bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between gender inequality and climate adaptation across the global
Authors: Pinho-Gomes A C , Woodward M 
Published: October 2024

Abstract

Introduction
Climate change has a disproportionate impact on women in comparison to men and women have a key role to play in climate adaptation. However, evidence is lacking on how gender inequalities may be associated with climate vulnerability and ability to respond at country level.

Methods
This ecological study investigated the association between climate adaptation, measured by the Notre Dame Global Adaptation Initiative Country Index (ND-GAIN), and gender inequality, measured by the Global Gender Gap Index (GGGI) developed by the World Economic Forum and the Gender Inequality Index (GII) developed by the United Nations. Simple linear regression was used to estimate the associations between the indices and their subdomains for 146 countries.

Results
There was an approximately linear association between the GGGI and climate adaptation. Each 1% increase in gender equality was associated with a 0.6% increase in the ND-GAIN score (slope 0.59, 95% confidence interval [0.33 to 0.84]). This was driven by a negative association between gender equality and vulnerability (-0.41 [-0.62 to -0.20]), and a positive association between gender equality and readiness (0.77 [0.44 to 1.10]). Gender equality in the education domain of the GGGI had the strongest association with climate adaptation. There was a strong negative linear association between the GII and climate adaptation, which explained most (87%) of the between-country variation in climate adaptation. Each 1% increase in gender inequality was associated with a 0.5% decrease in the ND-GAIN score (-0.53 [-0.57 to -0.50]). The association between gender inequality and readiness was stronger than the association with vulnerability (0.40 [0.37 to 0.44] for vulnerability versus -0.67 [-0.72 to -0.61] for readiness).

Conclusions
Gender inequality measured broadly across different domains of life is associated with climate adaptation at country level, both in terms of vulnerability to impact and readiness to respond.

Key messages
• Gender inequality, considered broadly across multiple domains of life, is associated with increased vulnerability to climate change and poor readiness to respond.
• Addressing gender inequality needs to be a priority for governments and inter-governmental organisations if populations worldwide are to adapt to climate change.
Development of a heat mortality surveillance approach for England
Authors: Lo E , Thompson R 
Published: October 2024

Abstract

Background
England’s unprecedented temperatures in 2022 and 2023 highlighted the severe risks of rising global temperatures on public health. This study considers the impact of heatwave events on mortality rates, supporting the development of improved health surveillance and intervention strategies.

Methods
Firstly, heat-associated mortality for each heat episode was estimated by comparing observed daily mortality values with the expected baseline of daily deaths. Secondly, the historic temperature-mortality relationship was established at national and regional levels using a distributed lag non-linear model with temperature and mortality data from the previous 5 years. Finally, modelled estimates of heat-associated excess mortality were generated based on the historic temperature-mortality relationships, to assess any difference between observed and modelled estimates.

Results
In 2022 which saw record-breaking maximum temperatures in the UK, an estimated 2,985 (2,258-3,712) heat-associated deaths were recorded across five heat episodes, the highest annual count to date. Despite relatively cool temperatures, 2023 saw the third-highest heat-associated mortality since reporting began in 2016 of 2,295 (1,681-2,910). Comparisons between modelled and observed mortality were generally similar, but showed statistically significant discrepancies for certain heat episodes across the two summers.

Conclusions
Heatwaves have a rapid and clear impact on health, emphasising the need for effective early warning systems and interventions. The comparison of observed mortality with predictions from historic temperature-mortality relationships at regional level demonstrates the need for a nuanced approach to surveillance and health protection for adverse heat, with factors other than temperature also playing a critical role in health impacts. This will inform continuous improvements in England’s impact-based Heat Health Alerting system.

Key messages
• Heatwaves pose a significant risk to public health, as evidenced by the unprecedented excess deaths during the record-breaking temperatures in England in Summer 2022.
• Comparison of observed mortality with predictions from historic data can provide insight into contextual factors modulating the health impacts of heat, and inform future surveillance and response.
Preparing health students for climate change: the impact of an innovative ‘Plan Health Faire’ course
Authors: Guihenneuc J , Boissinot L , Cambien G , Gueritault M , Fritel E , Le Gonidec P , Migeot V , Ayraud-Thevenot S 
Published: October 2024

Abstract

Introduction
Recent studies highlighted the need for climate change (CC) training in universities, especially for health students. In France, a collaborative teaching program, “Plan Health Faire” (PHF), addresses this need. This study aimed to assess PHF’s impact on health students’ reactions, knowledge, and behaviour.

Methods
A cross-sectional study was carried out among all second-year health students enrolled in Medicine, Pharmacy, Odontology, and Maieutics at the University of Poitiers in September 2022. During a mandatory seminar, all students took part in the innovative and scientific PHF teaching program which aims to raise awareness of the challenges of CC as applied to healthcare. Two structured questionnaires based on the Kirkpatrick evaluation model were administered before and after the course. Using a comparative statistical analysis, the changes in students’ knowledge were assessed.

Results
In all, 294 students took part in the study, and 97.4% were satisfied or very satisfied with PHF. An average score of 8.6/10 was given to the collaborative dynamics of the training. In terms of changes in their level of knowledge and their perception of these changes, 98.3% of students felt that they had learned new knowledge about CC and healthcare. A comparative analysis of the answers to the knowledge questions showed that students’ level of knowledge is indeed significantly higher at the end of the course (p&lt;0.0001). Finally, 94% of students expressed their probable or certain intention to integrate these issues into their future professional practice.

Conclusions
These results indicate that the PHF training program has a significant impact on health students, particularly in terms of satisfaction and knowledge. PHF could be an interesting way to teach health students about the challenges of CC in healthcare. PHF is currently tested in other French Universities and health care facilities.

Key messages
• Plan Health Faire is an innovative and collaborative educational program aimed at raising awareness among healthcare stakeholders about the challenges of climate change.
• Plan Health Faire is an effective program for raising awareness among health students about climate change and is also an interesting lever for integrating climate change into their future practice.
1.G. Scientific session: Forecasting dietary habits trends, human and planetary health
Authors:   Organised by: EUPHA-FN, -CHR, WHO/Europe Special Initiative for NCDs and Innovation,   Chair persons: Saverio Stranges (EUPHA-CHR), Mary Rose Sweeney (Ireland)
Published: October 2024

Abstract

Extensive research has elucidated that dietary factors are pivotal in influencing both human health and the ecological stability of the planet. Suboptimal dietary patterns are implicated in over 10 million annual fatalities attributable to non-communicable diseases. Concurrently, the agricultural sector, a major component of food production, contributes significantly to environmental degradation. This sector is responsible for more than a quarter of global greenhouse gas emissions and utilizes approximately 50% of the planet’s habitable land. Moreover, it accounts for over 70% of global freshwater consumption and is a primary contributor to marine ecosystem disruption through nutrient runoff leading to ocean eutrophication. Despite these critical linkages, current global trends related to dietary practices show little alignment with the improvements needed to achieve the Sustainable Development Goals set for 2030. The existing policy framework and interventions lag considerably in addressing these concerns. Historical and ongoing discussions have repeatedly highlighted these issues, yet the allocation of resources necessary to counteract the pervasive influence of industry-driven marketing promoting less healthful dietary choices remains markedly inadequate. There is an urgent need to intensify dialogues and enhance the conceptual framework regarding the role of diet in sustaining global health and environmental integrity among public health professionals. Such measures are crucial for facilitating a shift towards more sustainable and health-promoting dietary habits globally. The EUPHA Food and Nutrition Section, the Chronic Diseases Section, in collaboration with the World Health Organization (WHO) Regional Office for Europe, aim to propose a joint workshop to share innovative research and activities held in the context of diet and environment. The workshop aims to provide new findings and stimulate the debate about the projections for the future of human and planetary health.

Key messages
• Human health and environmental preservation require an adaptation of dietary habits globally: are we going in the right direction?
• Current evidence suggests that there is an wide area of intervention to improve actual dietary habits, reduce the environmental impact, and improve human health.
Foresight diet quality: current trends and future problems
Authors: Bonaccio M , Grosso G 
Published: October 2024

Abstract
Current evidence suggests that several aspects of diet quality is globally suboptimal. While increasing animal-based products could exert certain benefits against undernutrition in developing countries, the preference of mass-produced low-quality meat-products over other animal-based ones (i.e., milk, dairy, and eggs) and their overall excessive consumption in spite of plant-based ones has been deemed responsible, at least in part, of the rise of non-communicable diseases. The industry-led response to the growing need of animal-food alternatives may not necessarily meet the health objectives of a natural vegetable source against highly processed products rich in chemical additives. Research in this area is growing producing mixed results, while adoption of plant-based dietary patterns seems less and less equivalent to be synonymous of a healthy nor sustainable choice. In this presentation, data on the current state of evidence on global food consumption, dietary patterns, as well as the relation between level of food processing and health will be provided.
System-wide health needs segmentation: innovating integrated care for complex needs households
Authors: Piroddi R , Baker W , Daras K , Buchan I , Rafferty J , Astbury A , Barr B 
Published: October 2024

Abstract

Background
Health needs segmentation is increasingly used in healthcare delivery and health policy planning to cater for diverse population groups and develop effective and equitable health policies. But existing models often lack a systemic approach, focusing instead on single conditions or settings. This leads to fragmentation, gaps and inefficiencies in service provision and inequities in health outcomes, particularly when addressing complexity, and specifically for children, as adversity clusters in families.

Aims
To develop a household health needs segmentation model to identify those households with children with high levels of complex cross-sectoral needs, to plan for integrated care services.

Methods
Data linkage of primary, secondary, mental, community and social care services, mortality records, residential information, and small-area multiple deprivation measures was used to design a rule-based model to identifying households with children with the most complex needs in the UK region of Cheshire and Merseyside (C&M), with large variation in demography, (human) geography, and deprivation.

Results
Of 2,645,329 individuals in C&M (97% of the registered population in 2021), 1,022,840 lived in 266,939 households with children aged 0-16: 21,527 households had complex needs. This 8% of families accounted for an estimated 34% of health and social care costs for families, £362 million in total, 42% of which spent on children in care of local authorities.

Implications
The model identified a specific group of families with complex service use patterns, high mental and physical comorbidity and socioeconomic vulnerabilities. These exhibit potential for improved outcomes through better integration of services and targeting of community building and family support resources.

Conclusions
Our model represents a significant innovation in health needs segmentation. By using whole system linked data, it provides a pragmatic way of profiling complexity for proactive care.

Key messages
• Complex health and social problems in children cluster in families with adults also having complex needs, so we need to transform fragmented services to support the whole family to improve outcomes.
• Household level segmentation using cross-sectoral, whole system data is an innovation to identify households with complex needs with respect to their locality to improve integration of support.
Active education for reducing the attainment gap in a public health course in the United Kingdom (UK)
Authors: Lima do Vale M , Murdoch J 
Published: October 2024

Abstract

Background
A diverse cohort of students join our UK postgraduate public health programme. We wanted to reduce attainment gaps between students. Active and inclusive educational activities may be important mechanisms for reducing attainment gaps as well as promoting student wellbeing. Our aim was to explore how active and inclusive curriculum design could support development of public health functions (e.g., designing interventions to address health inequalities) whilst reducing attainment gaps.

Objectives
Our 12-week module included a project to model determinants of adolescent’s health inequalities and design an evidence-based intervention to address determinants. Informed by Fink’s taxonomy and the assessment for learning framework, we designed educational activities (i.e., small group work and presentations, ethnographic visits, discussions with stakeholders) and assessments (i.e., group poster presentation and individual critical reflection) to structure the project. We assessed attainment gaps in student marks and surveyed student attitudes to the project (1 = strongly disagree; 5 = strongly agree).

Results
53 students (9 groups) completed the assessment with the following marks: poster (M = 61, SD = 7), critical reflection (M = 59, SD = 9), overall mark (M = 59, SD = 10). More students received ‘fails’ and ‘distinctions’ when only the critical reflection was considered (p &lt; 0.001). Students (N = 39; 72% response rate) agreed that activities were intellectually stimulating (M = 5, SD = 0.8), supported their learning (M = 4, SD = 0.8) and made them feel included (M = 5, SD = 0.7). Active learning approach (i.e., benefits of interactions; creating effective groups); student’s caring and commitment; choice and inclusivity; complex and authentic tasks; informal, formal and timely feedback were highlighted.

Conclusions
Evidence that an active and inclusive approach functions to reduce attainment gaps is equivocal but appears to promote engagement, inclusion and learning.

Key messages
• Active learning strategies combined with authentic and flexible tasks and rich in feedback stimulate student’s interactions, inclusivity, and learning with potential for reducing attainment gaps.
• Active and authentic education requires educators to work on how to properly implement these strategies.
How have respiratory tract infections changed in the post-covid era for children under 5 years?
Authors: Foley K A , Hargreaves D S , Quint J K , Bottle A , Majeed A , Saxena S 
Published: October 2024

Abstract

Background
Social distancing measures introduced in response to the covid-19 pandemic reduced transmission of all respiratory pathogens. Exposure to respiratory pathogens in early life affects future lung health. We aimed to describe changes in the incidence of respiratory tract infections (RTIs) in children &lt;5 years in England in the post-pandemic era.

Methods
Population-based retrospective cohort study using electronic health records. We included all children aged &lt;5 years registered with a primary care practice from April 2016 to March 2023. We compared monthly GP consultation rates for RTIs in the two post-pandemic years (April 2021 - March 2022 and April 2022 - March 2023) with corresponding months during pre-pandemic years (April 2016 - February 2020).

Results
There were 3 045 701 respiratory tract infections among 2 894 539 children &lt;5 years registered with a GP practice during the study period. Pre-pandemic, monthly RTI rates varied from lows of 29.1 per 100 child-years in August to highs of 108.8 per 100 child-years in November. In 2021/22, monthly RTI rates were bimodal peaking in June and October, although the winter peak was lower than pre-pandemic years and mean monthly RTI rates were ∼15% lower overall. In 2022/23 mean monthly RTI rates remained ∼15% lower than pre-pandemic years, but there was a single peak in December 2022 of 117.6 RTIs per 100 child-years, exceeding the pre-pandemic winter peaks by 8.1%.

Conclusions
Overall, monthly RTIs in post-pandemic years were 15% lower than pre-pandemic years. However, there was a concerning peak in December 2022 that exceeded the winter peaks from previous years. Comparisons with national surveillance data suggest this peak reflects changes in RTI incidence, particularly among group A streptococcal infections, but this peak may also reflect changes in access to care or healthcare seeking behaviour. Continued monitoring of post-pandemic seasonal patterns will assist in planning for health service use.

Key messages
• Respiratory tract infections in children &lt;5 years in post-pandemic years were 15% lower than pre-pandemic years, but winter peaks in incidence may be of greater magnitude in the post pandemic era.
• Ongoing monitoring of patterns of respiratory tract infections in young children is important for future health service planning and delivery.
1.K. Scientific session: Health literacy of children and adolescents across Europe
Authors:   Organised by: EUPHA-HL, -HSR,   Chair persons: Jany Rademakers (Netherlands), Orkan Okan (EUPHA-HL)
Published: October 2024

Abstract

Health literacy is developed throughout the life course. Enhancing health literacy at an early age is especially important since it may impact both current and future health skills and outcomes. Low health literacy in child and adolescent populations has been linked to worse health outcomes and health disparities in Europe, making health literacy of children and adolescents an important public health topic. Developing and delivering targeted interventions and services for these age groups requires insight and data on the development and state of health literacy in early age. However, child and adolescent health literacy is still an under-researched topic. This is partly due to a lack of appropriate measurement instruments and methods to involve children in research. In the past years, new studies on child and adolescent health literacy have emerged in several European countries. In this workshop, innovative studies from Germany, the Netherlands and the UK on HL in childhood and adolescence are introduced and discussed. Both methodological findings as well as empirical data will be presented. In Germany, an instrument to measure child health literacy was developed and validated for primary school children. This instrument, the HLS-Child-Q15, has been used both in Germany and in the Netherlands to study the relationship between children’s health literacy and their health behaviors and outcomes. In the UK, methods of involving primary school children in health literacy research were studied. Experiences with a Children’s Advisory Group will be shared. Another study in the Netherland focuses on the health literacy profiles and needs of adolescent patients with rheumatic diseases. The format of this workshop will be 4x10-minute presentations (including questions) followed by a 20-minute interactive discussion, reflecting on the relevance of these results to further research, health promotion and health services. which will be followed by Q&A and an open discussion with the audiences. This workshop offers a forum for researchers, health educators, practitioners and policy-makers interested in health literacy measurement and research in children and adolescents.

Key messages
• Child and adolescent health literacy is an important, yet under-researched public health topic.
• Child health literacy is an important predictor of their health behavior and outcomes.
The influence of health literacy on health outcomes and behaviors in fourth-graders in Germany
Authors: Bollweg T M , Okan O 
Published: October 2024

Abstract

Background
For the adult population, evidence suggests that a high level of subjective health literacy is associated with a number of favorable health outcomes and behaviors. However, for younger populations, particularly children, little evidence is available. This study investigates the relationship between subjective health literacy, health outcomes, and health behaviors in children.

Methods
We conducted a representative survey of 4th-grade students (age 8-11) in North Rhine-Westphalia, Germany, between Oct. 2022 and Feb. 2023. Subjective health literacy was measured with the HLS-Child-Q15 questionnaire. For mental and physical well-being, the KINDL-R was used. For health behaviors, we asked about the frequency of (1) brushing teeth, (2) eating fruit and (3) vegetables, (4) exercising, (5) consuming sweetened drinks, and (6) wearing a helmet when riding the bike. Regression analysis was used to determine the impact of health literacy on outcomes, controlling for a number of sociodemographic indicators (birthplace, home language, sex, age), as well as the tendency to give socially desirable responses. Health behaviors were rated on a Likert scale and where dichotomized for ordinal regression.

Results
n = 1085 students are included with a mean age of 9.5 years (SD=.6). 50.3% are female. While controlling for a number of variables, health literacy was a significant predictor (p&lt;.05) for every indicator except the frequency of (1) brushing teeth, (4) exercising, and (5) consumption of sweetened drinks. For mental well-being, health literacy was the strongest predictor.

Conclusions
Our findings highlight the potentially enabling role of subjective health literacy regarding favorable health outcomes and health behaviors. However, because this is a study among younger children, further research is needed on the interplay of individual subjective health literacy, social contexts (e.g., parental health literacy and health behaviors), and children’s health outcomes and behaviors.