bluuebunny/crossref_metadata_2025_split huggingface dataset:
8.C. Workshop: Female leadership in times of crisis – fostering a sustainable future for humanity
Authors:   Organised by: Women in Global Health (WGH) European Chapters, EUPHA-MIG,   Chair persons: Bernadette Kumar (EUPHA-MIG), Peggy Maguire (Ireland)
Published: October 2023

Abstract

Women in Global Health (WGH) is a global movement with the largest network of women and allies working to challenge power and privilege for gender equity in health. It has grown to include over 50,000 supporters in 90 countries and has 41 official chapters. The WGH European network is an established hub of the global WGH movement focusing on gender equality in Europe Some of the WGH European Chapters have been engaged in the work with Ukrainian migrants.The workshop will start with a brief introduction to the WGH network and European hub. Following these opening remarks, the session will review the ongoing conflict in Ukraine through a gender equity lens, exploring what the crisis has taught us and how these experiences can help improve gender equity interventions in the future. The session will focus on two topics. 1) exploring the daily realities of women living in the conflict situation in Ukraine and 2) the situation of Ukrainian female refugees in European Member States. We will hear personal stories and accounts from Ukrainian women themselves and from professionals working with them both in-country and in European Member States. The inputs will be moderated in an interview style by one of the WGH European Chapter leads. The interviews will be followed by an interactive section where discussions will be facilitated with the audience in small groups. These discussions will centre on the accounts heard in the session and draw on any personal experience audience members may have of working with women in/from conflict situations, in Ukraine or elsewhere. In the plenary, we will then ask the small for feedback on their conversations. with the aim of discussing what the WGH movement can learn from these experiences with respect to applying them to interventions in gender equity in migrant health in the future. A final input from a female health leader will reflect on the session content and summarise its conclusions.

Key messages
• Gender equity can bring about transformative change in times of crisis.
• Gender equity is not merely the ethical way to advance, but an operational necessity in time of crisis.

Speakers/Panelists
Sabine Ludwig
Charité - Universitätsmedizin Berlin, Berlin, Germany
Halyna Skipalska
Ukrainian Foundation for Public Health, Kyiv, Ukraine
Paloma Cuchi
WHO, Poland
The German National Cohort (NAKO): Design, current state, and further follow-up data collection
Authors: Greiser K H , Bohn B , Hilger-Kolb J , Panreck L , Breunig E , Lieb W , Pischon T , Schikowski T , Völzke H 
Published: October 2023

Abstract
The German National Cohort (NAKO) is the largest population-based cohort study in Germany and provides a central resource for epidemiologic research. NAKO aims to investigate the development and aetiology of diseases, and to identify risk factors and enhance early detection and prevention of diseases with a focus on diabetes, cancer, cardiovascular, pulmonary, neurological, psychiatric, and infectious diseases. Between 2014 and 2019, overall 205,415 participants aged 20-74 years were recruited and examined at 18 study centres across Germany. During their visit to the study centre, they participated in an extensive examination programme including a face-to-face interview, self-administered, computer-based questionnaires, broad biomedical examinations (e.g., blood pressure, electrocardiograms, oral glucose tolerance tests) and provision of bio-samples (blood, urine, stool, saliva, nasal swabs). In addition, a subgroup of 30,861 participants received whole-body Magnet Resonance Imaging (MRI) with a focus on brain, heart, the musculoskeletal system, and body fat distribution. All study participants are re-invited for examinations at the study centres at 4-5 year intervals. The programme of the first re-examination is similar to the baseline programme in order to detect changes in risk factor profiles and in vascular, cardiac, metabolic, neurocognitive, pulmonary and sensory function. By 31.03.23, 100,822 participants were re-examined, including 14,950 with MRI re-examination. A third examination will start in 2024. Data collection is standardized, and central quality control and data cleaning is performed. For more complex data (e.g., echocardiography, accelerometry), competence units process the data and derive variables on exposure, functions, and disease. Due to its large sample size, the in-depth examination programme and the longitudinal design, NAKO provides an excellent source for better understanding of determinants for health and disease at the population level.
Environmental exposure assessment in the German National Cohort (NAKO)
Authors: Wolf K , Schikowski T , Dallavalle M , Niedermayer F , Bolte G , Lakes T , Moebus S , Schneider A , Peters A , Hoffmann B 
Published: October 2023

Abstract

Background
The environment plays a major role in human health and wellbeing. Air pollution, non-optimal temperatures, noise and lack of greenspace have been identified as the main external drivers, but their interplay is not well understood. Moreover, negative impacts are expected to increase in the coming decades due to population growth and climate change, especially in urban areas. Therefore, we aimed to assess the exposure to multiple environmental indicators and compare the spatial variation across NAKO participants to lay the foundation for subsequent health analyses.

Methods
We collected German-wide data from different sources for the following environmental indicators: short- and long-term air pollution (particulate matter, nitrogen dioxide, ozone), short- and long-term meteorology (air temperature, relative humidity), noise and greenness. All exposures were assigned to the NAKO participants based on their baseline residential addresses.

Results
The NAKO study regions ranged from highly urbanized areas (Berlin, Hamburg) with up to 4,123 inhabitants/km2 to rural regions (Neubrandenburg) with 732 inhabitants/km2. This large variation is reflected in the individual environmental exposures. PM2.5 and NO2 levels ranged from 7.7-16.2 and 4.2-32.6 µg/m3, respectively. Annual mean temperature for 2017 ranged between 8.1-11.7 °C. Noise data were available only for 22% of participants, of which 42% fell into the lowest and 1.9% into the highest category of Lden 55-59 and Lden &gt;75 dB(A), respectively. Greenness also showed considerable contrasts (Normalized Difference Vegetation Index between 0.09-0.82).

Conclusions
An extensive population-based data set with high-quality environmental indicators is available for the first time across Germany. Expanding the database by adding innovative indicators (e.g. light pollution, walkability) as well as socioeconomic factors (e.g. unemployment rate, deprivation) will further increase its impact on science and public health.
Building up public health resilience to tackle climate change in an urban context
Authors: Schmidt A , Lampl C , Aigner E , Haas W 
Published: October 2023

Abstract

Background
By 2050, about 70% of the global population will be living in cities. At the same time the health burden due to climate change is increasing in urban areas e.g. as heat waves become more frequent and prolonged and the socio-economic inequalities increase. Also, health systems are faced with multiple stress tests due to multimorbidity, lack of health personnel, and the direct and indirect health impacts of the climate crisis, falling disproportionately on disadvantaged populations. Gaining a better understanding of the climate-health-equity nexus represents huge potential for health policy to contribute to climate change mitigation and for climate policy to reduce disease burden while tackling socio-economic inequalities and health inequity.

Objective
Building on a systematic literature review, this paper presents a framework of the interdependencies between the climate crisis, public health, and social aspects and applies it to urban areas. It then links the domains identified with data requirements at the European level and highlights potential pitfalls for European health information systems, and all six building blocks of health systems following WHO's framework on climate resilience, from governance to health workforce to early warning systems.

Results
The review showcases risks associated with acting in “policy-silos”, neglecting the interactions between climate, health and inequality, compounding negative consequences both for planetary health and human health. Our data framework shows that the interdependencies described open up various opportunities for a European research infrastructure, in the aftermath of the COVID-19 pandemic and in a transformation towards more health promotion.

Conclusions
A European Green Deal with a strengthened focus on public health would have the potential to address these challenges, in cities and beyond. All health system building blocks need to contribute to such a climate-health pact at the European level.
Case report Montenegro
Authors: Obradović A 
Published: October 2023

Abstract
Montenegro is an upper-middle income country, with an estimated population of 620,739 (Eurostat, 2021). A national strategy for sustainable development until 2030 was adopted in July 2016, taking into account the implementation results of the Action Plan from the previous strategic document. Data for the period 2016-2021 are showing changes in a certain number of indicators, but also that Montenegro continued to face a large number of challenges (especially in No poverty and Gender equality goals), which became even more complex during the COVID-19 pandemic. Montenegro is reporting 69 out of 248 SDGs indicators. Indicators are not reported at all for 3 goals. Data similar to those required exist for some indicators, so a rough picture of trends in individual SDG goals can be obtained. For the remaining 14 goals, the median percentage of reported indicators is 31% (Range: 14%−58%). Some indicators are reported periodically, as part of research. Also, the UN methodology is not followed for all the reported indicators. For example, for the assessment of the first goal, 13 indicators were determined, and none of them are monitored by the UN methodology. However, since 2013, the Statistical Office of Montenegro has been calculating some indicators (based on the EU-SILC survey) that can be used for the same purpose. For SDG 3; Good health and well-being, there are improvements in certain segments: reduction in the infant mortality rate (2.8/1,000 from 2020) and mortality rate among children under 5 (3.7/1,000 from 2020) and reduction in the tuberculosis and malaria incidence. Numerous challenges are mainly reflected in the inequality of access and quality of health services, the high prevalence of current tobacco use among those over 15 years, and low air quality. Existing information system in healthcare is incomplete, fragmented and insufficiently interoperable to provide satisfactory data for monitoring the progress of indicators in this area.
Learning from experience: Integrating patient experience survey responses with other key metrics to understand and improve care quality and patient safety
Authors: Martin J , McDonnell T , O'Dowd M , Hogan E , Cosgrove G , Foley C , Healy O 
Published: October 2023

Abstract

Issue
The Irish National Care Experience Programme (NCEP) collects rich qualitative and quantitative data on patient and service-user experiences of healthcare. These survey data are not routinely triangulated with other quality and safety datasets for patient safety surveillance.

Description of the problem
The Irish Health Service Executive has commenced development of a quality and patient safety surveillance system called Quality and Safety Signals (QS Signals). This programme seeks to optimise the use of existing data to reduce variability in quality and safety of services, identify risks and signals of concern, as well as learnings from signals of excellence. Patient experience data is a rich source of insight into quality and safety of care but currently, it is not routinely considered alongside other quality and safety measures.

Results
As a proof of concept, the Quality and Safety Signals programme is collaborating with the National Women and Infants Health Programme (NWIHP) to develop a composite profile of quality and safety for maternity and neonatal services. A Clinical Advisory Group (CAG) has been established with multi-disciplinary clinical representation from Ireland's six Maternity Networks. To reach agreement amongst the CAG on the indicators relevant to the measurement of quality and safety, a series of interviews, workshops and a Delphi Survey are being conducted. The co-design process seeks consensus on the themes and classification structure appropriate for a composite profile of quality and safety.

Lessons
The implementation of a patient safety surveillance system challenges the Irish health system to reflect on how available data can best be harnessed. Person-centredness is a core domain of healthcare quality. Capturing the person's experience of care through the NCEP surveys is vital to ensuring the development of a comprehensive profile and guiding quality improvements.
The commercial determinants of health practices: a short introduction
Authors: Makhoul J 
Published: October 2023

Abstract
The field of study around the commercial determinants of health or commercial determinants of ill-health, corporate determinants, health harming commodities/industries, commercial drivers of NCDs, is a decade old. It encompasses the systems, practices, and pathways through which commercial actors drive health and equity (Gilmore et al, 2023) as well as sophisticated strategies that are designed to protect and promote commercial interests, at the expense of public health, the environment, and democracy (Lacy-Nicols et al, 2022). These strategies are common across varying types of industries and constitute unethical/illegal political, scientific, and business practices, such as manipulation, hiding the truth, coercion, exploitation, violation of workers’ rights, secrecy, deliberate exposure of the public to harm, and many more. This presentation will provide an overview of the commercial determinants, their playbook and illustrations from examples around the world to set the stage for exemplars of industry strategies and tactics of the tobacco, alcohol and fossil fuel industries.
Promoting Achievable Goals to Increase Physical Activity
Authors: Booth L , Jongenelis M , Hasking P , Hastings G , Pettigrew S 
Published: October 2023

Abstract

Background
Physical inactivity is a leading contributor to the development of non-communicable diseases including cardiovascular disease, diabetes, and cancer. Public health messages that advocate activity guidelines with specific duration thresholds (e.g., 30 minutes per day) have had limited success. This approach may risk an ‘all or nothing’ mindset whereby people feel exercise is not worthwhile unless they can meet recommended guidelines. World Health Organization guidelines recognise that any activity is better than none. In line with this, the present study aimed to test the effectiveness of two messages that referred to relative rather than absolute increases in physical activity: ‘Sit less, move more’ and ‘Add 2000 steps to your day’.

Methods
A representative sample of 7995 Australian adults responded to three surveys over six-weeks, with random assignment to a control condition (non-physical activity message) or one of two physical activity message conditions: Sit less, move more or Add 2000 steps to your day at each time point. At all three time points, respondents were exposed to their allocated message and reported their frequency of enacting the recommended behaviours. To account for attrition over the surveys, an intention-to-treat approach was adopted. Two generalised estimating equations models were run to examine time-by-condition interactions for the enactment of each message.

Results
Compared to control, respondents in the Add 2000 steps to your day condition significantly increased their enactment of adding 2000 steps to their day over time (B=.161, p=.011). Those in the Sit less, move more condition did not significantly differ from control in the frequency of enacting this message.

Conclusions
Promoting a specific physical activity goal that was relative to baseline activity increased the enactment of the recommended behaviour. Messages seeking to promote physical activity may be more effective if they include goals that are clear and feasible.

Key messages
• A message encouraging people to add 2000 steps to their day successfully increased physical activity.
• Promoting achievable goals in physical activity messages might be a useful public health strategy.
Health Literacy, lifestyles, and socio-economic factors in the Italian population: a national survey
Authors: Marcozzi B , Rosano A , Unim B , De Castro P , Cadeddu C , Lorini C , Donfrancesco C , Bonaccorsi G , Galeone D , Palmieri L 
Published: October 2023

Abstract

Introduction
Health literacy (HL) entails people's knowledge and abilities to find, understand and use health information to make health-related decisions. This study aims to evaluate HL association with lifestyles in the Italian adult population.

Methods
In 2021, in the framework of the Italian participation in the WHO network Measuring Population and Organizational Health Literacy M-POHL, a survey was conducted on a representative sample of the Italian population aged 18+ years (n = 3,500). A validated 47-item questionnaire was used to collect core HL information, plus 31 items for correlate information, including lifestyles. For each HL-item, a 4-point Likert scale was applied: very easy/easy/difficult/very difficult. The HL index (percentage of very easy/easy), was stratified in Inadequate (0%−50%), Problematic (51%−66%), Sufficient (67%−80%), Excellent (81%−100%). Inadequate/Problematic were merged into “Limiting”, Sufficient/Excellent in “Not limiting”. Multivariate logistic regression analysis was implemented to assess the association between dichotomous HL and obesity (BMI &gt; =30 Kg/m2), physical activity-PA (intense (5-7 days a week)/not intense (0-4 days a week)), fruit and vegetable diet-FVD (daily/not daily), smoking habit (yes/no), adjusted by sex, age, region, education-ED, financial deprivation-FD.

Results
Prevalence of Limiting HL is 64.6%. In Limiting HL, obesity is significantly higher than in Not limiting HL (14.6% vs 12.0%), similarly not intense PA (82.3% vs 75.7%), not daily FVD (54.0% vs 47.7%), low ED (22.3% vs 18.0%), severe FD (20.8% vs 9.1%); the opposite for smokers (30.2% vs 34.7%). Significant association with Limiting HL was found for not intense PA (Odds Ratio-OR=1.48), not daily FVD (OR = 1.24), low ED (OR = 1.39), severe FD (OR = 3.33).

Conclusions
Results show that persons with not intense PA and those with not daily FVD need targeted support to improve HL, as well as those with a lower level of education and problematic financial situation.

Key messages
• This study aims to evaluate Health literacy association with lifestyles and socio-economic factors in the Italian adult population.
• Intense physical activity and a regular fruit and vegetable diet lifestyles are associated with ‘Not limiting’ Health Literacy, as well as high educational level and low financial deprivation.
Evidence-based infographics and visual communication as powerful tools to improve health outcomes
Authors: Chanzu A , Wells M , Vitkin N , Nersesian S 
Published: October 2023

Abstract

Background
Anemia can double the risk of death in pregnancy, with women in developing countries being the most at risk. Adherence to an iron supplementation regimen can markedly improve overall health outcomes for those who are affected by iron deficiency anemia. Still, most adherence-boosting programs require significant counseling time with a primary care provider, a resource that is becoming increasingly scarce. In our review of the literature, we explored infographics and other visual science communication tools for their ability to improve medication adherence, with a special focus on low literacy populations in the developing world. With the results of this review being favourable, we conducted a subsequent literature search on factors that can amplify the useful effect of infographics.

Methods
We conducted a literature search on PubMed, Ovid MEDLINE, CINAHL, Web of Science, and PsycInfo to identify literature on effective visual science communication techniques. Techniques from the literature were then compiled and sorted into the categories of “DOs” or “DON’Ts” of developing impactful infographics. These guidelines were then utilized to develop an infographic depicting an iron supplementation regimen for pregnant women.

Results
27 recommendations on developing effective and impactful infographics were identified from the literature. These included, but were not limited to, the following: utilize accompanying text that is understandable at a low literacy level to prevent misinterpretation of the message depicted through pictogram(s), and use a culturally-sensitive lens to design images that would be easily relatable among the target cultural demographic. These recommendations were adapted to develop an evidence-based infographic.

Conclusions
Our review of effective visual science communication techniques supports the importance of using evidence-based methods to develop infographics that are effective among a range of demographics and medical conditions.

Key messages
• Evidence-based infographics and visual science communication tools can amplify the effectiveness of science and health communication.
• Infographics and visual science communication tools can be applied to a variety of literacy levels and medical conditions to improve patient outcomes.
Self-perceived and calculated health literacy score in long-term unemployed people
Authors: Singh H , Hübner W , Samkange-Zeeb F , Lakeberg M , Randles K , Kolschen J , Brand T , Zeeb H , Schüz B 
Published: October 2023

Abstract

Introduction
Recent studies show that low levels of health literacy are widespread in Germany, especially among socioeconomically disadvantaged groups such as long-term unemployed individuals. At the same time, it is unclear to what extent commonly used health literacy tools are tailored to the needs and literacy skills of socioeconomically disadvantaged populations. Therefore, we examined to what extent self-perceived and calculated health literacy scores of long-term unemployed people in Germany correlate.

Methods
We conducted 171 semi-structured interviews between November 2022 and February 2023 with long-term unemployed people in 11 occupational reintegration settings in Bremen, Germany. Health literacy was measured by the HLS-EU-Q16 (self-report health literacy score) and the Newest Vital Sign (calculated health literacy score). Descriptive and correlation analyses were performed with R.

Results
According to HLS-EU-Q16, 37% of the 171 participants (male=112, female=59) had sufficient health literacy, according to NVS only 29%. An inadequate health literacy score was shown by 19% according to HLS-EU-Q16, and by 48% according to NVS. The applied tools did not show a statistically significant correlation (r = 0.105, p = 0.17).

Conclusions
Self-reported health literacy data (e.g., measured by the HLS-EU-Q16) could underestimate deficits in health literacy and may be insufficient as a sole assessment tool to determine health literacy among low-literate populations as long-term unemployed people.

Key messages
• Various tools exist to measure health literacy. Not all measures might be suitable for all population groups. Literate skills should be considered while applying different health literacy measures.
• More health literacy data on low-literate populations is needed in the literature. Health literacy tools applied in these population groups should be short and easy to understand.