bluuebunny/crossref_metadata_2025_split huggingface dataset:
Migrant carers in Europe: double jeopardy of labour market exploitation and hostile environments
Authors: Kuhlmann E , Burau V , Falkenbach M , Klasa K , Pavolini E 
Published: October 2020

Abstract

Background
Many health systems have responded to growing population needs and expanded long-term care services for older people (LTC). However, no country managed to adequately increase the human resources for health. A large group of transnationally mobile migrant carers fill the gaps and mitigate policy failure. This study aims to explore the connections between health labour markets, migrant care workers and populism and to reveal blind spots in the governance of the LTC workforce.

Methods
An explorative comparative approach was applied, which draws on a rapid review of the literature, public statistics and document analysis. A novel analytical framework was developed, which is informed by transsectoral governance and combines four major dimensions: LTC system (e.g. cash benefits, public responsibility), health labour market situation (supply-demand) in the LTC sector, labour migration policies relevant for LTC, and the role of populist parties. Five EU countries were selected which represent different conditions in LTC: Austria, Denmark, Germany, Italy and Poland.

Results
Typologies of sending and receiving countries are no longer sustainable, but transnational mobility flows still impact differently in healthcare systems and national labour markets. Undersupply coupled with cash-benefits and a culture of family responsibility are predicting high inflows of migrant carers, who are channelled in low-level positions or in the informal care sector. These conditions can often be observed in countries with strong populist movements.

Conclusions
Health labour markets, LTC systems, culture and political factors combine to create a double jeopardy for migrant carers, exploited as labour market subjects and exposed to hostile social environments as individual citizens. Action has to be taken to improve public health advocacy for migrant carers and to establish effective European health labour market regulation and transnational health workforce governance.
Multi-stakeholder engagement
Authors: Gabrijelčič Blenkus M , Kronegger L , Pushkarev N , Robnik M , Sotlar I 
Published: October 2020

Abstract
With the method of the social network analyses, the STOP project is investigating social structures and alliances among stakeholders, by using social theory, network and graph theory. The stakeholder engagement process is an integral component of the project. One of the main aims of this process is to recommend to national authorities and the European Commission a sustainability plan for future stakeholder engagement in the area of childhood obesity. To this end, we would like to better understand stakeholders' views and positions (such as willingness, knowledge and trust for collaboration) and get feedback on the project processes and outcomes.
Analytical results show that following moderated discussions, consensus papers are often the main outputs of the stakeholders’ platforms, and a limited number of organisations dominate the membership of the platforms, with private organisations often having stronger representation.
The aim of the stakeholders’ dialogues is to discuss policies and measures related to childhood obesity and, with the input of different sectors, contribute to identifying possible policy solutions and reflect on the work of the STOP project. Concepts of power; transparency and trust; the importance of evidence and different definitions and perceptions of the evidence; and political will and empowerment all appeared as important in the dialogues. Equity and sustainability issues were also brought in the debate. Non-formal stakeholders are less represented at the EU level, so certain views and approaches are absent from EU debates. Therefore, we plan to explore and identify promising means of the engagement of all different stakeholder groups in a transparent, trustful and constructive approach.
31.C. Workshop: Development and implementation of action plans on health literacy
Authors:   Organised by: Bielefeld University (Germany), GOeG (Austria), EUPHA Health promotion section,   Chair persons: Doris Schaeffer - Germany, Jürgen M Pelikan - Austria
Published: October 2020

Abstract
Health literacy (HL) has become an important topic in many countries. As HL - meaning the ability to access, understand, appraise and apply health information (Sørensen et al. 2012) - is important to make sound health decisions, to promote health and to take an active part in managing health and illness in everyday life and navigating the health care system. In the modern digital knowledge society, HL is also indispensable for orienting oneself in the abundance of mostly digital health information, including incorrect and false information, for locating reliable information and for assessing the trustworthiness and quality of information. However, available studies show that HL is insufficient in many countries. Low HL has - as many studies show - negative social consequences ranging from unhealthy behaviour, higher risk for diseases, less self-care and deficits in coping with illness and chronicity, to over- and misuse (extensive use) of health care. The promotion of HL is therefore an important public health task. An increasing number of population studies and policy documents currently underline this. The WHO has therefore included HL into many of its strategies, like the declarations of Shanghai (2016) and Astana (2018), and has published several publications focusing on HL, like the Solid Facts (2013), the 57th Health Evidence Network Report (2018) or the Roadmap for Implementing Health Literacy Activities (2019). In many countries, strategies and national action plans to improve HL have been developed in response to the political call for action, e.g. in Scotland, Germany and recently also in Portugal. Other countries and regions are currently working on the development of a HL action plan, e.g. Belgium and the WHO European Region action plan on HL. The development and especially the implementation strategies of action plans in different countries and the experiences gained will be discussed comparatively in the workshop. Following an introduction (10'), two countries, which already have action plans will introduce their implementation strategy in one presentation each: Germany and Portugal (30'). This will be followed by two presentations of countries/regions in which action plans are currently being developed: Belgium and WHO Europe (30'). Afterwards the participants will have the opportunity to ask questions and discuss on the different strategies (20'). The workshop will help other initiatives to successfully develop and implement policy plans and strategies in different fields of public health.

Key messages
Strategies and national action plans to improve HL have been developed in different countries/regions. It is important to reflect on the chosen development and implementation strategies and to discuss their effects, successes and barriers.
Bilateral internal thoracic artery grafting in coronary surgery: 10-year outcomes
Authors: D'Errigo P , Barili F , Rosato S , Biancari F , Cerza F , Cicala S D , Forti M , Badoni G , Seccareccia F 
Published: October 2020

Abstract

Background
The advantages to use the bilateral internal thoracic artery grafting (BITA) technique for coronary artery bypass grafting (CABG) have been recently questioned, but data on long-term follow-up is limited. Using data from the PRIORITY project, this study aims to assess the outcome with the use of BITA grafting and its implications for public health.

Methods
The PRIORITY project was planned to evaluate the long-term outcomes of two prospective multicenter studies on CABG conducted between 2002-2004 and 2007-2008. Data on isolated CABG were linked to administrative data in order to retrieve patients' late outcome. Time-to-event distributions were analyzed accordingly to primary event-type (death, major adverse cardiac events (MACEs)) using the Kaplan-Meier and the Cox proportional hazards methods.

Results
The study population consisted of 11021 patients who underwent isolated CABG. BITA grafting was employed in 24.6% of patients. The median follow-up time was 8.0 years (interquartile range 7.6-10.0 years). After adjustment for potential confounding factors, BITA grafting was significantly associated with better survival (HR 0.85, 95%CI 0.76-0.95, p = 0.003). Moreover, using BITA grafting reduced the incidence of MACE (HR 0.87, 95%CI 0.80-0.94, p = 0.001), showing to be a protective factor for recurrent acute myocardial infarction (HR 0.84, 95%CI 0.71-0.99, p = 0.05) and for rehospitalization for percutaneous cardiac intervention (HR 0.82, 95%CI 0.70-0.96, p = 0.013).

Conclusions
BITA grafting during isolated CABG is associated with survival advantage at 10-year with a significantly reduced incidence of MACE. Being the choice to perform isolated CABG with or without BITA based mainly on operator personal preferences, these findings may have important implications from a public health perspective.

Key messages
The choice to perform CABG with or without BITA grafting is associated to different outcomes. The choice to perform CABG with or without BITA grafting is mainly based on operator preferences and may have important implications in terms of healthcare expenditures.
Joint Action on cancer iPAAC - building on experience and streamlining recommendations for the future
Authors: Jelenc M , Albreht T 
Published: October 2020

Abstract

Background
Policy initiatives, proposals and projects often end up proposing solutions and/or measures that are eventually either not or only partially implemented or they are lacking a system, which would consistently evaluate their implementation and/or impact. Good solutions are often not visible enough to the broader professional community and it is important to identify certain outstanding challenges in cancer control and policy. Driven by the need to better use the outputs from projects on cancer policy, European Commission was trying to address two challenges - one was in solving the problems with the implementation and use of the solutions that have already been proposed and the other one in identifying the outstanding challenges in cancer policy.

Results
We have decided to follow the structure to develop a series of recommendations and examples of good practices at the national level by selected areas. These would be streamlined into a roadmap to support policymakers at the national and EU level in formulating their cancer policies.
Three pairs of targeted recommendations have been identified: Cancer prevention, including health promotion, implementation of the European Code Against Cancer and the reshaping and extension of cancer registriesGenomics and immunotherapy in cancerChallenges in cancer care and governance of cancer control

Conclusions
Multinational collaboration can bring about important consensual solutions, which build on the existing good practices in the countries. This can be combined well with the existing work on specific areas, carried out both internationally and nationally. Consensus building on jointly defined challenges represents a task that appears to be resolved rather pragmatically.

Key message
It is important that advance in cancer care and control are quickly analysed and that policymakers receive up-to-date recommendations to improve their policies on cancer control.
Leadership styles and job satisfaction. Results of a systematic review
Authors: Specchia M L , Cozzolino M R , Carini E , Di Pilla A , Ricciardi W , Damiani G 
Published: October 2020

Abstract

Background
Healthcare organizations are social systems in which human resources are generally the most important factor for the provision of care. In these contexts, leadership plays a key role in providing effective and efficient care and results in positive outcomes for professionals, patients and work environment. The aim of this review was to identify and analyze the knowledge present to date in literature concerning the correlation between leadership styles and nurses' job satisfaction.

Methods
A systematic review of the literature was carried out on Medline and CINAHL databases between June and October 2019 by using a specific search algorithm. The following inclusion criteria were set: focus on the impact of different leadership styles on nurses' job satisfaction; secondary care; nursing setting; full-text available; English or Italian language.

Results
6681 titles, 410 abstracts and 57 full texts were analyzed. The 12 selected studies considered 7 leadership styles: Transformational, Transactional, Passive-Avoidant, Laissez-Faire, Resonant, Authentic and Servant. Four studies (33%) considered only 1 style, 3 studies (25%) 2 styles, 4 studies (33%) 3 styles and only one study (9%) considered 4 styles. Transformational and Transactional styles were the most represented (75% and 67% respectively). Most of the studies conducted (88%) showed a significant correlation, both positive and negative, between the adopted Leadership style and the nurses' job satisfaction.

Conclusions
In a complex and constantly evolving context, healthcare organizations need to guarantee not only technical and professional competence, but also satisfaction as a motivational lever for health workers. It is therefore necessary to identify and fill the gaps in leadership abilities as a present and future objective in order to positively affect health professionals' job satisfaction and therefore healthcare quality indicators.

Key messages
Job satisfaction plays a key role in healthcare and nursing as a motivational lever for health workers. Leadership styles directly impact on nurses' job satisfaction which in turn affects healthcare quality and patient outcomes.
Outcome monitoring of the Austrian health targets
Authors: Griebler R , Winkler P , Antony G 
Published: October 2020

Abstract

Background
The ten Austrian Health Targets, developed in a Health-in-All-Policies process and adopted in 2012 with a time horizon until 2032, are monitored by a series of indicators. The (interim) results are reported regularly.

Methods
Indicators were discussed intensively with experts and defined in advance. The outcome monitoring enables to observe developments over time, to analyse differences by gender, education and region, and comparisons with other EU-countries. For each indicator an overall qualitative assessment is done. This makes monitoring very comprehensive. The challenge is to communicate the monitoring results in an easily understandable way. Therefore, besides reports and presentations further in depth-discussions about communication formats with decision makers were required.

Results
The outcome monitoring shows that there is potential for development in all areas: Between 2006 and 2014 only 25 % of the outcome-indicators developed positively. As far as equal opportunities are concerned, the most improvements were seen in gender differences, significantly less for educational differences and hardly any positive developments in regional differences. In an EU comparison, Austria performs well concerning 15 out of 35 indicators (43 %). However, for some indicators - contrary to the EU trend - no improvements can be observed.

Conclusions
The results confirm the relevance of the ten health targets and identify whole-of-society areas for action. The monitoring provides steering impulses and information enabling decision-making for politics, administration, the health target plenary, and the intersectoral working groups.

Key messages
The monitoring contributes to strategic steering, helps optimising strategy and action plans and enhancing the overall process. Stakeholder involvement is important for development of a format to communicate the results in the best comprehensible way.
Powerful Influencers: Kenyan & Zambia Religious Leaders Advocate for Family Planning
Authors: Bormet M 
Published: October 2020

Abstract
Faith-based organizations (FBOs) provide approximately 40% of healthcare in Kenya and 30% in Zambia. Promoting healthy families is a value at the heart of faith communities. This intervention focused on equipping and encouraging religious leaders (RLs), whose churches own and operate faith-based health facilities, to advocate for family planning (FP) within their congregations, communities, governments. This project included baseline assessments, FP sensitization, and media trainings. Religious leaders were trained through an adaptation of the AFP SMART training by ensuring culturally appropriate messaging for religious audiences were included (i.e. using scripture to discuss and develop messages on families, planning, having children, etc.). Training RLs provides an entree into government fora as culturally respected leaders in positions of power. In order for external advocacy to take place outside of church settings, it is crucial to identify how each church defines FP before meeting with external stakeholders. Creation of low-literacy terms in English and local languages that equipped RLs to interact with community members in-person (i.e. church services, weddings, funerals, community barazas, etc.) and via TV and radio shows was key in addressing myths and misconceptions. Eighty-six religious leaders from 16 denominations in Kenya and Zambia were engaged to sensitize communities and advocate with their Ministries of Health on behalf of the faith community to ensure family planning services reach communities. Equipping RLs in culturally and language appropriate contexts builds stronger advocates for healthy families and communities.

Key messages
To demonstrate how religious leaders in Kenya and Zambia are equipped to advocate for family planning from a faith perspective. Words and definitions and messengers matter in Family Planning Advocacy from a faith perspective.
How to assess health policy impacts of new generation trade agreements
Authors: Koivusalo M 
Published: October 2020

Abstract

Issue
Negotiation of trade agreements has become a key part of current international policy environment with the consequence of increasing concerns over impacts on public health, health protection and policy space for health. Trade agreements represent 'meta-regulation' where key impacts will be on how governments can regulate with different implications depending on existing regulatory framework within a country. Engaging with trade requires understanding how health-related arguments can be made and where they reside.

Results
This presentation discusses where and how public health advocates can engage with trade related decision-making on new generation trade agreements with focus on regulation, services and protection of investment and intellectual property rights. The innovative approach on policy space for health will overcome focus on existing standards and allows discussion on what exceptions and exclusions in trade agreements actually imply. Policy space allows analysis on impacts which may not relate to direct health outcomes, such as issues with privacy, health data, access to new technologies, and pricing of medicines. The presentation will use case examples from European Union trade agreements and will discuss politics of mandate negotiations as well as how diversions, rhetorical/empty claims and circular traps are used in in political decision-making and the extent to which and how these can be counteracted on key public health and health systems -related issues.

Lessons learned
If negotiated agreements will affect how governments can regulate in future rather than existing standards, this requires a different approach for public health researchers and advocates. The lessons learned will provide suggestions on how to approach trade policies as part of Health in All Policies and where limits and opportunities of health and sustainability impact assessments reside.

Key messages
New generation trade agreements impact on regulatory policy space. Assessing impacts of trade agreements need to go beyond impact assessments.
Processed meat eater profile in a Latin-American cohort
Authors: Ruedlinger J , Paredes F , Cid V , Huidobro A , Ferreccio C 
Published: October 2020

Abstract

Background
We aim to describe the prevalence, distribution and factors associated to processed meat (e.g. sausages, bacon) consumption (PMC) in a Chilean population-based cohort. This is the first study to explore this exposure in Chile.

Methods
We studied 7841 participants of the Maule Cohort, 4358 women, 3483 men aged 37 to 77 years, who answered an epidemiological survey (diet, alcohol, health, socioeconomic), had a medical examination, and provided fasting blood. We stratified them in five groups by weekly frequency of PMC from (1) none, (2) &lt;1/week, (3) 1/week, (4) 2-4/week to (5) &gt;5/week. We analyzed MAUCO cohort baseline data in association with PMC. We estimated Prevalence ratios (PR) with Poisson regression (age, schooling & sex adjusted) and with multinomial logistic regression we modelled PMC using group 1 as reference.

Results
High consumers were 8% (7% women, 9% men). Binge drinking was more common among participants in groups 2, 3 & 4 (Relative Risk Ratio, RRR) 1.26, 95% confidence interval (CI) 1.04-1.52; 1.28, CI 1.0-1.55 & 1.32, CI 1.08-1.6). As for diet, participants consuming red meat (&gt;4 /week, 2.79; CI 2.13-3.66), butter/cream (&gt;4 times/week, 2.07; CI 1.62-2.64), sugary snacks/sweets (≥1 time/day, 2.26; 1.81-2.83) and sugary drinks (≥1 time/day, 1.85; CI 1.48-2.31) were more likely to be in the high PMC group. Cardiovascular diseases (1.72, 1.17-2.52) and large waist circumference (1.01, 1.0 - 1.02) were more common in participants in the high PMC group.

Conclusions
High consumption of processed meat is accompanied by other behaviors and risk factors that can potentiate adverse health effects in this population.

Key messages
In Chile, little attention has been given to potential health impacts of processed meat. This work aims to bring focus to this issue. High processed meat consumption was associated with other non-healthy foods, risky alcohol intake and unhealthy weight, all of which can increase the risk of chronic diseases.
Passive suicidal ideation in older adults from 12 European countries
Authors: Lee S 
Published: October 2020

Abstract

Background
Highest rates of suicide in older adults are a major public health hazard in many industrialized societies. The current study aims to provide an overview of demographic, psycho-social, and health-related risks for suicidal ideation among European older adults.

Methods
Study builds on secondary data analysis using data drawn from the Survey of Health, Aging and Retirement in Europe (SHARE) wave 7.0. A total sample of 33,719 older adults, aged 65+, were analyzed. Risk factors included socio-demographic variables, psychological distress, and health conditions. Descriptive statistics and ANOVA were used to provide information about prevalence and demographic correlates of passive suicidal ideation. Standardized significant path coefficients were examined between predicting variables and suicidal ideation.

Results
Suicide ideation was at its highest level among older adults from France, Poland, Spain, Germany, Italy, and Belgium. Highest rates of suicidal ideation were found among widowed, but also married couples, aged between 65 and 70, and older adults living in rural area. Results also reinforced that elderly's suicidal ideation was universally associated with poor health, limited access to activities, a lack of social contact, and worse subjective well-being. The path from depression to suicidal ideation was significant with a larger magnitude.

Conclusions
Passive suicidal ideation is a critical mental health index. In order to diminish the likelihood of suicide thoughts and acts in older adults, national policy should integrate psychological services in elderly care to help older adults better cope with depressive symptoms and long-term health problems. Local government should foster local support groups for elderly and promote suicide prevention-intervention program for those elderly seeking help.