience poorer mental health than other young people, especially those living in high deprivation. Cultural connectedness is related to positive mental wellbeing, however, its potential to buffer against the harms of structural disadvantage for young Māori mental health has not been investigated.

Methods
We used data from 1224 Māori young people in the longitudinal Growing Up in New Zealand study. Structural disadvantage measures included material hardship, deprivation, employment, residential mobility. We conducted Latent Class Analysis and Social Sequence Analysis to identify clusters and longitudinal patterns of structural disadvantage. Cultural connectedness and mental wellbeing (depression & anxiety symptoms, quality of life) were measured at age 12. Linear regression analysis was used to determine associations between structural disadvantage, cultural connectedness and mental health.

Results
We identified 3 trajectories of structural disadvantage for Māori youth: 21% experienced persistent high structural disadvantage, 35% intermittent high structural disadvantage and 44% persistent relatively low structural disadvantage. Few differences in mental health were found between groups. Cultural connectedness was independently associated with positive mental wellbeing, yet there was mixed evidence it might buffer the impacts of structural disadvantage on mental health.

Conclusions
Our results highlight the importance of policies that uphold Indigenous rights to health and address structural disadvantage as a persistent threat to Indigenous wellbeing. Our findings call for holistic, early-life, family-centred strategies and to reduce barriers to accessing support. We highlight the need for policies that enable young people to flourish in their identity and culture.

Key messages
• Many Māori young people experience pervasive structural disadvantage starting before they are born, persisting throughout childhood and adolescence which is an omnipresent threat to their wellbeing.
• Supporting cultural connectedness for Indigenous youth is important but cannot substitute for policies addressing structural disadvantages that contribute to health inequities.