EuroHealthNet

<title>Abstract</title> Purpose Contemporary food systems pose challenges for both human and planetary health. This study aimed to assess and compare adherence to the Planetary Health Diet (PHD) in nine European countries. Methods Nationally representative dietary surveys (post-2013) from Estonia, Finland, France, Hungary, the Netherlands, Portugal, Spain, Switzerland, and the United Kingdom, with ≥ 2 non-consecutive 24-hour recalls, were used (n = 16,083 adults). Adherence to the PHD was assessed at two levels: 1) compliance for each food group, calculated as the intake relative to the corresponding PHD targets, and 2) overall adherence, captured by three valid dietary indices. Multivariate regression analyses were conducted to identify associations with demographic factors. Results Dietary patterns across Europe were characterized by insufficient intake of plant-based foods (whole grains, legumes, nuts, vegetables, and unsaturated oils) relative to PHD targets, alongside excessive consumption of foods to limit (red meat, saturated fats, and added sugars). Spain, Portugal, and the Netherlands showed comparatively better alignment with the PHD, whereas Hungary, the United Kingdom, and Estonia had the lowest scores. Red meat, particularly pork, and added sugars were the primary drivers of low scores across PHD indices. Being female, older, and having a higher level of education were positively associated with PHD adherence. Conclusion European diets show systematic deviations from the PHD. Targeted and multilevel policies are needed to promote healthy and sustainable diets.

Abstract Antimicrobial resistance (AMR) is a pressing global health crisis, exacerbated by a stagnating antibiotic discovery pipeline and the emergence of multidrug-resistant pathogens such as Klebsiella pneumoniae . We hypothesize that dual-target strategies may offer a more robust means to overcome AMR by reducing the likelihood of resistance development compared to single-target approaches. In response, we leveraged Moremi Bio Agent, an agentic large language model (LLM) for the autonomous design, in silico validation, and prioritization of broad-spectrum antibiotics targeting Enterobacteriaceae. Using our proposed dual-target strategy, we generated and evaluated 1,002 candidate molecules predicted to simultaneously inhibit the FabI enzyme and the AcrAB–TolC efflux pump—two key resistance mechanisms in Gram-negative bacteria. Our fully autonomous pipeline integrated compound generation, molecular docking, pharmacodynamics/pharmacokinetic predictions &amp; toxicity profiling, and molecule-ranking based on ADMET and drug-likeness properties. Out of 1,002 molecules generated, 774 passed preliminary ADMET benchmarks, with majority of the 60 top-performing candidates (score ≥ 0.8) showing favorable drug-likeness, minimal toxicity. 391 of the compounds exhibited moderate binding interaction to both targets. This study demonstrates the feasibility of AI-driven antibiotic discovery and lays the foundation for future experimental validation to address AMR.

The burden of chronic disease in Europe continues to grow. A major challenge facing national governments is how to tackle the risk factors of sedentary lifestyle, alcohol abuse, smoking, and unhealthy diet. These factors are complex and necessitate intersectoral collaboration to strengthen health promotion, counter-act the social determinants of health, and reduce the prevalence of chronic disease. European countries have diverse intersectoral collaboration to encourage health promotion activities. In the Joint Action CHRODIS-PLUS success factors for intersectoral collaboration within and outside healthcare which strengthen health promotion activities were identified with a mixed method design via a survey of 22 project partners in 14 countries and 2 workshops. In six semi-structured interviews, the mechanisms underlying these success factors were examined. These mechanisms can be very context-specific but do give more insight into how they can be replicated. In this paper, 20 health promotion interventions from national programs in CHRODIS PLUS are explored. This includes community interventions, policy actions, integrated approaches, capacity building, and training activities. The interventions involved collaboration across three to more than six sectors. The conclusion is a set of seven recommendations that are considered to be essential for fostering intersectoral collaboration to improve health-promoting activities.

ObjectivesLesbian, gay, bisexual, trans and intersex (LGBTI) people experience health inequalities and barriers to accessing healthcare at a greater rate than the general population. This paper aims to present the Health4LGBTI training course for healthcare workers and the results of its pilot implementation. MethodsFunded by the European Parliament, the training course was developed by a multidisciplinary team including LGBTI organisations as part of the Health4LGBTI Project. 110 healthcare professionals from diverse medical fields attended the pilot training in six European Member States. Knowledge and attitudes were compared on the basis of a pre-post evaluation design utilising an ad hoc questionnaire. ResultsKnowledge scores increased after the training, irrespective of age and sexual orientation of participants. Attitudes scores generally improved, particularly in terms of inclusivity and a greater acknowledgement of LGBTI health needs and self-competence. ConclusionThe Health4LGBTI training course is both feasible and effective in training healthcare professionals and support staff to improve cultural competence and thereby promoting inclusive healthcare practice. Practice ImplicationsThe Health4LGBTI training course can be implemented in different healthcare contexts. Piloting of the course provided an opportunity for healthcare professionals and for support staff to improve their knowledge of, and attitudes towards, LGBTI people.

Abstract It has been estimated that chronic diseases cost EU economies €115 billion or 0.8% of GDP annually. Approximately 70% to 80% of health care budgets are spent on treating chronic diseases. There is a wealth of knowledge within EU Member States on effective ways to prevent chronic diseases and promote health and wellbeing. There is great potential to reduce the burden by making better use of this knowledge as we know that the majority of chronic diseases can be prevented, or their onset delayed. In order to unlock this knowledge we have compiled health promotion landscape reports from twenty-one European countries involved in the Joint Action CHRODIS PLUS. This paper will present the current actions, policies, and programmes that European countries are currently undertaking in health promotion. It is based on responses to a specially designed questionnaire that asked countries to assess their good practices, identify their gaps and needs, and outline their policy contexts and capacity in relation to health promotion. This paper makes four key conclusions: (1) health promotion across Europe receives limited attention from policy makers; (2) there is a division between medical and social approaches to health and health in all policies needs to be fully implemented more widely in more countries in Europe; (3) there is not enough funding for health promotion; (4) health promotion needs further operationalisation to facilitate easier monitoring and value assessment. The need to develop mechanisms to share information, examples of good practice, and support for capacity development in health promotion and primary prevention is a shared goal across European countries. The Joint Action CHRODIS PLUS will lead the effort in implementing good practices, exploring inter- and intra-sectoral collaboration, and encouraging resilient and better informed investment in health promotion and primary prevention. The country reviews and this paper are a first step in that direction.

Urbanization, costs of green space maintenance, and diminishing connection between people and nature all exert pressures on urban green space. This is regrettable as green space has the potential to create wins for environmental sustainability, health, and health equity. This paper explores this potential triple win and investigates how to increase the use of urban green space through behavior change. A narrative literature review was conducted and was supplemented with literature suggested by experts. Results show that creating well-designed green spaces and stimulating people to use them can indeed deliver this triple win. Providing accessible, attractive, well-maintained green space with room for socialization, and where people feel safe, may increase the opportunity and motivation of people to use it more often. Informing and educating people and organizing activities may increase capability (and motivation) to use green space. Since the use of green space depends on life stage, lifestyle factors and individual values, it is important to involve potential users in its design. We recommend a specific focus on those groups who may benefit most from the use of green space. More evaluation is needed to inform effective green space interventions and to assess related economic, social, and environmental benefits.

BackgroundThe health inequalities experienced by lesbian, gay, bisexual, trans and intersex (LGBTI) people are well documented with several reviews of global research summarizing key inequalities. These reviews also show how the health‐care needs of LGBTI people are often poorly understood whilst suggesting that targeted initiatives to reduce inequalities should involve LGBTI people.ObjectivesTo determine what is known about the health‐care inequalities faced by LGBTI people? What are the barriers faced by LGBTI people whilst accessing health care, and health professionals when providing care? What examples of promising practice exist?DesignRapid reviews of grey literature were co‐produced with LGBTI people in 27 countries followed by a thematic analysis and synthesis across all data sets. The review included grey literature from each country that might not otherwise be accessible due to language barriers.Main resultsRapid reviews showed that LGBTI people faced various inequalities and barriers whilst accessing health care. Where heterosexuality, binary gender and assumed male/female sex characteristics were upheld as the norm, and where LGBTI people differed from these norms, discrimination could result. In consultations where LGBTI people feared discrimination and did not disclose their LGBTI status, health professionals lacked the information required for appropriate assessments.ConclusionWith greater understanding of sexual orientation (LGB people), gender identity (trans people) and sex characteristics (intersex people), combined with access to contemporary knowledge and training, health professionals can work in collaboration with researchers, policymakers and LGBTI people to develop systems that are better attuned to the needs of all service users.

Based on an empirical study of recreational running clubs, this chapter offers a longitudinal view of ongoing material and discursive transformations associated with efforts to foster an alternative vision of life in the post-socialist urban context of Sofia, Bulgaria. In doing so, it contributes new understandings of autonomous geographies and attempts at fostering pluralistic alternative spaces across different urban contexts. Recreational running has the potential for creating alternative urban worlds through uses of space, bringing bodies together, and re-envisioning forms of collective practice. In identifying techniques for building new worlds through cooperation and re-envisioning corporeal politics, thinking with everyday utopias fosters the material and non-material methods of innovation, highlighting the potential of mundane actions to bring forth new urban worlds.

ContextHealth inequalities are systematic differences in health among social groups that are caused by unequal exposure to—and distributions of—the social determinants of health (SDH). They are persistent between and within countries despite action to reduce them. Advocacy is a means of promoting policies that improve health equity, but the literature on how to do so effectively is dispersed. The aim of this review is to synthesize the evidence in the academic and gray literature and to provide a body of knowledge for advocates to draw on to inform their efforts.MethodsThis article is a systematic review of the academic literature and a fixed-length systematic search of the gray literature. After applying our inclusion criteria, we analyzed our findings according to our predefined dimensions of advocacy for health equity. Last, we synthesized our findings and made a critical appraisal of the literature.FindingsThe policy world is complex, and scientific evidence is unlikely to be conclusive in making decisions. Timely qualitative, interdisciplinary, and mixed-methods research may be valuable in advocacy efforts. The potential impact of evidence can be increased by “packaging” it as part of knowledge transfer and translation. Increased contact between researchers and policymakers could improve the uptake of research in policy processes. Researchers can play a role in advocacy efforts, although health professionals and disadvantaged people, who have direct contact with or experience of hardship, can be particularly persuasive in advocacy efforts. Different types of advocacy messages can accompany evidence, but messages should be tailored to advocacy target. Several barriers hamper advocacy efforts. The most frequently cited in the academic literature are the current political and economic zeitgeist and related public opinion, which tend to blame disadvantaged people for their ill health, even though biomedical approaches to health and political short-termism also act as barriers. These barriers could be tackled through long-term actions to raise public awareness and understanding of the SDH and through training of health professionals in advocacy. Advocates need to take advantage of “windows of opportunity,” which open and close quickly, and demonstrate expertise and credibility.ConclusionsThis article brings together for the first time evidence from the academic and the gray literature and provides a building block for efforts to advocate for health equity. Evidence regarding many of the dimensions is scant, and additional research is merited, particularly concerning the applicability of findings outside the English-speaking world. Advocacy organizations have a central role in advocating for health equity, given the challenges bridging the worlds of civil society, research, and policy.