bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of health literacy as a public health strategy to counter act the anti-vaccination movement in the web
Authors: Saboga-Nunes L
Published: November 2019

During the last three years information systems in Europe have shown an increase of cases related to certain diseases considered under control due to vaccination. In April 2017 ECDC reported 9 fatalities by measles and rubella outbreaks. More than 1500 cases of measles in 14 countries were reported in January and February (one of the worst outbreaks in recent years). In the first semester of 2018 in Europe 41 thousand more new cases were registered (17.073 more than in 2017). In Portugal during the first 4 months (2017) there were more cases of measles than during the last 10 years, and in 2018 new cases registered indicated a 5 times increase (162 cases), when compared with the previous year (2017). In Germany, 18% less vaccines were sold (significant drop between 2015 and 2016). It is essential to understand how health literacy is shaping social representations built around the anti-vax movement and the role of the media in their building process (e.g. Facebook /study case Portuguese community). We conducted a content analysis of Facebook pages related to ‘vaccines’ in Portuguese show that the first 2 hits are anti-vax pages with more than 4k likes while the first pro-vax Facebook page (from a nurse) has only one like. In the fourth rank with 43 likes, comes the first institutional Facebook pro-vax page. When considering health literacy of those involved in the dissemination of these messages, a clear mandate to public health stakeholders to become more engaged emerges as an urgent need. Public health is not visible on the web with the same intensity as anti-vax movements. A public health strategy should be based in a pro-active approach instead of being reactive to negative opinions about vaccinations.
Risk factors of disability pensions – what will twin studies from Finland and Sweden add?
Authors: Ropponen A , Svedberg P
Published: November 2019

Background

Finland and Sweden have been forerunners to investigate social insurance in twin cohorts. Using twin cohorts to research disability pension (DP) has provided a unique possibility to control for genetic and environmental factors (i.e. familial confounding). This is important, since genetics is known to play an important role in many chronic diseases for DP such as low back pain (30%), depression (40%) and a moderate (35-48 %) role in DP. Furthermore, familial confounding can be expected to affect many risk factors, i.e. health and behavior related factors and is therefore of interest in the associations between risk factors and DP.

Methods

In twin cohort studies for DP, first, the twins are treated as singletons, and the effect of risk factors on the incidence of DP is analyzed by applying regression models. Second, analyzing twin pairs discordant for both outcome (DP) and risk factors provides a possibility to control for familial confounding. This co-twin-control design is a unique tool, includes investigation whether twins who are exposed to a specific factor of interest more often are granted a DP than their non-exposed co-twins.

Results

Co-twin control design allows adjustment for familial confounding. Therefore, the results based on discordant twin pairs add to the epidemiological findings of unrelated subjects. Based on population-based twin cohort studies with long follow-up, indications exist that the familial confounding may have different role in the association between risk factors and DP depending on risk factors of interest but also on diagnosis group for DP.

Conclusions

Evidently the underlying medical condition is important, and the risk factors vary between diagnosis groups of DP. However, also familial factors play a role in process of sickness absence, in the transition from sickness absence to DP, and for DP. Therefore, need for early identification of risk factors and tailored interventions of prevention is emerged for public health.
Mental health in childhood and adolescence in association to sickness absence and disability pension
Authors: Narusyte J , Amin R , Ropponen A , Svedberg P
Published: November 2019

Background

A large amount of studies have previously reported associations between sociodemographic, socioeconomic, health- and work-related factors and future sickness absence (SA) or disability pension (DP). However, the knowledge is still scarce regarding the associations between mental health problems and disorders during childhood and adolescence in association to future work incapacity, and regarding the role of familial influences on the associations.

Methods

The studies were based on 2,690 twins born 1985-1986 in Sweden who participated in the Twin Study of CHild and Adolescent Development (TCHAD). The twins were followed repeatedly at ages of 8-9, 13-14, 16-17, and 19-20 years. The presence of depressive, anxiety, rule-breaking, and social phobia symptoms were assessed through self-reports. SA and DP data were obtained from national registries. Group-based trajectory, logistic regression and Cox proportional regression analyses were applied.

Results

More than half of the twins that were on SA or granted DP had stable moderate levels of the mental health symptoms during adolescence. Cox regression analyses showed that rule-breaking behavior was associated with a higher risk for SA with the highest HR of 1.12 (95% CI 1.05-1.19) at age of 8-9 years. High levels of anxious and depressive symptoms were associated with DP despite age at symptom assessment. The associations attenuated slightly when familial factors were taken into account. The association between social phobia and SA was to some extent explained by sex and parental education except for when social phobia was measured at ages 19-20 years (OR 1.22, 95% CI 1.10-1.34). The results changed slightly when further adjusting for familial factors.

Conclusions

Familial factors had no major importance for the studied associations. Hence, early life public health interventions to improve mental health might reduce the risk of future work incapacity in young adulthood.
EU level actions and instruments to support the implementation of integrated care
Authors: Gatzoulis L
Published: November 2019

Issue/Problem

The significance of integrated care as a means for improving health outcomes and the effectiveness and sustainability of health and care systems is acknowledged in several policies at national and EU level, for example: the European Commission’s Communication on effective, accessible and resilient health systems, the 2017 European Semester: Communication on Country Reports, the Joint Report on Health Care and Long-Term Care Systems and Fiscal Sustainability by the European Commission and the Economic Policy Committee, the Companion Report 2017 of the State of Health in the EU and the most recent Commission Communication on the digital transformation of health and care in the Digital Single Market. As such, there may be no doubt about whether one needs to transform the health and care model and move to integrate care, but the question is how to design and implement integrated care successfully. One pre-condition for this to happen, is for health authorities to have adequate capacity and relevant know-how.

Results

The European Commission aims at assisting Member State authorities at national, regional and local levels to fulfil this pre-condition and proceed with their health system reforms. There is a number of instruments, initiatives and funding support to raise the capacity of national and regional healthcare authorities to adopt and scale up integrated care.

Lessons

There is an increasing demand and need to provide support and assistance to Member states to drive the transformation of healthcare systems towards more coordinated, integrated and sustainable healthcare systems.
Maturity of integrated care in Scotland - What can we learn?
Authors: Anderson S
Published: November 2019

Issue/Problem

Multiple chronic conditions and the complexity of needs arising from them demands a rethinking of delivery systems, innovation, and resourcing. Tools and methodologies that help understand these complex transformational processes and orchestrate discussions of all stakeholders involved are core to this process. As a result, Scotland was keen to apply SCIROCCO tool to assess their readiness for integrated care.

Results

The application of SCIROCCO self-assessment tool showed a range of strengths and weaknesses of Flanders region to adopt and implement integrated care. More than 15 stakeholders were involved in this process which proved the importance and added value to the assessment process. In addition, the outcomes of this process help to identify the potential focus of the capacity-building support.

Lessons

SCIROCCO tool is a very useful participatory tool which can help to drive the transformational change towards integrated care.
Maturity of integrated care in the Basque Country - What can we learn?
Authors: Txarramendieta J
Published: November 2019

Issue/Problem

The need for sustainable resourcing drives professionals, end-users and the wider public and private sectors to draw on their experience and expertise to meet those needs. Tools and methodologies that help understand these complex transformational processes and orchestrate discussions of all stakeholders involved are core to this process. As a result, Basque Country was keen to apply SCIROCCO tool to assess their readiness for integrated care.

Results

The application of SCIROCCO self-assessment tool showed a range of strengths and weaknesses of Basque Country to adopt and implement integrated care. More than 15 stakeholders were involved in this process which proved the importance and added value to the assessment process. In addition, the outcomes of this process help to identify the potential focus of the capacity-building support.

Lessons

SCIROCCO tool is a very useful participatory tool which can help to drive the transformational change towards integrated care.
Slovenian PH system: reshaping and new approaches to interventions and linkages with primary care
Authors: Albreht T , Pribakovic Brinovec R , Gabrijelcic M
Published: November 2019

Slovenia’s public health started a new era of proactive interventions jointly with primary care since early 2000s, based on the heritage of the outreach approach developed in that territory in early 1930s. The National Programme for the Early Detection of Risk Factors for Cardiovascular Diseases was launched two decades ago.

Development of a screening programme led to the need to build capacity for lifestyle interventions and the subsequent broader involvement of public health and health care professionals.

Public health interventions addressing challenges, such as those related to primary and secondary prevention, have to be closely linked to the work in the local communities. This is best achieved in developing programmes jointly with primary care, municipalities, educational and social sector as well as NGOs. The original approach of developing secondary prevention interventions needs a further amplification in broadening the base for interventions from a single problem to an array of issues.

Previous approach with the development of Health Education Centres (HECs) was to be upgraded through the development of Health Promotion Centres (HPCs). This required the move from a more traditional approach to addressing individual determinants arising primarily in individuals to a comprehensive approach addressing health and health determinants in all ages. The focus of intervention becomes the local community and the central location is the primary health centre with the specific focus to health equity.

Development of primary and secondary prevention interventions is a measure to address health in the local community. Their placement in primary care ensures equality in access to all citizens in all age groups. Flexibility in approach enables us to develop interventions for the different facets of health.
Introduction to soft skills
Authors: Czabanowska K
Published: November 2019

She will introduce soft skills, their use and development through a PH career. She will outline soft skills related to medical background and those related to non medical background and how people using them should work together. The last part will introduce soft skills use for vulnerable population providing examples of their importance in specific situations. (30’)
Building bridges between public health and law
Authors: Tahzib F
Published: November 2019

The nanny state has become a metaphor in debates about public health regulation, cautioning governments against taking action. The nanny state metaphor is being used to criticize health policies for restricting choice and autonomy and warn against undue paternalism. Nanny state accusations can function as powerful rhetorical weapons against interventions that are intended to benefit people.
Example 3: The Dutch ‘polder model’
Authors: Plochg T
Published: November 2019

The Dutch are known for their ‘polder model’, a form of consensus decision-making and cooperation despite differences. In line with this longstanding tradition, the Federation for Health has transformed itself from a national public health association into a national public-private network that strengthens the foundation for health actions at the widest scale possible. More than 70 organisations have joined the network. Amongst them organisations like public health institutions, professional societies, healthcare insurers, private companies, and health start-ups. Instead of calling for regulation or legislation, the Federation for Health promotes the incorporating of the ‘right’ incentives in healthcare and society at large. Examples are the advocating for a national prevention agreement, the development of a new business model based on health (instead of disease), and the advocating for a national digital health agenda. The Federation for Health is using the following tools: Sharing of informationDevelop common groundDevelop an all-inclusive advocacy strategyBroaden the vision to non-health-related areas (e.g. social domain, housing, education, businesses)Collaborate outside the field of health (building bridges)
Country Report: How do Greek municipalities currently promote health and health equity?
Authors: Velissari J , Vantarakis A , Zamparas M
Published: November 2019

The establishment of municipalities in Greece is governed by Kallikratis Law (2011). There are 325 municipalities in Greece. The municipalities promote activities relating arts, education, health, sport and social services. In addition, there are a few national laws giving municipalities extra possibilities. Main financial sources of municipalities are municipal taxes, fees and duties, VAT tax. Central government finances major infrastructure projects in the municipalities, based on individual projects. Also, some NGOs are helping municipalities in their social role.

Aim

The investigation of the promotion of health and health equity in municipal level.

Findings: Social determinants of health are the main causes for health inequalities at a municipal level. Due to that, some municipalities have developed programs to mitigate them. Municipalities have developed the National Intermunicipal Network of Healthy Cities - Health Promotion has as its sole purpose the prevention of diseases, health Promotion, the screening control of high-risk population groups and generally promote integrated policies in the field of Public Health. Today includes 218 (67%) KALLIKRATI Municipalities from all regions of the country.

Municipal social capacities are: kindergartens, programs for migrants, daily care centres for elder people, health care centres (urban and rural), community nursing /home nursing care, mainly to elder and vulnerable groups.

Environmental hygiene: The most important role is the collection of household waste and their appropriate disposal, as well as the protection of the environment.

There are difficulties in promoting health and health equity by the municipalities: a) lack of financial & human recourses, b) lack of explicit responsibility of Municipalities c) lack of capacity about health issues and 4) bureaucracy.

Conclusions

There is place for action at the municipal allowing municipalities to implement various programs relating to healthy living environments.
How the City of Utrecht develops a Health and Equity in all Policies approach
Authors: Weber M
Published: November 2019

Public health policy, spatial and environmental policies are within the Dutch municipalities’ competencies. In 2021 a new act will be implemented, in which todays’ more sectoral acts and decrees will be integrated into the so-called (Healthy) Living environment act. This will require more integrated, inter-sectoral and multi-level governance approaches. And new topics and societal challenges, such as health, sustainability and resilience, are introduced within the physical planning domains.

Dutch reviews learn that public health and social domains are collaborating quite well at the local level. The cooperation and integration of health, environmental and spatial planning, on the other hand, often is less or even absent. In Utrecht, though, the latter inter-sectoral approach is strong; health in all policies has been the ‘mantra’ since several years. Supported and institutionalized through strong political leadership, and inter-disciplinary teams at neighbourhood and city level, for policy development and implementation in line with the city’s ambitions of Healthy Urban Living for Everybody.

Utrecht is the healthiest and fastest growing city in the Netherlands, and aims to use its growth (in population, jobs, houses, etc.) to address health inequalities. The city is linking spatial challenges with social challenges, building and improving houses and residential areas for all citizens. A new initiative, called social renovations, will be explored and reviewed within the JAHEE process. This initiative addresses many of the relevant topics, such as healthy living environment planning, stakeholder involvement and specifically reaching ‘hard to reach groups’, and improving housing and public space conditions and subsequently health and well-being of vulnerable groups.
Developing a health information (HI) training programme: strengthening the public health workforce
Authors: Velez-Lapão L , Beja A , Nogueira P
Published: November 2019

Background

New developments and technologies require skilled professionals to manage and use public health information in most efficient ways. However, currently training in specific fields is lacking and large inequalities exist in Europe in terms of the availability and training of qualified professionals.

Methods

In order to set up a sustainable EU HI training program for HI professionals, core modules need to be selected to provide adequate training across Europe. This study a scoping review and is doing a survey on current existing HI programmes and aimes to identify the main educational components needed to train HI professionals. The databases of Pubmed and Ebsco were searched for the scoping review. The survey is being circulated to representatives of InfAct in 28 countries. Based on the results a baseline HI training programme for practicing public health professionals will be proposed.

Results

Initial search identified 249 papers. After the exclusion of duplicates and unavailable documents, 53 papers were selected for review. Only 5 papers were found related to the European context. However the results from other papers could be extrapolated. The results were organised in 3 domains: organisation, people and technology dimensions. The development of HI capacities is often done through multiple and sequential interventions, which are adapted to the needs, conditions and resources available within each HIS. Thus, the importance of aligning training with working processes and usability in professional practice is key. This can be challenging, as HI functions are diverse across Europe. The results of the survey will be presented when processed by the time of the workshop.

Conclusions

There is a need for qualified skilled professionals in HI taking into account a changing global environment. Most of HI capacity building programmes are yet to reach maturity, and this review and survey identify a set of important areas for further development of the HI training programme.
Researching the health workforce: a framework for action
Authors: Kuhlmann E , Batenburg R , Dussault G
Published: November 2019

Background

The importance of a sustainable health workforce is increasingly recognised. However, the building of a future health workforce that is responsive to diverse population needs and demographic and economic change remains challenging. There is a need to improve research and education to address these questions effectively and build capacity for public health approaches in health workforce policy. This paper introduces an agenda for health workforce research.

Methods

The research agenda has been developed through bringing together expertise and knowledge from a wide range of authors and leading organisations involved in health workforce research and policy. It takes a health system approach and focuses on Europe.

Results

Six major objectives for health workforce policy were identified: (1) to develop frameworks that align health systems/governance and health workforce policy/planning, (2) to explore the effects of changing skill mixes and competencies across sectors and occupational groups, (3) to map how education and health workforce governance can be better integrated, (4) to analyse the impact of health workforce mobility on health systems, (5) to optimise the use of international/EU, national and regional health workforce data and monitoring and (6) to build capacity for policy implementation. The research highlights critical knowledge gaps that currently hamper the opportunities of effectively responding to these challenges and advising policymakers in different health systems. Closing these knowledge gaps is therefore an important step towards future health workforce governance and policy implementation.

Conclusions

There is an urgent need for building health workforce research as an independent, interdisciplinary and multi-professional field. Action has to be taken to establish new training courses and Master programmes to create competences for leadership in health workforce research.
Community-based participatory health research: principles and practice
Authors: Unger H
Published: November 2019

Community-based participatory research (CBPR) is a collaborative approach to research that aims to improve the health of marginalized communities and reduce health disparities. It starts with a topic of concern for the community and involves iterative cycles of action and reflection to initiate change. Community members are involved as partners and trained as peer researchers to take an active role in the research process. Processes of capacity building and empowerment play a prominent role. As a general principle, participatory research does not primarily focus on health problems, but pays at least equal attention to the resources and capacities of communities. It places a strong focus on developing trust and reciprocity in research relationships.

Regarding methodology, various empirical research methods are used in CBPR study designs, including qualitative, quantitative, mixed-methods and arts-based methods. Arts-based methods such as photovoice, digital storytelling, mapping and drawings facilitate the expression of lived experience, including sensitive aspects, through creative verbal and non-verbal means. These methods expand the available means of expression and as such are highly valuable in research fields where verbal communication is challenged by language barriers and diverse cultural backgrounds as well as sensitive topics and experiences. Participatory health research has been conducted with diverse migrant and refugee groups internationally. Due to legal and other reasons, refugees may be limited in their capacities for participation. The presentation will discuss the strengths and limitations of CBPR including structural obstacles to equitable partnerships.
Capacity building in the field of public health in Tunisia: processes and challenges
Authors: Chereches R , Coman M A , Oltean O , Bozdog E
Published: November 2019

Introduction

Capacity building activities between 3 Tunisian Medical Faculties (University of Sfax, University of Tunis el Manar and University of Sousse) and 3 European Universities (Babes-Bolyai University, University of Southern Denmark and Trnava University) began in 2017 in the framework of an Erasmus+ project. The aim of the collaboration is threefold: first, Tunisian partners were assisted in developing the infrastructure of the Centre for Evidence into Health Policy (C4EHP); second, EU- Partners delivered the Research into Policy training programme with 3 modules: public health research methods, evidence-based policymaking and health promotion policies. The program consisted of train-the-trainer and train-the-trainee sessions; third, partners are continuously working on strengthening the collaboration between the academic and non-academic sectors in the field of public health.

Lessons learnt

Developing the C4EHP contributed to the official recognition of the research structure in the partner Universities. The challenges faced were administrative and legislative national procedures and delays in the equipment delivery and instalment. The train-the-trainer sessions empowered the 18 Tunisian participants to acknowledge their importance in the development of the public health field. Knowledge transfer faced challenges due to differences in the culture and working process, adhering to deadlines, communicating via email as well as due to language barriers. The capacities were, however, strengthened when the trainers started teaching themselves and delivered the train-the-trainee sessions. We observed a level of distrust from the non-academic sector due to previous international projects, unrelated with the current project or implementation team, and which had elicited little to no impact. Development of local collaboration between academic and non-academic sectors needs to be explored deeper.
Capacity building in public health with two Saudi universities: Challenges of knowledge transfer
Authors: Aro A R , Palianopoulou M , Ikonen A L , Eklund Karlsson L
Published: November 2019

Introduction

Collaboration between SDU and two Saudi Arabian (KSA) Universities started in 2012. Case 1 was a new public university for women; the contract (until spring 2017) aimed at knowledge transfer from SDU to two Bachelor of Science curricula (Epidemiology, and Health Education and Promotion). The aim was to train the trainers by teaching the 1st student cohort 100% by the SDU staff and for later cohorts to increase the teaching by local staff gradually. The SDU teams travelled to KSA to run 1-month courses at a time. In Case 2 (ongoing since 2017), 1-week courses for health professionals are offered in an established mixed-gender university; the courses are for a fee.

Lessons learnt

In case 1, knowledge transfer was challenging, since the local staff was busy ‘with their own courses’ and had low interest to learn from SDU. The SDU and the local group were working as separate teams. The local staff saw knowledge transfer as receiving the slides and other material from SDU. Only in the 5th contract year, interaction started mainly via staff capacity building workshops organized by SDU. The students appreciated the SDU teaching, and on the administrative level collaboration worked very well. Due to the lack of ownership among local teachers and deficits in cultural adaptation on- site, knowledge transfer was not successful.

In case 2, different cultural approaches seem to clash; SDU prefers to market the courses early and e tailor them for the target groups; the Saudi cultural tradition relies less on organized marketing and is flexible with the registration deadlines. For the 1st course, this meant that the SDU team travelled to KSA without knowing who and how many participants had signed up. Learning the background of the participants only when the course started meant that the teaching was finalized from day-to-day while running the course. In the end, based on the course evaluation, the 9 participants were very satisfied with the course.
Experiences and pedagogical considerations of training the trainers in Saudi Arabia
Authors: Ikonen A , Eklund Karlsson L , Palianopoulou M , Aro A R
Published: November 2019

Introduction

A student-centered teaching method engages the student to take responsibility for his/her own learning. In this pedagogical approach, the role of the teacher has become to be a supportive coach rather than an authority and one-way superior knowledge provider. A teacher with good teaching skills actively involves and engages students in the learning process. Qualified teacheŕs competence consists of the substance of the subject taught, pedagogical skills as well as of the teaching experience gained after teacher training.

Lessons learnt

In our case we organized a 9-day workshop to enhance the teaching skills of teachers in one department of our collaborator university in Saudi Arabia (KSA). The workshop included lectures on-site and individual and group assignments such as integrating active learning methods into teaching. The pedagogical workshop was a part of the cross-cultural knowledge transfer project between SDU and (case 1) university in KSA in the Bachelor level education in 2013-2017. The project disclosed the cultural differences in teaching and learning and the different traditions of education. We found that there was a strong tradition of memorizing among students in KSA, which reflected into the attitudes of both teachers and students.

This workshop was the first pedagogical training for the most of participants and it revealed that they lacked theoretical knowledge on teaching, e.g. the concepts of student-centered teaching were new to the participants. However, they had extensive teaching experience and strong knowledge of the content of the subjects taught. The acquired knowledge of the basic approaches of student-centered teaching expanded participantś thoughts on how they could better interact with students instead of one-way lecturing. In the workshop, dialogue was used as a teaching method, and participants found the sharing of learning experiences in a peer group a useful and new way to learn at work.
A health screening of European political party manifestos to inform priorities and strategies for influence
Authors: Bos N , Bekker M P M
Published: November 2019

Background

The European Parliament (EP) elections gave way for a new political cycle for the European Union (EU), and thus for public health (PH); an area 70% of the European citizens want the EU to do more on. This research clarifies if and how EU political parties prioritise health and where the gaps are.

Methods

A literature search was undertaken to 1) gain insight in which sectors the EU can establish policy impacting PH, 2) map actors that play a role in PH policy, and 3) find building blocks for a receptive environment. Four interviews were held with NGOs. Eleven EU political parties’ manifestos were thoroughly screened and two interviews were held with MEPs of two different parties.

Results

Eight sectors were identified in which the EU has (shared) legislative power and can positively impact PH. How these policies are packaged depends on who places their beliefs on the EU agenda. Actors in the political arena such as, parties that will dominate the EP, the Member States, NGOs, and epistemic communities need to make use of building blocks such as trusting relationships, broad and long term coalitions between different actors, and effective translation of expert knowledge, in order to create a receptive environment. In the manifestos health is (in)directly touched upon, but not prioritised. They look beyond the medical sector, but whether plans are meant to be linked to PH improvements is not always clear. MEPs are keen to prioritise health more at EU level, but respect the EU’s health competences.

Conclusions

Health is recognized by parties as relevant in non-medical sectors, which offers positive perspectives for the future, as other EU sectors’ policy can impact public health. The agenda-setting of health can be boosted by organizing actors in such a way that they create receptive environments amongst each other.
Practical experience with SCIROCCO twinning and coaching- the perspective of a receiving region
Authors: Txarramendieta Suarez J
Published: November 2019

One of the SCIROCCO twinning and coaching activities was conducted between two healthcare systems: Scotland and The Basque Country. The objective of this presentation is to describe the experience of the receiving region, the Basque Country. In particular, it will outline the role and engagement of the voluntary sector in the provision of integrated care in the Basque Country, in terms of: Organisation, including the definition of the voluntary sector, its size and stakeholders;Engagement of the voluntary sector with integration of careMotivation for the knowledge transfer activity with ScotlandObjectives of twinning, potential benefits of the knowledge transfer activityFeasibility and required adaptation for the transferPriority actions, main learningsConclusions, lessons learned
Discussion and dialogue on steps forward for the SCIROCCO tool
Authors: Whitehouse D
Published: November 2019

The objective of this presentation is to inspire input from workshop participants about how the enhanced SCIROCCO tool could even better support knowledge transfer in different regions. Participants will be encouraged to reflect on what the tool can do for them, how they can help to shape its content, and to ask questions of their own. List of suggested questions: What do you think about the tool as it stands today?Can you see ways of using the tool in your region/ on your site?What do you think about the plans to expand the tool as part of the SCIROCCO Exchange project?Would you be willing to get involved in shaping and enhancing the tool?Would you be willing to get involved in expanding the tool’s use further? Could you use the tool for any twinning and coaching?Do you have any suggestions for improving the functionality of the tool?What are your opinions about the proposed way of evaluating the enhanced SCIROCCO tool?Do you have any suggestions for improving the evaluation?How would you get more involved in SCIROCCO Exchange?
Exploring equity, social determinants of health and gender considerations for antimicrobial resistance
Authors: Saint V
Published: November 2019

This presentation will focus on three aspects related to the equity, social determinants and gender considerations relevant to AMR. The presentation will begin with a general description of how structural forces and socioeconomic inequities can result in specific population groups in society having differential exposure and vulnerability to AMR as well as suffering differential social, economic and other consequences and impacts from the associated ill health. Secondly, will be an explanation of the how the application of conceptual frameworks and approaches on equity, social determinants and gender on can shed valuable light on the specific pathways and mechanisms through which these patterns arise, and how these factors may influence the effectiveness of any initiatives and interventions aimed at tackling aspects of this global health challenge. The presentation will conclude by providing an overview of the emerging results from a scoping review on the gender, equity and social determinants considerations for tackling AMR and promising directions for inter-/trans-disciplinary research on this theme.
Psychosocial aid provided to and sought by rescue workers after the March 2016 terrorist attacks in Brussels, Belgium. A qualitative analysis
Authors: Van Overmeire R , Van Keer R L , Vesentini L , Six S , Bilsen J
Published: November 2019

Background

During the terrorist attacks of 22/03/2016 in Brussels, Belgium, hundreds of rescue workers were present or came to the sites to give aid to the victims. However, until now, there is little research about these first responders’ own need for aid and support immediately after their work or later, and about how they experienced that aid.

Methods

Using half-structured interviews, we collected data from 31 first responders including 4 nurses, 5 soldiers, 7 firefighters, 11 airport police officers and 4 Red Cross volunteers. Interviews were transcribed, coded and analyzed by two researchers.

Results

Generally, debriefings were organized at hoc, informal and at the day of the event. Sometimes, an additional group conversation was organized in the week or weeks later. Further initiative was left to the rescue workers themselves to find psychosocial aid, whether inside or outside their organization. Because of many contextual factors (macho culture, no sense of normality of reactions on traumatic experiences, (lack of) social support, stigma of psychosocial health, lack of understanding of those who did not experience it...) rescue workers (mostly police officers and soldiers) often did not find the necessary psychosocial aid. Some workers simply accepted that they have changed due to the attacks. Those who did search for psychological help, experience several problems: the type of help, the financial costs, a lack of recognition of the psychosocial problems, etc.

Conclusions

Psychosocial aid of first responders is often too short-term, ad hoc, and poorly prepared and organized. Awareness of adverse changes in health or personality can come long after the debriefing sessions. Furthermore, the quality of the debriefings is not always up to standard.

Main message

Psychosocial aid must not only be aimed at the short term, and must be better prepared and organized.
Facilitating the collective expression of parents of disabled children at a scientific conference
Authors: Chatelin A , Scelles R , Sherlaw W
Published: November 2019

The European Academy of Childhood Disability is an academic association with over 500 members (health, social work and educational professionals working with children with disability) from some 35 different countries. The Academy wishes to put families at the heart of its agenda. Partnership with families has the potential to improve care and education outcomes and renew practice. It may also facilitate understanding between professionals and families. To this end for the annual conference in Paris a series of structured interactive group activities have been designed to facilitate the sharing of experience and expression of families and to gather their concerns. These activities designed by disability specialists in partnership with family representatives call on small group work “world café” style focus group methodology. They are structured, varied, interactive and take place in a specially organized conference session over 3 hours. Sensitive feedback is provided by experienced pediatricians in the childhood disability field. Parents provide narratives of significant experiences for their children prior to the conference. These are shared in groups of 3. Questions explored include “What matters for the happiness of your children? “Please give examples of things which have happened in your child’s life which seem to be key experiences” Relating to the concept of F-words, (Rosenbaum, Gorter, 2011) parents have also been asked to consider different dimensions of their children’s well-being such as friendship, functioning, fitness, family, fun, and future. Group discussions are noted, recorded, retranscribed and analysed allowing, the gain of insights and providing possible building blocks for professional training. Such qualitative data allows new topics and research on a joint family-professional agenda to emerge. These may be tackled at future conferences thus building bridges between specialists and families.
Estimated number of homeless people in Marseille in 2016
Authors: Daguzan A , Farnarier C , Jaubert S , Pironti G , Gentile S
Published: November 2019

Context

Since 2011, a project in favour of access to rights, access to care and continuity of care for homeless people has been implemented in Marseille (ASSAb project: Access to Care for the Homeless). One of its main lines of action is to improve public knowledge and has led to a census of homeless adults in Marseille in 2016.

Methods

The methodological approach chosen is based on a survey via homeless services, known as the ’Danish’ method, which consists of counting the number of people who have used homeless services at least once over a given period (Brousse, 2005; Marpsat, 2009; FEANTSA, 2016). This approach avoids the difficulties of recording seasonal variations or any other one-off event and controls double counting.

Results

In 2016, during the year, 14,063 people were at least once homeless in an emergency and accessed a dedicated reception or care facility. Compared to 2011, when 12,648 people were counted, this study reveals an overall increase of 11.2% in this population and a important increase in the number of women (+47%), elderly people (+24%) and minors (+85%).

Conclusions

Association, institutions and professionals in the field report a greater feeling of increase in the population concerned than shown in this study. The saturation of the reception and support capacities of the structures and the evolution of the situation since 2016 partly explains this representation difference.

Key messages

This study informs policy makers and helps them in strategic orientations (Court of Accounts, 2017). This study provides input for the thinking and actions of the homeless sector.
Health, wellbeing and access to care of undocumented migrants in Geneva, Switzerland
Authors: Jackson Y , Consoli L , Duvoisin A , Fakhoury J , Ferro-Luzzi G , Burton-Jeangros C
Published: November 2019

Background

Switzerland hosts 50’000 to 100’000 undocumented migrants but hardly any evidence exist about their health and wellbeing. A pilot regularization policy took place in Geneva (2017-2018).

Methods

Parchemins is a mixed-methods prospective study assessing the impact of legal status regularization on undocumented migrants’ health and wellbeing. The quantitative data collection uses yearly face-to-face health questionnaire. Wellbeing is measured by self-reported satisfaction with life on a 10-point Likert scale. We present the results of the first wave of data collection conducted before regularization.

Results

Participants were mainly women (71.9%) from Latin America (63.2%), aged 44.2 (SD 10.4) years, with secondary or higher education (77.3%), living in Geneva with a partner (47.6%) and minor children (22.3%) for an average of 11.8 (SD 5.4) years. While 82.2% reported good to excellent health, 54% presented overweight or obesity and 21% suffered 3 or more chronic conditions. Self-reported prevalence of hypertension, hypercholesterolemia and diabetes were 17.6%, 7.6% and 4.9%, respectively. Screening for depression and anxiety using PHQ-9 and GAD-7 scales was positive in 45.2% and 35.9% of participants. Only 29.9% had a health insurance. In the previous year, 74.8% had at least one medical consultation and 30.4% consulted in emergency but 27% had renounced to seek care for economic reasons. Overall, 97.3% were exposed to health hazards at the workplace and 5.9% suffered an accident leading to work interruption in the last 6 months. Overall, life satisfaction level amounted to 7.4 (SD 2.2) out of 10.

Conclusions

The baseline results show a contrast between good self-reported health and fair wellbeing with frequent comorbid health conditions notably of mental origin, exposure to occupational hazards and economic limitations in the ability to respond to one’s health care needs. Next study waves will shade light on the public health and clinical impact of regularization.

Key messages

Legal status may act as a key determinant of health therefore regularization is likely to produce significant health effects. Undocumented migrants good wellbeing and self-reported health contrasts with high morbidity notably of mental origin.
Parent emigration and physical health of children left behind: systematic review of the literature
Authors: Racaite J , Surkiene G , Jakubauskiene M , Sketerskiene R , Wulkau L
Published: November 2019

Background

Children left behind (CLB) are those, who have been left behind at their original residence while one or both parents migrate to other places for work. The aim of this study was to systematically review studies where the physical health consequences for CLB were analysed.

Methods

We searched the Web of Science, PubMed, Academic Search Complete, PsycINFO and Cochrane databases. We included studies reporting physical health outcomes of children affected by parent migration.

Results

We selected 35 studies from a total of 2191. The results reveal that, overall, the absence of one or both parents is related to poorer child health - the nutrition of CLB is not healthy or balanced and is insufficient, leading to higher rates of anaemia and poor growth indicators of affected children. Boys left by parents are smaller than boys who were never left behind. CLB face lower underweight or stunted growth risks due to the additional income from remittances which ensures sufficient food for the household, this can also lead, however, to overweight and obesity. Unhealthy lifestyle behaviours such as smoking, alcohol, food preferences, lower physical activity and higher risk of injuries were more prevalent among CLB. CLB were more likely not to have completed the recommended vaccination programme than those living with their parents. Opinions vary on how emigration of parents affects children’s well-being and quality of life. CLB had higher probabilities of higher well-being than children living in non-migrant households. However, health-related quality of life (HRQoL) of CLB scored significantly lower than HRQoL of non-left-behind children.

Conclusions

The migration of parents has negative impacts on the child’s physical health, however it can also have positive impacts on children’s well-being when basic needs for sufficient nutrition are not satisfied in the home countries. Public health interventions should be taken to ensure the health of the CLB population.

Key messages

This is the first systematic review on the physical health of CLB. The well-being of CLB is poorer and they are at risk of health problems, such as insufficient and/or unbalanced diet, unhealthy behaviours and incomplete vaccination status.