bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence-based decision making for prison health
Authors: Tavoschi L
Published: November 2019

The presentation will provide an overview of the current evidence base on prison health interventions, gaps and challenges for conducting research in prison settings. Evidence based decision making is relevant for prison health, not only in terms of resources allocation, but also in relation to interventions and implementation approaches. Yet scientific literature covering prison health is generally quite limited. Lack of research activities in prison settings may be the results of several factors, partly deriving from structural challenges, and partly from specific features of the prison population. These include supplementary ethical implications, issues related to confidentiality and management of personal information and shortage of health care and other staff trained in conducting research. Low priority attributed to prison health in the sub-national, national or international research agenda may result in less opportunities for funding. Grey literature and programmatic data are regarded as an additional source of information; however accurate or reliable data are rare in Europe. While evidence is limited, there is a growing interest in prison health in Europe. A number of systematic reviews conducted in recent years shed some new light on key aspects of epidemiology and healthcare in prison. At European level various institutions and agencies and national institutions have been engaged in prison health and have produced a number of authoritative documents, including a few guidance documents.
Effects of non-health-targeted policies on migrant health
Authors: Juarez S P , Rostila M
Published: November 2019

This presentation will commence with a brief overview of the field of migration and health with the purpose of contextualizing the need for more policy-oriented research in this area, in so far as policy is a crucial -yet still overlooked- social determinant of health. In this context, we will present the main findings of a systematic review and meta-analysis recently published in the Lancet Global Health which looks at the effects of entry and integration policies on migrant health. The findings will, in turn, serve as a starting point to discuss how migration issues in general, and migration and health in particular, should be framed in relation to economic and human rights. Acknowledging the role of economic arguments in decision making, the presentation will end with a general reflection about the invisible contributions of migrants to wealth creation in a global economy and the difficulties of estimating such contributions.
Studies from the Norwegian Twin Registry on risk factors for health related work incapacity
Authors: Orstavik R , Seglem K , Gjerde L C , Torvik F , Røysamb E , Reichborn-Kjennerud T , Vollrath M
Published: November 2019

Background

For the past decade, researchers from the Nordic countries have taken the advantage of their large twin cohorts and reliable official registries to deepen our understanding of sick leave and disability pension. This presentation will give a brief summary of studies based on data from The Norwegian Twin Registry (NTR).

Methods

Monozygotic twins develop from one fertilized egg cell and are genetically identical, while dizygotic twins are the result of two fertilized egg cells and share, as ordinary siblings, in average 50% of their segregating genes. With data from large cohorts of twins reared together, it is possible to calculate the proportion of variance in an outcome that stems from genetic, shared and non-shared environmental factors respectively. Furthermore, when exploring the contribution from measured risk factors on specific outcomes, adjustment for unmeasured confounders (genes and shared environment) can bring us closer to determine causality in epidemiological studies. Both methods were applied in our studies. NTR now includes data from about 30 000 twins, but until recently we focused on a subsample of about 8 000 young adults (born 1967-1979). Data from questionnaires and interviews were linked to registries on sick leave and disability pension.

Results

In line with previous studies, we found that the liability to sick leave and disability pensioning, as well as the transition from the former to the latter, was strongly to moderately influenced by genetic factors. We found no evidence for “social transmission”, e.g. that environmental factors shared by the twins contributed to these outcomes. Further details and results from studies on measured risk factors, with emphasize on mental health, will be presented at the conference.

Conclusions

Twin studies cast light on different aspects of work incapacity, including reducing stigma such as those associated with theories of social transmission of health related benefits.
The preventive health care act and the future forum public health in Germany
Authors: De Bock F , Shajanian Zarneh Y , Matusall S
Published: November 2019

The public health system in Germany, similar to education and cultural affairs, is characterised by the federal structure. It is mainly regulated and decided at the state and municipal level, and not primarily at the national level.

The preventive health care act (The Act to Strengthen Health Promotion and Preventive Health Care) (2015) underlines the setting-based approach of health promotion and takes a life course perspective by recommending goals of growing up healthy, living and working healthy and healthy ageing. The act formulates broad recommendations for prevention and health promotion at the national level, that in turn take on concrete forms in mandatory framework agreements at the federal state level with uniform health objectives. On the whole, the key objective of the act is to improve preventive health care and general health promotion. Also the financing of the act by the mandatory health insurance is a special feature and at the same time a novelty.

At the same time a bottom-up project has been recently launched with the aim to develop a public health strategy in Germany. The project future forum public health (ZfPH) is a platform for public health professionals, researchers and students following incorporated concepts of policy analysis as well as methods that will ensure participation, transparency and transferability of the results into policy and practice. Over the next three years, ZfPH’s steering group will moderate a participatory process, including stakeholders from public health practice and research as well as policy makers. In an evidence-based approach, they will first analyse the current state of Germany’s public health system before developing concrete policy recommendations for a coherent and efficient public health system.

The presentation will give a short overview over the German public health system and the preventive health care act, its structure and the achievements as well as the bottom-up project future forum public health.
The co-design approach in the MIWOCA project
Authors: Frahsa A , Farquet R , Abel T
Published: November 2019

MIWOCA study group

Background

The project MIWOCA researches how chronically ill women of Portuguese, Turkish and German origin and women without a migration background subjectively experience, understand, interpret and use the Swiss health care system.

Methods

We conducted 48 qualitative semi-structured interviews with chronically ill women between the ages of 23 and 85 in Bern and Geneva (n = 36 with German, Portuguese and Turkish migrant backgrounds) and n = 12 Swiss women. In addition, n = 12 stakeholder interviews were conducted (doctors, nurses, social workers, psychologists, physiotherapists). In focus groups with interviewed women in Bern and Geneva, results are reflected back, identified topics from the interviews prioritized and representatives named for the cooperative planning. In a participatory planning approach, affected women in the canton of Bern, together with stakeholders from the Swiss healthcare system selected by a systematic stakeholder analysis (e.g. Swiss Medical Association, Red Cross Switzerland, Spitex, Federal Office of Public Health), develop recommendations for improving the quality of care and concrete dissemination strategies.

Results

Interviewees had multiple and chronic diseases and resulting extensive experience with the Swiss healthcare system. Relevant aspects referred to issues such as quality of specific services, complexity of the healthcare system, costs of care, role of family and social support, and multidimensional stigmatization (migration, chronic illness, alleged overuse of the care system). Findings are incorporated in evidence briefs and narrative stories for focus groups and participatory planning.

Conclusions

MIWOCA contributes to a targeted and differentiated improvement of structures and options for action in health care for specific groups. Results will be relevant for planning in the health system and may be incorporated into academic teaching and practical training in PH, medicine and social sciences.
Populist radical right parties, welfare policy and population health in Europe
Authors: Rinaldi C , Bekker M P M
Published: November 2019

Background

The political system is an important influencing factor for population health but is often neglected in the public health literature. This scoping review uses insights from political science to explore the possible public health consequences of the rise of populist radical right (PRR) parties in Europe, with welfare state policy as a proxy. The aim is to generate hypotheses about the relationship between the PRR, political systems and public health.

Methods

A literature search on PubMed, ScienceDirect and Google Scholar resulted in 110 original research articles addressing 1) the relationship between the political system and welfare state policy/population health outcomes or 2) the relationship between PRR parties and welfare state policy/population health outcomes in Europe.

Results

The influence of political parties on population health seems to be mediated by welfare state policies. Early symptoms point towards possible negative effects of the PRR on public health, by taking a welfare chauvinist position. Despite limited literature, there are preliminary indications that the effect of PRR parties on health and welfare policy depends on vote-seeking or office-seeking strategies and may be mediated by the political system in which they act. Compromises with coalition partners, electoral institutions and the type of healthcare system can either restrain or exacerbate the effects of the PRR policy agenda. EU laws and regulations can to some extent restrict the nativist policy agenda of PRR parties.

Conclusions

The relationship between the PRR and welfare state policy seems to be mediated by the political system, meaning that the public health consequences will differ by country. Considering the increased popularity of populist parties in Europe and the possibly harmful consequences for public health, there is a need for further research on the link between the PRR and public health.
Workshop: New born screening in neuromuscular diseases
Authors:   Organised by: AFM Telethon
Published: November 2019

In the field of incurable neuromuscular diseases, the access to therapeutics is becoming a reality for some of them and some trials are on the way for the others. More precisely, all recent studies show the more effectiveness of these innovative therapies if administered early or pre-symptomatic stage of these diseases. For example, infant spinal muscular atrophy (SMA) is the most advanced with AMM treatment, several others, including gene therapy, in clinical trials, and three trials of pre-symptomatic administration. This makes this new-born screening a major public health issue with a diagnosis using molecular biology tools.

In this context, the French Muscular Dystrophy Association (AFM-Telethons) and the French muscular disorders network (FILNEMUS) with others associations and partners want to be a force for proposals in this area.

Speakers: Vincent Laugel

CHU Strasbourg

Christian Cottet Général

Director AFM Téléthon

Jean-François Malaterre

Vice Président AFM-téléthon

Brigitte Chabrol

AP-HM Marseille
Workshop: Terrorist attacks and aftercare
Authors:   Organised by: EUPHA (PMH) Chair persons: Jutta Lindert - EUPHA (PMH), Johan Bilsen - Belgium
Published: November 2019

In recent years several European countries have been confronted with terrorist attacks. Since the Oklahoma City Bombing in 1995, there has been a growing evidence of trauma-research showing that survivors and witnesses of such attacks not only are affected physically, often with serous injuries, but also often experience severe mental health problems, such as PTSD, depression, or anxiety, which can take months or years to fade away. Moreover, such impact not only affect directly involved, but also indirectly involved persons (e.g. relatives of victims) and even the broader population. Terrorism has become a public health issue, challenging researchers to profoundly study determinants of terrorism as well as the ways of how to organise and install adequate preparedness before and proper responses and effective healthcare for populations in need after an attack.

Until now, aftercare for people directly or indirectly affected by terrorist attacks and for the broader population gets rather little scientific attention. How did the health care services respond to such attacks? How should they respond and why? Were these services adequately prepared? Have survivors sought out help themselves? While there is an increasing body of knowledge on the association between a terrorist attack and PTSD, depression or other mental health problems, there is little known on the psychological aid that was given, and to whom this was given.

In this workshop, research findings on aftercare after terrorism will be presented and discussed. Four researchers from three different European countries confronted with terrorist attacks in recent years (France, Belgium and Norway) will present their findings. Dr. Cécile Vuillermoz will present data on the immediate and long-term aftercare for civilians following the attacks on Charlie Hebdo in January 2015 in France, while Dr. Stephanie Vandentorren will present data on the psychosocial aid provided to directly exposed, witnesses and relatives after these attacks. Drs. Roel Van Overmeire will focus on the psychosocial aid offered to rescue workers shortly after the attacks in Belgium, and the months and years after. Finally, Dr. Lise Eilin Stene will give a presentation on current problems of healthcare in Europe in reaching those inflicted by terrorism and other traumatic events, while pointing to solutions and challenges for the future.

Key messages

More research is necessary to find adequate ways of reaching vulnerable people in need of psychosocial aid after terrorist attacks. More scientific insight is needed in the mental health impact of and the proper psychosocial aid response after large-scale traumatic events, in the direct aftermath as well as in the long term.
Governance of collection, use and storage of RWD in the view of data protection concerns
Authors: Shabani M
Published: November 2019

Issue/problem

Collection, storage and sharing RWD raise concerns regarding the privacy, data protection and governance of access. To date, the concerns related to consent and adequate safeguards for data protection in conventional research and health care settings are being discussed in details in the literature. However, collection of RWD from individuals fuels questions regarding the applicability of the regulations for human subjects’ research and personal data protection.

Description of the problem

The data collected in the framework of RWD need to be protected in line with the overarching principles of human subjects research and personal data protection regulations such as the EU General Data Protection Regulations (GDPR). In particular, the purposes of data collection, potential further uses, duration of storage of data and the authorized users’ access to data should be managed in compliance with applicable data protection regulations. In addition, the adequate models for de-identifications of data should be used in compliance with the applicable data protection regulations. Ethical oversight on the process of data collection, storage and use should also be scrutinized.

Effects/changes

In order to respect the privacy rights of the patients, it is essential to first identify the potential risks and assess the adequacy of the existing safeguards in protecting the privacy of the patients.

Lessons

The effectiveness of the current access governance in the context of RWD should be assessed and the required safeguards to be proposed.
Critical thinking on strengthening the NGO contribution to improve solidarity in public health
Authors: Aslan D
Published: November 2019

Issue/background

Public health values transdisciplinary, multidisciplinary, and interdisciplinary perspectives. This background always advocates solidarity which usually finds its positive reflections in the society with the support of many institutional bodies including Non-governmental organization (NGO) movements. which move up solidarity. Globally, NGOs are represented by societies and associations. Turkey is one of the countries which NGO movement is frequent. Turkish NGOs in (public) health may vary on their vision(s) and mission(s). Such variety seems to be “good”; thus, complexity and duplications may occur when a strong systematic ground is not provided. In this paper, a systematic on the functionality of NGOs will be proposed to make the NGO movement more inclusive, accessible, transparent, and auditable in order to support solidarity using the experience of a local case.

Results

The number of the societies is high in Turkey and they have a wide range of working area including health. Officially they are recorded in the Turkish Ministry of Internal Affairs (MoIA) and can be accessed via the website of the MoIA. There are about 300 000 societies which 116 000 of them are active. The majority of them are founded in big cities. Societies working on health focuses on different areas including professionalism, prevention, rehabilitation, etc. Such varieties may have the potential to create difficulty to follow up their work in a systematic manner.

Lessons

As NGO/civil society movement is crucial for public health, the proposed steps may contribute to improve/support solidarity on any advocative work on health: To maintain transparency, and auditabilityTo develop methods to prevent duplicative workTo develop accessible “common” platforms to share experiencesTo improve adaptation capacity in the face of new requirementsTo improve networking among NGOsTo improve the global perspective as well as the local one

Key messages

Solidarity in public health can be achieved with the help of systematic and powerful NGO/civil society movement. Global needs and changes influence civil society dynamics and NGOs should be open to be updated in the face of new requirements.
Improving Health Care Management in Primary Care for Homeless People: A Literature Review
Authors: Jego M , Abcaya J , Calvet-montredon C , Gentile S
Published: November 2019

Background

Homeless people have poorer health status than the general population. They need complex care management, because of associated medical troubles (somatic and psychiatric) and social difficulties. However, they face multiple difficulties in accessing primary health care and receive less preventive health care than the general population.

Methods

We performed a literature review that included articles which described and evaluated primary care programs for homeless people. We searched into the MEDLINE, PsycINFO, COCHRANE library, and Cairn.info databases primary articles published between 1 January 2012 and 15 December 2016. We also performed a grey literature search, and we added relative articles as we read the references of the selected articles. We described the main characteristics of the primary care programs presented in the selected articles. Then we classified these characteristics in main categories, as a descriptive thematic analysis. Secondarily, we synthetized the main results about the evaluation of each intervention or organization.

Results

Most of the programs presented a team-based approach, multidisciplinary and/or integrated care. They often proposed co-located services between somatic health services, mental health services and social support services. They also tried to answer to the specific needs of homeless people. Some characteristics of these programs were associated with significant positive outcomes: tailored primary care organizations, clinic orientation, multidisciplinary team-based models which included primary care physicians and clinic nurses, integration of social support, and engagement in the community’s health.

Conclusions

Primary health care programs that aimed at taking care of the homeless people should emphasize a multidisciplinary approach and should consider an integrated (mental, somatic and social) care model.

Key messages

To improve the health care management of homeless people it seems necessary to priorize multidisciplinary approach, integrated care, involve community health and answer their specific needs. It is necessary to evaluate more non-tailored primary care programs that collaborate with tailored structures.
Impact of macro-socioeconomic determinants on perinatal healthcare quality for very preterm infants
Authors: Doetsch J , Marques S C S , Krafft T , Barros H
Published: November 2019

The WHO identified the importance of macro-socioeconomic determinants and the political context as interlinked key factors affecting health equity. The 2008 economic crisis was associated with a significant low-birth-weight increase in Portugal, 2007-2014. The Economic Adjustment Programme (EAP), implemented to economize non-essential health care costs (2011-2014), substantially affected healthcare delivery and occupational environment of Healthcare Professionals (HCPs). This study aims to analyse the impact observed by HCPs of the economic crisis and EAP on equitable quality of perinatal healthcare for very preterm infants in Portugal.

A Qualitative study design with 21 HCPs in clinical settings equally distributed among Portuguese mainland were selected according to their response. Semi-structured interviews were conducted between October 2018-April 2019 until saturation point was achieved. A content analysis was performed using Nvivo2011 software.

Preliminary results on macro-socioeconomic determinants, classified and conceptualized into a three-stage-effect framework, disclosed an interrelation between factors impacting perinatal healthcare quality, according to HCPs. Primary-stage: increase in working hours and patient-ratio per HCPs, cuts in salaries and investment, increasing waiting time and HCPs demotivation. Secondary-stage: burnout, work-absence, time constraints, decreasing quality and consultation availability. Tertiary-stage: HCPs Brain-drain to private sector, double-shifts in public-private sector, increasing inadequacy of transmissivity within sector communication.

The economic crisis and EAP were perceived to have modified equitable perinatal healthcare quality for very preterm infants in Portugal. Increased private-public sector transparency to maximise quality assurance, equal HCP wage distribution to sustain capability, strengthening of social maternity protection strategies to enhance socioeconomic equity in perinatal healthcare, is recommended.

Key messages

The added value is the disclosure of an in-depth understanding on the interrelation of macro-socioeconomic determinants and healthcare permitting a distinct representation from quantitative methods. The non-linearity between policy response and expected outcomes chiefly complements its comprehension and demonstrates its relevance for further research on assessing effects of austerity measures.
Increase of tuberculosis incidence in Ile-de-France region and the role of recent migration
Authors: Silue Y , Lepoutre A , Mounchetrou-Njoya I , Lapora S , Calba C , Guthmann J P
Published: November 2019

Background

In metropolitan France and in the Ile-de-France region, the incidence of tuberculosis has globally decreased since the year 2000 and has stabilized from 2011 to 2015. This study analysed the evolution of tuberculosis in the Ile-de-France region between 2015 and 2017.

Methods

We analysed tuberculosis cases reported in Ile-de-France from 2015 to 2017; 2015 was considered as the baseline year. Incidence rates of reported tuberculosis cases were estimated using French census data for the corresponding year for the denominator. Age-standardized rates were estimated for each of the 8 departments of the region based on the Ile-de-France region population. Foreigners’ population was based on the 2015 French census data. Differences in incidence and proportions were tested with the CHI2 statistic (STATA® v14.0).

Results

The incidence of tuberculosis increased in the Ile-de-France region from 14.6 to 15.8/100 000 pop. between 2015 and 2017 (+8.2%, p < 0.01). In this region, all department’s incidence were above 10/100 000 pop. in 2017. Sub-regional disparities were observed, with an important increase of the incidence in Paris, from 13,5 to 16.8/100 000 pop. between 2015 and 2017 (p < 0,01). The incidence rates among foreigners increased from 44.6 to 51.7/100 000 pop. (p < 0.01) and the proportion of tuberculosis cases among foreigners who arrived in France less than 2 years ago increased from 23% to 32% (p < 0.01), between 2015 and 2017. The incidence rates of tuberculosis cases increased particularly in men, foreigners, and recent migrants.

Conclusions

The incidence of tuberculosis increased in the Ile-de-France region in 2016 and 2017, particularly in newly arrived migrants. This situation requires actions to better detect and manage tuberculosis in this specific population.

Key messages

The incidence of tuberculosis increased in the Ile-de-France region. The incidence of tuberculosis increased in vulnerable population in relation with recent migration.
Social Gradients in Alcohol Use Disorders with and without Depression: Immigrants vs Norwegians
Authors: Leonhardt M , Shawel Abebe D
Published: November 2019

Background

The social gradient in health runs from top to bottom of the socioeconomic spectrum. Poverty is associated with poor health and problematic unhealthy behaviors. Depression is strongly associated with social inequalities, while alcohol use disorders are not necessarily associated with a low socio economic status. Immigrants often have a lower social economic status than the host population. Research regarding alcohol use disorders, depression and a social gradient among immigrants is scare. The present study explores social gradients in persons with alcohol use disorders with and without depression and examines potential discrepancies between immigrant and native Norwegian patients receiving public specialist health care.

Methods

Data of 2.4 million native Norwegians and 468.496 immigrants, registered in the national mandatory Norwegian Patient Register and population data from Statistics Norway were analyzed. ICD 10 main diagnoses were used to identify patient groups - at least diagnosed once during 2008 - 2016. Immigrants had been pooled into 5 world regions. Logistic regression models have been applied to show associations between socio demographics/regions and alcohol use disorders and/or depression.

Results

African (OR = 0.35; 95%CI:0.27-0.44) and Asian (OR = 0.23; 95%CI:0.16-0.32) immigrants had a lower risk of developing alcohol use disorders with depression than Western Europeans (OR = 0.76; 95% CI:0.60-0.98), using native Norwegians as a reference. In general, persons with a lower socioeconomic status are more often affected of alcohol use disorder only (OR = 3.77; 95%CI:3.64-3.91) than with alcohol use disorder and concurrent depression (OR = 3.52; 95%CI:3.25-3.83).

Conclusions

To detect possible deficits in patient care, knowledge of social gradients in a marginalized group such as persons with alcohol use disorders and/or depression is essential. This may contribute to targeted and individualized health care- regardless of immigrant status.

Key messages

The risk of developing alcohol use disorders with depression varies between immigrants according to their origin. Persons with a lower socioeconomic status are more often affected of alcohol use disorder only than with alcohol use disorder and concurrent depression.
Sustained virological response to Do hepatitis C DAA treatments in migrants and non-migrants groups
Authors: Djaogol T , Fontaine H , Baudoin M , Protopopescu C , Marcellin F , Dorival C , Bourlière M , Delarocque-Astagneau E , Carrat F , Carrieri P
Published: November 2019

Background

Although the efficacy of direct acting antivirals (DAA) against hepatitis C (HCV) has been widely proven, data lack on their effectiveness in the most vulnerable groups. In France, despite universal health coverage, migrants cumulate vulnerabilities including delays in screening that may affect both access to care and treatment effectiveness. We tested whether DAA-treated migrants had sustained virological response (SVR) rates comparable to not-migrants.

Methods

We used data collected in chronic HCV-infected patients of the ANRS CO22 HEPATHER cohort, receiving a first treatment with DAA, with follow-up from 2012 until 2022. SVR was measured by PCR, 12 weeks after the end of treatment. The main covariate was a 4-category variable comparing migrants and non-migrants, with or without other vulnerability conditions (including drug use, unhealthy alcohol use, living in poverty, being a man who have sex with men). We used a Poisson regression model to assess the relationship between this covariate and SVR after adjustment for significant predictors and potential confounders.

Results

The analysis included 5,080 individuals, of which 17% classified as migrants with at least one vulnerability, 10% as migrants with no vulnerability, 39% as non-migrants with at least one vulnerability and 35% as non-migrants with no vulnerability. Median [IQR] age was 57 [51-65] years, 56% of individuals were men, and 96% had SVR. The multivariable analysis showed no significant difference between the 4-category covariate and SVR. In addition, we found that SVR rates increased steadily during follow-up.

Conclusions

This is the first analysis exploring differences in SVR rates among migrants and not-migrants. The lack of significant differences found despite the power of the study suggests that migrants respond to DAA treatment as well as any other group of HCV-infected patients. These data can help advocating better screening and access to treatment for HCV-infected migrants in France.

Key messages

No significant differences were observed between migrants and non-migrants in terms of effectiveness of DAA treatment. These findings can help improving access to HCV care for migrants.
Health and behavioral changes among international students at the University of Georgia
Authors: Lobjanidze M , Rada-Fernandez de Jauregui D , Kvanchakhadze R
Published: November 2019

Background

During last decade the number of international students is rising not only in developed, but in developing countries. In this matter, Georgia is not an exception. In 2006-2016, country enrolled more than 13 000 International students in 127 English language programs in 33 Higher Education Institutions. Study aimed to investigate health and lifestyle changes among international students of one of the largest universities of Georgia.

Methods

A cross-sectional survey was carried out in 2018 by web-based anonymous questionnaires among international and local students at the school of health sciences (UoG). Data was obtained on self reported physical health conditions, dietary patterns, physical Activity, sleep, study routine, smoking, alcohol and drug consumption, sexual life and stress factors.

Results

112 local and 50 international students of UoG from more than 10 countries participated in online survey. 77% of local and 37% of international participants were female. Students reported health problems related to digestion (43% local, 23% int), musculoskeletal system (20% local, 33% int), sleep (62% local, 43% int ), skin, hair and nail (29% local -28% int) after attending university. 22% of international students reported to start smoking after coming to Georgia and 50% evaluated own stress level as 7 out of 10 point scale. Moderate positive correlation was found between stress and health problems among international students (r = 0.447, p = 0.005). As a main stress factors international students indicated study routine, homesickness, sleep and financial difficulties.

Conclusions

Survey results indicate that social and physical environment changes as well as busy time schedule can be led to different health problems, and lifestyle changes among international students of UoG. Hence, health promotion campaigns, even among students of health sciences might play supportive role.

Key messages

22% of international students of UoG reported to start smoking after coming to Georgia and 50% evaluated own stress level as 7 out of 10. There is a need of health promotion campaigns, even among students of health sciences.
Combined sexual prevention targeted to LGBTI+ migrants: between ’outdoor’ and ’indoor’ hospial
Authors: Bouchet-Mayer C , Sow A , Kouadio-Sankadio C-P , Peltier A , Héteau F , Legrais F , Shelly M
Published: November 2019

Issue

It is estimated that there are about 10,000 HIV-positive and undiagnosed people in Île-de-France (French region). They are composed of 70% men, 40% of whom are MSM and 40% of sub-Saharan African migrants. A bridging process has been designed by the Public Health association AREMEDIA and developed in partnership with Fernand-Widal Hospital’s testing center, to reach underserved populations. From March 2018, a screening test session for sexually transmitted infections (STIs) is taking place weekly in the hospital walls. This action is dedicated to the population of ARDHIS association, which accompanies more than 1,000 people each year, seeking asylum because of their sexual orientation or gender identity.

Description of the problem

Despite the promotion of this ’indoor’ targeted consultation via ARDHIS volunteers and directly to asylum seekers during occasional community events, the consultation only allowed the screening of 23 people in 4 months. It has been decided to carry out screening ’outside the hospitals walls’, where the people are, in order to promote the return of results, treatment, access to PrEP, HBV vaccination at the weekly indoor hospital consultation. “Community health relays” training together with the development of phone contact procedures were developed to facilitate the access to the indoor consultation.

Results

The methodology made it possible to double the average number of consultations over the following 5 months from 5 to 10 consultations per 3-hour slot, not counting PrEP appointments and vaccines, which averaged 6 per session. By the end of 2018, 261 people were screened, 23 had a PrEP treatment and many were vaccinated. As the scheme continues to develop, the results from January to July 2019 will be reported.

Leçons

To reach the most at risk populations, specific public health approaches are needed, taking account the context and representations of the target populations. Community involvement has proven to be effective.

Key messages

To fight HIV, innovative devices are needed to reach targeted populations. This has allowed hundreds of LGBTI asylum seekers to be screened and a significant number to receive preventive treatment.
The way towards Migrant Sensitive Occupational Health Care System
Authors: Szilárd I , Marek E , Jaksa C , Katz Z
Published: November 2019

Background

The European Union (EU) is facing to the demographic challenge of the ageing society on the one hand and a growing influx of migrants on the other hand. Although since 2008 WHO repeatedly called member states for developing ’migrant sensitive’ health care system, still there is a significant shortage in education programs, aiming to build the required human capacity in general, and on the field of occupational health, no any initiative could be observed aiming to empower the service providers with the additional knowledge and skills for facilitating the safe integration of the migrant workforce into the EU’s economy.

Objectives

University of Pécs Medical School (UPMS) has integrated migrant and ethnic minority health - as a new overarching topic - in its optional and/ or regular training program. Occupational health and migration belongs to the compulsory part of the education.

Results

Each study year more than two hundreds Hungarian, English and German speaking medical students meet at least at a ’sensitization’ level the migrant specific aspects of occupational health. In order to improve and - in the need - even extend our program on this field, we have launched a ’quick response’ questionnaire research among the students, asking for their opinion, how they see the importance and necessity of this topic within the frame of their medical training. 67 % of the 2012 students highly and/ or mostly agreed with our initiative and 87 % founded the topic very relevant. The majority of the students have expressed that the training has changed their views.

Conclusions

The endowers of UPMS, as a WHO Collaborating Centre on the field of migration heath training and research are in accordance with WHO newly adopted ’Strategy and action plan for refugee and migrant health and achieves every year several hundreds of medical students who are already ’sensitized’ towards the health of migrants.

Key messages

EU economy needs migrant sensitive health workforce ont he field of occupational health. Medical studens understood the need for migration health training.
eHealth Literacy and Fertility – managing complex information in a digital environment
Authors: Sykes S , Wills J
Published: November 2019

Background

There is increasing reliance on the internet as a source of health information including for those seeking information about fertility. This study investigates how people access, understand and process online fertility information and engage with digital services.

Methods

Purposive sampling was used to recruit 27 participants from a range of groups including those diagnosed with infertility, those who successfully conceived after a period of infertility, same sex couples, those over 40 and younger people making decisions about delaying parenthood. Semi structured telephone interviews explored information seeking behaviour and ehealth literacy competencies. Data were analysed using thematic analysis.

Results

Digital platforms were identified as a primary source of information but presented barriers including gaps in content, and concerns about relevancy and complexity. Source credibility was a priority alongside a recognition that emotional drivers led to the active seeking of specific information. Participants described a journey from general information to specific, detailed and tailored content. Participants moved between conversational forums on social media sites and information based internet platforms as part of an ongoing process of identifying and understanding information. However, participants were typically purveyors of information in their real world relationships. Information was used to prepare for and understand interactions with health professionals.

Conclusions

Sources of digital information need to respond to the ehealth literacy competencies of users. Users go beyond the passive accessing of information through digital platforms and are actively engaged as contributors of information through social media and app based technology. The value placed on other people in accessing and understanding fertility information, through online forums and virtual communities, shows the importance and complexity of distributed health literacy.

Key messages

Digital platforms are a key source of information around fertility. Interaction with digital platforms is complex and requires the digital environment to respond to their ehealth literacy needs.
Artificial Intelligence-based tools to control healthcare associated infections: where do we stand
Authors: Scardoni A , Balzarini F , Cabitza F , Odone A
Published: November 2019

Background

Control of Healthcare associated infections (HAI) is a key public health concern in Europe. Current HAI surveillance systems are based on manual medical records review, vulnerable to misclassification and expensive. Artificial intelligence (AI) offers great potential to public health action and, specifically, to HAI control. Still, scant evidence is available on both its practice and impact.

Methods

As part of a broader multidisciplinary project, we conducted a systematic review to retrieve, pool and critically apprize all the available evidence on practice, performance and impact of AI-based HAI control programmes. We followed PRISMA guidelines and searched the Medline and Embase databases for relevant studies. Included studies were stratified by HAI type and outcomes of interest, including all possible performance measures, clinical, organizational and economic outcomes.

Results

We screened 2873 records, resulting in 27 papers included in the review. Studies were carried out in 9 countries, the majority in the US (56%), 18.5% in EU countries, 25.9% published in 2018. Two thirds of studies focused on selected types of infections. Study designs were very diverse and performance observed for HAI detection were very heterogeneous, precluding pooled calculation of summary diagnostic accuracy estimates in most instances, but generally higher than non AI-based models. The highest performance outcomes were Specificity and Negative Predictive Value. Overall performance measures of AI algorithms were: sensitivity range 19%-92%, specificity range 64%-96%, accuracy 70.2%-96.1%.

Conclusions

Use of AI algorithms for HAI surveillance of HAI has increased reliability compared to traditional surveillance or to automated surveillance models. With ongoing improvements in information technology, implementation of AI models will improve the quality and capacity of surveillance will support hospital HAI surveillance.

Key messages

Artificial Intelligence (AI) offer great potential to healthcare associated infections (HAI) control. Preliminary evidence show AI-based models have perform better than manual or automated models for HAIs detection.
Social capital and social networks
Authors: Corvo E , De Caro W
Published: November 2019

Introduction

Social capital can be defined as the ’sum of the resources, actual or virtual, that accrue to an individual or a group by virtue of possessing a durable network of networks or less institutionalized relationships of mutual acquaintance and recognition’. Nowadays there are a number of new way to have social relationship. Developing community and individual social capital is an important aspect for health promotion in order to decrease social isolation and health inequalities.

Methods

This research aims to detect to what extend online social networks can help in building social capital and decrease social isolation. An analysis of the content of an open Facebook group of people who are experiencing chronic diseases was carried out (7912 individuals).

Results

Text mining analysis was carried out, as well as a content analysis in order to identify which kind of social support and social capital emerged among participants. Results based on text mining (234.943 words) and thematic analysis (information, relationship, support) show that even virtual social group have an important impact on participants’ wellbeing and health. Participants seems to develop through participation all construct of social capital i.e. bonding, bridging and linking social capital. There is an overall increase in confidence and sense of community. However, virtual communication seems lacking of a number of crucial aspect of human interaction such as face to face communication or physical contact.

Conclusions

The use of social network as a new place of aggregation and socialization is an important aspect to look at. Virtual networks can have a role in developing relationship and to build trustiness on individuals. Public Health and Health Promotion, as well as health care professionals should be aware and concern about social capital as a key aspect of health and explore in depth the role of new social networks as a new way to build social capital and health of individuals and communities.

Key messages

Text mining as new useful tools for health research. Social capital and social network intersection.
Factors associated with activity limitation: are the risk patterns the same across Europe?
Authors: Von Der Lippe E , Baumert J
Published: November 2019

Background

The Global Activity Limitation Indicator (GALI) is part of the Minimum European Health Module and has been shown to be a valid indicator of functional limitations. The present study aims to identify determinants of GALI prevalence among adults in Europe.

Methods

We used data from the European Health Interview Survey (EHIS) Wave 2 which included adults aged 15 years and older and was conducted between 2013 and 2015 in all European Union member states. We examined patterns regarding age, sex, education and chronic diseases. After excluding some inconsistencies in the data the sample size was 284,732 respondents from 26 countries.

When making comparisons across countries one has to bear in mind that the data was collected through different modes, the indicators were obtained through various instruments and in some countries interviews were conducted not always with the target person, but with a proxy person.

Results

Our findings revealed that age and education are very strong determinants of functional limitation in all countries. Sex showed to be mostly non-significantly associated, however in some Eastern and Southern countries it plays a significant role. The additional factors examined showed less consistent picture. While chronic diseases with stronger disease burden were associated with higher limitation, diseases that are well treatable (like high blood pressure) showed in some countries strong associations with functional limitation while in others there was no clear relationship.

Conclusions

Having in mind the aging of the population, the problem with the functional limitation in higher ages will increase furthermore. This is an issue which should be taken into account in health promotion policies. The role of chronic diseases and their association with disability cannot be neglected. Prevention policies should put more effort in identifying earlier the vulnerable population (e.g. less educated) and promote health care initiatives.

Key messages

Age and education are strong determinants of functional limitation across all European countries. Sex showed inconsistent patterns. Functional limitation is in general strongly associated with chronic disease. However, differences in Europe were found with regard to some specific conditions.