bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expert Recommendations for Health Literacy Policies addressing Children and Adolescents
Authors: Okan O , Corsmeier M , Sørensen K , Bauer U 
Published: October 2020

Abstract

Background
There is an on-going and a well observable uptake of health literacy in the national and international agenda-setting pertaining to the development of new policy strategies to address the issue of promoting health literacy in whole societies. Therefore, the aim of this research is to analyse those policies on how they address children and develop recommendations for future policies.

Methods
Policy documents on national levels, published by February 2019 were retrieved using a two-pronged strategy: (1) systematic review methods (database and online search) and (2) expert consultation. Based on a SWOT analysis of these policies, an interview guide was developed and policy experts (N = 63) from 46 countries across the world were interviewed. Based on the qualitative analysis, a Delphi Study was developed to gather expert comments and validation.

Results
The search has identified 26 policies in 19 countries including case-laws and enacted statues, governmental strategies, polices driven by national key experts, and educational policies. The content of these informed the interview guide. The initial analysis of the interviews led to several recommendations pertaining to schools and the education sector, including principals, teachers and whole-school approaches, characteristics of different settings, such as policy, education and administration, economic perspectives, and the need for research and evidence in order to inform future strategies.

Conclusions
The results will be compiled into a recommendation report and a policy brief. In addition, those will be translated into other languages to share with the countries of the experts who participated in this project. While almost all policies address children somehow, several limitations make it difficult to evaluate the quality of the different policies. To secure and sustain more effective, child-focused policies, current knowledge gaps regarding research on children`s health literacy should be addressed.
Turning constraints into resources: the experience of TRAIN4M&H training program on migrants’ health
Authors: Declich S , DePonte G , Russo M L , Marchetti G , Dente M G , Punzo O , Marceca M 
Published: October 2020

Abstract

Background
The tender TRAIN4M&H (Provision of training for first-line health professionals and law enforcement officers working at local level with migrants and refugees, and training of trainers- contract 20167204), funded by the EC-DG SANTE under the 3rd EU HP, intended to conduct training programme in all EU/EEA countries for health professionals, law enforcement officers an social workers in front-line countries and coach trainers in the others.

Objectives
Training was aimed at reinforcing skills, improving understanding and positive attitudes, and promoting a holistic approach in the work with migrants. The boundaries set by the tender included a short training duration; exclusive use of pre-existing and validated training materials; different professional targets. Italian National Health Institute and Sapienza University of Rome designed the training programme. Criteria for content selection and methodological choices were submitted for consultation to an inter-professional Expert Group in two steps.

Results
Given the limited training timeframe, the delivery of specialised content could not be the focus of this training. It was decided therefore to transform the target requirement into added value, by mixing the target groups into multi-professional classes. This bring a diversity of understandings into the classroom and enhance communication between sectors. The training included also topics such as “context of migration” and “intercultural competences” to create common ground for multi-professional exchange. Similarly, the need to adapt to different EU/EEA contexts argued for a modular structure where Units are selected by the Local Trainer based on a training needs assessment questionnaire sent to trainees beforehand. All materials are on EU Health Policy Platform's Agora (webgate.ec.europa.eu/hpf/).

Conclusions
Training on migrants' health is a complex process, requiring the engagement of learners from their previous experiences and an interdisciplinary approach.

Key messages
Inter-professional training programme can be used for the adult trainings especially in case of a cross-sectoral topic as migrants’ health is. Inter-professional training is a strategy that can guide coherently content design, outcome identification and the choice of evaluations tools.
Do leaders in departments with low nurse turnover use unique strategies? A positive deviance study
Authors: Hølge-Hazelton B , Berthelsen C B 
Published: October 2020

Abstract

Background
High nurse turnover in hospitals is a global problem and factors such as nurses' relationships with their managers have been associated with retention and turnover. Previous studies have utilized a deficit-based approach. This study aims to investigate nurse leaderś experiences and descriptions of practices in hospital departments with low nurse turnover in a region facing the highest nurse turnover rates in Denmark. The research questions were: What considerations and strategies regarding turnover do the nurse leaders have? How do the nurse leaders describe the culture and work environment in their departments?

Methods
A constructivist design with a focused ethnography methodology was used to construct data, primarily through interviews. Positive deviance inspired the theoretical perspective. Head nurses and ward managers from medical, surgical, acute and psychiatric departments with the lowest nurse turnover participated in the study (total 9 leaders). The female leaders, had an age range from 43 to 65; their management experience ranged from 1 to 27 years.

Results
Despite the fact that leaders came from very different contexts, they all had clear visions for the culture and values of their departments, including ideas about how to proceed with the current and future challenge of nurse turnover. The results are presented as two categories related to the research questions: The culture is unique, and Maintaining, protecting or re-establishing the unique culture.

Conclusions
Nurse leaders from departments with low nurse turnover compared to similar departments in the same region all described their cultures as unique, but held in common values of diversity and balance in the group of staff, and the leaders' roles were focused on maintaining, protecting or re-establishing that culture.

Key messages
Nurse leaders with clear cultural awareness and visions for the context in which they operate may be positively associated with lower nurse turnover. The head mainly nurses lead indirectly by securing the best possible conditions at a strategic level, so the nurses could thrive.
Implementation of the European health interview survey into the National FinSote survey in Finland
Authors: Parikka S , Koskela T , Ikonen J , Kilpeläinen H , Tolonen H 
Published: October 2020

Abstract

Background
This methodological paper describes the integration of the European Health Interview Survey wave 3 (EHIS 3) into the National FinSote Survey (FinSote2019/EHIS). Finnish Institute for Health and Welfare (THL) conducted the survey in Finland.

Methods
FinSote 2019/EHIS was conducted as a cross-sectional health, welfare and services survey. A simple random sampling was used to recruit 15 000 individuals aged 15 years and older. Data collection was carried out by self-administered questionnaire that was available in web and paper form. To minimize the respondent burden socio-demographic background variables were obtained from administrative registers. In Finland, EHIS wave 3 was conducted as a part of the National FinSote survey. The questionnaire included both EHIS 3 modules on health status, health care, health determinants (excluding derogation variables), social background variables and additional national questions. In data processing, two datasets were formed: national dataset for sustaining time series as well as monitoring nationally relevant topics and EHIS dataset including the quality and validation rules specified by Eurostat.

Results
In total, 6,251 questionnaires were completed. The response rate was 44 % in EHIS data (aged 15+) and 45 % in national FinSote data (aged 20+). The representativeness of the results was increased by applying weighting procedures. The sample size was just large enough to achieve the precision requirements determined by Eurostat. Access to micro data of the EHIS 3 will be provided by Eurostat and to the FinSote 2019/EHIS by THL.

Conclusions
Integrating EHIS wave 3 into an existing national monitoring system was challenging in Finland. The harmonization might lead to interruptions of existing national time trends. Inclusion of some national well-being and social care variables might be irrelevant to respondent aged 15-19 years.

Key messages
Conducting EHIS as a part of National FinSote survey in Finland was cost-effective but challenging. Cultural differences in regards to living conditions in younger respondents and health care system made it challenging to integrate EHIS into national survey.
Health system responsiveness to refugees: a population-based, cross-sectional study in Germany
Authors: Biddle L , Wenner J , Bozorgmehr K 
Published: October 2020

Abstract

Background
Responsiveness, a critical component of health system performance, has received little attention in the context of international migration. Yet the concept provides a unique lens to study the system's ability to meet the legitimate expectations of its users. This study aims to identify predictors of responsiveness for asylum seekers and refugees (ASR) in Germany.

Methods
A population-based, cross-sectional health monitoring survey was conducted in Germany's third-largest federal state using random sampling at the level of all 1938 accommodation centers. Established instruments were used to measure responsiveness, health status, and socio-demographic factors. Data were weighted for sampling design and calibrated using asylum statistics. Adjusted logistic regression models were applied to identify predictors of responsiveness related to health status, structural, and socio-demographic variables.

Results
Of 560 respondents (response rate: 42%), 344 provided data on responsiveness. Combined weighted scores for responsiveness were 75% (CI: 69%-82%), with large variations between domains ranging from 86% (CI: 80%-90%) for cleanliness and 83% (CI: 76%-89%) for respect domains, to 56% (CI: 48%-63%) for choice and 52% (CI: 46%-59%) for timeliness domains. Overall responsiveness was worse for ASR with poor general health (OR 0.35; CI: 0.14-0.84), chronic illnesses (OR: 0.37; CI: 0.17-0.81), symptoms of depression (OR: 0.37; CI: 0.15-0.90) and anxiety (OR: 0.26; 0.10-0.68), and poor quality of life (OR: 0.18; 0.06-0.60). Socio-demographic and structural factors were not significantly associated with responsiveness.

Conclusions
There is room for improvement, especially regarding choice of provider and timeliness of care for ASR in Germany. Poor health status is a predictor of responsiveness, indicating that ASR most in need of a supportive care environment are being sold short. There is therefore an inequitable distribution of health system responsiveness among ASR.

Key messages
There is a large variation in scores across responsiveness domains, with choice of provider and timeliness of the health system being rated as particularly poor by ASR. Responsiveness is worse for individuals with poor health status, indicating that those most in need of a supportive care environment are being sold short.
Can a community empowerment intervention improve health and wellbeing in a post-industrial UK town?
Authors: Coan S , Woodward J , South J , Bagnall A , Southby K , Button D , Trigwell J 
Published: October 2020

Abstract

Background
'Local People' programme operates in 29 UK communities experiencing disadvantage and economic stressors that impact on population wellbeing. The programme uses a community empowerment approach to increase social connections, and collective control, improve health, and reduce inequalities. This links to SDGs 3 and 11. Mechanisms include a decision-making group led by residents, a project lead, funding, and support from a national charity.

Methods
A mixed method evaluation was conducted (2017-19) to identify processes and assess outcomes and impacts. This presentation outlines the findings from five in-depth qualitative case studies (c140 interviews) with emphasis on one post-industrial UK town suffering from the effects of industrial decline. A within case and cross case qualitative analysis was undertaken using a thematic framework.

Results
Priorities set by local areas focused on increasing community involvement and connections between people. A wide range of activities took place including regular classes and community events. The five case studies found strong qualitative evidence of increased social connectedness, community spirit and a sense of purpose, along with the area becoming a better place to live. People involved in project delivery gained confidence and skills, improved their wellbeing and gained a sense of control. There is, as yet, limited evidence that increased involvement has influenced the wider determinants of health. In the post-industrial town, people's social networks expanded, enriching their lives and providing missed companionship. Participants in the programme reported improved mental and physical health, as well as increased confidence and skills. Involvement gave a voice to marginalised older people in the area.

Conclusions
Empowering communities and putting residents in control can lead to improvements in connectedness and some aspects of health and wellbeing, even in post-industrial towns facing considerable and complex challenges.

Key messages
The community empowerment programme increased social connectedness. The programme led to improved mental and physical health in participants.
Environmental and individual characteristics associated with car use across Europe
Authors: den Braver N R , Kok J G , Mackenbach J D , Rutter H , Oppert J M , Compernolle S , Twisk J W R , Brug J , Beulens J W J , Lakerveld J 
Published: October 2020

Abstract

Background
This study aimed to determine which neighbourhood- and individual-level characteristics were associated with car driving in adults of five urban areas across Europe, and to determine the percentage of variance in car driving explained by characteristics at both levels.

Methods
Neighbourhood environment characteristics potentially related to car use were identified from the literature. These characteristics were subsequently assessed using a Google Street View audit and available GIS databases, in 59 administrative residential neighbourhoods in five European urban areas. Car driving (min/week) and individual level characteristics were self-reported by study participants (analytic sample n = 4,258). We used linear multilevel regression analyses to assess cross-sectional associations of individual and neighbourhood-level characteristics with weekly minutes of car driving, and assessed explained variance at each level and for the total model.

Results
Higher residential density (β:-2.61, 95%CI: -4.99;-0.22) and higher land-use mix (β:-3.73, 95%CI: -5.61;-1.86) were significantly associated with fewer weekly minutes of car driving. At the individual level, higher age (β: 1.47, 95%CI: 0.60;2.33), male sex (β: 43.2, 95%CI:24.7; 61.7), being employed (β:80.1, 95%CI: 53.6; 106.5) and ≥3 person household composition (β: 47.4, 95%CI: 20.6;74.2) were associated with higher weekly minutes of car driving. Individual and neighbourhood characteristics contributed about equally to explained variance in minutes of weekly car driving, with 2% and 3% respectively.

Conclusions
Residential density and land-use mix were consistently associated with minutes of weekly car driving, besides age, sex, employment and household composition. Although total explained variance was low, both individual- and neighbourhood-level characteristics were similarly important in their associations with car use in five European urban areas.

Key messages
Both individual and neighbourhood level characteristics contributed equally to explained variation in car driving, across Europe. Higher residential density and land-use mix are consistently associated with lower care use.
Health Management Information for Decision Making
Authors: Iqbal Anwar A 
Published: October 2020

Abstract
With support of the European Union, icddr, b partnered with Directorate General of Health Services in the Ministry of Health and Family Welfare in Bangladesh, to improve the health management information system in the country. The project first performed analysis of strengths and weaknesses. New data analytic systems were developed, new dashboards and other tools for visualisation were put in place. Health managers in different areas were trained in using data analysis for decision-making. By making data available for communities more transparency was created in health management.
The SHARE project organised two international conferences on Data for Decision-making, publish reports, policy briefs, organised think tank meetings and community interventions to enhance data use in evidence-based policies.
Most important lesson learned: with appropriate tools, information can be understood by service providers as well as service users and lead to better healthcare. Researchers can mediate between statisticians and end users of data.
Developing local knowledge centre for health policy
Authors: Chenge F 
Published: October 2020

Abstract
With the support of the European Union, the Health Knowledge Centre in DR Congo was initiated. The Centre is a small independent organisation, that has strategic liaisons with three Schools of Public Health in DR Congo and with the National Biomedical Laboratory. The Centre produces policy advice, often based on knowledge generated in the universities.
Through its direct relationship with the Ministry of Health it is able to develop new policy directions in the health sector, e.g. through analysing and advising on healthcare financing.
The Centre produces policy briefs, organises round tables, and has a website to inform stakeholders on policies in health.
Most important lesson learned: an organisation that mediates between universities on the one hand and policy makers on the other hand is able to formulate evidence-based policies.
Conducting a national burden of disease study in South Korea: from past to present
Authors: Yoon S J , Kim Y E , Park H , Oh I H , Jo M W , Ock M , Go D S , Kim K A , Kim K 
Published: October 2020

Abstract
South Korea has been measuring its own burden of disease since the early 2000s and has developed a methodology for its calculation. Since 2012, South Korea has been carrying out disease burden research through the Research and Development Project, supported by the Ministry of Health and Welfare. Because the Korean health insurance system covers the entire population of the country, the Korean National Burden of Disease (KNBD) study is based on individual claims data. Disease prevalence, incidence, and mortality rates, which are the epidemiologic indicators used to calculate burden of disease, are based on actual data, and the incidence-based approach is used for Years Lived with disability (YLD), Years of Life Lost (YLL), and Disability Adjusted Life Year (DALY). The KNBD study is conducted for 260 diseases and injuries and subdivided into sub-national levels. Disability weights (DW) are calculated to reflect the sociocultural characteristics of a disease. For cause-specific DWs, we conducted a self-administered web-based survey for medical doctors and students. Using a ranking method, we calculated cause-specific DWs. For this reason, KNBD study results cannot be directly compared with GBD results.
The major findings of the KNBD study are as follows. In Korea, the DALY rate (per 100,000 people) steadily increased for all income levels. The higher the income, the lower the burden of disease; low-income people had a higher burden of disease than high-income people. However, thyroid cancer, refraction and accommodation disorders had a high burden of disease in the high-income group. Growth in the YLD rate was faster than in the YLL rate. In 2016 the leading causes of disease burden were diabetes mellitus, low back pain, and chronic obstructive pulmonary disease.
We will present South Korea's disease burden calculation methodology and its results and share the efforts to calculate disease burden in other countries.
Use of non-health EU databases for health surveillance. En-risk application
Authors: Fernández-Navarro P , Pérez-Gómez B , Gómez-García T , Sarmiento-Suárez R , Padrón-Monedero A , Ortiz-Pinto M , Galán I , Noguer I 
Published: October 2020

Abstract

Background
To combine health information and environmental health determinants is key, for epidemiological monitoring and health risk studies but its integration represents a challenge that requires specific expertise. An example of a potentially useful source of significant environmental data relevant for health is the European Pollutant Release and Transfer Register (E-PRTR), which allows estimating exposure to industrial pollution. Our aim was to develop an easy-to-use tool that allows to perform a screening suggesting the presence/absence of excess risk of a disease linked to residential proximity to industrial pollution.

Methods
En-risk: java interactive tool was developed to merge E-PRTR information and municipal mortality/morbidity data, to perform an exploratory spatial analysis of association between them by type of industrial facility using distance as proxy of exposure. The application needs cartography of the country and a database of the annual observed deaths (mortality) or cases (morbidity) and population broken down by age groups and sex per municipality. With this it calculates the expected number of deaths, the distance from the municipal centroids to the industrial location (classifying municipalities as exposed or not exposed), and perform the statistical analyses. Municipal lung cancer deaths (2005-2009) in Spain provided by the National Institute of Statistics were analyzed with this application as an example.

Results
En-risk gives a table of Relative Risk of mortality/morbidity due to exposure to industrial pollution by industrial sector and sex. The analysis in lung cancer deaths showed an excess of mortality associated to proximity to several industrial sectors.

Conclusions
En-risk facilitates the study of the relationship between industrial pollution and health around Europe. It can be used by public health services to identify health problems.