bluuebunny/crossref_metadata_2025_split huggingface dataset:
6.C. Workshop: Digitalizing maternal and child public health
Authors:   Organised by: EUPHA Child and adolescent public health section,   Chair persons: Julia Dratva - Switzerland, Danielle Jansen – EUPHA-CAPH
Published: October 2020

Abstract
Digital Technologies have transformed many sectors in societies, and, increasingly, is changing the health care sector and health research. In comparison the potential of digital technologies in public health has been less explored. The workshop aims to address both the challenges and potentials of digital public health with focus on maternal and child public health. Presenters will provide examples of how digital technologies and digital health innovations can sustain and improve maternal and child health.
The workshop presents three perspectives on digital maternal and child public health from different continents. This is a deliberate choice to highlight the universal and global relevance of digitalization in maternal and child public health. After the presentations, time is foreseen for a discussion on potential and limitations, as well as the generalizability of methods and results for maternal and child health globally, as well as on the question of governance in digital public health.
The workshop topics will span from digital health information seeking to monitoring and the use of artificial intelligence for policy development. Each presentation covers a different technology or digital approach to public health. The presentations will critically explore how these technologies and approaches can improve public health from a local and global perspective, and will raise central issues, such as acceptance and availability of novel technologies, generalizability of results, governance and participatory approaches in the digital transformation in maternal and child health globally.

Key messages
Digital technologies can provide different impact for maternal and child public health depending on area of implementation, e.g. health promotion, policy development. Challenges and potentials range from specifically local and health-system related to globally generalizable factors.
Use of artificial intelligence based models for learning better policy for maternal and child health
Authors: Sethi T , Awasthi R 
Published: October 2020

Abstract
More than 640,000 babies died of sepsis before they reach the age of one month in India in 2016. Despite a large number of government schemes aimed at reducing this rate, this number still remains high because of the complexity and interplay of factors involved. Finding an optimum policy and solutions to this problem needs learning from data. We integrated diverse sources of data and applied Bayesian Artificial Intelligence methods for learning to mitigate sepsis and adverse pregnancy outcomes in India. In this project, we created models that combine the robustness of ensemble averaged Baeysian Networks with decision learning and impact evaluation by using simulations and counterfactual reasoning respectively. We will demonstrate the process of learning these models and how these led us to infer the pivotal role of Water, Sanitation and Hygiene for reducing Adverse Pregnancy Outcome and neonatal sepsis in the population studied. We will also demonstrate the creation of explainable AI models for complex public health challenges and their deployment with wiseR, our in-house, open source platform for doing end-to-end Bayesian Decision Network learning.
Energy and Climate Change Scenarios in the Mediterranean: An opportunity for cooperation
Authors: Velez Lapão L 
Published: October 2020

Abstract

Background
Climate change is modifying weather patterns, producing far-reaching effects on the environment, the economy and society as a whole, endangering global livelihoods, health, food and energy security, and water resources. Europe, and the Mediterranean will not escape the effects of climate change, which will aggravate risks and threats to human security (mainly public health) and regional stability. Actual cooperation and appropriate instruments are needed to address these threats. In this context, higher temperatures and extreme weather phenomena, such as severe droughts and heat waves will inevitably cause water scarcity in these regions and significant health issues. The degradation of the environment will foreseeably create security and health crisis scenarios, arising from energy shortages, air quality, water stress and food supply problems.

Methods
A scenario analysis was designed to address the relation between security, healthcare, energy and climate change, which contains multiple dimensions. We did a review of the literature and use it to feed the scenario analysis development, to better describe a phenomenon that is complex, with many possible paths and outcomes.

Results
Among the possible scenarios, two were considered: one based on collaboration and the other, on conflict. Several dimensions were examined to address both cooperation instruments and the consequences of non-cooperation: Energy production (e.g., conventional versus renewable) and use; water resources and food security; the environment (air quality) and the impact on health; Population and migration flow.

Conclusions
Climate change is a serious threat. To achieve and implement cooperation, there must be multilateral collaboration between the EU and the other Mediterranean countries, including stronger investment flows from north to south, in conjunction with the promotion of both energy efficiency policies and better healthcare system in the south.
6.E. Workshop: Health promotion: An integrative paradigm for sustainable health, wellbeing and development
Authors:   Organised by: IUHPE,   Chair persons: Margaret Barry - Ireland, Margaret Barry - Greece
Published: October 2020

Abstract
This workshop addresses the importance of health promotion for enabling all human beings to have healthy lives, to maximise their health potential and ensure that no one is left behind. Health promotion is a critical component of modern health systems and a vital strategy for sustainable health development and human flourishing. Effective health promotion strategies are essential in addressing the broader determinants of health, reducing health inequities, and tackling current and emerging health challenges to human development.
Achieving the UN Sustainable Development Goals (SDGs) and universal health coverage calls for concerted action on health promotion as an integral component of modern health systems and future development. While successive global health policies have endorsed the need to invest in health promotion, political commitment to implementing health promotion is lacking and health policies and budgets remain focused on curative approaches. Health promotion is often poorly understood, both within the health sector and society more widely, and there is a limited appreciation of what is required to translate health promotion into effective action. Transformative health promotion actions are needed to deliver on improved population health and wellbeing and the creation of a healthy society where human wellbeing can flourish.

Objectives
This workshop will engage participants in an interactive discussion on how health promotion policy, research and practice can be strengthened in order to advance human health and wellbeing. Critical insights will be exchanged on how to bring a renewed focus on health promotion as a key transformative and disruptive strategy for advancing human wellbeing development. The workshop will critically consider what mechanisms are needed for strengthening health promoting policies, implementation processes and structures, capacities and research, to advance population health and wellbeing and a healthier future for all.

Key messages
Health promotion actions are critical to the delivery of improved population health and health equity, transforming health systems and enhancing human wellbeing and sustainable development. Strengthening health promoting polices, practices and research is essential to achieve the UN Sustainable Development Goals and enable the conditions for a healthier world.
Experiences of healthcare workers displaced by conflict: lessons from past conflicts and implications
Authors: Moqeem U , Mukhtar O , Abbara A , Jabbour S , Abouzeid M 
Published: October 2020

Abstract

Background
Conflicts cause mass displacement, including of healthcare workers (HCWs). Understanding experiences of HCWs over the displacement trajectory, from push factors out of conflict zones, to barriers and facilitators in transit and host countries, is key to developing support mechanisms and informing policy discussions regarding return and reintegration.

Methodology
We systematically reviewed 6 academic databases and grey literature using combined search terms for HCWs, displacement, conflict, and experiences to identify English-language literature documenting personal or professional experiences of HCWs displaced by conflict, published between 1945 to 2020. Open coding and thematic analysis were used to identify emerging themes. Quality appraisal was conducted.

Results
25 publications from academic journals, snowballed references, and grey literature from 10 geographical contexts and various types of HCW met inclusion criteria, many from conflicts in the Middle-East. 5 themes emerged: Conflict drives displacement: HCWs fled due to direct violence and deteriorating working conditions caused by increased workload, depleting resources, workforce attrition and attacks on healthcare. Giving back: Refugee HCWs were determined to continue working but had to do so informally or by working with humanitarian agencies. Personal and professional integration in host countries: refugee HCWs overcame barriers to relicense after which they reported disadvantage in job applications due to professional gaps and discrimination; many ended up working under-qualified jobs. Psychological toll on HCWs was pronounced. Prospects on return: HCWs desired to return to their home countries but feared political instability and violence.

Conclusions
Policies which support HCW retention during conflict, integration into host health systems, and encourage return post-conflict must be implemented. Further research is required to understand the individual and systemic support mechanisms required.

Key messages
Displaced HCWs experience many personal and professional challenges. Policies that support HCWs across the displacement trajectory and support return and post-conflict system rebuilding are required.
Team Climate in Primary Health Care in a region of São Paulo countryside, Brazil
Authors: Silva J A M , Mininel V A , Ogata M N , Machado M L T , Feliciano A B , Sampaio S F , Pedro W J A , Souza G C , Agreli H F , Meirelles E 
Published: October 2020

Abstract

Background
Interprofessional teams are responsible for Primary Care at Brazilian HealthCare System. Teamwork climate is considered a key for quality of healthcare services and care perceived; it results in perceptions about a team, considering aspects that influence their relationship and effectiveness. The study aims to analyse the teamwork climate of Primary Care workers.

Methods
Survey cross-sectional carried out in a region of São Paulo countryside with 419 Primary Care professionals from 60 teams of public health services. We collect data through the Team Climate Inventory with 38 items and 4 factors. We analysed the data using a psychometric, factorial confirmatory analysis. This research is part of the Universal CNPq Project, process 431461/20163, and all ethical concerns were observed.

Results
In the sample 47 (11.2%) were nurses, 143 (34.1%) community health workers, 87 (20.7%) nursing assistants and 27 (6.4%) physicians and 115 (27,6%) other health professionals. Cronbach was &gt;0,90 in all factors of Team Climate Inventory and the correlation was confirmed with p &lt; 0,05. In the factor 1 - Team Participation M = 3,79, DP = 0,66; factor 2 - Support to new ideas M = 3,66, DP = 0,68; factor 3 - Team objectives M = 5,04, DP = 0,98; factor 4 - Tasks orientation M = 4,92, DP = 1,30 with p-value 0,001 to all factors. Tukey's post hoc analysis indicated that the group with less than one year in the teams (M = 5.31) had a significantly higher average when compared to groups with 6 to 10 years in the team (M = 4.91) and 11 years old or more (M = 5.04).

Conclusions
Results showed a good team climate in the sample, the potential to strengthen the teams and the relevance of working time together to get better results for patient health care. The magnitude of the public health impact by reporting on the team climate indicators of the 60 Brazilian teams are local and international relevance.

Key messages
The time of work together in a team can be a predictor of clear objectives in teamwork. The team climate recognizing can promote reinforce of the teamwork and the results to Public Health. Policy makers and managers can apply these results to build workforce management actions.
Nurse density matters: a 30-country observational study of antimicrobial resistance priority type
Authors: Kaba H , Kuhlmann E , Scheithauer S 
Published: October 2020

Abstract

Background
Although the warming climate and antimicrobial use were associated with antimicrobial resistance (AMR), they showed poorer explanatory strength in southern and eastern European countries, characterized with higher levels of nurse emigration. The present study investigated the contribution of nurse density to AMR variance explanation in the EU/EEA region for “Priority 1” AMR types (WHO).

Methods
A 30-country observational study was conducted. Combined species six-year prevalence of carbapenem resistant gram-negative bacteria (Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae and Acinetobacter spp.; CRGN) were determined using public ECDC data of clinical isolates, which were subjected to statistical analysis.

Results
Countries with low nurse density (&lt; median) displayed a 10-fold higher median CRGN prevalence compared to those with high density (p &lt; 0.001). Furthermore, proportions of reported isolates for all species (standardized by the total number of reported isolates per country) negatively correlated with nurse density with the exception of Ecoli, which showed a positive correlation (rs = 0.73, p &lt; 0.001). In multivariate analysis, nurse but not physician density significantly explained total log_CRGN variance (R2=83%). Notably, nurse density had a higher contribution to variance explanation than outpatient antimicrobial use. However, this observation could be retained only for countries without a gate-keeping role of GPs.

Conclusions
This study contributes novel data by identifying a potential association between nurse density and CRGN. Statistical observation might be supported by survey data on health workers' attitudes, which identified nurses and associates as the professionals most likely to perform hand hygiene.

Key messages
Including nurses in future AMR policies may help to tackle the spread of critical AMR types, such as CRGN. Strengthening the role of nurses in fighting AMR may be most beneficial in countries without a gatekeeping system.
Knowledge, attitude and practice on antibiotic use and resistance among the Italian population, 2019
Authors: Vaccaro C , Fortunato F , Iannazzo S , Furiozzi F , Martinelli D , Prato R 
Published: October 2020

Abstract

Background
Public knowledge, awareness and behaviors related to antibiotic use and antimicrobial-resistance (AMR) are vital to ensure the prudent use of these drugs. In this work, we present the top-line results of the first national survey of AMR among the Italian general population aged ≥18 years.

Methods
From August to September 2019, we conducted a population-based cross-sectional random survey through mixed CATI/CAMI/CAWI methodologies among representative samples of the general population, parents of children aged 0-11 years, adults ≥65 years and pet's owners. Results were summarized using relative frequencies.

Results
Of 1,400 persons interviewed, 47% and 68% respectively correctly said that it is false that antibiotics kill viruses and are effective at treating colds and flu. More than 80% of respondents considered themselves to be well-informed about antibiotics but only one in two people knew what is meant by AMR. While the vast majority (96%) of respondents said that they obtained the last course of antibiotics that they used from a medical prescription, 11% incorrectly said that they stopped taking antibiotics when they felt better or that they used those left over from a previous course. In addition, 55% of pet's owners said they obtained antibiotics without a prescription from a pharmacy or elsewhere. Almost all respondents (97%) believed that it's everyone's responsibility to use antibiotics wisely, with the 80% who expressed concerns about the potential of AMR to affect themselves and their families; however, 40% did not think that action at an individual level is the most effective way of tackling resistance to antibiotics.

Conclusions
Our findings show some improvement in Italians' knowledge, awareness and behaviors related to antibiotic use and AMR but there are needs to be a greater sense of responsibility to take charge of the AMR problem. These results may be drivers of structured national awareness campaigns.

Key messages
In 2019, we conducted the first national survey of AMR among the Italian population: &gt;80% of respondents felt themselves well-informed about antibiotics but only 1/2 people knew what is meant by AMR. Almost all Italian sample believed that it's everyone's responsibility to use antibiotics wisely, but 40% did not think that action at an individual level is effective to tackle AMR.
Key indicators for harmonized European population health surveillance: an iterative approach
Authors: Do S D , Murrin C M , Hebestreit A H 
Published: October 2020

Abstract

Introduction
A pan-European approach to evaluate policy impact on health behaviours requires the employment of a consensus set of established, relevant indicators. This set includes indicators for policy and action, behavioural aspects, determinants and health outcomes.

Methods
Following an iterative selection process, we prioritised an agreed set of health indicators of high priority for policy makers. During this process, over 30 European experts were invited to attend a workshop and consult on inclusion and prioritisation of indicators. These experts were representatives of surveillance systems and informants of similar initiatives, e.g. STOP, Co-Create, HBSC, WHO COSI as well as representatives of organisations providing monitoring data such as OECD, EC DG SANTE, WHO and Eurostat. The consultation process was initiated prior to the workshop via email and continued with facilitated group discussions during the workshop.

Results
Lists with indicators relevant for policy evaluation and monitoring of 1) dietary behaviour (N = 76), 2) physical activity/sedentary behaviour (N = 86) as well as 3) socio-demographic indicators (N = 9) have been composed; examples will be presented. This suite of key indicators was agreed and then mapped against data in existing pan-European monitoring systems in order to provide an open-access catalogue suitable for the design and evaluation of new and existing policies.

Conclusions
The presentation will offer an opportunity for researchers and stakeholders to learn more about this catalogue, the indicators and how they could be applied and integrated into their activities.

Key messages
We provide a set of health indicators relevant for pan-European policy impact evaluation. These indicators - ideally measured using harmonized instruments - may facilitate collection of comparable data across EU surveillance and monitoring systems.
Spatial patterns in regional life expectancy trends in the European Union between 1990 and 2018
Authors: Hrzic R , Vogt T , Brand H 
Published: October 2020

Abstract

Background
A substantial life expectancy gap exists at the regional level in the European Union (EU). It has consistently followed an east-west pattern since 1990. The spatial pattern in the rate of change of regional life expectancy is less well established. Understanding both patterns is necessary to guide regional cohesion and health inequalities policy in the EU. Our aim was to investigate whether there are distinct spatial patterns in regional life expectancy trends in the EU since 1990.

Methods
Using Eurostat's regional life expectancy database, we constructed a panel of sex-specific period life expectancy at birth (PLE) for 201 EU NUTS2 regions between 1990 and 2018. Regions with populations less than a hundred thousand and with more than ten years of missing data were excluded. We clustered the regions based on the similarity of the shapes in PLE trends for each sex using a bootstrap version of the K-means algorithm. The optimal numbers of clusters were determined based on a majority of five empirical criteria. Finally, we used a bootstrap version of the join count test to assess the degree of the spatial association of the identified clusters.

Results
Preliminary results of clustering on PLE trends support a two-cluster model for women (high and moderate rate of PLE improvement) and a three-cluster model for men (very high, high, and moderate rate of PLE improvement). The clusters do not correspond to EU macro-regions or the year of EU accession. The female high rate and male very high rate of PLE improvement clusters overlap in northern Portugal, northern Italy, Finland, Poland, Czechia, Austria, the Budapest region, and Slovenia. The join count tests reject a random spatial patterning of clusters.

Conclusions
EU regional life expectancy trends since 1990 exhibit a spatial pattern that does not correspond to EU macro-regions or recent EU accession. Analysing spatial patterns in regional lifespan disparity trends would be an interesting next step.

Key messages
Subnational EU life expectancy trends exhibit a spatial pattern that undermines the prevailing east-west divide narrative as eastern European regions are among the best performing since 1990. National differences in health may not reflect the experience of European citizens in their regions. Subnational and dynamic perspectives are key for future health disparities research in the EU.