bluuebunny/crossref_metadata_2025_split huggingface dataset:
Workshop: Paving the path to the health systems of the future
Authors:   Organised by: Chafea, EUPHA, DG Sante Chairperson: Anne-Marie Yazbeck, Chafea
Published: November 2019

Abstract
Reforming health systems is a priority that is being addressed at local, regional, national and European level. Health system reforms are complex; they require political commitment, know-how, skills and sustained financial investments. The EU can provide support in various stages of such reforms: from initiation to design and to implementation. The session will describe the main EU tools for this, such as the European Semester, programmes that can offer technical assistance, as well as programmes that provide opportunities for financial support.
EU tools to support health system reforms
Loukianos Gatzoulis
DG SANTE
Technical support / twinning
Sonia Mueller
VIGOUR
Financing support
Dita Protopopová
Mental Healthcare reform project, Ministry of Health, Czech Republic
Long working hours and mortality in Central and Eastern Europe: the HAPIEE study
Authors: Pikhart H , Liu Q , Pajak A , Malyutina S , Kubinova R , Bobak M 
Published: November 2019

Abstract

Background
Long working hours are common in countries of Central and Eastern Europe (CEE). A wide range of epidemiological studies have showed that long working hours had an adverse effect on health but the evidence mostly comes from Western Europe, East Asia and North America. This study aimed to assess the relationship between long working hours and the risk of mortality in employed people in three Eastern European countries.

Methods
Participants, aged 45-69 years at baseline, were from the Health, Alcohol and Psychosocial Indicators in Eastern Europe (HAPIEE) cohort study conducted in Russia, Poland and the Czech Republic. Baseline survey included a structured questionnaire and examination in the clinic during 2002-2005. Working hours were assessed by a self-reported questionnaire at baseline. Participants have been followed-up for all-cause mortality and cause-specific mortality for an average of 11 years. Impact of long working hours on mortality was analysed by Cox proportional hazards regression. In all-cause mortality analysis, a total of 10878 men and women were included, and 10399 participants were included in cause-specific mortality analysis.

Results
During the follow-up, there were 1187 deaths from all causes, 288 from CVD, and 251 from cancer. Those who worked 61 hours or more in a week showed higher risk of mortality compared to those working 36-45 hours per week: HR 1.32 (95%CI 1.01 to 1.74) for all-cause mortality and 1.73 (95% CI 1.03-2.93) for CVD mortality. There was no significant increase in risk of cancer mortality associated with working long hours. There was no significant association between working 46-60 hours a week and risk of mortality, including all-cause mortality and cause-specific mortality.

Conclusions
The risk of all-cause and CVD mortality in three CEE was significantly higher among employees working extensive hours. These findings suggest that more attention should be paid to shortening working hours for those who work extensively.

Key messages
Long working hours increase risk of all cause and CVD mortality. Cancer mortality is not related to long working hours.
Workshop: Transferring innovation in health systems: The role of national mirror groups
Authors:   Organised by: TO REACH Consortium, EUPHA Chair persons: Natasha Azzopardi Muscat - EUPHA, Karine Chevreul - France
Published: November 2019

Abstract

To-Reach has the aim to build and push forward a strategic agenda at European level for health services and policy research into practice in order to help decision makers in identifying and understanding the value of a given innovation in the field, the potential for joint development of innovation and facilitating implementation to fit the regional/local contexts.
Given the diversity of health systems in Europe and the element of subsidiarity within the European Treaty, in order, to achieve this aim the commitment of all categories of stakeholders (funding bodies, researchers, policy makers, systems managers...) at national level is as essential prerequisite for success.
France has created a mirror group to consult these stakeholders to ensure that national priorities will be reflected at European level and respectively that national priorities and funding direction are influenced by the European strategic agenda. The objectives of this workshop will be to learn from the French experience and to discuss how similar experiences in other countries could be shared and promoted. Their role going forward in the project and their contribution to the expected outcomes will be the focus of this workshop. Stakeholders from a number of European countries will be invited to present and discuss their perspective on this issue.

Key messages
Joint development of health services research at European level is necessary to overcome key system challenges. National stakeholders are key to the development of a European health services research progarmme.
Skills building seminar: How to improve vaccination coverage in the European Union?
Authors:   Organised by: EC, Observatory Chair persons: Josep Figueras - European Observatory, Isabel de La Mata - European Commission - DG Sante
Published: November 2019

Abstract

In recent years, the European Union (EU) has been facing several serious outbreaks of vaccine-preventable diseases, including measles. Vaccination coverage rates for the first dose of the vaccine against measles vary from 85% in Italy to 99% in Luxembourg and Hungary, with the average for the EU (93.6%) falling below what is required to ensure herd immunity. Similar variations can be seen for other vaccinations, including influenza immunization programmes targeting older adults who are at greater risk of severe complications. Of particular concern is that in a number of EU countries anti-vaccine groups, aided by social and mainstream media, and sometimes populist politicians, are gaining traction and have started to influence public and health worker attitudes towards the safety and effectiveness of vaccinations.
The EU has started to respond to these developments in a number of ways. In his 2017 State of the Union address, Jean-Claude Juncker, the President of the European Commission, has called for action to increase vaccination coverage and to ensure that everyone in the EU has access to vaccines. This was followed by a number of new policy and research activities initiated by the European Commission.
The workshop provides an overview of some of these activities. It starts with an introductory presentation on recent initiatives of the European Commission to support national vaccination efforts. This is followed by a presentation on the work of the Expert Panel on effective ways of investing in Health and their report on vaccination programmes and health systems in EU countries. A third presentation presents EU-funded research on vaccine hesitancy in EU member states, based on the largest ever study on attitudes to vaccines and vaccination in the EU. A final presentation explores a study undertaken for the European Commission by the European Observatory on Health Systems and Policies on the organization and delivery of vaccination programmes in EU member states, based on detailed country fiches.
The workshop will provide opportunity for the audience to comment on and discuss presentations and to consider current policy options in Europe to address vaccine hesitancy and improve vaccination coverage through health system interventions. It will be of interest to public health researchers, practitioners and policy-makers from across Europe.

Key messages
The workshop provides a forum for discussing European initiatives to overcome vaccine hesitancy and improve vaccination coverage. It explores policy options at the European and national level.
Vaccination programmes and health systems in the European Union. Report of the Expert Panel on effective ways of investing in Health
Authors: McKee M , Siziliani L , Wild C , Kringos D , Barry M M , Barros P , De Maeseneer J , Murauskiene L , Ricciardi W 
Published: November 2019

Abstract

Background
Vaccination is one of the most cost-effective public health interventions available and the main tool for primary prevention of communicable diseases. However, the EU is facing increasing outbreaks of vaccine preventable diseases, while some fatal cases of measles and diphtheria have been reported.

Methods
The presented report is based on the work of the Expert Panel on effective ways of investing in Health, which was informed by a literature review on the main factors (enablers and obstacles) influencing vaccination uptake.

Results
Obstacles to vaccination coverage include individuals’ and parents’ concerns or fears about vaccine safety and side effects, lack of trust, social norms, exposure to rumours and myths undermining confidence in vaccines, failure by some healthcare providers to counter these myths and provide evidence-informed advice, access barriers (e.g. poor availability, co-payments), and failure to understand the underlying mechanisms that decrease vaccination confidence. Enablers include sources of reliable information about vaccination, exposure to positive media messages, building trust in institutions and providers, building confidence in vaccination, easy access and availability to healthcare services, ease of administration, active involvement and engagement by healthcare providers, and targeting of high-risk groups.

Conclusions
There is a range of policy options that countries can implement to increase vaccination coverage. Communication strategies about the benefits of vaccination are important but need to be combined with opportunities for dialogue with vaccine hesitant groups and participatory approaches. These strategies need to be targeted not only at the uninformed (i.e. the lack of information) but also at the misinformed (when the information is incorrect) or disinformed (when information is spread with the intention to deceive).
Vaccination coverage in the European Union
Authors: Pastore Celentano L 
Published: November 2019

Abstract

Background
Vaccination coverage rates in the European Union (EU) vary considerably across countries and there has been a decline for some diseases in some countries in recent years.

Methods
The ECDC supports member states in their vaccination programmes through a range of activities, including identification of threats, surveillance, international collaboration, scientific working groups, assessments of national vaccination programmes, and communication activities.

Results
For the first dose of the vaccine against measles, coverage ranges from 85% in Italy to 99% in Luxembourg and Hungary, with the average for the EU (93.6%) falling below what is required to ensure herd immunity. Uptake of the second dose against measles reached the target of 95% in only four countries in 2017, compared to 14 in 2007.

Conclusions
Despite the fact that there are safe and efficient vaccines, there seems to be a crisis of confidence in them. Each EU citizen should receive correct evidence-based information on vaccines and have the same immunisation opportunities.
Skills building seminar: Measuring children mental health
Authors:   Organised by: EUPHA (PMH) Chair persons: Viviane Kovess-Masfety - France, Kerry Keyes - USA
Published: November 2019

Abstract

This workshop will be a skills building seminar aimed to present different instruments that have been used in measuring children or adolescents mental health, plus some results to illustrate their pertinence.
It aims to render child psychiatric epidemiology accessible by presenting easy to use instruments for children and adolescents that allow to conduct surveys in schools or in other contexts. It will also present and discuss some results in order to stimulate the epidemiological approaches for child mental health problems as well as evaluating access to care,specialized and no specialized, and the relationships between school achievements and mental health problems.
This will be based on two major studies: The School Children Mental Health Europe, an EU funded project designed to set up a kit of instruments enabling cross EU comparisons. For this project a literature review allows to select the SDQ (Strengths and Difficulties questionnaire) to be administered to the parents and teachers and the Dominic Interactive, a sort of video game designed to evaluate DSM more commune diagnoses since the children were primary school children 6 to 11 years old.Previously done in France, the project has collected around 1000 children per country in Germany, Italy, Netherlands, Lithuania, Bulgaria, Romania and Turkey. In addition it measured parental attitudes, domestic accidents, some physical diseases, parental mental health, access to care for mental health problems and some socio demographics. Teachers are asked to evaluate school achievements in addition to their own child mental health evaluation.The project allows evaluating relative concordance on the above instruments results with clinical judgments on separate clinical samples from each of the countries using the DAWBA (a clinical instrument).The lecture proposes to present the instruments and their usage and some of the comparative results among them the relationships between academic performances and mental health problems.The US National Comorbidity Survey Adolescent Supplement (N = 6256), in that survey the Composite International Diagnostic Interview (CIDI) assessed fifteen lifetime mental disorders and The Sheehan disability scale assessed disorder severity. ID was defined as: 1) IQ ≤ 76, measured using the Kaufman Brief Intelligence Test; and 2) an adaptive behavior score ≤76, measured using a validated scale.
The lecture will present the instruments and some of the results concerning psychiatric comorbidity and intellectual disability.

Key messages
Children mental health problems are affecting around 12% of the children and should be evaluated and monitored. Easy to use instruments exist; as children could be surveyed in schools it becomes relatively easy and not too costly to conduct surveys that will integrate risk factors and access to care.
Comparing children mental health across countries: challenges and results
Authors: Kovess-Masfety V 
Published: November 2019

Abstract

Background
The School Children Mental Health Europe was a EU funded project designed to set up a kit of instruments enabling cross EU comparisons.

Methods
A literature review allows to select the SDQ (Strengths and Difficulties questionnaire) to be administered to the parents and teachers after a validation process in each country and the Dominic Interactive (DI), a sort of video game designed to evaluate DSM more commune diagnoses on children 6 to 11 years old.

Results
Data were collected on 7682 children randomly selected in a two stages selection: schools by country and children within the schools for whom 1) either parent- or teacher SDQ were completed: Overall, 12.8 % of children have any probable disorder with significant inter-country differences, 8.4 % probable conduct disorder, and 2.0 % probable hyperactivity/inattention. Adjusting for socio-demographic variables and parental psychological distress, country of residence did not predict the odds of having any disorder. 2) Overall, 22.0% of children were identified per their own evaluation as having at least one mental disorder, ranging from 16.4% in the Netherlands to 27.9% in Bulgaria. The prevalence of internalizing disorders was 18.4% across countries and ranged from 11.8% in the Netherlands to 24.3% in Turkey. The prevalence of externalizing disorders was lower with an average of 7.8%, ranging from 3.5% in Turkey to 10.5% in Bulgaria. Combining samples across European countries, 1 in 5 children reported internalizing problems and 1 in 12 children externalizing problems.

Conclusions
This lecture aims to present and discuss child mental health measure instruments from different informants perspectives, comparisons across countries and the challenges for interpreting the differences.
French validation of a measurement scale of life skills for children
Authors: Simar C , Masson J , Pironom J , N’Sambu C , Tessier D 
Published: November 2019

Abstract

Background
According to WHO (2003), ‘Life skills’ are defined as psychosocial abilities for adaptive and positive behaviour that enable individuals to deal effectively with the demands and challenges of everyday life. They are loosely grouped into three broad categories: cognitive for analyzing and using information, personal for developing personal agency and managing oneself, and inter-personal skills for communicating and interacting effectively with others. Skills-based health education is an approach to creating or maintaining healthy lifestyles and conditions through the development of knowledge, attitudes, and especially skills, using a variety of learning experiences, with an emphasis on participatory methods. Our aim was to develop an integrated measure of the life skills grouped into three broad categories of skills for children who are at least 9 years old. The present communication is focused on the validation in a French validation of a tool measuring social competencies in children - Weiss et al. (2014) - which represents one of the three categories of psychosocial competencies (emotional and cognitive competencies).

Methods
Data were collected three times during year 2017-2018: 614 questionnaire (T1), 564 (T2), 331 (T3) - 311 children filled the questionnaire three times. Three types of analyses were conducted in order to assess the validity and reliability of social competence (SPSS version 23 et AMOS version 21): Validity of construct, concurrent validity and reliability.

Results
The results show a high reliability and a good validity of construct and concurrent, thus indicating satisfactory psychomotor qualities.

Conclusions
This compendium will also assess the validity and reliability of this scale with the data collected at the other two measurement times and study the predictive validity of the scale. The same process will be applied to the cognitive skills measurement scale for validation. Acknowledgment: CPS team and schools and pupils involved.
Development of a European Public Health Emergency Preparedness Training Toolkit
Authors: Guicciardi S , Fantini M P , Savoia E , Stoto M A , Nelson C , Piltch-Loeb R , Pommier J , Ciotti M , Riley P 
Published: November 2019

Abstract

Background
In 2017, under the supervision of the European Centre for Disease Prevention and Control (ECDC), a list of competencies and knowledge and skill statements for EU professionals working in Public Health Emergency Preparedness (PHEP) systems were identified and integrated into a Competency Model. Building on these efforts, a PHEP competency-based training toolkit was developed, pilot tested and finalized with the goal of providing a standardized training resource for experts involved in response to cross-border threats to health.

Objectives
Led by the ECDC, an international research team drafted a preliminary version of a curriculum consisting of five modules, with a list of targeted competencies, learning objectives, reading and training methods including case studies and simulation exercises. In May 2018, the curriculum was pilot tested in a 3.5-day training course at the University of Bologna, Italy. The participants included 20 representatives from 8 EU Member States. An evaluation strategy, combining both quantitative and qualitative methods, was designed to assess the impact of the training on participants’ applied knowledge and competence.

Results
Overall, the participants’ feedback on the pilot course was positive, with scores from 4.0 to 4.8 out of 5 for all the items considered. Several suggestions were made both by the trainers and the trainees to enhance the effectiveness of the learning activities, and the curriculum was integrated into a training toolkit with more exercises, teaching materials and a guide for facilitators.

Conclusions
This European Public Health Emergency Preparedness Training Toolkit is the first EU competency-based toolkit intended to help Member States improve their response to public health emergencies through standardized training. Designed for individuals working in strategic positions at the national level, its general approach, modular structure and content are relevant and can be tailored to a wider range of professionals.

Key messages
To improve PHEP in the EU, competency-based curricula and standardized training programs and resources for health professionals are needed. By enhancing the overall public health professionals’ experience and competency, the European PHEP Training Toolkit represents a step towards strengthening preparedness and response systems in the EU.
Heat Waves and occupational injuries: the importance of a consistent working definition
Authors: Riccò M , Balzarini F , Mezzoiuso A G 
Published: November 2019

Abstract

Introduction
Heatwaves (HWs) have been linked with increased risk of occupational injuries (OIs). As no consistent definition of HW is globally acknowledged, also the actual impact of HWs on the workplaces is not well defined.

Background and aims
Daily numbers of workers compensation claims from all Northern Italy (2013 to 2017, warm season: April to September) from Agricultural and Industry economic sectors (n = 1,907,122) were associated with daily weather data. The impact of average (Tday) and maximum (Tmax) daily temperatures on the risk of OIs was assessed using a time-stratified case-crossover study. HW was defined by 3 or more days having Tday &gt; 97.5th percentile or by Tmax exceeding 5 °C or more historical reference.

Results
A total of 1161205 OIs were retrieved (94.4% from industrial sector). Assuming Tday &lt; 90th percentile as the referent category, the risk for OIs was higher for Tday exposure 95 to 97.5th percentiles (OR 1.43, 95%CI 1.09-1.20 for agriculture; OR 1.40, 95%CI 1.03-1.05 for industry) and for exposures exceeding 97.5th percentiles (OR 1.14, 95% CI 1.09-1.20, OR 1.02, 95%CI 1.01-1.03, respectively), and for days characterized by Tmax &gt; 35 °C (OR 1.27, 95%CI 1.21-1.33; 1.03 95%CI 1.02-1.04). An increased risk for OIs was similarly identified during HWs defined by Tday (OR 1.15, 95%CI 1.08-1.23 for agriculture; OR 1.06, 95%CI 1.05-1.08 for industry), while HWs defined by Tmax were characterized by increased risk only for agricultural workers (OR 1.14, 95%CI 1.12-1.16).

Discussion
Days characterized by very high temperatures were associated with the greatest risk of OIs in the industrial and agricultural settings. As a working definition for HW based on maximum temperatures apparently missed a possible increased risk for OIs in the industrial sector identified by average daily temperatures, our results stress the urgent need for a common and shared definition of HWs, allowing potential stakeholder to put in place appropriate prevention strategies.

Key messages
High environmental temperatures are associated with an increased risk of occupational injuries. Different working definitions of Heat Wave may lead to missing the actual risk for occupational injuries. A shared definition is therefore strongly needed.