bluuebunny/crossref_metadata_2025 huggingface dataset:
SHadow Under the Lamp (SHUL): Smoking behavior of the health professionals
Authors: Rahman M A , Susanto A W , Quarashi A A , Raymond A , Taufik F F , Mahmud I , Al Kloub M I , Oli N , Martini S , Khan Z
Published: October 2020

Background

Smoking cessation is the best option a health professional can offer to the patients for averting the preventable causes of mortality and morbidity.

Purpose

To determine smoking behavior, preferred cessation methods, and attitudes towards smoking cessation amongst health professionals.

Methods

The cross-sectional study, conducted in six countries, included doctors and nurses working at different hospital settings. Participants responded anonymously to an online questionnaire.

Results

Among 1109 participants, 36% were from Saudi Arabia, 14% from Nepal, 14% from Indonesia, 12% from Australia, 12% from Jordan, and 12% from Pakistan. Mean age was 33 years, 61% were females and 58% were nurses. One in eight (12%) was daily smoker. Among current smokers, 42% smoked 2-9 cigarettes/day, and 26% had their first cigarette within 5-30 minutes after waking up. Half of the smokers perceived it as 'very important' to quit smoking, 30% had tried to quit in the last six months, and 31% preferred to have a group quit program with the same health professionals. Only 17% had formal training on smoking cessation, but 57% were interested to receive one. Half of the participants said they (53%) 'always' asked patients if they smoked, but 89% said they advised to quit, 76% said they assessed intention to quit, 28% said they assisted by providing materials on cessation, and 33% said they arranged follow up for cessation. Compared to current smokers, never smokers were more likely to 'always' ask patients if they smoked (78% vs. 22%, p = 0.044, ORs 1.39, 95%CIs 1.01-1.91), assist smokers by setting quit dates (74% vs. 26%, p = 0.039, ORs 1.54, 95%CIs 1.03-2.29), arrange follow up (77% vs. 23%, p = 0.044, ORs 1.40, 95%CIs 1.01-1.94).

Conclusions

Health professionals reported moderately good behavior around advice to smokers, but it is much worse among current smokers. Health professionals who smoke should be both encouraged to quit and to better support their patients to do so.

Key messages

Smoking cessation support for patients was not good among health professionals, who were smokers. Health professionals need to quit smoking in order to provide better cessation support for patients.
Women’s health in prisons in Africa: prevalence and challenges to address HIV among women in prison in Africa
Authors: Salah E
Published: October 2020

In Africa around 3.2% of the prison population is represented by women. People in prison are 5 times more likely to be living with HIV than adults in the general population. Moreover, women in prison have a higher HIV prevalence than men. The factors that lead to women becoming incarcerated are often also those that lead to their increased risk of acquiring HIV infection.

Their situation in prison is exacerbated by stigma and discrimination, gender-based violence and inequality. Women have limited access to health care in prison settings and are less likely to receive treatment than men. This is even more the case in Africa, where the precarious and sometimes inhuman prison conditions, render the health-related interventions addressing women health particularly challenging. Their specific health care needs, such as sexual and reproductive health care, treatment of infectious diseases including STIs, as well as nutrition and hygiene requirements, are often neglected. The limited access for women (and their children) to ante- and postnatal care, labour and delivery services and antiretroviral therapy also leads to infants born in prisons being at high risk of contracting HIV. Women in prison should be able to access gender-responsive health care services which are equivalent and of the same quality as those available in the community.

The presentation will present the latest available data on health status and HIV in particular among women in prison in Africa and will present the international standards in health interventions of women in prison.
30.K. Round table: What is and what is not HIA; expectations and realities
Authors:   Organised by: EUPHA Health impact assessment section,   Chair persons: Gabriel Gulis - Denmark, Jean Simos - Switzerland
Published: October 2020

Health impact assessment as a public health tool to contribute to development of healthy public policy and later health in all policies approach entered public health practice, research, education and policy at the end of 1990'. During last 20 years the methodology spread around the globe, tools and guidelines have been developed, potential collaboration with other impact assessments discussed or even legally mandated. A quick search in PubMed using a MESH keyword “Health impact assessment” conducted in January 21, 2020 yielded 628 publications in time period of 2010-2019. Reading the abstract of last 100 from 2019 and partially 2018 based on first authors, manuscripts came from 31 countries of all five continents, USA being the most frequent contributor. This quick search revealed also substantial heterogeneity of the use of term; epidemiological studies, often environmental epidemiological ones, health care intervention evaluation studies, methodological development studies, general evaluation studies are often using health impact assessment label. Out of 100 abstracts, 14 seemed to be in-line with description of HIA by Gothenburg consensus paper, the basic document of HIA. On one hand, this is very positive showing the wide possibilities of use of HIA. On other hand however, it is hazardous as it could lead to misunderstandings and consequently to decreased interest for the methodology. With this regard it shall be noted that after a plateau in number of publications between 2014-2017, there seems to be a consistent decline of new research papers addressing using HIA. Looking at one database only can be a limitation of course. The aim of this round table workshop is to discuss where to go with HIA during coming years, identify potential facilitators for broader implementation and use of the methodology. After introductory presentation by workshop coordinators, five presentations will discuss potential facilitators such as common language and expectations, implementation and place of HIA within public health toolkit, capacity building and recent opportunities such as health in EIA and the SDG's. The final part of the round table will be as general discussion with involvement of the audience facilitated by workshop organizer.

Key messages

HIA is used for different purposes, not only the one described by Gothenburg consensus paper. There is a substantial heterogeneity in use of HIA influenced by language, implementation method, available capacities and motivation.
Building human capacities for HIA
Authors: Haigh F , Kim J
Published: October 2020

Health Impact Assessment (HIA) requires capacity building in technical, operational and strategic domains at individual and organisational levels. HIA capacity building frameworks also need to adapt to different types of HIA approaches and organisational, institutional and cultural contexts. To build capacity in these domains, many institutions around the world develop and provide training programs and technical support fit-for-purpose HIA in their respective local and regional institutional contexts. For example, in Australia, the Centre for Primary Health Care and Equity (CPHCE) has conducted Learning by Doing (LbD) programs in HIA since 2002 which aims at acquiring knowledge and skills through active involvement with practical, real-world experience. These training programs have supported building capacity to undertake HIAs in more than 30 countries and involved more than 2,000 participants. In South Korea, the Korea Institute of Health and Social Affairs (KIHASA) has provided technical and financial support for central and local governments to conduct HIAs since 2008. A total of 27 HIAs were conducted in diverse policy areas including urban planning, housing, transportation, education, welfare, and health services.

In this session, we review the competencies for HIA in the multilevel domains and compare international HIA capacity building programs against these domains to discuss strengths, limitations, challenges and future directions.
A qualitative study on resident engagement in a community-based health promotion intervention
Authors: Srivarathan A , Lund R , Christensen U , Kristiansen M
Published: October 2020

Emerging evidence points towards lower quality of life, more fragile social relations and suboptimal health behaviour and health status of residents living in social housing areas characterized by ethnic diversity and socioeconomic disadvantage. Residents from social housing areas are less likely to engage in health promotion interventions compared to the rest of society. Community-based health promotion interventions developed in collaboration with the target group and adjusted to local context can affect the acceptance of and engagement in such interventions. However, few studies have investigated the potential of community-based interventions in social housing areas. This study explores resident perspectives on engagement in a community-based health promotion intervention focusing on enhancing social relations. Engagement was the key foundation for the designing and implementation of the intervention by the use of graphic facilitation. The intervention consisted of social outings to different sights and historical landmarks in Denmark. The study builds on qualitative methods including participant observations combined with pre- and post-intervention interviews with a selected group of residents (n = 9). Data were thematically analysed with a focus on participation in an everyday life context and by concepts of othering and territorial stigmatization. Engagement in the intervention was motivated by a need for establishing and enhancing social relations, and exploring the world outside the housing area. However, barriers including cultural and language differences among residents and competing contextual factors challenged engagement. We conclude that participatory community-based interventions have a potential to enhance social relations in social housing areas. Nevertheless, it is necessary to understand the motives and barriers to ensure feasible and relevant health promotion interventions and future engagement among residents living in social housing areas.
Built environment and autism: towards a set of spatial requirements for autism friendly cities
Authors: Tola G , Talu V , Lindert J
Published: October 2020

Background

The opportunity for people functioning in an atypical way to autonomously and fully interact with the city is often compromised or denied, due to the gap between their specific spatial needs and the physical and functional organization of the urban environment. The need to reconsider the living environments taking into account the vast diversity of people gained an increasing importance in the overall debate and specifically in the field of urban planning and design. The research aims at investigating the relationship between the urban environment and people with Autism Spectrum Disorder (ASD).

Methods

A scoping review of current available original studies research exploring the relationship between autism and built environment was conducted. PubMed, Scopus, PsychInfo and Web Of Science where searched. Studies included provided spatial requirements for designing autism friendly environment.

Results

In total, 801 studies were identified and 22 were included. Current researches and applications investigating the role of spatial configuration as a means for improving the autonomy of people with ASD almost exclusively focus on closed and dedicated spaces (residences, schools, care facilities, healing gardens) mostly devoted to children.

Starting from this and the data collected, a first set of enabling urban spatial requirements addressing the atypical urban functioning of people with ASD - the reduction of sensory overload and the use of visual supports - in order to promote their possibility to walk autonomously and safely across the everyday city is proposed.

Conclusions

Despite the wide variability of the spectrum which makes it very difficult to define effective design criteria for all people with ASD, it's possible to identify a set of recurrent spatial needs. Furthermore, designing cities for people with ASD can also contribute to healthier and more inclusive urban environments for other groups of vulnerable inhabitants.
Concept and Strategy for Implementing the National Action Plan on Health Literacy in Germany
Authors: Schaeffer D , Berens E , Gille S , Hurrelmann K , Bauer U
Published: October 2020

Background

In Germany, the development of the National Action Plan on Health Literacy (NAP) was triggered by results of the HLS-GER, the first representative study on HL in Germany, showing that more than half of the German population perceive great problems in processing health information. In response to this, a group of 15 experts from academia, practice and policy worked together on a first draft of the NAP, which was refined based on various stakeholder consultations and finally published in 2018. The plan focuses on four areas of action and initially presents 15 specific recommendations to strengthen health literacy in Germany following five key principles. After the delivery to the Federal Minister of Health in 2018, it quickly became clear that the action plan and its recommendations need additional tools for implementation. Therefore, a systematic implementation strategy was developed.

Methods

Core elements of the implementation strategy were a systematic dissemination of the plan as well as workshops with important stakeholders from policy, associations, patient and self-help organisations. The aim of the workshops was it to concretise single recommendations of the NAP and to develop additional tools to implement them in specific fields of actions. The workshops led to policy papers, which were consented by a group of stakeholders and again disseminated broadly.

Results

Through numerous publications and presentations in different contexts the NAP received great attention. Furthermore, seven workshops and one international symposium were conducted focussing on single recommendations of the NAP, each leading to policy papers. The workshops and policy papers contributed to identification with the NAP and motivated the development of tools to promote health literacy.

Conclusions

The implementation strategy was effective as many stakeholders could be involved. It is also resource and time consuming which needs to be considered in project planning.
Health Literacy Action Plan: the Portuguese Implementation
Authors: Arriaga M , Freitas G , Costa A , Ribeiro da Silva C , Mata F , dos Santos B , Chaves da Silva N
Published: October 2020

Introduction

Noncommunicable diseases represent a significant burden in terms of mortality and years lived with disability within the Portuguese population. This burden can be prevented though the adoption of healthy lifestyles, making health literacy (HL) an important factor in this scope. In order to minimise the impact of NCDs, it is important to implement extensive and effective interventions for disease management. In view of this situation, the Directorate-General of Health (DGS) developed a National HL Action Plan to promote HL and design new opportunities to engage the population.

Methods

Recognising the importance of HL, in 2017, the DGS created the Division of Literacy, Health and Well-being. With this in mind, and with an intersectoral group of experts, this division defined the national policy for HL. The action plan was developed based on international best practices for the definition and implementation of actions to promote HL, taking into account that these actions should explore different approaches such as life-cycle and stage of development, taking advantage of all the opportunities to promote HL and self-care. Thus, three main goals were defined: Promote the adoption of healthy lifestyles; promote the proper use of the health system; promote well-being in chronic illness; promote knowledge and research.

Results

The implementation of the activities has been carried out with the citizens and multiple stakeholders in order to achieve a sustainable growth of the HL in all levels. This, in turn, directly contributes to an informed self-management of health for the improvement of the health levels of the Portuguese population.

Conclusions

The HL Action Plan is still in effect and the products developed in articulation with other sectors has been shown to be central for achieving the goals defined. Hopefully the impact of this action plan will be reflected in upcoming literacy assessments and allow the benchmarking with other stakeholders.
Developing the European Health Literacy Action Plan using a transformative future scenario planning approach
Authors: Sørensen K , Koylyu A , Mikkelsen B
Published: October 2020

Background

The 53 Member States of the WHO European Region adopted in 2019 a health literacy roadmap and a resolution to develop an action plan to guide the work of the Member States. The development of the action plan builds on achievements regarding the EU funded European Health Literacy Survey and the WHO action networks on health literacy measurement and NCD related demonstration projects as well as the multiple national initiatives launched in the European region in the last decade.

Methods

Scenario planning is a methodology that uses the inherent human capacity for imagining futures to better understand the present regarding the development of a new strategy or action plan. In the kick-off phase of the development process of the health literacy action plan, a transformative future scenario planning approach was applied in combination with a SWOT analysis (strengths, weaknesses, opportunities, threats) of current achievements, challenges and gaps considering the development of health literate societies involving 50 experts from a wide range of sectors and disciplines. Additionally, an iterative process followed including technical consultations with experts in Europe in preparation for a governmental consultation.

Results

The SWOT analysis, long-sight planning and generation of complementary concrete actions served as basis for the development of the action plan highlighting its relevance, sustainability and accountability. Additionally, the health literacy plan was developed in a process of co-creation with the wider health literacy community as well as stakeholders with multiple backgrounds in research, policy, education and practice.

Conclusions

The European health literacy action plan is multi-sectoral, people-centred and targeted governmental actions with the aim of developing health literate societies and populations. It can serve as a model for other world regions to adapt.
What in the world is happening? The numbers behind environmental health
Authors: Garcia T
Published: October 2020

Background

Climate change has made many headlines in the last few years. Because it threatens clean air, safe drinking water, nutritious food supply, and safe shelter, it can have a negative impact on health and undermine any progress on development. The price of inaction is high and the Sustainable Development Goals are a global effort to avoid it. However, Public Health must become a more active player to create greener services to serve a healthier world.

Objective

This presentation aims to provide a historical overview on the evolution of climate change, what we actually know about it, what is its impact on health and the need for green health services.

Results

Human activity since the mid-20th century has largely contributed to rapid climate change, including a rise in average surface temperature (0,9 degrees Celsius), most of which occurred in the past 35 years, and subsequent rise on other extreme events, such as intense rainfalls. Estimations make it that, by 2030, climate change will increase not only the number of deaths by malnutrition, malaria, diarrhoea and heat stress, but also the direct damage costs to health to USD 2-4 billion per year. This not only adds vulnerability to already fragile countries, but also compromises the Sustainable Development Goals. Along that, the healthcare sector is playing a role on generating millions of tons of waste, some of which is toxic, contributing to loss of global habitat and biodiversity and the impairment of the health of the world's ecosystem.

Conclusions

There is enough evidence-based data to support que need for relevant policies or innovative programmes that, besides implementing and advocating for better public health and health systems in each country, can also contribute to the Sustainable Development Goals, namely goals number 7, 8, 11, 12 and 13, and a healthy planet to go along with healthy people.
What can public health do about it? How public health projects and programs can be more sustainable
Authors: Rachadell J
Published: October 2020

Background

Our global society has evolved in the last century at an astonishing pace, with human population more than doubling in the last 50 years. Public Health has been largely influenced in a positive way by the social and technological advancements that lead to a decrease in child mortality and an increase in life expectancy. However, the accelerated pace of climate change and its predicted impact on population health is one of the greatest challenges the human species faces. There are many ways PH can contribute in that challenge, from legislative action and advocacy to reduce greenhouse gas emissions and toxic waste on a global scale to small projects that tackle locally specific problems.

Objective

This presentation is part of a workshop on how individuals and public health (PH) can create a more sustainable world. It aims specifically to present examples and ideas of how to make current public health projects at a local level more sustainable.

Results

Several examples will be discussed during the presentation, including the adherence to European directives, like reducing the amount of paper used in projects, and the focus on the environmental impacts of each program implemented, creating a mindset of “sustainability in all action”.

Conclusions

There seems to be a global concern about climate change, with many strategic documents and agreements outlining the path for a more sustainable world. However, there is also a clear difficulty in translating those strategies to action in our everyday Public Health practice. The changes referred during this presentation might not be directly related to the main goal of the project or program, yet they by contributing to climate action they will also contribute to population health gains.
Assessing health system functions
Authors: Rajan D
Published: October 2020

Health system functions are the core components of the HSPA Framework for UHC. In line with the existing work, we have distinguished four health system functions: governance, financing, resource generation and service delivery. For each of those functions we have identified a number of sub-functions through a systematic process. We then linked the sub-functions and functions to specific assessment areas and identified indicative measures from routinely collected data and/or existing health system assessment tools that can be used to operationalize the framework.

This presentation will introduce the four functions in terms of: 1) where they fit in the framework; 2) how they are conceptualised through sub-functions and 3) how they can be assessed using the framework. It will elaborate on how each of these functions makes contribution towards health system performance and will highlight the linkages between performance of the functions and health system goals.
The number of cancers attributable to tobacco by sex, in mainland Portugal, in 2008
Authors: Duarte S , Gonçalves L , Kislaya I , Garcia A C
Published: October 2020

Background

In Portugal, cancer incidence increases annually about 3%. In 2016, cancer was the first cause of premature death, corresponding to 5 296.8 DALYs/100,000 inhabitants. The aim of this study is to estimate the number of cancers attributable to tobacco in mainland's Portugal by sex.

Methods

An observational, ecological, analytic study was performed. Data was collected by sex: tobacco consumption (current or past) in mainland Portugal resident population older than 20 years, in 1998; incidence of 12 types of cancer, by location: Esophagus (C15), Stomach (C16), Colon (C18), Rectum (C20), Liver (C22), Pancreas (C25), Larynx (C32), Lung (C34), Kidney (C64) and Bladder (C67), according to the ICD-10 classification, in 2008. The population attributable fraction (PAF), for each type of cancer, was calculated with Levin's formula. The confidence intervals (CI) were estimated by Monte Carlo simulation.

Results

The prevalence of tobacco consumption in population between 20-79 years old was 33.41% (CI 95% 32.44-34.38) and 9.88% (CI 95% 9.29-10.54) for men and women, respectively. Higher values of PAF were estimated to lung cancer (76.32% in men, 46.99% in women) followed by larynx cancer (69.55% in men, 39.13% in women).The largest number of attributed cases was estimated for lung cancer (1211 in men, 368 in women) and bladder cancer (827 in men, 114 in women). Total cancers attributable to tobacco were superior in men (3776 vs. 677).

Conclusions

In 2008, 4453 of the total common cancers in both sexes could have been avoided if there was no tobacco consumption (current and past). More cancers would have been prevented in men because they smoked more, but also because in most cancers' RR is higher in men. Actually, tobacco consumption has been increasing in women, thus, it is expected that its number of avoided cancers will approximate the one in men. Campaigns with well-defined target populations are important to increase its health level.

Key messages

Tobacco is a modifiable risk factor which can be prevented; thus it is important to promote campaigns in order to prevent early consumption. Secondary data must be used to provide evidence that will help Public Health in taking better decisions regarding interventions.
The Brazilian conditional cash transfer program and cardiovascular mortality: a data linkage study
Authors: Pescarini J M , Craig P , Allik M , Amorim L , Ali M S , Smeeth L , Barreto M L , Leyland A , Aquino E M L , Katikireddi S V
Published: October 2020

Background

Conditional cash transfer programmes (CCTs) make monetary transfers to poor families conditional on health check-ups and/or education attendance. CCTs have been key in reducing poverty and improving child and maternal health in low- and middle-income countries (LMICs) but their impact on cardiovascular mortality have not been studied. We aimed to evaluate the effect of the CCT Bolsa Familia Program (BFP) on premature all-cause and cardiovascular mortality in Brazil.

Methods

The 100 Million Brazilian Cohort combined information about individuals applying for social programmes, the BFP and mortality data. We analysed ∼8 million individuals aged 30-69 who applied from 2011 to 2015. We calculated inverse probability weights (IPW) for the probability to receive BFP based on baseline observed characteristics (age, education, race, geographical location, household characteristics and year of application). Individuals were followed until they reached 70 years of age, died by any cause, or until 31st Dec 2015. We used Poisson regression (with person-years as the offset) and IPWs to compare BFP recipients to a comparable control population. Females and males were analysed separately.

Results

By following individuals for up to 4 years, 43,562 deaths by all-causes occurred among 4,197,658 females and 69,209 deaths among 3,672,393 males. Female BFP beneficiaries had approximately 60% lower all-cause mortality (IRR=0.40;95%CI=0.37-0.42) and CVD mortality (IRR=0.42;95%CI=0.37-0.47) than non-beneficiaries. Males who are BFP beneficiaries had ∼50% lower all-cause (IRR=0.53;95%CI=0.52-0.55) and 60% lower cardiovascular mortality (IRR=0.40;95%CI=0.38-0.42) than non-beneficiaries.

Conclusions

BFP, the world's largest CCT, may substantially decrease premature mortality. CCTs might have important implications for the growing burden of non-communicable diseases, with impacts potentially due to improved nutrition, socioeconomic conditions and improved primary care access.

Key messages

The Brazilian CCT, a widely recognized programme for poverty alleviation, have showed to be associated with lower overall and cardiovascular premature mortality in both women and men. Other countries, particularly LMICs, may learn from the health benefits of CCTs and should consider its potential large effect on mortality when planning austerity policies.
National nodes: a tool to enable efficient work of Distributed Infrastructure on Population Health
Authors: Zaletel M , Bogaert P , Abboud L A , Palmieri L , Van Oyen H , Tolonen H
Published: October 2020

The European framework of health information (HI) consists - besides the supra-national framework - of national frameworks of health infrastructures. It is therefore essential to strengthening capacities to provide HI and carry out research in countries.

Nowadays, one can experience lack of coordination, communication and cooperation between stakeholders in a country, leading to overlap or duplication of research and field-work. InfAct proposes a tool to overcome a majority of these difficulties by encouraging MSs to establish national nodes (NN) as a national focal point for DIPoH. A NN is a building block of DIPoH often coordinated by a national institution or governmental unit that functions as a NN and brings together relevant national stakeholders in an organised way. Researchers from public health institutes and research groups constitute the NN to share expertise and updated knowledge on HI with each other.

Currently, there are some active NN in the EU, with differences in scope, scale and initial purpose, due to different organisation of HI systems in countries. Such heterogeneity can also be found in national eHealth strategies. Diverse organizational arrangements exist which has proven to influence collaborative activities. At the same time new needs are arising, such as to better bridge the digital HI between research and health care, so that our health care systems can faster contribute to integrated data driven insights. This also relates to the debate on the Health Data Space, which creation is stated in the mission letter to the new European Commissioner for Health. For example, the eHealth Network has been discussing policy documents targeted at national level policy with regard to the organization of National eHealth Networks.

In this pitch presentation, an overview of different practices will be presented with proposals for future work in this area, including the role of NN in DIPoH and proposals for their sustainability.

Panelists:

H Van Oyen

Epidemiology and Public Health, Sciensano, Brussels, Belgium Department of Public Health, Ghent University, Ghent, Belgium

Contact: herman.vanoyen@sciensano.be

S Montante

Brussels Liaison Office, National Institute of Health of Italy (ISS), Brussels, Belgium

Contact: sabrina.montante@iss.it

E Bacry

Health Data Hub, Santś publique France, Paris, France

E Bernal-Delgado

Health Services and Policy Research Group, Institute for Health Sciences in Aragon, Zaragoza, Spain

Contact: ebernal.iacs@aragon.es

C Sousa Pinto

Advanced Analytics and Intelligence, Shared Services In Ministry Of Health, Lisbon, Portugal

Contact: catiasousapinto@gmail.com
The tool for mutual learning in cancer control: the iPAAC Roadmap
Authors: Kiasuwa-Mbengi R
Published: October 2020

Background

The last decade has seen great improvements in cancer care and prevention. A lot of initiatives followed in order to provide policy recommendations to manage these changes and implement the advances. These recommendations do not allow to solve practical implementation issues. In the framework of the third Joint Action on cancer control, iPAAC, the Roadmap is intended to facilitate the implementation of cancer control actions in European Member States (EU MS). As the identification of best practices in the field of cancer control implementation is challenged by country-specific contexts, the Roadmap will provide with options for the implementation. These examples were collected through interviews held in EU MS to collect practice and experience and by 6 work packages, which delivered thematic results regarding the specific cancer control domain.

Results

The iPAAC Roadmap has been developed to be a mutual learning tool. It is foreseen as a web-based tool and presented as a searchable repository of examples of implemented actions. The Roadmap gathers all results from EU Joint Actions on cancer control as well as the evidence, background documents and legal frameworks related to the implementation of the examples provided.

Conclusions

Many EU MS do face similar implementation challenges and some of them developed innovative approaches to overcome these barriers. An organized and facilitated mutual learning was therefore needed to gather knowledge and experience, leading to the improvement of cancer control among EU MS. It allows the identification of remaining gaps, providing with key information on additional efforts needed at the EU level, especially in terms of research.

Key message

Roadmap will bring a solution that can help EU MS address the challenges in cancer control through mutual learning and/or by research efforts at the EU level.
Introducing the integrated, cross-sectional psycho-oncology intervention programme and PIM
Authors: Krieger T
Published: October 2020

From the literature and experience, we know that the quality of patient information material (PIM) has a direct impact on its utilization and therefore also on the acceptance and success of an intervention. In this brief introduction session (10 minutes), the innovative “integrated, cross-sectional psycho-oncology” (isPO) programme and the context of its implementation will be sketched. In the programmés development phase, isPO specific-PIM was developed and utilized in its early implementation phase. This will be presented to the audience. Next, an overview regarding the general PIM quality criteria: correctness of content, legibility, comprehensibility and usability in detail will be given. Finally, common guidelines, checklists and quality assessment instruments will be presented, and the role of the target group (participation degree) in the development or examination process will be critically worked out.
Data inputs and assumptions in calculating the fatal burden in burden of disease studies
Authors: von der Lippe E , Grant I , Devleesschauwer B
Published: October 2020

Years of Life Lost (YLL) is a measure of premature mortality used in the calculation of the Disability-Adjusted Life Year (DALY), as well as stand-alone measure in itself. The concept of years of life lost is to estimate the length of time a person is expected to have lived had they not died prematurely. The YLL is based on comparing the age of death to an external standard life expectancy curve, and can incorporate time discounting and age weighting. Furthermore, YLL can be calculated for specific causes of death. In this way the indicator can be used to compare the relative importance of different causes of premature death within a particular population. Thus, it can be used by health planners to define priorities for the prevention interventions.

The process of calculating a YLL involves several components and this presentation will provide a sequential walk through each step in the YLL calculation, including causes of death statisticsdefinition of ill-defined deathsmethods of redistribution of ill-defined deathsthe use of life tablessocial weighting

The aim of this presentation is to outline a simple step by step guide on the key components in the YLL calculation. Using the real-life example of cerebrovascular disease, the presentation will outline the key choices and assumptions that underline each data inputs in the YLL calculation. Participants in this session will also be provided with links to resources to help facilitate this decision making process. The workshop will end with an interactive session where the presenters will discuss the implications of the different methodological choices with the audience.
Discrimination accessing to health care services: Feelings of migrants and misunderstandings of professionals
Authors: Gil-Salmerón A , Karnaki P , Zota K , Riza E , Linos A
Published: October 2020

Discrimination against migrants in healthcare settings and also the negative impact of this discrimination on their health are well documented. These experiences of discrimination may present a barrier to accessing or seeking appropriate health care. For this reason, the Mig-HealthCare project aimed to study the perceived feeling of discrimination against migrants and explore the perception of community members regarding health-related issues about migrants. In order to answer both questions, based on a mix-methods design, the Mig-Healthcare consortium collected data from 1,286 questionnaires completed by migrants/refugees in 10 EU countries and carried out 6 focus groups and 5 individual interviews in 7 countries.

Quantitative results show increased levels of mental health-related symptoms among migrants/refugees as well as dental health problems. The majority of respondents in all countries of the interview, needed more information about their rights and the way to use the health care services, while in Greece migrants showed the biggest need for more information about several health topics.

Moreover, qualitative results pointed out the presence of deeply rooted misconceptions towards migrants and refugees that span across different thematic areas: migrants and refugees represent a vector for the transmission of new or eradicated diseases and a burden for the already overstretched welfare system since they often demand preferential pathways to health or social services at the expenses of the local population.

Implications for the quality of healthcare services available for migrants/refugees are discussed as well as health issues which are of particular importance to this population. Feelings of discrimination and the extent to which they influence the quality of care received are analysed in combination with health being a basic human right to which need to all people have equal rights.
WHO Working Group on Health Literacy in Schools
Authors: Paakkari L , Okan O , Aagaard-Hansen J , Barnekow V , Weber M W , Sørensen K
Published: October 2020

Background

Addressing children`s and adolescents` health literacy is a bedrock for personal and societal growth, health and wellbeing over the life-course, and sustainable development in the WHO European Region and beyond. Promoting health literacy competencies should already be addressed in schools. To outline a strategy for the national education sectors, WHO Europe has launched a working group on health literacy in schools, which aims to develop a conceptual framework for decision makers within the educational and health sector to advocate for health literacy, facilitate the implementation process, and support the uptake on the national level.

Methods

Based on expert workshops and meetings, literature and document analyses and discussions, this working group has developed a concept note on health literacy addressing the education sector of the WHO member states.

Results

This work is linking health literacy in schools with the wider WHO health literacy strategy. Emphasis is placed on the critical role of the education sector and the necessary resources to implement action in schools. In addition, this report provides curriculum examples from Member States and key health literacy learning objectives. This includes an action agenda in order to implement monitoring and surveillance of health literacy in schools. The concept paper acknowledges the large variation in the level and organizational structure of the school health services among the 53 regional Member States.

Conclusions

This report highlights the reason why health literacy of children and adolescents should be addressed as early as in schools. It outlines the available evidence on children and adolescent`s health literacy and the challenges the Member States might face when they aim at addressing health literacy in the education sector and schools. The report should help policy and decision makers to implement health literacy in their countries taking into consideration the importance of adapting to local contexts.
Self-learning Courses EaD to qualify clinical practice
Authors: Fassa A , Fantinel E J , Soares D C , Carret M L V , Linhares R , Maagh S , Pinto L R , Fassa M E G , Facchini L A
Published: October 2020

Background

Health service evaluation studies point to the low quality of care, however the permanent education of health professionals is a major challenge. Within the scope of the Open University for the Unified Health System (SUS), the Department of Social Medicine of the Federal University of Pelotas produced open access self-learning courses, for primary health care, based on interactive clinical cases, through distance learning.

Methods

The courses, with 45 hours, provides interactive clinical cases, medical calculators and textual materials for use by the professional or with the community. The cases are presented and followed by multiple choice questions, focusing diagnosis and treatment. The feedback is automatic. An expanded theoretical content ('learn more') that privileges the use of illustrations, images, infographics and flowcharts useful for professional practice can be accessed. Bibliographical references on the subject are also available. The courses are available in a responsive web client app, for various types of devices, providing control of progress and automatic certification. The app allows the work offline, enabling the permanent education of professionals working in remote areas.

Results

Six courses were produced for doctors, nurses and dentists, more than 30,000 users were certified.

Conclusions

This problem-based learning initiative allows the student to have a menu of cases, providing a choice of the subject, decision on the time allocated to the activity, repetition according to its need, access to a large bibliography and reading in the quantity and depth chosen by the student. In addition, the format is challenging and develops clinical reasoning. The proposition of questions promotes the reflection of the student in relation to his knowledge on the subject. Automatic feedback, 'learn more' and selected bibliographies provide formative assessment and subsidize students to define their study needs in each subject.

Key messages

Distance learning expands the possibility of qualifying the clinical practice of health professionals, especially those in remote areas. Interactive clinical cases provide the development of clinical reasoning, content review and promote formative assessment.
Deporting immigrant parents: Impact on the health and well-being of their citizen children
Authors: Martinez-Donate A , Tellez Lieberman J , Bakely L , Correa C , Valdez C , McGhee Hassrick E , Gonzalez-Fagoaga E , Asadi Gonzalez A , Rangel Gomez G
Published: October 2020

Background

In the United States (U.S.), over 4 million citizen children live with an unauthorized immigrant parent who is at risk of deportation. Children of Mexican immigrants are disproportionately represented among this population, as 1 out of 3 deported immigrants are from Mexico. Parental deportation can have profound and long-lasting consequences for children, yet research on this topic is sparse. We present preliminary findings from an ongoing, longitudinal study examining changes in health, well-being, behavior, and environmental factors among U.S. citizen children of recently deported Mexican immigrants.

Methods

Forty-eight deported Mexican parents were recruited from deportation processing stations on the Mexican border region. We completed phone interviews with one of their U.S.-based, citizen children and an adult caregiver, collecting retrospective information on health, health behavior, household, academics, and socio-ecological health determinants from a year earlier, as well as shortly after deportation of their parent. Pre-post analyses of caregivers' survey data were conducted to assess changes in outcomes associated with parental deportation.

Results

Following deportation of their parents, children were reported to have more frequent health problems (p=.008), including mental health problems (p=.002), externalizing (p=.040) and internalizing (p=.011) behaviors, school absences (p=.092), and experiences of food insecurity (p=.007) than a year before. Academic expectations were also significantly worse (p=.006) than those prior to parental deportation.

Conclusions

Children are the unintended victims of indiscriminate immigration enforcement. Deportation of parents is associated with significant deterioration of physical and mental health, behavior, academics, and home environment for their U.S. citizen children. Our results call for immigration policy reform and interventions to support families affected by the deportation of a parent.

Key messages

Immigration policies that separate families can have significant detrimental impacts on the health and well-being of U.S. citizen children. Policies must be revised to keep families together and protect children in mixed-legal status families.
Healthcare systems strategies to manage pandemics transition phases: a systematic review
Authors: Cascini F , Hoxhaj I , Zaçe D , Ferranti M , Ricciardi W , Boccia S
Published: October 2020

Background

Several countries facing the COVID-19 pandemic were not prepared to manage it. Public health mitigation strategies, ranging from isolation of infected cases to implementation of national lockdowns, proved their effectiveness for the outbreaks control. However, the adjustment of public health measures is crucial during transition phases to avoid new outbreaks. To address the need for designing evidence-based strategies, we performed a systematic review, identifying healthcare systems approaches, experiences and recommendations used to manage COVID-19 and other epidemics.

Methods

PubMed, Web of Science, Scopus and Cochrane were searched to retrieve eligible studies of any study design, published in English until April 17th, 2020. Double-blinded screening process was conducted by titles/abstracts and subsequently eligible full-texts were read and pertinent data were extracted. We performed a narrative analysis of each implemented strategy.

Results

We included a total of 24 articles addressing the public health strategies implemented for respiratory viral infections outbreaks as COVID-19, influenza A H1N1, MERS and SARS. The identified strategies are ascribable to two main categories: healthcare systems management at a national level and healthcare providers strategies at a local level. The key components of the transition strategies regarded the implementation of evidence-based contextual policies, intrahospital management approaches, community healthcare facilities, non-pharmaceutical interventions, enhanced surveillance, workplace preventive measures, mental health interventions and communication plans.

Conclusions

The identified healthcare systems strategies applied worldwide to face epidemics or pandemics, are a useful knowledge base to inform decision-makers about control measures to be used in the transition phases of COVID-19 and beyond.

Key messages

Healthcare systems strategies that can be implemented to manage pandemics/epidemics transition phases are a useful knowledge base to inform policy makers about the most effective solutions to adopt. The evidence reporting the healthcare systems management of respiratory viruses epidemics/pandemics, show the lack of a common and shared approach and more evidence-based research is needed.