bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of health literacy as a public health strategy to counter act the anti-vaccination movement in the web
Authors: Saboga-Nunes L 
Published: November 2019

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

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract

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

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

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

Abstract

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

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

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

Abstract

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

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

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

Abstract
Slovenia’s public health started a new era of proactive interventions jointly with primary care since early 2000s, based on the heritage of the outreach approach developed in that territory in early 1930s. The National Programme for the Early Detection of Risk Factors for Cardiovascular Diseases was launched two decades ago.
Development of a screening programme led to the need to build capacity for lifestyle interventions and the subsequent broader involvement of public health and health care professionals.
Public health interventions addressing challenges, such as those related to primary and secondary prevention, have to be closely linked to the work in the local communities. This is best achieved in developing programmes jointly with primary care, municipalities, educational and social sector as well as NGOs. The original approach of developing secondary prevention interventions needs a further amplification in broadening the base for interventions from a single problem to an array of issues.
Previous approach with the development of Health Education Centres (HECs) was to be upgraded through the development of Health Promotion Centres (HPCs). This required the move from a more traditional approach to addressing individual determinants arising primarily in individuals to a comprehensive approach addressing health and health determinants in all ages. The focus of intervention becomes the local community and the central location is the primary health centre with the specific focus to health equity.
Development of primary and secondary prevention interventions is a measure to address health in the local community. Their placement in primary care ensures equality in access to all citizens in all age groups. Flexibility in approach enables us to develop interventions for the different facets of health.
Building bridges between public health and law
Authors: Tahzib F 
Published: November 2019

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

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

Abstract

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

Aim
The investigation of the promotion of health and health equity in municipal level.
Findings: Social determinants of health are the main causes for health inequalities at a municipal level. Due to that, some municipalities have developed programs to mitigate them. Municipalities have developed the National Intermunicipal Network of Healthy Cities - Health Promotion has as its sole purpose the prevention of diseases, health Promotion, the screening control of high-risk population groups and generally promote integrated policies in the field of Public Health. Today includes 218 (67%) KALLIKRATI Municipalities from all regions of the country.
Municipal social capacities are: kindergartens, programs for migrants, daily care centres for elder people, health care centres (urban and rural), community nursing /home nursing care, mainly to elder and vulnerable groups.
Environmental hygiene: The most important role is the collection of household waste and their appropriate disposal, as well as the protection of the environment.
There are difficulties in promoting health and health equity by the municipalities: a) lack of financial & human recourses, b) lack of explicit responsibility of Municipalities c) lack of capacity about health issues and 4) bureaucracy.

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

Abstract
Public health policy, spatial and environmental policies are within the Dutch municipalities’ competencies. In 2021 a new act will be implemented, in which todays’ more sectoral acts and decrees will be integrated into the so-called (Healthy) Living environment act. This will require more integrated, inter-sectoral and multi-level governance approaches. And new topics and societal challenges, such as health, sustainability and resilience, are introduced within the physical planning domains.
Dutch reviews learn that public health and social domains are collaborating quite well at the local level. The cooperation and integration of health, environmental and spatial planning, on the other hand, often is less or even absent. In Utrecht, though, the latter inter-sectoral approach is strong; health in all policies has been the ‘mantra’ since several years. Supported and institutionalized through strong political leadership, and inter-disciplinary teams at neighbourhood and city level, for policy development and implementation in line with the city’s ambitions of Healthy Urban Living for Everybody.
Utrecht is the healthiest and fastest growing city in the Netherlands, and aims to use its growth (in population, jobs, houses, etc.) to address health inequalities. The city is linking spatial challenges with social challenges, building and improving houses and residential areas for all citizens. A new initiative, called social renovations, will be explored and reviewed within the JAHEE process. This initiative addresses many of the relevant topics, such as healthy living environment planning, stakeholder involvement and specifically reaching ‘hard to reach groups’, and improving housing and public space conditions and subsequently health and well-being of vulnerable groups.
Developing a health information (HI) training programme: strengthening the public health workforce
Authors: Velez-Lapão L , Beja A , Nogueira P 
Published: November 2019

Abstract

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

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

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

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

Abstract

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

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

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

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

Abstract
Community-based participatory research (CBPR) is a collaborative approach to research that aims to improve the health of marginalized communities and reduce health disparities. It starts with a topic of concern for the community and involves iterative cycles of action and reflection to initiate change. Community members are involved as partners and trained as peer researchers to take an active role in the research process. Processes of capacity building and empowerment play a prominent role. As a general principle, participatory research does not primarily focus on health problems, but pays at least equal attention to the resources and capacities of communities. It places a strong focus on developing trust and reciprocity in research relationships.
Regarding methodology, various empirical research methods are used in CBPR study designs, including qualitative, quantitative, mixed-methods and arts-based methods. Arts-based methods such as photovoice, digital storytelling, mapping and drawings facilitate the expression of lived experience, including sensitive aspects, through creative verbal and non-verbal means. These methods expand the available means of expression and as such are highly valuable in research fields where verbal communication is challenged by language barriers and diverse cultural backgrounds as well as sensitive topics and experiences. Participatory health research has been conducted with diverse migrant and refugee groups internationally. Due to legal and other reasons, refugees may be limited in their capacities for participation. The presentation will discuss the strengths and limitations of CBPR including structural obstacles to equitable partnerships.