bluuebunny/crossref_metadata_2025_split huggingface dataset:
Welsh Health Equity Solutions Platform
Authors: Couzens L , Hill R , Dyakova M , Allen J , Stewart D , Peden J 
Published: October 2023

Abstract

Health inequities are a longstanding issue in Wales, as they are across the globe. They disproportionately affect the health& wellbeing outcomes of disadvantaged groups, restricting opportunities to live full and prosperous lives. Post COVID-19 new groups are emerging with disproportionately higher risk of poor health and premature death and disease, especially those with unmet needs and vulnerabilities. More recently, the rising cost of living is amplifying health inequities. Despite their prevalence, health inequities are avoidable. Caused by multiple, interlinked factors; efforts to reduce health inequities thus require action on all the social determinants of health across the life course. Improved understanding of the key drivers of health gaps is needed to address the problem& provide support for solutions-driven action to break down the barriers to health equity. The Welsh Health Equity Solutions Platform (WHESP) is a new innovative tool developed around the WHO Health Equity Status Report initiative framework of the ‘five essential conditions’ for healthy, prosperous lives for all. WHESP aims to inform and facilitate policy and decision making to improve population health and address the increasing health gap. WHESP is an online gateway to data, health economics and modelling, policies, resources and innovative tools on health equity. Emerging evidence is highlighted to identify tools and solutions for achieving healthy prosperous lives for all in Wales and beyond. WHESP will be linked with and feed into a WHO health equity gateway, providing an example and inspiration for countries to learn and follow, as well as to contribute and share. WHESP recognises that there is not a ‘one size fits all’ approach. It provides an extensive body of evidence to inform evidence-based decision making to reduce the health gap, improve overall population health and wellbeing, and achieve inclusive and sustainable economic growth and prosperity for all.

Key messages
• Efforts to reduce health inequalities require action across all of the social determinants of health.
• WHESP provides extensive evidence to facilitate cross-sectoral action and policy change.
Men who have sex with men under mpox threat- changes in sexual behaviors and mpox-vaccines uptake
Authors: Mor Z , Poliker E , Avni G , Anis E 
Published: October 2023

Abstract

Introduction
Since May 2022, 261 cases of mpox were reported in Israel. Of those 259 (99.2%) were men who had sex with men (MSM). The outbreak was contained following the use of MVA-BN vaccines, which became available in August 2022. This longitudinal study aims to assess MSM’ change in sexual behaviors (CSB) due to mpox and appraise the adherence for vaccination.

Methods
The anonymous questionnaires were published in a popular geospatial application frequented by MSM (Grindr) between September and October 2022. Participants were asked to report their demographic characteristics, use of pre-exposure prophylaxis (PrEP), CSB and MVA-BN vaccines uptake.

Results
In total, 665 MSM included in the study with an average age of 35.5 years, 425 (63.6%) lived in Tel Aviv area, and 169 (25.4%) were in steady relationships. Mpox diagnosis and HIV infection were reported by 19 (2.9%) and 21 (3.2%), respectively. The 317 (47.7%) who CSB due to mpox concern were more likely to live in Tel Aviv, more commonly in open relationships, performed sex in gay-related venues, involved in unprotected anal sex, were concerned about mpox and more commonly vaccinated against mpox compared with participants who did not CSB. In multivariate analysis, living in Tel Aviv, open relationships, unprotected anal sex, being concerned with mpox and vaccination predicted CSB. The 221 (33.3%) who were vaccinated were more commonly older, more likely to live in Tel Aviv, in steady relationships, performed sex in gay-related venues, were infected with HIV, used PrEP and CSB compared with non-vaccinated participants. In multivariate analysis, living in Tel Aviv, being in steady relationships, HIV infection, PrEP use and CSB predicted vaccination.

Conclusions
Nearly half of the participants CSB and one-third were vaccinated- both outcomes were more common among MSM who were at high risk for mpox infection. MSM are responsive to potential sexual risks and adopt their sexual behaviors according to the threat.

Key messages
• Nearly half of the MSM who participants in the study changed their sexual behavior and 1/3 were vaccinated against mpox.
• MSM are responsive to potential sexual risks and adopt their sexual behaviors according to the threat, whether it is HIV, STD or mpox.
An optimisation study to reduce greenhouse gas emissions from adults’ current diet in Italy
Authors: Biasini B , Donati M , Rosi A , Kalmpourtzidou A , Bonaccio M , Ruggiero E , Iacoviello L , Scazzina F 
Published: October 2023

Abstract

Background
Trade-offs between health and sustainability dimensions should be addressed since environmentally sustainable diets can require a substantial dietary shift and result in nutrient deficiencies. The study aimed at modelling the current dietary consumption of the adult population in Italy to reduce diet-related greenhouse gas emission (GHGe) while complying with the National Recommended Energy and Nutrient Intake Levels (LARN), food-based dietary guidelines, and preferences.

Methods
Food consumption data from the Italian Nutrition & HEalth Survey (INHES) study (n = 8944, 53% females) have been used as reference diet. Through a non-linear programming model, two intermediate nutritionally adequate dietary scenarios, which alternatively minimised the impact on climate change or modifications in current food consumption, have been generated contextually to a final diet model combining both outcomes. Several constraints ranging from recommended dietary intakes to proper food associations and substitutions were applied to the model.

Results
The final modelled diet had an average energy content of 2100 kcal/d with carbohydrates, proteins, lipids, and fibers accounting respectively for 49%, 16%, 31%, and 4% of the total energy. The associated GHGe were 2.01 kg CO2 eq/d: 49% less than the current diet, 22% more than the balanced diet with the lowest GHGe, and 12% less than the balanced diet closest to actual food consumption. Wholegrain bread, peas, seasonal fruit and vegetables, chicken, tuna, whole milk and extra-virgin olive oil were the most represented products within each corresponding food group.

Conclusions
The study proposes a balanced and climate-friendly diet which simultaneously minimises changes in food preferences, reducing barriers towards more sustainable food choices. Diet optimisation can be a promising tool to support public health strategies by suggesting less environmentally impactful and culturally acceptable dietary shifts at the country level.

Key messages
• The present study provides a culturally acceptable and nutritionally balanced dietary scenario optimised for greenhouse gas emissions to be proposed as a model for the adult population in Italy.
• The study contributes to the development of public health policies by supporting feasible dietary behavioural shifts towards healthy and sustainable dietary choices.
Assessing care quality: impact on renal outcomes in non-diabetic chronic kidney disease patients
Authors: Wu H-Y , Hsu L-Y , Tsai P-H , Chien K-L 
Published: October 2023

Abstract

Background
Chronic kidney disease (CKD) is a major global noncommunicable disease, with significant burden on healthcare systems. Quality indicators (QIs) are useful tools for evaluating healthcare quality, but existing QIs for renal care mainly focus on dialysis population. This study aims to explore the association between quality of renal care and outcomes in non-diabetic CKD patients.

Methods
This study utilized Taiwan's National Health Insurance claims data and death registries to enroll non-diabetic adults with advanced CKD (stage 3B-5) from 2016 to 2019, following them through 2020. QIs evaluated included prescription of renin-angiotensin system (RAS) inhibitors, testing for proteinuria, and avoidance of nonsteroidal anti-inflammatory drugs (NSAIDs). An overall quality score was calculated by summing scores of each QI. The primary outcome was long-term dialysis, and secondary outcomes included death, acute kidney injury (AKI), hyperkalemia, and acidosis. Univariate and multivariate Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of the effects of QIs on outcomes.

Results
Among 27,842 patients, 59.8% received RAS inhibitors, 56.5% underwent proteinuria testing, and NSAIDs were avoided in 97.9% of cases. Only 33.5% received the highest QI score of 3. Multivariate Cox proportional hazard models showed that higher overall quality scores were associated with a lower risk of long-term dialysis (HR 0.87, 95% CI 0.83-0.92), death (HR 0.90, 95% CI 0.86-0.94), and acidosis (HR 0.87, 95% CI 0.79-0.96). Additionally, higher overall quality scores were borderline associated with a lower risk of AKI and hyperkalemia.

Conclusions
QIs for renal care were associated with better outcomes in non-diabetic patients with advanced-stage CKD, particularly in long-term dialysis, death, and acidosis. More patients need to be prescribed RAS inhibitors and tested for proteinuria to achieve better quality of renal care.

Key messages
• Our study shows quality of renal care can impact outcomes for non-diabetic CKD patients, with higher quality indicator scores associated with lower risk of long-term dialysis, death, and acidosis.
• Prescription of RAS inhibitors had the most significant protective effect, but more patients need to be prescribed RAS inhibitors and tested for proteinuria to achieve better renal care quality.
Costs and benefits of climate services for heat-health adaptation in Europe
Authors: Rao-Skirbekk S , Budin-Ljøsne I , Chaudhary P , Sitoula S , Chersich M 
Published: October 2023

Abstract

Background
Climate services for health aim to support informed decision-making and enable early action and preparedness. More knowledge is still needed regarding the costs and benefits of climate services, as well as effectiveness, and technical, structural, and societal barriers and facilitators to implementation and use.

Aim
To map the evidence on the economic assessment and use of climate services for health in reducing heat-associated mortality and morbidity and explore the societal impact of climate services, particularly in Europe.

Methods
We focus on two methods in this study: 1) a scoping review of literature on the economic assessment and health benefit of climate services 2) a set of interviews with climate service developers and providers in Europe to understand further technical and societal aspects as well as evaluation of such services.

Findings
From the scoping review, a total of 27 peer-reviewed articles all presenting heat early warning systems (HEWS) that work on a weather timescale were identified. The results from economic assessment studies suggested HEWS can produce health benefits greater than the operational cost, even during future climate change scenarios. While most of the studies assessing health outcomes have suggested that HEWS can help in reducing heat-related mortality and morbidity, some concluded no significant impact and some suggested increased healthcare services utilization after implementation of HEWS. The findings from the six interviews conducted across Europe identifies barriers for climate service development and implementation such as insufficient financing and cultural differences between climate and health professionals.

Conclusions
Our results find limited evidence on the economic assessment of climate services, gap in knowledge regarding health benefits from climate services using seasonal/sub-seasonal and long-term climate information and several barriers to making these services useful for end-users.
6.F. Workshop: Digital public health in Europe - What is the new normal?
Authors:   Organised by: EUPHA-DH,   Chair persons: Laura Maass (Germany), Anthony Staines (Ireland)
Published: October 2023

Abstract

Digital public health has influenced how countries use health data for research and practice, how we deliver healthcare, and how health professionals monitor infectious diseases. The COVID-19 pandemic accelerated the international adoption of digital health interventions for public health aims. While some European countries were already advanced in digital health and digital public health before the pandemic, other nations took the opportunity to catch up. Internationally, governments introduced contact-tracing apps, telemedical services, digitally supported health promotion programs, nationally regulated medical apps, and education programs for citizens and experts to improve digital (health) literacy. The planned European Health Data Space will lift the level of digital public health in Europe once more. However, the maturity of digital public health among European countries varies drastically. While some are global leaders in digitalizing their health systems, others barely implemented the necessary infrastructure. But there is also a third perspective: Some countries that led Europe through the pandemic from a digital public health perspective started withdrawing from digitalizing their healthcare and health promotion and returning to “normal”. It is time to examine what this new “normal” post-pandemic means and how countries evolved. We will learn from the experience of 4 different European countries (Romania, Ireland, Slovenia, and Germany) how COVID-19 changed their health system and if digital public health is still applied now that the pandemic is officially over. The workshop's ultimate goal is to highlight and discuss which digital transformations in European health systems were permanent and whether or not Europe will continue to take a leading role in digital public health in the future. Each representative will have 10 minutes to contextualize their country's digital public health strategy before the pandemic (the old normal), their strategy to address the crisis, and how the country includes digital public health in its health system after the pandemic (the new normal). We will use the remaining 20 minutes of the workshop for a discussion between the speakers and the audience.

Key messages
• The COVID-19 crisis pushed Europe's digital public health transformation so that countries were enabled to use digital health data for improved healthcare and health promotion on a national level.
• In order for the transformation to be sustainable, countries need to fundamentally rethink their health systems and make way for better digital innovation.
Development of a Core Outcome Set for Patient Safety in Perioperative Care: Insights from the SAFEST Project
Authors: Nunes A B 
Published: October 2023

Abstract
Although surgical-related adverse effects are among the most common in-hospital adverse events, no set of indicators has yet been defined for a comprehensive and patient-centred analysis of this phenomenon. Thus, it is crucial to standardise a minimum set of indicators, a Core Outcome Set (COS), to allow for monitoring and evaluation of implemented patient safety best practices in perioperative care. The SAFEST project aimed to develop a relevant and feasible COS for patient safety in perioperative care, including patient-relevant data. Following a multimethod approach, an initial list of indicators (ILO) was developed by conducting an umbrella review on patient safety in perioperative care in surgical adult patients. The ILO was prioritised by a diverse group of experts, including patients, through a two-round eDelphi Technique, according to the importance and feasibility of each indicator. Exploring the challenges of measuring specific indicators, the same experts will define the final list of indicators in a consensus conference. From 588 indicators extracted in the umbrella review, 247 indicators were included in the ILO to be independently rated, on a 9-point Likert scale, by participating experts. The indicators were grouped by the perioperative period (preoperative, intraoperative, postoperative and mixed) and further subgrouped by Donabedian's quality of care conceptual model Structure - Process - Outcome. During the eDelphi process, some indicators were reworded, split, merged, added or removed, according to experts’ comments. The final set of indicators results is not yet available as this study is still undergoing. This COS contributes to enhancing standardised reporting in perioperative patient safety, allowing for benchmarking across EU countries and facilitating data comparison across studies.
Effect of school-based HPV vaccine campaigns on inequalities in uptake in France: the PrevHPV trial
Authors: Dussault J , Le Duc-Banaszuk A S , Gagneux-Brunon A , Bruel S , Gauchet A , Barret A S , Sicsic J , Thilly N , Mueller J E ,   PrevHPV consortium
Published: October 2023

Abstract

Background
HPV vaccination is recommended in France for all adolescents aged 11-14. Coverage has increased over recent years but remains below 50% by age 15, with social disparities by area deprivation level, parental education and income. We analysed the effect of school-wide campaigns on adolescent vaccine uptake and related disparities.

Methods
PrevHPV is a controlled cluster-randomised trial to assess the effectiveness and efficiency of a multi-component intervention targeting middle schools and general practitioners. Sixty-one French middle schools were randomised in a partial factorial design to one of six intervention arms, some of which included school-based vaccine campaigns combined with in-class education and motivation. We assessed HPV vaccine status using online questionnaires that were administered in class to pupils (aged 13-15 years) at baseline and after 5 months. Using linear regression, we explored the decomposed effect of campaigns on vaccine uptake and interactions of the effect with sociodemographic variables.

Results
In total, 2639 adolescents provided complete vaccination data on both questionnaires, with a ≥ 1-dose coverage of 24% at baseline. Among previously unvaccinated pupils (N = 2017), 21% (7%) of girls (boys) in the control group reported receipt of first vaccine dose during the follow-up period, compared to 49% (33%) in arms with vaccine campaigns. Adjusting for baseline vaccine intention, vaccine campaigns increased the 5-month probability of a first dose by 25 (95% confidence interval: 19-31) percentage points compared to the control group. The effect of vaccine campaigns on student-reported vaccine uptake did not substantially vary by school area deprivation level, parental education level, or family multilingualism (compared to French monolingual family).

Conclusions
School-based campaigns substantially increased vaccine coverage among all adolescents within a short time period. Yet, underlying disparities in HPV vaccination were unchanged.

Key messages
• School-based vaccine campaigns can quickly increase HPV vaccine uptake among adolescents.
• Vaccination campaigns need tailored implementation strategies to eventually reduce social disparities in HPV vaccination.
Changes in health of older adults during the COVID-19 pandemic: a longitudinal cohort study
Authors: Besselink D , Herber GCM , van der Lucht F , Sealy M J , Krijnen W P , Jager-Wittenaar H , Finnema E J 
Published: October 2023

Abstract

Background
COVID-19 measures affected the lives of many older adults. Yet, little is known on changes in health among older adults, especially in periods when COVID-19 measures relaxed. We aimed to assess changes in health of older adults during multiple turning points of the COVID-19 pandemic and to analyse differences in changes in health between subpopulations of older adults.

Methods
This longitudinal study includes data from Dutch older adults (≥65 years) participating in the Lifelines COVID-19 Cohort and consists of seven questionnaires administered every 2-4 months between May ‘20 and October ‘21. The outcomes were quality of life (n = 14,682), physical fitness (n = 14,761) and feelings of isolation (n = 14,611). Changes in health and differences between subpopulations were analysed by multivariable linear mixed-effects models. Fluctuations in COVID-19 measures were described by the Government Stringency Index.

Results
Changes in quality of life and feelings of isolation of older adults coincided with fluctuations in the stringency of COVID-19 measures. In periods when measures were tightened, quality of life and feelings of isolation decreased and when measures relaxed, they improved. For example, when measures relaxed after the first lockdown in May ‘20, quality of life improved with 0.23 [95%CI: 0.16, 0.29] (p&lt;.001). For physical fitness, changes were characterised by a slight decline of 0.26 [95%CI: 0.15, 0.37] (p=.001) during the study period. Differences in subpopulations were found for feelings of isolation for which differences between men and women congregated after a longer period of relaxed measures with 0.59 [95%CI: 0.49, 0.69] (p&lt;.001).

Conclusions
Quality of life and feelings of isolation among older adults recover after periods of stringent measures. For physical fitness, the slight but continuing decline suggests a negative impact of COVID-19 measures. Our findings might indicate the need for health policy strategies to mitigate this effect.

Key messages
• Changes in quality of life and feelings of isolation of older adults coincided with fluctuations in stringency of COVID-19 measures and display recovery after periods of stringent measures.
• Changes in physical fitness were characterized by slight decline and did not recover after stringent measures, suggesting an impact of COVID-19 measures on physical health of older adults.