bluuebunny/crossref_metadata_2025_split huggingface dataset:
Co-creation of an Escape Game on University students’ mental health
Authors: Montagni I , Vié C , Thellier D , Labrosse D 
Published: October 2023

Abstract

University students’ mental health has been strongly impacted by the health crisis linked to Covid-19, with increased levels of stress, anxiety and depression in this population. During the pandemic and afterwards, there was the urgent need to implement interventions to promote students’ well-being and help them cope with these stressful conditions. Gamification - defined as the use of game features in serious contexts - can increase knowledge on health-related topics using a learning-by-doing approach. Studies have proved its effectiveness in promoting players’ health literacy. For this, a team of researchers and a start-up worked together to create an Escape Game (called EscapeCovid) addressed to students on their mental health during the Covid-19 series of lockdowns and curfews. Through playing, students could improve their mental health literacy, destigmatize mental illnesses and learn how to tackle psychological problems. The aim of this study was to describe the preliminary steps of the co-creation of EscapeCovid by researchers, industrials and students. Starting from a prototype, 45 students tested the game and provided their comments through mixed-methods data collection. All players completed a questionnaire before and after the game. They were asked about their knowledge and mental health status to observe a modification due to the game. Satisfaction questions were also asked concerning the design and contents of the game. In addition, semi-structured interviews were conducted with 10 students for in-depth opinions. According to the results of the evaluation, participant appreciated the Escape Game as an innovative tool for health promotion. Especially because of its ability to transmit knowledge and increase skills through gamification. University students seemed very receptive to this type of tool. In order to guarantee its effectiveness, it was clear that the game must be adapted to the target audience and meet its expectations.

Key messages
• Escape Games are innovative tools in health promotion and disease prevention which can be well received by young people.
• It is essential to test an intervention with end-users before deploying it in order to ensure its effectiveness.
5.O. Workshop: Best Practices against child obesity
Authors:   Organised by: Health4EUKids,   Chair persons: Apostolos Vantarakis (Greece), George Karidas (Greece)
Published: October 2023

Abstract

European countries in the field of health promotion and prevention of non-communicable diseases, indicating best practices and specific risk factors from research results on child obesity that have already developed from previous research actions. The overall goal of the JA is to implement two best practices Grunau Moves established in Germany and Smart Family established in Finland in different MS. The implementation process will include the knowledge transfer between best practice owners (Smart Family and Grunau Moves) and partner organisations from the Member States through the implementation of actions, the cooperation and exchange of knowledge between member states, the organisation of meetings, and related technical support. Also important part of the project is to produce policy developments to foster public health investments at community level in each country member on Health Promotion, Disease Prevention and Management of Non-Communicable Diseases. Scope of the project will be to promote to participating member states healthy lifestyles in families with children to prevent childhood obesity, to increase physical activity and healthy diet in children,families and communities with a focus on social norms, recognition and self-esteem in deprived districts in member states. Also, to study the different prerequisites for member states to implement either Grunau Moves or Smart Family. Finally, to prepare the sustainability of these best practices and transfer to other member states based on the acquired knowledge and experience. The expected results focus on the identification of concrete challenges in the prevention of non-communicable diseases and policy solutions in the form of best practices and innovative solutions for collective action between the Member States and the Commission, to tackle the main public health challenges

Key messages
• To strengthen a cooperative approach in tackling childhood obesity.
• To improve the planning and development of the policies to tackle childhood obesity.
An intervention to improve self-care among people with diabetes mellitus: A quasi-experimental study
Authors: Kumar Gupta S , Lakshmi P , Rastogi A , Malhotra S , Kaur M 
Published: October 2023

Abstract

Background
An increased self-efficacy promotes better diabetes self-care behaviours, which help in achieving glycemic targets among patients with diabetes mellitus.

Methods
A quasi-experimental study was conducted among patients with T2DM living in rural areas of Punjab, North India. A total of 283 in the intervention and 291 in the control arms were participated at baseline, and a total of 242 in the intervention and 237 in the control arms at endline assessments. Summary of diabetes self-care activities and diabetes management self-efficacy questionnaires were used at baseline and endline (after 6 months) surveys. Outcomes were net changes in proportion of population having diabetes self-management self-efficacy, overall diabetes self-care activities (health dietary habits, physical activity, adequate foot care, medication adherence and blood glucose monitoring) and net mean change in HbA1c. Data were analysed using per protocol analysis principle. Difference in difference analysis (DiD) using Generalized Estimating Equation model was done to adjust for confounders. p &lt; 0.05 was considered as significant.

Results
There was a significant net increase in participants proportion (39%; 95% CI: 25% -52%, p &lt; 0.001) on diabetes management self-efficacy scale. At the baseline assessment for overall self-care behaviours, only 4% of participants in the intervention arm were in the action stage and 12% were in the preparation stage; however, at the post intervention assessment, this proportion increased to 24% for action stage and 67% for preparation stage. There was a significant net increase in participants proportion (49%, 95%CI 37% -60%, p &lt; 0.001) engaged in optimal diabetes self-care. There was a significant net decrease in mean HbA1c (-1.06%; 95%CI: -1.62 - -0.50, p &lt; 0.001) at post intervention phase.

Conclusions
Diabetes self-care intervention was successful in promoting self-efficacy and self-care practices among patients with T2DM of rural areas.

Key messages
• Self-efficacy theory-based diabetes self-care intervention successfully improves the diabetes related self-care practices.
• There is a need for a structured diabetes self-care management education programme to improve the ability of patients with T2DM who live in rural areas.
Adaptation to heat and concomitant environmental risks in Europe: a GAP Analysis
Authors: Mazzalai E , De Sario M , Turner G , Natukunda J , Nordeng Z , Aunan K , Kovats S , de’Donato F 
Published: October 2023

Abstract

Background
Climate change is increasing the frequency and intensity of extreme events like heatwaves, wildfires and droughts. Within the ENBEL project, a GAP analysis was carried out to provide evidence on vulnerability factors of concomitant environmental risks during heat waves and promote the implementation of public health response.

Aim
To assess the level of implementation of heat wave and co-exposures (air pollution, wildfires and drought) response actions and to identify gaps and needs for public health adaptation in Europe.

Methods
A scoping review was performed to identify clinical and social vulnerabilities to heatwaves and concomitant exposures and prevention measures in place. Interviews with key stakeholders will provide additional information on response measures addressed to vulnerable groups as well as identifying needs and gaps for adaptation. Furthermore, an assessment of how Covid-19 recovery plans and funding in Europe are supporting climate adaptation and health care resilience was carried out.

Results
From the literature review interventions mainly focused on outdoor workers and athletes, include guidance, plans and actions on hydration, rest in the shade, cooling clothes and food, as well as acclimatization procedures. The elderly are among those consistently targeted in heat prevention plans, with health and social care surveillance, tele-medicine and awareness campaigns carried out during summer in several high-income countries. Regarding multiple environmental exposures, studies on preventive measures are scarce, and stakeholders reported the need for further research, sharing of knowledge and evaluation of measures to enhance action.

Conclusions
Although Covid-19 recovery funding is providing marginal benefits for health systems resilience, key barriers to climate adaptation still remain in terms of limited resources, personnel capacity; governance constraints and unclear policy remit.
Transforming perioperative patient safety clinical guidelines recommendations into measurable standards: insights from the SAFEST project
Authors: Valli C 
Published: October 2023

Abstract
Adopting evidence-based practices can improve the safety outcomes of surgical care. However, translating evidence into practice is slow in the healthcare field; an effort should be made to overcome this challenge. One approach could be to develop measurable standards to allow the evaluation and prioritization of healthcare improvements. The SAFEST project aimed to transform a list of prioritized clinical guidelines recommendations for adults’ perioperative care into measurable standardized practices (or standards) for hospitals to implement along the perioperative patient journey. Based on a previous systematic review of guidelines and an international expert panel review, we transformed recommendations into standards through an iterative and consensus qualitative approach. First, recommendations were classified according to the perioperative period (pre, intra or post) and based on predefined clinical areas. Second, one or more recommendations were transformed into one standard. Third, for each standard, measurable elements were developed to highlight in practical terms what needs to be implemented and measured, and the source of information and responsible stakeholder were identified. The overall transformation was performed by independent reviewers and the list of measurable standards was approved and finalized through discussion. From an initial list of 101 prioritized clinical practices recommendations, we developed 103 standards with 164 measurable elements. The standards with the related measurable elements, classified based on the perioperative period, were grouped in 12 different areas based on specific topic (e.g., complications preventions). Overall, these measurable standards can enhance dissemination and implementation of patient safety standardized practices in the continuum of care for adults’ patients undergoing surgery.
SARS-CoV-2 incidence and effect on absences at a university hospital in Germany
Authors: Zhelyazkova A , Bonigut M , Weber M , Geiser-Metz S , Geis M , Heindl B , Mayr T , Prueckner S 
Published: October 2023

Abstract

Background
The COVID-19 pandemic highlighted the challenges and risks of in-hospital exposures among the health workforce. Health facilities were compelled to conduct their operation while both securing patient care and employees’ health in the context of changing regulatory requirements.

Methods
We performed Time Series Models and a T-Test for Polymerase Chain Reaction (PCR) SARS-CoV-2 in-hospital test results reported via the digital COVID-19 platform of the LMU University Hospital, Germany. The cohort consists of all persons employed at the hospital during the platform's utilisation (N = 14,419; 11.2021-12.2022).

Results
Overall, 179,135 in-hospital PCR tests were executed (monthly range: 5,528-24,560; R2=.993) of which 6,538 were positive (monthly range: 92-1,095; R2=.991). In a symptomless or evanescent course of infection, employees were able to get a control test and resume their duties prior to the designated end of isolation if their viral load were below the benchmark of, initially, 100,000 or, as adapted later, 1,000,000 copies/ml (as per Robert Koch Institute's recommendation): 8,100 PCR control results below the respective benchmark were reported (monthly range: 92-1,429; R2=.995). In total, 6,841 persons were able to resume duties prior to their isolation expiration date (monthly range: 10-1,478; R2=.996). No significant differences between the monthly number of PCR tests indicating a new infection and control tests were observed (t=−1.246, p=.235). Incidence trends were tracked closely via the hospital's platform.

Conclusions
The number of executed and positively reported tests fluctuated considerably. The benchmark for PCR tests in positive symptomless or evanescent cases allowed for a large number of staff to resume their duties prior to the expiration of their mandated isolation, yet without presenting a risk to other employees or patients. This measure prevented major staff shortages and ensured the uninterrupted provision of patient care at the hospital.

Key messages
• The establishment of a control test process facilitates the risk-reduced resumption of duty following a positive PCR test and reduces the isolation period with a decisive effect on staff capacity.
• In-hospital test surveillance requires evidence-informed and agile adaptations, thus highlighting the need for centralised strategic management, including segmented visualisation and analysis.
Success story of food reformulation monitoring, building capacities from French good practice to implementation in 19 EU member states
Authors: Vin K , Gabrijelčič Blenkuš M 
Published: October 2023

Abstract
Obesogenic environments stimulate the consumption of excess calories through HFSS foods. Therefore, activities aimed at reformulating foods into healthier alternatives are the first crucial step in improving the food supply for children. Harmonised EU monitoring of the reformulation actions was addressed as one of the key approaches in creating healthier options for children and their caregivers. Supported by the EU AP on childhood obesity 2014-2020, access to an improved and healthier food offer in supermarkets should be made easier. Currently, only a few European countries are monitoring processed food supply at the brand level, and this deprives European and national policy makers of an objective description of the situation to define and assess nutrition policies. JA Best-ReMaP, building on the JANPA and EUREMO outcomes, aimed to fill in the reformulation monitoring gap and to add to the improved access to high quality foods for the European citizens, especially for children. To do so, in 19 European countries, JA Best-ReMaP implemented a standardised European monitoring system for processed food reformulation. Such a tool, at a country level, enables to monitor food offerings and nutritional content of individual monitored processed foods, as well as to identify best formulation and room for reformulation of the food produced, sold, and consumed. Complex steps were taken in the project implementation, including the identification of the priority processed food groups for a European monitoring of the food supply, exploration of the new technologies and new sources of data capacities for nutrition data collection, development of the knowledge to conduct and analyse own data collection in the participating EU MSs, explorative development of an open European branded foods database, and first attempt of the European analysis of the trends of the nutritional quality of processed food and their impacts.
Barriers in the implementation of burden of disease estimates in Belgium and potential solutions
Authors: De Pauw R 
Published: October 2023

Abstract
Injuries are a leading cause of morbidity and mortality in Europe, and not only place a huge burden on individuals and health care services but on society as a whole. However, estimates on the burden of disease expressed as disability adjusted life years (DALY) are only available in some countries. Other countries don’t have the required data or resources available to calculate DALYs attributable to injuries. The recent report on the European Injury Data Base (IDB) shows that there are important between-country differences in morbidity and mortality related to injuries, emphasizing the important of country-specific estimates. In the current presentation the process of DALY calculations will be briefly discussed, after which a more in-depth scope will be given on the barriers that exist in Belgium to calculate these valuables DALYs. These barriers include, for example, a lack of data availability and specific barriers in linking data registries. Afterwards, the potential solutions to yield estimates based on incomplete information will be discussed.
The dark side of light at night: assessing breast cancer risk with a dose-response meta-analysis
Authors: Urbano T , Vinceti M , Wise L A , Filippini T 
Published: October 2023

Abstract

Light at night (LAN) is a ubiquitous environmental issue resulting from exposure to artificial light during the night-time hours. The adverse effects of LAN include circadian disruption, melatonin suppression and altered clock gene expression. Very recent evidence suggests that LAN may increase risk of several diseases, including cancer. Breast cancer is the most common diagnosed cancer globally and the second leading cause of cancer-related mortality. Several environmental and life-style related risk factors have been linked to breast cancer onset. In this updated meta-analysis, we investigated how exposure to LAN may affect breast cancer risk. Using systematic online database searches (PubMed, Scopus, and Web of Science), we included 19 eligible studies (10 cohort and 9 case-control) investigating the association between LAN, either outdoor or indoor, and breast cancer risk. We first performed a meta-analysis comparing the highest versus lowest levels of exposure. Then, we performed a dose-response meta-analysis to investigate the shape of such relation. Overall, we found a positive association between LAN and breast cancer (risk ratio [RR] 1.08, 95% confidence interval-CI 1.03-1.13). In stratified analyses, the risk was more pronounced in premenopausal (RR 1.15, 95% CI 1.05-1.26) and normal-weighted (RR 1.17, 95% CI 1.00-1.36) women, while stratifying for outdoor/indoor exposure and for estrogen receptor status did not gave substantial differences in the risk estimates. The dose-response relation showed a linear risk increase up to 60 nW/cm2/sr after which the curve reached a plateau, especially among premenopausal women. These results strengthen the hypothesis that LAN is associated with breast cancer risk. Public health measures are warranted to minimize LAN exposure and reduce its related adverse effects on human health.

Key messages
• Light at night is positively associated with breast cancer risk.
• The dose–response relation between light at night and breast cancer supports a positive association particularly in premenopausal women.
Mitigation potential of local traffic interventions on paediatric asthma incidence in EU cities
Authors: Vandeninden B , Bouland C , Declercq E , Devleesschauwer B , Faes C 
Published: October 2023

Abstract

Issue/Problem
Motorised road traffic is a major contributor to Nitrogen Dioxide (NO2) emissions, contributing to the development and worsening of asthma. With a substantial and escalating prevalence of asthma in urban areas worldwide, this is an issue of public health significance.

Description of the problem
Deploying methods such as Random Forests and Boosted Regression Trees, this study aims to determine the potential reduction in paediatric asthma incidence in European cities that could be achieved through policy interventions targeting local traffic reductions, such as car-free days.

Results
In trafficked areas in European cities such as Brussels and Paris, up to 40% of asthma incidence can be attributed to NO2 exposure. Preliminary results show a potential reduction of 29% [95% CI: 20-34%], 21% [95% CI: 13-25%], and 12% [95% CI: 7-15 %] in paediatric asthma incidence in trafficked areas, central urban areas, and residential areas in Brussels, respectively. In Trafficked and Urban Background Areas in Paris, we found a potential reduction of 17% [95% CI: 11 -19%] and 13% [95% CI: 8-16%] in paediatric asthma incidence respectively. Trends and findings are consistent with several methodologies applied.

Lessons
Using real-world interventions such as car-free days is an innovative way to assess the mitigation potential of diseases associated with traffic. Our study highlights the public health significance of local traffic reduction policies in addressing asthma incidence in urban areas. The recommended public health actions include implementing policy interventions to reduce traffic levels and emissions in urban areas. These findings can be useful for other countries/settings facing similar issues with traffic-related air pollution and asthma incidence. The policy intervention can also positively impact other traffic-related health effects such as physical activity, noise, and availability of green spaces.

Key messages
• Local traffic reduction policies can significantly reduce (paediatric) asthma incidence in urban areas in large European Cities.
• Reducing traffic levels reduces traffic-related air pollution and improves public health via pathways such as promoting physical activity, reducing noise, and increasing green space availability.