bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and use of best practice portals: a European perspective
Authors: Maassen A , Maassen A 
Published: November 2019

Abstract
Across Europe, a number of best practice portals are in different stages of planning, implementation, and evaluation. At the European level, joint best practice initiatives are also underway, notably the Best Practice Portal of the Steering Group on Health Promotion and Disease Prevention managed by the European Commission’s Directorate General of Health and Food Safety (DG SANTE), as well as topic-specific portals such as the Xchange portal managed by the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and best practice databases from European projects (such as INHERIT on health and sustainability) or Joint Actions (CHRODIS). This presentation will look at how joint European initiatives such as these can successfully link with initiatives at the national level, as well as how they can support the achievement of international objectives such as the United Nations’ Sustainable Development Goals (SDGs).
This presentation will also provide an overview of learnings and key takeaways from the Developing Health Promotion and Disease Prevention Best Practice Portals workshop, hosted by BZgA and EuroHealthNet in Cologne, Germany in June 2019. We will present further collaboration and learning conducted by participants subsequent to the June workshop.
Finally, the presentation will kick off the debate following the presentations on the value added of best practice portals and how to promote awareness, engagement, and uptake by professionals and policymakers - both of specific best practices and the portals themselves. This exercise will draw on examples from countries across Europe, as well as from European projects such as CHRODIS+, and look at ways to evaluate the success of portals, as well as practical concerns such as transferability, ownership and scalability.
The changing context of public health in Europe
Authors: McKee M 
Published: November 2019

Abstract
From a public health perspective there is much to celebrate. Europe enters the third decade of the 21st century with a population that has never been healthier. Advances in knowledge, from basic sciences to public health, have transformed our ability to tackle the diseases that afflict our populations. It would be easy to become complacent. Yet, at the same time, our world is transforming rapidly and profoundly. Changing demographics, globalization, technological developments, climate change, shifting public opinions on the value of scientific evidence, a political arena that increasingly seems to focus on highlighting differences rather than looking for common ground: all these trends result in massive and complex societal challenges, which will place great strain on our public health and health care services. In addition, deep and persistent health inequalities within and between countries continue to demand action. New threats (e.g. fake news) are surfacing, old threats (e.g. measles and TB) are coming back and EUPHA and its members need to adapt. This presentation will survey the changing public health landscape in Europe and globally, highlighting key issues for EUPHA to address.
Geospatial data sources to produce new evidence for routine population health monitoring
Authors: Costa C 
Published: November 2019

Abstract

Background
Many public agencies collect geospatial data in relation to Environment and Territorial Planning. This data is harmonized, standardized, made available online, and it is often collected for a group of countries. These characteristics make this data particularly useful for population health studies, yet in public health there is a certain lack of knowledge with regard to this type of data. The large datasets, the data format and the ways to access this data all hamper their use. The aim of this work is to present an overview of geospatial databases that produce routinely available geospatial data able to support population health monitoring and interventions. The process of how to transform this data in evidence at the local scale will also be highlighted.

Methods
First, we conducted a survey via the websites of international public institutes with relevant geospatial data gathered for Europe. Second, we identified how we could transform the data into evidence relevant to both, population health studies and decision makers, namely at the local level.

Results
At the EU level, the European Territorial Observatory Network (ESPON), EUROSTAT, the Joint Research Centre and the Environment European Agency (EEA) are some examples of public agencies both producing and offering access to geospatial data. They are responsible for collecting data regarding, e.g., land use, road and rail networks, amenities and pollution.
Although geospatial data has been compiled all over Europe, it can be used to produce evidence at the local level. For instance, it is possible to extract information on the greenspace area at a local administrative level from the Corine Land Cover project, managed by the EEA, and then, measure the share of area per inhabitant.

Conclusions
Geospatial data have much more to offer than the obvious location factor. It brings new evidence at the local level, supporting studies and empowering decision-makers at all levels.
Example C: Using online respondent-driven detection for communicable disease control
Authors: Helms Y B , Hamdiui N , Eilers R , Hoebe C J P A , Dukers N , van den Kerkhof H , Timen A , Stein M L 
Published: November 2019

Abstract
Online respondent-driven detection (online-RDD) is a novel method of case-finding that may enhance contact tracing (CT). However, the opportunities and barriers of online-RDD for public health practice have not yet been investigated from the perspective of public health professionals (PHPs). Therefore, it is unclear what the potential strengths and limitations of online-RDD for CT are.
We conducted a sequential exploratory mixed methods research. First, we conducted semi-structured interviews with Dutch PHPs involved in CT. Questions were derived from the diffusion of innovations theory. Second, we distributed an online-questionnaire to 260 Dutch PHPs to study the main findings in a larger population. We used hypothetical scenario’s (scabies, shigella, and mumps) to elicit PHPs’ perceptions of online-RDD.
Twelve interviews were held. Response rate to the online-questionnaire was 31% (n = 70). Four themes related to characteristics of online-RDD that influenced PHPs’ intention to adopt online-RDD emerged: advantages over traditional CT, task conflicts and opportunity costs, public health risks, and situational compatibility. PHPs believed online-RDD may enhance CT through increased reach, low-key communication options, and saving time. Limitations were foreseen in the delivery of measures, supporting patients and contacts, missing information and contacts, and causing unrest. Online-RDD may be particularly applicable in situations with digitally skilled and literate target populations, low urgency, low time-pressure, and a simple perspective for action. A majority of PHPs (70%) had a positive adoption intention towards online-RDD.
PHPs perceived online-RDD as beneficial to public health practice. Further development of online-RDD should focus on facilitating opportunities for personal contact between PHPs, patients and contacts. A comparative study of ‘traditional’ CT and online-RDD could yield further insights in the potential of online-RDD for public health practice.
Political support for the institutionalization of health assessment within Environmental Impact Assessment
Authors: Moya Ruano L , Rodríguez Rasero F J , Madrid Verdugo E , Vela J 
Published: November 2019

Abstract
Health Impact Assessment (HIA) as a stand-alone report integrated in environmental impact assessment has been compulsory for the last 5 years in Andalusia. In this time, it has been proven as a successful tool for implementing the Health in All Policies strategy, delivering consistently better outcomes for the examined projects.
The effective implementation of HIA required huge institutional and political support as this choice was very controversial and sparked opposition from developers. They alleged it would worsen the adverse socioeconomic situation and made claims about how it would generate unfair competition for companies in the region.
Nevertheless, the main source of opposition was located within administrations, unaccustomed to collaborative work. There were also fears about the increased bureaucracy and lack of coordination in procedures. It was a major challenge, as it seemed conflicting with other political objectives as achieving economic growth and job creation, while offering doubtful political gains due to difficulty in achieving results in the short term.
The support implied assuming a political leadership focused on the inclusion of health in the government’s list of priorities, advocating for the population value as a strategic element. It also meant raising awareness among all sectors by searching for strategic alliances and being prepared to compromise and reach agreements.
It needed technical and organisational leadership too. First, by defining a feasible model of HIA, and then by building bridges between the different sectors. Regarding coordination, several joint instructions have been drawn up to clarify the activities that each organization must undertake, including deadlines and persons in charge. Finally, other successful strategies have been the development of facilitation mechanisms and the provision of specific training courses for developers and administrative staff.
The Sweden cohort consortium (Cohort.se)
Authors: Sundstrom J S 
Published: November 2019

Abstract
The scientific literature is continuously flooded with non-replicable results from underpowered studies. The insight that very large sample sizes are needed in order to generate robust results has led to the establishment of very large cohorts and cohort consortia in the last decades. Sweden is a country with unique opportunities for epidemiological research. Sweden has a large number of carefully collected population-based cohorts that have been followed for decades, ongoing recruitment into several cohorts, and a variety of high-quality national socio-demographic and medical registries covering the whole population since many decades. However, Swedish cohort research is poorly coordinated. Many research projects are underpowered by using only one cohort at a time, leading to uncertain results with little benefit to patients and the public. We have proposed a coordination of all Swedish cohorts in a common national infrastructure, the Swedish Cohort Consortium (Cohorts.se), aiming to facilitate greater use of Swedish cohorts for better-powered research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure would enable more precise research findings and facilitate research on less common exposures and outcomes, leading to better utilization of study participants’ data, better return of funders’ investments, and higher benefit to patients and populations. A standing Swedish cohort consortium may drive development of epidemiological research methods and strengthen the Swedish epidemiological competence, community, and competitiveness.
Workshop: Care4Care: the migrant care workforce in Europe
Authors:   Organised by: EUPHA (HWR), EUPHA (HSR), EUPHA (PHPP) Chair persons: Ellen Kuhlmann - EUPHA (HWR), Judith de Jong - EUPHA (HSR)
Published: November 2019

Abstract

Background
Foreign trained health workers increasingly fill the care gaps caused by labour market shortage and governance failures. As doctors, nurses and carers they make a crucial contribution to health system performance and the health of the population. These contributions are likely to increase in future, especially in high-income countries, where demographic change and NCDs reinforce the gap between demand for care and labour market supply. However, health system demands for migrant carers do not sit easily with the new wave of nationalism and populist movements in Europe and globally; they may also reinforce the ‘care drain’ in less well-resourced sending countries. There is an urgent need for more inclusive health workforce governance in order to take ‘care’ for the migrant health workforce both nationally and globally and ensure ‘health for all’.

Objectives
This workshop addresses these questions and fosters critical debate. It has three major aims: to make the migrant carers visible as important part of the health workforce and health system performance, to unmask the threats of growing nationalism and populist movements to healthcare systems and universal healthcare coverage, and finally to critically discuss how to govern the migrant care workforce in ways that improve both integration in the host country and solidarity across Europe and globally. The workshop brings together knowledge and expertise from the areas of health workforce, health services, and health policies and systems. It is organised as round table discussion, facilitated by an overview of migrant care workforce patterns and policies in selected European Union (EU) high-income countries and two in-depth country cases, namely Italy and Austria, both known for growing populism and nationalism and strong anti-migrant policies in the EU. The three panelists will discuss the role of migrant care workers and explore, from different perspectives, how to build capacity for new forms of health workforce governance that move beyond narrowly defined national/regional interests of health systems. The workshop will foster a wider debate on migrant careers and health workforce needs, and how public health can contribute to better take ‘care’ for the human resources for health.

Key messages
Migrant carers form an important part of the health workforce in European countries. Health systems must take care of the migrant health workforce and counteract growing nationalism.
Nation-wide profile of women using hormonal contraception in Finland in 2017
Authors: Toffol E , But A , Heikinheimo O , Latvala A , Partonen T , Haukka J 
Published: November 2019

Abstract

Background
Up to 69% of European women use contraception. Nordic countries have traditionally high levels of contraception use, of welfare and social equality. However, the uneven population distribution across the Finnish territory makes the easiness of access to health care structures and trained professionals an important issue in relation to effective contraception use. Understanding the patterns of contraception prescription and their underlying determinants is crucial to guarantee the best contraceptive option for each woman.

Methods
In Finland, users of hormonal contraception (HC) can be identified from register records only starting from 2017. This nationwide, register-based study includes all women with at least one HC prescription in 2017, and a reference cohort of non-users, matched by age and municipality. Through linkages to Finnish National Registers we retrieved sociodemographic data. We calculated national and regional rates and distributions, and compared distributions with t-test, Kruskal Wallis or Chi-squared test.

Results
The HC cohort included 294445 women aged 15-49 years (mean 28.9, SD 8.6), 25.8% of Finnish women of that age range. The majority of them were unmarried (71.8%) and employed (71.6%). Compared to non-users, HC users were more often unmarried, a cohabiting couple without common children, employed, had upper secondary or bachelor level education, and higher annual income (p &lt; 0.001). Differences between HC users and non-users were non-homogenous across 70 Finnish regions.

Conclusions
These preliminary results show different sociodemographic correlates of HC use across Finnish regions. Our findings will guide public health strategies aimed at guaranteeing the best contraceptive option for each woman across the whole country.

Key messages
Sociodemographic correlates of HC use differ across Finnish regions. These differences may reflect differences in access to health care services, in prescribers’ characteristics and in HC methods.
Health situation and health care of women aged 50 years and older in rural regions in Germany
Authors: Prütz F , Krause L , Nowossadeck E , Thißen M , Dini L 
Published: November 2019

Abstract

Background
In many countries demographic changes and regional differences lead to inequalities in healthcare provision. In Germany, this applies especially to rural regions and could affect the healthcare situation of middle-aged and older women in particular. Our study, which is part of the project “Frauen 5.0”, explores the health and healthcare situation of women 50 years and older in Northeastern Germany, with focus on outpatient gynaecological and general medical care and reasons for healthcare utilisation.

Methods
Our analyses comprise the health situation of women aged 50 years and older, their utilisation of outpatient gynaecologists and general practitioners (GPs), reasons for utilisation, access barriers to outpatient care, the demographic situation and the spatial distribution of gynaecological and GP practices in Northeastern Germany. We use a variety of data sources; main data source is the German Health Interview and Examination Survey for Adults (DEGS1, 2008-2011), which was carried out by the Robert Koch Institute and is representative of the German adult population.

Results
There is an unequal distribution of gynaecologic and GP practices in Northeastern Germany, with the highest density in and around Berlin. About 30% of gynaecologists and GPs in the study region are aged 60 years and older. Whereas in all age groups at least 80% of women used GP services in the last 12 months, the use of gynaecologic services declines from 80% in 18- to 29 year-old to 45% in 70- to 79 year-old women. Most important reasons for seeking gynaecological treatment are menopause and early detection of cancer.

Conclusions
The analyses show that there is need to ensure adequate health care for women aged 50 and over in rural regions in Germany. Based on the results, within the project “Frauen 5.0” innovative solutions for this task, e.g. interprofessional cooperation, will be identified.

Key messages
Analyses of outpatient healthcare services show an unequal distribution of gynaecologic and GP practices in Northeastern Germany; about 30% of the gynaecologists and GPs are aged 60 years and older. Whereas in all age groups at least 80% of women used GP services in the last 12 months, the use of gynaecologic services declines from 80% in 18- to 29 year-old to 45% in 70- to 79 year-old women.
Mothers’ Oral Health Literacy and children’s oral health: study in the department of Pikine, Senegal
Authors: Dieng S , Lombrail P , Cissé D , Azogui-Levy S 
Published: November 2019

Abstract

Background
Several studies have shown that social conditions in which children are raised and family psychosocial factors affect their oral health. Oral health literacy (OHL) has been shown to be associated with prevalence of dental caries, access to care and prevention of oral diseases. No studies have addressed this issue in Senegal.
Objective: To study the characteristics of the mothers’ OHL and its association with children’s dental health.

Methods
Cross- sectional study in the district of Pikine, a suburb of Dakar including 16 municipalities. Two-stage cluster sampling and a sample comprising 315 children from 3 to 9 years old and their mothers. Data on oral health status were collected from clinical examinations, sociodemographic and OHL (Sistani et al’ OHL-AQ) data were collected during face-to-face interview.

Results
More than half of the mothers (56.5%) had a low OHL, but 68.9% had an adequate score for the communication/interactive dimension. The level of OHL increased significantly with education level, household wealth and dynamism of the social support. Prevalence of dental caries was 64.8%, following a social gradient and significantly associated with the mothers’ OHL level (OR = 5.2) CI[2.2-14.1]. The oral health behaviour of families was significantly associated with the level of OHL and children’s dental health. A structural equation model showed the OHL was a mediating factor between social characteristics and oral health behaviours.

Conclusions
The OHL of mothers is an important variable to be included in the study of social inequalities in oral health. The communication/interactive dimension seems to be decisive in the African context of an oral culture and dynamic social support which makes it possible to provide better knowledge and preventive behaviour.

Key messages
High maternal OHL should be reinforced to lessen oral health inequalities among Senegalese children. The communication/interactive dimension seems to be decisive in the African context of an oral culture and dynamic social to enhance OHL.
Medical records completeness: can Link Professionals improve quality in a Rehabilitation Hospital?
Authors: Scarpis E , Poletto M , Guardini I , Dal Bo O , Maestra M R , Tea G P , Zampa A , Lattuada L , Castriotta L , Brusaferro S 
Published: November 2019

Abstract

Background
The completeness of Medical Record (MR) is an indicator of the quality of care provided. IMFR (Medical and Physical Rehabilitation Institute), a hospital part of the Udine Healthcare Trust with 400 discharges yearly, launched at the end of 2017 a MR-quality program based on the involvement of Link Professionals (LP): doctors, nurses and therapists specifically trained. The main aim of this study is to determine if involving LP would improve MR completeness and would keep it over time. The second aim is to describe the 1-year experience of MR completeness and professional attitude toward recording medical information in it.

Methods
In December 2017 a new MR was introduced at the IMFR and its completeness was evaluated in January 2018. From January to April 2018, 17 LP educated all colleagues on the recording behavior through periodic meetings and focus groups. Then, LP peer-reviewed 20 inpatients paper-based MRs, assessing completeness, in April 2018 and then quarterly until January 2019. The evaluation was performed with a tool including a total of 73 items, divided in pertinence to the three professional figures involved. Feedbacks on MR completeness were given to professionals by LP in two-weeks. External data validation was performed to ensure data consistency. Significance (p &lt; 0.01) was assessed by Cochran-Armitage test for trends.

Results
The overall completeness of MR improved significantly from 59.6% (552 items out of 926; Jan-18) to 77.0% (738/959; Apr-18), settling to 78.3% (696/889) in January-19, with an overall trend of + 18.7%. Items pertaining to doctors improved significantly from 56.4% (217/385) to 81.4% (1173/1441), nurses’ from 60.7% (165/272) to 78.6% (740/941), therapists’ from 79.0% (79/100) to 91.7% (277/302). External validation results in 75% of agreement.

Conclusions
The involvement of LP proved effectiveness in encouraging professionals behavior, supporting the MR completeness improvement and keep it over one year time.

Key messages
Professionals involvement and short-term feedbacks contribute to the healthcare quality improvement. Peer-reviewing medical records improves professionals attitude in recording behavior.