bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Constances cohort
Authors: Zins M Z 
Published: November 2019

Abstract
The overarching objective of CONSTANCES is to constitute a research infrastructure based on a large population-based cohort to serve as a versatile, high quality and efficient platform for population health research. Constances is designed as a representative sample of 200,000 adults aged 18-69 at inception living in different regions of France. CONSTANCES, which is accessible to the national and international research community, enables the conduct of valid and well-powered studies in a wide range of scientific domains. For each participant, it combines detailed data collection at baseline, englobing lifestyle, environmental, social, and medical history information, with medical examinations, neuropsychological testing with the added advantage of linkage with two major national administrative data bases (SNDS and CNAV). Further, CONSTANCES collects information about changing lifestyles, environments, health behaviors and health conditions on a prospective ongoing basis. A biobank of blood and urine samples is in the process of being constituted. As of April 2018, 85 nested projects designed by French and international teams in many areas of biomedical and public health research were initiated. Constances participates in several French and international consortiums. We established relationships with public health institutions and industrial companies. In the next years, we plan to continue longitudinal follow-up CONSTANCES along the same lines by extending the follow-up of the cohort and by developing innovative new themes prioritizing the strengthening of certain “niches” where CONSTANCES can have international leadership.
The German National Cohort: aims, study design and current status
Authors: Ahrens W A 
Published: November 2019

Abstract
The German National Cohort (GNC) is a joint interdisciplinary endeavour of the Helmholtz and the Leibniz Association, universities, and other research institutes. It focuses on the causes of major chronic diseases, i.e. cardiovascular diseases, cancer, diabetes, neurodegenerative/psychiatric diseases, musculoskeletal diseases, respiratory and infectious diseases, and their sub-clinical stages or related functional health impairments. Less frequent disorders may be investigated by pooling studies. Random samples of regional populations were drawn by 18 study centres, including a total of 200,000 women/men aged 20-69 years. Starting in 2014, the baseline assessments included an extensive interview and self-completion questionnaires, a wide range of medical examinations and the collection of blood, urine, stool and nasal swabs stored in a central biorepository. A random subgroup of ≥ 40,000 participants participated in an intensified examination (’’Level 2’’) programme. Also, about 30,000 participants, who were in addition invited to Level 2, participated in a magnetic resonance imaging examination programme. In 2018 we began to invite all participants for a re-assessment that will be completed in 2023. Information about chronic disease endpoints is obtained through a combination of active follow-up (mailed questionnaires every 2-3 years) and record linkages with cancer registries, healthcare databases, the statutory pension fund and other social insurance data. The examination and questionnaire modules are partly harmonised with those of other large European cohorts to facilitate collaboration. Data access requires a formal application by researchers and will be granted according to the use-and-access regulation of the GNC. The GNC is planned for an overall duration of at least 25-30 years. It will provide a major epidemiological resource, and will help to identify new and tailored strategies for early detection, prediction, and primary prevention of major diseases.
Health literacy policy-making regarding children and adolescents
Authors: Okan O , Sørensen K , Bauer U 
Published: November 2019

Abstract

Background
There is an on-going and a well observable uptake of health literacy in the national and international agenda setting pertaining the development of new policy strategies to address the issue of promoting health literacy in whole societies. Even though children have been declared to be a priority target, no research is available that has analysed if and how children are addressed by these policy approaches. Therefore, the aim of this research is to analyse those policies on how they address children.

Methods
Policy documents on national levels that have been published by February 2019 were retrieved by using a two-pronged strategy comprising of (1) systematic review methods (database and online search) and (2) expert consultation.

Results
The search has identified 26 policies for 19 countries including case-laws and enacted statues, governmental strategies, polices driven by national key experts, and educational policies. No policies on children’s health literacy were found for South America and Africa. The policies differ in many ways, such as their embedding into general health policy making, policy and implementation processes, rationality and networks, and influence of governance. Children are either addressed by (1) specific programmes, (2) school health approaches, (3) their parents, (4) healthcare action, or (5) using a combination of those areas. However, there is almost no evaluation data available nor are these policies underpinned by health literacy evidence generated within the children`s population. Most policies are designed for adult populations rather than children.

Conclusions
Health literacy has developed into an important health policy-making target. 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.
Partnerships for public health between regional governments and academic institutions – status quo in European regions
Authors: Ihlebaek C , Ese J , Zambon F 
Published: November 2019

Abstract
The development of partnerships is described as an important tool for achieving goals in the 2030 Agenda for Sustainable Development. Partnerships between regional governments and academic institutions could be important for solving public health issues, as they are often complex, and both academic and practice-related knowledge is necessary. Such partnerships at the regional level might be especially important as many sub-national regions in Europe have considerable responsibility and power in decision-making on important areas such as prevention, health promotion, and health care. The overall aim of this project was to provide more knowledge about public health partnerships between regional governments and academic institutions in different regions within WHO’s Region for Health Network (RHN). Through a mixed methods research design, we wanted to identify and describe good examples of existing partnerships, and to investigate enabling factors, challenges, and lessons learned. Information on ongoing partnerships were collected by sending an electronical questionnaire to contact persons of the 43 members regions in the RHN. Based on the mapping, four regions were selected for group interviews with different stakeholders within regional universities and regional government. There were 31 regions (72%) who answered the questionnaire, and group interviews were carried out in Østfold (Norway), Varna (Bulgaria), Utrecht (the Netherlands), and Saskatchewan (Canada). In this presentation the results from the survey will be presented; describing the occurrence of partnerships, how public health partnerships are formalized and organized, important enablers, hindrances, how collaborations are carried out in practice, perceived benefits and successes, and experienced challenges.
Panelists: Klara Dokova
Faculty of Public Health, Medical University of Varna, Varna, Bulgaria
Contact: klaradokova@gmail.com
Liesbeth van Holten
Healthy urban living at Provincie Utrecht, Utrecht, Netherlands
Contact: liesbeth.van.holten@provincie-utrecht.nl
Cordell Neudorf
College of Medicine, University of Saskatchewan, Saskatoon, Canada
Contact: cory.neudorf@usask.ca
Anni Skipstein
Chief officer Public Health, Østfold county, Norway
Contact: annis@ostfoldfk.no
Italy: nationalist anti-migrant policies and emigration of Italian health professions
Authors: Pavolini E 
Published: November 2019

Abstract

Background
Traditionally Italy has been characterised by a limited investment in healthcare personnel, apart from physicians. The outcome has been a low health worker to population density; especially nurses and long-term care personnel face shortages. The outcome has been, at least until 2010 an increasing presence of migrant care workers. However, the situation has changed for several reasons. On one hand, since austerity policies have been implemented, the whole healthcare system has registered a freeze in new healthcare personnel hiring. One the other hand, in more recent years policies have started to be implemented, especially by the latest government (where one of the two governing parties is a radical right one) to make it more difficult for migrants to access the country.

Methods
The study draws on an analysis of administrative data and previous researches in the field, matched by qualitative interviews with key informants at the national level.

Results
Shortage of skilled workers in the health sector is likely to increase in future. It is becoming more difficult for foreigners to get access to work in this sector, while Italian healthcare workers are leaving the country. In recent years there has been a strong increase in healthcare professionals’ emigration toward North America and other EU countries.

Conclusions
Italy needs both a new effective strategy of health workforce governance and a more migrant-friendly policy to manage incoming and outgoing flows of health professionals.
Reproductive and contraceptive healthcare for vulnerable people in the Netherlands: Pregnant not now!
Authors: Rijlaarsdam C W , van Sambeek D W M , Rust L 
Published: November 2019

Abstract

Issue/problem
Unplanned and unwanted pregnancies are an important issue in public health. Especially when parents already are in complex or vulnerable situations, for example being homeless, having an addiction, serious psychiatric- or financial problems or intellectual disabilities. Although most of these parents are in contact with several professionals, family planning and contraceptives are rarely discussed.

Description of the problem
In 2014 a pilot programme was developed to support vulnerable adults on family planning and adequate use of contraception. In a qualitative explorative case study the pilot was evaluated.

Results
The pilot showed a significant increase in postponed pregnancies by using appropriate contraceptives. Over eighty percent of this population started contraception on a voluntary basis. The study showed 5 determinants influencing contraception use: responsibility, knowledge, finance, emotion and social environment. If needed, the programme played a role on all different determinants. The method of working was the key element in the success: addressing family planning and contraceptive use through an outreach practise orientated presence approach and empowerment. Another important factor for success was the collaboration between public health and medical doctors.

Lessons
The successful pilot became regular care for vulnerable (potential) parents in Tilburg. The pilot was replicated in two other cities, Rotterdam and Nijmegen, with similar results. In 2018-2021 the programme will be implemented nationwide with financial support of the Ministry of Health, Welfare and Sports, coordinated by GGD GHOR Nederland (the Association of GGDs (Regional Public Health
Services) and GHOR-(Regional Medical Emergency Preparedness and Planning) offices in the Netherlands).

Key messages
‘Pregnant not now!’ successfully supports vulnerable people with family planning and contraceptives, helping them to gain control over their future and preventing unplanned and unwanted pregnancies. The programme is unique and preventive, its innovative character is applicable in other communities in the Netherlands and possibly across Europe.
The health of asylum seekers in Finland: a total population health examination survey (TERTTU)
Authors: Skogberg N , Koponen P , Lilja E , Mustonen K-L , Garoff F , Ahmed A , Castaneda A E 
Published: November 2019

Abstract

Background
There is scarcity of representative population-based data on the health and wellbeing of asylum seekers in Europe. The Asylum Seekers Health and Wellbeing Survey (TERTTU) was launched to provide the evidence-base for developing services for asylum seekers as well as for planning and allocation of healthcare resources at a national level.

Methods
A sample of all first-time asylum applicants between 19.2-30.11.2018 was drawn from the Finnish Immigration Services electronic asylum database. Altogether 784 adults aged 18 years and older took part in the standardised health examination and face-to-face interview with participation rate of 79%. Interviewed health measures included the Minimum European Health Module, conditions previously diagnosed by a physician, permanent injury due to violence or accident and somatization.

Results
Self-rated health was good among 66% (95% CI 62,5-69,1) and 42% (95% CI 38,5-45,4) reported having some self-reported long-term illness or health problem. The most common previously diagnosed conditions were diseases of the circulatory system (19%, 95% CI 16,5-22,0), musculoskeletal system (18%, 95% CI 15,6-21,1), mental and behavioural disorders (13%, 95% CI 10,9-15,6) and diseases of the respiratory system (10%, 95% CI 8,0-12,2 ). Nearly half (47%, 95% CI 43,7-50,8) reported having a permanent injury due to violence or accident. Somatisation was common: 23% (95% CI 20,3-26,2) reported having headache, 23% (95% CI 19,9-25,8) back ache and 13% (95% CI 10,8-15,6) other pains at least several times a week.

Conclusions
The overall health of newly-arrived asylum seekers was poorer compared with the general Finnish population and migrant origin populations from similar countries of origin permanently living in Finland. Significant differences in asylum seekers health were found by sex and region of origin. Survey data will be used for developing the national initial health assessment protocol for asylum seekers during 2019.

Key messages
The TERTTU Survey is the largest population-based health examination survey among newly-arrived asylum seekers in Europe to date. The extensive data gathered over the course of the survey will be used for developing services for asylum seekers at a national level and is of high relevance also to other European countries.
Health monitoring among refugees: a state-wide, cross-sectional, population-based study in Germany
Authors: Biddle L , Menold N , Bentner M , Nöst S , Jahn R , Ziegler S , Bozorgmehr K 
Published: November 2019

Abstract

Background
Health monitoring in Germany falls short on generating timely, reliable and representative data among migrants, especially transient groups such as asylum seekers and refugees (ASR). We aim to advance health monitoring approaches and obtain reliable estimates on health status and access to health services among ASR in Germany’s 3rd largest federal state.

Methods
We conducted a state-wide, cross-sectional, population-based health monitoring survey in nine languages among ASR in collective accommodation centres. Questionnaire items capturing health status, access to care and sociodemographic variables were taken from established surveys and translated using a team approach. Random sampling on the level of 1,938 accommodation centres was employed to draw a balanced sample. Multilingual field teams recruited eligible participants using a “door-to-door” approach.

Results
Fieldwork was conducted in 58 centres, obtaining a response rate of 42.2% (n = 412). Age, sex and nationality of the included sample were comparable to the population of asylum applicants in Germany. Adults reported longstanding limitations (16%), bad/very bad general health (19%), pain (25%), chronic illness (40%), and depressive (46%) and anxiety symptoms (45%). 52% utilised primary and 37% specialist care services in the previous 12 months, while reporting unmet needs for primary (31%) and specialist care (32%). Younger and male participants had above-average health status and below-average utilisation, in contrast to older and female ASR.

Conclusions
Our health monitoring survey yielded reliable estimates on health status and health care access among ASR, revealing relevant morbidities and patterns of care. Applying rigorous epidemiological methods in linguistically diverse, transient and marginalized populations is challenging, but feasible. Integration of this approach into state- and nation-wide health monitoring strategies is needed to sustain this approach as a health planning tool.

Key messages
Applying rigorous epidemiological methods in linguistically diverse, transient and marginalized populations is challenging, but feasible. Sustainable integration of multi-lingual epidemiological methods is required in state- and nation-wide health monitoring to capture health status and access to health services for ASR.
Establishment of Centre of competence “Leonardo Da Vinci” in Medical University of Pleven, Bulgaria
Authors: Yankulovska S , Tomov S l 
Published: November 2019

Abstract

Issue/problem
In 2016 Ministry of education and science initiated a call for projects for establishment of centres of competence aiming to increase the level and market orientation of the research activities in Bulgaria and to support the development of innovation capacity. The center of competence on personalised medicine, 3D and telemedicine, robotic and minimally invasive surgery in Medical University of Pleven is to be developed from 2018 to 2023.

Description of the problem
The objectives are: 1) To create a high-tech research and educational product with long-lasting tendencies to improve the community’s scientific development and level of public health; 2) To set up research teams of young researchers to write modern PhD theses and publications in high impact scientific journals; 3) Ð¢Ð3/4 integrate research results into the business.

Methods
classical and virtual microscopy, computer-assisted morphometry, clinical-genealogical method, functional endoscopic sinus surgery, laparoscopic transanal total mesorectal excision, hysteroscopic morcellation and others.

Results
About 2500 patients will be treated in the centre for 5 years. Diagnostic panels will be developed for different cancer types and the most common hereditary diseases within Bulgarian population. Individual orthotics suitable for 3D printing will be developed and patented. Tissue transplants will be created for body models that will be used for training on robotic surgical simulator. The telemedicine center will allow distant consultations with other centers, specialized training and research in virtual reality. The teams are experienced in the genetic testing and robotic surgery. Till 2015 all robotic surgeries in Bulgaria were performed in Pleven. The proportion for 2016, 2017 and 2018 was respectively 81.1%, 71.5% and 32% due to the increase of number of robotic surgery centres. Pleven’s centre has strong training traditions to guarantee the high quality of planned 72 workshops and seminars.

Key messages
The introduction of new technologies requires new models of training of health professionals to develop the necessary skills to take full advantage of their benefits. Better dissemination of innovations increases the access of population to health care of good quality and the achievement of highest attainable standard of physical health.
Final Products: a regional integrated output assessment in Public Health services, 2017-19 Italy
Authors: Smaniotto C , Del Bianco F , Giardinelli E , Bravo G , Oppi C , Campanale C , Cinquini L , Brusaferro S 
Published: November 2019

Abstract

Issue/problem
The classification of Public Health services (PHS) and related healthcare information systems (HIS) in Friuli Venezia Giulia, Italy, are complex and non-homogeneous. Since 2017 the Region has been realigning HIS according to the new Final Products (FP) System to classify PHS. The aim is to implement an integrated FP-based HIS, easing data transmission and improving the quality of planning, scheduling and expense reporting activities.

Description of the problem
From June 2017 to October 2018 68 Public Health professionals (PHP) from 10 Public Health areas outlined 102 PF from HIS through flowcharts and technical dossiers. Afterwards (10/5th-10/29th 2018) they assessed HIS through a questionnaire of 24 items. Statistical analysis was performed with Fisher’s Exact Test, stratifying 4 categories (physician, veterinarian, prevention technician, other professional). In June-July 2019, through a matrix-based assessment, PHP of regional PHS were invited to weight each FP activity on the basis of involved personnel and possible required transfer (valorisation phase).

Results
The questionnaire got 45/68 responses (66%). Among responders, 27% reported a HIS for their PHS not being available at all; 65% of responders agreed on the usefulness of an integrated regional HIS for PHS. Fisher’s Test showed significant differences in HIS features according to profession, as interoperability with national/regional databases (p = 0.0144), mobile usability for external activities (p = 0.0302), real correspondence between monitored data and performed activities (p = 0.0215). Valorisation was performed by 445/557 PHP (80%).

Lessons
PHS currently often deal with functional flaws or inappropriateness of HIS when compared to real activities. Valorisation data will be submitted to the attention of policymakers in October 2019 in order to apply an integrated classification of PHS considering both effectiveness and generation of value of activities performed in Public Health.

Key messages
Healthcare is a multilayered product and measuring healthcare outputs requires managerial skills and tools, to assess need of resources and to plan activities. The regional Final Products project defines a uniform classification of Public Health services and implements a standardised accounting system for activities performed in Public Health.