Challenges in finding and measuring behavioural determinants of childhood obesity in Europe.

AIM: Childhood obesity is an important concern for child health. However, despite widespread concern about the increase in childhood obesity, its causes are not monitored systematically in Europe. In 2007, the Scientific Platform Project on Lifestyle Determinants of Obesity identified routine data sources nationally available in European countries to measure childhood obesity. This work was revisited in 2014 to monitor any progress made. SUBJECT AND METHODS: In 2007, a literature review and project discussion resulted in a list of desirable indicators that could be collected in Europe to describe child populations at risk of overweight and obesity. Participants from EU member states, the EEA, Croatia, Macedonia and Turkey set out to discover which countries collected these indicators. Eight years later, a literature search sought to establish if the surveillance of children's nutrition and physical activity behaviour had changed. RESULTS: In 2007, no countries collected all variables for all ages, leading to major gaps in knowledge. A literature search carried out in 2014 suggests that this is unchanged. There remains inconsistency of data surveillance in Europe, and disagreement on which age groups to collect data from or how to define obesity and overweight. CONCLUSION: There is a lack of consistent data collection on upstream influences on obesity. The true causes of the childhood obesity epidemic remain undiscovered, and the ability of research to identify effective prevention and treatment methods is compromised

Health effects of ultrafine and fine particles in Central Europe : Results from the UFIREG study.

Background: Evidence on health effects of ultrafine particles (UFP) is still limited. The UFIREG project aimed at investigating the short-term effects of ultrafine and fine particles on daily (cause‑specific) mortality and morbidity in five European Cities. Methods: UFP (20-100nm) and fine particles <2.5µm (PM2.5) were measured in Dresden and Augsburg (Germany), Prague (Czech Republic), Ljubljana (Slovenia) and Chernivtsi (Ukraine). Meteorological data were obtained from country-specific network stations. Data on cause‑specific mortality and hospital admissions were collected for all cities. Depending on data availability the following periods were chosen: Augsburg and Dresden 2011-2012, Ljubljana and Prague 2012-2013, Chernivtsi 2013-March 2014. The effects of UFP and PM2.5 on health outcomes were assessed using confounder-adjusted Poisson regression models examining single (lag0-lag5) and cumulative lags (lag0-1, lag2-5, lag0-5). City-specific estimates were pooled using meta-analyses methods. Results: Results indicate delayed and prolonged increases in the pooled relative risk (RR) of respiratory mortality (lag5: 5.5%[95%-confidence interval:‑1.6;13.2]) and hospital admissions (lag0-5: 2.9%[‑2.8;8.9]) in association with a 2,750 particles/cm3 increase (average interquartile range across all cities) in UFP. Our findings point to delayed increases in the RR of cardiovascular mortality (lag3: 1.7%[-1.0;4.4]) and hospital admissions (lag5: 1.6%[0.1;3.1] with a 12.4 µg/m3 increase in PM2.5. We observed a 7.4%[4.7;10.2] increase in the RR of respiratory hospital admissions with an increase in the 6‑day average of PM2.5. Conclusions: Our results indicate delayed and prolonged effects of UFP on respiratory health outcomes. PM2.5 was associated with delayed effects on cardiovascular and respiratory health outcomes. Further multi-centre studies are needed investigating several years in order to produce powerful results and to draw definite conclusions on health effects of UFP

Associations between ultrafine and fine particles and mortality in five central European cities - results from the UFIREG study.

BACKGROUND: Evidence on health effects of ultrafine particles (UFP) is still limited as they are usually not monitored routinely. The few epidemiological studies on UFP and (cause-specific) mortality so far have reported inconsistent results. OBJECTIVES: The main objective of the UFIREG project was to investigate the short-term associations between UFP and fine particulate matter (PM)<2.5μm (PM2.5) and daily (cause-specific) mortality in five European Cities. We also examined the effects of PM<10μm (PM10) and coarse particles (PM2.5-10). METHODS: UFP (20-100nm), PM and meteorological data were measured in Dresden and Augsburg (Germany), Prague (Czech Republic), Ljubljana (Slovenia) and Chernivtsi (Ukraine). Daily counts of natural and cardio-respiratory mortality were collected for all five cities. Depending on data availability, the following study periods were chosen: Augsburg and Dresden 2011-2012, Ljubljana and Prague 2012-2013, Chernivtsi 2013-March 2014. The associations between air pollutants and health outcomes were assessed using confounder-adjusted Poisson regression models examining single (lag 0-lag 5) and cumulative lags (lag 0-1, lag 2-5, and lag 0-5). City-specific estimates were pooled using meta-analyses methods. RESULTS: Results indicated a delayed and prolonged association between UFP and respiratory mortality (9.9% [95%-confidence interval: -6.3%; 28.8%] increase in association with a 6-day average increase of 2750particles/cm(3) (average interquartile range across all cities)). Cardiovascular mortality increased by 3.0% [-2.7%; 9.1%] and 4.1% [0.4%; 8.0%] in association with a 12.4μg/m(3) and 4.7μg/m(3) increase in the PM2.5- and PM2.5-10-averages of lag 2-5. CONCLUSIONS: We observed positive but not statistically significant associations between prolonged exposures to UFP and respiratory mortality, which were independent of particle mass exposures. Further multi-centre studies are needed investigating several years to produce more precise estimates on health effects of UFP

Ultrafine and fine particles and hospital admissions in Central Europe: Results from the UFIREG study.

RATIONALE: Evidence on short-term effects of ultrafine particles (UFP) on health is still inconsistent and few multi-center studies have been conducted so far especially in Europe. OBJECTIVES: Within the UFIREG project, we investigated the short-term effects of UFP and fine particulate matter <2.5 µm (PM2.5) on daily cause-specific hospital admissions in five Central and Eastern European cities using harmonized protocols for measurements and analyses. METHODS: Daily counts of cause-specific hospital admissions were obtained for Augsburg and Dresden (Germany) 2011-2012, Chernivtsi (Ukraine) 2013-March 2014, Ljubljana (Slovenia) and Prague (Czech Republic) 2012-2013 focusing on cardiovascular and respiratory diseases. Air pollution and meteorological data were measured at fixed monitoring sites in all cities. We analyzed city-specific associations using confounder-adjusted Poisson regression models and pooled the city-specific effect estimates using meta-analyses methods. MAIN RESULTS: A 2,750 particles/cm3 increase (average interquartile range (IQR) across all cities) in the 6-day average of UFP indicated a delayed and prolonged increase in the pooled relative risk of respiratory hospital admissions (3.4% [95%-confidence interval:-1.7%;8.8%]). We also found increases in the pooled relative risk of cardiovascular (exposure average of lag 2-5: 1.8% [0.1%;3.4%]) and respiratory (6-day average exposure: 7.5% [4.9%;10.2%]) admissions per 12.4 µg/m3 increase (average IQR) in PM2.5. CONCLUSIONS: Our findings indicated delayed and prolonged effects of UFP exposure on respiratory hospital admissions in Central and Eastern Europe. Cardiovascular and respiratory hospital admissions increased in association with an increase in PM2.5. Further multi-center studies are needed using harmonized UFP measurements to draw definite conclusions on health effects of UFP

Tobacco use among medical students in Europe: results of a multicentre study using the Global Health Professions Student Survey

To examine smoking prevalence, knowledge and attitudes, and tobacco cessation training among university students attending European medical schools using the Global Health Professional Students Survey approach

Methodology for measuring environmental health within Europe. Health Risk from Environmental Pollution Levels in Urban Systems (HEREPLUS)

Background: The European Commission funds a European research project titled "Health Risk from Environmental Pollution Levels in Urban Systems" (HEREPLUS) that focuses on environmental health within Europe. The HEREPLUS project was presented at the 16th EUPHA conference in Lisbon in November 2008 within a workshop named "The assessment of the effect of air pollution on population and environmental health: the integration of epidemiology and geographical information system (GIS)". Methods: The HEREPLUS project aims to measure the correlation between air pollution (especially ozone and particulate matter), meteorology, vegetation and human health in four European cities (Rome, Madrid, Athens and Dresden) by using a Geoinformation System to develop risk maps and subsequently guidelines to reduce air pollution and number of diseases. Results: The project started in September 2008 and a large, structured, relational database has been developed and completed. A literature review including national as well as international scientific literature goes on and will be completed in April 2009. Final results will be presented and published in 2011. Conclusions: Detailed scientific knowledge is important and needed to implement environmental programmes with the overall aim to protect human population against environmental related diseases

Essential Skills for Health Communication, Barriers, Facilitators and the Need for Training: Perceptions of Healthcare Professionals from Seven European Countries

Many healthcare professionals are unaware of the necessary skills and barriers hindering interpersonal health communication. This study aimed to evaluate the healthcare professional's perception regarding health communication training's necessity, barriers, facilitators and critical skills in health communication. Data from a cross-sectional online survey in the framework of the H-Com project were utilized. The study included 691 healthcare professionals (physicians, nurses, students and allied health professionals) from seven European countries. Only 57% of participants had participated in health communication training, while 88.1% of them indicated a willingness to be trained in health communication. Nurses were more likely (OR = 1.84; 95% CI 1.16, 2.91) to have received such training, compared to physicians. Most examined communication skills, barriers and facilitators of effective communication, and perceived outcomes of successful communication were considered crucial for most participants, although physicians overall seemed to be less concerned. Most agreed perceived outcomes were improved professional-patient relations, patient and professional satisfaction, physical and psychological health amelioration and patients' trust. Nurses evaluated the importance of these communication skills and communication barriers, facilitators and outcomes higher than physicians. Physicians may underestimate the importance of communication skills more than nurses. Health communication should become an integral part of training for all health professionals