bluuebunny/crossref_metadata_2025_split huggingface dataset:
Needs and perceptions regarding healthy eating among people at risk of food insecurity in the Netherlands
Authors: van der Velde L , Nyns C , Engel M D , Neter J E , van der Meer I M , Numans M E , Kiefte-de Jong J C 
Published: October 2024

Abstract

Background
Healthy eating behaviour is an essential determinant of overall health. This behaviour is generally poor among people at risk of experiencing food insecurity, which may be caused by many factors including perceived higher costs of healthy foods, financial stress, inadequate nutritional knowledge, and inadequate skills required for healthy food preparation. Few studies have examined how these factors influence eating behaviour among people at risk of experiencing food insecurity. We therefore aimed to gain a better understanding of the needs and perceptions regarding healthy eating in this target group.

Methods
We conducted a qualitative exploration with 10 participants at risk of experiencing food insecurity in the Netherlands.

Results and conclusions
The analysis using an inductive approach identified four core factors influencing eating behaviour: Health related topics; Social and cultural influences; Influences by the physical environment; and Financial influences. Overall, participants showed adequate nutrition knowledge. However, eating behaviour was strongly influenced by social factors and physical environmental factors. Perceived barriers for healthy eating behaviour included poor mental health, financial stress, and high food prices. Participants had a generally conscious attitude towards their financial situation, reflected in their strategies to cope with a limited budget. Participants were familiar with several existing resources to reduce food-related financial strain and generally had a positive attitude towards these resources. An exception was the Food Bank, of which the food parcel content was not well appreciated. Proposed interventions to reduce food-related financial strain included facilitating social contacts, increasing healthy food supply in the neighbourhood, and lowering prices of healthy foods. The insights from this study increase understanding of factors influencing eating behaviour of people at risk of food insecurity.
6.Y.2. AI and health care: what are the capabilities and limitations?
Authors:   Organised by: The Commonwealth Fund (USA),   Chair persons: Evan Gumas (USA), Reginald Williams (USA)
Published: October 2024

Abstract

With the rapid advancement of artificial intelligence (AI) technologies and their implementation in health care, there is a critical need to explore the different applications and implications of AI. This workshop seeks to look at different aspects of AI, both potential applications for AI technology in health, public opinions of use of AI in health care, and the reality of implementing AI in different contexts. Understanding health care approaches to AI from different countries is a unique opportunity for shared learning of innovations across various sectors of health care and patient engagement in order to most effectively engage this emerging field. AI, in whichever form it may be incorporated into health care, has the opportunity to impart meaningful, innovative change, but understanding this new technology comes with important questions. This session will dive into research on AI in various areas of health care by 1) looking at different ways AI is being harnessed in health care; 2) discussing lessons which can be learned and adapted from other countries; 3) discussing promising solutions and approaches to implementing AI in health care; 4) discussing the limitations or concerns of integrating AI in health care.
The panel will be composed of 1 moderator and 2 panelists. Panelists are experts in their fields, established researchers and practitioners, and alumni of the Harkness Fellowship from Germany and the United Kingdom. A moderator will briefly frame the discussion for the audience and introduce the speakers and their presentations before leading an interactive, engaging question and answer portion. The coherence of this panel lays in its theme of leveraging AI to enhance healthcare delivery and understanding ways we can work across countries to foster ethical, equitable AI technologies that revolutionize healthcare practices with the ultimate goal of improving patient outcomes and health system efficiencies. Dr. Saira Ghafur from the U.K. will begin by presenting her research on evidence-based reasons for implementing AI in health care and Dr. Benedikt Simon from Germany will close out by discussing his work in AI in Germany and the challenges that have prevented robust integration. Each panelist will speak for roughly 8-10 minutes, with about 5 minutes reserved for moderator and audience questions.

Key messages
• Sharing cross-country experiences and research enables us to better understand how AI can impact health care.
• In weighing both the benefits and challenges or limitations of implementing AI, we can best understand effective approaches to utilizing AI in health care.
Challenges to implementing AI in health care
Authors: Simon B 
Published: October 2024

Abstract
Germany, renowned for its robust healthcare system, finds itself at the early stages of AI integration. This is a reality for many European countries, emphasizing that, despite general technological prowess, AI adoption remains in its absolute infancy. However, in Germany there are areas where AI shows promise, notably in fields like radiology. Beyond such niche applications though, Germany grapples with a significant challenge - the scarcity of robust data essential for meaningful AI utilization, particularly in the realm of public health. While these insights are specific to the German context, understanding the intricate hurdles impeding widespread AI implementation is a meaningful takeaway for countries around the world. In order to effectively leverage new technologies, there is an acute need for advancements in data infrastructure and governance to unlock the full potential of AI in healthcare. Overcoming barriers and charting a path towards a future where AI serves as a transformative force in German healthcare, could one day lead to enhanced system efficiencies and patient experiences, but for now we have to be thoughtful about the realities of implementing AI within current existing health system infrastructure.
Applying a Planetary Health approach in the European urban context: Lessons from Preparing Traditional Lasagna
Authors: Cadeddu C 
Published: October 2024

Abstract
Lasagna is a quintessential Italian dish, renowned worldwide. The most traditional version is “alla Bolognese”, which requires a complex preparation process involving careful attention to mixing ingredients and layering to achieve the final delicious result. The images depicting the preparation steps of this typical Italian dish will be used to inspire participants to creatively reflect on how to implement a transdisciplinary approach to address a planetary health issue, such as heatwaves, in a European urban context.
The presentation will be structured as follows: 1. Identification of current problems; 2. Stakeholder analysis; 3. Possible solutions; 4. Barriers and limitations.
The first phase will focus on selecting quality ingredients, analogous to analyzing the urban map of the city, the presence of green areas, identifying vulnerable residents, mapping transportation, etc. The second phase will identify all relevant stakeholders to be involved in creating transdisciplinary solutions for the city, paralleling the proper mixing of lasagna ingredients. The third phase will propose various solutions to be applied, taking into account the inputs and viewpoints of the involved stakeholders, showcasing best practices already adopted, and comparing them to different variations of lasagna alla Bolognese. The final phase will present barriers and limitations to implementing such an approach in a European urban context (e.g., costs, historical monuments, lack of stakeholder collaboration), drawing parallels to challenges in preparing lasagna, such as ingredient unavailability, oven issues, or overcooking. Through this original modality, participants will learn about the process of implementing a planetary health approach to one of the major climate change issues affecting the European landscape.
Mental health support for healthcare workers: what is it about governance and policy implementation
Authors: Falkenbach M , Kuhlmann E , Brinzac M G , Correia T , Panagioti M , Ungureanu M-I 
Published: October 2024

Abstract

Background
We adopt a health system and governance perspective to address the mental health needs of healthcare workers, considering the nature of interventions and the levels and actors involved in governance. The aim is to move the debate forward by identifying governance gaps hampering the implementation of health workforce policies and exploring strategies to effectively increase mental health support.

Methods
A qualitative comparative methodology is applied based on a case study design utilising a multi-level intersectoral governance matrix. The assessment matrix comprises four key categories: health policy and data, social policy and psycho-social conditions, organisation of work, and job and professional conditions. We conducted a rapid assessment of healthcare workforce developments in the European context, drawing on secondary sources and country experts. The country sample comprises Germany, Portugal, Romania, Switzerland and the United Kingdom.

Results
Awareness of mental health threats among healthcare workers increased, but policy discourse is driven by service delivery and labour market demands. The attention to healthcare workers’ needs is stronger on the international level especially supported by WHO action, and weakest at national/regional levels. Although organisations and professions demonstrate varying degrees of activity, their efforts are scattered and lack sustainability. Similar challenges were identified across healthcare systems, including limited action, disconnected actors, missing coordination, and a lack of attention to governance gaps and system weaknesses.

Conclusions
There are similar problems across countries. Mental health policy is driven by labour market needs and ignores research evidence and the individual needs. Successful mental health policy implementation needs multi-level governance and coherent coordination mechanisms, and generally greater attention to the ‘human side’ of the healthcare workforce.

Speakers/Panelists
Sara Alidina
Central Administration of the Health System, Lisbon, Portugal
Tomas Zapata
WHO/Europe, Copenhagen, Denmark
9.X.2. Activating the ASPHER-WHO Public Health Core Curriculum: Interprofessional Skills
Authors:   Organised by: ASPHER, Faculty of Public Health (UK),   Chair persons: Alison Mc Callum (UK), Judit Simon (Austria)
Published: October 2024

Abstract

The updated ASPHER-WHO Public Health Core Curriculum builds on ASPHER’s previous work on Competencies for Public Health Professionals (2006-2020), reflects the changing needs of our population and planet and public health professionals.
The key objectives of this workshop are to: - Share the updated ASPHER core curriculum for public health; - Illustrate examples of public health challenges that young professionals have championed for inclusion; - Share the Faculty of Public Health (UK)’s work on Fair training as a case study on operationalising public health leadership on equality, diversity and inclusion and demonstrating the core competencies in action.
A curricular content survey of member schools and programmes yielded responses from 60 schools, with &gt; 500 submissions of detailed. subject curricula. These have been compiled into 36 Subject Areas in four Domains, namely: (1) Core Subject Areas in Public Health: (2) Subject-specific Areas in Public Health;(3) Core Cross-curricular Subject Areas; and (4) Core Interdisciplinary Professional Skills in PH. The development process was guided and grounded by the expertise and passion of young public health professionals. They are helping us make the core curriculum fit for purpose for the near future and provide them with the skills required to be a competent member of a supportive public health team in an ever changing world. This Workshop will profile selected Subject Areas from each Domain using real life challenges facing WHO European Region to show how the core curriculum integrates research, theory and practice to help build those essential interdisciplinary skills. The examples will focus on Economics in Public Health (Domain 1); Public Health and Criminal Justice; (Domain 2); Health Literacy and Infodemiology, Mental Health and Wellbeing (Domain 3); and Integrative Learning in Action; Communication Skills; Advocacy, Negotiation; Collaborations and Partnerships; and Leadership, Management and Implementation Science (Domain 4). Discussions for each of the Subject Areas will be led by an expert in the area. We will also illustrate an example of these competencies in action, how they are helping shine a light on the challenges we face in creating that supportive team and environment and how the potential for collaboration helps us to capitalise on the expertise available in some schools and programmes for the benefit of all.

Key messages
• Learning interdisciplinary skills are essential for effective public health analysis, advocacy and action.
• Collaboration across countries, schools, professions and generations can create transformational change.

Speakers/Panelists
Mary Codd
University College Dublin, Dublin, Ireland
Karl F Conyard
University College Dublin, Dublin, Ireland
Jenny Houston
University of Edinburgh, Edinburgh, UK
Samia Latif
Faculty of Public Health, London, UK
Olalekan Popoola
ASPHER, UCD, Dublin, Ireland
About the need for a Swiss digital health ‘Sistine Chapel’ – lessons from 25 years of health policy
Authors: Zavattaro F , Gille F 
Published: October 2024

Abstract

Background
The Swiss government’s ‘DigiSanté’ program 2025-2034 aims to address Switzerland’s delay in digitising its healthcare system. Public and professionals’ trust is central for the implementation of digital health initiatives and partially based on past experiences with the digital health system. To inform DigiSanté, it is crucial to analyse the evolution of the socio-political discourse surrounding health data sharing in Switzerland in the past 25 years to identify the main obstacles encountered and lessons learned during this period.

Methods
We designed a multi-method study comprising a policy analysis of 65 Swiss policies on health data sharing from 1998 to 2023; scoping review of 250 editorials; sentiment analysis of 400 news articles from six major Swiss newspapers; and thematic analysis of transcripts from 11 online interviews with key stakeholders.

Results
We identified 32 key policy milestones in Swiss health data sharing, with the COVID-19 pandemic emerging as a trigger for present policymakers’ awareness of health data’s potential and the need for healthcare system digitization. The troubled implementation of the Electronic Patient Dossier (EPD) and its negative narrative are identified as more central in eroding long-term public trust than scandals. Primary obstacles to implementation of the EPD include misaligned stakeholders’ interests, slow policy processes, lack of professional support, low public awareness, and technical interoperability issues. Future strategies involve increasing actors’ involvement to establish a common vision and strategy and improving public communication.

Conclusions
The present socio-political discourse on health data sharing in Switzerland is shaped by past negative experiences with the EPD, compounded by additional scandals. To cultivate public trust, stakeholders should collaborate to align interests and ensure all parties work cooperatively toward common goals.

Key messages
• National and international scandals marginally affect public trust compared to the impact of the negative narrative surrounding the slow EPD implementation.
• Misalignment of stakeholder interests is the main barrier to implementing health data sharing initiatives, causing delays and trust erosion.
Changing the environment: Removing HFSS items in prominent areas of stores in Nottinghamshire
Authors: Brown O , Langley T , Murray R , Bogdanovica I , Bains M 
Published: October 2024

Abstract

This study examines the change in exposure to high-fat, salt, or sugar products (HFSS) after the implementation of a policy restricting the placement of HFSS items in prime locations in England that came into legislation in October 2022. 132 observations were conducted in 2022 and 2023, using a food environment survey. Supermarkets (SM), chain convenience stores (CSS), and independent convenience stores (ICS) were observed in the highest and lowest socioeconomic districts (SED) in Nottinghamshire. Descriptive statistics were used to analyse changes in exposures in prime locations by product category, the policy’s inclusion criteria, the Food Standard Agency’s Nutrient Profile Score (NPS), and the Nova classification. Exposure defined as is the presence of a product at a prime location in stores. A decrease in exposure to restricted products in both SED in SM and CCS was observed. No notable changes were observed in the ICS due to their exemption from the policy. In all SM, the observed exposure to products restricted by the policy was reduced from 39% to 14%. The study found that the policy was successful in reducing exposure to high-sugar products such as biscuits and chocolate. NPS and NOVA showed that exposure rates were notably higher in less healthy and ultra-processed food (UPF) categories compared to the exposure to products restricted due to the policy’s exemption criteria. Exposure to alcohol products increased after the policy’s implementation, with a 20-percentage point increase in alcohol exposure in all SM checkout areas. The study suggests that the policy may have narrowed the differences in environments between the SEDs, highlighted by the findings in the ICS, whereby exposure to less healthy products was higher in the lower SED. The policy also created an opportunity for the alcohol industry to increase its exposure. Shortfalls in the policy’s design were identified through the use of the NPS and Nova classification system.

Key messages
• Despite the equitable outcomes in socioeconomic districts, loopholes in policy design allow the alcohol industry to exploit prime locations and undermine health objectives.
• Policy success is evident in HFSS reduction; however, continued exposure to HFSS items exempt from the policy, and UPF products highlight policy design flaws that undermine health objectives.
Patient and healthcare provider perspectives on a digital first general practice: mixed-method study
Authors: Versluis A , Willemsen R F , Chavannes N H , Aardoom J J 
Published: October 2024

Abstract

Background
General practitioners (GPs) are facing an increased workload as a result of an aging population and a growing prevalence of chronic diseases. Utilizing eHealth may help to enhance healthcare accessibility and reduce costs. A digital platform was developed that integrates eHealth into the organizational aspects of general practices. This study aims to provide insight into the experiences of patients and healthcare professionals with this new, digital way of working.

Methods
A mixed-method study was conducted in three Dutch general practices working with the digital platform. The digital platform focuses on digital communication and remote healthcare delivery in primary care. Primary outcomes included acceptability, the implementation process, suggestions for improvement, and facilitators and barriers for future implementation. Patient perspectives were identified through online questionnaires and focus groups, and healthcare professionals’ experiences were explored through in-depth interviews.

Results
Five focus groups and ten in-depth interviews were held. The questionnaires were completed by 616 patients. Patient acceptability of the care concept was high (M = 3.9, SD = 1.0; on a scale from 1-5) and they were satisfied with received care (M = 30.1, SD = 3.4; on a scale from 8-32). Regarding the perceived quality of consults, patients were positive about the longer duration of physical consults (i.e., 20 instead of 10 minutes). Some participants indicated a less personal doctor-patient relationship, because care was provided by various GPs.

Conclusions
Overall, patients and healthcare professionals were positive about the digital platform. The study gives insights into how to improve the care concept, e.g., how to enhance the doctor-patient relationship.

Key messages
• Digital first general practices that integrate eHealth into the practice’s organizational aspects of are considered acceptable by patients and healthcare professionals.
• Digital first general practices can help to improve healthcare accessibility for both patients and healthcare professionals.
Ethical Dilemmas in Home Palliative Care
Authors: Yakov G , Halevi Hochwald I , Weiss M , Sabar R 
Published: October 2024

Abstract

Background
In the past two decades, there has been a noticeable shift towards home-based care, reflecting the broader trend among OECD countries to prioritize a comprehensive approach to health and well-being. This approach emphasizes preventive and proactive measures, often relying on home-based care delivered by multidisciplinary teams providing both curative and palliative care. However, the unique nature of providing care in a home environment raises ethical questions among healthcare providers, necessitating high levels of attentiveness and sensitivity from the caregiving team to address them effectively.

Research Objectives
This study aims to identify ethical challenges encountered by a multidisciplinary team, as perceived by managers of an organization offering home palliative services in Israel.

Methods
A qualitative study was conducted, involving interviews with nine key managers to explore prevalent ethical issues in delivering home-based care.

Findings
Thematic analysis unveiled common ethical dilemmas in providing Home Palliative Care. These dilemmas include balancing patient preferences with professional obligations, addressing the needs of both patients and their families, navigating caregiver-patient relationships, understanding patients’ cultural backgrounds, and advocating for home care as the preferred option while considering alternative treatment approaches.

Conclusions
Home palliative care poses ethical dilemmas for caregiving teams. It’s imperative for organizations in the home care sector to devise strategies aimed at assisting teams in navigating these challenges while upholding the autonomy and dignity of patients within their home environment.

Key messages
• Home-based care faces ethical challenges, requiring strategies to balance patient preferences and professional duties.
• Ethical home hospice care needs strategies that respect patient autonomy and dignity.