bluuebunny/crossref_metadata_2025_split huggingface dataset:
Climate change and health topics in pre-university education in Kosovo: A Content Analysis
Authors: Ramadani L , Boeckmann M , Sioen G 
Published: October 2024

Abstract

Background
Climate health literacy (CHL), recommended and recognized as vital for the global response to climate change and impacts on health, lacks comprehensive studies on its integration into primary and secondary school curricula. In Kosovo, where numerous environmental issues already exist and are expected to worsen due to climate change, the resulting health outcomes pose significant challenges. Moreover, the low environmental knowledge among youth further adds to the complexity of addressing these issues. This study addresses this gap by focusing on understanding and enhancing the inclusion of climate change and health topics in pre-university education.

Methods
A content analysis was conducted on: (1) core curricula, (2) subject curricula, and (3) textbooks for pre-university education (grades 0-12) in Kosovo. The outcomes of the content analysis were then juxtaposed with the CHL framework to identify alignment and gaps.

Results
We found that curricula in Grades 0-5, contained one topic on climate change and health topic out of 638 (0.16%) topics documented; however, textbooks did not elucidate this focus. Grades 6-9 had 2 out of 701 (0.28%) and the relevant textbook revealed that various environmental and health topics are covered, but that they lack exploration of the interrelatedness between environmental pollution, climate change, and health. Grades 9-12 had the highest integration with 4 out of 745 (0.54%). Textbook analysis of these grades revealed a more in-depth coverage of climate change and health linkages. In total, seven topics out of a pool of over 2000 topics encompassed learning outcomes related to climate and health in Kosovo’s pre-university education.

Conclusions
The current efforts to integrate climate change and health into Kosovo’s curriculum fails to meet the recommendations for achieving CHL levels. Localized and context relevant additions are needed to fulfil CHL among students in Kosovo and other countries interested in improving CHL.

Key messages
• This case serves as a testing ground for a framework assessing climate health literacy within curricula. The results identify gaps and areas of improvement, which inform the implications to attain CHL.
• Results reveal shortcomings in the incorporation of climate change and health topics in schools, underscoring the necessity for tailored strategies to foster CHL among students.
National early warning systems for emerging AMR in high-income countries: a systematic review
Authors: Iera J , Isonne C , Seghieri C , Tavoschi L , Ceparano M , Sciurti A , Migliara G , Villari P , D’Ancona F , Baccolini V 
Published: October 2024

Abstract

Background
An urgent need of implementing national surveillance systems for timely detection and reporting of emerging antimicrobial resistance (AMR) was recently advocated by the World Health Organization (WHO). However, public information on existing national early warning systems (EWSs) is often incomplete. Furthermore, when findings are available, understanding these systems is challenging due to different approaches used for data collection, reporting and definitions, with a comprehensive overview on this topic currently lacking. The aim of this study was to map existing EWSs for emerging AMR, focusing on high-income countries, and describe their main characteristics.

Methods
A systematic review was performed on bibliographic databases, and a targeted search was conducted on national websites. Any article, report or webpage describing national EWSs in high-income countries was eligible for inclusion. EWSs were identified considering the emerging AMR reporting WHO framework.

Results
We identified seven national EWSs in 72 high-income countries: two (Australia, Japan) in the East Asia and Pacific Region, three (France, Sweden, United Kingdom) in Europe and Central Asia, and two (United States, Canada) in North America. The systems were established quite recently; in most cases they covered both community and hospital settings, but their main characteristics varied widely across countries in terms of organization and microorganisms under surveillance, with also different definitions of emerging AMR and alert functioning. A formal system assessment was available only in Australia.

Conclusions
A broader implementation and investment of national surveillance systems that allow early detection of emerging AMR is still needed to establish EWSs in countries and regions lacking such capabilities. A more standardized data collection and reporting is also advisable to improve cooperation on a global scale.

Key messages
• This study provides a synthesis of publicly available information on national EWSs for emerging AMR in high-income countries, highlighting the urgent need for a broader implementation of such systems.
• Main characteristics of EWSs have been outlined, varying widely across countries. Findings could help stakeholders in strengthening current standard national AMR surveillance systems.
Advancing urban health in Portugal: exploring liveability and its association with mental morbidity
Authors: Baptista A C , Morgado P , Matias Dias C , Ribeiro A I , Sousa Uva M 
Published: October 2024

Abstract

Background
As cities face challenges posed by urbanisation, it becomes essential to understand how city planning can contribute to protecting public health. In this study, we aimed to assess the liveability of different areas in Lisbon, Portugal, by developing a liveability index at the parish level. Secondly, we aimed to explore its association with hospitalisation due to mental disorders.

Methods
The liveability index was built based on the World Health Organisation’s Urban Health Index methodology. We obtained data on liveability related to housing, socio-economic conditions and access to services (e.g. healthcare) from the 2011 census and other open data sources for Lisbon’s parishes (n = 22). Data on hospital admissions due to mental disorders was sourced at the parish level from the national database for hospital morbidity for the period 2013-2016 and sex-age-standardised. Binomial negative regression was employed to estimate the association between the liveability index tertiles and observed hospital admissions. We used the expected number of hospitalisations as the offset variable and tested for spatial autocorrelation among the regression residuals.

Results
Our analysis showed that living in the most liveable parishes is associated with a significant decrease in the standardised admission ratio due to mental disorders, compared to living in the least liveable areas (Incidence Relative Ratio=0.643; 95% CI: 0.427, 0.967). We did not observe any geographical pattern in the regression residuals (Moran’s I= -0.035, p = 0.427).

Conclusions
Our findings show disparities in liveability among Lisbon’s parishes and identify a protective association between living in higher liveability areas and hospital admissions due to mental disorders. This work should prompt further studies concerning this subject to inform urban planning policies to improve liveability and equally reduce the risk of mental health-related harm within cities.

Key messages
• A spatial index to assess liveability in urban areas was developed. The association between the liveability of Lisbon’s parishes and hospital admissions due to mental disorders was explored.
• We found a significant protective association between higher liveability and hospital admissions due to mental disorders. This work is relevant to inform the implementation of urban planning policies.
Climate Change, Air Pollution, African Dust Impacts on Public Health and Sustainability in Europe
Authors: Adamopoulos I , Syrou N 
Published: October 2024

Abstract

Climate change poses a significant threat to environmental sustainability and public health, leading to extreme weather events, rising sea levels, and biodiversity loss. Research on air pollution from African dust adversely associated with climate change highlights its significant role in trapping heat in the atmosphere and causing heat-related illnesses, cardiovascular disorders, and respiratory ailments. Smog, dust, acid rain, and ozone depletion also negatively impact ecosystems. The methods of the study also include the dynamics of climate change-induced air pollution. The implications for public health and environmental sustainability through GWR modeling and MODIS-NDVI analysis of controlling air pollution are crucial for reducing the climate crisis, safeguarding public health, and maintaining ecosystem sustainability. Results from particulate matter (PM 2.5-10), which consists of tiny particles with varying diameters, can enter the respiratory system through inhalation. This can lead to a diameter of less than 10 μm (PM 2.5-10). According to the relevant legislation, the limit value refers to the daily average value and must not exceed 50 μg/m3. While ozone in the stratosphere serves a protective function against ultraviolet radiation, excessive levels at ground level can be harmful and have been recorded in atmospheric samples ranging from 146.6 μg/m3 up to 702.3 μg/m3. impacting the respiratory and cardiovascular systems. Policy leaders, businesses, and individuals need to be proactive in reducing air pollution, adopting clean energy technology, and implementing stricter pollution rules. Stricter pollution rules, environmentally friendly transportation choices, and the adoption of clean energy technology. The sustainability of the ecosystem and public health are significantly impacted by climate change linked to air pollution. To solve these global problems and move toward a healthier, cleaner future for future generations, we must act now on climate justice.

Key messages
• Examine the impact of African dust air pollution on public health and its significant impacts from climate change, provide solutions to mitigate its effects on environmental sustainability in Europe.
• Public health workers, Policymakers and stakeholders must prioritize reducing emissions and enforcing strict air quality laws to mitigate the negative impact of African dust on European populations.
Building bridges in Climate Pact activities and Climate Action - example from Serbia
Authors: Jevtic M , Cattoir C , Matkovic V 
Published: October 2024

Abstract

The European Climate Pact is a movement of citizens united around a common cause, each taking steps in their own worlds to build a more sustainable Europe. Launched by the European Commission, the Pact is part of the European Green Deal and is helping the EU to meet its goal to become climate-neutral by 2050. This work presents examples of activities of the EU Climate pact ambassador in different directions (international and national/local level), with an unique goal, to increase awareness of importance of action, change of mindset, and exchange positive experiences. Climate Action is presented:
• through educational activities in EUGLOH project (European Global Health Universities Alliance) - by organizing Course Climate Action for Health and presenting to students at international level different Climate actions activities.
• engagement of citizens through Rotary Climate Action in RD 2483 and wither in Rotary international community - as citizens activities - Rotary Climate Action with the aim to increase awareness of climate change and health consequences.
• as mentorship activities with PhD students in the field (climate change and air pollution impact on respiratory diseases) - as a research activities.
• as an example of cooperation with media in Serbia - increasing of awareness among journalists.
There are a lot of possibilities to work in the long-term in the community, using glocal principles and trying to find a way to change the behaviour of citizens towards acceptance of climate neutrality as an important goal.

Key messages
• Climate Action is citizens action.
• Climate action is a way to change the behaviour of citizens towards acceptance of climate neutrality as an important goal.
Determinants in disaster preparedness of nurses in the Azores
Authors: Costa A , Gatinho E , Nogueira P , Mexia R , Arriaga M , Henriques A 
Published: October 2024

Abstract

Background
Disasters are situations of complexity and unpredictability, increasingly frequent and more destructive. They require rapid and effective action from different teams from different contexts, with preparation and qualifications for an adequate response to victims, recovering the environment, and restoring living conditions, and nurses play a significant role in these events. Understanding the level of preparedness of nurses for disasters is fundamental for defining the competency framework in the disaster management cycle.

Objectives
To analyze the preparation of nurses in the Azores for a catastrophe.

Methods
A cross-sectional study was performed with 160 nurses from the Azores. The questionnaire validated for the Portuguese population “Disaster Preparedness Evaluation Tool (DPET ®): Preparation of nurses in the face of a catastrophe” was applied. It was approved by the Ethics Committee.

Results
More than half of respondents (n = 137, 71%) indicated that they were not fully prepared to respond to disasters, while 29% (n = 46) acknowledged that they felt adequately prepared. Of the 160 respondents, only 20% (n = 30) participated in the development of emergency plans and only 14% (n = 22) participated in the creation of emergency plans that contribute to improvements at the local level. Training through simulation training was cited as important in disaster preparedness (n = 129, 78%).

Discussion
The present study identified little involvement of RAA nurses in preparing emergency plans and less than half feel poorly prepared in responding to a catastrophe. This finding is consistent with studies by Baker, Alamri, & Aboshaiqah (2019) and Emaliyawati et al. (2021).

Conclusions
This study was conducted in a region prone to natural disasters. It is vital to invest in the training of these professionals throughout the disaster cycle so that they can contribute to reducing the impact that the catastrophe will have on the individual/family and community.

Key messages
• Strengthening capabilities through regular disaster training based on effective information.
• Low participation in the development of emergency plans that contribute to improvements at the local level.
The burden of lung cancer attributable to ambient PM2.5 exposure: a systematic literature review
Authors: Corda M , Clemente M , Oliveira J , Morgado J , Redondo H , Charalampous P , Haagsma J A , Pires S , Martins C , Assunção R 
Published: October 2024

Abstract

Background
Lung cancer is recognized as one of the most common causes of cancer morbidity and mortality worldwide and is the second cause of death with highest years of life lost in highly developed regions. Ambient exposure to particulate matter (PM2.5) is the leading global environmental risk factor. Long-term exposure to PM2.5 is associated with several health outcomes, including lung cancer, ischemic heart disease, and chronic obstructive pulmonary disease.

Aim
To review and estimate the impact attributable to PM2.5 exposure due to lung cancer.

Methods
A systematic review and a meta-analysis were conducted to determine whether long-term exposure to PM2.5 increases the risk of lung cancer and to derive exposure-response relationships between PM2.5 and lung cancer. The literature search was performed in databases (i.e., Pubmed/Scopus) and studies published from January 1, 2010 onwards were considered. Studies describing the association between long-term exposure to the pollutant under research and the incidence, prevalence, and mortality of lung cancer, considering a relative measure of association were included, with no restriction in geographical area.

Results
In the literature review, 2215 articles were considered for the first step of data synthesis, all articles were screened, considering the screening of titles (first step), abstracts (second step) and full-text (third step) considering the inclusion criteria. In a second step the data was extracted from the included articles (n = 129) and considering the variables related to the characteristics of the study and the study population, exposure, and outcome measurement, and details of risk of bias assessment.

Conclusions
These findings provide data to synthesize effect size estimates using a Meta-Regression - Bayesian, Ensemble, Regularized, Trimmed (MR-BRT) model, important to provide evidence data on the impact of air pollution on human health, which is crucial for decision-making.

Key messages
• Long-term exposure to PM2.5 increases lung cancer risk so the estimating of the impact of the exposure is an urgent need to provide evidence-based data for air quality improvement.
• Meta-analysis aims to establish a relation between PM2.5 exposure and the burden of lung cancer.
Health burden and economic costs of vector-borne diseases in Italy: the AUSL Romagna case
Authors: Monti M , Golfera M , Angelini P , Soracase M , Angelini R 
Published: October 2024

Abstract

Introduction
Vector-borne diseases (VBDs) are a serious threat for global health, representing around 17% of communicable diseases and more than 700.000 deaths every year. In Europe, and especially in Italy, this is a subject of growing concern, due to the increase of VBDs outbreaks that need vector control plans.

Objectives
Evaluate the 2013-2022 trend of VBD outbreaks within the AUSL Romagna area (provinces of Ravenna, Rimini, and Forlì-Cesena, in Emilia-Romagna Region, Italy) and the economic impact caused by hospitalizations and local prevention/disinfestation treatments.

Methods
We used aggregated and anonymized data from 3 informative systems: communicable disease system (SMI) for VBD prevalence; hospital discharge records (SDO) for hospitalizations, with a contribution of the VBD-related Diagnosis Related Groups (DRG); municipality records regarding the cost of dedicated interventions for vector prevention and disinfestation, communicated to the Emilia-Romagna Region.

Results
For the area of interest, 479 cases of VBDs were notified from 2013 to 2022, with a slight increasing trend over the years. Through hospital SDOs, 252 cases were identified with a diagnosis of VBD, plus 283 with a VBD-related DRG, with a total expenditure of €9.587.777. The distribution was not uniform between the provinces, Ravenna having the highest expense. The municipality records highlighted expenses for €95.443 for prevention and control interventions against mosquitoes, with a very variable trend over the period considered. Forlì had the highest expense.

Conclusions
VBDs show a highly variable trend and distribution during time, also in relatively small, sub-regional areas. The Emilia-Romagna regional plan against arboviruses, annually updated, can contribute to reduce this specific health and economic burden, lowering transmission among the population and resulting hospital pressure, thanks to prevention and timely interventions.

Key messages
• The use of information systems enables monitoring of the impact of arboviruses, as well as the related cost for hospital care and local treatments.
• Putting in place an effective and updated plan against arboviruses, like the Emilia-Romagna Region one, helps managing VBDs and mitigating economic costs.
Microbial source tracking to address of bacterial contamination in recreational waters
Authors: Esenther S , Pascucilla M 
Published: October 2024

Abstract

Background
Beach closures in the USA are determined by fecal indicator bacteria thresholds, which are insufficient to identify causes of contamination. We use microbial source tracking (MST) to identify the species source of bacteria entering chronically impaired waters. We find canine bacteria is the primary source of high E.coli levels and demonstrate the power of MST for direction of remediation efforts.

Methods
This environmental sampling study was performed in Short Beach, Branford, Connecticut, USA. Water samples were collected from outfalls under wet and dry precipitation conditions by 10 Citizen Scientist volunteers. The highest E.coli samples were analyzed for avian, human, and canine markers using MST.

Results
E.coli from 103 samples was tested from April-October 2023. Pearson’s r between average site E.coli and same day precipitation was 0.71 (p-value = 0.006). Among the high E.coli samples, 19 (76%) were low/non detectable, 5 (20%) were moderate, and 1 (4%) were high for human tracers; 10 (50%) were low/non detectable and 10 (50%) were moderate for avian tracers, and 3 (15%) were low/non detectable, 11 (55%) were moderate, and 6 (30%) were high for canine tracers.

Conclusions
Precipitation is a driver of elevated bacteria levels. Canine bacteria is likely the primary source of elevated bacterial levels in beach waters, while avian contributors are of moderate concern and human contributors are of low concern. As a result, an education campaign and watertight waste receptacles, rather than costly sewer line replacements, are being deployed to improve beach quality.

Key messages
• Use of microbial source tracking found canine bacteria is the likely driver of elevated E.coli levels in local beaches, initiating a community education campaign rather than costly sewer replacements.
• Microbial source tracking technology offers a powerful public health tool for identifying causes of bacterial contamination in chronically impaired recreational waters.
Reducing the climate impact of food choices with comparable nutritional quality: a randomised trial
Authors: Aguirre-Sánchez L , Maione S , Maeder S , Infanger E , Suggs L S 
Published: October 2024

Abstract

Background
Diets largely contribute to the global disease burden, and a third of global warming emissions. We assessed the climate footprint reduction effect of framing the climate impact of diets as a collective action problem (social dilemma), compared or in combination with a reflective intervention (information) and a choice architecture intervention (nudge). Interactions with lifestyle factors were examined.

Methods
A randomised 2X2X2 between-subjects online experiment was conducted among university students ≥18 years, enrolled at a Swiss university, and not following a medically prescribed diet. The outcome was the mean climate footprint of food choices (in kg CO2-eq), based on a Life Cycle Assessment. Meals varied in climate footprints while adhering to the Swiss dietary guidelines.

Results
This analysis focused on the subset of meat eaters (n = 1691). Median age was 24 years, and 59.85% (n = 1012) were female. Seven intervention groups resulted in significantly lower climate footprints compared to the control. The social dilemma plus a nudge menu was the most effective behavioural intervention leading to 20.20% footprint reduction (b = -1.20 kg CO2-eq) compared to the control group (Mcontrol=5.94, SDcontrol=2.76; Mdilemma+nudge=4.74, SDdilemma+nudge=2.09 t(436) = -5.10, p &lt; 0.001). Lifestyle factors linked to a higher climate footprint of food choices included adhering to a low-calorie diet (b = 1.21 kg CO2-eq, p &lt; 0.05), or a muscle gain diet (b = 2.12 kg CO2-eq p &lt; 0.05) and practising physical activities (PA) while adhering to a muscle-gain diet (Aerobic/Cardio: 3.82 kg CO2-eq, p &lt; 0.05; Muscle-strengthening: 2.24 kg CO2-eq, p &lt; 0.05).

Conclusions
The combination of reflective collective action communication and menu nudges is an effective strategy to mitigate the climate footprint of food choices in education institutions. Adherence to a muscle-gain diet was identified as a critical but manageable lifestyle factor linked to a higher climate footprint.

Key messages
• The dilemma plus a nudge was the most effective to reduce the climate footprint of food choices.
• This combined intervention can manage the high climate footprints linked to lifestyle factors.