bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparedness and Public Health: an Italian Local Health Authority plan for a mass gathering in 2023
Authors: Lesa L , Longobardi G , Turello D 
Published: October 2024

Abstract

Issue
Mass gatherings represent an important Public Health challenge. The increased number of people present in a specific area puts local health systems under stress (i.e.workload of emergency services, environmental health and food safety) and at the same time it rises the risks of a potential mass casualty incident. Effective planning and disaster preparedness have to be achieved through collaboration among local health authorities(LHA) and other stakeholders (event planners, law enforcement, local transportation services).

Problem
Every year, for 3 days, the Italian Alpine troops gather in a different city to remember First World War fallen. During those days, the city centre transit is not allowed to car (in specific areas even to emergency vehicles).In May 2023 this event occurred in Udine, a city in the North East of Italy with almost 100.000 inhabitants. For that year at least 300.000 participants were expected. LHA had to reorganize preparing itself to manage a temporary quadrupled catchment area.

Results
In the previous months, local authorities met local health representatives and other stakeholders in order to define a single emergency response plan. For healthcare services it was decided to: institute first aid points within the city; reorganise patients’ emergency transport system; increase hospitals’ treatment capacity (beds, life support equipment); increase healthcare professional availability; empower drugstores (opening times, drugs procurement); strengthen human and animal health surveillances;activate alternative communication systems. During the event, LHA updated other authorities involved three times a day about hospital and emergency system situation. At the end of the event,a multiprofessional debriefing meeting was held and no critical situations were reported.

Lessons
Preparedness requires a great commitment in terms of resources and time, but it is confirmed to be essential to guarantee adequate assistance even in extraordinary conditions.

Key messages
• Mass gathering s events put under stress all the main areas of public health system.
• Public health preparedness cannot be effective without a strong involvement of other public and private stakeholders.
Prevalence and sociodemographic correlates of COVID-19 vaccine acceptance in 20 European countries
Authors: Pezzullo A M , Di Berardino F , Tricomi V , Boccia S 
Published: October 2024

Abstract
Our study aimed to analyze the prevalence and socio-economic factors associated with COVID-19 vaccine hesitancy using individual data from representative national samples of 20 European countries. Data from round 10 of the European Social Survey, collected from May 2021 to September 2022, were analyzed. Prevalence (with a 95% confidence interval (CI 95%)) of participants’ intention to get vaccinated against COVID-19 was calculated. Crude differences in vaccine hesitancy proportions across sociodemographic strata were assessed using the Chi-square test. There were 31,771 adult participants (46.0 % men). The percentage of those hesitant (i.e. those who were not already vaccinated and intended not to be) toward the COVID-19 vaccine was 18.0% (CI 95% 17.6 - 18.4). Men and women were equally hesitant (18.0% vs. 18.0%, p = 0.93). There were differences between those under 40 (22.9%), adults between 40 and 59 (18.1%), and those over 60 (14.3%, p &lt; 0.001). The unemployed had a higher proportion of hesitancy (32.9%) compared to the employed (17.4%), retirees (14.8%), and students (21.1%, p &lt; 0.001). People living in rural areas have higher levels of hesitancy compared to those in urban areas (19.3% vs. 17.3%, p &lt; 0.001). The estimates indicate that the highest prevalence of vaccine hesitancy was in Bulgaria (61.6%), Slovenia (40.4%) and Slovakia (30.7%), while Iceland (2.3%), Portugal (3.6%) and Italy (4.0%) had the lowest. Our study confirms high prevalence and high variability of hesitancy towards COVID-19 vaccines in Europe and identify groups for potential targeted interventions.
Environmental and health databases used together for boosting a One Health approach
Authors: Viegas Susana 
Published: October 2024

Abstract
Publicly available European environment data, and specifically those collected and published by the European Environment Agency represent a great asset for environment and health researchers and practitioners. This presentation will summarize the use of such data for various environment and health projects and assessments at the National School of Public Health of NOVA University in Lisbon, Portugal.
EEA data streams of public health relevance: the examples of air pollution, environmental noise and industrial emissions
Authors: Djurhuus Sune 
Published: October 2024

Abstract
The knowledge work of the European Environment Agency relies on high-quality data from our network and other institutional partners across 38 European countries. We collect, quality-assure and quality-check data on the environment, climate and sustainability, many of which are of high public health relevance. This presentation will summarize the most importance EEA datasets of public health relevance, including on air pollution, noise, industrial emissions, and others.
Developing survey instruments for low back and neck pain to improve disease severity estimates for burden of disease assessment
Authors: Wyper G , de Pauw R , Porst M 
Published: October 2024

Abstract
Two people living with the same disease can have very different experiences; one has little consequence, whilst the other struggles with much more debilitating consequences that impacts how they live their lives day-to-day. A growing body of research highlights the need for better estimates of disease severity to facilitate better estimation of the non-fatal burden of disease (BOD). Routine data does not always offer solutions because it’s often not coded at a granular enough level to map to individual health states. Data offering solutions are scarce and therefore not available across time or space. Most commentators have quantified the problem of assuming the same proportional severity splits to fill data gaps; a problem common to the Global Burden of Disease (GBD) study and independent BOD studies. However, whilst the need for highlighting the problems associated with this assumption remains, there are other positive steps that can be taken to overcome it. We propose how reproducible approaches can be developed, and present how they can be used to develop disease severity estimates. This involves developing a survey instrument to estimate the overall and health state prevalence of back pain and neck pain, basing health state definitions from the GBD non-fatal disease models, where the classification of cases by severity is based on the combination of respondent’s answers. Furthermore, we discuss how self-assessed severity estimates allow for internal validity checks, but also more widely offer opportunities to appraise the appropriateness of GBD non-fatal disease models. The development, and publication, of survey instruments can assist both independent studies and the GBD study to improve estimates of disease severity, as well as retaining important opportunities for cross-country comparability. Understanding the spectrum of severity is important for understanding how disease impacts populations and can inform healthcare provision and expenditure strategies.
Exploring changes in the distribution of health status in type 2 diabetes over time - methodological aspects for estimating years lost due to disability for Germany
Authors: Porst M , Rommel A , Schüssel K 
Published: October 2024

Abstract
Knowledge of the severity distribution (SD) of certain diseases is crucial for calculating the years lost due to disability (YLD), as the time spent with a disease is explicitly weighted on the health state level. Depending on the disease, different severity levels are considered. In most cases, the SDs vary from mild, moderate, severe to most severe. This is different in the context of diabetes, where an explicit distinction is made according to the sequelae resulting from the disease progression. In general, these include diabetic neuropathy (with foot ulcers or amputations) and (mild or moderate) vision impairments including blindness due to diabetic retinopathy. These complications cause a considerable loss of quality of life for those affected and high costs for the healthcare system. However, the progression of many of the sequelae can be avoided through (secondary) preventive measures. Estimating the degree of severity is therefore an important indicator of the population affected and in need for care. Due to a lack of data, the Global Burden of Disease Study often uses time-invariant and regionally fixed SDs. Important insights as to the temporal variance of SDs thus remain unnoticed. As part of the BURDEN 2020 pilot project in Germany, SD for diabetes-related complications were estimated from routine health insurance data for the year 2017. In a follow-up project (BURDEN 2.0), these results will also be available for the years 2017 to 2022. If there are any changes in the proportion of individual health conditions, implications can be generated from routine healthcare data of those affected. The SDs overall and according to certain sequelae will be presented over time and discussed. Also, the resulting YLD over time for type 2 diabetes will be examined, including changes in the prevalence of the disease. This makes it possible to analyse and interpret the burden of disease due to diabetes during the years 2017 to 2022.
Digital health literacy of adults with low reading and writing skills: A mixed-methods study
Authors: Muellmann S , Wiersing R , Brand T 
Published: October 2024

Abstract

Background
Around 12% of the adult population living in Germany have low reading and writing skills. Little is known about their digital health literacy and use of digital health technologies. The objectives of the Liter@te study were to assess the digital health literacy of adults with low reading and writing skills and to explore which digital tools they used in everyday life.

Methods
A cross-sectional survey (n = 96) and five focus groups (n = 39) were conducted with adults aged 18-64 years with low reading and writing skills. Digital health literacy was measured using the eHEALS scale and compared with results from a nationwide sample. Focus group participants completed a task course on digital health information and then discussed their experiences. Survey data were analyzed using descriptive statistics and logistic regression. Qualitative content analysis was applied to analyze the focus group data.

Results
Survey participants were on average 44 years old, 72% were female and 92% were not born in Germany. Compared to the nationwide survey, use of digital health technologies and digital health literacy were lower. In addition, use of digital health technologies was associated with higher digital health literacy. Lack of technical skills, language problems, and searching and finding health information online were most challenging for focus group participants (mean age 43 years, 87% female). Focus group participants reported that they prefer videos when searching for health information online and seek support from family members or local organizations if they cannot find a solution to their health issue.

Conclusions
Adults with low reading and writing skills search for health information online, but have difficulties to find the appropriate information. Interventions to promote digital health literacy are needed to ensure that persons with low reading and writing skills are not further left behind.

Key messages
• Adults with low language skills have a low digital health literacy.
• Reading and writing requirements and lack of technical skills make it difficult for them to search health information online.
7.C. Scientific session: Commercial determinants of health: impeding attainment of the Sustainable Development Goals
Authors:   Organised by: American University of Beirut (Lebanon), Global Commercial Determinants of Health Action Network,   Chair persons: Jihad Makhoul (Lebanon)
Published: October 2024

Abstract

The commercial determinants of health (CDOH) and the adverse impacts they have on health equity globally, have recently emerged as an innovative growing field of research in public health. The corporate playbook comprises a myriad of strategies and tactics that aim to enhance profitability for the commercial actors, while harming health and posing grave risks to planetary health for current and future generations. The literature however, rarely explicitly makes the connection between commercial determinants and the impact they have on the attainment of the Sustainable Development Goals (SDGs) set out by the United Nations in 2015. This workshop aims to use the commercial determinants of health framework as a new approach to draw attention to, and make linkages between, commercial determinants and the challenges they pose to the attainment of several if not all the global SDGs. The four presentations showcase exemplars of the commercial determinants to include the firearms industry, fossil fuel industry, food industry and the tobacco industry focusing on impacts in low- and middle-income countries (LMICs). The workshop will start with a brief overview of the CDOH framework, their corporate playbook, and the progress in SDG attainment globally while presenting the first case on the firearms industry trade impacting armed conflicts that impede SDG 3 (good health and wellbeing), 10 (reduced inequalities), and 16 (peace, justice and strong institutions). The second presentation will discuss how the fossil fuel industry uses greenwashing tactics to conceal its harmful activities thereby compromising SDGs 7 (affordable and clean energy), 11 (sustainable cities and communities), and 13 (climate action). The third presentation will address how the tobacco industry impedes the advancement of SDG 3, 8 (decent work and economic growth), 13 (climate action) and 17 (partnerships for the goals) perpetuated by national system level attributes. The last presentation will showcase how the food industry challenges SDG 3 in its production of ultra-processed foods. The workshop will draw on evidence from LMICs, but is also eye opening for high-income countries of Europe which face industry interference in social and health policymaking progress in SGD attainment. The audience will be engaged in a short warm-up exercise at the start of the workshop through an app for real-time feedback accessed through a QR code on the screen, and will interact with the presenters at the end of the workshop if time permits.

Key messages
• All commercial actors pose a direct or indirect threat to progress in attaining the SDGs.
• The commercial determinants of health pose are in direct contradiction to the SDG 17 through their corporate playbook.
Digital divide in access and use of digital health technologies: what do we know from Germany?
Authors: Muellmann S 
Published: October 2024

Abstract
Even though Germany is an industrialised country, health inequalities exist between individuals or population groups due to unequal access to scarce social resources such as money or knowledge. This case study illustrates the extent of the digital divide in access and use of digital health technologies. Data from the Liter@te study, in which 96 adults aged 18-64 years with low reading and writing skills living in Germany were asked about their digital health technology use and their digital health literacy, were compared with two parallel conducted population surveys in Germany (i.e., nationwide telephone survey on digitalisation and health with 1020 internet users aged 18 years and above, online survey on digitalisation in health care with 1839 adults aged 18-80 years insured at a statutory health insurance company). Adults with low reading and writing skills used digital devices in the health context such as computers (23% vs. 71%) or activity trackers (21% vs. 35%) less frequently than the general population, whereas no differences were reported in the use of smartphones (79% vs. 70%). In addition, 18% of adults with low reading and writing skills and 4% of the general population stated that they do not use digital health technologies. Other digital health technologies such as online appointment scheduling (25% vs. 81%) or health websites (32% vs. 45%) were also used less frequently by adults with low reading and writing skills compared to the general population. Participants in the Liter@te study who do not use digital health technologies reported more frequent access problems (e.g., no suitable device, technical problems, poor internet connection) than participants in the population survey. 35% of participants in the Liter@te study have a low digital health literacy (eHEALS score between 8-19/40 points), compared to only 8% in the population survey.
Population health status and green urban areas: impact on health outcomes in two Italian regions
Authors: Congedo G , Perilli A , Filomeno A , Rodeschini M , Lombardi G S , Zjalic D , Di Russo M , Nachira L , Garda E , Bruno S 
Published: October 2024

Abstract

Background
Living in urban areas has been linked to a rise in noncommunicable diseases. Nevertheless, there is scarcity of evidence emphasizing the combined impacts of certain urban attributes (e.g. pollution, excessive soil sealing, urban temperatures) and the existence of green spaces on health outcomes. Further studies are imperative to evaluate the association between chronic illnesses such as dementia and ischemic heart disease, and the presence of urban green areas.

Methods
We conducted an ecological study in two Italian regions. Prevalence of chronic diseases in Tuscany and Latium were obtained at the municipality level from public health databases available online and Normalized Difference Vegetation Index (NDVI) was calculated for 2023. Descriptive analyses and Poisson regression models were run to assess the association between green space and chronic diseases prevalence, adjusting for age, sex, education, employment, foreign residents, income, urbanicity and spatial correlation.

Results
Preliminary analyses were conducted on 273 municipalities in Tuscany. Mean prevalence per 1000 inhabitants of dementia and ischemic heart disease were 15.75 (SD = 5.3) and 48.25 (SD = 11.06), respectively. Mean NDVI across municipalities was 0.37 (SD = 0.04). Higher green exposure is associated with lower prevalence of ischemic heart disease (β= -0.21; p &lt; 0.05) and dementia (β=-0.3, p &lt; 0.05). Analyses will be executed for the Latium region and complete results will be available by mid-June.

Conclusions
The presence of urban greenery appears to be associated with a reduction in chronic illnesses. While further studies are warranted, it is crucial to adopt urban policies focused on green spaces and citizens’ health outcomes. Generating evidence for decision-makers is essential for shaping urban environments in ways that promote both health and overall human wellbeing.

Key messages
• Living in green urban areas appears to positively impact human health, reducing chronic disease prevalence.
• Greenery serve as a tool for mitigating and adapting to the climate crisis, promoting health.
Does the way workplace canteens are managed influence users’ plate waste?
Authors: Menis D , Fiori F , Cautero P , Zago D , Driutti M , Lesa L , Conte A , Scarpis E , Brunelli L , Parpinel M 
Published: October 2024

Abstract

Background
Plate waste (PW) is part of the food waste and is defined as the amount of edible food served not eaten. There are few estimates of PW in the food services, mainly in school canteens, where PW appears to differ depending on the provider. Our aim was to analyse the role of different canteen management in determining PW in three hospital canteens in Italy.

Methods
On 5 working days between August and September 2022, healthcare workers’ trays were photographed before and after meal consumption. We compared two canteens managed by an external catering service (EC) with one internally managed (IC). The two canteens with similar sample size had different management. A modified visual Comstock scale was used to assess the PW. The Carbon Footprint (CF), Water Footprint (WF), energy and nutrient content were estimated using the SU-EATABLE LIFE database and the Italian Food Composition Database for Epidemiological Studies (www.bda-ieo.it). Significance was set at p &lt; 0.05.

Results
1227 trays were analysed (1026 in EC; 201 in IC), most of which contained no waste. The percentage of trays with leftovers was higher in EC (34%) than in IC (21%), as was the mean amount of PW (104g EC vs 60g IC) (p &lt; 0.001). The PW contained significantly more energy (125 kcal vs 73 kcal) and protein (6.0g vs 2.4g) and had higher CF (204 CO2eq EC vs 76 CO2eq IC) and WF (178 LH20 EC vs 75 LH20 IC) in CE than in IC. The significance was confirmed independently to the sample size of the canteens, and when the analysis was repeated and only the first access of each user was considered.

Conclusions
Results suggest that an internally managed canteen produces less leftovers than a canteen operated by an external provider. This could be because an internally managed canteen is more adaptable to users in terms of food offerings and portion sizes, despite a smaller number of food options. However, further studies are needed to confirm our findings and to identify the causes of PW in food service.

Key messages
• Internally managed canteens seem to reduce plate waste, probably due to certain flexibility according to users’ plate waste.
• Non-served food of the canteen should be estimated to confirm our data.
Screen time and social media exposure in children and adolescents - the landscape
Authors: Elias Cecília 
Published: October 2024

Abstract
Dr. Cecilia Elias is a Public Health Consultant, collaborating with the Infant, Youth, Sexual and Reproductive Health Division at the Health Directorate General, in Lisbon, Portugal. Following on from John’s introduction, Cecilia will dig deeper into the impacts of the omnipresence of social media and phones in modern society. She will provide an overview of the harms and benefits for today’s youth. She will highlight data for example on impaired development of language, cognitive and social skills from screen exposure at young ages, and increased rates of depression, anxiety, self-harm, and school refusal among adolescents with problematic social media usage, including examples of significant outcomes. Exposure to disturbing and harmful content on social media platforms like TikTok and Instagram will be covered also.
Social media use in children and young adults: the Malta experience
Authors: Calleja-Agius Jean 
Published: October 2024

Abstract
Prof. Jean Calleja Agius MD PhD is Professor at Faculty of Medicine and Surgery at the University of Malta. Jean will demonstrate further examples of interventions to make the internet safer for young people, drawing on her experience of collaborating with the Children and Youth Council within the Malta Foundation for the Wellbeing of Society (MFWS), which in turn is affiliated with EUROCHILD. She will share the outcomes of initiatives which have been carried out within MFWS and outline recommendations made directly by children and adolescents. More stringent regulation of social media companies will be addressed, as well as the need for other measures to engage children in other healthier activities and empower them to opt for the right choices.