bluuebunny/crossref_metadata_2025_split huggingface dataset:
Public health work in Sweden during the COVID-19 pandemic
Authors: Guldbrandsson K , Månsdotter A 
Published: October 2022

Abstract

Background and objectives
This study examines the consequences of the COVID-19 pandemic for public health practice carried out at local and regional levels in Sweden. The work includes, for example, interventions in health care, schools and preschools, social services, and non-profit organisations.

Methods
By means of written questions and interviews in municipalities, regions, county administrative boards, networks, and organisations, we investigated whether public health-related interventions had decreased, increased, or changed as a result of the COVID-19 pandemic. Data were analysed by content analysis.

Results
The results show that a large number of interventions from a variety of local and regional actors aimed at broad target groups were cancelled or paused during the time of our survey. Eventually, many, but not all of the cancelled interventions were replaced with other options, most of which are included in the following themes:
• Digital solutions and support over the phone instead of physical meetings.
• Outdoor activities instead of indoor activities.
• Organisational adaptations, for example, from drop-in visits to booked appointments and from open activities to scheduled visits.
The interviews also revealed that public health issues had been highlighted and that existing collaboration structures were a success factor in managing the consequences of the COVID-19 pandemic. The risk of and concern for the spread of infection and compliance with the authorities’ recommendations were stated to be the main reasons why public health-related interventions had decreased, increased, or changed.

Conclusions
Both general public health practice and targeted interventions in health care and municipal activities have been cancelled or rescheduled according to our survey. Because many public health-related interventions have an equalising effect on health, this can be of great importance for groups that are socially, economically, or health-relatedly vulnerable.
Artificial sweeteners and risk of cardiovascular diseases in the prospective NutriNet-Santé cohort
Authors: Debras C , Chazelas E , Sellem L , Julia C , Kesse-Guyot E , Allès B , Deschasaux-Tanguy M , Huybrechts I , Srour B , Touvier M 
Published: October 2022

Abstract

Background
Artificial sweeteners are widely used today by the food industry as sugar alternatives. Potential adverse effects of these food additives on cardiovascular disease (CVD) have been suggested in experimental studies, but data from studies involving humans remain very limited. Previous cohorts have focused on artificially sweetened beverages. Our objective was to study the associations between artificial sweeteners from all dietary sources, overall and by molecule (aspartame, acesulfame-potassium and sucralose), and risk of CVDs (overall, coronary heart and cerebrovascular).

Methods
The study included 103,388 participants of the web-based NutriNet-Santé cohort (2009-2021). Artificial sweetener intakes were assessed using repeated 24h dietary records including names and brands of industrial products consumed. Multi-adjusted Cox proportional hazard models were performed. Exposure to artificial sweeteners were coded as 3-category variables: non-consumers, lower consumers (artificial sweetener intake below the sex-specific median) and higher consumers (above the sex-specific median).

Results
Compared to non-consumers, higher consumers of total artificial sweeteners had increased risk for CVD (n = 1502 incident cases, HR = 1.17 [1.01-1.35], P-trend=0.04) and more specifically cerebrovascular diseases (n = 777, HR = 1.34 [1.10-1.62], P = 0.004). Higher consumption of aspartame was associated with increased cerebrovascular diseases (HR = 1.29 [1.03-1.60], P = 0.01). Higher consumption of acesulfame-K was associated with a higher risk of CVD (HR = 1.24 [1.04-1.47], P = 0.02) and cerebrovascular diseases (HR = 1.29 [1.02-1.64], P = 0.1). No association was detected for coronary heart diseases (n = 730 incident cases).

Conclusions
These findings suggest a direct association between higher artificial sweetener consumption and increased CVD risk, in particular cerebrovascular. These results provide key novel information for the ongoing re-evaluation of sweeteners by the European Food Safety Authority.

Key messages
• In this large-scale prospective cohort (n = 103,388), artificial sweeteners (especially aspartame and acesulfame-K) were associated with increased risks of cardiovascular and cerebrovascular diseases.
• These results provide key insights to feed EFSA’s expertise for the ongoing risk assessment of artificial sweeteners.
One Health approach for the SDGs achievement
Authors: Viegas S 
Published: October 2022

Abstract
One Health is an approach characterized by the integration of human and animal health, plants, and ecosystems and encourages multisectoral and multidisciplinary efforts to achieve optimal levels of health and collaboration among different sectors and scientific areas to address challenging health problems. Through this approach is possible to obtained better results since the actions taken are normally focused to obtained co-benefits in several of the Sustainable Development Goals, including health for all and cost savings. The dissemination of One Health research and experiences is important to raise awareness for this approach. In this workshop, this will be done with the presentation and discussion of several themes where the One Health approach is of most relevance allowing to identify the most relevant barriers and opportunities for integrating One Health more widely.
1.F. Skills building seminar: Podcast 101 - Lessons learnt and how you can create your own unique experience
Authors:   Organised by: EUPHA-DH,   Chair persons: Stefan Buttigieg (EUPHA-DH), Brian Li Han Wong (UK)
Published: October 2022

Abstract

Podcasts are one of the fastest growing communication channels globally with more than 850,000 podcasts available globally through all the different podcast distributors. Furthermore, Health-related podcasts are gathering steam on their own front and herein lies the opportunity for public health and digital health professionals to embrace this channel and develop the necessary skills to start communicating their visions in a world that is plagued by misinformation and disinformation. This skills building workshop intends to cover the experience of three public health professionals in their involvement as co-hosts of three different podcasts that have their own voice with differences in their setup and availability of resources. Furthermore, the authors intend to cover the following aspects:
Getting started with your own podcasts
The typical setup for Podcast Recording
Promoting and growing your podcasts
Ensuring sustainability and consistency in your approach
Tips and Tricks for Podcast Success

Key messages
• Podcasts are a unique opportunity to create a meaningful connection with a wide audience in a world plagued by misinformation and disinformation.
• Setting up a Podcast has gotten much less complicated and this workshop will provide the basic knowledge to get you started with tools that you already own.
Reducing health inequalities through general practice in the UK: a realist review (EQUALISE)
Authors: Gkiouleka A , Wong G , Kuhn I , Sowden S , Head F , Bambra C , Harmston R , Manji S , Moseley A , Ford J 
Published: October 2022

Abstract

Background
In the UK, chronic conditions such as cancer, heart disease, stroke, and chronic obstructive pulmonary disease are driving health inequalities in life expectancy and were responsible for two-thirds of premature mortality in 2017. Voices that stress the importance of primary care in reducing health inequalities have been strengthening during the last decade. However, defining the most effective strategies to reduce health inequalities through general practice remains a challenge.

Aims
This study examines the evidence on interventions in primary care that are likely to decrease inequalities in NCDs and especially cancer, diabetes, cardiovascular and chronic obstructive pulmonary disease and will provide healthcare organisations with guiding principles on what should be commissioned.

Methods
The study is a realist review following Pawson's model. Based on a programme theory, we screened systematic reviews of interventions delivered in primary care and through their references, we identified primary studies reporting on inequalities across PROGRESS-Plus criteria. The data were analysed in light of the initial program theory and organised in a model informed by Collins’ Domains of Power framework.

Results
Out of 251 included reviews we retrieved 6,555 primary studies which resulted in 333 studies for data extraction. We found that there are five guiding principles operating simultaneously across four different domains which can reduce health inequalities in General Practice. The principles include flexibility, continuity, inclusivity, intersectionality, and community and operate simultaneously across the domains of structures and policies; narratives and ideas; rules and practices; and relationships and experience.

Conclusions
Flexibility, continuity, inclusivity, intersectionality, and community are the five principles which should guide the design and delivery of General Practice for the reduction of health inequalities.

Key messages
• Flexibility, continuity, inclusivity, intersectionality, and community are the five principles which should guide the design and delivery of General Practice for the reduction of health inequalities.
• Action to reduce health inequalities should be taken simultaneously across the domains of structures and policies; narratives and ideas; rules and practices; and relationships and experience.
Is Ireland ready for tobacco endgame? A national survey of knowledge and attitudes to tobacco endgame
Authors: Cosgrave E , Blake M , Murphy E , Sheridan A , Doyle F , Kavanagh P 
Published: October 2022

Abstract

Background
In 2013 ‘Tobacco-Free Ireland’ (TFI) shifted Irish national policy from tobacco control to “tobacco endgame”: policies, plans and interventions seeking to end the tobacco epidemic completely. Recent trends suggest the current 2025 TFI goal will not be achieved. This cross-sectional study is a timely assessment of public knowledge and attitude to re-focus Irish “tobacco endgame” planning.

Methods
A literature-informed, pre-tested survey instrument was telephone-administered to a representative sample of 1000 members of the Irish public aged ≥15 years recruited via random digit dialling in February 2022. Prevalence of “tobacco endgame” views was measured; logistic regression determined factors associated with key responses.

Results
Response rate was 30% (n = 1,000, post-hoc weighting applied). While TFI goal awareness was low (34%), support was high (75%), albeit most (61%) recognised postponement beyond 2025 was required for achievability. There was majority support for 18/22 endgame measures assessed. Product-focused tactics were popular, while views on targeting users were mixed: e.g. 86% supported a reduction in tobacco-product nicotine content; 40% supported introduction of a tobacco-user license. Phasing-out tobacco sales was highly-supported (83%); however, this was contingent on special supports for those currently addicted. Support for the TFI goal was higher among non-tobacco users (aOR 2.66, 95%CI 1.89-3.76), females (aOR 1.57, 95%CI 1.17-2.11) and those of higher social class (aOR 1.72, 95%CI 1.25-2.35).

Conclusions
While achievement by 2025 is increasingly unrealistic, findings strongly affirm Irish public opinion is ready for “tobacco endgame”. Recognition of the needs of currently addicted tobacco users and focusing on subgroups with lower support levels should be integral to equitable “tobacco endgame” planning and communication. This study should mobilise renewed Irish political commitment to bold actions aimed at ending smoking-related harm.

Key messages
• There is strong support for tobacco endgame measures among the Irish population, which is a supportive factor for bold political leadership to make these radical ideas a reality.
• Public preference for product and non-user-focused measures aligns with tobacco endgame discourse and should aid policy reframing to tackle structures and dynamics sustaining the tobacco epidemic.
1.L. Workshop: Building capacity for a resilient and healthy post-COVID health workforce
Authors:   Organised by: EUPHA-HWR, WHO Europe,   Chair persons: Ellen Kuhlmann (EUPHA-HWR), Tomas Zapata (Denmark)
Published: October 2022

Abstract

Background
The COVID-19 pandemic added new challenges to health workforce resilience. High workload, increased risk of COVID infection and continuing stress threaten the health and wellbeing of healthcare workers (HCWs) and increase existing (gendered) inequalities, thus reinforcing health labour market problems. Investment in the health workforce and prioritisation of the health and wellbeing needs of healthcare workers in health policy and pandemic recovery plans is therefore called for by the WHO, the European Union and others. However, health systems and policymakers across countries have not sufficiently understood the importance of HCWs.

Objectives
This workshop brings health workforce needs onto the health policy agenda. It seeks to build capacity for a resilient and healthy health workforce, setting the focus on protection and preparedness of HCWs and their individual wellbeing, and reduction of gendered inequalities. The following major questions will be addressed: What do we know about COVID-19 and the health and wellbeing of HCWs? What skills are needed to respond to new demands? What policy approaches are available to improve protection, preparedness and mental health support of HCWs? How to integrate gender equality and the situation of migrant/refugee HCWs in these approaches, and finally build capacity for effective health workforce governance and its implementation.
The workshop introduces novel results drawn from European comparative research and country case studies. It connects policy and practice, as well as health system and individual HCW needs. A number of important policy recommendations are emerging from the research. (1) The health and wellbeing of the health workforce must be addressed systematically across all levels of health policy and governance, including the organisation settings. (2) Health systems must take responsibility and leadership in responding to health workforce needs. (3) Important lessons to be learned from HCWs’ experiences should guide future health workforce policy and pandemic recovery plans. (4) Participatory governance and inclusion of HCWs must be strengthened, including gender equality and diversity.
The workshop will stimulate critical debate and improve knowledge exchange across countries and between researchers. It will contribute to strengthen resilience of the health workforce and health systems, and to build back better after COVID-19 in a fair and equitable manner.

Key messages
• Health workforce needs and mental health support must become policy priorities and addressed as part of health system resilience.
• Action has to be taken to strengthen participatory health workforce governance sensitive to new needs.
Health workforce governance during the COVID-19 pandemic: learning lessons from Europe
Authors: Williams G , Buchan J , Zapata T 
Published: October 2022

Abstract

Background
This study considers some of the effective governance tools that have been utilised to mobilise, redeploy and repurpose the health workforce during the COVID-19 pandemic to create surge capacity, protect workforce health and wellbeing and ensure effective implementation of vaccination programmes.

Methods
Data were systematically extracted from the Observatory/WHO Europe/European Commission Health System and Response Monitor, covering the period from March 2020 to May 2021 with a focus on four dimensions of health workforce governance: national/regional government policies; legislation; regulation; the role and remit of employers and management.

Results
A wide-range of governance actions across all levels were required to ensure the health workforce could provide effective pandemic responses. Creating surge capacity, for example, often required adoption of emergency legislation to facilitate exceptional hiring procedures and the changing of (re-)registration requirements, as well as additional training and development of new competencies among other actions. Putting in place physical and mental health support meanwhile required defining infection control policies, monitoring PPE supply and distribution, ensuring access to free mental health support, and implementation of breaks. Some countries also allowed “new” types of workers to vaccinate; online or in person training; adjustments to payment mechanisms; and creating new supervision requirements.

Conclusions
Pandemic responses have broken up sclerotic governance structures which have hampered past health workforce development and reform, new training programmes have been rapidly developed, leadership roles have been delegated to a wider-range of health professionals than before and monitoring systems that provide more rapid data on staffing levels have been put into place. Learning from and evaluating these changes will be important to help inform future pandemic responses.
Health workforce needs and health policy responses to COVID-19: a European comparative assessment
Authors: Kuhlmann E , Brînzac M-G , Burau V , Correia T , Falkenbach M , Ungureanu M-I 
Published: October 2022

Abstract

Background
The COVID-19 pandemic revealed the importance of the health workforce for health system resilience. This study aims to explore whether and how healthcare system in Europe have responded to new emergent needs and transformed their health workforce policies.

Methods
A qualitative comparative approach is applied, based on multi-level governance theory and a rapid assessment of three areas of health workforce policy: mental health, gender equality, and public health competencies. We consider two years of the pandemic with a focus on recent waves, October 2021-January 2022. Denmark, Germany, Portugal, Romania and Switzerland are selected for comparison, representing different health systems, health workforce conditions and COVID-19 indicators in the European Union and European Economic Area.

Results
Across countries the pandemic has highlighted mental health needs, persisting gender inequalities and demand for public health competencies. Our comparison reveals similar weaknesses and governance gaps. (1) Mental health needs of healthcare workers are increasingly recognised (more strongly in Denmark and less in Romania with the other countries clustering in-between); however, health workers’ perceptions are not used as guidance and effective programmes are lacking. (2) The situation is worst in relation to gender equality goals that are largely ignored in pandemic policy and recovery plans. (3) Public health competences are more advanced and integrated in the NHS systems in Denmark and Portugal, but no country has taken action to innovate health workforce education and strengthen public health.

Conclusions
The comparative assessment highlights that health systems failed to adequately respond to health workforce needs and the COVID-19 challenges. Action has to be taken to implement participatory governance and step up efforts towards more responsive and resilient health workforce policy.
Hospital doctors in Ireland working through COVID-19 pandemic: learning from individual experience
Authors: Humphries N , Byrne J-P , Creese J 
Published: October 2022

Abstract

Background
This study was part of a 5-year, HRB-funded research project about hospital doctor retention and emigration.

Methods
In 2021, we conducted a Mobile Instant Messaging Ethnography (MIME) with 28 hospital doctors in Ireland. This involved interviewing doctors via Zoom and engaging them in a 12-week work-related conversation via WhatsApp.

Results
Our findings illustrate that the pandemic intensified already difficult working conditions. Respondents described working in an under-staffed and under-resourced system, in which they were unable to protect their own wellbeing or achieve a work-life balance. Morale was low and few had hope of health system improvement.

Conclusions
The findings reveal a workforce under strain and raise concerns about health worker wellbeing and health worker attrition, post-pandemic. However, they also highlight the importance (and value) of listening to the voices of frontline health workers and using their insights to inform and enhance retention policies.
Predictors of seropositivity against SARS-COV-2: a population-based seroepidemiological study
Authors: Musheghyan L , Sahakyan S , Sargsyan Z , Muradyan D , Aslanyan L , Gharibyan N , Harutyunyan A , Khachadourian V , Petrosyan V 
Published: October 2022

Abstract

Background
Data on parameters of actual exposure to SARS-CoV-2 is limited, and specific population groups might be at a higher risk of infection. In line with the growing need for large-scale investigations to determine the presence of antibodies against SARS-CoV-2 among different population groups, we conducted a nationwide assessment in Armenia.

Methods
We performed a cross-sectional seroepidemiological study among the adult population in Armenia, in May-September 2021. A multi-stage cluster random sampling was performed to recruit the participants across the capital city and regions. The study had two main components: blood sampling, which took place in primary care facilities and a phone survey on socio-demographic characteristics, comorbidities, and previous history of COVID-19.

Results
The number of participants included in both blood sampling and phone survey was 3483. The nationwide prevalence of SARS-CoV 2 antibodies weighted by age and gender was 66.4% with significantly higher prevalence in urban compared to rural areas (67.3% vs 59.3%, p &lt; 0.001). Only 22.7% (n = 772) of the total sample reported a previous history of PCR confirmed COVID-19, among whom antibodies were detected in 94.2% (n = 727). In the final adjusted model, the seropositivity was associated with being female (OR = 1.60, 95% CI: 1.32; 1.92), employed (OR = 1.41, 95% CI: 1.17; 1.69), and having previous PCR confirmed COVID-19 (OR = 10.6, 95% CI: 7.39; 15.21).

Conclusions
Over 66% of the population were seropositive for antibodies against SARS-CoV 2; and over ⅕ of the sample reported a previous PCR diagnosis. Factors associated with increased odds of seropositivity included gender, employment status, and place of residence. Targeted interventions are recommended to minimize the risk of infection among those groups, including vaccination and infection prevention and control measures.

Key messages
• The prevalence of SARS-CoV 2 antibodies is about three times higher than the rate of infection based on PCR confirmed prevalence of COVID-19.
• Women, people living in urban areas, and those employed are at a higher risk for exposure to SARS-CoV 2.