bluuebunny/crossref_metadata_2025_split huggingface dataset:
10.M. Scientific session: JA ImpleMENTAL Abstract Workshop
Authors:   Organised by: JA ImpleMENTAL, EUPHA-PMH,   Chair persons: Vasileia Konte (Greece), Jutta Lindert (EUPHA-PMH)
Published: October 2024

Abstract

JA ImpleMENTAL is major initiative across Europe and was initiated on the request of Member States, on October 2021 under the European Union 3rd Health Programme. The workshop is organized by JA ImpleMENTAL in partnership with EUPHA Mental Health Section, a member of the JA ImpleMENTAL Stakeholder Forum. It will include four presentations that will contribute to an interesting discussion about the future of community mental health services that are user-centered, recovery-oriented and human rights based as well as about the synergies with national strategies and the EU Initiatives. Vasileia Konte the JA ImpleMENTAL Coordinator will provide an overview of the Mental Health System Reforms based on the Belgian Best Practice model, which is implemented in 11 countries. It will elaborate on key activities and prioritized key areas of mental health system transformation as well as enablers, barriers and key lessons learned from the implementation process. Danijela Štimac Grbić from Croatia will present the Croatian experience in the implementation of a mobile rehabilitation team for providing psychosocial interventions in the community in which peer workers are employed for the first time. Based on the successful work of the mobile team, Croatia has included 30 new mobile teams in its network of public health services that will operate throughout Croatia. Teresa Nicolas Lopez from Murcia Spain will present the project “Inclusive Life Projects” which offers comprehensive community care to adults with severe mental illness within projects of autonomous living and provides a concrete and real response to their needs, with the ultimate objective of avoiding the risk of institutionalization. Anna Paradesioti from Cyprus will focus on how to achieve a smooth transition from inpatient to community mental health services promoting collaboration among those services and professionals, by adopting an intersectoral approach. Jutta Lindert will provide valuable comments by bringing helpful insights and views of the Stakeholder Forum.

Key messages
• Transformation towards community based care increase availability and efficiency of services.
• User’s centered human rights based recovery approach care with engaging stakeholders including people with lived experience.
The indirect costs of motherhood and fatherhood: impacts on income, working hours, and perceived health across 32 European countries
Authors: Leão T , Perelman J , Amaro J , Mamelund S E , Pereira M , Severo M 
Published: October 2024

Abstract

Background
Parenthood may affect men’s and women’s personal lives, professional careers, and well-being differently. In the last decades, structural modifications in gender norms, the labor market, and family-supporting policies have occurred, but with cross-country variations, even within European borders. This study aimed to update the estimates on the impact of parenthood on men’s and women’s income, working hours, and perceived health status, and better comprehend their variation across 32 European countries, using a longitudinal approach.

Methods
Data from the European Survey on Income and Living Conditions (2004-2020) were used to estimate the income variation and the likelihood of transitioning into a non-income status, less than 40 weekly hours, and less than very good health status, from one year before to one year after parenthood. Estimates were done by sex and country. Pooled effects were estimated using random effects meta-analysis.

Results
We found a short-term 29% income penalty for women and a 12% income premium for men after parenthood. Seventy percent of women who transitioned their status after motherhood shifted to work less than 40 hours per week while no effect was found for men. Regarding perceived health, no shifts were overall observed. A large cross-country heterogeneity was found.

Conclusions
Motherhood-related income penalties concurred with losses of employment and reductions of weekly working hours, while among men the income premiums were not necessarily coupled with transitions to employed status or 40 weekly working hours. The cross-country heterogeneity is, probably, multifactorial, depending on countries’ policies, norms, labor market, and social structure.
The long-term impact of parenthood on women and men’s income in 26 European countries
Authors: Moreno J , Severo M , Mamelund S E , Perelman J , Leão T 
Published: October 2024

Abstract

Background
Historically, women’s roles were predominantly associated with motherhood, leading to significant career interruptions and lower incomes compared to men. As gender roles have evolved, as did labor policies protecting parents, it would be expected that income penalties in women and income premiums in men would attenuate, especially in the long term. This study aims to assess the association between the number of children and the income earned by women and men in older adulthood.

Methods
We used data from wave 8 of the Survey of Health, Ageing, and Retirement in Europe (SHARE), which includes 43,772 participants with 50 years old or over and their partners, living in 26 European countries. Multilevel analysis was employed to estimate the association between having children and the total, employment-related, and pensions-related incomes, adjusting for sociodemographic characteristics and clustering by country.

Results
The highest median annual total income was identified for individuals living in Bismarkian (€19,000) and Scandinavian countries (€17,708), more than twice the income earned in the European remaining countries. Having had children was associated with lower total income (OR = 0.870 for 1-2 children, OR = 0.773 for 3-5 children, OR = 0.666 for more than 5 children; p &lt; 0.005), and women received lower total incomes (OR = 0.694; p &lt; 0.001). These patterns were also found for employment- and pensions-related incomes.

Conclusions
There is a long-term negative effect of having had children, and of the number of children, on income, both employment and pension-related, but women continue to receive about 30% lower incomes than men. The adoption of comprehensive policies stimulating a more equal gender distribution of childrearing responsibilities, while protecting parenthood, along with recognizing caregiving responsibilities in pension calculations, could mitigate these disparities and promote gender equity and better living conditions at the older ages.
Developing a structured framework to address vaccination barriers for Newly Arrived Migrants in EU/EEA
Authors: Declich S , Scarso S , Marchetti G , Russo M L , Tosti M E , Papaevgeniou N , Karnaki P , Marceca M 
Published: October 2024

Abstract

Background
Access to vaccination is a critical aspect of public health, particularly for newly arrived migrants (NAMs) in European Union/European Economic Area (EU/EEA) countries. Despite this, significant barriers exist, necessitating urgent attention. This study addresses the pressing need to improve vaccination coverage for NAMs by developing a General Conceptual Framework (GCF) to understand and overcome system barriers and analyzing possible strategies.

Methods
starting from a theoretical conceptualization, the study employed a mixed-method approach, incorporating literature review and qualitative research. The GCF was formulated based on key components of the vaccination process. Barriers and solutions were identified through a non-systematic literature review and qualitative investigation. The GCF served as a guide for study activities, facilitating data integration.

Results
The study outlines a structured GCF comprising five interconnected steps in the vaccination process: entitlement, reachability, adherence, achievement, and evaluation of vaccination. Barriers and solutions identified through literature review and qualitative research are presented. Strategies to enhance professional knowledge, accessibility, adherence, coverage, and intervention evaluation are proposed. Recommendations include proximity strategies, provider training, migrant-sensitive approaches, and robust data collection.

Conclusions
Equitable access to vaccination is paramount for public health, particularly for vulnerable populations like NAMs in EU/EEA countries. The development of the GCF represents a crucial step towards understanding and addressing barriers to vaccination access. Implementation of recommended strategies can significantly improve vaccination outcomes for NAMs, ultimately contributing to the overall health and well-being of these communities.
Paving the way for equitable and guaranteed access to vaccination for Newly Arrived Migrants
Authors: Papaevgeniou N , Karnaki P , Radaios V , Declich S , Serre Delcor N , Ayala Cortes S N , Marceca M 
Published: October 2024

Abstract

Background
There is a gap in knowledge on the country-specific access to vaccination for Newly Arrived Migrants (NAM) in Europe, the obstacles encountered, and the resources available to surmount these barriers. The AcToVax4NAM project addresses gaps in the vaccination process of NAM in 8 European countries by developing country-specific, action-oriented flowcharts of the vaccination pathway that identify barriers and provide barrier-specific solutions. The flowcharts are linked to a comprehensive Repository of Tools aimed at providing tools to overcome system barriers and ensuring equitable immunization access for NAM in all consortium countries.

Methods
Country-specific action-oriented flowcharts group the vaccination pathway for NAM in the five hubs (entitlement, reachability, adherence, achievement, and evaluation) and offer solutions for identified barriers. Participatory research validated these flowcharts via focus group discussions with 84 total professionals FOR health (PFH) involved in NAM immunization. The tools were sourced from all consortium countries, encompass diverse formats and languages, and provide a holistic approach to vaccination promotion.

Results
The validated instrument was deemed useful, relevant, and easily understandable. Validated barriers included the lack of multi-stakeholder collaboration, culturally competent PFH, tailored educational materials, and language barriers. Meanwhile, the linked Repository includes 359 tools categorized according to the five hubs of the vaccination pathway. These can be filtered by language, country, type of tool, year of issuance, and/or intended target population.

Conclusions
The flowcharts and the Repository serve as the basis for a pilot intervention aiming to strengthen healthcare system responsiveness to promote NAM immunization. This participatory approach aims to equip PFH with a clear understanding of system-level vaccination barriers and solutions to enhance vaccination uptake among NAMs.
Empowering Professionals For Health to promote Newly Arrived Migrant vaccination uptake
Authors: Papaevgeniou N , Karnaki P , Radaios V , Russo M L , Marceca M , Declich S 
Published: October 2024

Abstract

Issue/Problem
The imperative task of making access to vaccinations equitable and guaranteed for Newly Arrived Migrants (NAM) in Europe not only highlights a public health challenge but also offers a chance to tackle barriers within health systems. NAMs frequently encounter hurdles in accessing healthcare services, with vaccinations often ranking lower on their list of health priorities. The AcToVax4NAM project developed and implemented tailored interventions for Professionals FOR Health (PFH) working with NAMs in 8 EU countries.

Description of the problem
NAM often overlook vaccinations due to more immediate concerns, and health systems lack a comprehensive approach to vaccinations. Thus, piloted interventions were developed in consortium countries, working with PFH to tackle vaccination barriers. Over 3 months, each country implemented context-specific interventions to enhance health systems’ responsiveness using culturally appropriate tools. Key objectives included developing procedures, improving PFH cultural sensitivity communication skills, and assessing NAM vaccination intentions.

Results
Initial findings vary depending on the country’s context but generally show notable enhancements in PFH cultural competencies and increased willingness among NAM to get vaccinated. The pilots underscored the importance of tailoring strategies to specific contexts and fostering collaboration among stakeholders for a successful intervention.

Lessons
The results highlight the pivotal role of tailored interventions in addressing vaccination disparities among NAM. As PFH working with diverse populations, their role in implementing similar training programs in other settings facing similar challenges is invaluable to achieving equitable vaccination processes. Recommendations encompassing the lessons learned and challenges encountered throughout the pilot implementation will further facilitate the dissemination of this knowledge amongst relevant stakeholders.
Preparing for outbreaks of vaccine preventable diseases: why are prisons invisible?
Authors: O’Moore E 
Published: October 2024

Abstract
From 1 March 2023 to 29 February 2024, 30 EU/EEA Member States reported a total of 5 770 cases of measles, 4 864 (84.3%) of which were laboratory-confirmed. Th7e highest number of cases were reported by Romania- at the time of writing, 11,397 confirmed cases, including 12 deaths from 1 January 2023 to 7 April 2024. Measles is a highly infectious disease. The best mitigation is vaccination which is highly effective. Outbreaks in many countries have been driven by decreases in vaccine coverage with a two-dose measles-containing vaccine (MCV), especially evident since the COVID-19 pandemic. In many countries, vulnerable migrant populations, ethnic groups and communities experiencing social deprivation have been over-represented in cases and under-covered by vaccine programmes. We know that prisons contain such populations. Historic seroprevalence studies of prison populations, which themselves are scant, show that prison populations are under-vaccinated. Prisons are a setting that can cause disease amplification. Given these facts, it is perhaps surprising that many countries in Europe cannot provide specific surveillance data on either cases in prisons or vaccine coverage specifically in prison populations. Further, that prisons are not often cited as specific settings for vaccine catch-up programmes in national or regional programmes. This is despite evidence of measles cases and outbreaks historically and currently in several European countries. In the presentation we will ask why this ‘blind spot’ in national and international disease surveillance continues and what Member States could and should do to prevent the risk of mass outbreaks of measles in prisons, causing pressures on justice and health systems and risking wider community outbreaks. Finally, we will reflect on how this experience should alert us to the risk of other infectious diseases going undetected, unprevented, and under-studies in prisons, threatening our collective health security.
Towards better prepared prisons: monitoring and response to the use of new substances inside prison
Authors: Montanari L 
Published: October 2024

Abstract
The use of new psychoactive substances (NPS) became an emerging issue in prisons in a number of European countries in 2014-2015. Synthetic cannabinoids were the new psychoactive substances most often reported, followed by synthetic cathinones, synthetic opioids and new benzodiazepines. Quantitative qualitative data on prison and drugs provided by 27 European Member States, Norway and Turkey to the EMCDDA (European Monitoring Centre for Drugs and Drug Addiction).
An exploratory study conducted in 2017 found signs of NPS use in prison in 22 countries. Based on 2021-2022 data from a few countries, the lifetime prevalence of NPS in prison ranges from &lt;1 to 19%, with large variation by country. Anecdotal information from 2024 referred to the use of new strong synthetic opioids (nitazene) inside prison. A wide range of physical and mental health harms (e.g. psychosis, disorientation, suicidal ideation, aggressiveness to others or self-harm) has been associated with acute intoxication by, and chronic consumption of NPS inside prison. Recent overdoses associated with the use of nitazene were reported in some prisons in Ireland and the UK. Additionally, the use of NPS in prison can have a disturbing impact on prison management, internal violence and bullying. To date, interventions to tackle the problems related to the use of NPS in prison have tended to focus on supply reduction and controls. Health and social interventions have begun to emerge, but they remain limited. Despite signs of increasing challenges posed by the emergence of NPS since several years, prisons remain largely unprepared to monitor and respond to those challenges. A new key task of the revised EMCDDA mandate (EUDA - European Drug Agency from 2nd of July) is to be better prepared to monitor, forecast and respond to new challenges in the drug field. Prisons should be prepared to adequately address the new challenges posed by the NPS to benefit the health and security of people living and working in prison.
Framework for approaching federated causal inference based on real-world observational data sources
Authors: Meurisse M , Schutte N , Van Goethem N , Estupiñán-Romero F , Bernal-Delgado E 
Published: October 2024

Abstract

Context
Causal inference methods, generally requiring detailed individual information, allow us to evaluate public health interventions in real-world observational settings. When comparing interventions across borders and for this purpose leveraging distributed sensitive individual-level data, a federated approach can be aided. However, reusing such distributed data while maintaining privacy and interoperability, is a challenging endeavor.

Methodological framework
In the context of the BY-COVID project, a methodological framework to approach federated causal inference was published in October 2023. It is presented as a set of guidelines in the form several consecutive steps, starting with defining a research question, to building a causal model, translating the causal model into data requirements captured within a Common Data Model (CDM), generating synthetic data complying with the requirements captured in the CDM, and developing interoperable analysis scripts which can be distributed for deployment in different federated nodes. The proposed framework was built through implementing and combining existing methodologies and taking into account the principles of legal, organizational, semantic and technical interoperability.

Objectives
This presentation will provide an overview of the proposed framework, and its demonstration by performing an international comparison of the real-world effectiveness of SARS-CoV-2 primary vaccination campaigns in preventing infections at different federated sites. Challenges encountered (e.g. difficulties in complying with data requirements by linking heterogeneous local data sources) and lessons learned in the course of the demonstrator will be highlighted.

Implications
We aim to contribute to a public health research field where the rapid assessment of emerging population-health research questions (potentially feeding into evidence-based policy-making) is achievable, in that way contributing to European pandemic preparedness.
Unraveling Social Health Inequalities during COVID-19 in Belgium: The Vital Role of Data Linkages
Authors: Van den Borre L , Cavillot L , De Pauw Robby , Devleesschauwer B 
Published: October 2024

Abstract

Background
During the COVID-19 crisis, data linkages were set up to efficiently monitor the outbreak and identify vulnerable population groups. Yet, considerable technical, administrative and data security issues have hindered the effectiveness of data linkages as a critical instrument during public health emergencies. This workshop aims to provide a practical demonstration of the challenges encountered in a Belgian data linkage during the COVID-19 crisis, along with the strategies implemented to overcome these challenges. This case study offers insights into the development of a highly sensitive linkage between COVID-19 hospital data and information related to social and health use in Belgium.

Methods
The HELICON data linkage is developed at the individual level to investigate the risk of COVID-19 hospitalization and the influence of various social and biomedical factors during and after the crisis. Data are drawn from data collections on hospitalization from the COVID-19 health surveillance (Sciensano), on the socioeconomic and sociodemographic context (Statistics Belgium), and on healthcare use and reimbursement (InterMutualistic Agency).

Results
A representative case-cohort study is established comprising 1,149,264 million randomly selected Belgians and 44,508 hospitalized patients. Annual follow-up is scheduled over a four-year span, allowing the investigation of pre- and post-pandemic health data from July 2020 to January 2026.

Conclusions
The HELICON data linkage took 3.5 years to complete. Among the many challenges, we were faced with complicated approval procedures, ambiguous data security guidelines, unclear cost estimates, and technical issues related to the analysis environment. Building on these experiences, we explore the strengths and weaknesses of data linkages as a research instrument during the COVID-19 pandemic and discuss which lessons should be drawn to for the post-pandemic era.