Good Health Research Articles

Skandinaviske retningslinjer for behandling av psykisk lidelse hos barn og unge: En kvalitetsvurdering

Children and young people with untreated mental health disorders can develop chronic disorders and severe somatic diseases later in life. The right treatment at the right time is therefore important to promote good mental health. Healthcare personnel are required to follow national guidelines, and high-quality guidelines are thus important for patient safety. We wanted to assess the quality of Norwegian national guidelines for the treatment of mental disorders in children and young people and compare these with corresponding guidelines in Sweden and Denmark. We conducted manual searches in the relevant national health authorities’ websites and selected five Norwegian guidelines (treatment of ADHD, bipolar disorders, psychosis, suicide and eating disorders), three Danish guidelines (ADHD, anorexia and bulimia) and one Swedish guideline (ADHD). For the purpose of quality assessment, we used an internationally recognised checklist (AGREE II), on which Norwegian guidelines must be developed in accordance with the Norwegian Directorate of Health’s own guide for developing guidelines. The checklist consists of 23 items divided into six domains: scope and purpose, stakeholder involvement, rigour of development, clarity of presentation, applicability, and editorial independence. We found that the overall quality of the Danish and Swedish guidelines was very high and met most of the 23 criteria organised within six domains. The Norwegian guidelines met the criteria for scope and purpose and stakeholder involvement, but had major shortcomings in terms of rigour of development, clarity of presentation, applicability, and transparency of editorial independence. Keywords: evidence-based practice, national guidelines, children and adolescents, mental disorders

A Recent Advance on Phytochemicals, Nutraceutical and Pharmacological Activities of Buckwheat.

Buckwheat, a member of the Fagopyrum genus in the Polygonaceae family, is an ancient pseudocereal with noteworthy nutraceutical properties that have been relatively less explored. This crop holds great promise for the future due to its gluten-free protein, wellbalanced amino acid profile, and the presence of bioactive flavonoids that promote good health. With its gluten-free nature and a combination of beneficial nutritional components, buckwheat shows significant potential for a variety of health benefits. The objective of the present review aims to explore various nutritional and pharmacological properties of buckwheat. With the help of various search engines such as, Pubmed, Google and Semantic Scholar, research and review papers were carefully investigated and summarized in a comprehensive review. A fascinating spectrum of nutritional and pharmacological activities of common buckwheat and Tartary buckwheat were explored such as antidiabetic, anti-inflammatory, neurological disorders, antiobesity, anticancer, cardiovascular agents and many more. This review provides a concise overview of the current understanding of the chemical composition of both common buckwheat and Tartary buckwheat and the captivating spectrum of pharmacological activity and also underscoring their immense potential for future advancements.

Screening levels spatial interpolation of lifetime carcinogenic risk by organochlorine pesticides across catchments of river chenab

The present study has employed an advanced GIS based statistical technique for spatial interpolation of lifetime carcinogenic risk to OCPs in water and sediments from tributaries of River Chenab. The findings revealed that among all detected isomers, DDT exhibited the highest concentrations (mean 14.41 ng/l: range 9.33 – 20.21 ng/l and mean 16.47 ng/l: range 10.55 – 21.24 ng/g) for water and sediment, respectively. Results of OCPs fingerprints revealed the presence of dicofol confirmed fresh input of OCPs isomers along with the DDTs (Dichloro-diphenyl trichloroethane) historical usages in water bodies. The evaluation of ecological risk to benthic organisms’ fish, daphnia and green algae (RQ 2 × 102) indicated that DDTs (DDD, DDE) pose potential hazardous risks (>1) to fish species across all the studied sites. Moreover, Spatial interpolation of the lifetime carcinogenic risk denoted the sites along downstream zone surpassed the permissible limit. The non-carcinogenic risk (∑HQ) ranged from 2 × 10-3 – 1.0 with the highest value for DDT, indicating DDT as a potential hazard through oral exposure (∑HQ≥1). In the case of sediments results of SQGQs (Sediment Quality Guideline Quotient) levels for DDE (Dichloro-diphenyldichloromethane) and DDD (Dichloro-diphenyl dichloroethylene) denoted a severe biological risk to ecological integrities. The findings comprehend the more inclusive monitoring of OCPs usage and distribution in the studied region to reduce risks ecological integrities and to promote good health and wellbeing’s.

Dental Management of Pedatric Patient with Autism Spectrum Disorder under General Anesthesia: A Case Report

Autism spectrum disorder or autism, corresponds to "a pervasive developmental disorder (PDD), characterized by an abnormal or a deficient development. It is manifested before the age of three, with a characteristic disturbance in the functioning of each of the following three areas: social interaction, verbal and non-verbal communication, and restricted and repetitive behaviors. The combination of these three elements corresponds to the autistic triad. The latter appears in different forms, with varying degrees of severity, and can also vary with age. The oral care of this patient remains delicate, due to the difficulty of communication and the apprehension of his behavioral response. The young female, 13 years old and in good general health, presented to the dental center of Cheikh Khalifa Hospital with spontaneous pain in the right mandibular and left maxillary sectors. She was diagnosed with one of the autistic spectrum disorders: Asperger's syndrome. In our case, the patient was uncooperative and unable to attend the dental treatment in a vigorous state or under conscious sedation. General anaesthesia was the choice option. This last resort allows the patient to lose consciousness, eliminates pain and relaxes the muscles, making dental treatment a pleasant experience. The aim of this poster is to illustrate, through a case study, the protocol for managing a patient with autism spectrum disorder, and to demonstrate the indication for general anesthesia in the treatment of this patient.

The effect of special exercises using some auxiliary tools to develop some bio-kinetic abilities and the accuracy of the crushing and snatch forehand strikes among badminton players

The best means and ways to develop an athlete's physical and skill capabilities, and among these means is the use of training aids that help develop some bio-kinetic abilities, and prepared exercises have had an important role in improving athletic performance in badminton, where the player must possess physical fitness, explosive power, and strength. Characterized by speed as well as accuracy, awareness, and focus while playing on the court, the badminton player must be physically fit through a continuous movement of small and large muscles to achieve good performance, which requires special physical abilities and skills, and the most important of these bio-kinetic abilities are agility, coordination, and measuring the coordination between the eye and the arm. These abilities are needed by the badminton player while playing on the court. The study aimed to prepare special exercises using some auxiliary tools to develop some bio-kinetic abilities and the accuracy of the crushing and lightning forehand strikes among badminton players, in addition to identifying the effect of special exercises using some auxiliary tools on For badminton players, the researcher adopted the experimental method, and the sample number was (10) players from the badminton training center in the Armenian club, aged (17-19). They were distributed into two experimental and control groups, and they were chosen randomly because the research objectives require the use of athletes proficient in the game's technical performance. The researcher applied her main experiment using special exercises with some auxiliary tools, with (4) training units per week for (8) weeks. The results of the study showed that there was a positive effect on the results of bio-kinetic abilities between the two groups and in favor of the experimental group. It was shown in the kinetic response speed test for the first experimental group 7.423, agility 3.012, and compatibility 3.123, and for the second experimental group in the kinetic response speed test 3.208, agility 6.861, and compatibility 6.907. As for the skill tests for the first experimental group, The front smash hit was 7,234 and the diagonal front snap shot was 28.00. It was shown in the skill tests for the second experimental group that the front smash hit was 3,372 and the diagonal front snap shot was 3,400, which included exercises. The researcher recommends adopting the results of this study and disseminating them, and emphasizing equipping the stadiums with modern training methods, due to the results they achieve. Positive physical development serves one of the goals of sustainable development: good health and good education.

MedDietMenus4Campus: Integrating Views from Nutrition, Marketing and Psychology to Improve Diets

Abstract Food service is an important setting for public health interventions, educating consumers and modulating behaviours through the meals provided. Social Marketing is one of the strategies designed to promote behaviour change, which contributions to health and well-being of consumers are widely recognised. This project aims to identify the compliance of food service menus with the Mediterranean Diet (MD) in public high education institutes (HEI) canteens, pinpointing opportunities to intervene, namely: 1) promoting changes in the food offer addressing proximity to the MD, creating, and offering plant-based meals, with seasonable and local food products and 2) developing tailored social marketing strategies to engage stakeholders to encourage healthier and sustainable food habits. It gathers a team comprised of nutrition experts on public health and food service, food technologists, gastronomy experts, psychologists, and marketers. To achieve the objectives researchers will: 1) develop an index to evaluate compliance of menus with the MD; 2) define priority stakeholders and define a methodology for engagement; 3) evaluate perceptions, barriers and facilitators; 4) develop a meal plan framework; 5) develop a new food concept “student bag” (meal on the go) and test it for industry scale-up; 6) use previous diagnosis to develop social marketing strategies directed to stakeholders and consumers to achieve food behaviour change and 7) measure the impacts of the implemented strategies. This research intends to create and implement a new healthy and sustainable food service concept, expecting to define the standpoint to inspire other food service settings to achieve an effective and sustainable food offer change and positively influence food service consumers’ food pattern towards Mediterranean recommendations, while addressing the Sustainable Development Goals (3 - good health and 12 - responsible consumption and production; 17 - partnerships for the goals).

11.Q. Round table: A Guide for creating a code of ethics for public health professionals and institutions

Abstract The professional discipline of public health is driven by its values. Public health professionals face decisions that have far-reaching ethical implications. Our norms, values, beliefs and the way we see the world, as individuals, communities and institutions which serve us, do matter and fundamentally affect our decisions, behaviours, policies, and practice. The ability to be aware and reflect on norms and values when taking decisions, is a decisive professional virtue in public health practice. The World Health Organisation (WHO) and Association of Schools of Public Health in the European Region (ASPHER) Roadmap for the professionalisation of the public health workforce, has highlighted ethics as an essential pillar for professionalisation, a core competency, and the need for a Code of Ethics and Professional Conduct for good public health practice. In order to further advance the issue the Global Network for Academic Public Health (GNAPH), ASPHER, the European Public Health Association (EUPHA), the UK Faculty of Public Health and other partners set up an expert international joint working group on public health ethics and law (PHELWG). The PHEL expert working group - which includes senior public health professionals, ethicists, lawyers and academics - has been working to carry out research and develop a guide for creating a Code of Ethics and Professional Conduct for public health professionals and institutions. This has included consideration of the competencies, principles and values for good public health practice. The project has involved literature review, research and the wide professional experience of the international group of experts who have been working on the issue.The development of a guide for creating a code of ethics for public health professionals and institutions is part of the overall objective of the PHELWG to build a ethico-legal competency, capacity and resilience of public health workforce. The proposed Guide and related resources will be a timely resource, practical tool and support for public health professionals, organisations, or regulatory bodies to develop their own local country code of ethics and build further ethico-legal capacity of their public health professional workforce and institutions. Purpose of the roundtable workshop will be to: - present the guide on creating a code of ethics for public health public health professionals and institutions, which will be launched at that time - Share the proposed ethical competencies/skills, principles and values for good public health practice, with particular consideration of Indigenous knowledge and world views - reflect and consult with the workshop participants around the guide and the proposed pilot sites for implementing the Codes in various centres. Key messages • Development of Code of ethics and professional conduct is a key requirement for public health professionalization. • The Guide for creating code of ethics by international expert group provides significant resource for development of codes locally. Speakers/Panelists Kasia Czabanowska Maastricht University, Maastricht, Netherlands Farhang Tahzib Faculty of Public Health, Haywards heath, UK Paul Athanasopoulos Public Health Department, Stirling, UK

Health behaviour and well-being in the Faroe Islands prior to and during the first COVID-19 lockdown

Abstract Detrimental effects on health and well-being were reported during the COVID-19-induced lockdown periods in several countries, but these associations have not been studied in small-scale island societies. This study aimed to examine the lockdown period’s impact on health behaviour, social media use and measures of well-being in the Faroe Islands. We used cross-sectional data from two extensive population-based surveys of public health conducted in November 2019, the pre-COVID survey (n = 2906), and 4-6 weeks into the first national lockdown, the lockdown survey (n = 1204). A larger proportion of participants in the lockdown vs. pre-COVID survey people reported high physical activity levels (42.1 vs 30.7% p < 0.001), while nutritional habits were rated worse and social media usage increased. Furthermore, the proportion displaying excellent/very good self-rated health was larger in the lockdown vs. pre-COVID survey (68.1 vs 62.0% p < 0.001), and the same pattern was observed for reporting good quality of life (85.7 vs 82.7% p < 0.05). These associations remained statistically significant in a logistic regression model after adjusting for characteristics for which varying impact of the pandemic has been shown. Indicators of health behaviour showed that larger proportions of participants kept active during the lockdown vs pre-COVID survey, and these differences were statistically significant for physical, mental, and spiritual activities (p < 0.001). On the other hand, similar stress levels in the pre-COVID/lockdown periods were observed, but stratified analysis showed that participants with a high-stress level displayed better self-rated health in the lockdown period compared to the pre-COVID period (p = 0.001). Conclusions Findings indicate that self-reported health and quality of life improved during the early phase of the COVID lockdown, and individuals reported higher activity levels associated with good mental health during the COVID-19-induced lockdown period. Key messages • Physical activity improved, but dietary habits worsened during initial COVID-19 lockdown in the Faroe Islands. • Measures of wellbeing and quality of life improved during initial COVID-19 lockdown in the Faroe Islands, while there was no overall difference regarding stress levels.

Health services consumption and barriers in the health care of persons of Roma origin in Bulgaria

Abstract Introduction Persons of Roma origin often face serious inequities concerning their state of health and their access to good quality health services. The aim of the study is to analyze the health services consumption and barriers in the health care of persons of Roma origin in Bulgaria. Methods The cross-sectional study was conducted and a semi-structured face to face interview were applied in 2022. Adult citizens of Roma origin were covered as follows: residents of Knezha - a total of 59 people and households from the towns of Knezha and Kotel - 18 families (50 persons). The cities are representative of settlements of medium size with separate neighborhoods of Roma origin. Data processing was performed by SPSS v.24. Results Over two thirds of the covered persons of Roma origin do not have health insurance. In each household an average of 1.8 uninsured people was found, but in some of the families almost all of the elderly members are not insured. Due to lack of health insurance in 14% of the households were reported a refusal to provide health care by general practitioners (GPs) and specialists in out-hospital care. 82.1% of Roma women have never had a mammography and 71.4% a smear test. In 83.3% of the households required direct payment for the provision of health services, which corresponds to the high share of informal payments in health care in Bulgaria (34 % in 2023), but among the Roma population this share is significantly higher. The households have to pay for specialized out-hospital care (66.6%), GPs (22.2%), and for emergency assistance (5,6%). 44.4% of the families have used the services of emergency care in the last one year. While in one third of the families an adult member was hospitalized in 27.8% of them there is a need for hospital treatment, which is unrealized. Conclusions The Roma population in Bulgaria is characterized by an unfavorable health profile and the health services provided to the persons of Roma origin are inadequate to their needs. Key messages • Persons of Roma origin in Bulgaria often face serious inequities concerning their state of health and their access to good quality health services. • Improving the socioeconomic status of people of Roma origin will increase their opportunities for health insurance and going to improve their access to health services.

4.P. Round table: Advancing genomic diagnostics for rare genetic diseases: a focus on non-clinical domains of HTA

Abstract Genetic rare diseases are a burning global public health issue requiring a thorough assessment of the related burden. Unfortunately, curative therapies are oftentimes unavailable for genetic rare diseases; nevertheless, a prompt diagnosis could allow clinicians to elaborate supportive care plans for patients and their caregivers, determine the best care setting, and potentially consider enrolling them in clinical trials, if suitable. Innovative, effective, and sustainable diagnostic techniques, such as Whole genome sequencing (WGS), are needed to address this growing health concern. At global level, there is a paucity of research that specifically investigates the implementation of WGS into clinical practice which is even more constrained at the European level. Furthermore, given the current challenges impacting pediatric patients suspected of having genetic diseases without a definitive diagnosis, there is an urgent need to improve the diagnostic workflow based on genomic techniques, such as WGS. Delving into this topic could contribute valuable insights that can inform policymakers, at macro-level, and health professionals, at micro-level, on how to develop suited genomic policies and clinical guidelines for the proper adoption of WGS within the daily clinical practice. From an international standpoint, it could be argued that these considerations resonate with the United Nations Sustainable Development Goals (SDGs), particularly SDG 3 (i.e., “Good health and well-being”) and 10 (i.e., “Reduced inequalities”), as a priority for research and action. Notwithstanding, the broader implementation of WGS encounters hindrances owing to its complexity and the multifaceted social, economic, organizational, and ethical implications. In view of these challenges, Health Technology Assessment (HTA), as an integrated and multidisciplinary process, provides a comprehensive framework for the evaluation of these dimensions. This round table is intended to provide attendees with insights into nonclinical domains of HTA of WGS which, unlike clinical domains, demand a nuanced approach within the framework of the HTA. The intended objective is pursued through the initial presentation of a case study on the evaluation of WGS in paediatric genetic disorders from the Italian National Health Service perspectives followed by an open discussion with experts. The discussion will delve into issues related to economics, genomics, health services organization and ethics. Key messages • For pediatric patients suspected of having a genetic disease, WGS could shorten the so-called diagnostic odyssey. • Context-depending aspects of implementing WGS should be properly taken into account through HTA.

From crisis to chronic: a comparative analysis of Long COVID impact in Italy and the United States

Abstract Background The aftermath of COVID-19 is bringing about socio-economic consequences, such as diminished quality of life (QoL), decreased productivity, and considerable healthcare expenditures. Despite the emerging acknowledgment of a clinical syndrome following COVID-19 disease, known as Long COVID (LC), notable research gaps persist. This study aims to assess the epidemiological and economic impact of LC in both Italy and the United States (US). Methods This ecological analysis comprises epidemiologic and economic data from 2020 to January 2023, regarding working-age individuals (18-64 years). An Italy/US incidence rate ratio (eIRR) was estimated to compute LC cases in each country. The product between the value of a year spent in good health, individual Quality-Adjusted Life Year (QALY) loss, and LC cases yielded total lost QoL. Temporary productivity loss (TPL) was calculated through the Human Capital Approach. All estimates were deemed significant at a p-value less than 0.05. Results Up to date, the eIRR was 0.78 [0.43 - 0.91] implying 22% fewer LC cases in Italy with respect to the US. Total LC cases were 11 [8.7 - 13.5] and 1.8 [0.9 - 2.1] million in the US and Italy, respectively. The relative QALYs loss was 1.5 [0.8 - 3.1] and 0.2 [0.1 - 0.9] million. Reduced QoL cost roughly $189 [164 - 214] billion in the US and €6 [1 - 11] billion in Italy. TPL amounted to $37 [21 - 57] billion in the US and €2.8 [1.2 - 7.4] billion in Italy. Americans aged 30-39 years showed the largest income loss (26.6%), while in Italy it occurred in the age group 50-64 years (38%). Conclusions LC places a substantial burden in Italy and the US, impacting both the productivity of the working-age population and influencing the younger generation, who constitute the future workforce. Our study underpins the necessity for comprehensive health policies, programs, and interventions alongside effective tertiary prevention strategies to tackle the challenges posed by LC. Key messages • According to this analysis, both countries show significant productivity and quality-adjusted life years loss due to LC among working age individuals. • Steering the formulation of evidence-based sounding health policies to address LC burden, among working age individuals, both in Italy and in the US.

Digital services as alternative for in-person visits among clients with long-term illnesses

Abstract Background For individuals managing long-term illnesses and often requiring complex care across health and social care sectors, the transition to digital platforms holds considerable potential to facilitate management of one’s health. This study examined factors among people with long-term illnesses associated with their perception that digital services had replaced in-person visits in health and social care. Methods A total of 11,012 Finnish residents with long-term illnesses necessitating regular care (56% female, mean age 56.9, SE .23) responded to a nationwide population survey between September 2022 and March 2023. The Inverse Probability Weighting method was used to correct for bias. Complex samples binary logistic regression was used to examine whether factors related to self-rated health, distress, digital skills and perceived benefits of digital services were associated with the replacement of in-person visits by digital services. The model was adjusted for age, gender, education, and urbanicity. Results Approximately one third (35.8%) of the respondents indicated that the use of digital services had replaced in-person visits within the past 12 months. Respondents in poor or moderate health (OR 1.17, 95% CI 1.02-1.34) had greater odds of reporting the replacement compared to those in good health. Those with proficient digital skills (OR 1.84, 1.57-2.14) and those perceiving more benefits in digital services (OR 1.56, 1.47-1.74) had greater odds of reporting of the replacement compared to their counterparts. Conclusions Transition to digital services could facilitate access to care for individuals with long-term illnesses perceiving their health poorer. Promoting digital skills and perceptions of benefits of digital services can significantly increase the use of digital services as substitutes of in-person visits and contribute to more efficient allocation of health and social care resources. Key messages • Especially those reporting poorer health seem to use digital services as replacements of in-person visits, offering the potential to optimize resource utilization in health and social services. • Promotion of digital skills and perceptions of the benefits of digital services could increase the use of digital services as replacements for traditional visits with health and social professionals.

Exploring Electronic Personal Health Record usage in Northern Italy: a cross-sectional study

Abstract Background The Electronic Personal Health Record (EPHR) is a patient-centered tool that enables citizens to manage their health information. The EPHR has been implemented worldwide, including in Italy, and holds immense potential, but it has shown a generalized underutilisation. Therefore, this paper aims to identify its fulfillment and the reasons behind its poor use, potentially uncovering the key to unlocking its benefits. Methods A survey was distributed on social media and in the waiting rooms of vaccination facilities in a Region of Italy. Multivariable regression models were conducted to detect a connection between the general population’s usage of the EPHR and specific independent variables. Results Of the 1634 respondents, 710 activated the EPHR, especially women, Italians, highly educated, unemployed, with good health but affected with chronic diseases. Amongst those who activated the EPHR, the multivariate analysis showed that the number of accesses to the platform was significantly associated with lower age (adjusted Odds Ratio (adjOR) 0.96 p = 0.015), higher level of education (adjOR 2.17 p = 0.029), unemployment (adjOR 5.61 p = 0.008) and considering the information on the EPHR complete (adjOR 3.83 p = 0.001). As age increases, the perceived ease of access to the EPHR decreases (adjOR=0.98 p = 0.049). Having a higher level of education (adjOR=0.41 p = 0.042), autonomy in reading health materials (adjOR=0.32 p = 0.043), and less self-confidence in filling out medical forms (adjOR=0.61 p = 0.033) were linked to a decrease in perceived ease of access. Conclusions The study showed that the EPHR is more utilised by specific categories of citizens, especially the young and those with higher education. More efforts should be made to increase access to the EPHR for the whole community by making it more intuitive and user-friendly. The present study provides valuable foundations to foster the implementation of a platform for sharing health data at a European level. Key messages • The Electronic Personal Health Record (EPHR) is underutilised despite its potential; it’s mainly accessed by young and highly educated individuals. • Efforts to increase EPHR usage must focus on improving accessibility and ease of access, as well as enhancing user confidence and autonomy in managing health information.

Greenwashing by the fossil fuel industry: impediments to SDGs

Abstract The fossil fuel industry, a major commercial determinant of public and environmental health, constitutes a central challenge to the achievement of the SDGs. Motivated by profit, the industry has contributed to establishing the current global reliance on fossil fuel as the primary energy source and essential raw material in global production. Major oil companies have purposefully hindered the research and transition towards renewable energy. This was achieved through an intricate web of interference and mechanisms that fall under the corporate playbook, such as political interference through lobbying to stagnate carbon emission reduction, influences on carbon pricing policies, and hinderances to environmental protection legislation. These practices known as ‘greenwashing’ have resulted in misinformation, interfered with climate action in an aim to increase demand for their products, to decrease the pressure from society on the industry, and portray a green image to consumers. Using the commercial determinants of health framework and focusing on the Middle East, this presentation will illustrate how fossil fuel companies falsely advertise their products as environmentally friendly, resulting in environmental degradation, and impede the achievement of most SDGs, especially SDG 3 (good health and wellbeing), SDG 7 (affordable and clean energy), and SDG 13 (climate action).

7.C. Scientific session: Commercial determinants of health: impeding attainment of the Sustainable Development Goals

Abstract The commercial determinants of health (CDOH) and the adverse impacts they have on health equity globally, have recently emerged as an innovative growing field of research in public health. The corporate playbook comprises a myriad of strategies and tactics that aim to enhance profitability for the commercial actors, while harming health and posing grave risks to planetary health for current and future generations. The literature however, rarely explicitly makes the connection between commercial determinants and the impact they have on the attainment of the Sustainable Development Goals (SDGs) set out by the United Nations in 2015. This workshop aims to use the commercial determinants of health framework as a new approach to draw attention to, and make linkages between, commercial determinants and the challenges they pose to the attainment of several if not all the global SDGs. The four presentations showcase exemplars of the commercial determinants to include the firearms industry, fossil fuel industry, food industry and the tobacco industry focusing on impacts in low- and middle-income countries (LMICs). The workshop will start with a brief overview of the CDOH framework, their corporate playbook, and the progress in SDG attainment globally while presenting the first case on the firearms industry trade impacting armed conflicts that impede SDG 3 (good health and wellbeing), 10 (reduced inequalities), and 16 (peace, justice and strong institutions). The second presentation will discuss how the fossil fuel industry uses greenwashing tactics to conceal its harmful activities thereby compromising SDGs 7 (affordable and clean energy), 11 (sustainable cities and communities), and 13 (climate action). The third presentation will address how the tobacco industry impedes the advancement of SDG 3, 8 (decent work and economic growth), 13 (climate action) and 17 (partnerships for the goals) perpetuated by national system level attributes. The last presentation will showcase how the food industry challenges SDG 3 in its production of ultra-processed foods. The workshop will draw on evidence from LMICs, but is also eye opening for high-income countries of Europe which face industry interference in social and health policymaking progress in SGD attainment. The audience will be engaged in a short warm-up exercise at the start of the workshop through an app for real-time feedback accessed through a QR code on the screen, and will interact with the presenters at the end of the workshop if time permits. Key messages • All commercial actors pose a direct or indirect threat to progress in attaining the SDGs. • The commercial determinants of health pose are in direct contradiction to the SDG 17 through their corporate playbook.

Including highly educated migrants in academia to improve their health—protocol for a pilot intervention

IntroductionNorway’s healthcare system needs a diversified work force to meet societal demands for improved cultural competence. However, many migrants in Norway who were educated as health professions in their home countries are not practicing these professions. This may negatively affect their physical and mental health and hinder their personal social integration. Though good health is often seen as a precondition for work, relevant working activities can also improve health. However, including health professionals with foreign education in academic institutions prior to receiving necessary accreditation is a complex task. This study will pilot an intervention aiming to improve health through meaningful integration of these professionals in academic environments.Materials and methodsThis paper is a protocol for a non-randomized pilot intervention study targeting migrants who are waiting for their health education accreditation in Norway. To test the benefits of meaningful activity on health and explore possibilities for implementing such activity, we have designed a six-month long intervention consisting of including nurses, doctors, and other highly educated migrants with healthcare backgrounds between 20 and 67 years of age, into health-related working tasks, at two higher education institutions in Bergen, Norway. The intervention will be tailored according to the participant’s expertise. This hybrid type 2 pilot protocol paper will present how feasibility, fidelity, dose received (satisfaction), and dose of exposure (participation), will be assessed and whether the intervention is experienced as beneficial for the participants’ health as primary outcome utilizing both quantitative and qualitative methods.ConclusionWe present a complex, personalized intervention that has the potential for large scale implementation in the future. By thoroughly presenting our designed intervention and assessment methods, this protocol will add to the study’s transparency and facilitate replicability and comparison with future studies. This study will be of benefit to the migrants themselves, policy makers, government agencies and academia at large as it can point to a unique and sustainable way of speeding up the integration of highly educated migrants in their respective fields in a new host country.

Sustainability in the Next Generation Hospital. Needs and Requirements collection from healthcare infrastructures supply chain stakeholders with One Health approach

Abstract Technological, demographic, epidemiological, environmental and social changes require investment in new sustainable hospital infrastructure; there is a lack of guidelines and interaction between Stakeholders. In February 2022, the Joint Research Platform Healthcare Infrastructures (JRP HI) was established consisting of Hospital Strategic Directions and Industrial Partners in Italy. Starting from the WHO Techincal Brief “Hospitals of the Future”, a national survey was carried out via web-survey and semi-structured interviews with a sample of 30 stakeholders to collect the main drivers and constraints for innovation and the framework from a One Health perspective and in terms of sustainability. The main needs to be addressed through the guidelines refer to digitalization (27%), flexibility (32%), environmental sustainability (36%) and economic sustainability (27%) as well as flow management (18%) and hospital infection (14%). The participants consider SDG-3 ‘Good Health and Wellbeing’ to be the most relevant for development activities. Hospital managers prioritize SDG-8 ‘Decent Work and Economic Growth’ (23%); vice-versa the industrial partners suggest SDG-11 ‘Sustainable Cities and Communities’ and SDG- 13 ‘Climate Actions’ (32%) as topics to be addressed. Furthermore, 57% of the respondents state that they lack adequate training, budget or leadership to apply innovative strategies in the day-to-day management of the healthcare organization. The survey highlighted a lack of initiatives, budget, and standardization for enhancing environmental sustainability in healthcare infrastructures. The sustainability of building systems depends on factors such as energy consumption, alternative energy sources, thermal comfort, water usage, waste management, ventilation, lighting efficiency, air quality, and construction materials. Ensuring the adoption of monitoring systems and harmonized standards of performance measurement is crucial for increasing the environmental sustainability.

Health as predictor of unemployment. A population based study in Belgium

Abstract Background Health and employment are interrelated, but this can be both the result of social causation and health selection. Insights in the association between health and employment should be explored in different settings and countries because contextual factors may differ. In this study we investigate if at the Belgian population level, ill health leads to a higher risk of unemployment. Methods We used data from the Belgian health interview survey 2018 linked with administrative data from the compulsory health insurance including information on employment status in 2018 and 2019. The sample for this study consisted of people with a paid job, aged 18-64 year, with no record of having being unemployed in 2018 (n = 3769). Multivariate logistic regression was used to assess if the risk of becoming unemployed in 2019 varied in function of the health status assessed in the 2018 survey. Results After adjustment for age, sex, education and social support, the risk of becoming unemployed was significantly higher for people with moderate to very bad self-rated health compared to those in good health (OR 2.76; 95% CI 1.34-5.67). Similarly, unemployment in the year following participation in the survey was significantly higher among people with activity limitations because of health problems (OR 2.32; 95% CI 1.14-4.72). The higher the number of chronic diseases and conditions, the higher the risk of unemployment (OR 1.37; 95% CI 1.13-1.53). Specific predictors of unemployment were a history of serious depression in the past 12 months (OR 4.47; 95% CI 1.85-10.80) and hypertension (OR 2.54; 95% CI 1.08-6.00). Conclusions In Belgium, health problems are a risk factor of getting unemployed. Especially people with a history of serious depression in the past year have a higher risk to lose their job. The findings confirm the health selection of unemployment and the need for the labour market to invest in interventions to support people with health problems to keep or find a job. Key messages • As employment is a fundamental right, also for people with health problems, further efforts are needed to create an inclusive labour market, with also job opportunities for more vulnerable people. • To be able to understand better the link between health and unemployment at population level, longitudinal population data are needed including both dimensions.

Who are the superheroes? A cross-sectional study on the determinants of healthy ageing

Abstract People who reach old age while enjoying good physical and mental health are, in a sense, ‘superheroes’ (of health): in fact, they not only have a relatively low impact on health care spending but are also advantaged in playing an active role in society and achieving their aspirations (and perhaps helping others to do so). The aim of this study was to assess the prevalence and determinants of being ‘physical superheroes’ (i.e., lacking the 10 major chronic conditions plus obesity), ‘mental superheroes’ (i.e., lacking major mental symptoms) and ‘superheroes’ (i.e., both mental and physical superheroes). We used data from a telephone-based cross-sectional study (LOST in Lombardia) conducted in November 2020 (i.e., during the COVID-19 pandemic) on a representative sample of 4,400 adults aged ≥65 years from the Lombardy region, Northern Italy. All the participants provided data both during and before the COVID-19 pandemic. Mental and physical superheroes were 59.0% and 17.6%, respectively. Superheroes were 12.8% overall, 15.1% among men and 11.1% among women; 20.2% among individuals aged 65-69 years, 11.3% among 70-74, 10.0% among 75-79, and 8.3% among ≥80 years. Multivariable analysis showed that, besides female sex, higher age, and disadvantaged socio-economic status, ever tobacco smoking (adjusted odds ratio, aOR=0.71), alcohol drinking (aOR=0.77), and physical inactivity (p for trend<0.001) were inversely related to being superheroes. Participants with feelings of hopelessness showed an extremely low presence of “superheroes” (OR = 0.17). The COVID-19 pandemic reduced by 16.3% the proportion of superheroes. Given a steadily ageing population, public health policies should aim to ensure that people reach old age in the best possible state of health by preventing risky behaviours and paying special attention to inequalities derived from economic and social factors.

7.Y.1. Health Literacy in a multi-modal world: innovation challenges

Abstract Good Governance, Healthy Cities and Health Literacy (HL) (The Shanghai Declaration, WHO 2016) are presented as the three pillars of Health Promotion. In order to pursue these pillars as a global strategy to ensure that citizens can make healthy choices, there is a need to explore innovative ways that are accessible and affordable to all, that will ensure that all have the right to health. In this workshop five presentations will trigger a discussion that is proposed to be developed around the consequences of innovating from the health literacy perspective: Floriane Silvestri from Portugal, will focus on health literacy and health coaching as a node towards health promotion; Juliana Bertani from Basil will address Health literacy & somatic education from a salutogenic self-resource critical health intervention; Alcina Ilharco will focus on mental health and the health literacy of university students; Paula Vital will consider the role of social prescription multi-modal approach and Sukran Peker from Turkey will present a qualitative study of the relationship between health information and behaviors. The discussion that will follow these presentations is aimed at providing new perspectives on the topic of health literacy with participants interaction and networking. Key messages • Innovative ways to bring health promotion into effectiveness needs to be established from health literacy focused initiatives. • Salutogenesis is a structural paradigm to drive innovative mechanisms to help improve wellbeing and quality of life by health literacy innovative approaches.