bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health system recovery from Covid-19: What policies are health systems using to tackle backlogs and bring down waiting times in the wake of the pandemic?
Authors: Reed S , Schlepper L , Edwards N 
Published: October 2022

Abstract
The pandemic has left even the most well-equipped health systems vulnerable and required difficult trade-offs to balance both Covid-19 and non-Covid-19 health services. Across the globe, planned and routine health services have been scaled down during peaks of the crisis to meet the needs of acute and Covid-19-related care, resulting in growing care backlogs and increase in the number of patients waiting for treatment. To identify potential policy solutions, we have consulted the Covid-19 Health System Response Monitor, interviewed experts and analysed recovery strategies in 16 OECD and EU countries. Many country responses display striking similarities despite very real differences in the organisation of health and care services. These include:
1) increasing the supply of workforce by widening the scope of authority for different roles, investing heavily in recruitment and training for key roles, and improving the terms and conditions of work;
2) boosting productivity by introducing financial incentives and targets, reconfiguring facilities to better separate planned and emergency work”, optimising referrals and waiting list management, and outsourcing more care to the private sector; and
3) investing in out-of-hospital alternatives to care, including expanding primary and community care models and developing digital, home care and rehabilitative capacity
Policymakers will need to balance the immediate pressures of clearing backlogs with long-term measures that place services on a more sustainable footing. International experience shows how these can be at odds, especially if actions taken in the short term exhaust an already depleted workforce, or resolve Covid-19-specific problems but leave services less prepared for tomorrow's challenges.
Euregional Youth Survey Structure and results of the cross border youth surveys
Authors: Philippsen D 
Published: October 2022

Abstract
The Euregional Youth Study takes place at intervals of currently 4 years since 2001. The Dutch, German and Belgian municipalities of the Euregio Meuse-Rhine (EMR) can participate. Pupils in the 8th and 10th grades are asked about various topics in an online questionnaire. These include: physical and emotional well-being, physical activity, nutrition, media behaviour, drug use and school behaviour. In 2019, 88 schools with more than 13,500 participants took part. With its cross-border approach, the study provides the opportunity to compare the living conditions, behaviour and health situation of pupils in the three countries. Ideally, this would result in common policy and prevention approaches and best practice options. For example, there are differences between the regions of the EMR regarding drug use or overweight, while risky media use is rather universal. It is striking that the Dutch participants almost consistently show the best values. It is also important to stress the importance of insight in policy along the border. Changes in policy actions have a huge effect on border regions. Examples are:
The change in drinking age in the Netherlands: from 16 to 18 resulted in organizing their parties in the neighbouring countries.
The change in cannabis policy in the Netherlands in the 2000s, is clearly reflected in the purchasing behaviour of German young people.
Independent of the cross-border aspects, the Euregional Youth Survey provides a standard data set (also with trends over time) for the adolescents of the participating districts, which the local health offices could not realise on their own and which is not self-evident for German municipalities.On the other hand, it is certainly considered as problematic that there is no binding and uniform participation of the EMR partners in the study. This leads to a partial loss of comparability and significance of the Euregional Youth Study.
Euregional Health Atlas: how to use it for cross-border public health policy Building a common health monitoring platform for the Meuse-Rhine Euroregion
Authors: Stabourlos C 
Published: October 2022

Abstract
Studies show that European border regions -that account for over 30% of all European citizens- are faced with more deficits. Living in a border region still means fewer possibilities in the fields of employment, mobility, care and well-being. In order to tackle this, an absolute prerequisite is to dispose of relevant and comparable data across borders. The Euregional Health Atlas is an initiative that aims to collect and to visualize validated and comparable data for the municipalities of the Euregio Meuse-Rhine (EMR: Zuid Limburg (Nl), Zweckverband Aachen (De), the provinces Limburg, Liège, Ostbelgien (Be)). Themes addressed are: demographics (population, socioeconomic status, vulnerable groups), health care (care contacts, difficulties in daily living, chronic diseases, mortality), lifestyle (use of alcohol, smoking, weight, nutrition) and quality of life (perceived health, happiness).
Data used to feed the Euregional Health Atlas are derived from registers, health surveys and from former and current Interreg projects like the Youth Euregional Scan (YES). During the COVID-19 pandemic, data on the daily number of cases and 7-day incidence, the number of tests performed, the hospitalisation rate and the number of reported deaths related to Covid-19 were processed and presented on our dashboard and this not only for the Euregio Meuse-Rhine, but also for other Euregios. The Euregional Health Atlas is a work in progress: existing data are continuously being updated to improve their suitability for comparison purposes and new data are added to broaden the perspective. It contributes to knowledge-sharing, mutual understanding and cross-border policy development. The Atlas is a free, easily accessible platform, available for everybody; health care professionals, policy makers and citizens, see www.euregionalhealthatlas.eu!
Concept of cross border policy in public health: what is it and how does it
Authors: Van der Zanden B 
Published: October 2022

Abstract
Cross-border cooperation depends on many factors. Not least because of the perception of a border and its influence. Literature shows that the perception of a border is different for different stakeholders. A citizen has a different perception of a border than a policy worker of the government. This influences the effects of cross-border policies. The first three presentations already show this indirectly. Apart from the perception of a border, it is important to look at how cross-border policy in the field of public health is actually made in Europe. On the basis of European policy documents, it has been analysed how policy and policy issues concerning cross-border public health care in Europe are established and what can be deduced from this for policy in cross-border regions such as the EMR. Elements in this are the ‘existence’, ‘genesis’, ‘influencers’ (+/- stakeholders) of cross-border policy and the potential relation with public health. Questions that will be addressed during the presentation are: What does cross-border policy look like? Is this also available in the field of public health? When yes how has this come about (genesis)? How is this concept of cross-border policy influencing the current way of looking at cross-border public health? Are there currently main ‘influencers’ that have impact on creating cross-border public health policy?
Sustainable dietetic models: strategies for communication and promotion
Authors: Scazzina F , Biasini B , Rosi A , Franchini C 
Published: October 2022

Abstract
Global Burden of Disease identifies the makeup of diets as a significant risk factor for mortality and morbidity, with 11 million deaths and 255 million disability-adjusted life years attributable to dietary risk factors. 690 million people lack sufficient food and economic projections suggest that COVID-19 pandemic may add an additional 83 to 132 million people to the ranks of the undernourished, as the outbreak has exacerbated the global food flaws and insufficiencies, impacting the most vulnerable populations. Diets and related food systems also contribute to significant environmental degradation and climate change. Demand for animal-source foods is also increasing, particularly in emerging economies, which entails risks for the environment. 1.3 billion tons of food are wasted globally yearly, utilizing 38% of total energy consumption in the global food system. The real cost of acquiring enough nutrient-rich food to meet national dietary guidelines for a healthy diet exceeds available income for ∼38% of the world's population. A balanced diet that meets food-based dietary guidelines calls for even larger quantities of more costly food groups than would be needed just for nutrient adequacy, owing to their many functional attributes beyond just the essential nutrients that they contain. Faced with this scenario, there is urgent need for an appropriate strategy to increase people's awareness of the relationship between specific food choices and health and to facilitate the educational environment on this issue. Actual examples of current strategies for communication and promotion of healthy and sustainable diets will be discussed. With awareness and knowledge, clear and precise information, a supportive social environment, available and accessible healthy and sustainable food items, and the implementation of related policies, individuals have a great potential to achieve healthiness and environmental sustainability by choosing healthier and more sustainable foods.
What is interdisciplinarity, and how can we apply it to research and practice?
Authors: Freye M 
Published: October 2022

Abstract
The concept of interdisciplinarity is an integral part of contemporary academia. Successful academic careers or innovative study programs: Interdisciplinarity is often claimed, expected, or required. Public health scientists also claim to facilitate health-related interdisciplinary research under the umbrella of public health and to apply findings from interdisciplinary research in practice. These aspects already point to one of many problems in using the term interdisciplinarity: When using the term, it is not always evident whether it is a merely descriptive term or whether normative expectations are also associated with it. We consider that successful interdisciplinary research is enabled by a shared understanding of what is meant by interdisciplinarity in concrete research projects. This urgency is re-emphasised by the participation of new disciplines in digital public health. Through this presentation, we would like to give participants a brief theoretical overview of the concept of interdisciplinarity and related concepts such as transdisciplinarity and multidisciplinarity. In this way, all workshop participants will have a shared understanding that will serve as a basis for further work in groups during the workshop. After the terminological distinctions, we will turn to the practical challenges of interdisciplinary research, which arise beyond the clarification of terms. We will outline these challenges in fundamental terms and then provide some best practice examples on how interdisciplinarity in scientific competence can be promoted among individual scientists and in research groups. In the best case, the workshop participants will draw inspiration for the subsequent group work from the best practice examples to generate new motivation for interdisciplinary work in this way. A concise summary will conclude this compact-informative presentation. Merle Freye will host the tables on law and ethics during the world coffee.
Health System Performance Assessment: how equitable is the Belgian health system?
Authors: Van de Voorde M , Bouckaert N 
Published: October 2022

Abstract
Access to and delivery of effective, high quality and affordable healthcare are fundamental objectives that have shaped health policy and the universal health insurance system in Belgium. A health system should be evaluated against these objectives. Monitoring equity within a health system - an equitable distribution of healthcare use and of payments for healthcare - is a core component of a health system performance assessment. We use the horizontal equity principle to evaluate equity in healthcare use in Belgium. Unfair inequality in healthcare use is measured by the fairness gap, comparing actual use and expected use corrected for needs. The empirical analysis was conducted using a linked dataset which contains data from the European Union Statistics on Income and Living Conditions (EU-SILC) and administrative data. Two sets of results are reported for a selected set of indicators of use: the deviation between the average fairness gap in the population and the average fairness gap in a subgroup of interest and an assessment of systematic socioeconomic inequity in the fairness gap using the absolute concentration index. We show that important socioeconomic inequities in healthcare use exist. Inequities differ by type of care, e.g., the use of hospital care and medications is more equitable than the use of GP, outpatient specialist and dental care. When accounting for healthcare needs, we find that use among high-income groups and individuals with a high educational attainment is higher compared to financially vulnerable groups (individuals at risk of poverty or with severe material deprivation, unemployed, singles). Also, individuals who are entitled to an increased reimbursement of healthcare costs, show a lower use of outpatient specialist care than expected based on their care needs. On the other hand, increased reimbursement is effective in improving accessibility to GP care, while for other financially vulnerable individuals we find a lower use of GP care.
Results from a systematic review of interventions promoting mental health literacy in youth
Authors: Fretian A , Kirchhoff S , Okan O , Bauer U 
Published: October 2022

Abstract

Background
Mental illnesses are amongst the leading causes of ill-health and disability, with most onset of many mental health problems (ca. 75%) emerging before the age of 25 years. Thus, adolescence is an important time period for preventive measures, such as strengthening mental health literacy (MHL). This review aims to give an overview of those interventions which promote MHL on the long run.

Methods
Five databases were searched for English or German articles published between January 1997 and May 2020, leading to a total of 4,375 original articles. Interventions were included only if they had measured MHL and/or stigma on three different time points, had a control group, and delivered an intervention program. Studies reporting means and standard deviations for the outcomes of interest were further included into a meta-analysis using a random effects model. The analysis was carried out with STATA 16.

Results
25 studies were included into the review, and 13 of them were suitable for the meta-analysis. The great majority of studies (76%) were conducted within schools and the addressed topics were general mental health, depression, and schizophrenia. Interventions mostly used psychoeducation or a combination of educational elements and contact as delivery method. The combined use of educational and contact components led to worse results for mental health literacy, but not stigmatizing attitudes or social distance. Generally, interventions led to positive outcomes. The changes were sustained for mental health literacy d = 0.48, as well as for stigmatizing attitudes d = 0.30, and social distance d = 0.16, after an average follow-up of about 5 months.

Conclusions
MHL-interventions targeting adolescents are mostly conducted within schools and generally have a brief follow-up period. They show a stable improvement in mental health literacy and are to a smaller degree able to destigmatize mental illness or improve social distance.
Teachers’ mental health literacy and action competencies
Authors: Dratva J , Kerry M , Albermann K , Robin D 
Published: October 2022

Abstract

Background
Teachers are very important in mental health promotion and early recognition of mental health burden (disorder, illness). Teachers’ surrogate mental health literacy (MHL) may be key to improving mental health in youth but has been little investigated. We assessed surrogate MHL in Swiss teachers and tested a measure of mental health action competencies (MHAC).

Methods
In 2020, all teaching and support staff at compulsory school level were invited to an online survey covering individual and professional characteristics, MHL (finding, understanding, critical appraisal of information) and action competencies (adapted scale Ahnert et al. 2016, range 17 - 68) personal experience with students’ MHB. Data was explored descriptively and with multivariate regression. Item response theory analyses were conducted to examine internal psychometric MHAC scale properties, and group-mean differences tested between school levels.

Results
Participation rate was 38% (N = 459). Nearly all participants had taught at least 1 mentally burdened student in the past year (average 4.7). 77% felt experienced to very experienced regarding these students. Only 32% felt they had sufficient tools and teaching resources. Participants felt it was difficult to very difficult to find (47%), understand (53%) and appraise (90%) information on students’ mental health. Kindergarden teachers and teachers without class responsibility showed significantly lower MHL. Internal psychometric properties of the MHAC measure support the use of a 1-factor scale and indicates discriminant validity with respect to age; experience and school level, median score was high (P50 48, P25 44, P75 53), but single items, e.g. on suicide signs, were rated low.

Conclusions
While overall subjective MHAC are high, teachers are insecure regarding MHL and report a lack of tools and resources. Targeted training could strengthen surrogate mental health literacy with a focus on critical appraisal and certain action competencies.
Impact of COVID-19 on emergency department use among home care recipients
Authors: Peano A , Minutiello E , Politano G , Dalmasso M , Gianino MM 
Published: October 2022

Abstract

Background
The impact of COVID-19 pandemic on Emergency Department (ED) was remarkable throughout Europe. We focused upon ED utilization among integrated home care (IHC) recipients comparing ED between pandemic period with pre-pandemic (February -December 2020 and 2019, respectively) in Piedmont, Italy.

Methods
A retrospective observational study was conducted. All recipients of IHC during the two periods studied were enrolled and all ED visits that occurred among IHC recipients were accounted for. Several variables related to IHC admission, reason of ED visits and demographic characteristics were collected. The average of ED visits in pre-pandemic and pandemic periods were calculated. Analyses were stratified by all variables.

Results
Patients enrolled were 11968 in 2019 and 8938 in 2020. In 2019, 3573 patients had at least one ED visit and 1668 patients in 2020. Number of ED visits was 5503 in 2019 and 2197 in 2020. The average of ED visits in 2020 has reduced in comparison with 2019 (0.464 C.I. [0.44-0.489] and 0.24 C.I. [0.227-0.252], p &lt; 0.001 in 2019 and 2020 respectively). This reduction is regardless of sex, age, duration of IHC, presence of a non-family caregiver or reason for ED visits, except for abdominal pain, cardiac rhythm alteration and gynaecological symptoms. The averages of ED visits were significantly lower for IHC recipients with neoplasm (0.549 C.I. [0.513-0.585] and 0.328 C.I. [0.298-0.358], p &lt; 0.001, and with low level of emergency (1.77 C.I. [1.662-1.877] and 1.397 C.I. [1.348-1.447], p &lt; 0.036), but an increase in mortality rate was not registered.

Conclusions
Our results showed a reduction of ED visits among integrated home care recipients in pandemic period in comparison with pre-pandemic period. If the reduction can be the consequence of an unprepared health service that needs of necessary changes in its organization, these results suggest a great potential of the home care system to reduce the use of the hospital especially for low-risk conditions.

Key messages
• The COVID-19 pandemic overwhelmed health services of all European Countries. A reduced utilization of ED has been shown by literature, especially during the early phase of the COVID-19 pandemic.
• We showed a reduction in IHC recipients and a great decrease in ED visits among IHC patients in 2020 versus 2019, mainly in oncological patients, while an increase in mortality rate was not reported.
Disruptions of cytological screening procedures due to the COVID-19 pandemic in Slovakia
Authors: Melichova J , Marusakova E , Bilikova L , Sivčo P , Plancikova D , Hazerova D , Pham T , Paulik S , Putekova S , Majdan M 
Published: October 2022

Abstract

Background
During the COVID-19 pandemic, most settings experienced healthcare service disruptions. The majority of cytological screening procedures were postponed to focus on assisting patients infected with COVID-19. In this study, we aimed to analyse the impact of the impact of the COVID-19 pandemic on the uptake of cervical cancer screening in Slovakia.

Methods
Data on cytological screening procedures were obtained from two of the three health insurance companies in Slovakia for the years 2019 and 2020, covering the population of women aged 15 and older. All data were calculated stratified for age groups. Rates of cytological screenings were calculated as the number of procedures per women registered in the insurance company in the same age group and rate ratios were calculated as ratios of the rates for the years 2020 and 2019 for the same age group. Incidence rates were calculated as the number of newly diagnosed cervical cancer cases per women registered in the insurance company in the respective year.

Results
Rate ratios of cytological screening procedures revealed that in both examined health insurance companies, the rate of cytological exams was lower in 2020 compared to 2019 (0.95 and 0.89). This was observed across all age groups. The results showed a clear and statistically significant age gradient, indicating that the level of disruption increased with age. The age group 60-69 years had the highest incidence rate of cervical cancer in 2019, at 54.3 per 100 000. In 2020, the highest rate was 48.3 in the age group 50-59 years. The lowest rates were in children and young adults (&lt;20 years).

Conclusions
This study confirms the significant impact of the pandemic on cervical cancer screening uptake in Slovakia, which may have delayed the diagnosis of cervical cancer into later stages of the disease with a worse prognosis. This may lead to increased mortality and years lived with disability due to this disease in Slovakia.

Key messages
• Disruptions in cervical cancer screenings were observed in Slovakia during the COVID-19 pandemic which may result in an increase in cervical cancer incidence and mortality.
• Strategies should be implemented to maintain cancer screening programs during health emergencies to avoid excessive mortality and morbidity.