European Journal of Public Health最新文献

{"title":"Retention of health and care workers needs more than listening to needs: towards an active role in governance and a comprehensive implementation strategy.","authors":"Ellen Kuhlmann, André Beja, Monica Brinzac, Alicja Domagala, Martijn Felder, Ber Oomen, Erica Richardson, Tomas Zapata, Tiago Correia","doi":"10.1093/eurpub/ckag186","DOIUrl":"10.1093/eurpub/ckag186","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatitis B screening among asylum seekers: a retrospective cohort study in Modena, Northern Italy.","authors":"Riccardo Mazzoli, Lucia Borsari, Maria La Torre, Zaynalabedin Kahfian, Alessandra Fantuzzi, Marco Vinceti, Annalisa Bargellini, Tommaso Filippini, Stefania Paduano","doi":"10.1093/eurpub/ckag188","DOIUrl":"10.1093/eurpub/ckag188","url":null,"abstract":"<p><p>Hepatitis B virus remains a major health challenge among migrants from high-endemic regions arriving in low-endemic countries like Italy. However, more evidence on both infection burden and immunity gaps among asylum seekers is needed to inform prevention policies. We conducted a retrospective cohort study of 739 asylum seekers screened for Hepatitis B virus (HBV) in Modena, Northern Italy, between 2019 and 2023. Serological testing included quantitative determination of HBsAg, HBcAb, and HBsAb, allowing identification of active infection, natural immunity, vaccine-induced immunity, and susceptibility. Demographic characteristics, geographic origin, and migration routes were analyzed in relation to HBV status. Participants were predominantly male (94.7%), with a mean age of 27.2 years, and originated mainly from South Asia (59.4%) and Sub-Saharan Africa (26.1%). Overall HBsAg prevalence was 4.1%, substantially higher than what reported for the Italian general population (<1%). Prevalence was highest among Sub-Saharan African migrants (7.3%), who also showed the greatest proportion of natural immunity (36.3%), while South Asian migrants had a prevalence of 3.6% and Northern African migrants null. Among HBsAg-negative individuals, 57% were susceptible to HBV infection, particularly those from South Asia and Northern Africa. Susceptibility was associated with male sex (OR 4.08, 95% CI 1.34-12.44) and age ≥25 years (OR 2.38, 95% CI 1.40-4.04), consistent with birth before the introduction of universal HBV vaccination in many countries. Most HBsAg-positive individuals reported transit through Libya. Asylum seekers in Italy show a high prevalence of HBV infection alongside substantial immunity deficits. Systematic screening and targeted catch-up vaccination should be prioritized within migrant health services as a key public health intervention.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13686764/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149237380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns and potential indications of WHO AWaRe Watch antibiotic use across UK community and hospital care: a national observational study.","authors":"Elin J Rowlands, Cecilia Campanile, Hiba Junaid, Jennifer C E Lane, Usama Rahman, Ben Eaton, Xavier L Griffin, Andy South, Ana Cavalcante, Duncan Cartner, Steve Harris, Ofran Almossawi, Lydia Briggs, Daniel Key, Prasiddha Khadka, Timothy Howcroft, Vishnu Vardhan Chandrabalan, Peter S Hall, Mahéva Vallet, Marta Pasikowska, Nicola Symmers, Colin McLean, Spyro Nita, Daniel Dedman, Zara Cuccu, Stelios Theophanous, Geoff Hall, Martí Català, Daniel Prieto Alhambra, Edward Burn, Danielle Newby","doi":"10.1093/eurpub/ckag198","DOIUrl":"10.1093/eurpub/ckag198","url":null,"abstract":"<p><p>There are major concerns regarding the risk of antimicrobial resistance evoked through the inappropriate use of antibiotics. The WHO AWaRe classification has identified antibiotics that have high resistance potential. This cohort study utilized data from seven UK databases, including two community care databases and five hospital databases. The study period was from 2012 to 2025, or from the start of electronic prescription data. Longitudinal trends in Watch antibiotic use and patient demographic information were summarized. Data-driven large-scale characterization was used to identify conditions of interest, and prior use of Access and other Watch antibiotics was summarized. The study included 433 368 hospital and 11 705 843 primary care records of Watch antibiotic use. Quarterly crude incidence rates showed seasonal variation in community prescribing, with rates generally higher in the third and fourth quarters. Although use in community care increased during the COVID-19 pandemic, it remained below prepandemic levels. Most community users were female, while most hospital users were male. Hospital users had more severe conditions, including healthcare-associated infections and sepsis, while community care users were more commonly treated for skin and respiratory tract infections. Prior Access antibiotic use was generally recorded in fewer than 50% of patients. Prior Access of Watch antibiotic use was minimal in community care. Our results highlight the complexity of antibiotic use across different healthcare settings. Regional and demographic variation indicates areas where prescribing practices could be refined. Ongoing surveillance and targeted stewardship interventions are essential to promote appropriate use and prevent resistance.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13728849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149319384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The underdeveloped population dimensions of inoculation theory in public health.","authors":"Josh Compton","doi":"10.1093/eurpub/ckag195","DOIUrl":"10.1093/eurpub/ckag195","url":null,"abstract":"","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13722440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149295619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access without published appraisal: orphan medicine reimbursement and health equity in Türkiye.","authors":"Ferit Sevim, Çağdaş Erkan Akyürek","doi":"10.1093/eurpub/ckag204","DOIUrl":"10.1093/eurpub/ckag204","url":null,"abstract":"<p><p>Rare diseases are individually uncommon but collectively affect a substantial share of any population. The medicines developed for them combine severe conditions, very small treatable populations, high prices, and evidence that is often immature at launch. Conventional cost-effectiveness analysis handles this poorly, and systems relying on it heavily tend to reimburse fewer orphan medicines than those applying alternative evidence standards. Türkiye offers an instructive current case. Of the 66 orphan medicines granted central marketing authorization in the European Union between 2021 and 2024, 3 were available in Türkiye at the start of 2026, against a European Union average of 28. The comparable figure for all new medicines was 9 of 168, against an average of 76. Restricted access to orphan medicines should therefore not be read solely as an orphan-specific exclusion, but as part of a broader constraint on new medicines, distinguished by one feature: a parallel route in which medicines are authorized for named patients, imported, and reimbursed outside the standard list. That route carries real access that list-based indicators capture only in part, and it makes a patient entitlement depend on which list a medicine occupies. A rule issued in June 2026 restricting reimbursement of spinal muscular atrophy medicines after gene replacement therapy illustrates the limited public availability of the clinical and economic reasoning behind reimbursement restrictions. Broadening the basis of appraisal, rather than reducing reliance on economic evaluation, requires published criteria, instruments for managing uncertainty, and monitoring of the pathway as well as the list.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13734380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149333067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social inequality in COVID-19-related morbidity and mortality during the first three waves of the pandemic in Denmark: a nationwide register-based cohort study, 2020-22.","authors":"Thora M Kjærulff, Mikkel B Nielsen, Michelle T Pedersen, Kristine Bihrmann, Janne S Tolstrup, Annette K Ersbøll","doi":"10.1093/eurpub/ckag196","DOIUrl":"10.1093/eurpub/ckag196","url":null,"abstract":"<p><p>This nationwide cohort study aimed to examine social inequality in coronavirus disease 2019 (COVID-19)-related morbidity and mortality in Denmark during the first three pandemic waves using different individual-level measures of socioeconomic position. Additionally, the study aimed to investigate potential changes in social inequality in COVID-19-related morbidity and mortality throughout the pandemic. The cohort comprised the total Danish population. Individual-level, linkable register data were extracted and analysed for all residents of Denmark across the first three pandemic waves (26 February 2020-15 April 2022). Poisson regression of incidence rates (IR) was performed to compare COVID-19-related morbidity and mortality rates between individuals grouped according to length of educational, household income, and employment status. Social inequality in COVID-19-related hospitalization, ICU admission, and mortality was observed across the three measures of socioeconomic position. The social inequality in COVID-19-related hospitalization and ICU admission increased throughout the pandemic. The incidence rate ratio (IRR) for COVID-19-related hospitalization for individuals with elementary vs. long education increased from 0.93 [95% confidence interval (CI): 0.83-1.05] in wave 1 to 1.75 (1.67-1.84) in wave 3. The corresponding changes in IRRs for low vs. high household income and unemployed vs. employed individuals were 0.87 (0.75-1.01) to 1.83 (1.71-1.95) and 1.04 (0.86-1.25) to 3.23 (3.02-3.45), respectively. Social inequality in COVID-19-related morbidity changed during the pandemic. Interventions that reduce differential vulnerability to and consequences of COVID-19 between groups defined by socioeconomic position seem to be increasingly important as pandemics evolve.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13722283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149295569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intergenerational patterns of overweight and obesity among parents and preschool children: a population-based study in Sweden 2010-18.","authors":"Hasanka Kodagoda, Marie Lindkvist, Anneli Ivarsson, Sven-Arne Silfverdal, Masoud Vaezghasemi","doi":"10.1093/eurpub/ckag201","DOIUrl":"https://doi.org/10.1093/eurpub/ckag201","url":null,"abstract":"<p><p>Childhood overweight and obesity (OWOB) are important public health concerns and parental BMI is associated with childhood adiposity. Less is known about the joint associations of maternal and paternal OWOB with childhood OWOB and obesity and this is the aim of this study. This population-based repeated cross-sectional study included 5937 three-year-old children and their parents from the Salut Programme in Västerbotten, Sweden, linked to national register data. Logistic regression was used to examine associations between parental BMI categories and child OWOB and obesity. Additive interaction between maternal and paternal obesity was further explored. The prevalence of OWOB among 3-year-old children was 15.3% including 2.4% with obesity. Maternal and paternal OWOB and obesity were associated with children's OWOB and obesity, while no clear associations with parental socioeconomic or lifestyle factors were observed in this sample. Children with two parents with obesity had the highest observed prevalence of both outcomes. In adjusted analyses, the odds of child obesity were more than 3× higher when both parents had obesity than when neither had obesity. The findings indicate a possible positive departure from additivity. Parental OWOB and obesity were associated with children's OWOB and obesity at 3 years of age, with the highest observed odds among children with two parents with obesity. No clear associations with parental socioeconomic or lifestyle characteristics were observed in this sample. These findings highlight an intergenerational pattern in weight status and the importance of considering parental weight status in early childhood obesity prevention.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149370102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shaping public health policy in personalized prevention: the multidimensional PROPHET framework.","authors":"Astrid Moura Vicente, Angelica Valz Gris, Cristina Costa, Maria Luis Cardoso, Alexandra Costa, Fátima Lopes, Pragathy Kannan, Markus Perola, Roberta Pastorino, Angelo Maria Pezzullo, Stefania Boccia","doi":"10.1093/eurpub/ckag180","DOIUrl":"10.1093/eurpub/ckag180","url":null,"abstract":"<p><p>There is currently no widely accepted framework to guide decision-making for preventive approaches using genetic and genomic technologies. In the context of the PROPHET project, we developed a multidimensional framework integrating Health Technology Assessment and Health Impact Assessment, complemented by a monitoring phase to assess the impact of policies implementing personalized prevention interventions. This integrated approach links technical, clinical, and societal dimensions, supporting prevention strategies that are effective, equitable and sustainable. The PROPHET framework supports policy makers in the equitable and efficient implementation of personalized prevention policies at scale.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149180368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-time incidence of ischemic heart disease among immigrants in Sweden: variation by country of origin, duration of residence, and immigrant generation in a nationwide cohort study.","authors":"Daniel Nigusse Tollosa, Kazem Zendehdel, Sol P Juarez, Alexander Miething, Andrea Dunlavy, Mikael Rostila","doi":"10.1093/eurpub/ckag192","DOIUrl":"https://doi.org/10.1093/eurpub/ckag192","url":null,"abstract":"<p><p>As Sweden's immigrant population has become increasingly diverse and many countries of origin have undergone an epidemiological transition with rising cardiovascular disease (CVD) risk factors, understanding disparities in ischemic heart disease (IHD) among immigrants and their descendants has become increasingly important. This nationwide registry-based cohort study included over 8.5 million individuals aged 35-85 years [50.1% women; 18.2% first-generation (G1) and 9.4% second-generation (G2) immigrants] who followed from 1993 to mid-2023. Adjusted Cox regression models were used to examine associations between migrant-related factors-including country of origin, duration of residence, period of immigration, and immigrant generation-and first-time IHD incidence. During follow-up, 703 212 first-time IHD events occurred. Compared with Swedish-born individuals, G1 immigrants from the Nordic countries, the Middle East, and selected Asian countries (Afghanistan, Pakistan, India, and Sri Lanka), as well as G2 individuals with Finnish parental origin, had a higher risk of IHD. The highest risks were observed among recent immigrants from the Middle East and among immigrants with the shortest duration of residence. Risk generally declined with increasing duration of residence and became lower than that of the reference population in many immigrant groups. Although age-standardized IHD incidence rates declined over the past three decades, the pace of decline varied across immigrant groups and was slowest among Asian immigrants. In conclusion, most immigrant groups, particularly recent immigrants from the Middle East and immigrants with the shortest duration of residence, had a higher risk of IHD. Tailored cardiovascular prevention strategies are essential to reduce these disparities among immigrants in Sweden.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149370101","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is adherence to the 24-hour movement guidelines related to a lower risk of cardiovascular events? A prospective cohort study including 13 897 participants from the SUN project.","authors":"Alexander Finnemore, Reyes Viñals Soler, Maira Bes-Rastrollo, Miguel Ángel Martínez-González, Alejandro Fernandez-Montero","doi":"10.1093/eurpub/ckag191","DOIUrl":"https://doi.org/10.1093/eurpub/ckag191","url":null,"abstract":"<p><p>Cardiovascular disease (CVD) remains the leading global cause of death, and preventive interventions are likely to be the most effective strategies. The 24-hour movement guidelines emphasize an integrated score, including physical activity (PA), sedentary time, and sleep. The combined effect of adhering to all three 24-hour movement guidelines on CVD events remains unclear. In a prospective assessment of 13 897 Spanish university graduates from the Seguimiento Universidad de Navarra cohort, the relationship between a comprehensive exposure (adherence to all three 24-hour movement guidelines) and CVD incidence was investigated. Participants completed baseline questionnaires from 1999, with biennial follow-up. Exposure was assessed using the Canadian 24-Hour Movement Guidelines: ≥ 150 minutes/week of moderate-to-vigorous PA, ≤ 8 hours/day sitting, and 7-9 hours/night sleep (or 7-8 hours for ≥ 65 years). A composite score (0-3 points) was calculated for the exposure. The primary endpoint was incident CVD (nonfatal myocardial infarction, stroke, cardiovascular death). Nearly half (46.68%) of participants met all three guidelines, while only 0.96% met none. Over a mean follow-up of 14.48 years, 148 cardiovascular event (CVE) occurred. Fully adjusted models revealed a significantly reduced CVE risk for participants meeting two [hazard ratio (HR) = 0.37; 95% confidence interval (CI): 0.14-0.99], or three (HR = 0.36; 95% CI: 0.14-0.95) guidelines compared to meeting none. Adherence to at least two of the 24-hour movement guidelines appears to be associated with a lower risk of CVEs. These findings suggest that a comprehensive approach to daily movement behaviors may play a beneficial role in CVD prevention. Public health strategies could consider promoting these integrated guidelines as part of broader efforts to improve cardiovascular health.</p>","PeriodicalId":12059,"journal":{"name":"European Journal of Public Health","volume":"36 6","pages":""},"PeriodicalIF":5.2,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13695055/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149264772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}