bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring health systems readiness for domestic violence in Brazil and Palestine
Authors: Colombini M , d’Oliveira A F , Alkhayyat A , Shaheen A , Garcia-Moreno C , Feder G , Bacchus L 
Published: October 2020

Abstract

Background
Increasing attention has been paid on health systems readiness around domestic violence (DV), a global health issue leading to adverse health consequences. This article aims to present a comparative synthesis of the health system pre-conditions necessary to enable integration of services for domestic violence in Brazil and Palestine.

Methods
A health systems readiness assessment was conducted to explore health systems gaps. Multiple, data sources were used, ranging from qualitative interviews with various stakeholders (e.g. providers, health managers and key informants); structured facility observations (8 clinics); policy document reviews.

Results
Our findings highlight deficiencies in policy and practice that need to be addressed for an effective response. Common preparedness gaps include unclear governance and unsupportive leadership structure; challenges around service delivery such as limited staff protection and limited coordination; and untrained health workforce. Our results illustrate the importance of having clear guidance on roles and responsibilities for both health managers and clinicians. In Brazil, although there is a legal and regulatory system on domestic violence, its implementation has been patchy as health regulations are not well-defined. In both settings, the limited higher-level commitment and political will to reduce violence has affected implementation. Limited guidance, coupled with limited training and perceived lack of support in the facility environment, also impacted on providers' knowledge and confidence in responding to violence. Fear of family retaliation affected frontline providers' actions in both countries.

Conclusions
Our innovative framework helped identify anticipated readiness gaps. It has shown the importance of nurturing the role and values of managers and engaging the leadership across every system to reframe challenges, and strengthening routine practices to encourage staff engagement in responding to DV.

Key messages
Conducting a health systems readiness assessment before integrating a new service can anticipate preparedness gaps and inform adaptation that will enhance service uptake and effectiveness. Critical systems gaps to address before integrating domestic violence services in healthcare include staff and managers’ values, leadership and organisational support to frontline providers.
School connectedness, violence-related behaviours and mental health status among in-school youth
Authors: Akinmoju O , Odigwe B , Olusakin T , Fakayode D , Olaopa F , Adejuwon A , Eze D , Olaleye O , Balogun B , Adebayo A 
Published: October 2020

Abstract

Background
Young people spend significant amount of time in school which has a substantial impact on the development of this group. Mental health problems and violence-related behaviours (VRBs) are common among youth including those in school. Studies on the relationship between school connectedness (SC), VRBs and mental health status (MHS) are currently scarce in the literature. This study was conducted to assess SC, VRBs, MHS of in-school youth in a rural community of southwest Nigeria and the association between SC, VRBs, and MHS.

Methods
A cross-sectional study was conducted among 655 respondents randomly selected students of 4 public and 4 private senior secondary schools in Eruwa, Oyo State. A semi-structured interviewer-assisted questionnaire was used to obtain information on SC, VRBs and MHS. SC comprised of a 42-item scale, VRBs had 20 and MHS had 14-item scale. Data was analysed using descriptive statistics and chi-square with level of significance set at 10%.

Results
Mean age of students was 16.4±1.3 years (public 59.2%; private 40.8%). Above one-half (55.8%) were disconnected from school, 86.4% reported participation in or experience of VRBs and 28.3% had poor mental health. Students who did not experience VRBs were less likely to have poor MHS (OR: 0.438; 95%CI: 0.23-0.82; p = 0.010). Students from monogamous family setting were less likely to have poor MHS than those from polygamous setting (OR: 0.672; 95%CI: 0.46-0.99; p = 0.046). Non-smokers were less likely to have poor MHS than their smoking counterparts (OR: 0.298; 95%CI: 0.12-0.73; p = 0.008). Students who rarely experienced being sent out of school were less likely to have poor MHS than those who had regular experience (OR: 0.315; 95%CI: 0.11-0.89; p = 0.029).

Conclusions
There was high prevalence of VRBs among students with majority of them having good MHS. Predictors of poor MHS were experience of VRBs, family setting, smoking status and experience of being sent out of school.

Key messages
Predictors of poor MHS among youth lacking in literature were found. Pathway to addressing these globally is shown below. International bodies’ support for restriction of cigarette’s use by &lt; 18years. Funding of education in rural areas to reduce financial difficulty, parents modelling their children to correct attitude to violence and more studies unravelling mediating factors of polygamy on MHS.
Production losses attributable to suicide mortality in the European Union in 2015
Authors: Łyszczarz B 
Published: October 2020

Abstract

Background
Suicides are an important public health problem with multidimensional consequences for the whole society. One of the under-researched areas of suicide consequences are production losses associated with these deaths. The aim of this study was to estimate the production losses (indirect costs) of suicide deaths in 28 European Union states (EU-28) in 2015.

Methods
The study applied the top-down approach, societal perspective and human capital method to sex- and age-specific data on suicide mortality at working age. The WHO Mortality Database was used to identify the number of deaths (3-year average) in each country while the Eurostat's labour and economic indicators were used to proxy the value economic output lost.

Results
The production losses attributable to suicide deaths in EU-28 in 2015 were €8.81 billion. The per capita indirect costs of these deaths were €17.28 for the whole EU-28 population; Ireland experienced the highest per capita burden (€50.38), while the average costs were the lowest in Cyprus (€3.84). The losses constituted an economic burden of 0.06% of EU-28's GDP; this share ranged from 0.016% (Cyprus) to 0.149% (Latvia). Most of the losses were due to men's deaths and the proportion of losses associated with male mortality ranged from 70.9% (Sweden) to 91.4% (Poland). The results of sensitivity analysis exhibit large variation of losses; the highest costs were estimated with no adjustment for lower employment rates among those committing suicide (36.9% to 238.9% higher than in base scenario) while the lowest costs resulted from the scenario of adjustment for minimum productivity (-47.6% to -65.7% lower than in base scenario).

Conclusions
The production losses caused by suicide deaths are a substantial burden for European economies. Therefore, the use of cost-effective actions aimed at limiting self-harm mortality might be beneficial not only in terms of health gains but could also contribute to limiting indirect costs.

Key messages
Production losses attributable to suicide deaths are 0.06% of EU’s GDP, ranging from 0.02% of GDP in Cyprus to 0.15% of GDP in Latvia. Indirect costs of men’s deaths dominate in all the countries and this can be explained by both higher suicide rates and longer economic activity than among women in Europe.
How to increase the value of self-reported health service data by using data linkage: a case study
Authors: Peng W , Maguire J , Hayen A , Adams J , Sibbritt D 
Published: October 2020

Abstract

Background
This is a case study for recurrent stroke prevention. Lifestyle factors account for about 80% of the risk of recurrent stroke. Most health services studies examining stroke prevention rely on stroke survivors' self-reported lifestyle behaviour data. How can researchers increase the value of collected self-reported data to provide additional information for more comprehensive assessments?

Methods
45 and Up Study is the largest ongoing study in the Southern Hemisphere focusing on the health of people aged 45 years and older living in NSW, Australia. This case study linked self-reported longitudinal lifestyle data in the 45 and Up Study, with corresponding mortality data (i.e. NSW Registry of Births, Deaths and Marriages & NSW Cause of Death Unit Record File) and hospital data (i.e. NSW Admitted Patient Data Collection) via the Centre for Health Record Linkage (CHeReL). The main outcome measures are health services, clinical outcomes, and mortality rates for stroke care. The analyses will include descriptive analysis, multivariate regression analysis, and survival analysis.

Results
A total of 8410 stroke survivors who participated in the 45 and Up Study were included in this data linkage study. From January 2006 to December 2015, 99249 hospital claims (mean: 13 times admission to hospital per person) and 2656 death registration records have been linked to these participants. The mean age of the stroke survivors was 72 (SD = 11) years, with 56% being males. These results are preliminary and more analyses will be conducted by using quality of life status, clinical diagnosis, comorbidities, and procedures.

Conclusions
Data linkage enables researchers to generate comprehensive findings on health services studies and gain a more holistic understanding of the determinants and outcomes of stroke prevention with lower data collection costs and less burden on participants.

Key messages
Data linkage brings about a new opportunity for self-reported data on health services utilisation. It is a cost-effective way to enhance existing self-reported data via the data linkage approach to increase its usefulness for informing health service planning.
28.G. Workshop: Foresight studies at the global, European and national level: what can we learn from them?
Authors:   Organised by: RIVM (Netherlands),   Chair persons: Henk Hilderink - Netherlands, Robert Vonk - Netherlands
Published: October 2020

Abstract
Foresight studies provide valuable information for (strategic) policy-making. They provide insights into the most important future trends and challenges, which is essential for well-informed policy-making. The number of foresight studies in the field of Public Health was limited but the number of studies is growing rapidly over last years. With these studies becoming available, their findings might become a more a regular component of population health monitoring activities. Given the relatively early stage of development of foresight studies in the field of Public health, a proper understanding and interpretation of the future studies might need some further guidance. How to deal with an (uncertain) future in the policy making process is one of the issues that needs to be addressed. This workshop starts with an interactive session to get a better understanding of the level of knowledge and needs regarding foresight studies, followed by the presentations of four different applications of foresight studies. The first one is at the global level from the institute for health metrics and evaluation (IHME) who has a long track record regarding public health data gathering and applying these, for example, to calculate the Global Burden of Disease. Next, EURO-HEALTHY project will present the Scenarios for population health inequalities in 2030 in Europe, partly based on a Web-Delphi process with a multidisciplinary panel. The third presentation will be from Public Health Wales on Futures for Wales which puts future health in the broader perspective of wellbeing. The last presentation will also be a national one, the Public Health foresight study, which has been conducted for more than 2025 years with an update published in 2020. After these presentations, ample time will be reserved for discussion on how these studies could best contribute to better public health policy making. Workshop participants will be informed about the main results of recent foresight studies, allowing them to reflect on these from their own perspective. They will get insight into the approaches and methods used in these recent studies, which may be helpful or inspiring for their own practice.

Key messages
Public health foresight studies are done more frequently and their findings can influence public health policy making. In this workshop, the methodology and findings of foresight studies at the global, European, and national level will be discussed.
Scenarios for population health inequalities in 2030 in Europe
Authors: Vieira A C L 
Published: October 2020

Abstract
Health inequalities have been consistently reported across and within European countries and continue to pose major challenges to policy-making. In the EURO-HEALTHY project, funded by Horizon 2020, three 2030 time-horizon scenarios were developed, depicting the key factors that may affect the evolution of PH inequalities across European regions. A three-stage socio-technical approach was applied: i) identification of drivers (key factors expected to affect the evolution of PH inequalities across European regions until 2030) - this stage engaged in a Web-Delphi process a multidisciplinary panel of 51 experts and other stakeholders representing the different perspectives regarding PH inequalities; ii) generation of scenario structures - different drivers' configurations (i.e. their hypotheses for evolution) were organised into coherent scenarios using the Extreme-World Method; and iii) validation of scenario structures and generation of scenario narratives. Stages ii) and iii) were conducted in two workshops with a strategic group of 13 experts with a comprehensive view about PH inequalities. Three scenarios were developed for the evolution of PH inequalities in Europe until 2030: 'Failing Europe' (worst-case but plausible scenario), 'Sustainable Prosperity' (best-case), and an interim scenario 'Being Stuck' depicting a 'to the best of our knowledge' evolution. These scenarios show the extent to which a combination of Political, Economic, Social, Technological, Legal and Environmental drivers shape future health inequalities, providing information for European policy-makers to reflect upon whether and how to design robust policy solutions to tackle PH inequalities. The work presented owes its innovation to the use of a technological platform to interact with participants for idea-generation, together with the use of future-oriented evidence within a face-to-face environment to trigger discussion among a small strategic group to enrich the scenario narratives.
Dutch Public health Foresight study 2018/20
Authors: Hilderink H 
Published: October 2020

Abstract
The four-year Public Health Foresight Study (VTV) provides insight into the most important societal challenges for public health and health care in the Netherlands. The seventh edition of the Dutch Public Health Foresight study was published in 2018, with an update in 2020. In this update a business-as-usual or Trend Scenario was developed using 2018 as a base year. In the trend scenario demographic and epidemiological projections have been used to depict the future trends regarding ageing, health, disease, health behaviors, health expenditures and health inequalities. Next, these trends are used to identify the most important future challenges and opportunities for public health. In the 2020 update, special attentions is given to climate change and the local living environment and their impacts and interaction with public health outcomes. Trends in lifestyle-related lifestyle show both positive (smoking prevalence) and negative (overweight prevalence) future developments. Dementia will be the leading cause of mortality and disease burden in 2040 by far. Health care expenditures will double by 2040, with cancers showing the most rapid growth of all disease groups. The insights of this study are directly used as input for the National Health Policy Memorandum and for the National Prevention Accord.
Engaging patients: how to speak so patients want to listen
Authors: Rubinelli S 
Published: October 2020

Abstract
The paternalistic approach to health professional-patient communication is often no longer successful. The main reasons for this include the fact that trust in medicine and health professionals is no longer taken for granted. In many domains, the concepts of 'expert' and 'science' are in shadow. Moreover, patients can access all sorts of health information, including information that is or seems inconsistent with the advice given by their health professionals. This talk aims to illustrate some basic approaches to communication that can enhance health professional-patient interaction. First, health professionals should consider their communication with patients as a form of persuasion. Persuasion, that does not equal manipulation, is a way to communicate that takes into consideration the knowledge, beliefs, and attitudes of interlocutors. By adopting a person-centered style, health professionals should present their advice by contextualizing it into the emotional and cognitive setting of the patients. Second, communication should consider the lived experience of patients, that is the impact that a health condition or a preventive behavior has on their quality of life and their experience of pleasure. Indeed, managing health conditions is not just applying health advice: it often demands a change in lifestyles that can negatively impact how patients live their lives. Third, health professionals should develop clear strategies to engage with information that patients find from other sources. Health professionals must ask patients if they disagree with them, and to clarify any eventual difference of opinion. The information age has positively favored a democratization of health information. Yet, it imposes that health systems care for their communication. This talk concludes by presenting main evidence from on how to reinforce hospitals, public health institutions, and health services in communication so that patients want to listen.
Engaging policy makers: how to make the message pass?
Authors: Greco D 
Published: October 2020

Abstract
Vaccination remains a serious matter of concern from a relevant part of the population, therefore a quite delicate issue for policy-makers. The paradox between vaccination success and vaccination hesitancy is a current issue: the more vaccination has been successful in eliminating or reducing the incidence of diseases the lower the perception of risk among younger parents' cohorts that never saw diseases for which their children are requested to be vaccinated.
This hesitancy is reflected in the politicians' space, as they are quite reluctant to impose measures that will target the mass of healthy young children potentially raising negative reaction from the parent's population.
Financial issues are not a concern in the rich world: vaccination global budget is a small fraction of the running health expenditures; money is still a problem in developing countries, but there population and politicians do accept happily donation for new vaccination campaigns.
But the situation is quickly changing: in the northern hemisphere, despite the growth of vaccination hesitancy seven new vaccines have been successfully introduced in the last decade (e.g. Chickenpox, HPV, Rotavirus) and new ones are close to introduction (e.g. Herpes Zoster, Gonorrhea, Norovirus, RSV).
Are policy-maker changing the traditional reluctant attitude against new vaccines? Few factors have been underlined in the last decade: Vaccination cost-benefit analysis offer politicians a good argument to show they are working for the population health.Mathematical models are becoming frequently used tools to show the economic gain of vaccination.The consequences of fake news and antivaccine narrative are warning politicians for more respect for science.Newly emerging epidemic diseases are increasing population confidence for public health interventions.
Those factors are influencing health communication and could become useful tools to complement policy-makers' strategies.
Developing a strategic plan for sustainable health inequality monitoring – the basic step towards tackling health inequalities in long run
Authors: Lesnik T 
Published: October 2020

Abstract
Slovenia has had periodic reporting on health inequalities for almost a decade. The importance of reporting is well recognised and stated in the National strategy on health care 2015-2025. Yet, the assessment of the status of the national health inequality monitoring system (HIMS) conducted within the Joint Action Health Equity Europe project, made the unsystematic nature of current practices obvious. A need for developing a more systematic and sustainable HIMS and to have a long-term monitoring strategic plan in place was acknowledged.
The set-up of systematic and sustainable long-term monitoring of health inequalities will provide reliable and comparable longitudinal data on the direction, magnitude and trend of health inequalities in Slovenia. This is in turn necessary to inform any future policies and/or programmes, thus stimulating action. Furthermore, identifying relevant stakeholders will facilitate formation of a network of partners who take part in tackling health inequalities, thus allowing for a more proactive (i.e. bridging) role in addressing health inequalities in Slovenia.
The aim of this presentation is to demonstrate the process and the steps taken to prepare a document (strategic plan) detailing a systematic approach to long-term monitoring of health inequalities complete with goals, objectives, methodology, a pragmatic set of indicators and an evaluation plan that will inform and facilitate most reporting/monitoring activities
Brief materials and programmes for children and families who have experienced conflict and displacement
Authors: Calam R , El-Khani A 
Published: October 2020

Abstract
This presentation will provide an overview of a set of materials and programmes designed for families who are living through or have escaped conflict and displacement. Delivery formats include i) brief leaflets giving parenting advice for caregivers; ii) a more extensive booklet and format for a Conversation Group, and iii) a programme designed to address post-traumatic stress in children, Teaching Recovery Techniques (TRT), to which a caregiver and parenting skills module was added, to form TRT+Parenting. Each intervention has been tested or trialled with families living in challenged contexts. The leaflet was distributed to 3000 families via bakeries in conflict zones in Syria. The Conversation Group was trialled for feasibility in Palestine. TRT+Parenting was piloted with Syrian families living on the Turkey-Syria border, and then trialled with 120 families in Lebanon, with teachers and social care workers trained as facilitators. In Syria, 59.5% of 3000 parents returned questionnaires and reported satisfaction with the leaflet despite the study being conducted in a conflict zone and in the context of humanitarian intervention. The Conversation Group proved feasible and acceptable, and caregivers in Palestine gave positive feedback. Children and caregivers showed significant improvements across measures of trauma and mental health, with higher levels of improvement seen in the TRT+Parenting group compared to TRT alone or waitlist. Caregivers who took part in the Plus Parenting component also reported improvement in their own mental health. The results demonstrated valuable improvements across all interventions, and indicate that brief programs can and should be widely used as components of preventive strategies.