bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health literacy among adolescents: summary of some key findings from ten European countries
Authors: Paakkari L , Lahti H , Kulmala M , Paakkari O , Lyyra N 
Published: October 2022

Abstract

Introduction
In research on disparities, the concept of health literacy (HL) as a set of competencies to promote and sustain health may help in understanding the disparities better and in addressing avoidable and unfair health disparities. The presentation will present some key findings on adolescents’ HL levels in ten European countries, and how HL mediates and moderates between various background factors and health outcomes.

Methods
Data consisted of cross-sectional data from Health Behaviour in School-aged Children (HBSC) study from year 2017/18 of ten European countries (Austria, Belgium (Fl), Czechia, England, Estonia, Finland, Germany, Macedonia, Poland, and Slovakia). Data (n = 14,590 - 22,291) of 13- and 15-year-old pupils were used. Indicators include background variables (e.g. age, gender), Health literacy, Health indicators (e.g. self-rated health (SRH) and problematic social media use (PSMU)). Analysis include (1) Mediator analysis (with Mplus): pearson correlation coefficients, path models (Mplus 7.3 and Maximum Likelihood estimator) and (2) random effects models and moderator analyses (with R-sofware).

Findings
HL is an independent factor explaining disparities in health (e.g. SRH), and a mediator as well as a moderator between health outcomes and background factors. Based on the national analyses HL had significant main effects in every country, but group level differences emerged only in some countries. For instance, in Finland and Belgium, among girls HL lowered the likelihood to problematic social media use, but not among boys.

Discussion
HL is of use in understanding and tackling health disparities among adolescents. Results confirm the need to adopt the principles of proportionate universalism when promoting HL among adolescents to avoid widening the disparities within population groups. Also, country-specific health literacy interventions are needed to secure equity in opportunities of different population groups to benefit from the HL interventions.
Training health professionals in infodemic management to mitigate the harm caused by infodemics
Authors: Purnat TD , Bertrand-Ferrandis C , Yau B , Ishizumi A , White B , Briand S , Ngueyn T 
Published: October 2022

Abstract

Background
Due to their multifaceted impacts on health and society, understanding and controlling infodemics to support uptake of vaccines, public health and social measures, treatments, and health behaviours is rapidly becoming a priority for many health authorities. WHO has developed a comprehensive training programme to support health professionals in the new field of expertise of managing infodemics.

Objectives
The WHO infodemic management multiformat and transdisciplinary training program builds the skills and knowledge needed to prepare for and respond to infodemics. The trainings are built on WHO competency framework for building an infodemic response workforce. The methodology used relies on human-centred and emotional design evidence and practice and uses evaluation for continuous learning design improvement.

Results
Since November 2020, three WHO global trainings organized online with US Centers for Disease Control and Prevention, UNICEF and other partners, including four-week-long simulation exercises, creating a network of 772 infodemic managers in 133 countries. A “train-the-trainers” companion package was prepared and by April 2022 delivered in Iran and Malaysia. Deep dive training modules on specialist infodemic management practice topics have been prepared for use at country level. In addition, a comprehensive set of self-paced free online courses enhances infodemic literacy and resilience to misinformation. Between December 2021 and April 2022, the OpenWHO Infodemic Management 101 course reached over 17 000 enrolments. The training programme will be updated based on evaluations, the feedback from field responders and the updated to the WHO competency framework for infodemic management workforce.

Conclusions
The WHO multiformat blended training program allows an efficient and rapid dissemination of infodemic management skills and knowledge.

Key messages
• A global network of trained infodemic managers is ready to support national preparedness and response planning.
• Skills and knowledge in infodemic management are accessible to all thanks to free online courses.
Impact of Sugar-Sweetened Beverage Taxation Scenarios in Germany: A Comparative Modelling Study
Authors: Emmert-Fees KMF , Felea A , Kypridemos C , Scarborough P , Laxy M 
Published: October 2022

Abstract

Objectives
Taxing sugar-sweetened beverages (SSBs) is recommended to reduce the burden of obesity, cardiovascular disease (CVD) and type 2 diabetes (T2DM). The objective of this study was to quantify the potential long-term health and economic impact of different SSBs taxation scenarios in Germany using simulation models with different granularity.

Methods
We used a multi-state life table Markov cohort (MSLT) and a microsimulation (IMPACT) model to simulate the impact of different SSB taxation assumptions and scenarios on CVD and T2DM in the German population aged 20 years and older over 20 years. Data sources included official population counts, anthropometric and dietary intake data from national surveys and published meta-analyses. Change in beverage consumption by sex and age under different taxation scenarios was estimated using de-novo national price elasticities and changes in body weight were based on an energy equilibrium model. We projected incremental disability-adjusted life years (DALYs) and healthcare costs, comparing results between both models.

Results
Preliminary results from the MSLT model show that a 20% SSB excise tax in Germany could lead to moderate body weight reductions across all age-sex groups. Over 20 years, the tax would reduce healthcare costs by €753 million [95% CI: 527; 1,021] and save 24,380 DALYs [18,460; 33,900] from T2DM alone. Health and economic gains largely depend on the relevance of substitution effects, tax amount and taxed beverage categories. Results including CVD and comparisons with the IMPACT model are work-in-progress.

Conclusions
We show that SSBs taxation in Germany has the potential to reduce healthcare costs and improve population health. The impact of any SSB tax depends on its implementation scenario, which behavioural assumptions hold, and the obesity-related disease outcomes considered for its evaluation. Further research should compare various obesity prevention approaches to support health policy priority setting.

Key messages
• Taxation of sugar-sweetened beverages can reduce healthcare costs and improve population health in Germany.
• The estimated health and economic impact of sugar-sweetened beverage taxation critically depends on tax design and behavioural modelling assumptions.
Measuring Health Insurance Literacy in the Netherlands – first results of the HILM-NL questionnaire
Authors: Holst L , Rademakers JJDJM , Brabers AEM , de Jong JD 
Published: October 2022

Abstract

Background
Many Western countries have healthcare systems that expect their citizens to make critical, well-considered decisions about which health insurance policy best fits their needs and preferences. There are indications that citizens struggle to fulfil this role due to the complexity of the healthcare systems and lack of skills, support or motivation. This can lead to citizens being sub-optimally insured, suffering inadequate coverage and facing unexpected costs. To understand how citizens choose and use a policy, the health insurance literacy measure (HILM) was developed in the US. It seems valuable to investigate the concept of Health Insurance Literacy (HIL) in other countries. This study aims to examine how HIL is distributed among citizens in the Netherlands; and to find out whether certain groups have more difficulty choosing and using a health insurance policy.

Methods
We measured HIL using the HILM-NL questionnaire, a validated and translated version of the HILM. In February 2020, the HILM-NL was sent to 1,500 members of the Nivel Dutch Health Care Consumer Panel. The response rate was 54% (n = 806). Higher HILM-NL scores imply a higher self-assessed ability in choosing and using health insurance.

Results
There is a wide variation in HIL among citizens in the Netherlands. The average total HILM-NL score is 55.14 (ranging from 21-84). Lower-educated citizens (p&lt;.04) and citizens with lower income (p&lt;.01) are relatively more likely to have lower HIL, than, respectively, higher-educated citizens and citizens with higher income.

Conclusions
Citizens who completed less education or earn a lower income are relatively more likely to have difficulty choosing and using a health insurance policy. It is important to support these vulnerable groups, so that Dutch citizens in general will be better able to choose a policy that fits their needs and preferences. This should ensure that citizens are less likely have to deal with inadequate coverage and unexpected costs.

Key messages
• There is a wide variation in HIL among citizens in the Netherlands.
• Citizens who completed less education or earn a lower income are relatively more likely to have difficulty choosing and using a health insurance policy.
Case based approach to the application of standards and Interoperability in practice
Authors: Hussey P , Das S 
Published: October 2022

Abstract
Digital infrastructure and connectivity is layered and requires a number of defined viewpoints in order for safe data flow and use to occur. To address context specific challenges to support communication in health and social care, health informatics standards supporting interoperability are key. In this skills building seminar we will introduce participants to a standards based roadmap for interoperability. We will provide examples of projects and resources detailing the process of engagement to optimise system design for sustainability through a use case based approach.
How ontology can be used to achieve semantic interoperability in healthcare
Authors: Das S , Hussey P 
Published: October 2022

Abstract
Semantic interoperability allows machines to share, interpret and use data without ambiguity. Semantic Interoperability is a major concern in healthcare (c.f. the EU commission 2021 report on electronic record exchange formats). The lack of interoperability with regard to electronic health record (EHR) leads to fragmentation and a lower quality of cross-institution and cross-border healthcare. The simple choice of an interchange language (HL7, FIHR etc.)is not sufficient to ensure interoperability. Healthcare interoperability is associated with multi-level and multi-sectoral complexity, and this cannot be addressed without consideration of a range of people and needs, from application design to knowledge sharing. Each transaction needs to be defined in unambiguous details as part of a complete, consistent, coherent, and machine-readable set of specifications for interoperability between the machines to minimize any potential error. We propose a systematic process to achieve healthcare interoperability, working with healthcare professionals starting from design level to implementation level. In our seminar we will explain with examples how ontology can be used to achieve semantic interoperability in healthcare. Technical requirements, including the choice of tools (e.g. Protégé); data base (e.g. GraphDB); data model (i.e. Web Ontology Language 2 (OWL2); formal specification (i.e. Description logics (DL)); and the right syntax (RDF/XML). Will be introduced.
Oral Health Care in Europe: Financing, Access and Provision
Authors: Winkelmann J , van Ginneken E , Gomez Rossi J 
Published: October 2022

Abstract
With growing awareness of the large burden of oral diseases and how limited coverage affects both access and affordability, oral health policy has been receiving increased attention in recent years. This culminated in the adoption of the WHO resolution on Oral Health in 2021, which urges Member States to better integrate oral health into their universal health coverage and noncommunicable disease agendas. This study investigates major patterns and developments in oral health status, financing, coverage, access, and service provision of oral health care in 31 European countries. While most countries cover oral health care for vulnerable population groups, the level of statutory coverage varies widely across Europe resulting in different coverage and financing schemes for the adult population. On average, one third of dental care spending is borne by public sources and the remaining part is paid out-of-pocket or by voluntary health insurance. This has important ramifications for financial protection and access to care, leaving many dental problems untreated. Overall, unmet needs for dental care are higher than for other types of care and particularly affect low-income groups. Dental care is undergoing various structural changes. The number of dentists is increasing, and the composition of the health workforce is starting to change in many countries. Dental care is increasingly provided in group practices and by practices that are part of private equity firms. Although there are early signs of a shift towards more prevention of oral diseases, dental care overall remains focused on treatment. A lack of data affects all areas of oral health care and impede to inform policy-making on the underlying causes and the prevalence of oral disease, as well as the effectiveness of community preventive activities and oral health services.
Horizon Europe: the DELIVER (DELiberative ImproVEment of oRal care quality) project
Authors: Vassallo P 
Published: October 2022

Abstract
Oral diseases and conditions affect more than 3.5 billion people worldwide. They are the 3rd most expensive diseases to treat in the EU and disproportionally affect vulnerable groups. In deviation from the UN and WHO goal of Universal Health Coverage, many EU citizens do not have access to quality oral care without financial hardship. To this end, the DELIVER (DELiberative ImproVEment of oRal care quality) project aims to enhance the quality of oral care through deliberative dialogue and action involving citizens, patients, providers, payers and policymakers. DELIVER will create a synergistic problem-solving ecosystem to convert deliberative dialogues into meaningful improvement of oral care quality. Using a mixed-methods research approach, DELIVER will co-develop and co-produce new quality improvement approaches in three phases. The 1st phase involves situational analysis, consenting of core quality indicators, and development of a EU-wide monitoring framework. The 2nd phase involves in-depth analysis of select quality improvement approaches: (i) PROMs/PREMs-based quality improvement in dental practices; (ii) community-based quality improvement for vulnerable groups; (iii) quality-oriented commissioning of oral health services. The regulatory determinants of oral care quality improvement will be scrutinized. In the 3rd and final phase, the knowledge gained in the 1st and 2nd phases will be merged into the DELIVER Quality Toolkit with manuals and digital tools for concretely actionable and context-adaptive approaches for oral care quality improvement. This presentation will give an overview of the DELIVER project and discuss how it can contribute to improving oral health systems.
What matters to families about the healthcare of preterm or low birth weight infants
Authors: Odd D , Mann M , Beetham H , Dorgeat E , Isaac T , Ashman A , Wood F 
Published: October 2022

Abstract

Introduction
Preterm and low birth weight (LBW) infants have complex long-term healthcare needs. The impact on families of caring for a sick infant is increasingly understood, with consequences for attachment and bonding and parental health and wellbeing immediately after birth and beyond. In this qualitative evidence synthesis, we aimed to understand what matters to families about the care provided to preterm or LBW infants in hospital and the community.

Methods
We searched nine databases and the reference lists of included studies for eligible studies using qualitative methods examining the views of families on healthcare for preterm or LBW infants. We used the Critical Appraisal Skills Programme checklist for qualitative studies to assess study quality and the GRADE-CERQual approach to assess confidence in each review finding. Studies were sampled after data saturation, and thematic synthesis techniques were used for analysis.

Results
203 studies were eligible for inclusion. We selected 49 studies from 25 countries for the analysis, based on methodological quality, data richness and on ensuring representation from settings with varying resources. Eight analytical themes were identified. Confidence in most results was moderate to high. What mattered to carers was a positive outcome for the child; active involvement in care; support to cope at home after discharge; emotional support for the family; the healthcare environment; their information needs were met; logistical support was available; and positive relationships with staff.

Conclusions
Enabling a positive post-natal period for families of small and sick infants is difficult. Experiences of care for preterm or LBW infants vary, but we found high consistency in what matters to families. This information can be used to shape global recommendations on support for infants and carers. More research is needed on what matters to parents who receive community-based care, especially in low resource settings.

Key messages
• We found high consistency across settings in what matters to families in the care of preterm infants.
• Understanding carers views and values ensures that care can be planned to meet the needs of infants and families.
Design strategies to influence health behaviour and mental wellbeing in the urban setting
Authors: Rehn J , Müller H , Wasmer A , Chrysikou E 
Published: October 2022

Abstract
The design of objects, spaces and systems can have a profound influence on the behaviours as well as emotional and cognitive states of the people confronted with it. With regards to health behaviour, elaborating on Schwarzer's HAPA model (1992), the Design Model for Health Behaviour Change - DMHBC (Rehn, 2018) proposes the use of the built environment to act as situative barriers or opportunities to change health behaviours and overall health promoting mindsets. Regarding urban space and mental health, most environmental stimuli and related behavioural patterns focus on consumption (e.g. retail stores) or daily routines (e.g. commuting). Using objects such as specifically designed furniture, installations and other elements to act as perceived affordances and stimuli can affect both cognitive-emotional states as well as specific behavioural responses. For instance, based on the research on mindfulness, drawing people's attention towards their own bodily sensations (e.g. breath) by playful interactive installations or information signs can increase feelings of calm, appreciation and contentment. The same applies to design interventions that guide one's view towards otherwise overlooked urban features (e.g. natural scenery). While mindfulness and relaxation are powerful techniques for increasing mental health, many other approaches (such as physical activity, social interactions etc.) can be found to have similar benefits. In fact, the orchestrated combination of various forms of stimuli might prove to be more effective than the sum of the individual interventions as they create a subsequent chain of stimuli that form a coherent experience. This approach poses particular potentials to foster mental health in vulnerable groups that usually suffer most from urban environmental risk factors. Thus, providing public and open access stimuli and affordances in this way, can have a significant effect on overall urban public health and reduce social inequalities at the same time.
Using individual-level stratification as an approach to integrating social inequalities into the burden of disease
Authors: Baravelli CM , Eikemo TA , Klitkou ST , Kinge JM , Clarsen BM , Bølling AK , Balaj M , Knudsen AKS 
Published: October 2022

Abstract
Substantial social inequalities in almost all non-fatal and fatal health outcomes are one of the most consistent and universal epidemiological findings. Therefore, monitoring social inequalities in health is considered a key priority for researchers and policy makers. The Global Burden of Disease Injuries, and Risk Factors Study (GBD) is the most comprehensive worldwide observational epidemiological synthesis of data to date. However, currently, the GBD Study does not include the potential to stratify associated metrics, such as the disability-adjusted life years metric, by different socioeconomic factors, such as education or income level. Although The GBD Study does include the Socio-Demographic Index, this measure is only useful when comparing between, and not within, countries or regions. We conducted a Cox regression analysis using a national longitudinal prospective cohort study design and registry-based data linked at the individual-level. We stratified on educational groups and investigated cause-specific mortality rates over a 30-year period, adjusting for age, sex and 5-year age cohorts. We also calculate years of life lost (YLLs) stratified by educational groups, standardised by age, and presented for specific years - to investigate trends over time. We discuss the benefits and limitations of this “individual-level” stratification approach as one possible solution to the integration of social inequalities into the GBD study or when using a burden of disease framework approach more generally.
Labor migration, the food supply chain and the COVID-19 syndemic: Germany, Netherlands, and the USA
Authors: Jungwirth I , Glassner M 
Published: October 2022

Abstract
In Germany, the COVID-19 syndemic has brought questions regarding precarious labor migration in the food supply chain (FSC) to the forefront of the public debate. An analysis of responses to COVID-19-related challenges in agriculture and meat-processing pinpoints similarities and differences between the two industries, offering lessons for workers’ health and safety, and for the improvement of the FSC's systemic resilience. Agriculture and meat-processing were highlighted as “essential” during the COVID-19 syndemic in Germany. In agriculture, amidst lockdowns and border closures, special arrangements allowed permits for migrant workers to harvest seasonal and perishable produce, thus ensuring food supply and mitigating economic loss. Bilateral agreeements with countries neighbouring the EU were concluded to increase temporary labor migration for seasonal work; while COVID-19 specific occupational health standards were set. In meat-processing, which emerged as a hotbed for COVID-19 in Germany, the public debate problematized the contradictions between migrant workers’ essential contribution to the economy on the one hand, and their poor working and living conditions on the other hand. Here, the pandemic led to new legislation, prohibiting subcontracting in the meat processing industry and requiring higher standards for the housing of temporary migrant workers. While the long-term outcomes of these reforms remain to be seen, enforcement of health standards and other social rights will need attention. The German case, thus, underscores the importance of structural changes for ensuring social protection and dignified working conditions for labor migrants, which can, in turn, improve fairness, sustainability and systemic resilience of the FSC.