Status Report Research Articles

Global, Regional, and Country-Level Economic Impacts of Oral Conditions in 2019.

The recent World Health Organization (WHO) Oral Health Resolution and the subsequent WHO Global Oral Health Action Plan highlight the key relevance of providing information on the economic impacts of oral conditions. The purpose of this study was to provide updated estimates for the global, regional, and country-level economic impacts of oral conditions in 2019. Extending previously established methods, dental expenditures (costs for treatments) and productivity losses for 5 oral conditions (caries in deciduous and permanent teeth, periodontitis, edentulism, other oral diseases) were estimated for the year 2019. The estimated total worldwide economic impacts of oral conditions in 2019 were US $710B, of which US $387B (US $327B to US $404B) was due to direct costs and US $323B (US $186 to US $460) was due to productivity losses for the 5 main oral conditions. Low-income countries spent an average of US $0.52 (US $0.22 to US $0.96) per capita on dental care, while high-income countries spent an average of US $260 (US $257 to US $268) per capita-a 500-fold difference. These findings suggest that oral conditions continue to substantiate an enormous economic burden to individuals and society. The comprehensiveness of estimates supersedes that of previous work as the primary information on direct costs was identified for a larger number of countries. The need for more and better routine reporting and monitoring of the economic impact of oral conditions is emphasized. The relevance of such information is also highlighted by its inclusion in the first-ever WHO Global Oral Health Status Report and Global Strategy on Oral health 2023 to 2030. Given the persistently high economic burden of oral conditions, there is a key role for better prioritization of cost-efficient oral health programs as well as needs-responsive capacity planning.

The German Status Report on Climate Change and Health 2023

Abstract The German Status Report on Climate Change and Health was coordinated by the Robert Koch Institute, Germany’s public health institute, and published in 2023 through a collaboration of approximately 100 authors from 30 German institutions. It is an update of a similar report from 2010 and includes review articles and syntheses on the effects of climate change on human health through various influences such as heat, extreme weather, UV radiation, air pollutants and allergens, as well as the effect of climate change on infectious diseases through vector-borne, water-borne or food-borne pathogens. Literature reviews on the potential impact on antimicrobial resistance and mental health explore less well researched effects of climate change on health. The report discusses climate change communication and climate justice as cross-cutting issues and closes with an analysis of the options for action recommended throughout the preceding chapters. While the coordination of this report was funded by the German Federal Ministry of Health, the content was compiled by an advisory board of scientists and the authors recruited by them. The status report is published as 14 individual scientific papers in three issues of the peer-reviewed Journal of Health Monitoring and is available open access in English and in German in order to reach a large scientific audience. Besides the scientific audience, another target group are local authorities contributing towards adaptation and mitigation measures. Insights from the report are being communicated by diverse channels specifically to this latter group and are taken into consideration in the process of shaping the German Strategy for Adaptation to Climate Change.

The wisdom layer: how to support evidence-informed policymaking

Abstract One of the returning challenges faced by public health scientists is bridging the ‘evidence-policy gap’-the disparity between identifying public health issues and implementing policies to address them. Despite the extensive literature documenting the challenges of promoting evidence-informed policymaking, opportunities for researchers to exchange experiences and learn from each other’s failures are limited. This presentation seeks to: (a) analyze key concepts in evidence-informed policymaking, based on the health information pyramid; (b) identify obstacles and facilitators in the translation of knowledge into actionable policy; and (c) present both successful and unsuccessful examples from our initiatives to influence health policy in Belgium. Specifically, we will discuss the concrete impact of the Belgian Health Status Report and the role this report plays in the development of actionable health objectives for Belgium. We will also cover the role of healthybelgium.be in governing and monitoring the health status of the Belgian population by discussing why this website has been recognized by WHO Europe as a model of good practice in evidence-informed policymaking.

Ensuring sustainable impact of the national report on climate change and health in Germany 2023

Abstract Issue/problem The Robert Koch Institute recently coordinated a status report on climate change and health for Germany, detailing the current and future impact of climate change on health through 14 chapters. Description of the problem A central aim was to ensure the report’s long-term impact and public health value. Essential areas of focus have therefore been stakeholder-specific communication and establishing a network of experts for continued scientific exchange. Results The publication of the report as peer-reviewed articles has served to reach the scientific community. Another target group are public health practitioners and decision makers at subnational levels, who can contribute towards climate change mitigation and adaptation measures relevant to health, as recommended in the report. This latter group was reached through various methods and formats of science communication, including conferences aimed at the public health sector, through target-group oriented podcasts, social media engagement and digital town hall discussions. Following publication, the experts involved in writing, reviewing and using the report were invited to establish a network in order to support long-term scientific exchange and collaborations and in turn ensure the report’s sustainable impact and value. Lessons Through follow-up evaluations, the reception of the report and the further communication needs of this target group were analysed. A major lesson was to include the insights of public health practitioners more systematically and at an earlier stage in any future reports. As for the establishment of a network, a survey amongst the authors and other experts showed what this group considers the goals of this network: creating synergies and connections with existing initiatives and providing a platform for further exchange, especially amongst researchers addressing similar questions, such as the efficacy of mitigation and adaptation measures, from different angles. Key messages • Local public health practitioners are important stakeholders for climate change and health for ensuring public health impact. • The expertise in the network will support continued scientific exchange on climate change and health and thus ensure the national report’s sustainability.

The Welsh Health Equity Solutions Platform – a mechanism for health equity solutions

Abstract Health inequities are a longstanding issue in Wales, as they are across the globe. They disproportionately affect the health and wellbeing outcomes of disadvantaged groups, restricting opportunities to live full and prosperous lives. Post COVID-19 new groups are emerging with disproportionately higher risk of poor health and premature death and disease, especially those with unmet needs and vulnerabilities, with the rising cost of living amplifying health inequities. Despite their prevalence, health inequities are avoidable. Efforts to reduce health inequities require action on all the social determinants of health across the life course. Improved understanding of the key drivers of health gaps is needed to address the problem and provide support for solutions-driven action to break down the barriers to health equity. The Welsh Health Equity Solutions Platform (WHESP) launched on 22nd June 2023, a collaboration between Public Health Wales, Welsh Government and WHO European Office for Investment in Health and Development. The WHESP is an innovative digital tool developed around the WHO Health Equity Status Report initiative framework of the ‘five essential conditions’ for healthy, prosperous lives for all. It is a mechanism for health equity solutions and aims to inform and facilitate policy and decision making to improve population health and address the increasing health gap through an online gateway to data, health economics, policies, and innovative health equity tools. Emerging evidence is highlighted to identify solutions for achieving healthy equity, which informs evidence-based decision making to reduce the health gap, improve overall population health and wellbeing, and achieve inclusive and sustainable economic growth and prosperity for all. Collating and sharing health equity solutions, evidence, data and best practice both across Wales and globally supports equitable, long-term action to improve the health and wellbeing of the population. Key messages • Highlighting health equity solutions informs best practice on tackling health inequalities. • WHESP provides extensive evidence to facilitate cross-sectoral action and policy change.

Estimating the economic burden of mental and substance use disorders in Belgium

Abstract Mental and substance use disorders are the leading cause of disease burden (disability-adjusted life years, DALYs) in Belgium. Strong mental health policies are needed to reduce the burden, taking into account effectiveness and cost-effectiveness of possible interventions. Next to providing an overview of the economic burden of mental health conditions (what is), routine cost-of-illness studies also serve as a source of information for modelling the cost-effectiveness of policies and interventions to improve the mental health of populations (what could be). In the context of an extension of the Belgian Health Status Report and the Belgian National Burden of Disease Study, we calculated the direct medical costs of a range of health conditions, including mental health conditions such as depression. We used self-reported diagnostic data from the Belgian health Interview Survey linked with claims data to calculate the incremental costs attributable to mental health disorders with g-computation. We correct for confounders such as age and sex, and also look at uncertainty brought about by the data source and modelling. This presentation aims to share the experience of calculating the economic burden of mental ill-health in the context of a routine cost-of-illness study. We will present the results of the study and discuss alternative ways in which the costs of common mental health conditions such as depression could be estimated, for example based entirely on claims data using pharmaceutical cost groups.

The knowledge layer: the role of key messages for translating data into meaning

Abstract The large volume of data generated by health information systems often remains siloed within the institutions that produce it, posing significant challenges to its reuse and interpretation. This fragmentation can result in conflicting information on critical health topics, complicating the decision-making process for policymakers. To address this issue, Belgium has initiated the ‘Health Status Report’ website, hosted at healthybelgium.be. This website aims to synthesize and present health data in a manner that supports evidence-based policy formulation. The website adopts a structured approach to data integration and interpretation: initially, we identify and prioritize key health topics based on their relevance and the quality of available data. Subsequently, we merge and analyze data from diverse sources to discern patterns and trends that are crucial for public health monitoring. The insights gained are then presented through both narrative texts and interactive visualizations, facilitating access and understanding for a broad audience. Crucial to this process is ongoing communication with experts and stakeholders, ensuring that the data is not only accurately interpreted but also aligns with the needs and expectations of its users. We also aim to translate the raw data into meaningful key messages by consulting with internal and external experts. This interactive platform thus serves as a critical tool for translating complex health data into actionable knowledge, enabling informed public health strategies and interventions.

Erratum] Brain Imaging and neurostimulation in health and disorders: status report

INTRODUCTION: Despite being considered least important for clinical practice in the pyramid of evidence for recommendations, sometimes scientists' expert opinions could help to better understand the summarization of updated publications. OBJECTIVE: To provide a major summarized update about brain imaging and stimulation of the nervous system in health and disease. METHODS: Comprehensive review developed by experts in each subarea of knowledge in neuroimaging and non-invasive stimulation of the nervous system. A team of researchers and clinic experts was invited to present an update on their area of expertise. RESULTS: In basics on brain imaging techniques, we approach general and quantitative electroencephalography, functional magnetic resonance imaging, functional near-infrared spectroscopy, and experimental paradigms in brain imaging studies. Were included associations between transcranial magnetic stimulation and electromyography, electroencephalography, and functional near-infrared stimulation to evaluate brain activity. Furthermore, we showed several actualized central and peripheral neuromodulation techniques. And finally, we presented different clinical and performance uses of non-invasive neuromodulation. CONCLUSION: To our knowledge, this is a major summarized and concentrated update about brain imaging and stimulation that can benefit neuroscience researchers and clinicians from different levels of experience.

Experiences of Postpartum Follow-Up and Participation in a Lifestyle Intervention after Gestational Diabetes: A Qualitative Study

Background/Objectives: Gestational diabetes is associated with an increased risk of future type 2 diabetes and cardiovascular disease, but healthy lifestyle changes can prevent the development of these diseases. This study aimed to identify factors that can improve intervention programmes and postpartum support after gestational diabetes. Methods: Twenty-two women who had experienced gestational diabetes in Norway participated in in-depth interviews following a six-month intervention programme focusing on healthy lifestyle changes. Participants were included 3–12 months after giving birth. The data were analysed using reflexive thematic analysis. Results: Four themes were developed: (1) A status report on my health and lifestyle—crucial for recognising the need for change; (2) encouragement and cheering on: getting started and maintaining changes; (3) life’s challenging moments: looking after the baby and prioritising one’s own health; and (4) the first period with the newborn baby—a good time to make changes. Participants described maternity leave as a suitable time for lifestyle change. Adequate information about and insight into their health were important for success. The focus on small changes motivated them to improve their lifestyle. Participants emphasised individualised help, support from others, noticing an improvement and seeing a positive effect on their family members as motivational factors for maintaining the changes. However, they found it difficult to prioritise themselves and to maintain lifestyle changes in challenging life situations and transitional phases. Conclusions: The study findings can help support the development of future intervention programmes for women who have experienced gestational diabetes.

Excess dietary sugar and its impact on periodontal inflammation: a narrative review.

Sugar is omnipresent in the current food environment and sugar consumption has drastically risen over the past century. Extensive evidence highlights the negative health consequences of consuming excess dietary sugars, leading the World Health Organization (WHO) and the American Heart Association (AHA) to devise guidelines to restrict sugar intake. According to the WHO's Global Oral Health Status Report of 2022, oral diseases and severe periodontitis are a massive public health problem, and dietary sugars are a modifiable risk factor. We conducted a literature review using key databases to summarise the health effects of excessive sugar consumption and their potential role in periodontal inflammation. Available evidence suggests that excess dietary fructose and sucrose can cause low-grade systemic inflammation; and induce dysbiosis in both gut and the oral microbiota. Also, dietary sugar is potentially addictive and hypercaloric and its overconsumption can lead to obesity, metabolic syndrome, and other risk factors for periodontal inflammation. Hence, an unbalanced diet with excess dietary sugars holds the potential to initiate and aggravate periodontal inflammation. In the modern food environment that enables and facilitates a high-sugar diet, adopting a diverse diet and restricting sugar intake according to WHO and AHA guidelines seem beneficial to systemic and periodontal health. Since clinical evidence is limited, future research should study the effectiveness of dietary interventions that control sugar consumption in preventing and managing the global public health problem of periodontal inflammation.

Utilizing a medicinal plant and soil assays for heavy metal pollution assessment and its impacts in a Turkish Industrial Zone

Due to the worldwide growth in population, agricultural and industrial activities are expanding quickly, which pollutes the air, water, and soil and leads to the buildup of potentially hazardous substances in medicinal plants. The current study sought to determine the concentrations of various metals in Silybum marianum plants and soils in order to highlight the level of pollution in a Turkish Organized Industrial Zone in Dilovasi District, Kocaeli, and to investigate the effects of these heavy metals on plants. In order to determine the concentrations of elements evaluated within the scope of this study inductively coupled plasma optical emission spectroscopy was employed, due to the benefits of ICP that provides few or no organic molecules, few ionization interferences, as well as the ability to analyze many elements sequentially. Furthermore, in order to evaluate elemental analysis in terms of nutritional values, risk assessments using RDA, EDI, THQ, and HI parameters were conducted. The value of heavy metals in co-located soil samples is relatively high. However, except for Co, Mn, and Ni, it has stayed within the World Health Organization’s permitted limits. The evaluation of the co-located soil samples found that the highest contents (mg kg−1) of Al, Ca, Cd, Cr, Cu, Fe, K, Mn, Na, Ni, Pb, and Zn, were recorded as 7825.10, 4365.86, 4768.59, 2.50, 30.45, 38.49, 8352.00, 17452.26, 1495.82, 1495.82, 163.53, 1452.23, 28.67, 136.55 and 125.45, respectively, belonging to Location 1. These findings are in accordance with the Industrial Status Report since the place specified as Location 1 in the current study is characterized by its pronounced industrial activity and the robust electrical plant station with an industrial facility for generating electric power. Furthermore, the hazard index, the estimated daily intake and target hazard quotient for potentially harmful components and recommended daily allowance values for mineral nutrients were computed. Therefore, even though mineral nutritional values in some areas were found to be higher than Buyukada control location, this should be ignored. Consequently, this study warns against using S. marianum plants as food or medicine collected from current regions. As a result, ongoing inspection is necessary to prevent an excessive buildup of metals in the area and other places with similar human life-related features.

Big Data in Epidemiology: Brave New World?

Epidemiology is experiencing a significant shift toward the utilization of big data for health monitoring and decision-making. This article discusses the recent example of the World Health Organization (WHO) global oral health status report and regional summaries, which faced criticisms due to its reliance on big data from the Global Burden of Disease (GBD) study. We address the arguments for and against the use of big data in epidemiology and provide an assessment of the value and limitations of big data epidemiology. Moreover, we provide recommendations as to how the oral health community should reconcile traditional epidemiologic approaches with big data and advanced data analytics. This Perspective article highlights the challenges of the current epidemiologic landscape, the potential of big data, and the need for a balanced approach to data utilization in epidemiology.

The Budapest Tree-Ring Laboratory – Status report after 20 years of activity

AbstractThe Budapest Tree-Ring Laboratory (BTRL) is a fully equipped dendrochronological laboratory, established in 2002 at the Department of Paleontology and currently hosted by the Department of Physical Geography, Eötvös University, Budapest, Hungary. The lab has the proper sampling equipment for field work, a sanding workshop to prepare tree-ring samples for measurement and measuring-stages with software for recording and analyzing tree-ring data. Throughout the first 20 years of activity the BTRL collected and analyzed ∼360 living and ∼470 relict samples (including historical and subfossil material) from more than 33 sites distributed mainly in Europe but including a few localities in Asia. The most represented genera are Quercus and Pinus, both among the living and the relic subsets. Open access publication of the essential ancillary scientific information of the stored material will make the sample archive of the BTRL an actual national research infrastructure.

Diversity and Inclusion Issues in Physics in Asian Countries: A Status Report

The physics profession across Asia, like many other science and technology fields, faces ongoing challenges related to diversity, equity, and inclusivity (DEI). This report presents an overview of the current DEI landscape within the Asian physics community, with a particular focus on the participation and status of women in physics. It highlights the gender disparities prevalent in several Asian countries and reviews various initiatives aimed at addressing these issues, including institutional and government-led programs to support and empower women in the field. The findings underscore the need for sustained and collective action to foster an equitable and inclusive environment for all physicists across Asia.

Multisystemic Support Therapies for AKI in Latin America: Current Status and Preliminary Report

Multisystemic Support Therapies for AKI in Latin America: Current Status and Preliminary Report

Addressing India’s alcohol misuse crisis: The urgent need for screening and brief intervention to bridge the healthcare gap

India faces a significant challenge with alcohol misuse, as evidenced by the national survey revealing that 57 million out of 160 million persons with alcohol use exhibit harmful or dependent patterns, necessitating professional assistance. The Global Status Report on Alcohol and Health (2018) indicates a rising per capita alcohol consumption in the Southeast Asian Region, with India contributing substantially. To address this, implementing policies and programs to curb hazardous alcohol use is crucial. Despite a shortage of mental health professionals in India, they remain the primary caregivers for those with alcohol-related issues. Only one in five individuals with problematic alcohol use can access professional help. I argue for adopting Screening and Brief Intervention (SBI) to bridge this healthcare gap. SBI is a concise, structured counseling approach that proves effective and scalable. It can be delivered by various healthcare providers, including doctors, nurses, counselors, and paramedics. Hence, it can be seamlessly integrated into primary care, emergency, and nonclinical settings. The efficacy of SBI extends to electronic formats, providing a scope of expansion through telehealth. The WHO advocates SBI by its SAFER initiative aimed at reducing negative alcohol-associated health and social consequences. SBI is effective across age groups, including adolescents and young adults, constituting most of India’s population. Emerging evidence suggests that SBI is acceptable, feasible, and effective in the Indian context. Universal or targeted SBI can be a pivotal tool in achieving the Sustainable Development Goals (2030) and global commitments for noncommunicable diseases, fortifying efforts to prevent and treat alcohol misuse.

Status report on greenhouse gas emissions in lowland rice farming in Ivory Coast

Status report on greenhouse gas emissions in lowland rice farming in Ivory Coast

Capacity building for road safety in LMICs: the need for a sustainable local knowledge and research infrastructure

Road crashes continue to be a major cause of death and serious injury for low- and middle-income countries (LMICs). At the global level, 90% of traffic fatalities occur in these countries with a dramatic daily amount of 3 260 road deaths, many of whom are children. The first UN Decade of Action for Road Safety 2011–2020 was designed to develop a massive movement towards a decrease of these numbers. This resulted in many initiatives to introduce the safe system approach in LMICs, i.e. to implement road safety management, make roads, road users, and vehicles safer, and improve post-crash health care. International organisations together with NGOs and universities prepared road safety guides and manuals, gave courses and webinars, introduced auditing and inspection systems, with the overall intention to build capacity in LMICs. Together these actions contributed to a variety of road safety developments in LMICs but the overall results were still modest. At the third Global Ministerial Conference on Road Safety in Stockholm, 2020, and in the Global Status report by the World Health Organization, 2023, the results of all efforts were presented and evaluated. Many countries made progress through road safety management and better legislation addressing risk factors such as speeding, drinking and driving, failing to use seatbelts, and poor infrastructure design. However, the reduction in road deaths strongly lagged behind the original goals. Continued implementation of programs and development of new approaches are needed to make a breakthrough, and to reach the goals of the 2nd Decade of Action, i.e. a 50% reduction in fatalities by 2030, and the same percentage reduction in injuries. The present position paper argues that despite the enormous amount of road safety information, which has been and is ‘sent’ to LMICs, and despite the quality and robustness of international organisations behind these programs, there is a shortfall in the scale of the knowledge and research infrastructure currently existing in LMICs, which is needed to ‘receive and transfer’ this knowledge. In order to develop evidence-based policy, LMICs need research programs that are able to transfer safe system principles to the local context and culture. Several literature overviews illustrate the lack of such research in LMICs, i.e. the limited number of programs at local universities and research institutes. Although recently initiatives have been taken in some countries, the implementation of such programs is urgently needed. Based on this observation we call on international organisations to establish a special program for the development of a sustainable road safety knowledge and research infrastructure in LMICs. Such structural local capacity is a prerequisite to translate international road safety knowledge into local guidelines and to develop an evidence-based road safety policy. Most importantly, this local infrastructure will give countries a national knowledge bank, thus providing them with an urgently needed sustainable road safety memory.

Top causes of road traffic accidents in Romania

Abstract Road accidents worldwide impose a significant burden on national budgets, particularly affecting the least developed countries. According to the latest WHO “Global Status Report on Road Safety 2023,” road fatalities are the leading cause of death among young people aged 5 to 29. Among the European Union countries, Romania has the highest mortality rate. Between 2011 and 2021, approximately 2.8% to 1.1% of Romania’s GDP represented the social costs caused by road accidents. Statistical analysis of serious road accidents in Romania during this period reveals five main causes responsible for at least 50% of the total deaths recorded on the national public road network. The most significant cause is “speed not adapted to road conditions,” accounting for approximately 19% of the total. A road accident occurs due to the action or interaction of three determining factors: human, vehicle, and road (road environment). In most cases, the blame for road accidents is attributed to human error or behaviour. This conclusion is often influenced by data collection methods that do not consider all the influences of road infrastructure on the accident’s dynamics. A closer analysis shows that road infrastructure deficiencies often influence or cause road accidents, highlighting the importance of continuous evaluation and improvement of infrastructure to reduce accident risk. The implementation of Directive 2008/96/EC on road infrastructure safety management has prompted authorities to pay particular attention to infrastructure deficiencies in fatal accidents. During 2018-2021, following road safety inspections, auditors provided police and road administrators with detailed reports on deficiencies that caused or favored fatal accidents. Processing and analysing these reports can form the basis for developing a statistical model that provides a unified approach to road infrastructure deficiencies. This model can set up best practices for road safety, contributing to the uniform treatment of infrastructure problems found by auditors. With the transposition of Directive (EU) 2019/1936, which amends Directive 2008/96/EC, through Romanian Government Ordinance no. 3/2022, an innovative approach to managing road infrastructure deficiencies has been introduced. At the EU level, emphasis is placed on finding main road sections with low safety levels. Specific inspections are directed towards road sections with multiple risks, and remedial measures will focus on cost-effective solutions to enhance safety. Continuous evaluation and improvement of road infrastructure are crucial for reducing accident risk. By addressing deficiencies contributing to serious accidents, authorities can create safer road environments. This proactive approach involves detailed inspections and thorough data analysis to find and rectify potential hazards. The goal is to set up a system that not only responds to accidents but also prevents them by mitigating infrastructure risks. In conclusion, road safety management needs a multi-faceted approach that integrates human, vehicle, and road factors. By implementing directives and conducting rigorous inspections, authorities can significantly reduce road accidents. The development of a statistical model from inspection data will systematically address deficiencies, leading to safer roads and reduced fatalities, highlighting road safety as a public health issue.

Magnetohydrodynamical modeling of star-disk formation: from isolated spherical collapse towards incorporation of external dynamics

The formation of protostars and their disks has been understood as the result of the gravitational collapse phase of an accumulation of dense gas that determines the mass reservoir of the star-disk system. Against this background, the broadly applied scenario of considering the formation of disks has been to model the collapse of a dense core assuming spherical symmetry. Our understanding of the formation of star-disk systems is currently undergoing a reformation though. The picture evolves from interpreting disks as the sole outcome of the collapse of an isolated prestellar core to a more dynamic picture where disks are affected by the molecular cloud environment in which they form. In this review, we provide a status report of the state-of-the-art of spherical collapse models that are highly advanced in terms of the incorporated physics together with constraints from models that account for the possibility of infall onto star-disk systems in simplified test setups, as well as in multi-scale simulations that cover a dynamical range from the Giant Molecular Cloud environment down to the disk. Considering the observational constraints that favor a more dynamical picture of star formation, we finally discuss the challenges and prospects in linking the efforts of tackle the problem of star-disk formation in combined multi-scale, multi-physics simulations.