bluuebunny/crossref_metadata_2025_split huggingface dataset:
Copenhagen Burnout Inventory On A National Representative Sample Of Pre-School Teachers
Authors: Piperac P , Terzic-Supic Z , Todorovic J , Maksimovic A , Karic S , Santric-Milicevic M 
Published: November 2019

Abstract

Background
Pre-school teachers are faced with work-related stress and are at increased risk of development of burnout syndrome. The aim of this study was to evaluate the reliability of the Serbian version of Copenhagen burnout inventory (CBI) on a National Representative Sample of preschool teachers in Serbia.

Methods
This was a cross-sectional study conducted between October 2018 and April 2019 which included 456 preschool teachers in Serbia. The instrument contained questions on socio-demographic, socio-economic characteristics, lifestyle characteristics, workplace environment and Serbian version of CBI. Univariate linear regression, multiple linear regression, Cronbach alpha coefficients were performed.

Results
Cronbach alpha of three domains of CBI were: personal burnout-0.907, work-related burnout-0.878, client-related burnout- 0.903. Multiple linear regression analysis showed that having a tenured contract (ß=3.46, p = 0.04), working in shifts (ß=7.94, p = 0.01), and having worse self-perceived health status (ß=-8.88, p = 0.01) were significantly associated with personal burnout. Working in shifts (ß=-4.67, p-0.012) and having worse self-perceived health status (ß=-7.82, p &lt; 0.001) were significantly associated with work-related burnout. Age (ß=0.53, p &lt; 0.001), living in urban areas (ß=-6.55, p = 0.015), alcohol consumption (ß=5.09, p = 0.016), number of children teacher work with (ß0.407, p = 0.005), having teaching equipment (ß=-4.46, p = 0.033), and having worse self-perceived health status (ß=-7.17, p &lt; 0.0001) were significantly associated with client-related burnout.

Conclusions
CBI is a valid instrument for the assessment of burnout among preschool teachers in Serbia. Many workplace-related factors, which could be subject of preventive measures, are associated with domains of burnout in this population.

Key messages
Workplace-related factors are associated with burnout among preschool teachers in Serbia. CBI is valid instrument for assessment of burnout among preschool teachers.
Workshop: Alcohol policy reforms in European countries – challenges and solutions
Authors:   Organised by: National Institute for Health and Welfare, Finland, ANPAA; EUPHA (PHPP) Chair persons: Sofia Ribeiro - Portugal, Ilmo Keskimäki - Finland
Published: November 2019

Abstract

Alcohol-related harm is a major public health concern in Europe, with levels of alcohol consumption and associated health harm among the highest worldwide. According to the European Commission, premature deaths linked to alcohol account for over 7% of all European morbidity, and alcohol is a major avoidable risk factor for neuropsychiatric disorders, cardiovascular diseases, cirrhosis of the liver, cancer and unintentional and intentional injuries. Even moderate use of alcohol raises long-term risks of certain heart conditions, liver disease and cancers, and frequent use can lead to dependence.
There is extensive research on efficient strategies to reduce alcohol-related harm, alongside high-level policy recommendations. Examples are the WHO’s global strategy to reduce harmful use of alcohol and the WHO European office’s European action plan to reduce the harmful use of alcohol 2012-2020. The European Union (EU) strategy to support member states in reducing alcohol-related harm expired in 2012. Since then, the Committee on National Alcohol Policy and Action (CNAPA) has drawn up a non-binding Action Plan in relation to alcohol and EU countries have the main responsibility for their national alcohol policy.
Despite strong evidence bases supporting alcohol policy, the implementation of potentially effective alcohol policy is often challenged by companies with commercial interests seeking to undermine evidence and advocate for less effective alternatives. These alternatives, such as education or voluntary industry action, are often favoured by politicians and the public. This opposition to evidence-based alcohol policy represents a challenge to public health.
In this session, we will discuss recent developments in alcohol policy reform in Estonia, Finland and Scotland; reflecting on the outcomes of policies and the challenges faced in implementation. We invite commentaries from national experts and from the DG Sante and WHO Euro. Among these the French commentary will address the influence of the alcohol industry in circumventing effective public health policies, with discussions concerning the new strict French low-risk guidelines on alcohol use as one example. The objective of this workshop is to share experiences of the challenges faced in applying effective alcohol policies, to discuss ways to tackle those challenges, and to invite the EU and the WHO to share their views on ways to overcome these barriers in future policy advocacy.

Key messages
Commercial determinants of health are a powerful force in preventing effective public health policy on alcohol-related harm. The public health community need to work in a persistent and coordinated manner to bring in a suite of effective alcohol policy interventions across Europe.
Finnish alcohol policy reform: battle over public health objectives
Authors: Mäkelä P 
Published: November 2019

Abstract
A new Alcohol Act came into force in Finland in 2018. The preparation of a comprehensive reform of the alcohol legislation was started already in 2011. The aim of Finnish alcohol policy has been to reduce alcohol-related harm, and the central means to do that have been by way of high taxation and restrictions in the physical availability of alcohol, in which the state alcohol monopoly has had a central role. The process of reforming the act was a long battle between forces that wished to continue underlining the public health aims and using efficient tools to reach those aims on the one hand, and neoliberal politicians aligned with the strong alcohol industry lobby and enthusiasts in social media who wished to get rid of regulation. The new Act somewhat expanded the rights of grocery stores to sell alcohol and de-regulated the on-premise trade by dismantling regulations in the old legislation. The retail state monopoly was weakened as a result, but it still has an important impact on restricting the physical availability of alcohol. Previously when alcohol has been made more available, consumption has increased, and also this time this was the expected outcome. However, an interrupted time series analysis has shown no statistically significant effect of the law change in the first year. One central explanation seems to be that price competition has been less intense than expected. Nonetheless, despite the fact that alcohol taxes were raised, a 10-year downward trend in alcohol consumption from 2008 to 2017 was halted.
Organization and content of primary care for adolescents – comparison of actual and desired situation
Authors: Jansen D E M C , Visser A , Vervoort J P M , Kocken P , Reijneveld S A , Blair M , Alexander D , Rigby M , Michaud P A 
Published: November 2019

Abstract
To successfully navigate increasing autonomy, independence and health behaviors in adolescence, accessible adolescent health care services (AHS) are essential. AHS comprise all services in primary care that are aimed at the specific needs of adolescents and can be provided in various settings such as public services, private services, schools and hospitals. In the MOCHA project (Models of Child Health Appraised) we assessed the structure and content of AHS in 30 European countries against the standards in the field of adolescent health services: accessibility, staff attitude, communication, staff competency and skills, confidential and continuous care, age appropriate environment, involvement in health care, equity and respect and a strong link with the community. The results revealed that although half of the 30 countries did adopt adolescent-specific policies, many countries did not meet the current standards of quality health care for adolescents. For example, the ability to provide emergency mental health care is limited. In addition, one third of the countries do not have a formal policy which guarantees the confidentiality of a consult and the possibility to consult a physician without parents knowing. Finally, around half of the countries do not have specialized centers in adolescent health care in order to tackle comprehensive health issues. Access to adolescent health care services needs to be improved for vulnerable adolescents such as migrant adolescents. Schools, ambulatory settings and hospitals should offer accessible, comprehensive health care and a culturally appropriate approach, particularly given the number of migrant adolescents living in EU and EEA countries. Finally, the health care systems should improve their communication strategies, to assist young people in understanding their rights and responsibility in the domain of health, and how and where to access to adequate care.
Clinical philosophy in the context of pediatric care
Authors: Ehrich J , Hirn L , Manemann J 
Published: November 2019

Abstract
Medical care may be better in many countries than it currently is. Developing countries are in the need to catch up with affluent countries, and rich countries have a need for answering the question of how quality of health care can be improved for their total population despite increasing high-technology-induced cost through comprehensive cost-benefit analyzes. Health is about 85% dependent on general health care and 15% on medical care. The current quality differences of health care not only have their roots in economic crises, but in the lack of application of the thought model of ‘root-cause-effect long-term consequences.
The questions arise as to whether this lack of integration of philosophical perspectives and activities contributes to deficiencies in the health care system and how philosophy could lead to new pathways of thinking. Obviously, the health systems of many European countries are having major problems translating the necessary changes in care from the theory level to the policy executive at the practical level. Furthermore, in many health care systems, adequate socio-philosophical concepts for adapting to constantly changing social conditions are missing with regard to adequate, accessible and affordable health care.
This presentation discusses the pros and cons of greater involvement of spiritual welfare, clinical philosophy and philosophical practices in medical care for adolescents in order to improve 1. adherence to therapy, 2. resilience and 3. resonance in the treatment triangle of ‘patient-family-therapist’.
Identifying best practices in junk food taxation and other food policies: Selected examples and their assessment
Authors: Romaniuk P 
Published: November 2019

Abstract

Issue/problem
Noncommunicable diseases are the main contributor to the global mortality, being responsible, as estimated, for 71% of deaths each year. About 80 of dietary dependent diseases has been identified so far, and their prevalence tends to exceed 30% in some populations.

Description of the problem
The growing prevalence of these diseases, along with impact on the quality of life, disabilities, as well as rising direct and indirect economic costs, constitute a basic foundation for emerging efforts to develop and implement new solutions within national health policies aimed at modifying dietary behaviours and reducing their negative impact on health status of individuals and populations. To address these problems the Joint Funding Action “Effectiveness of existing policies for lifestyle interventions - Policy Evaluation Network (PEN)” has been initiated, in which 28 research group across Europe are collaborating.

Results
The primary aim of the presented study will be to discuss the usage of the PEN instrument to identify best practices in food policies, including sugar sweetened beverages and junk food taxation. Previous examples of the instrument implementation will also be presented, including New Zealand, Australia and Canada, along with the results of current works on its development within the project. The second basic aspect for the study is to discuss and assess examples of food policies implemented in selected countries in terms of their effectiveness in modifying unhealthy behaviours.

Lessons
The time that has passed since the implementation of the evaluated solutions is too short to assess actual impact on health. Nonetheless, the existing evidence, including data from countries being the most successful examples of junk food taxation, like Mexico and Hungary, suggest that their impact on consumer choices, health literacy and also food industry in terms of food products composition, is positive.
Round table: Using evidence for action – the story on life-course vaccination
Authors:   Organised by: EUPHA (IDC), ECDC Chair persons: Anna Odone - Italy, Karl Ekdahl - ECDC
Published: November 2019

Abstract

Vaccination represents a cost-effective public health intervention that saves millions of lives globally each year as well as increasing health and wellbeing of the population. Approximately 20 vaccines are currently in use in routine schedules, with several new or improved in the research pipeline. While immunisation programmes have traditionally targeted children, in recent strategic thinking around vaccination has shifted from an infancy focus to a life course approach that considers the benefits of vaccination at all ages. There are many benefits to targeting different age groups for vaccination, such as targeting individuals at an age that maximises protection (HPV among teenagers, shingles among older adults); boosting waning immunity (Td/IPV among teenagers); protecting at-risk individuals when they are most vulnerable (influenza in pregnancy, pneumococcal vaccine in older adults at clinical risk); protecting newborns in utero before they have the chance to be vaccinated (pertussis in pregnancy); or targeting an older age group to indirectly protect younger infants (MenACWY vaccination of teenagers).
Even though the public health benefits of the life-course approach are evident, delivering vaccination programmes spanning such disparate groups represent constant challenges. These challenges can be grouped into: a) limited access to services b) communication challenges influencing attitudes and knowledge of vaccination and c) logistical challenges associated with the use of a wide range of settings for vaccination.
This session will explore, at country and regional levels, experiences and reflections on delivering vaccination across the life course, and evidence-based policy and operational actions taken to deliver an optimal programme at all ages.

Key messages
Life course vaccination presents opportunities to better protect the population but also brings unique challenges, both from the patient side and from the health systems side. Evidence-based tools and strategies to improve vaccine programmes across the life-course are increasingly available. Country and European level action is needed to achieve optimal results.
Investing in communication education- the example of vaccine hesitancy
Authors: Ljungqvist I 
Published: November 2019

Abstract
The European Centre for Disease Prevention and Control (ECDC) works on vaccine acceptance by searching for evidence, consulting with key stakeholders (epidemiologists, public health experts, family doctors, non-governmental organisation representatives for Roma, travellers, other under-served population groups), and identifying pilot interventions/ practices.
ECDC aims to strengthen workforce capacity on vaccine acceptance by developing a training for trainers. To guide the development of this multi-annual programme ECDC organised an expert meeting in April 2019 focusing on discussing and designing main elements of the training for trainers in vaccine acceptance at the country level. Key conclusions of the meeting include: A range professionals should ideally be trained on how to communicate to increase vaccine acceptance: frontline healthcare professionals, pharmacists, gynaecologists, teachers, politicians, journalists.Investments should be made both in postgraduate professional development of frontline healthcare professionals, as well as in university curricula for medical, nursing and teachers training.Training should include both knowledge around vaccines and immunization, as well as communication skills to discuss about vaccines and motivate immunization. Possibly legal aspects at the country level should be included, too.Vaccine acceptance should be addressed throughout the life course and vaccines.Training should be delivered in a blended format, with face-to-face sessions (especially for skills building) and e-learning (especially for knowledge components).Training should include a common European-level core but be done by local trainers, in the local language and adapted to the local context.Training initiatives should be integrated into a “bigger picture”: sustainability of such an initiative should be taken into account, as well as the most efficient and interventions. Seeking synergies and partnerships are key in ensuring long-term success.
Designing and evaluating an information campaign on HPV vaccination in Denmark
Authors: Soborg B , Jaconsen S 
Published: November 2019

Abstract
Vaccinating 12-year-old girls against human papilloma virus (HPV) was included in the Danish vaccination program in 2009. Since 2014 safety concerns resulted in a dramatic decrease in uptake.
In order to nuance the debate, inform parents’ decision-making and increase uptake, we launched a national HPV vaccination information campaign in May 2017.
Before designing the campaign, we investigated parents’ knowledge, attitudes and decision patterns regarding HPV vaccination. Results showed that 34% parents were vaccine hesitant. Mothers were the primary decision makers regarding their daughters’ HPV vaccination, and their primary source of information was online media, particularly Facebook. Finally, parents had a lack of knowledge on several HPV-related facts and a high proportion requested more information before deciding on HPV vaccination for their daughters.
Based on these findings, we designed and launched an information campaign in partnership with the Danish Cancer Society and the Danish Medical Association. The campaign, “Stop HPV - stop cervical cancer”, was given a designated website and a public Facebook page posting infographics, written case stories, short movies with cases and experts, and updates on vaccination uptake. The overall strategy was to bring back focus on preventing cervical cancer and put faces on the cancer statistics.
Following the campaign, the proportion of hesitant parents and parents against HPV vaccination had declined and 70% of parents were now in favor of HPV vaccination. The number of vaccinated girls had doubled in 2017 compared to 2016 with nearly 31000 girls receiving their first doses. However, the remaining proportion of hesitant parents indicated that they still felt a lack of information and continuously worried about adverse events. Henceforward, effort will be put into guiding hesitant parents to the website and to disseminate the campaign throughout the country by organizing information meetings for parents locally.
How to institutionalise health promotion through legislation?
Authors: Hätönen H 
Published: November 2019

Abstract
Legislation is a powerful tool to enhance health promotion practices. The aim of this presentation is to describe legislation related to health promotion in Finland. The Finnish Constitution (1999) and the Local Government Act (2015) stipulate every citizen’s right to health and wellbeing. Concrete duties and tasks as well roles of different actors are stipulated in detail in the Health Care Act (2010) and many specific acts.
General strategic management obligations and tasks of the municipalities have been defined as follows: (1) Municipalities shall assess and take into consideration any effects that their decisions may have on the health and wellbeing of residents. (2) In their strategic plans, municipalities shall identify the objectives and define the measures for health and wellbeing promotion on the basis of local needs. (3) They shall monitor the determinants of health and wellbeing, measures taken and follow-up the health and wellbeing of their residents by population groups. (4) Reports on these shall be drawn up for the municipal council once a year and a more comprehensive review on health and wellbeing shall be produced for the municipal council once during each term of office. (5) They shall assign bodies responsible for health and wellbeing promotion. (6) All departments of the municipality shall work together for health and wellbeing promotion. (7) They shall cooperate with other public local authorities, with private enterprises and non-governmental organisations.
The Health Care Act as well other acts further defines the preventive services that municipalities need to offer. In Finland we have ensured effective implementation of the legislation by number of actions. First, different stakeholders were closely involved to the law-making process from the beginning of the process. Secondly, implementation was, and is still, supported by the National Institute for Health and Wellbeing. Finally, the implementation is systematically monitored.
Public health policy implementation and evaluation in portugal and israel (Project PH.PIE): the intersectoral pledge and the case of health literacy for tobacco control in the building of the Homo Salus
Authors: Saboga-Nunes L , Fernandes A C , Levin-Zamir D 
Published: November 2019

Abstract
Despite the overwhelming accumulated evidence of the negative effects of nicotine intake, the prevalence of tobacco use is not expected to decline in the near future in several countries. Israel and Portugal both signed the WHO Framework Convention on Tobacco Control (WHO FCTC) and implemented several strategies to achieve Positive Public Health Outcomes (PPHO) (e.g. policy making, legislation). Nevertheless during the past 10 years the number of smokers in Israel has decreased from 28% (in 2000) to about 20.6% (in 2017), while in Portugal, the number of smokers has not changed (2002, 19.2%). However, it has increased for women and adolescents.
The goal of PH.PIE project (Public Health Policy Implementation & Evaluation) is to document policy development and implement Health Impact Assessment (HIA) towards a knowledgeable civic society, searching for the real PPHO. Tobacco control is a selective topic because of its high relevance in public health. PH.PIE considers policy making and stakeholder analysis to comprehend HIA of strategic public health issues and PPHO.
The tobacco industry during the last 10 years has invaded the market with a comprehensive new approach, built around the concept of harm reduction and turnaround strategies to counteract WHO FCTC principles. This way, public health has apparently lost its grip from its own argumentative discourse, while several stakeholders have positioned themselves in the co-working facelift of nicotine use with smokeless tobacco, electronic cigarettes, and other forms of use that have not been scrutinized in terms of their real potential on public health terms.
Harm reduction approaches take the front line, in contrast to smoking cessation efforts as a cornerstone of WHO FCTC. We argue in this paper that health literacy can be critical tool in re-making nicotine addiction in the homo salus upbringing.