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Background: Healthcare associated foodborne outbreaks (HA-FBO) can result from exposure to contaminated food in premises where highly vulnerable patients are cared, including hospitals and nursery homes. The probability of developing severe foodborne diseases such as invasive listeriosis is much higher for susceptible populations. There is limited knowledge on the data on food exposures that could be used to investigate HAFBOs. There is also lack of data relating to specific policies in the health facilities aimed to prevent the administration of potentially risky foods, possibly bringing them from home. Methods: This study was in the framework of One Health EJP Project NOVA. A semistructured questionnaire was administered to 4 general hospitals, 1 specialist clinic and 3 nursing homes located in the Abruzzo and Molise regions, Italy. The questionnaire included 25 questions in 3 sections (I. General organization of the catering service; II. Food menu data; III. Food from home). Results: In most facilities (75%) external catering companies used inhouse kitchens. Trace-back of food to individual patients was possible in 5 premises out of 8 (62.5%), but only in 1 nursery home out of 3 (33.3%). Data were collected in electronic format (hospitals) or paper (nursery homes) and stored 1-12 months. Food at risk of Listeria monocytogenes were not excluded from the menus, such as pre-sliced cooked meat products (served in 4 out of 8 premises, 50%), smoked fish (20%), soft cheese (20%). The consumption of food brought from home was possible in ‘‘special occasions’’, mostly in the nursery homes (66.6%). Conclusions: In case of HA-FBO it could be difficult to trace back the food particularly in the nursery homes where food data are not individually collected and usually on paper. More studies are needed in order to understand the effective exposure to foodborne pathogens, given that some types of foods considered by EFSA as at high risk of microbial contamination are commonly served. Key messages: · Served food could not be traced back to the patient mostly in nursery homes. · Foods at risk of Listeria monocytogenes contamination are commonly served to patients and residents. [ABSTRACT FROM AUTHOR]

Background: Contact tracing (CT) is a pillar of infection control during outbreaks and its implementation has been great ally in the context of the COVID-19 pandemic that pressured national health systems. Digital CT (DCT) aids manual CT by logging proximity contacts and timely notifying contacts of positive cases, contributing to greater epidemic. We aim to systematically review and critically appraise the available evidence on adoption, effectiveness, acceptance and barriers to access of available CT apps. Methods: We conducted a systematic literature review by means of Pubmed, Embase, Cochrane and Web of Science and applying the PRISMA guidelines. We classified studies according to selected characteristics (eg, original data, mathematical models, policy papers, overview of the experience with national CT apps) in order to better outline our results. Results: Our queries yielded 1201 articles, of which 790 remained after duplicates’ removal. After applying a priori selected inclusion criteria, 428 (54.17%) were eliminated after screening by title and abstract. 362 records were included in our study: of them 33.7% were original studies, 54.1% were opinion papers not reporting quantitative data, 14.91% were mathematical models, 6% were systematic reviews on DCT-related topics. Among original studies, 11.47% described national experiences and 25.40% discussed adoption dynamics. Conclusions: DCT adoption still faces several cultural, normative and technical barriers, ranging from adoption mandates to privacy issues, to device compatibility. Overall, scant evidence is available on the impact of DCT in controlling infection spread and wide heterogeneity persists within studies in term of design and assessed outcomes Future research is needed based on shared evaluation frameworks. Key messages: Digital contact tracing apps are a powerful but underestimated tool to counter epidemiological emergencies. Future epidemiological challenges will require a shared implementation and evaluation protocol for digital contact tracing apps. [ABSTRACT FROM AUTHOR]

Background: Many studies around the world have been carried out to establish the association between deprivation and health outcomes. Both separate deprivation indicators (income, education) and indices that include several ones are used. Deprivation indices have been actively used in public health since the mid-80s of the last century. Nowadays, there is no clear classification of deprivation indices. Methods: In order to create a taxonomy of deprivation indices, scientific publications related to the development and application of indices have been combined, analyzed, and systematized. The search was carried out in two bibliographic databases (PubMed and Google Sholar). After conducting a full-text review and searching and adding relevant papers from the bibliography, and adding papers that were already known to the authors, 61 documents were included in the study. These documents referred to 61 original deprivation indices. Original index is defined as ‘‘an index that includes a combination of deprivation indicators that is unique and not repeated in other indices’’. Results: Four key characteristics of the indices included in the classification were determined: type of deprivation, spatial scale, data source and weighting method. To create the taxonomy, an integrative approach was used that allows you to add new classes and subclasses when new information appears. In accordance with the type of deprivation 72% (44 \ 61) socio-economic, 7% (4 \ 61) material deprivation, 5% (3 \ 61) environmental deprivation and 16% (10 \ 61) multidimensional indices were identified. Conclusions: The terms and definitions introduced during the review are aimed at ensuring uniformity in the taxonomy and finding a common language among researchers and specialists who develop and use indices. We also hope that the data from the study will stimulate the use of a competent approach and will help in resolving conflicts or inconsistencies that arise during the construction and use of indices. [ABSTRACT FROM AUTHOR]

Background: Patient-reported experience measures assess patients’ experiences with processes in healthcare and hence support a patient-centred orientation of care. The aim of the study was to measure patients’ experiences in Slovenian acute hospitals in the fields of internal medicine, surgery, gynaecology and obstetrics, oncology and orthopaedics. Methods: The survey was based on a 2006 questionnaire already in use in Slovenia, which was updated after a literature and documentary review. The questionnaire included the following domains: admission to the hospital, time from arrival to the hospital to the bed on the ward, attitude of doctors, attitude of nurses, treatment, privacy, hospital environment and discharge from hospital. Mixed-mode study design was used, which involved a combination of traditional paper-and-pencil method and a web survey. Results: The national survey was conducted in autumn 2019 and included 22 acute hospitals with 49 hospital wards. The questionnaire was validly completed by 3,684 patients, with 91.8% paper and 8.2% online questionnaires. The response rate was estimated to be 32.1%. The mean value for the general assessment of hospital treatment on a scale from 0 to 10 was 9.07. The worst rated indicators were related to hospital food (only 56.9% of patients were satisfied) and doctors’ explaining the possible side effects of the newly prescribed medications (65.0% of patients agreed on obtaining such explanation). Qualitative analysis of open questions revealed that patient paid considerable attention to poor infrastructure and needs for hospital renovations. Conclusions: The surveyed patients in our study rate highly the treatment in acute care hospitals. However, there is room for improvement. Increased attention to hospital environment and infrastructure is warranted in the future, including the amendments of the questionnaire. Key messages: • In autumn 2019, a national survey on patient’s experiences in acute care hospitals in Slovenia was conducted. 76.5% of the surveyed patients rated the medical treatment with a score of 9 or 10. • Qualitative analysis of open questions revealed poor infrastructure and needed renovation of the hospitals. [ABSTRACT FROM AUTHOR]

The article offers information on a workshop at the 16th World Congress on Public Health 2020 on addressing the commercial determinants of health.

The article offers information on a workshop at the 16th World Congress on Public Health 2020 about vaccination challenges in developed and developing countries.

The article offers information on a workshop at the 16th World Congress on Public Health 2020 which connects health labour market data with the human face of the health workforce and brings a global approach to the analysis, with a focus on Europe.

Policy simulation models (PSMs) have been used extensively, both to shape health policies before real-world implementation and to evaluate post-implementation impact. However, an accepted quality assessment framework for simulation models is lacking. This systematic review aimed to develop a novel quality assessment framework for tobacco control PSMs. We searched five databases to identify peer-reviewed tobacco control PSMs that projected tobacco-use and tobacco-related outcomes from smoking policy scenarios. We extracted information on modelling inputs, structure and outputs. Using our proposed quality assessment framework, we scored models on nine dimensions: representativeness of population, policy effectiveness evidence, simulated smoking histories, simulated smoking-related diseases, exposure-outcome lag time, transparency, sensitivity analysis, validation and equity. We then compared the model score with the number of cited papers using each model. The results were narratively presented. After screening 5046 candidate papers; 145 papers were included and categorised into 25 PSMs. After scoring the models using our proposed framework, we observed that seven models were given seven and more points. The higher-scored models were generally those with a higher number of publications. While all included models had been subject to sensitivity analysis, other best practices were often lacking. Nine models did not explicitly consider smoking-related diseases. Smoking histories were commonly collapsed into crude smoking status categories rather than reflecting smoking intensity or quitting history. Furthermore, only four models estimated policy equity impact. Our systematic review revealed a variety of modelling techniques used in tobacco control. Our novel quality assessment framework offers a potential quality measure for tobacco control policy simulation models. It may guide health decision modellers and inform health policymaking. Key messages: All nine framework dimensions were observed in two tobacco control PSM, suggesting the framework relevance and feasibility. However, few models achieved high scores in all dimensions. This novel quality assessment framework aims to support the development and sharing of good modelling practice and thus promote better health policy decision-making. [ABSTRACT FROM AUTHOR]

The Health Systems Response Monitor (HSRM) was established in March 2020 at the beginning of the COVID-19 pandemic to collect and organize up-to-date information on how 50 countries in the WHO European Region and Canada are responding to the crisis. The HSRM uses a structured template, focusing primarily on the responses of health systems but also capturing wider public health initiatives. The HSRM is a joint undertaking of the WHO Regional Office for Europe, the European Observatory on Health Systems and Policies, and the European Commission. The HSRM builds on the Health Systems and Policy Network of the European Observatory, which brings together an international group of high-profile institutions from Europe and beyond with high academic standing in health systems and policy analysis. The content collected on the HSRM platform has been used to enhance cross country learnings through topical snapshots, papers, webinars and more. At the end of 2020, the European Observatory initiated a Health Policy Special Issue (SI) based on the work of the HSRM containing both thematic policy papers and full comparative descriptions and analysis of country responses. Overall, work from the HSRM aims to provide coherent and comprehensive insight on lessons learned from the COVID-19 response so far to support policymakers for future waves or in case of future pandemics. This workshop aims to provide the audience with an overview of the COVID-19 HSRM and the insights gleaned from the SI. An introductory overview will briefly introduce the COVID-19 HSRM and the SI. The first presentation will compare provider payment adjustments across 20 countries. The second presentation will focus on how countries planned services for potential surge capacity, managed care provision, and maintained routine services in both hospital and outpatient settings during the first wave of the pandemic. The third presentation will zoom in on experiences in primary health care. The last presentation will feature one of the country comparison papers from social health insurance countries. The workshop will conclude with an audience discussion about the lessons learned from the COVID-19 HSRM, and future opportunities for research using the HSRM. Key messages: The COVID-19 Health System Response Monitor has tracked the progression of health policies throughout the pandemic and captures particularly policy relevant aspects. Both thematic and cross-country comparisons can illuminate how health systems have responded to the COVID-19 pandemic and provide lessons for future waves and pandemics. [ABSTRACT FROM AUTHOR]

Introduction: The emergence of COVID-19 has created global transmission. While effective at reducing the spread, public health measures implemented may impact individuals differently leaving them susceptible to the detrimental effects on their health and wellbeing. Therefore this review aims to synthesise the best available evidence on the relationship between the social determinants of health and health outcomes among adults during the COVID-19 pandemic. Methods: A three-step search strategy was used to find both published and unpublished papers. The databases searched included: MEDLINE, CINAHL, EMBASE, and Google Scholar. Following the search, all identified citations were uploaded into Endnote X9, with duplicates removed. Methodological quality of eligible papers was assessed independently by two reviewers, with meta-synthesis conducted in accordance with JBI methodology. Results: Fifteen papers were included. Three synthesized conclusions were established a) Vulnerable populations groups, particularly those from a racial minority and those with low incomes, are more susceptible and have been disproportionately affected by COVID-19 including mortality; b) Gender inequalities and family violence have been exacerbated by COVID-19, leading to diminished wellbeing among women; and c) COVID-19 is exacerbating existing social determinants of health through loss of employment/income, disparities in social class leading to lack of access to healthcare, housing instability, homelessness and difficulties in social distancing. Conclusions: Vulnerable population groups have been disproportionately impacted by COVID-19, including health outcomes such as hospitalisations and mortality. The COVID-19 pandemic has highlighted the need for action on health inequalities and the social determinants of health. Reflection on social and health policies implemented are necessary to ensure that the COVID19 pandemic does not exacerbate health inequalities into the future. [ABSTRACT FROM AUTHOR]

Facing the considerable variation in the computation of disability-adjusted life years (DALY) in the numerous updates of the Global Burden of Disease (GBD) study and many independent studies, the European burden of disease network (burden-eu) launched a series of systematic literature reviews (SLR) to explore the key assumptions used in the European burden of disease (BoD) studies. The SLR will provide an overview of the existing BoD studies and the computational variations used and will also help identifying ways to harmonize the approaches enhancing the comparability of BoD estimates. The SLR was split in four parallel reviews: noncommunicable diseases (NCDs), communicable diseases (CDs), injuries and risk factors. For the first three, the search strategy included terms describing the population (GBD area ‘‘European region’’) and the BoD measures (years lived with disability, years of life lost, and DALYs). We included studies published between January 1990 and April 2020, without language restrictions. The search strategy was run in PubMed, Web of Science, Cochrane, and Embase. OpenGrey, OAIster, CABDirect, WHO and targeted public health agency websites were screened for grey literature. In addition, burden-eu members were asked to supplement the list of publications with any material available within their national public health institutes. Data extraction focused on methodological information. The title, abstract and full-text screening resulted in the final inclusion of 165 papers regarding NCDs, 189 with CDs, and 124 papers regarding injuries. The final list includes peer-reviewed articles and reports showing a variability in data sources used (e.g. patient medical records, disease registries, insurance claims sources) and model assumptions (e.g. use of multi-morbidity adjustments, use of disability weights). Further data extraction and analysis is in process, and will be presented during the workshop. [ABSTRACT FROM AUTHOR]

Background: Digital sources such as Internet-based search tools have created prospects for augmenting traditional public health surveillance. These can support the identification of emerging public health concerns, intervention evaluation or policy making. Social Determinants of Health(SDoH) are key factors linked to health outcomes yet they are poorly recorded and seldom used. Scientific papers have reported SDoH impacts on various outcomes yet this data has not been explored for population trend analyses. We present an analysis of our approach to combining insights mined from PubMed with online search trends. Methods: PubMed-2019 database was used to build a knowledge graph(KG) of connected health and social concepts based on relative co-occurrences found throughout the abstracts. We then observed Google search trends for 10 SDoH concepts at the outset of the 2020 pandemic (March-May) and compared them with the previous 4 years. For concepts with increasing trends, the KG was used to identify other potentially relevant concepts. Subsequently we continued observing online trends for a further 12 months in order to examine the KG concepts’ trends. Results: Our analysis showed Food Security and Unemployment trended the highest compared to previous years. These became the seed concepts used to traverse the KG, where the top 20 relevant concepts were identified for each seed. An analysis of the 8 concepts overlapping both seeds showed 6 with increasing trends during follow-up. Correlation coefficients were computed and positive relations observed (Unemployment+Anxiety, r=.72; Distress+Food Security, r =.62). Data will be discussed. Conclusions: Positive correlations were observed between data from a 2019 PubMed KG and online search trends during COVID-19. These preliminary results suggest value in combining these digital sources to strengthen public health systems. This is important to understand the interactions between health and social factors and identify emerging trends. Key messages: Combining data from scientific research papers with online search trends yielded interesting results that may further complement traditional surveillance systems and clinical case ascertainment. Social determinants of health data should play an increasingly important part in complementing public health surveillance systems and in strengthening population trend analyses. [ABSTRACT FROM AUTHOR]

Background: In the first wave of COVID-19, the UK Government relied heavily on digital channels to provide information to the public. This disproportionately excluded older people - one of the groups with least access to (or experience of) using the internet. Approximately 11.5 million people in the UK lack digital skills and 4.8 million people never go online, with around half (51%) of these being aged over 65. The Greater Manchester (GM) response was to work collaboratively with a number of key Ageing groups to develop Keeping Well at Home, a booklet providing evidence based health and wellbeing information and advice for older people during COVID-19 restrictions. Methods: An evaluation of the booklet was undertaken during summer 2020 by the Healthy Ageing team at the Applied Research Collaboration GM. As national restrictions on movement remained in place at the time, a postal questionnaire was distributed to a sample of older adults in GM. Results: Nearly 500 questionnaires were returned. The response was overwhelmingly positive; 92% found the information helpful; 90% agreed the booklet would help older people stay healthy during lockdown; 74% had used the home exercises section; 78% found the tips for keeping their mind well helpful. Around 50% of respondents did not have internet access. Paper based resources was the preferred choice for 92% of respondents with only 6% opting for digital versions. Conclusions: The evidence from the evaluation challenges the growing trend towards communicating just through digital channels, and emphasises the need for tailored paper-based materials for older adults. The Keeping Well at Home booklet also shows the value of working with older adults to ensure the content and design are inviting to readers. Information, support and services must be made available in an offline equivalent and proactively disseminated to reach those who otherwise would not have access to it. Key messages: Print-based communications are preferred over digital for some groups; ensuring inclusivity is critical as the ‘digital by default’ approach excludes large numbers of our population. Including target group representatives as co-editors to advise on content and stylistic design is key to ensure content is relevant and useful. [ABSTRACT FROM AUTHOR]

The article provides updates on issues related to the European Public Health Association (EUPHA) as of October 2019. Topics covered include opportunity of the World Health Organization to renew its vision for health in Europe beyond 2020, a white paper published by the European Commission in March 2017 setting out five possible paths for the future of Europe, and EUPHA's statement on what European political parties are stating on health.

The paper will provide a global perspective on current public health policies to tackle the growing burden of multimorbidity both in high-income and low-resource settings. Specifically, over the past two decades, there have been multiple stepwise approaches to non-communicable diseases (NCDs), the development of a process to link the prevention and control of NCDs to health systems, the compilation of evidence linking NCDs to the global development agenda, the implementation of life-course approaches to the prevention of multimorbidity around the world. [ABSTRACT FROM AUTHOR]

Older patients, suffering from numerous diseases and taking multiple medications are the rule rather than the exception in primary care. A manifold of medical conditions are often associated with poor outcomes, and their multiple medications raise additional risks of polypharmacy. Such patients account for most healthcare expenditures. Effective approaches are needed to manage such complex patients in primary care. The paper will discuss different models of care as well as major health care challenges in the management of multimorbidity in primary care with focus on interactions (disease-disease, treatment-treatment, and treatment-disease) extrapolated from (disease specific) guidelines and the feasibility to apply these guidelines for and with patients who have multimorbidity. [ABSTRACT FROM AUTHOR]

Backgound: In Romania Roma women are vulnerable to pregnancy-related events, unwanted pregnancies, stillbirth, abortion and cervical cancer. This paper aims to analysis the use of reproductive health services, family planning, prenatal care and screening for cervical cancer by Roma women. Methods: A secondary analysis was performed on the data of the Reproductive Health Survey in Romania 2016, of a subsample of 314 Roma women, aged 15-44 years. Results: 2/3 of Roma women had their first pregnancy in adolescence, 66.9% between 15-19 and 8.4% under 15 years of age. 65.4% Roma adolescent girls had their first child at 15-19 years, and 2.8% at ages under 15 years. During pregnancy, 24.1% of Roma women do not use prenatal care services, three times more than the women from the reference population (7.1%) (p < 0.01). 73% of Roma women have never benefited from cervical cancer screening compared to 42.7% in the general fertile female population. 46, 7% of Roma women use any type of contraceptive method and 38.1% modern methods, a closed prevalence of contraception in the general population of fertile women (48.4% of any method and 38.7% modern methods) Conclusions: Roma women have their first pregnancy in adolescence. There are inequalities in the use of preventive services for prenatal care and cervical cancer screening of the Roma female population compared to the reference female population in Romania. Public health policies should include specific active measures for Roma women to improve their access to preventive services. In order to prevent unwanted pregnancies, public health policies in Romania should include family planning measures addressed towards all women, but using methods culturally adapted to the Roma population. Key messages: • There are inequalities in sexual reproductive health services use of Roma minories women I Romania. • Services and active preventive mesures should be adressed to Roma populationtion. [ABSTRACT FROM AUTHOR]

Introduction Big data is defined as the amount of data that once organized and analysed, can make a value, make decisions, make predictions and discover patterns in order to reduce costs, avoid risks and optimize services. Machine Learning (ML) is a field of artificial intelligence and is characterized as a method of machine learning, which uses algorithms that learn from data analysis, allowing computers to find patterns, draw conclusions and make predictions. These tools can be used in different areas of human knowledge, particularly in the health sector which are generated daily a huge amount of information, allowing the creation of algorithms that learn and gain understanding to assist in various clinical practices. Objectives The purpose of this paper is to analyse the benefits of Big Data and Machine Learning in providing overall health care. Methodology We conducted a review of the scientific literature published in the electronic databases PubMed/MEDLINE and Google Scholar, according to specific criteria, using keywords: Big Data", "Machine Learning". Results In the field of oncology (skin cancer, breast, lung, leukaemia) ML and Big Data have contributed to early diagnosis of different pathologies and their evolution, as well as optimizing therapies. In ophthalmology (diabetic retinopathy and congenital cataract) has shown high efficacy in rapid diagnosis and appropriate treatment crucial to prevent the progress of the disease. The tested algorithms achieved very favourable results in cases of Parkinson's and cardiovascular diseases. In the pharmaceutical industry these computer and digital tools have contributed to the optimization of clinical trials, genome sequencing of tumours to then identify and develop specific drugs to fight it. Conclusion Advances of MIL and Big data are notorious and development opportunities are immense and can come to revolutionize tasks such as diagnosis, treatment and health care in general. [ABSTRACT FROM AUTHOR]

The article highlights the importance of collaboration and collective action in advancing public health. Topics discussed include the strategic retreat of the European Public Health association (EUPHA), important factors of social factors in determining the health outcomes of different population groups, and the 17th European Public Health Conference in Lisbon, Portugal on November 13-15, 2024.

This report provides abstracts of papers to be presented at the 8th European Public Health Conference in Milan, Italy, from October 14 to 17, 2015, covering topics such as chronic diseases, mental health and health promotion.

Background: Hospitals operate under constant pressure to contain costs and improve the quality of care (Q). The potential association between hospital financial performance (FP) and Q can have two directions: (1) providers with better FP might have a greater capacity to maintain and/or improve Q; (2) a better Q might lead to better FP, i.e. increased revenues, and/or lower costs. The general objective of this study was to identify and map the available evidence on the association between hospital FP and Q. Methods: A scoping review based on the methodological framework outlined by Arksey and O’Malley was conducted. Five databases were used: (1) Medline via PubMed; (2) Embase; (3) Web of Science; (4) Scopus; and (5) EconLit. Search strategy combined multiple terms from three topics: (1) hospital,(2) FP and (3) Q. There was no limit for publication years, but only studies in English were included. Results: After screening 8,015 records and 129 full text papers, 54 empirical studies were included. They are mostly observational studies, applying diverse regression models, published between 1992 and 2019. FP is most often measured by profitability indicators while Q measures are much more diverse. In the majority of studies, FP measures are used as dependent variables, thus the impact of Q on FP is assessed. The comparability of the studies’ results is limited, yet a general overview shows that in the majority of papers, a positive association between hospital FP and Q is identified (positive in 24 studies and positive or mixed in 10). The studies’ authors emphasize numerous limitations related to both, the data used and the methods applied including the ability to identify associations yet not causality. Conclusions: There seems to be a growing interest in exploring the association between FP and Q. Our review provides a broad overview of the existing literature and helps to identify areas for further investigations. [ABSTRACT FROM AUTHOR]

Vaccination against pertussis in pregnancy is the main strategy to prevent the disease in the first trimester of life of new-borns. Effective communication is essential to successfully engage pregnant women. The use of digital devices within the outpatient setting may be helpful to engage patients before and during the consultation. The aim of this study was to develop and test an e-health tool to assess vaccine hesitancy and to deliver tailored information and education interventions to raise awareness and promote vaccine acceptance. Methods: One-hundred-and-five participants were recruited in 4 ob-gyn clinics. Participants were invited to complete a self-administered psychometric questionnaire to assess vaccine hesitancy, disease beliefs and self-efficacy perception on health behaviours on a tablet. Participants were randomly allocated to three communication-format types providing equivalent content: 1)a single video simulating a patient-doctor conversation on the topic; 2)an interactive platform with five infographics videos; 3)a paper leaflet followed by a brief consultation with the physician. The intention to get vaccinated during pregnancy was assessed through a specific question before and after the intervention. Results: In the pre-intervention phase there was no difference observed between groups in terms of the variable "intention" to get vaccinated. After the intervention, participants of groups 1 and 3 showed a higher intention to get vaccinated than group 2 at the Kruskal-Wallis test (H(2)=6.008, p < 0.05). Post-intervention intention to vaccinate correlated with Individual SelfEfficacy (rs(105)=0.30, p < 0.001) and was inversely associated with vaccine hesitancy (rs(105)=0.34, p < 0.001). Conclusions: We implemented and assessed the impact of different communication strategies to promote vaccine uptake among pregnant women. Our results suggest comparable effect may be obtained using simulated versus live patient-physician communication. Key messages: The use of digital devices allows an effective and manageable communication about vaccination to pregnant women. In the present study, the implementation of digital forms of communication allowed a comparison with standard procedures of information towards vaccination, demonstrating their equivalence. [ABSTRACT FROM AUTHOR]

Background: After rising for years, vaccination rates in Italy fell until 2015 because of unfounded safety concerns, abetted by some government and court actions. Public education and a 2017 law on mandatory vaccination have boosted rates since then. So far only a few papers have examined the correlation between beliefs and attitudes towards vaccines and the level of trust in the scientific community regarding vaccinations in the general population. Methods: Data were extracted from the Italian section of the last two editions of the European Social Survey (ESS), the first carried out between September and November 2017, the latter between December 2018 and March 2019. A descriptive analysis was conducted using survey data. In the two editions respectively 2,626 and 2,745 persons were interviewed. The main outcomes assessed was comparing the two surveys, so as to highlight the key changes in public opinion on vaccines. Results: In the 2017 edition, 19% of the respondents believed in the harmfulness of vaccines, out of them 29% did not even have trust in the scientific community while those confident in the safety of vaccines were 50%. In the 2019 survey, the proportion of those who believed vaccines to be harmful fell to 15%, the undecided rose to 15%, those opposed to the idea that vaccines are harmful became 63%, not responding people were 8%. Correspondingly, trust in the scientific community about vaccines has increased from 57% in the first survey to 70% in the last one. Conclusions: The scientific community and research bodies in the last years, in support of the Ministry of Health, have made a huge effort in the public debate on vaccines. This might play a role in increasing the public confidence in the safety of vaccines and the adherence to vaccination campaigns, changing the climate with regard to vaccination in general. Key messages: Italians changed their opinions on vaccines between two ESS surveys. The scientific community had a relevant role in the public debate on vaccines. [ABSTRACT FROM AUTHOR]

Background: Patients have increased biological metrics when entering healthcare environments as a response to stress. Priming them with nice settings before consultation or procedure might benefit their health. Yet hospital waiting areas might be neglected by regulators. Our aim was to understand how these are perceived by those who commission them and by those who deliver them in terms of their intangible value. Methods: After a comprehensive scoping literature review of evidence based-design research eight features –daylight, furniture, materials, nature, views, colours, artwork and positive distraction– were identified as the most significant in waiting areas for patient wellbeing. Using those features as criteria we explored the regulators’ views comparing and contrasting the UK, USA and Australia’s design guidance on waiting areas. Also, 16 awarded hospital buildings provided case studies under the scope of those features. We examined the way these buildings were presented postaward and how those therapeutic features were portrayed in that process. Results: Results indicate a hiatus between architects and regulators towards the therapeutic value of waiting areas design. Architects highlight qualities such as comfort and aesthetics. Yet, guidelines focus on functionality and transition and do not consider waiting areas design as important. Conclusions: The welcoming factor of health spaces pre-consultation has been ignored by regulations yet at the same time has been used by architects to communicate their projects to the public. Actions to improve national regulations could impact on waiting areas design and consequently on people’s health benefits. They could even have longer-term benefits supporting early detection of disease by reducing the fear and stigma that people feel when engaging with healthcare services. This paper supports a positivist and systemic approach and highlights a neglected area in terms of health services thinking and research. Key messages: · A welcoming pre-consultation experience might affect the patient/clinician relationship and make the patient feel valued by the institution. This should be supported by waiting area design regulations. · The research on hospital waiting areas features demonstrates that the therapeutic qualities of healthcare space have been ignored by regulators. [ABSTRACT FROM AUTHOR]

Background: High rates of vaccination are worldwide required to establish a herd immunity stopping the current COVID-19 pandemic evolution. Vaccine hesitancy is a major barrier in achieving herd immunity across different populations. This study sought to conduct a systematic review of the current literature regarding attitudes and hesitancy to receiving COVID-19 vaccination worldwide. Methods: A systematic literature search was performed in accordance with PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Multiple databases were searched, namely PubMed and Web of Science, on February 24th, 2021 using a set of developed keywords. Inclusion criteria included the study to be 1) conducted in English; 2) investigated attitudes, hesitancy, and/or barriers to COVID-19 vaccine acceptability among a given population; 3) utilized validated measurements techniques; 4) have the full text paper available and 5) be peer-reviewed prior to final publication. The Newcastle Ottawa (NOS) scale for cross sectional studies was used to assess the quality of the studies. Results: 73 studies were included in qualitative synthesis. Overall, vaccine acceptance rates ranged from 23.6% in Kuwait to 94.3% in Malaysia and Nepal. A variety of different factors contributed to increased hesitancy, some of which included having negative perception of vaccine efficacy, safety, convenience and price. Some of the consistent socio-demographic groups that were identified to be associated with increased hesitancy included: women, younger participants, less educated, with lower income, with no insurance, living in the rural area and self-identified as a racial/ethnic minority. Conclusions: Vaccine hesitancy rates against COVID-19 vaccine ranged widely among across different populations. Identifying the factors that interplay and result in high hesitancy rates among a population can allow formulating a directed intervention to increase their vaccination uptake rates. Key messages: • It is necessary to understand the factors that contribute to the COVID-19 vaccine hesitancy. • It is important to inform policy-makers and formulate direct intervention measures that will successfully handle the pandemic. [ABSTRACT FROM AUTHOR]

Background: The health harms caused by sex-normalising and unnecessary irreversible medical interventions on intersex infants and children can include chronic pain, a need for repeat surgeries, damage to sexuality, serious mental health problems, and sterility. However, access to appropriate healthcare is needed - occasionally for lifesaving treatments in minors, but more often for reparative treatment or condition management in those able to give consent. A social model of intersex health, drawing on disability theory, is useful but insufficient to address intersex issues. Agency and bodily autonomy are key for this population, and this paper aims to develop an agency based model. Methods: Qualitative semi-structured interviews were conducted with 40 stakeholders in Italy, Switzerland and the UK, and participant observation and action research was carried out with the intersex activist organisation Zwischengeschlecht. The research was funded by the European Commission (grant number 703352). Results: At present there are still serious healthcare deficits which are underpinned by social norms that include rigid ideas that there are only discrete categories of male and female, and entrenched medical practices that continue to violate intersex minor’s bodily integrity, whilst overlooking healthcare needs that intersex people may have. Key impediments to intersex agency include body normativity and sex and gender binarism. Conclusions: Agency-based approaches to the health of intersex people and those with differences of sex development (DSD) focus on bodily autonomy and the cessation of normalising medical interventions until an under-age person can exercise fully informed choice regarding treatment. These approaches can be useful in incorporating the social model’s critique of the pathologisation of bodily diversities, whilst supporting the provision of effective healthcare where needed. [ABSTRACT FROM AUTHOR]

European citizens are exposed to a variety of potentially hazardous chemicals through the environment, consumer products, food, drinking water and at work in their daily lives. Human Biomonitoring (HBM) detects traces of chemicals in our bodies, aiming to improve public health. This is why human exposure is the focus of the HBM4EU initiative, a 5-year European programme funded by Horizon 2020 involving 30 European countries aimed at coordinating and advancing human biomonitoring in Europe while providing evidence that supports policymaking. Climate change can influence the persistence, mobility and other aspects of chemicals/toxins in the environment and with this influence human exposure and health effects related. HBM is the tool we use to measure the internal burden of exposure. Some papers have been published that recognize that climate change can influence human exposure to chemicals/toxins by different means. But more research is necessary to assess the impact on contaminant behaviour and toxicity due to the altered patterns of distribution that results in differences in human exposure and, consequently, in the associated health effects. Changes in the population’s exposure pattern (type and intensity) to mycotoxins (a food contaminant fungi) could be a good indicator of climate change since crops infection by fungi and their own metabolism are very much dependent of climatic parameters. [ABSTRACT FROM AUTHOR]

Enhancing health literacy of children and adolescents is a critical means for health promotion and sustainable development. This is mainly because childhood and adolescence represent key stages for addressing health, social, cognitive, emotional and educational development and influencing health behavior and healthy lifestyles over the life-course. The education sector is particularly important, and schools represent a critical setting to facilitate health literacy teaching and learning, for example in health education classes or whole-of-school approaches. Regarding the question of what makes health literacy so important for children and adolescents these days, there are three key themes and recent developments which amplified the meaning and relevance of health literacy for public health and societies: (i) A globalizing world: Globalization and digitalization change the ways in which health is negotiated and promoted, including that today health information is almost limitlessly accessible in everyday life. (ii) The information overload: The overload of information - a.k.a. infodemic (short for information epidemic) - makes health literacy a critical skill-set in managing the overabundance of information that is available through digital communication channels; while at the same time children and adolescents are increasingly turning to the Internet and social media as sources of health information and for communication about health issues with their peers or social contacts. (iii) The COVID-19 pandemic: The pandemic has once again underlined how important health literacy is not only for understanding public health recommendations, applying health behaviours, avoiding unnecessary risks, and protecting individual, family, and population health, but also to learn about the importance of vaccination, to become knowledgeable and skilled in navigating the infodemic, and to identifying fake news and disinformation about COVID-19. The purpose of this workshop is to bring together five contemporary projects on health literacy from Germany in and with schools that reflect the above issues: (i) A cross-sectional pen-and-paper survey in primary schools on children's health literacy; (ii) A survey on adolescents health literacy; (iii) The development of a toolbox for health literacy interventions in schools; (iv) An intervention for improving adolescent's mental health literacy in schools, (v) A whole school approach and organizational health literacy in schools. Each project will be given ample time to present their findings, which will be followed by Q&A and an open discussion with the audiences. This workshop offers a forum for researchers, practitioners and policymakers interested in school related health literacy and school health promotion. By dialogue and two-way communication, vivid interaction will be ensured, allow building synergies, and facilitate networking and capacity building. Key messages: Health literacy contributes to promoting and maintaining child and adolescent health in times of crisis like the COVID19 pandemic. Health literacy needs to be strengthened through investments in the education sector and school health promotion programs. [ABSTRACT FROM AUTHOR]

Background The knowledge of the importance of intervention in the reintegration of people with addictive behaviors and dependencies (ABD), combined with the complexity of the process and the multiplicity of associated factors (SICAD, 2014), has motivated a study developed on social and community mediation, through a interinstitutional collaboration of seven public entities, linking the academy to entities that intervene in the field of health (SICAD, in press). This paper aims to explore and disseminate some of the research results, reflecting on the importance of social intervention in the global health of the citizen. Methods This research was carried out according to a mixed case study plan (multi-case and multi-perspective), which involved reinsertion professionals, people with ABD, families and other stakeholders, in a total of 18 cases, 51 interviews and 21 questionnaires. It has a national scope and combines the descriptive component with the analytical and reflective component. Results Crossing the mapping of the diagnosed problems with the results and impacts of the developed intervention, which translate into changes perceived by the interviewees in several areas, it is possible to explore axes of the effectiveness of the intervention implemented in the reinsertion process. Conclusions The results show a high level of effectiveness (individual, family and community level), which goes beyond the changes in the scope of dependencies and affects the various areas of life of the citizen. The developed intervention generated impacts felt in the health level by the interviewees as positive and allowed to modify the fragile conditions that were identified in the diagnosis. [ABSTRACT FROM AUTHOR]

Introduction Cyclophosphamide is a cytotoxic widely used in the treatment of various cancers. It has been observed, for many years, that those responsible for its handling and administration are exposed and levels of contamination have been detected in biological samples collected from these professionals, in surfaces and in the air. Objectives To review the literature on occupational contamination by cyclophosphamide. Methodology The following inclusion criteria were selected: articles published until the present year, articles in English, scientific papers on cyclophosphamide contamination in hospital health professionals, scientific articles on contamination detection methods and articles on the effects that can outcome from cyclophosphamide contamination. Results The cyclophosphamide levels have been decreasing with the implementation of preparation and cleaning guidelines as well as with the emergence of new techniques of manipulation and technological innovations. However, the dermal route remains the main route of contamination and those responsible for cytotoxic manipulation are not the only ones exposed. It was verified that hospital professionals, who in their profession would not be in contact with cyclophosphamide, also presented levels of contamination in the collected urine samples. Conclusion It is necessary to continue to alert hospital professionals to the importance of always complying with the handling and cleaning protocols, since one of the main causes of contamination is precisely the performance of incorrect procedures during both tasks. This is a topic that should be further studied in order to minimize the exposure and consequently the associated risks. [ABSTRACT FROM AUTHOR]

Introduction The different response to various drugs by individuals has been increasingly debated, since it has been concluded that there are large differences in response and increasing occurrence of adverse reactions. This set of issues led to more and more research on the implementation of genetic testing in the very near future, leading to benefits for the patient. The purpose of pharmacogenetics is to analyse each individual's genetic variability in response to therapy, increasing efficiency and safety. On the other hand, pharmacogenomics studies how the expression of a set of genes interferes in individual's responses to drugs, taking into account pharmacokinetics and pharmacodynamics. This concept also seeks to reduce adverse reactions and toxicity, maximizing drug efficiency. Objectives The present work aims at gathering information on the proposed theme, making the survey of drugs available on the market elucidating how it allows the adjustment of the dose to be administered to the patient according to their genetic profile. Methodology Databases such as Pubmed, Science Direct and Google Scholar were consulted and data were collected from 2015 until 2019. Paper was selected first by abstract and after by full text reading of the article. Results On this review we will list the drugs associated with each biomarker and the respective therapeutic area to which they belong, compiled by the Food and Drug Administration (FDA). This list includes the main therapeutic area: oncology, haematology, anaesthesiology and psychology. Biomarkers allow us to identify phenotype-associated variations in drug response, making it possible to understand whether drugs will have a beneficial effect, no effect or if there is a risk of toxicity. Conclusion This question requires a risk-benefit assessment, since it involves social, ethical and economic problems. [ABSTRACT FROM AUTHOR]

The article offers information on a workshop at the 16th World Congress on Public Health 2020 on the development and implementation of actions plans on health literacy.

The article offers information on a round table workshop at the 16th World Congress on Public Health 2020 on where to go with health impact assessment (HIA) during coming years, potential facilitators for broader implementation and use of the methodology.

The article offers information on a workshop at the 16th World Congress on Public Health 2020 on the regulation and use of apps for health management.

The article offers information on a workshop at the 16th World Congress on Public Health 2020 which addresses questions on global health and Sustainable Development Goals (SDGs) and fosters critical debate.

The article offers information on a workshop at the 16th World Congress on Public Health 2020 on migration and health.

The article offers information on a workshop at the 16th World Congress on Public Health 2020 which focuses on health literacy in policies.

Despite a decade of conflict, there has been little exploration of respiratory health in Syria. We explore the burden and trends of respiratory consultations in Syrian American Medical Society (SAMS) facilities in northwest Syria using mixed methods. We performed i) a scoping review of available academic and grey literature on respiratory health in Syria between 2011 and 2020 (17 databases) and ii) a retrospective review of routinely collected data relating to respiratory presentations in SAMS’ facilities between March 2017 and June 2020. We identified 23 papers (19 peer-reviewed); 7 analysed primary data. Key themes included the impact of conflict on asthma diagnosis and management, the burden of respiratory tract infections (RTIs), the impact of chemical weapons and those relating to the destruction of the health system. In our quantitative analysis, data were available for 5,058,864 consultations, of which 1,228,722 (24%) were respiratory presentations. 45% of respiratory presentations were from hospitals, 44% from primary healthcare clinics and 9% from mobile clinics. The median monthly number of respiratory cases was 30,279 (25,792-33,732) out of a median 128,923 total monthly consultations (112,917-140,189). 73% of respiratory consultations were for children. Key findings include: respiratory presentations accounted for up to 38% of consultations each month with seasonal variation. RTIs accounted for 91% of all respiratory presentations. A steep decrease in consultations occurred between the end of 2019 (160,000) and the first quarter of 2020 (90,000), correlating with an escalation of violence in Idlib governorate. This study presents the largest quantitative analysis of respiratory data collected during the Syrian conflict. Our findings support the need for improved measures to aid the prevention, diagnosis and management of respiratory conditions during conflict. Further work exploring such interventions is needed. Key messages: We present the largest study of the burden of respiratory presentations during the Syrian conflict accounting for 1,228,722 (24%) of all consultations; of these 72% were for children. Despite the burden of respiratory disease in the Syrian conflict, optimisation of respiratory health is neglected. Public health measures which address the causes and consequences are needed. [ABSTRACT FROM AUTHOR]

Background: Evidence available on the determinants of vegetable intake in young populations is inconsistent. No review has particularly focused on this topic in disadvantaged adolescents. This systematic review aimed to investigate the determinants of vegetable intake in disadvantaged adolescents reported in qualitative studies. Methods: Five electronic databases were searched until October 2020 using combinations of synonyms for vegetable intake, adolescents, and qualitative methodologies. Studies published in peer-reviewed journals were included if they used qualitative methods (e.g., interviews, focus groups, etc.), targeted disadvantaged individuals aged 12-18 years, investigated determinants, motivators and barriers to vegetable intake, and were conducted in urban settings of high-income countries. Two reviewers independently and systematically summarized the papers, assessed their quality and synthesized the findings across studies. Results: Sixteen studies meeting the inclusion criteria were included. The synthesis of findings identified the following determinants for vegetable intake: sensory attributes of vegetables; psychosocial factors (nutrition knowledge, preferences/liking, selfefficacy, motivation); lifestyle factors (cost/price, time, convenience); fast food properties (taste, cost, satiety); home environment; parental influence; encouragement/support outside the household; friends' influence; school nutrition education; teachers' support; school food environment; local produce; community nutrition knowledge; and availability and accessibility of vegetables in local stores, restaurants and fastfood outlets. Conclusions: Multiple determinants of vegetable intake were identified which complement those investigated in quantitative studies. Future large scale quantitative studies should attempt to examine the relative importance of these determinants in order to guide the development of successful interventions in disadvantaged adolescents. Key messages: Vegetable intake is influenced by multiple factors in disadvantaged adolescents. Main determinants are vegetable attributes, personal factors, friends, family, school and community environment. [ABSTRACT FROM AUTHOR]

Background: More than 50% of non-smoking women and children are exposed to second-hand smoke (SHS) in Middle Eastern countries. This review aims to synthesize the evidence on experiences and views of parents, children, and professionals towards SHS exposure prevention in Middle Eastern countries. Methods: We included qualitative studies exploring experiences and views on prevention of SHS exposure among women and children in all settings in Middle Eastern countries. A systematic review was undertaken according to the Joanna Briggs Institute (JBI) guidelines for qualitative systematic reviews. Nine databases were searched from inception to January 2021. Meta-aggregation was used to synthesize the findings. Results: Out of 5229 records identified, two qualitative studies reported in three publications met the eligibility criteria and were included. Using the JBI checklist for qualitative research, the critical appraisal scores of all papers were high. One study was conducted in Turkey and the other one in Israel, and study participants were parents of children. A total of 49 findings were extracted and aggregated into 8 categories, based on the similarity of meaning. Parents were aware that SHS is harmful, although the hazards of SHS exposure were not commonly discussed during pregnancy. However, there were conflicting views on ways of SHS exposure and approaches to minimise it. Parents implemented rules to decrease SHS exposure among children. While some parents were uncertain about the effectiveness of protective measures. Most common perceived barriers to reducing SHS exposure were beliefs about traditional values and personal psychological factors. Conclusions: Parents in Middle Eastern countries knew that children's SHS exposure is harmful, though knowledge was not comprehensive and did not translate into actions to protect children. Health education program is essential to improve parental knowledge on hazards of SHS and effective preventive measures. Key messages: Parents' risk-awareness of SHS exposure is inadequate. Health education program is essential to improve parental knowledge on hazards of SHS and effective preventive measures in Middle Eastern countries. [ABSTRACT FROM AUTHOR]

Introduction: Evidence-based practice (EBP) is a worldwide approach in optimizing quality of healthcare. As healthcare providers are increasingly more involved in clinical decision making, it is becoming important for them to use the best evidence to make effective and justifiable decisions. EBP is an important competency of undergraduate healthcare students that remains little known among Tunisian future healthcare professionals. This study aimed to describe health sciences students’ attitudes. Knowledge and skills in EBP; to determine factors associated with these competencies and to identify perceived barriers regarding EBP. Materials and Methods: A descriptive cross-sectional study was conducted at the Higher School of Health Sciences and Techniques of Sousse among 365 health sciences students enrolled during the second semester of the academic year 2017-2018. Data was collected using a self administrated questionnaire including a validated EBP-COQ questionnaire and focusing on identifying the perceived barriers to the usage of EBP. Results: The response rate was 93.11%. Approximately, 61.6% of students were familiar with the term ‘EBP’. The overall score of EBP-COQ questionnaire was 3.26 0.53 out of 5. The mean scores of attitude, skills and knowledge subscales were 4.04 0.41; 3.05 0.77 and 2.70 0.74 respectively. A significant statistical association was found between the competencies in EBP and age; gender, academic degree, year of study for license degree, students’ English-language reading skills, students’ education in research methodology and statistics (p < 10-3). The top reported barriers hindering their adoption of EBP were: lack of training in EBP, difficulty in obtaining full-text papers and lack of time. Conclusions: The strategic position of healthcare students may influence the adoption of EBP. It is necessary to understand students’ attitudes, knowledge and skills in the subject to be able to develop effective strategies for EBP curricula. Key messages: Evidence-based practice is a worldwide approach in optimizing quality of healthcare. It is necessary to understand students’ attitudes, knowledge and skills to develop effective learning strategies. [ABSTRACT FROM AUTHOR]

Background: Health workforce shortage in German rheumatology and its negative impact in healthcare are increasingly recognised. Health policy has increased staffing targets, but effective intervention strategies are lacking. This paper aims to systematically map the rheumatology workforce and to explore opportunities for intervention, thus contributing to better health workforce management. Methods: The WHO National Health Workforce Accounts (NHWA) provided a conceptual framework for the mapping exercise. Four major sets of indicators were selected, comprising staffing levels, health labour market flows, skill-mix and education/ training. Comparison of age-groups and time series was applied to explore trends. Public statistics and other secondary sources served the analysis, using descriptive methodology. Results: Rheumatologists nearly doubled in absolute numbers since 2000, but this trend shows a problematic demographic bias. Between 2000 and 2019 numbers increased markedly in the groups aged +50 years, but only about 9% in younger groups under 50 years. Most alarming, since 2010 the group 40 to 50 years showed a reverse trend and strong decreases. In 2019, absolute numbers of rheumatologists working in healthcare after retirement-age exceeded those aged 40 and under. Since 2015 an expanding workforce trend overall flattened, but strongest in the hospital sector; annual inflows do not show relevant growths. Conclusions: Health workforce assessment reveals negative demographic trends and decreasing appeal of the specialty especially to men, thus highlighting a need for more effective health workforce management. Intervention strategies should target innovation in resident training and task shifting and improve gender equality. Key messages: Health workforce trends indicate that new health policy planning targets cannot be met with an available stock of rheumatologist. The WHO NHWA provide a useful toolbox to map health workforce trends and identify weaknesses and gaps. [ABSTRACT FROM AUTHOR]

Background: Demonstrating long-term impacts of research can be fraught with methodological challenges, especially when approached retrospectively. Potential accusations of bias or over-interpretation, and a lack of clear and specific causal data, can be real obstacles. This paper presents a case study of research impact, including enablers and context to aid interpretation. To develop a national set of child wellbeing indicators in line with UNCRC commitments, a participative study of children’s understandings of wellbeing was undertaken to accompany a Delphi study with experts. The children contributed a number of unique indicators, including having ‘good places to spend free time’. Methods: Public actions which aimed to meet Irish commitments to child wellbeing were documented. Collected evidence comprised the development of, and reporting on, a national set of wellbeing indictors for children, the development and implementation of two national policies and cyclical monitoring data, collected through the nationally representative data sets of the Health Behaviour in School-aged Children (HBSC) study in Ireland, 2002-2018. Results: Measurement of stakeholder-informed indicators helped stimulate national policies on play (2004) and recreation (2007). Partnership-based policy implementation led to increases in spaces for play and recreation. Trends data from the HBSC study revealed significant and meaningful increases in ‘good places to go spend free time’ for children aged 10-17 from 45.1% in 2002 to 63.5% in 2018, and for all sociodemographic sub-groups. Temporal analyses showed that increases followed policy implementation. Conclusions: This impact case study links an original participative study, though policy development and implementation, to long-term improvements in Irish children reporting having ‘good places to spend free time’. An understanding of the decision-making context at key points is important to aid interpretation of the evidence under investigation. Key messages: · Commitment to child participation influenced national indicator adoption, policy development and implementation, with subsequent improvements to children’s healthrelated environments. ·The quality and specificity of data needed to demonstrate long-term research impact is challenging and interpretation requires contextualisation to avoid leaps of faith. [ABSTRACT FROM AUTHOR]

Background: Most of the countries in the world adopted isolation measures during the COVID-19 pandemic. According to Kola L. et. al (2021), ‘‘in most settings in low and middle-income countries (LMICs), ongoing in-person mental health services have been disrupted and patients with severe mental conditions and substance abuse disorders are often unable to obtain medications, attend to treatment centres, or receive social services’’. The aim of this paper is to describe the effects of the COVID- 19 pandemic on the demand for attention in a mental health service as reported by healthcare workers. Methods: A quantitative cross-sectional descriptive study was conducted and a survey designed by the Secretarı´a de Polı´ticas Integrales sobre Drogas de la Nacio´n Argentina was applied to a total of 29 healthcare workers of a mental health centre in the Province of Co´ rdoba, Argentina, during the month of November, 2020. Results: The perception of healthcare workers towards the demand for attention shows that the 3 main reasons for consultation during the first three months of isolation measures were drug abuse (50%), request for treatment (10.3%), and order for medication (10.3%). During the three subsequent months, the reasons for consultation were drug abuse (62.1%), request for treatment (44.8%) and remote treatment modality (24.1%). Healthcare workers state that drug abuse consultations increased 65.5% and the self-inflicted violence consultations increased 44.8%. Conclusions: The isolation measures generate a change in the demand for attention. There are differences between various phases of the isolation measures, where an increase in the drug abuse consultations and remote treatment modality could be observed. Key messages: · To develop predictability according to the variations in the demand for attention produced during public health crisis. · To train healthcare workers in order to make interventions in public health crisis. [ABSTRACT FROM AUTHOR]

Primary care is a growing medical field willing to become a more integrated and technological asset. Although big changes already happened and more investments have been made, a limited amount of literature describes processes and technologies there applied or to be used. This paper aims to evaluate the efficacy and usability of different types of algorithms in primary care to improve drug safety by speeding up processes and achieving greater accuracy opening the path to providing better healthcare overall. The PICO model was adopted, three electronic databases (PubMed, Cochrane, Web of Science) were searched using appropriate keywords. Selected studies were assessed for quality and risk of bias using the National Institutes of Health Quality Assessment of Controlled Intervention Studies. Data were analysed using descriptive statistic, comparison of drug usage between algorithms or artificial intelligence application and usual care was performed using a X² test(α= 0.05). Out of 2207,19 studies were included,37% of them regarding error prevention,21% drug interactions,21% drug monitoring,16% drug prescription,5% drug administration. Results showed an easier and safer medication use in 74% of studies, a loss of safeness and accuracy in 16%; 10% of total studies did not come up with a valid esteem of results either for inadequate availability of the AI machine or because of the heterogeneity of the results in different settings. The evaluation of errors prevention, 40% of total studies, showed the most statistically significant results with 88% of positive outcomes from AI application. The results support that this technological approach to drugs management could contribute to the safety of treatment and to increase patients’ and general practitioners’ satisfaction. The application of AI or algorithms is significantly associated with a reduction of drug use errors (p < 0.05). Future studies should work toward establishing a gold standard to measure AI performances. Key messages: · Artificial Intelligence and Algorithms in primary care have the potentiality to disrupt patient care with a safer and faster medication management. · A comparison between Artificial Intelligence or algorithms and standard clinical practice may help finding the medication fields where a technological support could lead to better results. [ABSTRACT FROM AUTHOR]