IABSE Congress, New Delhi 2023: Engineering for Sustainable Development

Abstract This review evaluates the effectiveness of interventions aimed at reducing loneliness across all age groups. Studies were eligible if alleviation of loneliness was one of ≤ 3 aims, and loneliness was assessed pre- and post-intervention using a validated quantitative measure. Random-effects meta-analyses of standardised mean differences (SMD) assessed pre–post-intervention differences in loneliness, including comparing control and intervention groups. A comprehensive search of peer-reviewed and grey literature sources identified 95 studies covering 101 interventions. Psychological interventions had the largest SMD effect size (n = 23: − 0.79 [95%CI: − 1.19, − 0.38]), followed by social interaction-based interventions (n = 23; − 0.50 [− 0.78, − 0.17]), social support-based interventions (n = 46; − 0.34 [− 0.45, − 0.22]), and finally interventions involving multiple themes (n = 9). Findings highlight the effectiveness of psychological and social interaction strategies in reducing loneliness. Future research should address gaps related to intervention types and populations, emphasising randomised controlled designs. Policymakers and practitioners can use these insights to prioritise interventions fostering social connections and psychological support across diverse settings.

Abstract To implement evidence-based health policy, public health researchers need to be equipped with the necessary skills or knowledge to engage with policymakers effectively. The study aimed to evaluate the impact of the Texas Research-to-Policy Collaboration (TX RPC) training on public health professionals and to compare the effectiveness of different training delivery modes (in-person or web-based). In the study, 59 researchers received training to increase their capacity for interacting with legislators and completed pre- and post-training surveys assessing three scales: self-efficacy, knowledge, and training needs. To determine researchers’ pre- and post-training changes, we applied paired t tests. Two-sample t tests were used to compare the differences in outcomes between the two training modes. Researchers showed significant improvement in reported policy and knowledge of the legislative process and reported reduced perceived training needs for both delivery modes. The TX RPC training prepared researchers for interacting with legislators by increasing their policy-related self-efficacy and knowledge.

Abstract While scientific understanding of the COVID-19 pandemic increased, conspiracy theories undermined the foundations of public health policy, making it significantly more difficult both to discuss and to implement. Popular alternative narratives include the claim that government was using restrictions to control people's behavior, and that the pandemic was caused by 5G cellular technology. We examine the extent to which alternative beliefs were associated with sociodemographic characteristics and the sources through which people acquired information during the pandemic. Our analysis uses a demographically balanced online survey of 10,022 participants from 50 US states, collected during August of 2021. Results indicate that those holding alternative theories tended to be right leaning, religious, young, male, and unvaccinated individuals. Sources of information were also strong predictors of such beliefs, specifically the extent to which social media were considered reliable.

Abstract Developing a women’s health index is particularly important in the Indian context due to the pronounced disparities in women’s health across various social, economic, and geographical segments. This paper focuses on the development and validation of a comprehensive Women’s Health Index (WHI) for India. In contrast to previous efforts that predominantly focused on indicators related to pregnancy, childbirth, and the postpartum period, often limited to reproductive or maternal health services, our index adopts a multi-dimensional approach. The WHI comprises 17 variables, representing life stages of women and encompassing a diverse range of factors. Utilizing Principal Component Analysis, we computed the index and conducted statistical tests for internal and external validation. The spatial pattern of WHI reveals substantial inter-district and inter-state disparities. This study thus provides a valuable tool for characterizing women’s health and identifying health inequalities at a smaller administrative level in India.

India launched the National Health Mission (NHM) in 2005 to reduce maternal and child mortality by providing equitable, affordable, and quality healthcare services. Studies evaluating the impact of NHM primarily focused on the uptake of maternal and child health (MCH) services, revealing a dearth of evidence on related health outcomes. Using annual time-series data, we estimated the population-level (intention-to-treat effect) impact of the NHM on MCH outcomes such as infant mortality rate (IMR), stillbirth rate, neonatal mortality rate (NMR), and maternal mortality ratio (MMR). Our results exhibit strong consensus on the positive impact on IMR in the post-NHM period, with a significant reduction in its rate and regional inequity. Conversely, our estimates show a moderate impact on stillbirth rate and an insignificant impact on NMR and MMR. Our findings inform policy decisions for strengthening the public health system to amplify the positive gains in MCH outcomes.

This study explores Taiwanese' perspectives on the potential legalization of surrogacy, an issue with diverse legal stances globally. Conducted between 17 December 2023 and 1 January 2024, this mixed-methods cross-sectional study employed Knowledge and Attitudes of Legalizing Surrogacy (KALS) questionnaire. This instrument assessed opinions and ethical considerations on various aspects including ethics and children’s rights, surrogate health, offspring welfare, and social justice. Responses were quantitatively measured on a 5-point scale (with higher scores indicating more accurate knowledge or stronger perceived impact of surrogacy on society) supplemented by qualitative content analysis of open-ended responses. Out of 7780 predominantly female participants (82.8%), all scores were higher for those did not support the legalization of surrogacy (82.1% of respondents). Noteworthy concerns were raised about potential repercussions of legalizing surrogacy, underscoring the need for broader public education before any legal reforms are implemented. There is significant apprehension about surrogacy legalization in Taiwan, especially regarding its impact on women’s health and children's welfare.

Collaborative initiatives of the drone industry and healthcare sector are becoming a pivotal step in restructuring healthcare service delivery in India. This paper documents knowledge and perceptions of healthcare workers from various districts of Manipur and Nagaland towards the use of drones for medical supply in the region. The study utilized 27 in-depth interviews with healthcare workers to collect qualitative data, which was then analyzed using NVivo 14 for thematic and content analysis. The findings indicated that 57% of respondents are unaware of drones’ applications, citing security and privacy concerns and a lack of understanding about their role in the program. This study demonstrates the optimistic perception among healthcare professionals regarding drone delivery of medical supplies to remote areas, highlighting its potential to enhance accessibility and overcome logistical challenges. It emphasizes the need for training, community engagement, and safety measures to ensure effective implementation of drone technology in healthcare delivery.

Abstract Vaccination during pregnancy is crucial due to increased maternal vulnerability to infectious diseases. However, uptake of recommended vaccines (influenza, pertussis, COVID-19) remains suboptimal, particularly among disadvantaged groups. This qualitative study explored healthcare professionals’ (HCPs) perspectives, selected purposively, on factors influencing maternal vaccination in London. Data from a workshop transcript and an online quality improvement survey involving 15 GPs, two midwives, two obstetricians and one pharmacist were thematically analysed. HCPs highlighted that pregnant women perceive the benefits of pertussis vaccination more positively than other vaccines. Clear, consistent communication and integrating vaccinations into routine antenatal care were identified as essential for improving accessibility and convenience. The critical role of midwives influencing vaccination decisions was emphasised. While recognising the potential of AI-based technologies to disseminate vaccine information, concerns were raised about trust, digital literacy and information quality, highlighting the need for tailored, reliable strategies to boost maternal vaccination rates and improve health outcomes.

Several jurisdictions have implemented legalization policies for non-medical cannabis, mainly towards improving public health and reducing illegal cannabis markets and crime. As some legalization initiatives are approaching maturity, conducting policy impact assessments has become timely. Emerging data, however, suggest rather mixed pictures for key outcomes and indicators. While many key health-related indicators show increases in adverse outcomes, improvements are shown for main crime-related outcomes associated with legalization. However, legalization policies are evaluated predominantly by utilizing separate approaches for the health outcomes and crime-related indicators, while comprehensive policy assessments require meaningful integration of all related indicators. We provide suggestions for an integrated approach to assessing cannabis legalization policies concerning health and crime-related outcomes. This approach is also valuable for policymakers and other stakeholders to create an empirical basis for relative valuations and choices regarding cannabis legalization’s main policy outcomes.

Abstract This study examines the relationship between vaccine mandates and public sentiment toward vaccines and health officials on Twitter. I analyzed 6.6 million vaccine-related tweets from July 2021 to February 2022 in the United States. Leveraging a large language model, BERT, I identified tweets discussing vaccine mandates even when lacking explicit keywords. Compared to non-mandate tweets, those mentioning mandates exhibit greater negativity, anger, and freedom-related language. Furthermore, increased state-level discussion of mandates correlates with rising levels of negativity and anger toward both vaccines and public health officials. Finally, greater disparity in vaccination progress across counties within a state is associated with increased anger in tweets directed toward both.

The objective of this study was to understand factors that influence the attitude, knowledge, use, and access to e-health services in Spain. We examined the relationship between socio-demographic characteristics of participants and their attitudes toward, knowledge of and use of video-consultation, digital medical records, and experiences with digital devices. We conducted secondary data analysis using information collected by the Health Barometer # 8822 carried out by the Centro de Investigaciones Sociológicas. People with a lower level of education and social class, less digital experience, older, and foreign nationality have a low use of digital medical records. Similarly, the attitude and willingness to receive medical care via video-consultation were related to these socio-demographic factors. Thus, the use of e-health services might exacerbate inequity of the health system in Spain. To improve equity related to the e-health services, we recommend implementing a tailored approach supported by educational programs.

Intimate partner violence (IPV) is common, and almost half of all IPV takes place in relationships with children in the home. We inventoried laws in the 50 states and the District of Columbia in the United States of America (USA) focused on addressing IPV committed in the presence of children, as these laws could help prevent or remediate this critical health and social issue. Using WestLaw, a web-based legal research service, we identified over 1,200 statutes and 500 regulations. We documented the laws’ key attributes and heterogeneities and coded 557 laws from 31 states. We determined that the most commonly prescribed penalty was stricter sentencing, followed by mandates to pay for counseling for any child witnesses, separate additional criminal charges, mandated receipt of counseling or intervention services, and a period of supervised parenting. Future research could assess the possible impacts of these laws on children’s short- and long-term wellbeing.

Abstract In Ghana and many other sub-Saharan African countries gambling advertising has become pervasive due to weak regulations that allow gambling operators to zealously promote their products as a risk-free way to make money. In this commentary, we provide a public health perspective based on document analysis of the Ghana Gaming Commission’s guidelines on advertisements, and recommendations for strengthening Ghana’s gambling regulatory environment. With the industry intensifying its focus on new markets to grow and sustain profits, and new global players entering Ghana’s market, the competition for market share will most likely intensify with an associated and aggressive increase in gambling advertising. Accordingly, a strengthened gambling advertising regulation underpinned by public health principles is required to restrict advertising across all forms of media and regulate advertising content. The next step for public health action should focus on advocating for new gambling advertising regulations and a review of the Gaming (gambling) Act.