bluuebunny/crossref_metadata_2025_split huggingface dataset:
4.Y.2. Building inclusive risk communication, community engagement and infodemic management strategies
Authors:   Organised by: Ludwig Maximilian University (Germany),   Chair persons: Zeliha Öcek (Germany), Dilek Aslan (Türkiye)
Published: October 2024

Abstract

Public health crises have their most devastating effects on people who are marginalized due to structural vulnerability mechanisms. As a reflection of this phenomenon, the Novel Coronavirus Disease (COVID-19) pandemic as a public health crises has increased the vulnerability of groups such as refugees, asylum-seekers and LGBTQ+ individuals facing discrimination, stigmatisation, displacement, economic instability, risk environments, precarious living and working conditions among others, and health inequities have been further deepened. A critical post-pandemic task is to develop comprehensive crisis response plans that prioritize inclusivity and address diverse needs. Integral to these plans are Risk Communication (RC), Community Engagement (CE), and Infodemic Management (IM) strategies. While international organizations have provided guidelines for RCCE-IM, there is an urgent need to translate these principles into tailored, context-specific strategies that account for the unique circumstances and requirements of diverse groups. The aim of this workshop is to reflect the lessons learned from the COVID-19 pandemic to strengthen the RCCE-IM strategies, using the cases of migrants and LGBTQ+ people, two groups who are intensively influenced by structural vulnerability mechanisms. The first 20 minutes of this workshop will feature four short presentations. First, the concepts of RCCE-IM will be defined, followed by an explanation of why related strategies should differ for vulnerable groups. The second presentation will focus on the issues that LGBTQ+ people faced during the COVID-19 pandemic, as well as their specific RCCE-IM needs. The third and fourth presentations are based on a collective project taking an expert perspective on the RCCE experience with migrants during the COVID-19 pandemic. Firstly, the extent to which the RCCE actions in Munich, Germany, has been able to include asylum-seekers and areas for improvement will be presented. This will be followed by a presentation on recommendations to enhance RCCE of the experts who were working with undocumented migrants, unaccompanied minors, and newly arrived refugees in Malmö, Sweden. In the final part of the workshop, participants will be invited to provide brief recommendations on the operationalization of international RCCE-IM principles across four key thematic areas: 1) Rapid adaptation of RC materials to culture and context, 2) Trust-building in crisis, 3) Navigating sociocultural and linguistic diversity, 4) Addressing LGBTQ+ migrants in RCCE activities.

Key messages
• Addressing vulnerable groups in (public) health and humanitarian crises using RCCE-IM strategies are needed to leave no one behind.
• To conduct inclusive RCCE-IM activities, cities need to address structural vulnerabilities, identify different needs and context-based strategies, and integrate various sectors and perspectives.
How do palliative care clinicians use their emotions during end-of-life encounters?
Authors: Moens K , Bilsen J , Zambrano S 
Published: October 2024

Abstract

Background
Palliative care clinicians are regularly exposed to emotionally laden end-of-life care situations. Until now, the use of their emotions during palliative care consultations has remained understudied. We aimed to develop a theory to understand how palliative care clinicians use their emotions.

Methods
Qualitative data were collected via individual interviews held with different types of palliative care clinicians across the world (countries were selected based on their Quality of Death Index ranking). We used a social constructivist grounded theory approach to analyze the data using a constant comparative method.

Results
We held interviews with 21 palliative care clinicians (5 nurses, 11 physicians, 2 psychologists, and 3 social workers) from 10 different countries. Fourteen were female. Participants’ average age was 46 and they had 14 or more years of palliative care experience. The mean length of the interviews was 52 minutes. The process of using emotions could be characterized as follows: first, a difficult end-of-life encounter (e.g. ethical dilemmas or conflicts) would trigger a strong emotion in clinicians. Second, clinicians become aware of the specific emotion via its physical or psychological cues. Third, an assessment of the appropriateness of the use of the emotion follows, in which facilitators and barriers (e.g. the level of emotion skills, the view on emotions, or the feeling of safety in the team) interplay, influencing the clinician to act upon a specific emotion or not. Finally, with a specific intent (e.g. to build connection, stimulate patients and relatives to express their feelings, or clarify a point of view) the clinician shares, shows, or expresses the emotion.

Conclusions
We found that the strong emotions clinicians experience can be used as a valuable resource to provide palliative care. We also identified key steps to aid clinicians reflect on the appropriateness of using certain emotions in patient care.

Key messages
• Palliative care clinicians’ emotions can be considered as tools to support palliative care provision.
• The developed theory shows potential to explore its applicability in other professions that are also regularly confronted with emotionally charged situations.
Levels of adherence to the Planetary Health Diet of current diets in Italian adults
Authors: Grosso G , Tucci M , Godos J , Martini D 
Published: October 2024

Abstract

Despite the efforts in the direction towards the identification of healthy and sustainable diets, little is known about the environmental impact associated with current diets. The aim of this study was to validate the application of the Planetary Health Diet Index (PHDI) to dietary habits currently adopted in a sample of adults living in southern Italy and background variables associated. Dietary intake from nearly 2000 individuals was assessed through a validated 110-item food frequency questionnaire. The PHDI was applied by considering the energy contribution of 16 different components with a gradual scoring system. For the estimation of the environmental impact, carbon and water footprint data for food commodities were extracted from the SU-EATABLE LIFE database and matched with the FFQ items. An energy-adjusted linear association between the PHDI scores and the majority of food groups included in the analysis was found; when considering the level of food processing, ultra-processed food consumption was inversely associated with PHDI scores. Among nutrients, PHDI scores were directly associated with fiber, antioxidant vitamins, potassium, plant-derived omega-3 poly-unsaturated fats, and inversely with sodium, total, saturated, mono- and poly-unsaturated fats, cholesterol, and protein. A significant difference in carbon and water footprint was observed across quartiles of PHDI scores as well as a linear direct association. After adjustment for potential confounding factors, 1-point increase in the PHDI score was associated with lower likelihood of being overweight or obese (OR = 0.99, 95% CI: 0.98-0.99). A linear inverse association between PHDI scores and waist and hip circumferences and, partially, with BMI but not with body weight was found. In conclusion, the PHDI seems to properly identify an environmentally friendly diet with a good nutritional quality.

Key messages
• An environmental-friendly dietary pattern resulted also having a good nutritional profile.
• Adherence to the Planetary Health Diet is associated with parameters of central obesity.
Establishing a healthy and sustainable diet in diabetes management: a social marketing approach
Authors: Ribeiro R T , Mourre M , Ribeiro L , Nascimento do Ó D , Charvet A , Sequeira M J , Dupont E , Raposo J F 
Published: October 2024

Abstract

Background
In recent years, there has been evidence that diets based on plant-based products have positive results in the management of type 2 diabetes (T2D). However, their adoption remains low.

Objectives
To evaluate and understand food consumption of people with T2D; and to define priority groups for intervention using a social marketing approach.

Methodology
An online questionnaire was developed and applied to 832 adults with T2D living in Portugal and France. The questionnaire included the collection of socio-demographic data, health data, as well as data on food consumption, eating habits, awareness and attitudes towards the consumption of plant-based foods. Finally, hands-on food workshops were organized to convey practical knowledge on plant-based food cooking.

Results
Regarding eating habits, 11% of participants have already excluded or would like to exclude meat products, and 37% would like to consume them in smaller quantities. 35% of the participants intend to increase the intake of plant-based products. The most well-known diets among the participants were the Mediterranean diet (80%) and Low Carb diet (51%). Regarding the Planetary diet, 86% of the participants expressed low or no knowledge. Regarding the consumption of plant-based foods, 61% of participants view them as a desirable and suitable option for people with diabetes. Furthermore, the planetary diet is among the least often recommended by healthcare professionals (1%). The clustering of participants originated five main groups, with two being highlighted as particularly relevant for intervention, namely through knowledge or practical support.

Conclusions
Overall, participants with T2D seem to have a positive attitude towards increasing the consumption of plant-based products and decreasing the consumption of meat products. Social marketing profiling identified specific clusters which constitute priority target groups for support in shifting to healthier and sustainable diets.

Key messages
• Social marketing profiling identified specific clusters which constitute priority target groups to support the shift towards plant-based/planetary diets.
• Hands-on food workshops were shown to be effective in conveying practical knowledge and motivation about plant-based diets.
International survey of young adults’ opinions on tobacco endgame measures & e-cigarette regulations
Authors: Gannon J , Forberger S , Bar-Zeev Y , Cattaruzza M , Kilibarda B , Jongenelis M , Cosgrave E , Sinha N , Gonzalez M , Kabir Z 
Published: October 2024

Abstract

In the last decade, while tobacco consumption has decreased, there has been a significant rise in e-cigarette usage particularly among young people. Tobacco-free generations and other endgame strategies are being considered in several countries, moving from tobacco control towards ending the tobacco epidemic. This online survey of 18-34-year-olds evaluated opinions on potential endgame measures and e-cigarette regulations, to generate evidence to inform policy decisions. The survey was developed with input from the World Federation of Public Health Associations and Tobacco-Free Ireland, asking participants about support (yes/no) for 20 endgame measures in 4 domains and attitudes towards e-cigarettes. Utilising convenience sampling, the survey was distributed through international networks. Of 295 responses in 34 countries, 72% were never smokers and 56% were never e-cigarette users. 31% were aware of tobacco endgame. 68% supported increasing tobacco purchasing age to 21. 70% supported restricting tobacco sales to a limited number of licenced shops. 73% supported reducing nicotine content in cigarettes. 74% supported tobacco companies having to pay for health costs from smoking. 73% would like to see tobacco-free generation legislation in their country, but only 31% expected it would be successful. Regarding e-cigarettes, they were judged as more desirable than cigarettes mostly due to different flavours and visual appearance (both 74%). They were perceived to be an important health risk (82%) and as or more addictive than cigarettes (78%). 65% believed overall harms from e-cigarettes outweigh benefits for society. 86% felt they should be subjected to the same advertising restrictions as cigarettes and 66% supported increasing their cost. There was strong support for various tobacco endgame measures and tobacco-free generation legislation in this 18-34-year-old cohort. The majority recognised health risks of e-cigarettes and favoured stricter regulation of these products.

Key messages
• An international survey of 295 young adults in 34 countries demonstrated strong support for various tobacco endgame measures including tobacco-free generation legislation.
• For e-cigarettes, there was wide acknowledgement of addictiveness and health risk, and support for increased education and warnings, lower nicotine content and reduced advertising and availability.
Consumer Preferences for Health Services Offered by Health Insurance Companies in Germany
Authors: Schilling R , Pavlova M , Karaman A 
Published: October 2024

Abstract

German health insurance companies increasingly strive to position themselves as health partners to their customers to improve customers’ health and contain costs. However, there is uncertainty about customers’ preferences for health services offered by health insurance companies. Therefore, this paper studies consumer preferences for health services that are or could be provided by health insurance companies in Germany. An online survey was conducted using two stated preference techniques to collect and analyze the data (namely, rating and ranking of health services considered by insurance companies). A sample of 880 German health insurance customers between 18 and 65 years old filled out the online questionnaire, of which 860 submitted complete responses. Ordinal logistic regression analysis was used for the rating and ranking. Preliminary examinations, care management, and health programs were the three health services most important to the respondents. The results suggest that people want their health insurance to support them with preventive health services that offer direct therapeutic value and not just informational, economic, access-related, or convenience-related benefits. These preferences for health services are homogeneous for most subgroups of the population, implying that health insurance companies could consider an overall strategy to address these preferences for all clients by focusing on the important health services.

Key messages
• People value health services provided by health insurers that offer direct therapeutic value over those that offer only informational, economic, access or convenience benefits.
• As preferences are homogeneous across the population, insurers could consider an overall strategy by focusing on the important health services.
Diagnoses of mental health disorders among Norwegian youth and young adults with immigrant parents
Authors: Sheikh N S , Straiton M L , Kjøllesdal M K 
Published: October 2024

Abstract

Introduction
Adolescence and early adulthood are associated with an increase in mental health problems. Migration is also a risk factor for mental disorders. Yet, there is a notable gap in research concerning the mental well-being of descendants of immigrants. This study investigates the risk of a diagnosis of a mental health disorder among those aged 16-30 years, born in Norway with at least one immigrant parent.

Methods
Data were sourced from the Medical Birth Registry of Norway, the Norwegian Patient Register, and Statistics Norway. Cox proportional hazard regressions were used to estimate hazard ratios (HR) of being diagnosed with different mental disorders, in total and by parental region of origin, compared to individuals of Norwegian background. Analyses were adjusted for sex, year of birth, and parental education.

Results
Individuals with two immigrant parents had a lower risk of most mental disorder diagnoses, while those of one immigrant parent had a higher risk. With the exception of schizophrenia, individuals with two immigrant parents had a lower risk of most mental disorder diagnoses compared to those with Norwegian-born parents. The HR for the risk of a diagnosis of anxiety for those with two immigrant parents was: 0.79 [95% CI 0.76 - 0.81], with immigrant mother: 1.07 [95% CI 1.04-1.10], with immigrant father: 1.28 [95% CI 1.24 -1.30]. Similarly, for depression, two immigrant parents: 0.85 [95% CI 0.82-0.88], immigrant mother: 1.13 [95% CI 1.09 - 1.17], immigrant father: 1.31 (95% CI 1.28-1.37). Bipolar disorders, two immigrant parents: 0.67 [95% CI 0.60-0.76], immigrant mother: 1.19 [95% CI 1.07 - 1.31], immigrant father: 1.47 [95% CI 1.35-1.61]. The pattern was relatively consistent across parental regions of origin.

Conclusions
Those with one immigrant parent are more likely to use specialist mental health services, while those with two immigrant parents are not. These need special attention in adulthood.

Key messages
• Differences in risk of diagnosis for mental disorders could be due to differences in the utilization of mental health services.
• Early prevention of mental health issues seems to be especially important among children and youth raised in families with one immigrant parent.
Dis-continuity in Continuity-of-Care: a pathway for more equal access to mental health care services?
Authors: Burau V , Buch Mejsner S , Fehsenfeld M 
Published: October 2024

Abstract

Background
Access to healthcare is core to achieving universal health coverage. Reaching and obtaining appropriate health care services requires engagement by health care organizations and users. For people with mental illness, access emerges as a continuous process, reflecting oscillating health conditions. This challenges aspirations of continuity of care (COC), but we know little about the experiences of users.

Methods
We carried out observations of interactions between professionals and users (n = 18) and semi-structured interviews with users, professionals, and managers (n = 33) in the specialised mental health services in Central Denmark Region and FACT-inspired teams in three municipalities. We also conducted 3 focus groups with regional and municipal professionals from these teams. Data was analysed through a qualitative thematic analysis.

Results
From the perspective of users, COC builds on the acknowledgment of their entire life situation. For users, this is about making connections between their past, present and future lives. Past experience affect their present abilities to follow treatment and influence future hopes and expectations. The acknowledgment of these connections often translates into spaces of discontinuity in continuity, where users need occasional breaks from treatment but worry about being excluded from treatment. Crucially, the organization of the FACT-inspired teams allows for flexibility in the intensity of visits and treatment. The norms of professionals also support users’ perspectives on COC, as the norms focus on building trust in the relations between users and professionals.

Conclusions
One important step to achieve more equal access is to integrate the social world of users. This requires organizational and professional approaches that allow for user needs for dis-continuity in COC.

Key messages
• For mental health service users, continuity-of-care includes breaks from treatment (discontinuity).
• More equal health access requires adapting continuity-of-care to needs as perceived by users.
A longitudinal study of the impacts of area-level social cohesion on multimorbidity in Scotland
Authors: Zheng C , Abubakar E , Dibben C , Marshall A , Pearce J 
Published: October 2024

Abstract

Background
Multimorbidity is a growing global public health challenge, commonly referring to the co-occurrence of 2+ conditions but with varying measurements. Prior evidence has linked social cohesion with single health conditions; however, its impact on multimorbidity remains unclear. This study aims to examine the association between area-level social cohesion and multimorbidity and to explore whether this association will vary across multimorbidity measurements and levels of urban-rural classification.

Methods
Using a dataset that links the Scottish Longitudinal Study (5.3% of the Scottish population) with hospitalisation records (2001-2019) and an index that reflects area-level social cohesion (2012), focused on the cohorts of adults aged 40+, we used 3-level logistic regression to account for the clustered data structure of diagnosed chronic conditions over time within individuals within neighbourhoods.

Results
Areas with the highest social cohesion were observed to have the lowest risks of multimorbidity (p &lt; 0.001), even after adjusting for area-level income deprivation. Varying by multimorbidity measurements, an inverted U-shaped pattern was observed between reduced area-level social cohesion and increased risks of having 2+ co-occurring chronic conditions; while a linear pattern was found for mental-physical multimorbidity. Moderated by levels of urban-rural classification, as compared to rural residents, urban residents were more sensitive to the impact of social cohesion on the co-occurrence of 2+ conditions; however, for mental-physical multimorbidity, no interaction effects between area-level social cohesion and urban-rural classification were found.

Conclusions
Although varying patterns were seen for different multimorbidity measurements, people living in areas with the highest area-level social cohesion were less likely to be multimorbid. This study offers new insights for developing effective place-based public health interventions.

Key messages
• This is the first longitudinal study that analysed the association between area-level social cohesion and multimorbidity using a nationally representative dataset based on secondary care data.
• Area-level social cohesion affects multimorbidity, but its impact may vary by multimorbidity measurements and by urban-rural classification.
Static output feedback control for positive 2D discrete systems in Roesser model
Authors: Bolajraf Mohamed 
Published: October 2024

Abstract
This paper investigates the output stabilization problem for multi-input multi-output positive 2D systems described by a linear discrete-time Roesser system. This kind of systems have the property that the horizontal and vertical states take non-negative values whenever the initial boundaries are non-negative. Conditions for the existence of desired static output feedback controllers guaranteeing the resultant closed-loop system to be positive and asymptotically stable are obtained. Also, the synthesis of static output feedback controllers, including the requirement of positivity of the controllers, is solved. These results are then extended to the case of uncertain plants. All of the proposed conditions are expressed in terms of Linear Programming, which can be easily verified by using standard numerical software. Finally, several numerical examples are included to illustrate the validity and the effectiveness of the developed results.