bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maturity of integrated care in Poland - What can we learn?
Authors: Wiktorzak K 
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, Poland 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 Poland 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.
Violation of maternal integrity during childbirth: a micro-, meso- and macrostructural perspective
Authors: Batram-Zantvoort S , Wandschneider L , Razum O , Miani C 
Published: November 2019

Abstract

Background
Violation of maternal integrity (VMI) during childbirth is reported by women world-wide and reflects one aspect of gender-related violence against women. Terminology and concepts to describe VMI range from disrespect and abuse over mistreatment in childbirth to obstetric violence. The choice of terms might determine the scope of reference: while mistreatment encompasses rather interactional forms of VMI embedded on a microstructural level of society, obstetric violence includes a critical view on gendered power imbalances and is therefore considering cultural, political and economic exposures situated on macro- and meso-level. To identify different ways of explicitly integrating or implicitly reflecting micro-, meso- and macrostructural dimensions of VMI, we examine terminology, methodology and results in published research.

Methods
For our review, we chose a meta-ethnographic approach, viewing studies on VMI as primary data in terms of defining, collecting, describing and analysing the phenomena of VMI. Our goal lies in first determining the explanatory model of each study and second synthesising these findings to outline a multilevel framework on maternal integrity.

Findings
Studies predominantly concentrate on interaction-related determinants of VMI. To integrate macro- and mesostructural factors of VMI within a comprehensive framework, further epidemiological research on structural and social determinants of maternal health as well as interdisciplinary collaboration on the intertwining of gender imbalances in health care is needed.

Conclusions
By differentiating between macro-to-micro-level factors of VMI, potential causes that go beyond the interaction level (e.g. policy, financial allocation, legal laws, maternal care conditions) can be identified to improve both research and implementation in obstetric care.
Nature-based health promotion: a valuable tool in prison partnerships
Authors: Baybutt M 
Published: November 2019

Abstract
In the context of the current UK prison reform agenda and concern about the high incidence of violence, substance misuse, self-harm and suicide, prison-based horticulture can make a significant contribution to the creation of safe, secure, supportive and health-enhancing environments. By joining up health and justice agendas, therapeutic programmes have the potential to serve as powerful catalysts for wider systemic change, tackling inequalities and social exclusion within societies across the globe.
This presentation critically discusses findings from evaluative research, ‘Greener on the Outside for Prisons’ (GOOP), delivered in prisons in North West England. It aims to illustrate impacts of prisoners’ participation in an innovative social and therapeutic horticultural programme. The qualitative study was informed by a theoretical exploration on socio-ecological model of health emphasising interconnections between environment, behaviour and wellbeing, recognising the dynamic interplay between situational and personal factors; by a psychosocial perspective, positioning the individual in networks of interpersonal relationships, organisations, and social, political and economic systems; and by insights from the Biophilia Hypothesis.
Findings suggest that engagement in GOOP were important to improvements in health and wellbeing with wider context-specific benefits. Working across key agendas of health, education and resettlement, GOOP has effectively demonstrated the potential of horticulture to impact positively on mental wellbeing, physical activity and healthier eating.
Additionally, it contributes towards social inclusion through the development of key transferable skills, life competencies, processes of socialisation, and preparation for successful resettlement and employment beyond prison, which are ultimately key determinants of future health and life chances.
Social cost-benefit analysis of tobacco control policies in the Netherlands
Authors: de Kinderen R J A , Wijnen B F M , Evers S M A A , Hiligsmann M , Paulus A T G , de Wit G A , van Gils P F , Over E A B , Suijkerbuijk A W M , Smit F 
Published: November 2019

Abstract

Background
In the Netherlands approximately 23% of the population of 15 years and older smokes. The main research questions were to identify what social costs- and benefits can be expected when various tobacco control policies would be implemented in The Netherlands, how do costs and benefits change over time, and which sectors in society could expect to incur costs and in which sectors accrue profits.

Methods
A SCBA was conducted using a combination of the Chronic Disease Model developed by the National Institute for Public Health and the Environment (RIVM), the SimSmoke model and a specially designed excel model. Policies included both tax increases (i.e. increase of excise tax on tobacco of 5% or 10% each year) and a policy package as proposed by the World Health Organization (i.e. including mass media campaigns and mediabans).

Results
When no new policy measures are implemented, the prevalence of smoking will decrease by 2.3 percentage points over the next 35 years. The policies reviewed in this report have the potential to decrease smoking prevalence by 14.2 percentage points (and in a ‘smoking-free society scenario, by as much as 17.4 percentage points). Furthermore, the results show that the intervention costs for all scenarios are minimal, and that investing in health is beneficial as seen from both the public health and fiscal perspective.

Conclusions
This study demonstrated that reducing the prevalence of smoking has beneficial effects for various stakeholders within the Dutch society: such as employers (e.g. increased productivity) and consumers (e.g. increase quality of life).
A social cost-benefit analysis of two One Health interventions to prevent toxoplasmosis
Authors: Suijkerbuijk A W M , Over E A B , Opsteegh M , Deng H , van Gils P F , Marinovic AA Bonacic , Lambooij M , Polder J J , Feenstra T L , van der Giessen J W B , de Wit G A , Mangen M J 
Published: November 2019

Abstract

Background
In the Netherlands, toxoplasmosis ranks third in disease burden among foodborne pathogens, with an estimated health loss of 1,900 Disability Adjusted Life Years and a cost-of-illness estimated at €44 million annually. We performed a Social Cost-Benefit Analysis (SCBA) to evaluate the net value of two potential interventions, freezing meat and improving biosecurity in pig farms, for the Dutch society.

Methods
We assessed the costs and benefits of the two interventions and compared them with the current practice of education, especially during pregnancy. A ‘minimum scenario’ and a ‘maximum scenario’ was assumed, using input parameters with least benefits to society and input parameters with most benefits to society, respectively.

Results
The freezing meat intervention was far more effective than the biosecurity intervention. Despite high freezing costs, freezing two meat products: steak tartare and mutton leg yielded net social benefits in both the minimum and maximum scenario, ranging from €10.6 million to €31 million for steak tartare and €0.6 million to €1.5 million for mutton leg. The biosecurity intervention would result in net costs in all scenarios ranging from €1 million to €2.5 millions.

Conclusions
From a public health perspective (i.e. reducing the burden of toxoplasmosis) freezing steak tartare and leg of mutton is to be considered.
Real world evidence for European health policy-making: making the case for interoperability
Authors: Bernal-Delgado E , Estupiñán-Romero F , Zeynep O , Lyons R , Ivanković D 
Published: November 2019

Abstract

Background
The foundations of evidence-based health policy-making are transitioning from the use of partial evidence yielded elsewhere and the application of heuristic rules, to the development of learning systems based on the reuse of routine data collected by the same institutions that have to implement those policies. Supporting that transition, the scientific production of real-world evidence (RWE) is becoming pivotal, particularly in international policy-making. However, leveraging the immense wealth of data curated in European public institutions, requires the development of a new world-class research infrastructure and a supporting interoperability framework (IOF).

Methods
Based on the European Interoperability Framework (EIF) legal, organizational, semantic, and technical issues are being assessed. While legal, organizational and technical topics are analyzed from the perspective of the type of infrastructure, centralized or federated, to be developed, semantic interoperability is explored using three case studies on the linkage of different real world data sources: for characterizing resilient populations, studying the burden of dementia, and the effectiveness of stroke care pathways.

Results
Preliminary assessments advocate for the development of a federated infrastructure where data remain in house and research questions, data access and interoperability services are shared according to the capacity of each specific partner in the federation. Interoperability services for such an infrastructure should cover: a) the development and maintenance of a common data model to assure semantic interoperability, b) the development of self-contained distributed analytical pipelines; and c) the implementation of a training program aimed at increasing the capacity of each RI hub.

Conclusions
An interoperable federated research infrastructure is required to leverage the potential of real world data for European health policy-making. InfAct is paving the way.
ParticipaTIC: Lessons from developing accessible on-line training for disabled people’s leaders
Authors: Cuenot M , Sherlaw W 
Published: November 2019

Abstract
The ParticipaTIC Erasmus+ project led by the EHESP School of Public Health in partnership with disability organizations and associations from France, Belgium, Switzerland, and Romania has co-designed an accessible digital platform. In line with the 2010-2020 European strategy and the United Nations Convention on the rights of disabled persons we aim to strengthen the competences of the leaders of disabled persons’ organizations to defend the rights of disabled people, and to develop participation. ParticipaTIC offers 4 modules on ‘What is disability?’, ‘Competencies for disability organization leaders’, ‘the United Nations Convention’ and ‘How to carry out a local accessibility analysis’. Different contrasts, font size, speech synthesis, captioned videos and content summaries in ‘Easy to read and understand’ French are available together with a cloned platform in Romanian and English. Two guides have also been produced on 1) on-line accessibility and 2) co-constructing an on-line accessible platform. Beyond the deliverables, adapting on-line instruction to the different capacities of people with disabilities raises many issues. New competencies for accessible design are needed. Tradeoffs between content, pedagogical style and accessibility seem inevitable. On-line activities need adaptations but these may be complex and costly. Taken-for-granted assumptions about what is attractive, and well-designed are called into question when designing for people with visual, auditory, and intellectual impairments. Lessons from ParticipaTIC are remarkably similar to those of participatory thinking design: advance in small steps, evaluating successive design phases with people with disabilities for fitness of purpose. Ultimately trainers need to redesign themselves to take into account unsuspected worlds, those of our fellow citizens with different capacities. Important lessons beyond the world of on-line instruction for the building of a truly inclusive society have emerged.
Disparities in smoking habits in Hungarian Roma and general populations
Authors: Fiatal S , Pikó P , Kósa Z , Sándor J , Ádány R 
Published: November 2019

Abstract

Background
Smoking status, dependence and cessation efforts of the disadvantaged Hungarian Roma living in segregated settlements were compared to those of the general population.

Methods
Data were collected through survey. Each study group consists of 500 randomly drawn subjects, and are representative of the adult (18-64) general and Roma population, living in two counties of North-East Hungary. Questions on smoking from the European Health Interview Survey were used with some modifications. Prevalence data were analysed according to age strata (18-29, 30-44 and 45-64 years) by chi2 test, and were compared to data from 2003 and 2014.

Results
In Roma the proportion of never smokers is much less compared to the general ones (men:27.27% vs.75%, women:38.6% vs.70.75%, p &lt; 0.05). Less Roma reported never smoking in all age compared to 2014, increasing trend can be found in the general population since 2003. Smoking prevalence is higher in Roma in all ages (72.73% vs.20 83%; 68.42% vs.28.42%; 59.02 vs. 32.26%, p &lt; 0.05, respectively). Interestingly, the prevalence of Roma men smokers is decreasing by age, in the general population the trend is the opposite. Heavy smoker status is the highest in 30-44 age group of both populations. Increasing trend of heavy smoking can be detected in the Roma, but the opposite holds for general population compared to 2014. Half of the Roma smoke within 5 minutes after wakeup (50% vs. 36.92%, p &lt; 0.05), smoke hand-rolled cigarettes (68.91%vs 30.77%, p &lt; 0.05), higher proportion of them tried to quit (34.78% vs. 23.38%, p &lt; 0.05) but smaller proportion of them obtained advise on how to quit (48.53% vs.59.09%, p &lt; 0.05). Initiation starts earlier age among them (men: 15.1 vs.16.6, women: 16.2 vs.18.2, p &lt; 0.05).

Conclusions
Regular smoking (especially heavy) is much higher in the Roma and decreasing by age compared to the general in all age-groups. The 30-44 age group of Roma mean are exclusively heavy smokers but half of the Roma show effort to quit.

Key messages
Tailoring cessation programs for Roma men especially those belong to 30-44 age group is a priority to reduce tobacco-related adverse effects. Complex public health programmes that taking into account special socio-cultural environment and lower formal education level of the Roma are needed.
Perceived risks and barriers to care for international migrants in transit through Mexico
Authors: Larrea S , Leyva-Flores R , Guarneros-Soto N , Infante-Xibille C 
Published: November 2019

Abstract

Background
Mexico has implemented policies seeking to reduce barriers to care for migrants in transit; however, it is estimated that only 3% of migrants use public health services when needed. The main purpose of this study was to identify the barriers to access public health services faced by migrants in transit through Mexico.

Methods
Under the human security perspective, in 2018, a qualitative study was carried out in Mexican communities with high migrant mobility. 34 semi-structured interviews were conducted with migrants in transit, and personnel from public health services and migrant shelters (NGOs). Values and meanings related to risks, health problems, barriers to care, experiences of health services utilization, and opinions on facilitating elements to diminish these barriers were identified.

Results
Migrants in transit through Mexico face risks that affect all dimensions of human security. Perceived anti-migratory and discriminative attitudes during the journey were constantly mentioned in the interviews. Barriers to care were found in the four stages of health care access, classified according to the Tanahashi framework, with the majority related to accessibility and acceptability. The following facilitating elements were also identified: political willingness of local government, knowledge and talent management of health personnel, and strategies implemented for adapting local health care services to migrants.

Conclusions
Social and political conditions in Mexico disrupt any effort to reduce social risks and barriers to care for migrants in transit. Non-governmental actors are key players for facilitating interactions between migrants and local governmental health care institutions. However, the general anti-migratory context negatively affects access to health care and influence the perspectives of migrants, NGOs, and health personnel.

Key messages
The predominant perceived barriers to care are in counterpoint to local governmental pro-migrant rights perspectives. NGOs are key actors to promote access to public health care services.
Support for unaccompanied children and youth - Results from a systematic literature review
Authors: Ascher H , Backlund Å , Östlund P 
Published: November 2019

Abstract

Background
A systematic literature review about unaccompanied minors was done with the following focus: scientifically documented effects of supportexperiences of unaccompanied children and youth about positive and negative factors

Methods
2 210 abstracts were examined. Assessment of relevance and quality and the analysis were done according to SBU standard.

Results
No controlled study on effects were fulfilling the inclusion criteria. However, 29 articles with qualitative design were included. Seven overall themes were identified: Security and control: a basic requirementThe new country: both opportunities and difficultiesManaging difficulties: a balance between different strategiesEveryday environments: supportive relationships as well as influence in housing and access to schools and activities are importantRelationships: support and guidance from adults is important, contact with peers important, but also difficultSocial services and health and medical care: varying views on and experiences of support and needsIdentity and affiliation: getting together the past, the present and the future.
The seven themes could be grouped in three overarching levels: Basic living conditions and survivalDifficulties and opportunities in everyday lifeWeighting of bringing together existence on an overall plan

Conclusions
To our knowledge, this is the largest literature review about support for unaccompanied children and youth. In the absence of controlled effect studies, it is particularly important to pay attention to unaccompanied children and youths own experiences when providing guidance for how societýs support for this heterogeneous group can be designed, in accordance with their rights in the Convention on the Rights of the Child. The results of the review are compared to common policies in handling unaccompanied children and youth.

Key messages
Unaccompanied children have commonly experienced trauma and loss. A lack of basic security has a pronounced effect on the ability to cope with daily issues and difficulties as well as with the future. Unaccompanied children and youth have a great need for adult support and guidance.
Self-reported discrimination in health surveys: results from a scoping review
Authors: Kajikhina K , Sarma N , Schumann M , Lampert T , Santos-Hövener C 
Published: November 2019

Abstract

Background
Surveying perceived discrimination in the context of health monitoring can help to clarify the connection between unequal treatment and health. We aimed to review, identify and extract data on definitions and measures of discrimination.

Methods
A scoping review of both peer reviewed and grey literature was conducted. Survey instruments used in representative surveys in Germany were compared and discussed regarding their strengths and limitations. Ethical and methodical guidelines and policy reports by WHO, ECDC, EUPHA, migration research institutions and local NGOs were considered.

Results
Research from North America, South Africa and, to a lesser extent, European countries shows a clear link between discrimination and health. Various scales, individual items and instruments operationalize discrimination as worse treatment in everyday life or disadvantage in the structural field (authorities, housing market, working life). Possible reasons and frequencies of experiences are surveyed. Additional instruments are used to evaluate moderators such as vigilance or coping. Besides validity and reliability, ethical aspects such as voluntary self-disclosure, avoidance of external ascriptions and assessment of multiple dimensions of discrimination should be considered.

Conclusions
We propose a three-stage instrument for surveying perceived discrimination in German health surveys. First, the frequency of interpersonal experiences is surveyed by the everyday discrimination scale validated for different settings. Second, possible reasons for the reported experiences are asked, based on the categories of the German General Equal Treatment Act. Lastly, questions on discrimination in health care and by public authorities will address specific public health areas.

Key messages
Only few studies are available on discrimination and health in Europe, more is needed to effectively address health disparities. We propose to consider specific ethical and methodical aspects when surveying perceived discrimination as a health determinant.