bluuebunny/crossref_metadata_2025_split huggingface dataset:
Country Report: How do Serbian municipalities currently promote health and health equity?
Authors: Karadzic V , Jovanovic D , Vasic M 
Published: November 2019

Abstract
A legal framework set in Serbia provide good basis for creating healthy living environment and health promotion at local level. The present system of local government in Serbia, with its 174 units is regulated by the Law on Local Self Government. In accordance to this Law each municipality has got a certain level of decision-making. Creating healthy living environment is one of the key objectives of municipal policy and its agenda. However, the extent of their inclusion and implementation is very heterogeneous between municipalities. Unequal municipalities’ capacities (financial, technical, human resources) for coordination and development of healthy living environment on the municipality level are crucial challenge. In order to support the activities at the local level, the Network of 24 regional institutes of public health, led by the Institute of Public Health of Serbia, develops public health guidance, participate in drafting local strategies, programs and activities. Additional support is provided by the Local Health Councils, increasing a political sensibility for prioritizing issues to achieve healthy living environment. The coherent framework of mandates, local strategies and action plans for improving the public health have been established through widespread cooperation between the institutes of public health, health councils, and other stakeholders (e.g. nongovernmental organizations and governmental bodies such as the ministries responsible for education, environmental protection, youth and sport). In spite of that, their implementation is restricted by low awareness of importance of health equity and health promotion. In that sense, training and education on health promotion and health equity issues are crucial to raise the awareness, increase health literacy and enable satisfactory and quality implementation of defined strategies, programs and activities at the municipality level.
Global cardiovascular risk assessment: a national training course for General Practitioners
Authors: Palmieri L , Unim B , Mattei E , Tijhuis M , Fehr A , Corrao G , Lavicoli I , Grisetti T , Bogaert P , Donfrancesco D 
Published: November 2019

Abstract

Background
Identification of high risk individuals is one of the main goals of the primary prevention of cardiovascular disease (CVD) and constitutes the basis for implementing actions aiming at reducing modifiable risk factors at individual level through changing life styles or drug interventions. The most appropriate method for identifying high risk individuals is the absolute risk assessment, a probability indicator of incidence, predictable on the basis of risk factors levels.

Objectives
The CUORE project score of the National Institute of Health-ISS is adopted in Italy; since 2007 ISS has implemented a national training course for General Practitioners-GPs with the aim of supporting and facilitating the use of CVD risk assessment in clinical practice as a preventive action in the general population.

Results
The training course is based on five sequential packages linked to educational credits: packages 1-2 facilitate the adoption of standardised methodologies for the assessment of CVD risk score; in package 3 patients are invited by GPs to assess the risk score; packages 4-5 evaluate and discuss data collected with GPs and stakeholders. A cascade training was implemented: ISS personnel provided training to local GPs who in turn provided the same training to other GPs. Two manuals for the training course were published.
Since 2007 about 4,300 GPs were trained; about 320,000 10-year CVD risk assessments were performed in 260,000 men and women aged 35-69 years. Feedback was provided to all GPs participating to the 4th-5th packages of the training courses.

Conclusions
Implementation of the training course for the use of CVD risk assessment in the population represents a primary preventive action according to the recommendation of the EU Guideline on CVD prevention. The collected data may play an important role in the identification of strengths and weaknesses of preventive actions and represents the first step to improve good clinical practices standards.
Lessons from the field: Gender roles and researcher reflexivity in smoking cessation in South Asia
Authors: Boeckmann M , Noor M , Zahid R , Firoze F , Shresthra P , Khanal S , Regmi S , Baral S , Elsey H 
Published: November 2019

Abstract

Background
In South Asia, dual epidemics of smoking and tuberculosis (TB) have contributed to a high burden of lung disease. To address these health risks, the TB & Tobacco study uses the TB diagnosis as a teachable moment and implements a behaviour support counselling intervention, conducted by TB health workers, for patients in Bangladesh, Nepal and Pakistan. In this region, smoking tobacco is perceived as problematic for women, and being confronted with questions on smoking from a health professional may be uncomfortable for men and women. Anticipating these challenges, we incorporated gender sensitivity into training of health workers.

Methods
During implementation of the cessation support in routine TB care, a process evaluation assessed interactions between participants and the intervention through interviews with health workers and patients with TB participating in the cessation program. This presentation focusses on a retrospective self-reflection on how we conceptualized gender roles based on prior research, and how research findings partially challenged these assumptions.

Findings
While parts of our interview findings point towards smoking as a stigmatized practice for women and some men in South Asia as expected, several male and female respondents across socio-economic and geographical spheres contradicted this assumption. We discovered that health workers’ self-efficacy and perceived smoking stigma among health workers influenced whether they discussed smoking with women or minors. Many patients, on the other hand, told us that they were interested in receiving help to cure their TB and were willing to talk to about smoking with their health workers and their family members.

Conclusions
Patients in this study were more open to talking about smoking than anticipated. When including gender sensitivity into the standard training for health workers, we should be careful not to increase doubts in health workers about addressing smoking with women.
Skills building seminar: Building skills and capacity for a future health workforce
Authors:   Organised by: EUPHA (HWR) Chair persons: Ronald Batenburg - Netherlands, Ellen Kuhlmann - EUPHA (HWR)
Published: November 2019

Abstract

Background
It is increasingly recognised that there is ‘no health without a workforce’ and that action has to be taken to develop an integrated and sustainable future health workforce. However, training and education opportunities are lacking for all those engaged in health workforce development. There is an urgent need for health systems and policy to foster skills building and institutional capacity for health workforce development to respond effectively to changing healthcare needs of the population and to the labour market shortages in many countries.

Objectives
This seminar will address these issues and help reducing the knowledge gaps. The seminar is arranged around for major topics: the WHO framework for action to guide health workforce planning and governance, the competences framework to strengthen the education and professionalisation of public health developed by the WHO Coalition of Partners and ASPHER, the internationalisation of health professional education using medical education in Romania as a case study, and finally a framework for strengthening health workforce research. The seminar aims to help PhD students and early career researchers to develop skills in the field of health workforce research and development. It also provides knowledge and tools for policymakers and practitioners who are responsible for health workforce education and governance. This seminar will promote the development of training programmes for health workforce research and thereby contribute to public health leadership in health workforce development. There will be ample time for discussion and teaching material will be made available for the participants.

Key messages
Building skills and institutional capacity is key to improve health workforce research and policy. People-centred care and universal healthcare coverage call for new skills and education programmes.
A public health approach to imprisonment
Authors: de Viggiani N 
Published: November 2019

Abstract
This presentation explores the contested meaning of “prison public health”. European Public Health aligns itself with legal, ethical, political and economic principles that govern human rights, the rule of law and social justice. The UN Universal Declaration of Human Rights and the WHO Commission on the Social Determinants of Health infer an egalitarian approach towards social justice that supports rights of all citizens to have their basic needs met, unnecessary threats to wellbeing minimised, and social competence maximised. In the spirit of the WHO Ottawa Charter for Health Promotion, this means operationalising agency of individuals and communities and of the broad structural determinants of health: economic, political, legal and institutional.
In contrast, the law conventionally positions criminal responsibility with the individual perpetrator who is held responsible for their ‘offending’ behaviour. In parallel, arguments surrounding responsibility for health have abounded for many decades, with the principle of collective responsibility for health forming the ethos of the Ottawa Charter. Only recently has it been acknowledged that criminogenic and pathogenic ‘determinants’ intersect, criminal risk behaviours and health risk behaviours sharing common aetiologies.
This presentation will reinforce that a public health approach towards imprisonment is fundamentally egalitarian and commitment to social justice, recognising that structure and agency intersect and that the health of the prison is as important as that of the prisoner. It will argue that it is short-sighted to attend only to prisoner behaviour if the system surrounding the prisoner is failing in its duty of care and capacity to serve society.
Most prison populations represent the most vulnerable or disadvantaged sectors of society. Governments must proactively facilitate sustainable human development and protection and empowerment of vulnerable groups including those in custody.
The longitudinal course of prisoners’ mental health problems during and after imprisonment
Authors: Dirkzwager A J E 
Published: November 2019

Abstract
Mental health problems are common in prison populations. Correctional institutions offer an important opportunity to improve prisoners’ health, which also benefit the wider public health agenda. At present, little is known about the longitudinal course of prisoners’ mental health problems during and after imprisonment. The aims of this presentation are: (a) to examine the longitudinal development of mental health problems in prison and after release; and (b) to identify individual and institutional factors associated with prisoners’ mental health problems.
Data are used from the Prison Project, a nationwide and longitudinal study examining 1.904 male prisoners in the Netherlands. Participants were surveyed at various intervals during detention, and 6 and 24 months after their release. Data include detailed longitudinal information on prisoners’ self-reported mental health problems, healthcare use, prison experiences (e.g. sentence length, victimisation, receiving visits, and exercise), and background characteristics (e.g. sociodemographic characteristics, financial situation, social support, and personality traits).
Prisoners reported more mental health problems in and after prison than men in the general population. Initial results demonstrate that prisoners who entered detention with pre-existing mental health problems and problematic alcohol and drug use, showed mental health improvements during detention.
The high levels of prisoners’ mental problems highlight the importance of addressing mental issues in prison and ensuring the continuity of care to support prisoners with their transition into the community.
Impact of austerity on prison health in England: a qualitative study involving national policymakers
Authors: Ismail N 
Published: November 2019

Abstract
Prisons offer states access to a population that is at high risk of morbidity. The UK austerity policy adopted in 2010 led to a 22% reduction (-£2.71bn) in prison spending by 2017. Whilst the number of prison officers dropped by 30%, the long-term impact of austerity on prison health in England has not been systematically contextualised. This research seeks to articulate the impact of austerity on prison health in England from the perspective of national policymakers.
Semi-structured interviews (X: 66 min) were conducted with 30 key prison policymakers. Constructivist grounded theory was used to assess the impact of austerity on prisoner health in England. Transcripts of 195,680 narrative texts were analysed using NVivo 11 until data saturation was achieved.
As a stealthy political ideology, austerity has caused societal disruption, which disproportionately affects prisons. The lack of access to services offered by the welfare state, including health-related provisions, precipitates societal unrest, increases prisoner numbers, and encourages harsher and longer sentences.
The prolonged constrained funding and the burgeoning population widen health inequalities in prisons. Healthcare provisions become increasingly limited, which unduly affects older and female prisoners who require more complex support. The degrading living conditions and lack of purposeful activities contribute to the increasing violence, self-harm and suicides in prisons, and reorient the healthcare provision from planned services to health emergencies. The excessive focus on Brexit and the perpetual changing political direction imposed on prisons reinforce the system’s instability.
Despite having the fifth largest economy in the world, England’s poorest population continues to bear the brunt of austerity. Initiating a more informed economic recovery policy and considering alternatives to imprisonment would help to ensure that England lives up to its view of itself as a progressive society.
An analysis of Croatian political parties’ pre-election manifestos and healthcare policies
Authors: Ivankovic D , Handanagic S , Dzakula A 
Published: November 2019

Abstract

Background
Before the regular 2015 Parliamentary elections in Croatia, we identified and analysed topics and comprehensiveness of health policies (HPs) included in political parties’ pre-election manifestos. After the loss of government confidence, we did a follow up before the 2016 preliminary elections. Here, we present a comparison of the 2015 and 2016 results.

Methods
We used the Walt-Gilson policy model for the content analysis of pre-election HPs. Five evaluators independently reviewed manifestos for HPs through four dimensions: content, actors, processes and context. HPs proposed by at least two parties were included in the final analysis and by referring to any of four dimensions for specific HP, parties scored one point (maximum of four points per HP).

Results
Seven out of the eight parties addressed healthcare topics in their manifestos, six discussed healthcare workforce and financing, while five discussed hospital systems, primary care, medical equipment and (re)organization of the healthcare. Parties earned 41% of all points for describing content, 28% for processes, 17% for actors and 14% for context of proposed HPs. Compared to the 2015 results, most comprehensively approached HPs changed to more focus on workforce and medical equipment. Topics of access to healthcare and people with disability earned significantly less points than in 2015.

Conclusions
Parties’ manifestos in both 2015 and 2016 focused on topics mostly represented in the public discourse on healthcare and daily media coverage. Financing the 2015 elections, as a consequence of a large financial restructuring effort of the hospital system at the time. Health workforce topped the 2016 elections, due to large emigration of health care professionals after legislative changes and Croatia’s accession to the EU. Parties mostly focus on the content while they less frequently address the role of processes, actors, and the context needed for successful implementation of the recommended HPs.
Introduction to the SCIROCCO online participatory tool and its evaluation
Authors: Alexandru C , Alhambra-Borrás T , Whitehouse D 
Published: November 2019

Abstract
This presentation will first introduce the SCIROCCO and SCIROCCO Exchange projects and the Maturity Model developed by the European Innovation Partnership on Active and Healthy Ageing. Then, a demonstration will be made of the three main functionalities of the SCIROCCO tool: assessing the maturity of healthcare systems, assessing the maturity needs of good practices, twinning and coaching with its two variants. For each piece of functionality, the methodology of using the tool will also be presented. Finally, the two main types of evaluation that were carried out for the SCIROCCO tool, and their results, will be described: Testing the validity and reliability of the SCIROCCO tool. This involved testing the content validity of the B3-Maturity Model through a literature review and Delphi survey, testing structural validity and reliability using quantitative analyses, and testing convergent validity through comparison with another tool that assesses a related concept. Results showed that the content of the wide range of dimensions and measurement scales reflects integrated care maturity, all 12 dimensions contribute to assessing integrated care maturity, the tool has good internal consistency and there is some support for convergent validity.Testing user experience with the SCIROCCO tool. This involved a qualitative approach using questionnaires and focus groups. The findings helped to improve the tool and learn about its potential future uses and wider implications.
Social cost-benefit analysis of Cognitive Behavioral Therapy for alcohol and cannabis addiction
Authors: Over E A B , van Gils P F , Suijkerbuijk A W M , Lokkerbo J , de Wit G A 
Published: November 2019

Abstract

Background
A considerable number of people with an alcohol or cannabis addiction currently do not receive addiction care. Some hundreds of thousands persons in the Netherlands suffer from alcohol dependency, while some tens of thousands adolescents suffer from cannabis addiction.

Methods
A (hypothetically) enhanced uptake of CBT in specialized addiction care centers was modeled using the SCBA approach. Two SCBA’s were performed: one with respect to alcohol addiction and the other regarding cannabis addiction among adolescents.

Results
Per person treated with CGT, these benefits accumulate to about 12,000 euro (range 10.000 - 14.000 euro). These profits originate from improved health and less mortality, improved quality of life and higher productivity. A decrease in the number of persons with an alcohol addiction will also lead to lower costs for police and justice following from less criminal activities. Furthermore, CGT is effective as treatment for adolescents with cannabis addiction. Per person treated with CGT, societal benefits accumulate to about 11.000 euro (range 9.700 - 13.000 euro). Here, the net benefits arise from improved health, improved quality of life, reduced early school leaving and higher incomes for those clients who have successfully participated in CGT in addiction care.

Conclusions
This study shows that society can benefit from an increase in people treated with CGT in specialized addiction care. Such an increase in number of people treated could for instance be realized by educational programs for professionals who come across people with dependency problems, such as general practitioners, professionals working in emergency care and youth care.
EVIPNet Europe – bridging the research-to-policy gap
Authors: Kuchenmueller T , Suvanbekov A 
Published: November 2019

Abstract

Issue/problem
Despite substantial investments into increasing the availability and accessibility of information in the WHO European Region, scientific evidence often plays a limited role in policy and practice resulting in lost opportunities to improving health systems and outcomes.

Description of the problem
The WHO Action plan and resolution to strengthen the use of evidence, information and research for policy-making, adopted in 2016, urges Member States to increase country capacity to foster the utilization of research in both policy and practice. To support and guide Member States in this effort, the World Health Organization (WHO) Regional Office for Europe launched the Evidence-informed Policy Network (EVIPNet) Europe, a capacity-building initiative that operates in line with, and in support of, Health 2020 and the 2030 Agenda for Sustainable Development. EVIPNet Europe aims to assist its member countries and catalyse sustainable change by strengthening both the evidence supply and demand sides, and building knowledge translation (KT) capacity at individual, organizational and system levels.

Results
EVIPNet Europe has been successful in enhancing the capacity of policy-makers and researchers to access, appraise, package and use evidence; strengthening organizational capacity and infrastructure; and creating institutional bridges between policy and research communities. The network’s activities have, furthermore, led to an increased conceptual and instrumental use of evidence in policy, introducing important changes in policy strategy development and legislations.

Lessons
To overcome the knowledge-to-policy gap, comprehensive capacity building strategies, operating at individual, organizational and systemic levels are required to create and sustain a culture more favourable to evidence-informed policy.