bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaccine hesitancy in Europe: the long and winding road
Authors: Cadeddu C 
Published: October 2023

Abstract
Vaccine hesitancy has always been a hot topic in the European public health discussions and the COVID-19 pandemic has increased its relevance for consequences not exclusively related to health. In this presentation, results of a recent analysis carried out on data from the last round of the European Social Survey will be shown, highlighting that the relationship of vaccine hesitancy with many socio-cultural elements, among which conspiracy theories and distrust towards scientific community. As for other public health topics, these considerations underline the need for a multidisciplinary and multistakeholder approach to vaccine hesitancy, particularly important for countries like Eastern Europe where hesitancy and conspiracy theories appear to be widespread. This approach would be able to explore and understand all the addressable factors to structure the right way of communicating and disseminating evidence, engaging the population of any sociocultural area, and reducing hesitancy by increasing trust in scientists and institutions, driving safely on this long and winding vaccination road.
Air pollution, mortality, and hospital admissions in Scotland: A 16 years register-based study
Authors: Abed Al Ahad M , Demšar U , Sullivan F , Kulu H 
Published: October 2023

Abstract

Background
Air pollution is associated with poor health and higher mortality. However, studies that link high spatial resolution air pollution data for several pollutants to individual-level data over prolonged period (&gt;10 years) and assess multiple health outcomes are limited. In this study, we investigated the association between 16-years exposure to air pollution and all-cause and cause-specific (cardiovascular, respiratory, cancer, infectious, and mental/behavioural disorders) mortality and hospital admissions in Scotland.

Methods
Individual-level data from the “Scottish Longitudinal Study” for 202,237 individuals (2002-2017) were linked to yearly concentrations of NO2, SO2, PM10, and PM2.5 pollutants at 1-Km2 spatial resolution using the individual's residential postcode. The association between air pollution and mortality and hospital admissions was examined using Cox Proportional-Hazards and multilevel mixed-effects negative binomial models, respectively.

Results
Increasing concentrations of PM2.5, PM10, and NO2 pollutants were associated with higher rates of all-cause, cardiovascular, respiratory, cancer, and infectious mortality and hospital admissions. Mortality from respiratory diseases increased by 6.2% (95%CI=2.8%−9.6%), 2.5% (95%CI=0.5%−4.5%), and 1.2% (95%CI=0.5%−1.9%) per 1 µg/m3 increase in PM2.5, PM10 and NO2 pollutants, respectively. Exposure to SO2 was mainly linked to mental/behavioural disorders mortality (HR = 1.05; 95%CI=1.02-1.07) and respiratory hospital admissions (IRR=1.02; 95%CI=1.01-1.03).

Conclusions
This study revealed a positive association between air pollution and mortality and hospital admissions in Scotland. Interventions on air pollution through stricter environmental regulations could help ease the mortality and hospital admission burden, for both physical and mental illness.

Key messages
• Air pollution is associated with a higher risk of mortality and hospital admissions for both physical and mental health-related outcomes.
• Policymakers are urged to provide incentives for the usage of greener energy sources to reduce air pollution emissions.
1.I. Keeping health at the forefront: A debate on health priorities of the European Union
Authors:   Organised by: European Commission, European Observatory on Health Systems and Policies,   Chair person: Matthias Wismar (European Observatory)
Published: October 2023

Abstract

The European Commission has launched a public debate on health priorities of the European Union in partnership with the European Observatory on Health Systems and Policies. Taking stock of achievements and current actions, this debate serves to gather different stakeholder perspectives and foster in-depth discussions on the way forward, while keeping health at the forefront of political agendas. This session will allow participants to dig deep into policy-relevant topics centred around tackling challenges such as climate change and ageing, as well as strengthening and promoting the sustainable transformation of health systems in the digital age. Expert opinions will inform the debate, followed by interactions with the audience allowing participants to share their perspectives. Inputs gathered during this session will feed directly into the European Commission's Conference plenary session held on Saturday. The ultimate aim of this public debate is to generate ideas, gather perspectives and to establish a meaningful dialogue that can support the European Union in carving out health priorities for the future.

Speakers/Panelists
Monica Brînzac
EUPHAnxt
Alessandro Berionni
Young WFPHA and Medical Resident in Public Health, San Raffaele University, Milan, Italy
Cristina Alina Modoran
DG Sante, European Commission, Brussels, Belgium
Matthias Wismar
European Observatory, Brussels, Belgium
1.K. Workshop: Health Promoting Sports Clubs: tackling intervention implementation and evaluation challenges
Authors:   Organised by: University of Limerick (Ireland), Katholieke Universiteit Leuven (Belgium),   Chair persons: Aurélie Van Hoye (Ireland), Jan Seghers (Belgium)
Published: October 2023

Abstract

Settings have been defined as ‘the place or social context where people engage in daily activities in which environmental, organizational and personal factors interact to affect health and well-being’. Settings-based approaches have successfully been applied in different traditional settings, like schools, cities, and workplaces. During the last two decades, the health promoting sports clubs theoretical and empirical foundation has emerged to support sports clubs’ investment in health promotion beyond the provision of sport itself, leading to physical, social and mental benefits. Two recent literature reviews have showed limited evidence on validated health promotion measurement instrument and interventions, identifying only three interventions worldwide that have been rigorously evaluated. The present workshop will synthetises the mechanisms used in different health promoting sports clubs’ interventions, reflect on methods for intervention evaluation and offer guidelines for sports federation and clubs. The first presentation will set the scene by describing youth sports club's participation in Finland from 2016 to 2022, specifically providing insights on the determinants of sport drop out. The second presentation will offer a deep understanding of context and mechanisms leading to effectiveness, used in interventions to promote men's health in organised sport, using a rapid realist review methodology. The third presentation will complete the second by mapping provision and evaluation practice of interventions delivered by professional sports clubs in the UK, through a practice-based targeted review. The fourth presentation will showcase the type of evaluation needed to investigate health promoting sports club's intervention, drawing from a pragmatic feasibility trial conducted in Ireland. The fifth presentation will offer practical guidelines for national sports federation on how to implement health promoting sports clubs, through a toolkit which has been edited in collaboration with the World Health Organisation. Based on the different presentations, discussion will be engaged with Jan Seghers, who has conducted major work on implementing health promoting sports clubs in Flanders, as well as the speakers and the audience. We also plan to discuss the active mechanisms identified in the interventions and how to address challenges in conducting empirical research on health promoting sports clubs. Lastly, we will open the floor for reflections on intervention research conducted in other settings.

Key messages
• The workshop will synthetises evidence on health promoting sports club's intervention implementation and evaluation.
• The workshop will provide guidelines and recommendations for conducting and evaluating health promoting sports clubs’ interventions.
Health literacy practices in 3D social virtual world
Authors: McElhinney E 
Published: October 2023

Abstract

Background
Social Virtual Worlds (VWs), for example, Second Life are online 3D multiuser virtual environments (MUVE). Access by users or ‘residents’ of these environments is through the creation of a representation of themselves, known as an avatar. These social immersive environments have been used to present health information using interactive games, simulations, support groups and healthcare seminars. The use of these environments during COVID-19 increased especially in countries with strict lockdown rules. However, limited published studies have investigated the health literacy (HL) skills and practices undertaken by individuals or communities in virtual worlds. Therefore, this study aimed to advance understanding of the social skills and health literacy practices used by individuals and communities within this immersive ‘place’ and the influence on physical world health behaviour.

Methods
25 semi-structured interviews were conducted with participants within the virtual world Second Life.

Results
Findings demonstrated that participants used their social VW networks within the VW to search for, access, experience, appraise, understand, and make decisions to use health information. These social methods allowed reciprocal sharing of information, access to people within multiple VW groups who had different VW knowledge, skills, and health literacy practices. Additionally, this maximised the health literacy resources available, meaning improvements to individual or community HL.

Conclusions
An adapted framework of social skills and cultural literacy competencies used within VWs to improve individual and community HL be discussed and how this leads to distributed HL within the community. This framework is the first collection of social skills and adult HL used within VWs and make a unique contribution to ncreasing the understanding of the type of literacies used in social VWs to manage health information in online and offline communities.
The Future of HSR Program Evaluation: A European Perspective
Authors: Sirven N , Mousquès J 
Published: October 2023

Abstract
There is a long tradition of program evaluation in public health, due to the influence of medical approaches and the development of evidence-based medicine. Health services research have thus provided substantial evidence and built itself partially on the evaluation of organizational innovations over time in various international healthcare settings. What is new here? What is the future of HSR from an evaluation perspective? Since the turn of the century, two main shifts in the resources and methods available to public health researchers could provide a significant leap for HSR research in Europe, and in France especially. First, more data are being produced and made available to researchers. Most healthcare systems in Europe have implemented DRGs and for doing so, information systems have been developed incidentally. This led to the routine production of data initially used for payment schemes, that are now increasingly being used for research. Although this is similar to what happened in the US, the main difference with European healthcare systems lies in the generalized approach of the welfare system to the whole population. Second, evaluation methods recently evolved towards the framework of what is known as “realist evaluation” based on the causal analysis of programs or public policies while incorporating contextual effects and a theoretical perspective to explain rather than merely measure the effect - or lack thereof. To conclude, we shall argue that the future of HSR program evaluation may bring together researchers, health professionals and policymakers to discuss, explore, experiment and implement innovative actions in healthcare to address the challenges to come.
Uncovering gender bias in health services: the case of kidney transplantation
Authors: Komla Adoli L , Châtelet V , Daugas E , Vabret E , Jais J P , Bayer F , Vigneau C , Couchoud C , Bayat-Makoei S 
Published: October 2023

Abstract
Gender-based inequalities of access to health care are major public health issues. Studies performed in several countries and in some French regions showed that women had less access to kidney transplantation waiting list (KTWL) than men. Through a quantitative study based on REIN registry data, we analysed gender-based disparities in the access to KTWL in France. All incident patients who initiated dialysis from 2017 to 2019 and aged between 18 and 85 years old were included. Cox proportional hazard models, adjusted on age, comorbidities and neighbourhood deprivation level using European Deprivation Index (EDI), at national level and in all French regions, were performed. Among 29 395 patients who started dialysis in 2017-2019, 35% were women. 40% of women and 34% of men lived in most deprived areas. Men were more comorbid than women at dialysis start. At the national level, women had less access to the KTWL compared to men one and three years after dialysis start. Analyses were stratified by age (&lt;60 and ≥ 60 years old). Only women aged more than 60 had less access to the KTWL one year (adjHR: 0.76 [0.71 - 0.82]) and three years (adjHR: 0.75 [0.71 - 0.81]) after dialysis start. At regional level, the same trends were found in Nouvelle Aquitaine and Pays de Loire one year after dialysis start and two more regions (Bourgogne-Franche-Comté and Île-de-France) 3 years after dialysis start. Gender-based disparities in KTWL persist even after controlling for EDI and comorbidities, especially among women over 60. These results are issued from a health service research project on gender-based disparities of access to KTWL in France. A qualitative study is ongoing to better understand the reasons of these disparities. Patients’ perspectives on Kidney transplantation and nephrologists’ practices are studied using Semi-structured interviews in three French regions.
What steps can improve and promote investment in the health and care workforce in Europe?
Authors: Williams G 
Published: October 2023

Abstract

Background
Recent experiences from Ireland and elsewhere have shown the urgent need for countries and international actors to prioritize investment in the health and care workforce (HCWF) and ensure funding is used well. This research, based on a European Observatory on Health Systems and Policies policy brief, explores: i) areas for strategic investments in the HCWF; and ii) how greater funding from domestic and international sources can be secured.

Methods
A scoping review of English-language peer reviewed and grey literature was conducted across databases and online repositories including PubMed, Scopus, Web of Science, Google Scholar, WHO data collections. The literature search focused on two areas: 1) areas for strategic investments in the organization, training, deployment and management of the HCWF; 2) actions that can help scale-up investment from domestic and international financing sources.

Findings
Strategic investments to effectively enhance the sustainability of the HCWF can be grouped into strategies that aim to: 1) increase the quantity, quality and diversity of available HCWs through education investments; 2) reskill and optimize use of the HCWF through investments in preventative and primary care, skill mix reforms and digital technologies; 3) improve employment and retention through labour market interventions and protecting, supporting and managing the HCWF. Ministries of Health must be able to share the measurable benefits of workforce development to secure greater investment, which requires: evidence on the socioeconomic benefits of HCWF investments; strong leadership and capacity; improved intersectoral governance processes; and more efficient and transparent health sector budget cycle processes.

Conclusions
Education, employment and retention of HCWs needs to be a priority in public expenditure to increase supply, protect the existing workforce and plan ahead to address future challenges.
Food, Nutritional Status and Health Literacy
Authors: Saboga-Nunes L , Medeiros M 
Published: October 2023

Abstract

Introduction
Azores is an autonomous region of Portugal situated in the middle of the Atlantic Ocean. As a catchment area of cultural identity, it can be an interesting setting to better understand Health Literacy (HL) personal & community development. Therefore developing ChildRen and ADolescents’ health Literacy (CrAdLiSa) become a local government strategy for all children and adolescents in the region. The aim of this study, is to explore the relationship between several components of adolescents living in Azores, like sustainable life style, focusing food, nutritional status, e.g. water intake (WI), and HL. With this situation diagnosis local authorities aim to develop policies towards HL increment while fighting health disparities.

Methods
A population (N = 852) cross-sectional study included (n = 515)) children enrolled in the 7th school year 2018/2019 of six schools in Ponta Delgada, Azores. Several indicators like anthropometric data, water intake, HL levels (using the HLS-EU-PT questionnaire) were collected with the CrAdLiSa online self-administered questionnaire.

Results
The instrument to measure HL (HLS-EU-PT) (Cronbach's alpha coefficient 0,94) allowed to consider that there is an association between HL and WI (p = 0,029), i.e. children with higher levels of HL have greater WI as they have a broader perception of the adequate amount of water needed to be healthy.

Discussion
These results continue to explore CrAdLiSa study, to better inform with ground base data policy makers regarding HL development.
From Data to Action: How the European Climate and Health Observatory is addressing climate and health challenges
Authors: Kazmierczak A 
Published: October 2023

Abstract
The European Climate and Health Observatory is a partnership between the European Commission, the European Environment Agency (EEA) and several other organisations that aims to support Europe in preparing for and adapting to the impacts of climate change on human health by providing access to relevant information and tools. This presentation will describe the aims and objectives of the European Climate and Health Observatory. As climate change continues to have far-reaching impacts on human health, it is important to have reliable information and data to guide policy decisions and public health interventions. The European Climate and Health Observatory aims to provide that by bringing together data and information on the health impacts of climate change in Europe, as well as the policies and interventions that can help mitigate those impacts. During this presentation, we will discuss the specific objectives of the Observatory, including its focus on providing accessible and timely information to policymakers, health professionals, and the public. We will also highlight key resources that are available through the Observatory, such as indicators of climate change impacts on human health, map viewers on risks, and examples of responses in policy and practice. Finally, we will discuss how the Observatory is working to engage stakeholders across the health and climate change communities, and how individuals and organizations can get involved in supporting its work. The aim is to build a robust and comprehensive understanding of the complex interactions between climate change and health, and to develop evidence-based solutions that can protect the health and well-being of individuals and communities.
Allergens detection in food and environmental samples in northern Italy
Authors: Pavoni E , Bertasi B , Finazzi G , Filipello V , Ragni L , Abdul M E , Losio M N 
Published: October 2023

Abstract

Background
The raise in global food trading showed an increase in allergic cases in Europe. Ethnic, novel and hidden food enhanced the probability of consumers to adverse events. The demand for allergens-free food grew with the need to be informed on the ingredients content. EU Reg. 1169/2011, details the products causing allergies or intolerances that must be indicated on the label if present. This work studied the prevalence of suspected allergens into apparently compliant food and environmental samples, aiming to verify their safety.

Methods
Totally, 1611 foodstuffs and 128 swabs were received from January 2022 to April 2023. They were independently tested for gluten, milk, egg, mustard, peanut, pistachio, sesame, soy or hazelnut. Commercial ELISA kits were used according to manufacturers’ instructions. Non-compliance to gluten was &gt;20 ppm, and for the other allergens it was “presence” above the limit of detection.

Results
Data showed 46 non-compliant samples (2.6%): 37 foodstuffs (2.1%) and 9 swabs (0.5%). Of these, 16 were irregular for gluten (34.8%) and 14 (9 swabs, 5 food) for egg (30.4%); 9 contained milk (19.5%), 4 (8.7%) hazelnut, 2 (4.3%) soy and 1 (2.2%) peanut. No positives for other allergens. The most tested parameters were gluten (85%) and milk (10%).

Conclusions
The frequency of food allergy in Europe has been increasingly reported. In this study, 97.4% of samples complied with the label and were safe for allergic consumers. Clients were highly sensitive to gluten, egg, milk, soy and nut-free products. Considering the importance of food for human health and the increase in illness cases, checking of compliance to the rules is important.

Key messages
• The majority of allergens can affect seriously allergic consumers (also death), even if present in traces. A continuous surveillance is very important to prevent risks for sensitive consumers.
• The foodstuffs collected in this survey are mainly safe for allergic people.
Point prevalence survey on healthcare-associated infections in Apulian region, Italy, 2022-2023
Authors: Fortunato F , Martinelli D , Iannelli G , Ascatigno L , Lopalco P L , Prato R 
Published: October 2023

Abstract

Background
Since 2011-2012, the ECDC coordinates the measurement of Healthcare-associated infections (HAIs) and antimicrobial use (AMU) in European acute-care hospitals through repeated point prevalence surveys (PPS) every five years. Here we present the main results of the 3rd ECDC-PPS conducted in Apulia region, Italy, during November 2022, in comparison as a benchmark with data from Italian PPS 2016-2017.

Methods
The ECDC protocols were applied. Prevalence of HAIs and AMU was expressed as percentages. Proportion of isolates resistant to selected AMR markers were also calculated.

Results
Twenty-four/39 Apulian hospitals provided data on 3,710 patients. The prevalence of patients with ≥1 HAI was 9.9% (PPS-2016-17:8.03%). The highest prevalence was recorded in rehabilitation wards (31.6%; PPS-2016-17:16.4%), in large hospitals (10.5%; PPS-2016-17:9.3%), among elderly (11.2%; PPS-2016-17:9.1%), males (11.1%; PPS-2016-17:7.9%), and patients with a rapidly fatal McCabe score (28%; PPS-2016-17:18.8%). The most reported types of HAI were pneumonia (19.8%; PPS-2016-17:22.8%) and urinary tract infections (18.3%; PPS-2016-17:18%). Prevalence of patients with ≥1 antimicrobial was 49.3% (PPS-2016-17:44.5%). At least a positive microbiological result was reported for 66.1% of the HAIs (N = 244/369; PPS-2016-17:53.8%). Klebsiella pneumoniae (14.9%; PPS-2016-17:10.4%) and Escherichia coli (9.8%; PPS-2016-17: 13%) were the most frequently isolated microorganisms. The susceptibility tests were available for 56% of microorganisms (N = 177/316) and a resistant result was reported for 50.3% (PPS-2016-17:42.3%) of tests.

Conclusions
HAI, AMU, and AMR prevalence estimated in Apulia region was higher, when compared with previous national PPS. Efforts in implementing antimicrobial stewardship and reducing HAIs should be established.

Key messages
• HAI and AMR remain a major public health threat in Apulia region, particularly for K. pneumoniae and E. coli.
• Frail patients bear a greater burden of illness.