Public Health Strategies Research Articles

Exercise as a Therapeutic Strategy for Obesity: Central and Peripheral Mechanisms.

Obesity is a complex, multifactorial condition involving excessive fat accumulation due to an imbalance between energy intake and expenditure, with its global prevalence steadily rising. This condition significantly increases the risk of chronic diseases, including sarcopenia, type 2 diabetes, and cardiovascular diseases, highlighting the need for effective interventions. Exercise has emerged as a potent non-pharmacological approach to combat obesity, targeting both central and peripheral mechanisms that regulate metabolism, energy expenditure, and neurological functions. In the central nervous system, exercise influences appetite, mood, and cognitive functions by modulating the reward system and regulating appetite-controlling hormones to manage energy intake. Concurrently, exercise promotes thermogenesis in adipose tissue and regulates endocrine path-ways and key metabolic organs, such as skeletal muscle and the liver, to enhance fat oxidation and support energy balance. Despite advances in understanding exercise's role in obesity, the precise interaction between the neurobiological and peripheral metabolic pathways remains underexplored, particularly in public health strategies. A better understanding of these interactions could inform more comprehensive obesity management approaches by addressing both central nervous system influences on behavior and peripheral metabolic regulation. This review synthesizes recent insights into these roles, highlighting potential therapeutic strategies targeting both systems for more effective obesity interventions.

Biases in COVID-19 vaccine effectiveness studies using cohort design.

Observational studies on COVID-19 vaccine effectiveness (VE) have provided critical real-world data, informing public health policy globally. These studies, primarily using pre-existing data sources, have been indispensable in assessing VE across diverse populations and developing sustainable vaccination strategies. Cohort design is frequently employed in VE research. The rapid implementation of vaccination campaigns during the COVID-19 pandemic introduced differential vaccination influenced by sociodemographic disparities, public policies, perceived risks, health-promoting behaviors, and health status, potentially resulting in biases such as healthy user bias, healthy vaccinee effect, frailty bias, differential depletion of susceptibility bias, and confounding by indication. The overwhelming burden on healthcare systems has escalated the risk of data inaccuracies, leading to outcome misclassifications. Additionally, the extensive array of diagnostic tests used during the pandemic has also contributed to misclassification biases. The urgency to publish quickly may have further influenced these biases or led to their oversight, affecting the validity of the findings. These biases in studies vary considerably depending on the setting, data sources, and analytical methods and are likely more pronounced in low- and middle-income country (LMIC) settings due to inadequate data infrastructure. Addressing and mitigating these biases is essential for accurate VE estimates, guiding public health strategies, and sustaining public trust in vaccination programs. Transparent communication about these biases and rigorous improvement in the design of future observational studies are essential.

Determinants of cognitive health in the elderly: a comprehensive analysis of demographics, health status, and lifestyle factors from NHANES.

This study analyzes data from the National Health and Nutrition Examination Survey (NHANES) to identify factors influencing cognitive performance among the elderly, as measured by the Digit Symbol Substitution Test (DSST). Employing multivariable linear regression, we evaluated the impact of demographic, lifestyle, and health-related factors on cognitive function in U.S. adults aged 60 and older. Our findings indicate that advanced age, particularly in those aged 70-79 and 80 + years, is associated with lower DSST scores. Male gender is linked with reduced cognitive performance, while higher educational attainment appears protective. Lifestyle factors, including current smoking and higher alcohol consumption, negatively impact cognitive outcomes, and excessive sleep duration (over 9h) is also detrimental. Among health conditions, diabetes, chronic heart failure, and a history of stroke were associated with cognitive declines. Furthermore, increasing severity of depression correlates with lower cognitive function. These results underline the need for comprehensive public health strategies that integrate lifestyle modifications and chronic disease management to maintain cognitive health in older adults.

A Retrospective Analysis of Emergency Versus Elective Surgical Outcomes in Colon Cancer Patients: A Single-Center Study.

Introduction: Emergency surgical interventions for colon cancer are often associated with poorer outcomes compared to elective surgeries due to the advanced state of the disease and the urgency of intervention. This retrospective study aimed to evaluate the management of emergency management of colon cancer and to evaluate differences in patient outcomes. Conducted at a single surgical emergency center, the study analyzed 182 cases, focusing on demographics, tumor characteristics, surgical methods and patient outcomes. Material and Methods: A retrospective observational study was conducted, involving 182 cases who underwent surgery for colon cancer in a single surgical emergency center. Data was collected from hospital records, encompassing demographic details, tumor characteristics, surgical intervention detail and outcomes, alongside with inflammatory profiles. Statistical analyses included descriptive statistics and t-tests with standard significance at p < 0.05. Results: The study showed that emergency cases had significantly poorer in-hospital survival rates (75.42%) compared to elective surgeries. Inflammatory markers such as Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio were higher in emergency cases, suggesting heightened systemic stress. Emergency surgery was also associated with a higher incidence of ostomy and postoperative complications. Conclusions: Emergency surgery for colon cancer is linked to more advanced tumors, increased physiological stress and lesser clinical outcomes. Early detection strategies and active targeted screening could reduce the need for emergency interventions. Future research should focus on early diagnosis protocols and enhancing public health strategies to minimize emergency presentations, thereby leading to better outcomes for colon cancer patients.

Smoking Behaviour, Knowledge, Attitude, and Practice among Students of University of Aseer Region at KSA

Background: Tobacco smoking remains a major global public health challenge, contributing significantly to respiratory, cardiovascular, and neoplastic diseases. (9)In Saudi Arabia, smoking rates among college students are of particular concern, reflecting a growing need for targeted interventions.(10) Objective: This study aimed to assess the knowledge, attitudes, and practices regarding cigarette smoking among college students at the University of Bisha, Aseer region, to better understand smoking behavior and inform public health strategies.(12) Methods: A cross-sectional descriptive study was conducted using a self-administered questionnaire based on the Global Adult Tobacco Survey (GATS). (18) The study included 100 college students who were surveyed about their smoking status, knowledge, attitudes, and practices related to smoking. Data were analyzed using IBM SPSS software, version 24, with chisquare tests employed for statistical significance (p &lt; 0.05). Results: Among the 100 participants, 66.4% were never smokers, 23.6% were current smokers, and 10.0% were ex-smokers. The study found that male students were significantly more likely to be current or ex-smokers compared to female students. (16) Increased education level correlated with a decrease in smoking prevalence.(15) Knowledge levels about smoking's effects and attitudes towards smoking differed significantly between never smokers, current smokers, and ex-smokers. (19)The majority of never smokers and ex-smokers cited health concerns as their primary reason for avoiding or quitting smoking, while current smokers predominantly viewed smoking as a stress reliever.(14) Only 49.2% of current smokers consistently declared their smoking status to healthcare providers, and 61.0% received advice to quit.(11) Discussion: The study highlights a significant disparity in smoking prevalence and attitudes between genders and across education levels. The results suggest that enhanced awareness and educational interventions are needed, especially targeting current smokers and integrating effective cessation methods such as counseling and nicotine replacement therapy.(17) Conclusion: This study underscores the importance of improving knowledge and attitudes toward smoking to reduce smoking rates among college students. Early intervention, increased access to cessation resources, and targeted health education can play crucial roles in addressing smoking behaviors in this population.(13)

Fractional-Order Modeling of COVID-19 Transmission Dynamics: A Study on Vaccine Immunization Failure

COVID-19 is an enveloped virus with a single-stranded RNA genome. The surface of the virus contains spike proteins, which enable the virus to attach to host cells and enter the interior of the cells. After entering the cell, the virus exploits the host cell’s mechanisms for replication and dissemination. Since the end of 2019, COVID-19 has spread rapidly around the world, leading to a large-scale epidemic. In response to the COVID-19 pandemic, the global scientific community quickly launched vaccine research and development. Vaccination is regarded as a crucial strategy for controlling viral transmission and mitigating severe cases. In this paper, we propose a novel mathematical model for COVID-19 infection incorporating vaccine-induced immunization failure. As a cornerstone of infectious disease prevention measures, vaccination stands as the most effective and efficient strategy for curtailing disease transmission. Nevertheless, even with vaccination, the occurrence of vaccine immunization failure is not uncommon. This necessitates a comprehensive understanding and consideration of vaccine effectiveness in epidemiological models and public health strategies. In this paper, the basic regeneration number is calculated by the next generation matrix method, and the local and global asymptotic stability of disease-free equilibrium point and endemic equilibrium point are proven by methods such as the Routh–Hurwitz criterion and Lyapunov functions. Additionally, we conduct fractional-order numerical simulations to verify that order 0.86 provides the best fit with COVID-19 data. This study sheds light on the roles of immunization failure and fractional-order control.

Mpox Vaccine Hesitancy Among Brazilian Men Who Have Sex with Men: A National Cross-Sectional Study.

Mpox is a viral zoonosis that has gained increased attention due to a global outbreak in 2022, significantly impacting men who have sex with men (MSM). Vaccination for this disease poses a public health challenge; because it carries a strong stigma, there may be greater hesitancy in vulnerable groups. This study aimed to determine the prevalence and factors associated with Mpox vaccine hesitancy among Brazilian MSM. A cross-sectional study was conducted between September and December 2022 using an online survey targeted at MSM. Recruitment was carried out through social media and dating apps. The sample consisted of 1449 participants and the analysis involved bivariate logistic regression. The prevalence of Mpox vaccine hesitancy was 7.57%. The significant factors associated with hesitancy were primarily related to sexual practices and attitudes towards Mpox exposure and diagnosis, such as not using "glory holes" (aOR: 19.82; 95% CI: 1.60-245.69), reluctance to undergo pre- and post-exposure testing for Mpox (aOR: 9.54; 95% CI: 5.52-16.48), and not knowing close contacts diagnosed with Mpox (aOR: 4.09; 95% CI: 1.72-9.73). Participants who would not take precautions after diagnosis (aOR: 3.00; 95% CI: 1.27-7.07) and those who would not disclose their serological status (aOR: 1.93; 95% CI: 1.13-3.30) also showed a higher likelihood of vaccine hesitancy. Public health strategies should address these factors to expand knowledge about vaccination barriers, plan educational campaigns with targeted messaging for the MSM population, and provide inclusive healthcare environments to increase vaccine acceptance and reduce Mpox transmission in vulnerable groups.

Zoonotic Paramyxoviruses: Evolution, Ecology, and Public Health Strategies in a Changing World.

The family Paramyxoviridae includes a number of negative RNA viruses known for their wide host range and significant zoonotic potential. In recent years, there has been a surge in the identification of emerging zoonotic paramyxoviruses, particularly those hosted by bat species, which serve as key reservoirs. Among these, the genera Henipavirus and Pararubulavirus are of particular concern. Henipaviruses, including the highly pathogenic Hendra and Nipah viruses, have caused severe outbreaks with high mortality rates in both humans and animals. In contrast, zoonotic pararubulaviruses such as the Menangle virus typically induce mild symptoms or remain asymptomatic in human hosts. This review summarizes current knowledge on the evolution, ecology, and epidemiology of emerging zoonotic paramyxoviruses, focusing on recently discovered viruses and their potential to cause future epidemics. We explore the molecular mechanisms underlying host-switching events, viral replication strategies, and immune evasion tactics that facilitate interspecies transmission. In addition, we discuss ecological factors influencing virus emergence, including changes in bat populations and habitats and the role of wildlife-human interfaces. We also examine the public health impact of these emerging viruses, underlining the importance of enhanced surveillance, developing improved diagnostic tools, and implementing proactive strategies to prevent potential outbreaks. By providing a comprehensive overview of recent advances and gaps in knowledge, this review aims to inform future research directions and public health policies related to zoonotic paramyxoviruses.

Effect of diabetes mellitus type 2 and sulfonylurea on colorectal cancer development: a case-control study

Background and aimsColorectal cancer (CRC) is a significant global health concern, with studies estimating a rise in new cases to 2.5 million by 2035. Type 2 diabetes (T2D) is also a growing issue, with an estimated 642 million adults affected by 2040. However, the relationship between T2D, its medications, and CRC remains unclear.Materials and methodsThis case-control study includes 810 controls without CRC and 684 cases with CRC admitted to Rasoul-Akram and Firouzgar Hospitals from September 2019 to 2023. Adjusted and unadjusted odds ratios (OR) were calculated to investigate the effect of T2D and sulfonylurea consumption on the chance of CRC development, using univariate and multivariate logistic regression analyses. The relationship between T2D and the clinicopathological features of the tumor was investigated.ResultsThe results show that the effect of T2D on CRC is significant based on unadjusted OR (OR = 1.39, CI = 1.07, 1.81) and insignificant in adjusted OR (OR = 0.67, CI = 0.37, 1.20). The effect of sulfonylurea consumption on CRC was significant in both unadjusted (OR = 2.39, CI = 1.40, 4.09) and adjusted ORs (OR = 2.35, CI = 1.12, 4.91). All analyses related to the relationship between T2D and tumor clinicopathological characteristics were insignificant.ConclusionThis study found an insignificant association between type 2 diabetes and the chance of CRC development in an adjusted state. Sulfonylurea consumption was also associated with a higher chance of CRC development among patients with T2D. These findings have implications for clinical practice and public health strategies in CRC prevention for patients with T2D.

Preventing battery ingestion in children: public health strategies and technological innovations

Abstract Background Accidental ingestion of button batteries can cause severe and sometimes fatal injuries, such as chemical burns, esophageal perforations, and long-term complications. In response to this challenge, prevention strategies have evolved. A recent example of safety-targeted technological innovation includes new coin lithium batteries with more secure packaging, a non-toxic bitter coating to deter ingestion, and a ‘color alert technology’ that activates a blue dye upon contact with saliva. These features are designed to discourage ingestion and facilitate the rapid identification of an injury, allowing for timely medical intervention. Methods This abstract reviews the public health strategies proposed or implemented to prevent this serious type of injury, augmented by an analysis of data from the Susy Safe registry, which identified 1,115 cases of battery ingestion in children, and an additional 94 cases from the literature, totaling 1,209 injuries. Results The review of existing prevention strategies highlights various approaches, including public awareness campaigns, enhanced product regulations, and the implementation of stricter safety standards for batteries and devices. Analysis of Susy Safe data helps characterize the issue, underscoring the frequency and circumstances of battery ingestions and provides an empirical basis to assess the effectiveness of existing prevention strategies and to guide the development of new policies. The combination of technological improvements and legislative initiatives could represent a significant breakthrough in preventing these dangerous injuries. Conclusions While technological innovations are promising, effective prevention of battery ingestion will require a multifaceted approach that integrates technology, education, public policy, and regulatory oversight. Collaboration among manufacturers, lawmakers, health professionals, and the community is essential to reduce the incidence of these medical emergencies. Key messages • Accidental ingestion of button batteries can cause severe and sometimes fatal injuries. • The combination of technological improvements and legislative initiatives could represent a significant breakthrough in preventing button batteries in children.

Risk factors for the gambling, smoking and alcohol consumption triad in Portuguese adolescents

Abstract Background Addiction to gambling, tobacco, and alcohol poses significant risks to mental, social, and physical health, particularly during adolescence, a critical period for habit formation. This study investigates risk factors linked to these habits among Portuguese adolescents. Methods This cross-sectional study used the 2019 ESPAD questionnaire, targeting 16-year-old adolescents. The sample comprised 4,365 responses. Descriptive analysis determined the prevalence of gambling, smoking, and alcohol use, as well as social, economic, and behavioral factors. Bivariate associations were assessed using the Exact Fisher test, and multiple logistic regression identified key predictors for the outcome of interest (cumulative presence of gambling, smoking and alcohol consumption). Statistical analysis was conducted with SPSS version 29.0, with a significance level of p &amp;lt; 0.05. Results Among adolescents, 6.2% presented probable problematic gambling according to the Lie/Bet test, with 3.7% spending at least 30 minutes a day gambling. In the past 30 days, 14.3% smoked, 42.7% drank alcohol, and 10.5% engaged in binge drinking. The behavioral triad was observed in 56 individuals. Male gender (OR = 2.024; 95% CI: 1.097-3.734; p = 0.024), problematic online gaming behavior (OR = 2.041; 95% CI: 1.005-4.144; p = 0.048) and going out at night at least once a week (OR = 1.439; 95% CI: 1.242-1.669; p &amp;lt; 0.001) significantly increased the risk of the behavioral triad. In contrast, parental control (parents knowing where the adolescent is on Saturday night) had a significant protective effect (OR = 0.162; 95% CI: 0.086-0.303; p &amp;lt; 0.001). Conclusions The study underscores the importance of parental supervision to curb risky behaviors in adolescents. It suggests implementing public health programs in schools, leveraging gaming for early screening, and tightening online gambling regulations to mitigate future health risks associated with gambling, smoking, and alcohol use. Key messages • Absence of parental supervision, male gender, problematic online gaming and frequently going out at night are risk factors for this behavioral triad. • Public health strategies are needed to prevent gambling addiction, emphasizing parental awareness, identification of at-risk students, and comprehensive school-based approaches.

Maternal near-miss and mortality associated with being referred: a case control study in Luanda

Abstract Background Understanding of determinants of severe maternal morbidity is crucial for reducing Maternal Near Misses (MNM) and Maternal Deaths (MD). We aimed to assess whether being referred from lower level to tertiary-level hospitals is a determinant of MNM and MD in Luanda, capital of Angola. Methods A facility-based case control study was conducted (June-September 2022) at 2 referral hospitals in Luanda. Consecutive sampling for the cases (women admitted with life-threatening conditions) and systematic sampling for the controls (women admitted for vaginal delivery) was used. Cases were classified by the outcome at discharge: MD or MNM. Multivariate multinomial regression was conducted to assess whether being referred is associated with MNM and MD (controls as reference). Sociodemographic, clinical and obstetric factors and circumstances at admission related with MNM or MM (p-value &amp;lt;0.05) were included in the models. Reduced models (forward technic) were fitted for obtaining adjusted odds ratio (AOR) and respective 95% confidence interval (95%CI). Results Data from 331 cases (245 MNM and 86 MD) and 662 controls were analyzed and bivariate analysis revealed large differences between groups in regards to the sociodemographic, clinical and obstetric characteristics and circumstances of admission. The proportion of being transferred from another facility was 7.9%, 51.0% and 65.1% among controls, MNM and MD, respectively. After adjusting for pre-existing diseases during pregnancy, previous cesarean section and delay in seeking care, being referred from another facility increased the odds of MNM (AOR=10.97; 95%CI: 7.19-16.75) and MD (AOR=18.89; 95%CI: 10.50-33.89). Conclusions According to our findings, being referred from lower level facilities is a strong determinant of MNM and MD. Strategies for improving lower level of healthcare services and the referral system for pregnant women could have a positive impact on prevention of MNM and MD in our setting. Key messages • Awareness should be given to the conditions of maternal transfer from lower level to tertiary level hospitals in Angola. • Public health strategies should address the quality of maternal care at primary and secondary level hospitals, before maternal transfer, as well as, the maternal referral system in this setting.

The evolution of vaccine mandates: from historical perspectives to contemporary applications

Abstract Luigi Sacco pioneered efforts in 19th-century Italian vaccination campaigns when mandatory vaccination practices began as a public health strategy. We bridge past and present through a systematic review of both historical and contemporary vaccine mandate policies. While Sacco’s early initiatives, characterised by compulsory vaccination and effective communication strategies, set foundational principles for vaccine mandates, the modern era, especially during the COVID-19 pandemic, has seen a significant shift in the nature and application of vaccine mandates. Recent legislative changes across various countries have introduced stricter mandates aimed at managing public health crises. For instance, Italy and France, deeply impacted by reduced vaccine uptake and subsequent measles outbreaks, responded by reinforcing vaccine mandates. These countries aimed to mitigate the dual challenges of achieving high vaccination coverage and combating growing vaccine hesitancy. Comparative analysis of recent legislative changes reveals a trend towards increasing coerciveness in vaccine mandates, reflecting a blend of functional and political pressures driving government decisions. This trend is evident in the legislative adjustments made in California, Australia, France, and Italy, where heightened penalties and reduced exemptions were introduced to counteract declining public compliance. The synthesis of these experiences highlights the critical role of robust, credible communication and the nuanced application of mandates that consider societal and cultural contexts. Contemporary strategies are characterised by targeted interventions aimed at specific populations, reflecting the complex interplay of social, political, and health dynamics in vaccine policy. The enduring relevance of vaccine mandates underscores the necessity of flexible, responsive public health strategies that effectively address both long-standing and emergent vaccine hesitancy and coverage challenges. Speakers/Panelists Carlo Signorelli HSR, Milan, Italy Maria Gańczak Department of Infectious Diseases, University of Zielona Góra, Zielona Góra, Poland

Intra-specific variations in Schistosoma mansoni and their possible contribution to inconsistent virulence and diverse clinical outcomes.

Schistosoma mansoni was introduced from Africa to the Americas during the transatlantic slave trade and remains a major public health problem in parts of South America and the Caribbean. This study presents a comprehensive comparative analysis of three S. mansoni strains with different geographical origins-from Liberia, Belo Horizonte and Puerto Rico. We demonstrated significant variation in virulence and host-parasite interactions. We investigated the phenotypic characteristics of the parasite and its eggs, as well as the immunopathologic effects on laboratory mouse organ systems. Our results show significant differences in worm morphology, worm burden, egg size, and pathologic organ changes between these strains. The Puerto Rican strain showed the highest virulence, as evidenced by marked liver and spleen changes and advanced liver fibrosis indicated by increased collagen content. In contrast, the strains from Liberia and Belo Horizonte had a less pathogenic profile with less liver fibrosis. We found further variations in granuloma formation, cytokine expression and T-cell dynamics, indicating different immune responses. Our study emphasizes the importance of considering intra-specific variations of S. mansoni for the development of targeted therapies and public health strategies. The different virulence patterns, host immune responses and organ pathologies observed in these strains provide important insights for future research and could inform region-specific interventions for schistosomiasis control.

Ultra-processed food intake and type 2 diabetes: A dose-response meta-analyses of prospective studies

Abstract Studies suggested a positive association between ultra-processed food (UPF) intake and risk of type 2 diabetes (T2DM). However, the magnitude of association varies across studies due to differences in population characteristics and methodological issues. It is also unclear about the exact shape of the association and whether the association is independent of diet quality and adiposity. We conducted a dose-response meta-analysis of prospective studies to summarize the association between UPF intake and T2DM risk. PubMed/MEDLINE, Web of Science, and Embase were searched through Jan. 2024 to identify relevant studies. Using random-effects models, summary relative risks (RRs) and 95% confidence intervals (CIs) were estimated for each of the following unit increment in UPF intake: 10% (of total g/d), 100-g/d, and 1-serving/d. A non-linear dose-response meta-analysis was conducted using restricted cubic spline analysis. After screening 569 publications, 12 prospective cohort studies were included in this study. The summary RRs associated with every 10%, 100-g, and 1-serving increment in UPF intake were 1.13 (95% CI = 1.10-1.16), 1.05 (95% CI = 1.03-1.06), and 1.04 (95% CI = 1.03-1.05), respectively. The positive associations remained statistically significant after additional adjustment for diet quality, BMI, and total energy intake. The dose-response curve for g/d of UPF intake suggested evidence of nonlinearity (p-nonlinearity=0.0005), showing a steeper increase in risk at UPF intake &amp;gt;300 g/d. However, evidence for non-linearity was not observed with % and serving/d of UPF intake. The association did not significantly vary by method and timing of UPF assessment. Higher summary RRs were observed among studies from Europe and North America compared with those from other countries (p-heterogeneity=0.048). Our data suggest that higher UPF intake may increase T2DM risk, independent of diet quality and adiposity. Key messages • Higher intake of ultra-processed food is positively associated with the risk of type 2 diabetes. • Public health strategies should encourage healthier dietary choices by emphasizing reduction of UPF intake in dietary guidelines and implementing regulations on manufacturing and labeling of UPF.

Regional variation in incidence and mortality due to hypertension in Sao Tome and Principe

Abstract Background The analysis of incidence and mortality due to hypertension (HT) provides statistical data for addressing public health programs, particularly in low-income countries where poor health systems impose constraints to address non-communicable diseases (NCDs). This study aims to assess the geographic pattern of incidence and mortality due to HT in Sao Tome and Principe (STP). Methods This is a descriptive ecological study. Aggregated data on new cases of and deaths due to HT by gender, age-group and district (2022-2023) were extracted from the Health National Database (STP Ministry of Health). Age-standardized incidence and mortality rates (ASIR and ASMR) and respective 95% confidence interval (95%CI) were obtained. Mortality-to-incidence ratio (MIR) was computed by district (lower values indicate better quality of care). Comparison between districts was done through standardized incidence ratios (SIR) and respective p-value. Analyses were stratified by gender. Results ASIR and ASMR per 100,000 were, respectively, 1168.9 (95%CI:1103.3-1237.6) and 76.8 (95%CI:62.0-96.2) among men and 2460.6 (95%CI:2365.0-2559.0) and 99.7 (95%CI:81.4-121.6) among women. Incidence of HT was significantly higher than expected (p &amp;lt; 0.001) in Agua Grande, Caue and Lemba with SIR varying from 122.8% (Agua Grande) to 201.1% (Caue) in men and from 125.1% (Lemba) to 224.1% (Caue) in women. Instead, Mé-Zochi presented much lower incidence than expected for both, men (SIR=43.1%;p&amp;lt;0.001) and women (SIR=38.4%;p&amp;lt;0.001). Large differences between districts were observed in MIR, varying from 0% (Caue and Lobata) to 84% (Mé-Zochi) in men and from 0% (Lobata) to 57% (Mé-Zochi) in women. Conclusions According to our findings there is, not only, a high incidence rate of HT, but also regional variation in this rate, deserving particular attention from policy-makers. Regional variation in hypertension incidence could be partially explained by differences in the quality of healthcare services. Key messages • Awareness should be given to the high incidence of hypertension demanding preventive strategies in the field of public health. • Public health strategies should address the quality of care in regards to the prevention, diagnosis and monitoring of hypertension.

Global health

Abstract Global health emphasizes the importance of addressing health challenges that transcend national borders and require strong international collaboration and governance. This concept is grounded in collaborative transnational actions aimed at promoting health for all, reducing disparities, and protecting against threats. Strengthening health systems, public health infrastructure, improving health service delivery, and ensuring equal access to healthcare for all are key focus areas in global health. This plenary will address several major health challenges and critical issues, such as the rising burden of non-communicable diseases, re-emerging pandemics, environmental threats, and the suboptimal responses of national healthcare systems to manage these challenges. The need to focus on vulnerable and marginalized populations, particularly those affected by migration and ethnicity, will be highlighted. The discussion will also showcase the importance of including ethnic minority and Indigenous people’s perspectives in health policy and decision-making processes, as well as addressing the social determinants of health that disproportionately affect these communities. Central to the discussion on global health is the role of global health policy and diplomacy, focusing on how countries can collaborate to address health threats and challenges, shaping international strategies and frameworks. Innovation, including reverse innovation and the development of evidence-informed policies and effective public health strategies that can be implemented globally and is relevant also in resource-constrained contexts, is another critical aspect in addressing the intersection of health and development. Finally, strong public health leadership is needed to shape practices and policies, as well as fostering the next generation of global health leaders. The multifaceted nature of global health calls for a comprehensive approach to health—one that integrates policy, leadership, and equity into the core of public health strategies. The integration of health into all policies at the global level is vital for creating supportive environments, policies, services, and communications that promote better health for all. Moderators Iveta Nagyova President EUPHA Henrique Barros President ASPHER Speakers/Panellists Emma Rawson Te Patu President World Federation of Public Health Associations Charles Agyemang Professor of Global Migration, Ethnicity &amp; Health, University of Amsterdam, Netherlands Agnès Buzyn Former Minister of Health and Social Affairs, France Moredreck Chibi Public Health Innovation Lead, WHO Regional Office for Europe

7.N. Round table: Social media &amp; smartphones: Threats to child &amp; adolescent health and public health solutions

Abstract The daily lives of children and adolescents in 2024 are heavily influenced by social media and smartphones, which is unprecedented in previous generations. While this technology offers undoubted benefits, there is strong evidence on the negative effects of social and cognitive development of infants and primary school aged children, and mental health impacts in adolescents including depression, anxiety, sleep disruption, addictive behaviours and self-harm. Internet companies are financially incentivised to maximise screen time of users to generate advertising revenue, and more time spent by young people on these devices in a largely unregulated online domain increases risk of consequences like bullying and harassment, body dysmorphia, gambling addiction, porn addiction, sexual predation and suicide. Comprehensive solutions are urgently needed to regulate the activities of social media and tech companies and support young people to protect themselves from serious harms. Governments have been slow to introduce policies such as smartphone bans or enhanced privacy laws, perhaps because they are perceived as unpopular infringements on the rights of adult users and/or due to a potential detrimental effect on commercial interests. Guidance can be disseminated to young people, schools, families and institutions on how to reduce screen time and smartphone addiction, and improve coping and self-regulation to mitigate these risks. Information campaigns with positive health messages in this area, to compete with the advertising dominance of social media companies, are another opportunity to improve behaviours and reduce adverse health effects. The objectives of this round table workshop are to share examples of strategies, guidance and policies from across Europe, and discuss with the audience how the public health community can collaborate to tackle this problem. Members of the EUPHA Child and Adolescent Public Health (CAPH) section will outline the latest available evidence on the negative impacts of social media and screens, present examples of innovative public health responses and strategies to protect children, and engage conference participants for their input and discussion. Five panellists will present. First, John will start with a quiz of the audience which will include presentation of current data and trends relating to social media and smartphone usage. The second presentation by Cecilia will highlight in detail evidence of both benefits and adverse effects of these technologies in the lives of young people. The third speaker Karin will discuss examples of effective policies to reduce this impact, with a focus on the role of schools. The fourth speaker Jean will give further examples of public health actions, and share recommendations directly from children and young people. The fifth panellist Silja will re-quiz the audience, to gauge the reaction and support of solutions that were covered, and this will lead into the interactive discussion. Key messages • Popularity of smartphones and social media has increased dramatically in recent years, particularly among minors, with significant impacts on mental and physical health. • Public health solutions are urgently needed, and this workshop will share examples of effective innovative responses in European contexts, followed by an interactive audience discussion.

An Irish public health policy research team: impact and lessons learned, one year on

Abstract Issue In 2023, in Ireland, a public health policy research team was established in the Health Information and Quality Authority to conduct evidence syntheses and provide evidence-based advice to inform national decision-making, at the request of the Department of Health. One year on, we reflect on the impact of this team and outline lessons learned. These findings may support other countries in creating and developing public health policy research teams. Description of the problem We aim to answer the following questions: What impact can a public health policy research team have and what are the lessons learned, one year on? Projects completed by the team in 2023 were reviewed for stakeholder engagement (such as expert and public and patient involvement) and impact (feedback from policymakers, resulting public health actions or policies and online report downloads). Results Seven public health projects were completed in 2023, in areas including: Long COVID, public health reform, rapid multiplex testing, and medical countermeasure stockpiling. National and international stakeholders were engaged with via expert advisory group membership, document review and project presentations. Patient representatives were included from Long COVID Advocacy Ireland and Rare Diseases Ireland. Project reports were downloaded a total of 281 times. Positive feedback was received from all stakeholders. Project findings were presented to policymakers to inform national public health and rare disease strategy development, and the Long COVID model of care in Ireland. Lessons Early and ongoing stakeholder engagement is key when translating research to practice, via policy. Innovative methods of engagement, including public and patient involvement, can ensure meaningful collaboration. Adapting methodologies to meet stakeholder needs, such as rapid evidence synthesis, enhances impact. Lastly, research impact on policy takes time, and an understanding of national policy development is required. Key messages • A public health policy research team provides impactful evidence synthesis to advise national policymakers. • Stakeholder engagement is key to developing impactful policy advice.

1.C. Round table: Navigating the 17th European Public Health Conference: A Guide for First-Time Attendees

Abstract Are you attending the European Public Health Conference for the first time? If yes, this session is for you. Join us for an engaging session tailored specifically for first-time attendees of the 17th European Public Health Conference in Lisbon, Portugal. This session aims to provide newcomers with valuable insights and strategies to maximize their experience and effectively navigate the conference. Our seasoned conference veterans will share practical tips on a range of topics, including, but not being limited to: 1. Conference Navigation: Learn how to navigate the conference programme, the venue efficiently, locate sessions of interest, and make the most of your time between sessions. 2. Networking: Discover the importance of networking in the field of public health and gain strategies for initiating meaningful conversations, building professional relationships, and expanding your professional network. 3. Session Selection: Gain insights into selecting sessions and workshops that align with your interests, career goals, and areas of expertise. Learn how to prioritize your schedule and make the most of concurrent sessions. 4. Poster Presentations: Understand the significance of poster presentations and how to effectively engage with presenters. Discover techniques for synthesizing information and asking insightful questions. 5. Self-Care: Explore strategies for maintaining physical and mental well-being throughout the conference, including tips for managing fatigue, staying hydrated, and finding moments of relaxation amidst the hustle and bustle. Whether you’re a student, researcher, practitioner, or policymaker, this session will equip you with the tools and knowledge needed to navigate the 17th European Public Health Conference with confidence and make the most of this invaluable opportunity for professional development and networking. Key messages • First-time attendee at the European Public Health Conference? Don’t miss this tailored session for essential insights and strategies to maximize your experience in Lisbon. • Join seasoned veterans for practical tips on navigating the conference, networking effectively, selecting sessions, engaging with poster presentations, and prioritizing self-care. Speakers/Panelists Robert Klarecki EPH Conference Office Jinane Ghattas Sciensano, Brussels, Belgium