bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residents’ perspectives essential for creating healthy neighborhoods in deprived areas
Authors: Dierx J A J , de Bot C M A 
Published: October 2020

Abstract

Background
Health inequality is related to socio-economic differences as people living in deprived neighborhoods show more social and health problems resulting in more sick years and shorter life expectancy. This however has predominantly been studied from the perspective of health and wellbeing professionals, not from the perspective of residents. Interventions based on these professionals' perspectives appear to have little sustainable effects on health and wellbeing, which might be (partly) explained by not matching residents' perspectives. Aim of the present study is mapping perspectives of residents, letting them mobilize their assets and generating their own (sustainable) activities.

Methods
Using the Triple-I action research method, residents' assets and perspectives were mapped in deprived neighborhoods in Breda (N = 12) and Oss (N = 23). Subsequently, residents were motivated to organize activities themselves using their assets which were monitored and described.

Results
In both cities similar results were found. First, residents mention their ability to organize activities, wanting to “meet each other”, “doing activities together”, being “self-reliant”, “inclusive” and “multicultural”. Second, they want to run a community centre with no or little interference of health and wellbeing professionals with the stating argument: “they should first learn how to communicate between each other and with clients”. Third, residents want to create “a green clean and safe surrounding”, while safety was more an issue in Breda than in Oss. In both cities this resulted in a self-run community centre with in Oss over 30 activities involving weekly over 300 residents and in Breda over 8 activities involving over 60 residents.

Discussion
Present study shows that including the residents' perspective and involving their assets and participation are important elements in interventions improving health and wellbeing. However, a longitudinal follow-up is necessary for showing sustainability.

Key messages
Including residents' perspective in developing healthy neigborhoods is an essential element. Most important elements in deprived neighborhoods is the ability to meet other residents and feeling connected and useful.
Urbanisation is a main driver for Aedes aegypti dynamics and arboviral risk in Côte d’Ivoire
Authors: Zahouli J , Koudou B , Müller P , Utzinger J 
Published: October 2020

Abstract

Background
Aedes mosquito-borne arboviruses have (re-)emerged and caused considerable public health concerns in major sub-Saharan African cities subjected to rapid urbanisation. We assessed the effects of urbanisation on Aedes aegypti dynamics and biting pattern, and the risk of transmission of yellow fever (YF) and dengue (DEN) viruses along urban-rural gradient in Côte d'Ivoire.

Methods
We collected Aedes mosquitoes as eggs, larvae/pupae, and adults seasonally in urban, suburban and rural areas using ovitrap, larval survey and human-baited double net trap methods from January 2015 to December 2016. We sampled household data and characterised Aedes larval breeding sites. Ae. aegypti indices and biting rates were compared by area.

Results
Ae. aegypti was the most abundant species in all areas. It showed higher abundance in urban areas (n = 26,072; 99.4%). Larval indices were associated with human activities, including waste and water management. Tires and discarded containers were the most productive breeding sites in all areas. Household water receptacles displayed high Aedes-positive rate (23.6%) in urban areas. Positive ovitrap index was higher in urban (53.5%) compared to suburban (43.1%) and rural (29.7%). Stegomyia indices were highest in urban followed by suburban and rural areas, with respective house index of 67.2, 51.4 and 27.8, container index of 57.1, 43.5 and 19.7, and Breteau index of 95.2, 78.9 and 8.8. Biting rate was 4.3 and 2.7-fold higher in urban (83.5 bite/person/day) and suburban (52.1 bite/person/day) compared to rural (19.4 bite/person/day), respectively. Ae. aegypti indices were higher during rainy seasons.

Conclusions
In Côte d'Ivoire, urbanisation raised Ae. aegypti abundance and biting rate. As a result, YF and DEN risk indices were above WHO-established epidemic thresholds in urban area thus exposing local communities to high risk of getting diseases. Integrated community-based vector control programs should be applied to reduce arboviral risk.

Key messages
Urbanisation raises Aedes aegypti abundance and arboviral disease risk in Côte d’Ivoire. Integrated community clean-up actions are required to control Aedes vectors.
Variability in public health ethics education in EUPHA and ASPHER members
Authors: Butcher F , Schröder-Bäck P , Tahzib F 
Published: October 2020

Abstract

Background
Public health professionals face decisions that have far-reaching ethical implications. Despite this, the field of public health ethics is relatively new, and teaching and training in ethics for public health professionals is “highly variable in quantity and content” [Doudenkova et al 2017]. Building on a prior body of research, surveys of ASPHER and EUPHA members were undertaken to explore current levels of ethics education.

Methods
Online surveys were distributed to ASPHER and EUPHA members with the aims of a) exploring the current status of ethics education in public health courses in ASPHER institutions and b) understanding the ethics education of individual public health practitioners in EUPHA.

Results
The ASPHER survey was completed by teaching staff at 35 different institutions between April and August 2019. The EUPHA survey was completed by 232 professionals between October 2019 and January 2020. ASPHER Survey: 39% (n = 12) of institutions awarding master's degrees in public health had one or more degrees in which no ethics was taught. Only 48% (n = 13) of institutions had someone in their academic team formally qualified to teach ethics by holding a master's degree, PhD or further academic role in ethics. EUPHA Survey: Despite 79% (n = 165) of respondents encountering ethical dilemmas on at least a monthly basis, 21% (n = 48) reported that they had never had any ethics education or training, and 50% (n = 101) respondents thought that they had too little training in ethics for their professional role.

Conclusions
There remains a significant proportion of those studying or working in public health who do not receive any public health ethics training or education.

Key messages
Ethics education in public health remains variable among ASPHER organisations and EUPHA members, a significant minority lacking any ethics training. To ensure ethically reflective and sensitive public health practitioners, access to ethics education is key.
14.H. Workshop: Ecosystems of HIV risk among key populations in Europe: empirical findings and solutions
Authors:   Organised by: EUPHA Sexual and gender minority health section,   Chair persons: John Pachankis - USA, Kristefer Stojanovski - USA
Published: October 2020

Abstract
Key populations, such as men who have sex with men and persons who inject drugs (PWID) have an increased risk of HIV. These same key populations experience extensive barriers in accessing HIV/AIDS services that are acceptable, accessible, and of high quality. These issues are particularly acute in Eastern Europe where stigma and structural barriers to HIV services are large. This workshop is important because of the rising incidence of HIV in Europe. This is particularly a challenge in Eastern Europe, the only geographical region in the world experiencing rising rates of HIV. Thus, understanding key population's specific HIV risk factors are crucial to address their needs and prevent new infections.
This workshop will give examples of studies on the health and HIV situation of key populations in Europe. The workshop will identify the social and structural contexts that create the specific determinants of HIV risks among the population in the region. The workshop will also discuss avenues and interventions to address their HIV risks. Kristefer Stojanovski (USA) will present results on a European analysis regarding the role of policy and laws in shaping HIV risk among MSM. Sladjana Baros (Serbia) will present findings on the barriers that persons living with HIV (PLHIV) in Serbia face, particularly stigma, that limits their access treatment and access to services. Elizabeth King (USA) will present on stigma's role in perpetuating HIV risk among women who inject drugs in Russia, including ways to address the issues. Lastly, Francisco Fernandes (Portugal) will present results from their work over the last 10 years providing community-based HIV and STI testing and counseling in Portugal.
After the individual presentations, the audience will be invited to a monitored open discussion on the papers, and how the findings can help inform public health and policy to address HIV in Europe. The situation for HIV and key populations in Europe is worrisome from a public health standpoint, especially as research shows how structural factors can drive HIV risk and infection. Our workshop aims to facilitate a conversation on understanding the structural situation and exploring ways to reduce the disproportionate health burden and risk factors. Given this year's theme of public health for the future of humanity, we believe our workshop asks salient questions to address HIV risk, globally.

Key messages
Key populations in Europe have an elevated risk of structurally induced stigma, which influences HIV risk. Disproportionate HIV burdens among key populations require urgent attention from public health professionals given the rising rates of HIV in Europe.
Learnings from a decade experience of a community-based HIV and STI testing and counseling center in Lisbon – Portugal
Authors: Fernandes F , Meireles P , Rocha M , Duque M , Barros H 
Published: October 2020

Abstract

Background
In the context of an increased number of men who have sex with men (MSM) being diagnosed with HIV infection in many European countries, it became a matter of maximum priority to consider new strategies to monitor and tackle the epidemic. In this scenario, CheckpointLX and a cohort study were projected as a sexual health and research center oriented towards MSM in Portugal.

Methods
In 2011 CheckpointLX was launched in Lisbon as a community-based center for anonymous and free rapid HIV and other sexually transmitted diseases (STI) testing with a strong component of counseling for sexual health, specially targeted at MSM. In the case of a reactive test, a medical appointment is proposed and scheduled. The Lisbon Cohort of MSM is an ongoing observational prospective study conducted at CheckpointLX. Collected data include sexual behaviors, preventive strategies, and history of STI.

Results
Until July 2019, 7,351 HIV-negative MSM chose to participate in the Lisbon Cohort of MSM. 3,523 had at least one follow-up visit. The median age was 29 (IQR 25 - 37), and 27% were born in a foreign country, including 15% born in Africa and South America. HIV incidence increased up until 2015, reaching 5 reactive tests per 100 tested annually. There has been a sustained decrease in HIV observed since 2015. The use of HIV prevention tools was provided: 31% used condoms consistently, 3% reported PrEP, and 4% PEP.

Conclusions
A decade since the beginning of this experience shows positive results, such as increased access and testing. We promoted a stigma-free service that facilitated MSM's and other key population's access to sexual health care. We contribute unique data for assisting in the monitoring of the Dublin Declaration in Portugal.
ChildMove: Transit experiences and mental health of unaccompanied refugee minors
Authors: Derluyn I , Verhaeghe F 
Published: October 2020

Abstract
Since early 2015, the media continuously confront us with images of refugee children drowning in the Mediterranean, surviving in appalling conditions in camps or walking across Europe. Within this group of fleeing children, a considerable number is travelling without parents, the unaccompanied refugee minors.
While the media images testify to these flight experiences and their possible huge impact on unaccompanied minors' wellbeing, there has been no systematic research to fully capture these experiences, nor their mental health impact. In this paper, we present the first results of the ERC-Starting Grant Project 'ChildMove', whereby we followed a large group of unaccompanied refugee minors (n = 200) over the course of two years in order to document their transit experiences and the mental health impact of these experiences. Our study started in different transit countries (i.e., Greece, Italy and Belgium; an additional cross-sectional study was carried out in Libya) and from there one we followed the minors wherever they went on their migration route. During this longitudinal follow, we collected data using a mixed-methods approach (i.e., self-report questionnaires on difficult experiences and mental health symptoms and in-depth interviews) at each of the three measurement moments. The data reveal that these youngsters experience a continued series of difficult events during their trajectories, such as being detained, violence at the borders (including borders within Europe), push-backs, abuse by smugglers and other persons, appalling living conditions, racism, etc., but also after (temporary or permanent) settlement in Europe. The participants also report over the course of the follow-up high levels of mental health problems (i.e., symptoms of depression, anxiety and posttraumatic stress).
Life expectancy inequalities and their evolution in Italy. How these impact on the equity of the pension system?
Authors: Ardito C , D'Errico A , Leombruni R , Ricceri F , Costa G 
Published: October 2020

Abstract
The article aims to present the most recent evidence on the life-expectancy differentials across socio-economic groups in Italy and discuss their implications in terms of equity and fairness of the pension systems. In fact, Italian pension rules are set according to average life expectancy, ignoring the shorter life expectancy at retirement observed in more disadvantaged socioeconomic groups, as well as in many occupations and economic sectors. This produces unintended consequences in terms of redistribution, which reinforce and exacerbate inequalities present in the labour market.
This article will present updated evidence on the evolution of life expectancy inequalities across job titles, sectors and occupational class in Italy to assess whether the social gap, already highlighted by previous scholars, has been widening or narrowing. Only a few studies are available in the literature on this subject, almost exclusively from the US, which suggest that the gap in terms of life expectancy at ages approaching retirement is increasing, mainly driven by a faster improvement in longevity across most advantaged groups. It is crucial to examine the trend in a country like Italy where retirement age has been strongly tightened and linked automatically to average life expectancy in the population. These results may be important in order to inform the public debate about future reforms on retirement rules and in particular for the definition of the so called “arduous and hazardous jobs” (in Italian: lavori gravosi), that could be exempted from the postponement of pension age.
In order to estimate life expectancy differentials among different occupations, three of the largest Italian longitudinal studies will be used: the Turin Longitudinal Study (SLT), the Italian Longitudinal Study (SLI) and WHIP-Health Study, all studies where it is possible to conduct mortality follow-up through administrative record linkage with archives of mortality of large cohorts until recent years.
Understanding the relationship between alternative pension systems and healthy ageing: cross-national and quasi-natural experimental analyses of 27 EU countries
Authors: Stuckler D 
Published: October 2020

Abstract
How do pension systems contribute to healthy ageing? It is widely speculated that more generous and stable pensions could promote better ageing outcomes, as well as could potentially result in lowered healthcare costs. Yet little is known about how alternative pension regimes shape health and healthcare expenditures in older persons. Here, using multi-level, cross-country data from the European Survey on Health, Ageing and Retirement (SHARE, n = 140,000) covering 27 nations, we test the hypotheses that more generous pensions, as well as systems with defined benefit (which are predictable and more stable) compared with defined contributions, associate with improvements in self-reported health, quality of life, better physical and mental health scores, and lowered healthcare utilization. To do so we report the results of two sets of studies. In the first, we evaluate cross-national longitudinal SHARE integrated with OECD pension generosity and replacement rate data. In the second, we perform a series of quasi-natural experimental studies in Ireland, Germany, and Greece, taking advantage of pension reforms mostly involving budgetary reductions that occurred in the wake of the Great Recessions in Europe. For the proposed workshop we present our results, as well as provide methodological insight into how to perform such integrated epidemiological-economic analysis. We will further discuss the implications for policy and for future research investigating the relations between pension and health systems.
The Leefplekmeter – Capacity-building for municipalities with the Dutch Place Standard Tool
Authors: Acda A 
Published: October 2020

Abstract
After being introduced to the Place Standard the Netherlands were the first country to test and adapt the tool. In this presentation we will focus on the following subjects: The need for this tool in relation with the Dutch context of a national programme to tackle health inequalities, coinciding with new legislation focusing on integral plans for the physical environment and the need to involve citizens. Half of the Dutch local governments are committed to working jointly on a healthy environment, but the process of working together can be daunting. The Dutch adaptation of the Place Standard Tool called “Leefplekmeter” can help to bridge the gap between the two domains using the window of opportunity the new legislation offers.
The adaptations: which adaptations were made and what was the effect? The tool was simplified and stripped from some health content. This was a strategic choice which was thought to make it easier for professionals in the physical environment to pick up the tool.
Lessons learned: how was the tool introduced, used and which strategies were used to implement the tool? Currently the tool is in demand but the support structure could have been better.
Plans for the future: Several research consortia are asking for a digital version; additionally Pharos is looking into simplifying the tool even further to make it more attractive for people with lower literacy skills.
The potential of the Place Standard Tool to foster healthy urban & rural development with an equity lens
Authors: Koeckler H , Sammet T , Mekel O C L , Plantz C 
Published: October 2020

Abstract
The Joint Action on Health Equity Europe (JAHEE) identified municipalities as relevant level of intervention to promote health equity. Place and health are both determinants of inequity and could be influenced through policy fields such as urban or social planning. One major challenge of this health in all policies (HiAP) approach is inter-sectoral collaboration within administration, politics and with other stakeholders, including the public. Within different sectors, concepts of equity vary and are not on the agenda of everyday work. We explore the potential of the German adaptation of the Place Standard Tool to foster inter-sectoral multi-stakeholder dialogue on health equity in urban and rural contexts, and how it can possibly support local governance for health in all policies in Germany.
Our presentation is based on a transfer project of the Place Standard Tool to the German context within the JAHEE project. In 2020, the tool is pilot tested in four municipalities in Germany, which differ in size, urban and rural context and which are located in two federal states. It is applied in real municipal planning and participation processes. In this pilot study we also explore how the Place Standard Tool could be used to reach those people of the public who are usually underrepresented in healthy urban and rural development. This is essential to follow aspects of procedural justice and empowerment which are one dimension of health equity.
Exploring young professionals’ hesitation to joint German public health service – a mixed method study
Authors: Stratil J , Arnold L 
Published: October 2020

Abstract

Background
The “Öffentliche Gesundheitsdienst (ÖGD)” is the central public health institution in Germany. The ÖGD comprises of all public sector institutions responsible for protecting and monitoring the population health on the federal, state, county and municipal level. Its key functions contain identifying and addressing public health threats, and promoting the heath of the general population. Despite the important role, the ÖGD has not been successful in attracting and recruiting young professionals; a situation aggravated by an expected wave of retirements. We aimed to identify barriers and discuss solutions to promote the attractiveness of working in the German public health service among young professionals.

Methods
Firstly, we conducted a theory-based online-survey of medical and public health students enrolled in Germany. Secondly, we conducted key-informant interviews with a purposive sample of former public health students meanwhile working at the local health authority or a public health department as well as leading persons in the same institutions.

Results
In the survey of more than 2400 students, among others identified barriers included: students not being aware of the ÖGD and its activities, negative images of the ÖGD, and unattractive job profiles. In the interviews, some participants expressed or experienced a strong preference within the ÖGD to attract medical students to the detriment of public health students. A lack of appreciation and strictly hierarchical work contexts were identified as further obstacles.

Conclusions
The survey and interviews identified several potential barriers and obstacles for young professionals to join the public health workforce in Germany. Likely, major reforms within the ÖGD as well as in the education of medical and public health students is necessary to overcome this challenge. The results of the qualitative study identify several potential solutions for improvement.

Key messages
We conducted a mixed-method study of medical and public health students and young professionals to explore the challenges of the German public health service to attract young professionals. Our study shows that major reforms are likely necessary to increase the attractiveness of the German public health service.