bluuebunny/crossref_metadata_2025_split huggingface dataset:
Essential knowledge for junior doctors regarding infectious disease control: a modified Delphi study
Authors: van den Berg N M , de Hoog M L A , Seeleman M C , Jambroes M 
Published: November 2019

Abstract

Background
Physicians play an important role in the control of emerging infections and antibiotic resistance. Therefore, all physicians should have sufficient knowledge regarding infectious disease control. It is unknown what knowledge is considered as sufficient; the Dutch National Framework on learning outcomes for medical curricula only offers general terms for this topic. The aim of this study was to determine which learning items are considered as essential knowledge for junior doctors in the Netherlands. The results can support curriculum development regarding infectious disease control.

Methods
An online two-round Delphi study was performed, involving four expert groups: general practitioners; public health physicians; medical students; and educational coordinators of Dutch universities. Experts were asked to rate sixteen learning items, selected by a literature review. A learning item was considered as essential knowledge if at least 80% consensus was reached on a 5-point Likert scale. Respondents were able to explain their score, to alter the exact wording after each learning item and to add learning items. This input was used for qualitative analysis, in addition to the quantitative scores.

Results
Both rounds of the study were completed by 27 experts. Six learning items were identified as essential knowledge based on the 80% criterion. By combining qualitative and quantitative data, two additional learning items were identified. Important learning items were mainly focused on understanding and applying basic principles on a case, like identifying measures to prevent spread of infections based on transmission route.

Conclusions
To our knowledge, this study is the first to identify a list of essential learning items on infectious disease control, which can be used for training purposes. This list supports curriculum development in medical education and strengthens the infrastructure for infectious disease control in the Netherlands by training professionals.

Key messages
The Delphi method helped us to identify essential knowledge concerning infectious disease control for junior doctors. The results can be used to increase the knowledge base for this topic. Essential knowledge focuses mainly on understanding and applying basic principles to a case. Detailed knowledge is considered less important, provided that physicians know where and when to find it.
Case study: Drug related problems in prison settings
Authors: Montanari M 
Published: November 2019

Abstract
Persons in prison generally have poorer physical and mental health and social well-being than their peers in the community, reporting high rates of acute and chronic physical and mental disorders, including, substance use disorders and drug related infectious diseases. People in prison report high prevalence of illicit drug use before and during incarceration and high rates of drug related infections. Acute risks for those using drugs are found in the first period after prison release. Available interventions in prison setting lower life expectancy than their peers in the community. Common risk and social factors are related to poor health and imprisonment and those two components should be addressed in a comprehensive way. The presentation will provide an overview of the last available data on drug use, drug related problems and prevalence of infectious diseases in prison in the European countries.
Busting the myth of the ‘greedy elderly’
Authors: Lynch J 
Published: November 2019

Abstract

Background
The politics of ageing are both personal, involving judgements about specific family members as well as broad social groups. This chapter evaluates the argument that governments implement packages of policies that are favorable to the elderly, but that are societally sub-optimal, because of political pressure from the elderly. It begins by laying out the core premises of the “greedy geezer” narrative: because pension transfers, high-cost medical care, and policies that protect transferable assets like housing are highly salient to the elderly and their advocates, intense preferences for these types of policies communicated to politicians and policy-makers will eventually crowd out other, more societally-optimal policies.

Methods
Looking at public opinion data on ageing, intergenerational transfers, and the welfare state this chapter wants to understand both how different publics understand and frame ageing and health as well as what priorities these publics identify, and why?

Results
The elderly and their organized representatives (e.g. pensioner parties, pensioner unions, and advocacy groups) in some contexts do push for policies that are “greedy” in the sense of being beneficial for the elderly or their own children, but not for society as a whole. However, this phenomenon is far from universal: It is especially pronounced in the US and the UK, but much less so in other national contexts. Moreover, the policy packages adopted by national governments are generally motivated by concerns other than appeasing the elderly.

Conclusions
Characterizing the elderly as uniformly “greedy” obscures the fact that inequality among the elderly means that many need more support than they actually receive.
Current capacities and challenges for equity-oriented municipal health promotion in Europe
Authors: Plantz C , Quilling E 
Published: November 2019

Abstract

As a basis for implementing actions in the frame of Work package 6 - healthy living environments in the Joint Action Health Equity Europe, each of the 13 participating countries conducted a country assessment.

Methods
The country assessments were self-assessments conducted in the first quarter of 2019. Partners received templates that had been agreed upon beforehand. Most of them conducted the country assessments by themselves or with the help of colleagues from their institutions as a desk-based review, and validated results with external experts and stakeholders. The first part of the country assessment referred to how municipal health promotion capacities are currently developed in the countries. Through the second part of the country assessment, each of the 13 countries selected up to 4 promising practices.

Results
In most of the 13 countries, municipalities have a clear mandate to promote health. However, there is a big heterogeneity in resources, structures and capacities of municipal health promotion within and between countries. One key challenge is the self-government of municipalities and health promotion as a voluntary task. One of the main problems is a deficit in intersectoral working. It appears that poor municipalities are even more disadvantaged in terms of capacities for municipal health promotion. 33 promising practices were identified, covering programmes, strategies, tools and interventions mostly from the local level, with a big variety of topics and approaches for health equity.

Conclusions
There is a big fragmentation and heterogeneity in municipal health promotion between and within European countries. National and regional public health authorities are in the position to contribute a lot to support municipalities. This can include promoting quality development, providing data, integrating health equity in existing structures, plans and approaches or collaborating with the broad range of existing stakeholders and networks.
Strengthening health information systems in Europe through peer review assessments
Authors: Bogaert P , Abboud L A , Calleja N , Ziese T , Fehr A , Van Oyen H 
Published: November 2019

Abstract

Background
How does your Health Information System (HIS) measure up to others in the EU? How can you empower national HIS players with an objective peer-reviewed HIS assessment? Nine InfAct partners engaged in a capacity building exercise where experts in rotating groups of three countries performed peer assessments of each other’s national HIS. Using a WHO Europe adapted and refined tool, assessors analysed the HIS of a country (data collection, processing, analysis, dissemination and use) and exchanged practices in an intensive 2-day schedule of interviews with established key stakeholders.

Objectives
The aim of the peer assessment is three-fold: to test the feasibility of a peer-review HIS assessment, to map heath information inequalities across EU MSs, and to strengthen the knowledge of HIS players.

Results
Two cycles are now complete and the feedback is overwhelmingly positive - from assessors and hosts alike. So far, the HIS assessment has been a major success in its ability to systematically and concisely analyse a HIS. It identifies gaps in the HIS through desk review and interviews, and provides a SWOT analysis and SMART recommendations to address these gaps. Additionally, this exercise has shown the ability to increase stakeholders’ awareness of their role in their national HIS, and to build new networks within and between MSs. The exercise is also perceived as an opportunity for cross-fertilisation of ideas and exploration of methodologies on how to address specific challenges. This will stimulate actions to improve national HISs, and will lead to the identification of good practices which can then be used by other EU countries.

Conclusions
By bringing together key HIS stakeholders from different countries and stimulating the improvement of HIS and the exchange of good practices, InfAct contributes to capacity building in the EU, which in turn may lead to the reduction of health information inequalities between countries.
Development of composite indicators to monitor burden of disease across Member States
Authors: Haneef R , Gallay A , Hilderink H , Devleesschauwer B , Ziese T , Schmidt J , Newton J 
Published: November 2019

Abstract

Background
The burden of disease (BoD) methods are not part of routine public health activities and policy development process across all Member States (MSs). The main reasons for this are varying levels of knowledge, experience, and capability to apply and use BoD methods. Therefore, MSs need support, guidance and training to adopt and integrate BoD approaches in their public health systems. In this context, two workshops have been organised by InfAct. The main objectives of the workshops are to raise awareness, share knowledge and experience, and to provide mutual support to to integrate BoD indicators in the public health policies across Europe.

Methods
The workshops were about the BoD concept and methodologies, and the use of BoD data in public health policy. These workshops were supported by technical presentations describing methods and the use of BoD data in health policy with various case studies, followed by expert exchange with facilitated discussions and group work. The case studies included national BoD studies from Belgium, Germany, Netherland, and Scotland.

Results
Two workshops were held at Santé Publique France, and attended by 16 BoD experts and 40 participants from 25 MSs. The workshops were well received by the participants particularly with regards to the diversity of the group and the possibility to share knowledge and experience from various perspectives. Three areas of action were highlighted: 1. the need for methodological trainings to strengthen skills in interpreting and calculating BoD estimates; 2. the encouragement of more collaborations across MSs to share or exchange good practices on BoD; and 3. the importance of the implications of BoD data to guide policies across MSs.

Conclusions
The workshops highlighted the need for capacity building activities to implement BoD approaches across MSs in routine public health activities and to use BoD data to guide health policy. More collaborations among MSs on BoD activities are needed in the future.
Building a sustainable network of health examination surveys through training and mutual learning
Authors: Tolonen H 
Published: November 2019

Abstract

Background
Health information is a broad concept and can be obtained from variety of data sources such as administrative and disease specific registers, surveys, longitudinal studies etc. Health surveys comprise two main formats; questionnaire based health interview surveys (HIS) and more comprehensive health examination surveys (HES) which include also objective health measurements and collection of biological samples. At the European level, HISs are coordinated under European Health Interview Survey (EHIS) by Eurostat. For HESs, the European Health Examination Survey (EHES) initiative has been responsible for the coordination and capacity building.
Objective: The EHES initiative aims to establish a sustainable European network on nationally representative HESs, which use standardised methods and therefore, provide comparable information between and within countries.

Results
EHES has prepared standardised protocols for objective measurements and several guidelines for organisation of the survey. To enhance use of these protocols and guidelines, several capacity building activities took place during 2010-2019. These activities include hands-on training events, online training materials, person-to-person consultations, site visits and networking.
A survey among national HES organisers was conducted in 2017 to evaluate which of the capacity building activities were perceived as most important. Based on this survey, availability of standardised protocols and guidelines was seen very important as well as hand-on training events and person-to-person consultations.

Conclusions
National HES data is actively used for health monitoring and identification of public health problems, for development of health and prevention programmes and to support evidence-informed policies. EHES capacity building activities support establishment and development of national HESs across Europe and enhance benchmarking between countries.
Conceptual framework for intersectionality-based gender sensitivity in multivariable analysis
Authors: Mena E , Bolte G 
Published: November 2019

Abstract

Background
Intersectionality-based gender sensitivity in multivariable analysis might advance simultaneous consideration of intersecting social positions and identities. Identification and implementation of quantitative statistical approaches that adequately operationalise the concept of intersectionality are currently scarce.

Methods
An intersectionality-based framework for evaluation of gender sensitivity in multivariable analysis and for future study design was developed. The framework comprises operationalisation of sex/gender, definition of solution-linked variables from a gender mainstreaming perspective, definition and function of intersectional variables and consideration of central gender theoretical concepts. For evaluation of current practice regarding sex/gender sensitivity in intersectionality-informed analyses, a scoping review within selected thematic fields relevant for heath reporting has been conducted.

Findings
Based on 16 identified intersectionality-informed studies, sex/gender shows to be exclusively operationalised as binary. Solution-linked variables from a gender mainstreaming perspective are rarely taken into account. Sex/gender and race/ethnicity are the only intersectional variables considered in almost all studies, predominantly for stratification or as part of interaction terms. Income, education and employment status as proxies for social position as well as age are mainly used for adjustment in multivariable analyses.

Conclusions
The framework allows for comparison of gender sensitivity in intersectionality-based multivariable analysis. The project AdvanceDataAnalysis at the Institute of Public Health and Nursing Research, University of Bremen, Germany, will contribute to the detection and analysis of complex interactions from an intersectionality perspective, including the consideration of gender theoretical concepts in multivariable analyses.
Building institutional capacity for a future health workforce. The WHO Global HRH Strategy
Authors: Jacob G 
Published: November 2019

Abstract

Background
There is a growing recognition that the main population health challenges of sustaining universal healthcare coverage (UHC), and responding to the growing non-communicable diseases (NCDs) burden in all countries of the WHO European Region requires that each Member State has an effective, responsive and adaptive approach to human resources for health (HRH). However, there is a worldwide shortage of health workers and the situation is becoming more challenging globally and regionally. This presentation introduces the WHO Framework for Action, which builds on the Global Strategy on Human Resources for Health: Workforce 2030. The aim is to provide guidance to health policymakers, planners, analysts and others with a responsibility for health workforce issues.

Methods
The WHO Global Strategy was adopted in 2018 by the 69th World Health Assembly. It has identified four strategic objectives, which have been adapted to the regional context as follows: to transform education and performance, to align planning and investment, to build capacity, and to improve analysis and monitoring.

Results
The WHO Regional Office for Europe is working with Member States across the Region and supporting efforts to achieve sustainable health workforces. This includes promoting the use of the Labour Market Framework approach and maximising the utility of the National Health Workforce Accounts for national use and as a contributor to sustainable human resources for health planning.

Conclusions
Having a sustainable health workforce in place with the right skills and competencies is critical to making progress towards achieving UHC. Effective implementation of a labour market framework approach, including multisectoral workforce governance, can support effective, responsive and adaptive approaches to human resources for health.
Professionalisation of the public health workforce: why, what and how
Authors: Czabanowska K 
Published: November 2019

Abstract

Background
Member States of the WHO European Region are calling for guidance on how to build the capacity of the public health workforce to help strengthening health systems. The aim of this presentation is to stir the discussion about the professionalization of the public health workforce. Attention is paid to the why, what and how this should be done in countries of the European Region.

Methods
The European Competency Framework for the Public Health Workforce (Eco-FPHW) has been developed in the framework of the Coalition of Partners, led by WHO European Region, and is one of the pillars of the Roadmap to Professionalizing the public health workforce. The Eco-FPHW primarily relates to the core public health workforce, and that the definition of what constitutes the core public health workforce will differ from one country to the next.

Results
The Roadmap puts forward several possible levers and measures which include: public health education and training, competencies, formal organisation, credentialing and accreditation, codes of ethics and professional conduct as well as laws and regulations, enumeration and job profiles among others. These measures can be engaged with by a range of stakeholders who have important roles and insights into improving public health. Stakeholders include governments, ministries, national and regional/local health authorities, but also directors of public health training institutions, public health institutes, professional organisations, and employers of the public health workforce.

Conclusions
The Roadmap provides a guide for all those countries, institutions and organisations wishing to strengthen the delivery of the public health functions and to support the competencies of the public health workforce.
Internationalisation of health workforce education: the case of medicine in Romania
Authors: Ungureanu M 
Published: November 2019

Abstract

Background
Long recognised as a major source country for health professionals working in Western EU Member States, Romania has become increasingly attractive for international medical students in recent years. The current study explores the drivers of this trend, its opportunities and challenges, as well as its implications on the broader health system goals.

Methods
The study used secondary data analysis and interviews with key informants. Data originated in a study conducted for the OECD (grant no. EC-2017-5304 financed by the European Commission).

Results
Since 2011, 11 of the 13 Medical Schools in Romania have opened additional study lines in foreign languages (English and French) and gradually increased the number of places allocated to international students. Of all new-entrant student places available in the medical schools in 2018/19, nearly 30% (1740 out of 6121) are in the international study programmes - a 50% increase since 2011/12. Moreover, while the total annual number of places for new medical students have increased by nearly a fifth between 2011/12 and 2018/19 (from 5,250 to 6,121), the share of new study places in the Romanian division has decreased from 80% to 70% in the same period. For Medical Schools, internationalisation has been driven mainly by financial reasons and has had a positive impact on curriculum development and improvement. For many international medical students, in particular nationals of the EU countries, the main push factors are the numerus clausus policies limiting access to medical education in their home countries.

Conclusions
Internationalisation of medical education in Romania has taken place in the absence of a formal national internationalisation strategy and efforts have not translated into significant improvements in health workforce management in Romania. This suggests that potential benefits of internationalisation of health workforce education must be assessed in context of national health systems.