bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategies and tactics: what have we NOT learned from decades of tobacco industry interference
Authors: Makhoul J 
Published: October 2023

Abstract
The tobacco industry has historically targeted vulnerable populations to increase its profits and at the expense of health. More recently, the use of Electronic Nicotine Delivery Systems (ENDS or vapes) has reached epidemic levels among vulnerable populations such as youth, globally. The vape industry uses similar tactics to advertising and market ENDS products to youth and thus contributing to increasing rates. One particularly targeted population is the youth LGBTQ+ population. In the U.S, young LGBTQ+ individuals have higher rates of ENDS use compared to heterosexuals and are also more likely to initiate ENDS use at a younger age. In this presentation, we will highlight the research to date that has documented the ENDS industry strategies and tactics with a particular focus on young LGBTQ+ populations as a vulnerable targeted population in the US, highlight similarities to the tobacco industry practices and lessons NOT learned, and propose potential prevention and policy strategies going forward.
Circle of Friends - an encouraging intervention for alleviating loneliness
Authors: Jansson A , Pitkälä K 
Published: October 2023

Abstract
The Finnish Association for the Welfare of Older Adults developed a group model Circle of friends (CoF) for lonely older adults. In a randomized controlled trial, it improved lonely older adults’ wellbeing, health, and cognition. It reduced the use of health services and mortality. The aim of this presentation is to describe the successful implementation and dissemination of CoF and its impact in practice, which we believe reflects the rigorous attention to the main elements, careful training of professionals as well as annual quantitative and qualitative analysis and reports of the data. CoF is a closed group of 6-8 participants suffering from loneliness. They meet with their peers 12 times, once a week, for three months. In these closed groups new participants are not added after the group has started, even if some participant(s) drop(s) out. Each group's two facilitators receive thorough training and work supervision along with the group process. From 2006 on CoF has been disseminated into Finnish communities. Altogether 1200 CoF facilitators have been trained so far and at least 12'000 older adults have participated in CoF in 100 communities in Finland. It has maintained its essential elements over the years. According to a ten-year follow-up, 90% of participants felt their loneliness had been alleviated, and over 60% of the participants had continued the meetings after the facilitated group was over. At the beginning of the COVID-19 pandemic the CoF was modified into online groups with an easy and safe electronic platform, and free of charge for the participants. During the last years it has been exported to some other countries, for example in the RECETAS project.
Social and biological factors associated with unsuccessful TB treatment outcome in Ireland 2011-2021
Authors: Jackson S , Kabir Z , Comiskey C 
Published: October 2023

Abstract

Background
Tuberculosis (TB) treatment success rates are crucial for TB control programme evaluations. The World Health Organisation sets targets of &gt; 90% but Ireland remains below 70%. We analysed notifications from the Irish National TB Surveillance System from 2011-2021 to explore factors associated with successful treatment outcome in Ireland.

Methods
We selected potential predictor variables based on clinical relevance and literature review. We examined each predictor's unadjusted association with treatment success using univariable logistic regression. We used backwards elimination to remove predictors that failed to remain significant in multivariable logistic regression. Treatment success was defined as treatment completed or cured, while unsuccessful treatment was defined as treatment failed, treatment interrupted, transferred out and died from any cause. We used Stata for analysis.

Results
Between 2011-2021, 52% of cases were successfully treated, 10.7% were unsuccessfully treated and treatment outcome was not reported for 37%. Treatment outcome completeness declined significantly between 2019-2021. Univariable analysis showed successfully treated cases had higher odds of being a migrant (OR:1.9; 1.5-2.5), being linked to outbreaks (OR:1.9; 1.2-3.0), being a contact of a case (OR: 1.0-2.5;), having a normal X-ray (OR:1.7;1.1-2.6) and being an outpatient (OR:3.0;2.2-4.2). Significant predictors of unsuccessful treatment in the final model were age &gt;70 years, unemployment, immunesuppression and any anti-TB drug resistance.

Conclusions
Surveillance data shows that Ireland fails to meet the WHO target of &gt; 90% treatment success with high levels of missing data. Data quality improvement initiatives are needed to reverse the decline in completeness associated with the Covid-19 pandemic period so control programmes can robustly evaluate performance. Additional supports should be considered for patients who are older, unemployed, immunesuppressed or with drug resistant TB.

Key messages
• Additional patient supports should be considered for patients who are unemployed, age 70 years and older, immunesuppressed or with drug resistant forms of TB.
• Ireland fails to meet the WHO TB treatment success target with high levels of missing data. Treatment outcome completeness needs to be improved so control programmes can robustly evaluate performance.
The EC DG INTPA - World Health Organization partnership in the new global health order
Authors: Roura M , Appelt B 
Published: October 2023

Abstract

Issue
The 2022 EU global health strategy recognizes health as a global common good and sets twenty guiding principles, including the need to support a stronger, effective and accountable WHO as the indispensable cornerstone of the multilateral health system.

Description
Mixed-methods study using documentary, quantitative, and qualitative analyses to answer two questions: 1) Is the current EC DG INTPA-WHO partnership adequate to support the role envisaged for WHO in the new EU global health strategy)? and 2) How should the EC-DG INTPA-WHO partnership be restructured?. Documentary analysis includes review of academic literature, historical/contemporary documentation on EC-WHO collaboration agreements, monitoring reports of DG INTPA funded interventions since 2016, and selected WHO projects since 2010. Key informant in-depth interviews are conducted with 10 EC senior officials. Guided by results-oriented monitoring frameworks, we analyse interview notes/transcripts and key documents using NVIVO software. Projects are classified by geographic areas and mapped against priorities outlined in the strategy.

Results
WHO's essential role to provide global public health goods is hampered by insufficient authority and core funds to implement its constitutional mandate. As EU member states see the value of holding a common position, the EU can increase its political role in global health. The EC focusses on specific health threats while also adopting a health system strengthening approach including longstanding collaboration between WHO and the Directorate General for International Partnerships. With remarkable overall achievements, a clear pattern of strengths and weaknesses emerges with key cross cutting areas where the EU has extensive expertise to be strengthened (e.g., evaluation, visibility, inequality markers).

Lessons
Supporting the development of monitoring and evaluation frameworks could be useful to enhance the visibility and added value of the EC DG INTPA /WHO partnership.

Key messages
• As a new global health order emerges, the EU must contribute to shape it through a more strategic, coordinated, and effective cooperation with WHO.
• To enhance the EC DG INTPA/WHO partnership it is important to support the development of visibility strategies, as well as the further development of monitoring and evaluation frameworks.
Exploring the heterogeneity of obesity: A Public Health Perspective
Authors: Stranges S 
Published: October 2023

Abstract
Body Mass Index (BMI) has been traditionally used in the biomedical field as the main anthropometric measure to classify individuals in relation to their body weight status. High BMI levels are usually associated with an increased risk of adverse health outcomes. However, measures of obesity, including body mass index (BMI) and waist circumference (WC), do not fully capture the complexity of obesity-related health risks. In fact, obesity is a very complex condition with wide heterogeneity across individuals. The belief that weight loss is the best recommendation for all people with high BMI as the only path to health should be revisited. In fact, weight loss in some subjects does not necessarily translate in health improvements. Novel evidence support alternative approaches to weight loss in the promotion of health for high BMI individuals. This presentation will provide an overview of the complexity and heterogeneity of obesity, with a critical discussion about the current approaches used to define weight status as well as on alternative interventions to improve health independent of body weight loss.
COVID-19 vaccine and test data management – practice report from a university hospital
Authors: Bonigut M , Zhelyazkova A , Weber M , Geiser-Metz S , Geis M , Heindl B , Prueckner S 
Published: October 2023

Abstract

Issue
The COVID-19 pandemic generated the urgency for creating and implementing new tools, specifically for data collection, sharing. The data governance of healthcare workers (HCW) was layered on top of pre-existing digitalisation issues in health authorities as well as in health facilities.

Description of the problem
The vaccination act for the German healthcare sector adopted in December 2021, established the compulsory report of HCWs’ COVID-19 vaccination status. The LMU University Hospital management required an overview of the COVID-19 status (illness, isolation, vaccination, infection) of HCWs in order to ensure continuous clinical service. For the timely and accurate report, it was necessary to create a centralised real-time overview of data that were collected and managed by decentralised structures.

Results
We connected five in-hospital systems into one platform that was being synced three times a day. For each HCW, we created a dataset with three main categories: core personnel data, COVID-19 status and reason for absence. Two user groups were defined: strategic management (1) and operational management (2), where users of group 2 were only given access to their own unit and were required to update and verify data of their team. Overall, the platform contained data of 14,419 HCWs and had 656 users (Ngroup1 = 16, Ngroup2 = 640).

Lessons
The data merger revealed issues in interoperability and accuracy and thus expedited data standardisation. The decentralised approach facilitated the operational efficiency, digitalisation, service delivery and managerial empowerment at the hospital. The main challenges pertained to data accuracy and to the continuously changing regulatory requirements as well as privacy protection. As all data were previously hosted on different platforms, an exhaustive process of cleansing was needed prior to merging. Each HCW was assigned to an organisational unit with a respective responsible person in order to achieve data quality.

Key messages
• Dedicated digital human resources solutions in a university hospital pose a specific challenge for the balance between data privacy, availability and interoperability.
• To enable a centralised information display, data must be collected where it originates and made available through short paths. Our solution united decentralised collection and centralised management.
Evaluating achieving tobacco control targets in Belgium using modelled projections
Authors: Guariguata L , Nayani S , De Pauw R , Devleesschauwer B 
Published: October 2023

Abstract

Background
Tobacco use in Belgium remains a key public health concern with an estimated 15% of adults reporting daily tobacco use in 2018. In 2022, the Belgian government launched the “Interfederal Strategy 2022-2028 for a Smoke-free Generation.” The strategy outlines a number of targets for reducing daily tobacco use among adults 15+ years and young adults 15-24 years. We evaluate the feasibility of achieving these targets given current daily smoking trajectories at a national and regional level.

Methods
We modelled time trends of smoking in Belgium based on repeated cross-sectional data taken from the nationally representative Belgian Health Interview Survey. We applied a Bayesian inference model, the integrated nested Laplace approximation, to obtain a time series of daily tobacco use for adults by age, sex, and region of Belgium from 1997 to 2018. We then projected this model to 2070 using population projections from the Belgian Federal Planning bureau for population distributions. We compared trajectories with targets from the Interfederal Strategy to assess whether they are likely to be achieved.

Results
The national target of reducing daily smoking among adults 15+ years to 10% by 2028 and 5% by 2040 will not be achieved on current trajectories. Wallonia has the highest level of people smoking daily and is projected to miss the targets by the largest margin. Flanders is expected to reach the 10% threshold by 2032. The target for reduction of prevalence of daily smoking among youth 15-24 years to 6% by 2028 will not be achieved before 2040. Smoking among the youngest age group (15-24 years) is decreasing rapidly with prevalence of daily smoking in that age group projected to be &lt; 2% in Flanders by 2059.

Conclusions
No region of Belgium is expected to achieve targets for reduction in daily smoking given current trajectories. Tobacco control policies in the country should be re-assessed, targeted and intensified.

Key messages
• The Belgian national target of 5% daily smoking prevalence in adults by 2040 will not be achieved.
• Differences in smoking trajectories in Belgium exist by age and region; tobacco control policies should be targeted.
Development and validation of an instrument to measure social capital in disadvantaged neighborhoods
Authors: Stjernqvist N W , Elsborg P , Olesen K , Tetens A , Boye M C , Tørslev M K , Nielsen A V , Bloch P 
Published: October 2023

Abstract

Background
Building social capital within communities is an integrated element and outcome of the Supersetting approach, but knowledge on how to measure it within a disadvantaged urban context remain scarce.

The Objective
To develop, test, and validate a questionnaire-based instrument to measure social capital among adult citizens living in a disadvantaged neighborhood. The study is done in Tingbjerg - a disadvantageous urban neighborhood.

Methods/theory
The development of the instrument is based on the social cohesion approach from within the theory of social capital and takes place in three phases. 1) Development including specification of a theoretical model of structural and cognitive social capital with indicators, development of items, and content validity of the items by experts. 2) Testing of developed items including face validity by conducting individual and focus groups interviews with Tingbjerg residents, translation into five languages and subsequent data collection among all 2567 adults living in Tingbjerg. 3) Statistical evaluation to test for dimensionality, reliability and validity. In case of suboptimal performance of the instrument, modifications may be applied, and the updated instrument re-evaluated.

Findings
Evaluations obtained from experts and residents will be analyzed and used to reduce and modify items included in the instrument. The questionnaire's dimensional structure will be explored with confirmatory factor analysis and its reliability with Cronbach alpha. Convergent validity will be tested through testing the association between social capital and a construct of social relations. Concurrent validity will be tested through testing the association between social capital and measures of self-assessed health and life quality.

Conclusions
An instrument to measure social capital in disadvantaged neighborhood will be presented at the conference. Recommendation of the instrument will depend on the evaluation of the study findings.
Analysing public debates, to support productive engagement with politicians and stakeholders
Authors: Sinclair S 
Published: October 2023

Abstract

Issue
UK public health debates have become highly politicised. Sean Sinclair (SCS) conducted 37 semi-structured interviews with public health professionals to understand how this affects their engagement with stakeholders. Interviewees said it has become more difficult to gain stakeholder support for public health policies. They hypothesised that politicians didn’t listen to evidence regarding health outcomes. SCS counter-hypothesised that debates are not always about facts, but sometimes about values. If a politician's main concern is, say, economic growth or personal responsibility, then evidence of health outcomes will not address their concerns.

Solution
To understand people's values, SCS analysed UK public debates about four contentious issues: vaccine passports; lockdown; healthy living advice; and Prep (the HIV prophylactic). SCS used the techniques of argument analysis used in analytic philosophy, ensuring the structure of arguments was transparent, and so amenable to assessment.

Results
From the analysis, SCS developed a conceptual toolkit to allow public health professionals to analyse what motivates politicians from different points on the political spectrum. They can then tailor their evidence to show how a policy will deliver on a politician's concerns, or tweak the policy to mitigate the features that trigger scepticism. To assess the material, SCS presented it to public health professionals in qualitative discussion groups. Feedback indicated that it will help them engage more effectively with stakeholders, eg: ‘Makes me think about what argument might be most impactful, rather than my instinctive response.’

Lessons
In any country that is politically divided over public health policy, this method can reveal new ways of arguing for policies, eg by appealing to a politician's own values.
SCS has developed the expertise to help develop similar analyses in other countries.

Key messages
• In any country that is politically divided over public health policy, it can be difficult to gain stakeholder support for policies. Analysing public debates builds understanding of people's concerns.
• This method can reveal new ways of arguing for policies. Public health professionals can tailor the evidence they present to show how a policy will deliver on each politician's concerns.
Measuring mental health literacy in children: the development of the CHILD-MHL scale
Authors: Montagni I , Philiatreau A , González-Caballero J L 
Published: October 2023

Abstract

Background
One child out of 5 is affected by a mental health problem before the age of 12 years. Among the determinants of children's mental health, Mental Health Literacy (MHL) is a theory including 6 dimensions: understanding mental health; help-seeking actions; supports available; influences on mental health; coping and resilience; and stigma. High levels of MHL correspond to better children's mental health. Measuring children's MHL is essential to inform the development of interventions pro-MHL, evaluate their impact and conceive related policies. We describe here the process of developing the CHILD-MHL scale.

Methods
Two public health researchers generate some MHL items in French. These are discussed by a group of 30 experts (ex. psychologists, psychiatrists), parents and teachers to verify their content and wording (Delphi study). An artist co-draw with 5 children (8-11 years old) the illustrations of the items (visual scale). Then, the scale is tested in the school setting by 30 children with feedback through qualitative interviews. Finally, the scale is administered to 500 children and undergoes psychometric analyses.

Results
Results are preliminary. We have produced 50 items telling a story based on MHL through the characters of Émile and Amélie, two children facing mental health problems. Examples of MHL items are: “Emile doesn’t say nice things about himself, he doesn’t want to spend time with his friend Amélie anymore, do you think he might be depressed?” and “Emile feels very worried and nervous, do you think he is anxious?”.

Conclusions
Developing a scale is a complex process. The CHILD-MHL scale is the first instrument measuring MHL in children in France and worldwide. It can be included in large French cohorts to obtain prevalence of MHL in representative samples of children at the national level. The scale will also be translated in 3 other languages (English, Spanish, Italian) with an international outreach and for cross-cultural comparison.
Students Health Services in Israel from the Parents’ Point of View: Mixed-Methods Study
Authors: Satran C , Bord S , Itzhaky Y , Ben-haim M , Anfinger E , Berkovich E , Madjar B 
Published: October 2023

Abstract

Background
Student Health Services (SHS) are provided by school nurses to 1st to 9th-grade pupils in Israel. The nurse's role is to provide early detection and prevention services. SHS is provided by the Ministry of Health (MOH) or through outsourcing.

Aim
To examine parents’ knowledge, attitudes, and satisfaction with SHS; and the differences in these measures when the services are provided by the MOH vs. outsourced organizations.

Methods
This study combines mixed methods, including a quantitative cross-sectional study among 506 parents and a qualitative study that included interviews with ten parents (upon reaching saturation). The research questionnaires were distributed via social media as well as through the National Parents’ Leadership organization. The interviewees were recruited from among the quantitative study participants.

Findings
The findings of the quantitative and qualitative studies support each other. Sixty-five percent of the parents responded that there is no school nurse or that they do not know whether or not there is one. Only 13.4% believe that the school nurse is available to answer their questions. The parents’ knowledge level regarding the school nurse's role was intermediate (an average of 4.44 on a scale of 0-9). However, their attitudes support the importance of the nurse's role. Age, socio-economic status, and trust significantly predict parents’ satisfaction. The older the parents and the higher their socio-economic status is, the lower their chance of being satisfied with the school nurse's role. In addition, the higher the parents’ level of trust in the nurse, the higher the chance they will be satisfied. No significant differences were found when comparing the MOH and outsourced organizations.

Conclusions
Many parents are unaware of the nurse's existence and are insufficiently informed regarding her role or how to contact her. However, many feel the role is essential, necessary, and should be improved.

Key messages
• It is important to promote a public participatory process of parents, pupils, school staff and healthcare professionals in order to improve SHS and the way it's provided.
• Parents-nurse-students relationship and communication must be improved in order to ensure parents’ cooperation and pupils’ health.