Health Needs Research Articles

Determinant Factors of Microbial Drinking Water Quality at the Point of Use in Rural Ethiopia: A Case Study of the South Gondar Zone

Access to safe drinking water is a fundamental human need for health and well-being implemented globally by the United Nations under Sustainable Development Goal (SDG) 6. Storing drinking water is common in rural areas of Ethiopia due to off-premises water sources and intermittent piped water supply. However, this practice can lead to further contamination during collection, transport, and storage, posing a risk to public health. The objective of this study was to identify the determinant factors of drinking water quality at the point of use in the rural setting of northwestern Ethiopia, South Gondar zone. A questionnaire survey was conducted, and water samples from 720 households were collected during the wet and dry seasons. The determinant factors were identified using the multivariable logistic regression model. About 39.2% of the surveyed households had basic water supply services, 41.9% were using unimproved sources, and 8.3% were using surface water. Only 9.4% were using basic sanitation services, and 57.2% were practicing open defecation. Safe water storage was practiced by 84.3% of households, while only 2% engaged in household water treatment. About 14% of dry and 8% of wet season samples from the storage were free from fecal coliform bacteria. Furthermore, 52.9% of dry and 62.2% of wet season samples fell under the high microbial health risk category. The season of the year, the water source type, storage washing methods, and the socioeconomic status of the household were identified as key predictors of household drinking water fecal contamination using the multivariable logistic regression model. It was observed that the drinking water in households had a high load of fecal contamination, posing health risks to consumers. To tackle these problems, our study recommends that stakeholders should enhance access to improved water sources, implement source-level water treatment, increase access to improved sanitation facilities, advocate for safe household water management practices, and endorse household water treatment methods.

Oral Health Data Gaps and Needs in North Carolina

Effective oral health-related policymaking and program implementation rely on comprehensive, accurate, and timely data. This commentary will address the lack of data available and the need for a robust data dashboard, in addition to the importance of community water fluoridation.

Pivoting: Responding to the Mental Health Needs of Youth of Color With Technology

Mental health treatments currently available to address racial discrimination for 21 million youth of color are inadequate. Given the nascent but promising mechanisms found within behavioral health interventions via racial socialization, or the process through which children acquire knowledge about race, developing effective and scalable therapeutic strategies to contend with the stress from racism and discrimination is possible. We outline the active ingredients that facilitate behavioral change for youth psychosocial outcomes impacted by racial discrimination and describe how technology is being utilized for current and future implementation efforts. We argue that technological advancement, in addition to ecological considerations, is crucial for the reduction of structural and interpersonal risk factors negatively influencing the psychological wellness of youth of color. Technology integration across implementation and assessment will be critical, particularly given the potential for technology to further exacerbate mental health disparities.

Analysis of Occupational Safety and Health at Oil Plus Filling Station Installations: Literature Review

Background: Public Fuel Filling Station Installation which is an installation for distributing fuel oil into motor vehicle fuel tanks, with a significant risk of danger. The number of work accidents that occur at fuel filling stations continues to increase from 2018-2020. Program Safety and health need to be pursued to protect workers from the possibility of accidents and work-related diseases. Objective: This research aims to determine potential dangers and prevent accidents and occupational diseases among fuel station workers. Method: This research uses the "PRISMA" literature review method (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidances and The data source for this research comes from literature search results on the internet from databases from Science Direct and ResearchGate. Using keywords “Occupational health and safety for fuel filling installation workers” “Occupational health and safety for Hydrogen and Gas Refuelling Station” “Occupational health and safety for Electrical Vehicle” published in the last five years, from 2019 to 2024, which are indexed Q1, Q2 and Q3. Results: As many 5,657 journals were found, but 10 journals were selected that met the inclusion and exclusion criteria. Potential dangers that threaten fuel station workers include: physical factors namely physical fatigue and noise and hearing problems. Chemical factors namely toxic gasses, dangerous liquids and BTEX gas (benzene, toluene, ethylbenzene, p-xylene, o-xylene, dan m-xylene). Physiological factors, psychological fatigue and quality of work life. Safety climate as an effort to prevent accidents and work-related illnesses by implementing management safety priority and ability, management safety empowerment and management safety justice. Conclusion: Potential dangers that threaten fuel station workers are: physical factor, chemical factor and psychological factor. Safety climate by implementing safety management priorities and capabilities, management safety empowerment, and management safety justice, as well as compliance with occupational safety and health regulations such as the use of personal protective equipment to reduce the risk of danger and thus reduce the occurrence of work accidents.

Machine learning and deep learning models for preoperative detection of lymph node metastasis in colorectal cancer: a systematic review and meta-analysis.

To evaluate the diagnostic performance of Machine Learning (ML) and Deep Learning (DL) models for predicting preoperative Lymph Node Metastasis (LNM) in Colorectal Cancer (CRC) patients. A systematic review and meta-analysis were conducted following PRISMA-DTA and AMSTAR-2 guidelines. We searched PubMed, Web of Science, Embase, and Cochrane Library databases until February 16, 2024. Study quality and risk of bias were assessed using the QUADAS-2 tool. Data were analyzed using STATA v18, applying random-effects models to all analyses. Twelve studies involving 8321 patients were included, with most published in 2021-2024 (9/12). The pooled AUC of ML models for predicting LNM in CRC patients was 0.87 (95% CI: 0.82-0.91, I2:86.17) with a sensitivity of 78% (95% CI: 69-87%) and a specificity of 77% (95% CI: 64%-90%). In addition, when assessing the AUC reported by radiologists, both junior and senior radiologists had similar performance, significantly lower than the ML models. (P < 0.001). Subgroup analysis revealed higher AUCs in prospective studies (0.95, 95% CI: 0.87-1) compared to retrospective studies (0.85, 95% CI: 0.81-0.89) (P = 0.03). Studies without external validation exhibited significantly higher AUCs than those with external validation (P < 0.01). While there was no significant difference in AUC and sensitivity between the T1-T2 and T2-T4 stages, specificity was significantly higher in the T2-T4 stages than the low stages of T1 and T2 (95%, 95% CI: 92-98% vs. 61%, 95% CI: 44-78%; P < 0.01). ML models demonstrate strong potential for preoperative LNM staging and treatment planning in CRC, potentially reducing the need for additional surgeries and related health and financial burdens. Further prospective multicenter studies, with standardized reporting of algorithms, modality parameters, and LNM staging, are needed to validate these findings.

Improving Access to Surgical Residency for International US Medical Graduates: Potential Solution to Addressing the Growing Health Needs of Immigrant Population in the US.

Improving Access to Surgical Residency for International US Medical Graduates: Potential Solution to Addressing the Growing Health Needs of Immigrant Population in the US.

Global burden of zoonotic infectious diseases of poverty, 1990–2021

BackgroundThe zoonotic infectious diseases of poverty (zIDPs) are a group of diseases contributing to global poverty, with significant impacts on a substantial population. This study aims to describe the global, regional, and national burden of zIDPs—schistosomiasis, cystic echinococcosis, cysticercosis, and food-borne trematodiases (FBTs)—to support policy making and resource allocation for their control and elimination.MethodsData of zIDPs from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 were retrieved from 1990 to 2021. The age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life-year (DALY) rate were described and the estimated annual percentage changes (EAPCs) were calculated to quantify their burden and temporal trends. Spearman correlation analysis was conducted to examine the relationship between age-standardized rates and Socio-demographic Index (SDI).ResultsIn 2021, these zIDPs exhibited a certain level of ASPRs and age-standardized DALY rates, while maintaining relatively low ASMRs. Noticeably, schistosomiasis presented the highest ASPR of 1914.299 (95% UI: 1378.920, 2510.853 per 100,000 population) and an age-standardized DALY rate of 21.895 (95% UI: 12.937, 37.278 per 100,000 population) among the zIDPs. The tapestry of burden—woven predominantly through low and lower-middle SDI regions—stretched across Africa, Latin America, and parts of Asia. From 1990 to 2021, a kaleidoscopic shift was observed globally as ASPRs, ASMRs, and age-standardized DALY rates declined significantly, as reflected by the EAPC values. Negative correlations were observed between the ASPRs, ASMRs, age-standardized DALY rates of schistosomiasis (r value = − 0.610, − 0.622 and − 0.610), cystic echinococcosis (− 0.676 of ASMR, − 0.550 of age-standardized DALYs), cysticercosis (− 0.420, − 0.797 and − 0.591) and the SDI. In contrast, a slight positive correlation was noted between the ASPR, age-standardized DALY rates of FBTs and SDI with r value of 0.221 and 0.213, respectively.ConclusionThe burden of zIDPs declined across almost all endemic regions from 1990 to 2021, yet still predominated in low and low-middle SDI regions. Substantial challenges exist to achieve the goal of control and elimination of zIDPs, and integrated approaches based on One Health need to be strengthened to improve health outcomes.Graphical

Academic Performance, Health and Support Needs: Comparing Foster Care Alumni and Peers in Higher Education in Norway

The completion rates of higher education are low among young adults with a history of foster care. Understanding how students from foster care alumni fare is imperative for facilitating attainment and preventing drop-out. The aim of this study was to compare students from foster care alumni and the general student population by examining (1) sociodemographic characteristics, academic functioning and need for special assistance; (2) contextual factors important for student life; and (3) mental and somatic health, loneliness, life satisfaction and use of cannabis and alcohol. Data comprised self-reports from the Norwegian national survey Students’ Health and Well-being Study 2022. Reports from foster care alumni students (n = 508) were compared to those of the general student sample (n = 59,036). Compared to the general sample, twice as many foster care alumni students reported receiving or needing special assistance in their studies. Moreover, they reported substantially higher economic burden than their student peers, by higher frequency of work income, more financial worries, and less parental financial support. Foster care alumni students also reported a higher load of informal care responsibilities, poorer mental and somatic health, more loneliness and lower life satisfaction. Foster care alumni students fare comparably well in terms of grades and study progression despite the reported economic burden and impaired health and well-being. As these are factors shown to impact study completion, policies need to be put in place to ensure that care-experienced students receive adequate support through their young adulthood and specifically in higher education.

Rural versus urban healthcare through the lens of health behaviors and access to primary care: a post-hoc analysis of the Romanian health evaluation survey

BackgroundWorldwide, rural populations are recognized to be exposed to increased health challenges due to their living and working environment, socioeconomic status, and access to health services. According to the Romanian Country Health Profile 2023, approximately 46% of all deaths recorded in Romania in 2019 could be attributed to behavioral risk factors such as tobacco smoking, dietary risks, alcohol consumption and low physical activity. No data on rural versus urban areas are available to date, and research is needed to document health inequalities, identify barriers to health services, and explore solutions.MethodsThis study is an analysis of data collected during the Health Evaluation Survey carried out by the National Institute of Public Health in 2022 and aimed to reveal differences in health risk factors between rural and urban areas. The analysis was carried out under the methodological framework of the Health Evaluation Survey 2022, which is coordinated by the National Institute of Public Health.ResultsOur study’s objectively measured data revealed that the overall health profile of rural communities is characterized by lower education levels, lower incomes, and higher binge drinking rates than those of their urban counterparts. Additionally, rural inhabitants more often have high blood pressure, are more overweight and obese (per body mass index measurements) and have higher fasting plasma glucose. The health profile of the urban population revealed higher education levels and greater proportions of people with adequate monthly income, people with daily alcohol consumption, people who smoke, and people with hypercholesterolemia. Access to primary health care evaluated through proxy indicators was lower in rural areas but was relatively good overall.ConclusionsOur analysis of the health profile of rural communities revealed a greater prevalence of obesity and overweight, especially among women, and an increased prevalence of heavy drinking among men. Access to primary health care evaluated through proxy indicators is lower in rural areas but is relatively good overall. Lower education levels and the possibility of lower health literacy underpin the need for targeted health education campaigns. Sustainable strategies for rural health need to be identified, especially in the field of health promotion and disease prevention programs.Trial registrationThis study is observational research involving human participants where no interventions were applied to the study population.

Benefit equity of social health insurance in China and its provinces (2014–2020): implications for universal health coverage

IntroductionChina has increased fiscal input into social health insurance (SHI) schemes to achieve universal health coverage. Our study aimed to examine the equity of SHI benefits in the country and...

A systematic review on the prevalence of a silent female disorder in Arabic-speaking countries and the Middle East: sexual dysfunctions and the role of culture.

Female sexual dysfunction (FSD) remains a silent problem, especially in Arabic-speaking countries and the Middle East and most of the data are from Western countries. Sociocultural determinants haven't been getting the same attention as biological and psychological factors when studying sexual health. To assess the prevalence of FSD in the Arab and Middle Eastern world and understand the sociocultural determinants related. On January 13, 2024, we searched electronic databases including Pubmed, Scielo, PsycArticles, Scopus, Cochrane Library and Google Scholar, Middle East Current Psychiatry, and Journal of Middle East Women's Studies, following PRISMA guidelines. Female participants, aged at least 16years old from Middle East or Arabic-speaking countries, including North Africa, and cross-sectional studies in Arabic, English, and/or French were included. After careful screening of titles, abstracts, and full texts, ineligible articles were excluded. A total of 19 papers were included in the present review. The most common FSD in each country were as follows: in Egypt, Turkey, Morocco, and Jordan, desire problems. In Iran, orgasm problems, and pain. In Palestine, pain. In Saudi Arabia, arousal. Sociocultural determinants such as language, poor sexual education, poor sexual self-awareness-and of partners-, lack of training, and help-seeking were related to FSD. FSD is prevalent in Arabic-speaking countries and the Middle East, yet little to no attention is given to this matter. Causes for FSD are mainly cultural, and Arab and Middle Eastern healthcare professionals lack training. Culturally sensitive, evidence-based studies regarding sexual health need to be conducted.

Understanding young caring in the UK pre- and post-COVID-19: Prevalence, correlates, and insights from three UK longitudinal surveys

BackgroundDespite increasing awareness of young carers in recent years, there remains a significant gap in our understanding of both the prevalence and the characteristics of young carers. Our study aims to address this gap by examining the impact of the COVID-19 pandemic on the prevalence and characteristics of young carers. MethodsThis research utilised data from three UK longitudinal surveys: the UK Household Longitudinal Study (UKHLS), the COVID Social Mobility and Opportunities (COSMO) study, and the Millennium Cohort Study (MCS). We focused on adolescents aged 16–18, and examined two pre-COVID (UKHLS and MCS) and two post-COVID (UKHLS and COSMO) samples. ResultsThe prevalence of young carers increased from 8.0 % pre-COVID to 9.8–11.9 % since COVID. Young carers were more commonly found in single-parent and socioeconomically disadvantaged households, with a higher prevalence of young carers in homes where parents were out of paid employment or held lower educational qualifications. Young carers were also more likely to reside in deprived areas. Most young carers engaged in low-intensity caring (< 10 h/week), but post-COVID there was an increase in high-intensity caring (10 + hours/week), predominantly assumed by young female carers. The primary recipients of care were parents, followed by grandparents and siblings, with no change in the care recipient type since COVID. ConclusionThis study showed an increase in the prevalence of young carers, particularly those providing high-intensity care, since the onset of the COVID pandemic. Further, young carers were more likely to come from socioeconomically disadvantaged households and areas. Given the potential impacts that young caring can have on young peoples’ lives, it is imperative that support for young carers is increased, particularly for those facing multiple disadvantages. In tandem, services that support adult health and social care need to play a key role in identifying young carers.

Co-designing postpartum contraceptive services with and for immigrant women in Sweden: lessons learned from the IMPROVE-it project

Background and aimImmigrant women in many high-income countries including Sweden, report unmet need of sexual and reproductive health and rights, and face worse pregnancy outcomes and higher risk of unintended pregnancies. Postpartum contraceptive services are often inadequate to meet their needs. Co-design has shown to reduce health inequities, yet little is known about using this method for postpartum contraceptive service development and even less in collaborating with immigrant populations. The aim of this paper is to describe the co-design process and the strategies that were developed to help develop tailored and acceptable postpartum contraceptive services for immigrant women in Sweden.MethodsThe paper describes a co-design process that took place during 2022–2023, including the cyclical digital consultations with Arabic and Somali speaking immigrant women, midwives and researchers, as well as the outputs from the process. The theoretical framework for the co-design process was the ‘Double Diamond’ Design Process Model. Data analysis included qualitative content analysis.ResultsThe co-design process led to the joint development of intervention materials and strategies to improve postpartum contraceptive services. Specifically, the process revealed ideas on how to improve contraceptive counseling within three pre-identified areas of change: improve physical access to contraceptive services; improved communication strategies using visual aids and information charts; and empowerment strategies that focus on reflective practice without assumptions about what a group of women might expect. We found that participants contributed actively to the process with ideas and suggestions, and that the co-design process facilitated positive reflections on ongoing counseling practices.ConclusionThe co-design process resulted in the successful and participative development of innovative tools and activities to improve contraceptive counseling services. This approach is original because it involves both immigrant women, often left behind, and midwives delivering the services. Whilst this interplay allowed for careful refinement of services and tools by using an iterative process, it also facilitated reflective midwifery practice.

2.F. Scientific session: Challenges in healthcare architectures

Abstract The Workshop titled “Challenges in healthcare architectures” - proposed and developed by the three EUPHA Section: Urban Public Health (URB), Public Mental Health (MEN) and Environmental Health (ENV) - is aimed to foster the dialogue between designers (architects and urban planners), Public Health experts (operators, professionals and epidemiologists), general/sanitary Directors of healthcare facilities and medical staff, to establish a multidisciplinary approach for understanding together how to create and manage the healthcare facilities of the future. According to the main Conference topic “Sailing the waves of European public health: exploring a sea of innovation”, the workshop mainly addresses both the “Health care services and systems” and the “Health workforce, practice and training” EPH24 conference topics. The Workshops purpose is to explore the concept for the hospital of the future, that should be resilient to changes and capable of protecting different users’ health and tackle the transforming social, economic, environmental and epidemiological needs of the context in which they are located. As in many other spheres and economic activities, the pandemic accelerated the processes of innovation and digitization that had somehow already been activated. The healthcare issue, the use of smart devices for a dialogue between the healthcare professionals and the pervasive use of apps to monitor certain health parameters, are just some of the megatrends that were being observed and which have now necessarily entered into everyday life. In the same way, the hospital, which in the face of this gradual process of dematerialization and relocation of ‘softer’ clinical-diagnostic activities, reaffirms itself as a center of the highest specialty for the treatment and care of acute patients, for high-level clinical and experimental re-search, for diagnostics and more complex operations. At the same time, and finally, the hospital is inserted in a territorial healthcare facilities network, that should be planned, designed, and managed. The workshop program includes inputs which they argue current experiences, emerging practices and scientific outcomes related to the hospital design, planning and management sphere, coming from four different European countries. From designing to managing practices, in “Hospital Design and planning in the line of Foresight of Health Needs” and in “Sustainability in the Next Generation Hospital”. From digitalization in national resilience experiences, in “Digital Health Spaces in the City of Lisbon. The Role of Digitalization in linking Boundaryless Hospitals and Smart Health Cities” to novel approaches for specific disease, in “Building bridges: mobile mental health care units in four European countries”. Key messages • Explore the “hospital of the future” concept, resilient to changes, capable of protecting users’ health, and to tackle the transforming social, economic, environmental and epidemiological needs. • Establish a multidisciplinary and territorial approach, for understanding together how to create and manage the healthcare network of the future.

Balancing public health and public safety: a situational analysis of a substance use pathway

Abstract Background Public health solutions to substance use harms are of interest across Europe, where the level of health need among detainee populations is broadly consistent. A need for multiagency working is widely recognised, as well as role changes with a view to the police engaging in health generating activity, as part of the wider public health workforce. This qualitative study explores the prospect for a multiagency, public health pathway in an English county district. This involved multiagency working across the community and custody settings. Methods 25 semi-structured interviews with senior and frontline staff of diverse agencies involved in pathway development, including public health, police, treatment providers and the NHS. A ‘frame-critical’ situational analysis sought to understand the strengths, weaknesses, opportunities and threats presented by the pathway. Data were organised into themes. Results Three themes highlighted the challenges and opportunities for addressing substance use harms via multiagency collaboration across the community and custody settings. The themes highlighted how 1) agencies’ shared commitment to public health was unsettled by subtle differences on the meaning of prevention; 2) community police were more accepting of new health activity than custody police; 3) a trade-off impeded a proactive approach: the need for substance worker capacity to support police in the custody suite (a reactive approach) meant that limited community outreach was possible, despite opportunities for preventative community work involving substance workers and community police. Conclusions Public health solutions are challenging to develop in a context of contrasting understandings of ‘public health’, unclear national policy and resource constraints. The design of multiagency public health pathways must be participatory and inclusive to ensure staff buy-in: in particular, new health activities need to align with police staff’s sense of role congruence. Key messages • Multiagency public health collaborations should start by establishing a shared understanding of what ‘public health’ and ‘prevention’ mean. • A long-term perspective on training and motivational alignment (e.g., via feedback) is necessary to implement health-related activity among custody police staff.

Mapping barriers and bottlenecks for personalized preventive approaches in health systems worldwide

Abstract Over the past decades, the growing prevalence of chronic disease globally raised the public health need to plan tailored personalized preventive approaches, mainly through big data and -omic sciences. However, a conspicuous body of literature highlighted the existence of many barriers and bottlenecks hindering their actual implementation in real-word settings. From here, this scoping review of reviews aims to map all known barriers and bottlenecks to the implementation of personalized preventive approaches in European health systems and beyond. PubMed, Web of Science, Scopus and gray literature sources were consulted from 2017 to January 2023, identified barriers and bottlenecks were analyzed against the Consolidated Framework for Implementation Research (CFIR). Out of 11,602 records, 220 were deemed eligible for full-text screening, and a final sample of 34 review studies were extracted. Studies were mainly performed in USA 15 (44%) and UK 3 (9%), followed by Canada 2 (6%), India 2 (6%) and Italy 2 (6%). From our results, the lack of evidence on clinical utility, guidelines, specialized professionals, citizen trust and cultural issues are the most frequently reported barriers to the implementation of personalized preventive approaches worldwide. These in turn affect country specific policies and the applicability of such innovations across different populations, raising the risk of increasing health inequalities and discrimination concerns. Findings confirmed that most translational challenges pertain to primary and secondary prevention levels across several chronic diseases, with particular concerns for non-European ancestry individuals. Key messages • The identification of bottlenecks are informative of future precision public health interventions. • Barriers reported in most of the studies suggest the need to establish a targeted agenda.

Does staffing impact health and work conditions of staff in long-term care homes?: a scoping review

Abstract Background Long-Term Care (LTC) homes are highly regulated and task oriented, with demanding work and insufficient resources. Chronic underfunding of the sector, coupled with increased complexity of care, has deteriorated working conditions, resulting in precarious employment, intensified and stressful work, and decreased job satisfaction. These work conditions have contributed to severe staffing shortages of healthcare workers globally. To meet increased labour demands, OECD countries on average will need to increase the proportion of overall employment dedicated to LTC by 32% over the next decade. While reviews of literature have examined the association between staffing and care outcomes for residents in LTC, they have not examined how staffing structures affect the healthcare staff themselves. This scoping review asks: How does staffing impact the health of staff and working conditions in LTC? Methods A scoping review of empirical peer reviewed and grey literature was conducted to examine the association between LTC staffing practices and how they impact working conditions and the health and well-being of staff. PubMed, CINHAL, and Scopus databases were searched for relevant articles published within the past 10 years. Results Searches yielded 3994 unique articles, which were independently screened by pairs of reviewers. Preliminary results highlight that staffing levels are not optimized for healthy, sustainable work conditions. The level of staff, their skill mix, and ratios all impact the ability to provide care. In circumstances where there is inadequate staffing, care workers are more likely to experience stress, burnout, job dissatisfaction, and increased injury and illness. Conclusions Staffing practices shape working conditions which impact healthcare workers own health outcomes. To facilitate a strong LTC workforce, working conditions and occupational health need to be a priority in improvement initiatives. Key messages • With extreme staffing shortages challenging the healthcare sector, this review highlights the need for heightened attention to the impact of staffing practices on the healthcare workforce. • Improving working conditions and attuning to the needs of the workforce, ultimately improves quality of care.

About the need for a Swiss digital health ‘Sistine Chapel’ – lessons from 25 years of health policy

Abstract Background The Swiss government’s ‘DigiSanté’ program 2025-2034 aims to address Switzerland’s delay in digitising its healthcare system. Public and professionals’ trust is central for the implementation of digital health initiatives and partially based on past experiences with the digital health system. To inform DigiSanté, it is crucial to analyse the evolution of the socio-political discourse surrounding health data sharing in Switzerland in the past 25 years to identify the main obstacles encountered and lessons learned during this period. Methods We designed a multi-method study comprising a policy analysis of 65 Swiss policies on health data sharing from 1998 to 2023; scoping review of 250 editorials; sentiment analysis of 400 news articles from six major Swiss newspapers; and thematic analysis of transcripts from 11 online interviews with key stakeholders. Results We identified 32 key policy milestones in Swiss health data sharing, with the COVID-19 pandemic emerging as a trigger for present policymakers’ awareness of health data’s potential and the need for healthcare system digitization. The troubled implementation of the Electronic Patient Dossier (EPD) and its negative narrative are identified as more central in eroding long-term public trust than scandals. Primary obstacles to implementation of the EPD include misaligned stakeholders’ interests, slow policy processes, lack of professional support, low public awareness, and technical interoperability issues. Future strategies involve increasing actors’ involvement to establish a common vision and strategy and improving public communication. Conclusions The present socio-political discourse on health data sharing in Switzerland is shaped by past negative experiences with the EPD, compounded by additional scandals. To cultivate public trust, stakeholders should collaborate to align interests and ensure all parties work cooperatively toward common goals. Key messages • National and international scandals marginally affect public trust compared to the impact of the negative narrative surrounding the slow EPD implementation. • Misalignment of stakeholder interests is the main barrier to implementing health data sharing initiatives, causing delays and trust erosion.

Using English General Practice Patient Survey data to explore Long Covid prevalence

Abstract Background High global burden of Long Covid (LC) has significant implications for population wellbeing, health/social care and the economy. We aimed to assess prevalence of LC, the level of uncertainty general practice (GP) patients felt about whether they were experiencing it and patient characteristics associated with LC. Methods This is a secondary data analysis of GP Patient Survey 2023 data (759,149 participants aged 16+yrs in England). The outcomes included self-reported LC, and being unsure about having LC. Identity and socioeconomic characteristics were explored in relation to these outcomes using univariable and multivariable regression analyses. Results 4.8% of respondents described themselves as having LC, and 9.1% were unsure whether they had it. Patient age (highest odds at 35-54 years), sex (females more than males), ethnicity (highest odds in Gypsy or Irish Traveller), sexual orientation (increased odds in gay or lesbian or bisexual compared to heterosexual), religion, smoking, carer status, parental status, having a long-term condition, and area-level index of multiple deprivation (higher odds in more deprived areas) were all significantly associated with reporting having LC in the multivariable model compared to answering that question with ‘no’. Generally, similar patterns of association to the above were observed in those who answered the Long Covid question with ‘unsure’ compared to those answering ‘no’, except for parental status and sexual orientation which were not significantly associated with the outcome in the multivariable model. Conclusions This study quantitatively highlights the high levels of uncertainty among primary care patients around experiencing LC, and the unequal distribution of LC burden among population groups. Our findings underline the need for better public health and primary care messaging to raise awareness around LC and ensure that those needing support can access services, particularly those already disadvantaged in society. Key messages • There are high levels of uncertainty about having Long Covid among people attending primary care services. • There is unequal burden of Long Covid in England underlining the need for improved awareness and access to support, particularly for minoritised groups.

Investigation of a Norovirus GII.4Sydney[P16] outbreak in a care facility in Portugal, 2022

Abstract Background On the 29th of April 2022 the local Public Health unit was notified of 12 cases of acute gastroenteritis in residents of a long-term care facility (LTCF). A joint epidemiological investigation team was established and initiated an outbreak investigation to characterize the outbreak and implement infection control measures. Methods Epidemiological questionnaires were administered to staff (n = 44) and residents (n = 60). Case definition was LTCF residents or staff members with at least one of the following symptoms: diarrhoea, vomiting, nausea, between April 25th and May 14th, 2022. Stool or vomit samples were collected for 11 individuals. To assess environmental contamination fifteen food samples from previous meals and six surface samples from toilet faucets, wash tubs, and cutting boards were collected. Spatial distribution of cases within the LTCF was performed to guide infection control implementation. Results A total of 43 people met the case definition. Attack rates in residents and staff were 37% (23/63) and 42% (20/48), respectively. Of the total tested specimens, six (6/8) from residents and two (2/3) from staff were positive for the Norovirus (NoV) GII.4 Sydney [P16] variant by genotyping. Two (2/6) samples from surface swabs from the toilet faucet in the resident’s living room were also positive for NoV GII. Food samples were negative for major bacterial agents implicated in gastrointestinal outbreaks. Cases were distributed throughout the LTCF wards with no clear clustering. Four residents required hospital admission. Conclusions Results suggest person-to-person as well as environmental transmission of NoV. Identification of behavioural and spatial patterns of residents and staff and subsequent enactment of infection control strategies mitigated the outbreak. These findings reinforce the need for public health to maintain continuous technical support to LTCF on the implementation of infection control best practices. Key messages • Outbreak investigation in LTCF confirms Norovirus transmission, emphasizing the importance of infection control measures in long-term care facilities. • Study reveals Norovirus outbreak in LTCF, underscores the role of person-to-person and environmental transmission, highlighting the need for robust infection control protocols.