bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rapid synthesis of evidence on whole systems approaches to obesity prevention to inform policy
Authors: Reynolds C , Mack J , McAvoy H , Breslin G , Wills W , McGowan L 
Published: October 2023

Abstract

Background
The Department of Health in Northern Ireland is developing a new obesity prevention strategy. To support policy development, the Institute of Public Health commissioned a rapid synthesis of evidence on whole systems approaches to obesity prevention. Objectives were to present evidence from existing reviews on whole systems approach effectiveness, describe case studies where a whole systems approach has been applied and propose key policy considerations.

Methods
A rapid synthesis of evidence on whole systems approaches, rather than a full systematic evidence review, was conducted to meet policy development timelines. Review articles were included, as were national and international case studies that described whole systems approach implementation and/or evaluation. The Methodological Index for Non-Randomised Studies Framework was used to assess the methodological quality of the case studies.

Results
Five review articles and five case studies (majority moderate-borderline strong quality) were included. Results showed whole systems approaches can be associated with improvements in Body Mass Index, physical activity environment and improved community wellbeing, with a school component being particularly effective. Facilitators to implementation included leadership, community involvement, consistent language, adequate resources and evaluation/systems science knowledge.

Conclusions
Whole systems approaches can be effective in enhancing the capacity of communities to create healthier environments and deliver measurable reductions in Body Mass Index.

Key messages
• Whole systems approaches to obesity prevention can be effective in creating healthier environments.
• Findings from this research could support any future pilot of this approach in Northern Ireland.
COVID-19 Health Information System Assessments
Authors: Saso M , Schutte N 
Published: October 2023

Abstract
In the second presentation, the results from the 8 PHIRI assessments conducted between January 2022 and April 2023, that aim to map the health information systems (HIS) that monitor the effects of COVID-19 on population health, assessing the COVID-19 health information flows in European countries, will be presented. The mapping includes an assessment of the underlying needs and how these relate to current gaps in the European HISs. Additionally, it investigates potential future needs and gaps to which PHIRI can respond through its services. The methodology followed to perform the assessment as well as the topics covered such as data collection and data sources, data analysis and data management, development and use of indicators, human and technical resources, knowledge translation, reporting and dissemination will be outlined. Finally, the identified strengths and weakness across countries with connected tailored recommendations for more resilience health information systems will be showcased, setting the scene for the panel discussion later on.
Integrated Knowledge Translation in the Food and Nutrition Security for Manitoba Youth study
Authors: Slater J , Katz A , Chateau D , Cidro J , Falkenberg T , Nickel N , Sanguins J , Urquia M , Pilli B 
Published: October 2023

Abstract

Background
There are concerns that many children do not have healthy diets, which may be related to dietary choices as well as lack of access to healthy foods. The Food and Nutrition Security for Manitoba Youth (FANS) study examined diet, nutrition-related behaviours and food security of 1587 grade nine students in Manitoba, Canada. Results show that while one in five students were food insecure, almost all need significant dietary improvements. Engaging stakeholders through multiple communication channels is key to disseminating research outcomes to drive action for policy change.

Methods
Principles of integrated knowledge translation were followed, including a breadth of dissemination activities, to maximize impact of study results. These included diverse partnerships, academic and non-academic research outputs, and use of media.

Results
Study partners including academic co-investigators, school authorities, government agencies and non-profit organizations advocating for child nutrition contributed to study design, interpretation and dissemination. Results were published in academic journals, as well as translated into a suite of non-academic outputs including a community report, infographics (circulated on social media), and a searchable data dashboard, available through a web-based portal. This approach allows for tracking of research output downloads, which number over 500 to date. Due to active outreach to traditional media, study results received widespread attention adding to the breadth of knowledge translation methods employed. This also led to uptake by provincial health education curriculum developers. Results will also be circulated during an upcoming provincial election as part of engaging candidates around child nutrition and food security issues and policies.

Conclusions
This broad approach to integrated knowledge translation has resulted in extensive distribution of FANS study results and has potential to influence public health nutrition policy.

Key messages
• Integrated knowledge translation and a breadth of dissemination strategies in the FANS study has led to extensive distribution of research outputs and media coverage.
• The FANS knowledge portal, with diverse academic and non-academic research outputs including a data dashboard, is strategic for public health nutrition promotion and advocacy.
Implementation of the Baby-Friendly Hospital & Community Initiatives in Europe: a scoping review
Authors: Matthews A , Walsh A , Pieterse P , Mishra N , Chirwa E , Chikalipo M , Msowoya C , Keating C 
Published: October 2023

Abstract

Background
Promotion of and support for breastfeeding is essential for public health, to improve nutrition globally and save the lives of over 800,000 children annually. Since its launch in 1991, the Baby-Friendly Hospital Initiative (BFHI) has been implemented in 150 countries, to promote the ‘ten steps to successful breastfeeding', with the Baby-Friendly Community Initiative (BFCI), arising from the 10th step.

Aim
To synthesise evidence about BFHI and BFCI implementation in European countries.

Methods
This scoping review was conducted according to the Joanna Briggs Institute methodology for scoping reviews. Data were charted by country, study design, setting, study population, BFHI steps, study aim and objectives, intervention, results, barriers and enablers to implementation, evidence gaps, and recommendations. Qualitative and quantitative descriptive analyses were undertaken.

Results
A total of 278 articles were included in the review, of which 60 studies covered the implementation of the BFHI or BFCI in 18 European countries. Most studies were found from the UK (n = 11) Italy (n = 9) and Switzerland, Spain and Turkey (n = 6 each). Most were hospital-only based (n = 48) and most covered all ten steps of the BFHI (n = 44) and fewer BFCI (n = 4). Studies were carried out with health workers (n = 17), mothers (n = 34) and policy makers. Most studies were quantitative (n = 39) with many others designs used. Our charting of results highlights that effective implementation required political commitment, legislative and regulatory underpinning; support at organisational level; ongoing multi-professional leadership, education, training and teamwork, and effective education for women.

Conclusions
While contextual country-level factors are seen, there are clear patterns underpinning successful BFHI/ BFCI implementation, which can guide effective implementation.
Funded by the Irish Research Council and Department of Foreign Affairs Ireland, grant number: COALESCE/2019/89

Key messages
• Strong political and professional leadership is required to support the effective implementation of public health initiatives to support breastfeeding.
• Ongoing, effective multi-professional education and training is required to support breastfeeding.
Green Climate Fund adaptation's interventions on food security: metrics and health outcomes
Authors: Serli D , Parrish R , Lauriola P , Zeka A 
Published: October 2023

Abstract

Introduction
The Green Climate Fund (GCF) is the largest public climate fund, it claims to use an innovative approach in climate adaptation actions, however, it has faced significant criticism since its inception. 2016-2025 is the Decade of Action on Nutrition and climate change's impact on food security is one of the biggest threats to human health. Current models predict that Africa will be the most affected continent. Food security is a polyhedric concept that requires definitions and indicators to acquire meaning and provide in-field applications.

Methods
Among the GCF's projects the ones that address the result area “health, food, and water security” in the African countries have been selected. The means of verification (MoV) has been searched in every funding proposal, simplified approval process, and other relevant documents, if not found, were requested to the Fund and local managers. Projects have been divided into ‘International’ or ‘Local’ based on GCF's definitions. The study also sought to identify the food security definition adopted by the Fund and reviewed available food security indicators.

Results and discussion
21 projects, amounting to an investment of $887.2 million, met the criteria. National projects accounted for 17% of the investment, while international projects comprised the remaining $733 million. 7 of the 21 projects (circa 40% of the funds invested) did not provide measurable food security outcomes. The majority of the projects provided some measurable outcome but it is rarely possible to know how this will be measured, as only 3 projects, all from the World Food Program (WFP), declared their MoVs. The GCF seems to not adopt a clear definition of food security. The WFP's indicators, while validated for caloric adequacy, are not consistently validated for micronutrient deficiencies and other health outcomes.

Conclusions
Insufficient information on monitoring and evaluation may raise further concerns about the GCF's governance.

Key messages
• Food security is a poliedric concept that requires defintions and indicators to acquire meaning and provide in-field applications, evaluation processes are essential to detect real adaptation.
• The Green Climate Fund is the largest public climate fund, it claims to use an innovative approach in climate adaptation actions but it seems to lack robust monitoring and evaluation processes.
Correlates of adherence to a posteriori derived dietary patterns of an Italian sample of adults
Authors: Scarsi N , Pezzullo A M , Savoia C , Raspolini G M , Pastorino R , Boccia S 
Published: October 2023

Abstract

There is emerging evidence that the Italian population is switching away from the traditional Mediterranean dietary pattern towards unhealthy eating habits. We derived adults’ dietary patterns (DP) using a principal component analysis (PCA) on food groups intake of a representative sample of the Italian population (INRAN-SCAI 2005-2006), and correlated diet adherence scores with sociodemographic characteristics through multivariable linear regressions. After PCA, “High-fat”, “Western”, “Health-conscious”, “Italian, traditional” and “Junk, out of meal” DPs were retained. Female gender (β = 0.5103; p &lt; 0.001) showed an association with higher adherence scores on the Health conscious pattern. Conversely, being female was associated with lower Z-scores on the High fat (β=-0.1849; p = 0.024), Western (β= -0.0711;p= 0.004) and Italian traditional (β=-0.4799;p&lt;0.001) patterns. Age (β per one year increase=-0.0077;p&lt;0.001) was associated with lower adherence scores in the Western and in the Junk, out of meal (β=-0.0078;p&lt;0.001) pattern. Having either a secondary (β=-0.1301;p=0.016) or tertiary (β=-0.2156;p= 0.001) education level were independently associated with lower dietary Z- scores in the Italian traditional” pattern. Finally, there was wide regional variation, coming from different regions predicted adherence to different DPs. A substantial share of our sample showed unhealthy eating habits, which is consistent with the latest Italian dietary trends.

Key messages
• Future policies to improve diet quality at the national level should promote food literacy interventions targeting the differences between women and man among different age groups.
• This work will provide the basis to investigate the environmental impact of higher pattern adherence scores.
The Top 100 Most Cited Papers in 2022 on Global Health indexed in Web of Science
Authors: Taneri P E 
Published: October 2023

Abstract

Background
Even if it is a controversial topic, citation counts are frequently used as an indicator of how popular and valuable published articles are. In this study, we aim to identify and analyze the characteristics of the most cited articles in the global health area.

Methods
We searched the Web of Science (WoS) database with the keywords: (TS=global health) AND (PY = 2022) AND (SU=public health). We filtered highly cited articles and selected the top 100 for our analysis. Scopus was used for extracting the journals’ CiteScore 2022 metrics. We conducted frequency analysis and Spearman's correlation test wit using SPSS 27.

Results
Most of the articles were about COVID-19 (37%) and environmental health (36%). One of four studies about COVID-19 was investigating COVID-19's effect on the mental health of adults or children. Affiliations of the first authors were mostly from (USA 21%) or China (20%) and they were followed by India (10%). Most of the papers were reviews (38%). The other frequent study types were prevalence studies (12%), estimation studies (11%) and systematic reviews (9%). The median of the WoS core citations was 48.5 (min. 33, max 770) and overall it was 49 (min. 33, max. 792). The papers were mostly published in Lancet (7%), Science of the Total Environment (7%) and Environmental Research (6%). CiteScore median for the journals was 16.7 (min 3.8, max 131.8). There were no correlations between WoS core citations of the papers and CiteScore of the journals (Correlation Coefficient=0.075, p = 0.459) and overall citations (Correlation Coefficient=0.083, p = 0.409).

Conclusions
Most of the highly cited papers about global health in 2022 were published by the authors from USA and China, and the papers were mostly about COVID-19 and environmental health. The majority of the publications were reviews. This might refer to the lack of powerful original research on the topic.

Key messages
• Most of the highly cited papers about global health are reviews.
• Our findings suggest there is no correlation between one paper’s citation number and the CiteScore of the journal that published it.
Organising for health equality: assessing contexts for implementing integrated health access
Authors: Mejsner S B , Beck M , Fehsenfeld M , Lundberg L , Westergaard C L , Vixoe K , Burau V 
Published: October 2023

Abstract

Background
Social inequalities in health are complex and vulnerable people therefore need cross-sectoral initiatives that provides integrated access to different sectors of the health system. However, specialization makes systems fragmented, and health organization is an important but overlooked determinant of social inequalities in health. The Flexible Assertive Community Treatment (FACT) model offers integrated health access to people with severe mental illness, through interprofessional teams across health and social services. This study aimed to assess the organizational contexts that shape the implementation of this model of integrated care.

Methods
The study applied the theory of the Organizational Fields to identify the specific mechanisms by which organizational contexts influence the implementation of the FACT model. We analysed political and administrative documents at national, regional, and local levels to assess relevant contexts. We complemented with semi-structured interviews with managers and health professionals in three municipalities and the region in Denmark that implemented the model.

Results
Overall, this study found that the contexts for implementing FACT are highly complex both horizontally, between the health and social care sector, and vertically, between the national, regional, and local level. This leads to conflicting demands on the implementation of FACT in the municipalities. Local cultures of collaboration may nonetheless offer a lever to handle these demands, although this varies across municipalities.

Conclusions
For health systems, it is challenging to organize integrated health access as contexts are complex both horizontally and vertically. Assessing these contexts is therefore highly important to identify key determinants for successful implementation of models such as FACT. This may in turn reduce social inequalities in health through more coherent and accessible care.

Key messages
• Vulnerable people need integrated access to different sectors of health systems to secure health equity, but this is challenging to organise as health systems are complex horizontally and vertically.
• Assessing the contexts of health sytems is key to identifying the determinants for successful implementation of initiatives to reduce health inequalities through more coherent and accessible care.
Restrictions on access to medical care for the uninsured in Bulgaria
Authors: Kostadinov S , Stefanova P , Georgiev A , Vasileva R , Kamburova M , Stoilova I 
Published: October 2023

Abstract

Introduction
There are two forms of health insurance in Bulgaria - mandatory and voluntary. Despite the fact that all Bulgarian citizens are required to have health insurance, a high proportion of persons with interrupted health insurance rights due to irregularly paid health contributions is reported every year. These persons have limited access to health services, as they cannot be provided with free preventive activities, planned hospitalizations, and for pregnant women there is a minimum number of free examinations (4 examinations during the entire pregnancy). The purpose of the present study is to determine the share of persons with suspended rights and their opportunities to access health services.

Methods
Official data from the annual reports of the Health Fund and the National Statistical Institute for the period 2020 - 2022 for the Pleven region were used. The data were processed with statistical methods.

Results
It was found that for the period from 2020 to 2022, an average of 20.6% of the population had interrupted health insurance rights. Provided that persons under 18 and those of retirement age are insured by the state, persons with suspended rights are only of active age. Among this group, the share of the uninsured is 34%. Uninsured women giving birth in 2020 are 19.35% of all women giving birth, in 2021 - 16.54%, and in 2022 - 18.33%.

Conclusions
The high share of persons with interrupted health insurance rights in Bulgaria represents a serious problem for the access to basic medical care of these people. Limitation of activities for prevention, planned treatment and regular monitoring of pregnant women. poses a risk to both their individual health and the health of the population.

Key messages
• In Bulgaria, a high proportion of persons with interrupted health insurance rights is observed.
• The uninsured have very limited access to free medical care, preventive activities and planned treatment.
Prediabetes and lifestyle habits in Reunion Island: Need for targeted interventions
Authors: Bun R , Laguës-Hugouvieux H , Kichenapanaïdou L , Marimoutou C , Nobécourt E 
Published: October 2023

Abstract

Background
Prediabrun is a cohort study of prediabetic patients settled in primary care in Reunion Island, focusing on the transition to diabetes. This study aimed to analyze the lifestyle habits of the first 330 prediabetics included.

Methods
A dietary score was calculated from the food frequency questionnaire to assess the adherence of participants to the National Nutrition and Health Plan 4 (PNNS-4) recommendations (-14 to 13.25). Physical activity was classified according to the WHO recommendation of 30 minutes of moderate activity per day.

Results
The mean dietary score of the participants was 3.7 with an equal distribution of patients between ‘moderately close’ and ‘close’ adherence to PNNS-4 recommendations. Although the average perception of their dietary balance (6/10) seemed consistent with the mean dietary score, there was no correlation between the two variables. The main discrepancies concerned fruits and vegetables consumption: only 2.4% consumed at least five fruits or vegetables per day, and less than half at least one. About 9/10 prediabetic subjects declared 30 minutes of physical activity per day, mainly consisting of walking, and housework. Prior knowledge of prediabetes had no impact on the lifestyle habits.

Discussion
Effective management of prediabetes requires a balanced diet and regular physical activity to avoid evolution to diabetes. These study results highlight the necessity of lifestyle interventions to assist prediabetic patients in modifying their habits. While subjects perceived their dietary balance to be adequate, they did not comply with dietary recommendations, regardless of their knowledge of their prediabetic condition. This indicates the need for specific dietary and physical activity support, easily accessible that can be prescribed by physicians and reimbursed by the national healthcare system.

Key messages
• Prediabetics in Reunion Island need targeted lifestyle interventions to improve adherence to dietary recommendations.
• Prediabetic patients in Reunion Island require specific dietary and physical activity support, easily accessible and reimbursed by the national healthcare system.