bluuebunny/crossref_metadata_2025_split huggingface dataset:
The protective effect of reserves on mental health: a cohort study among undocumented migrants
Authors: Cullati S , Fakhoury J , Duvoisin A , Courvoisier D , Burton-Jeangros C , Jackson Y 
Published: October 2022

Abstract

Background
Resources are essential for mental health. In temporary stressful situations throughout life, people need to use a particular type of resources, their “reserves”, to handle the stress. We do not know whether “reserves” (economic, cognitive, and relational) are more protective of mental health than “conventional” resources. Using a cohort of undocumented migrants experiencing a stressful transition in their life course (in the process of regularisation with local authorities), we will determine which resources, or reserves, and which types, better protect their mental health.

Methods
A two-wave cohort study followed 362 undocumented migrants from 2017 to 2020, half of whom (48%) were involved in a regularisation process with the local authorities. Depressive symptoms were measured with the Patient Health Questionnaire, anxiety with the Generalized Anxiety Disorder. Economic reserves were measured at baseline and follow-up, cognitive and relational reserves at baseline only. Conventional economic and relational resources were assessed at both time points. The association between reserves and resources and mental health were examined using generalised estimated equations adjusted for age, sex and working hours per week, as well as the interactions between reserves/resources and regularisation status.

Results
The indicators of economic and relational reserves were consistently and strongly associated with lower levels of anxiety and depressive symptoms. On the other hand, we found that mental health outcomes were marginally associated with conventional economic resources but independent of the relational resources indicators. We did not find strong evidence of interactions between reserves/resources and regularisation status.

Conclusions
In a vulnerable population experiencing a stressful transition, reserves are more protective than resources. More research is needed in other vulnerable groups experiencing other stressful events.

Key messages
• Undocumented migrants’ economic and relational reserves protect their mental health.
• More research on the protective effect of reserves is needed in other vulnerable groups experiencing other stressful events.
Action recommendations to support people living in precarious conditions during a pandemic
Authors: Öcek Z , Volkmann AM , Klünder V , Basil A , Geise M , Coenen M 
Published: October 2022

Abstract

Background
The COVID-19 pandemic has deepened pre-existing health inequalities. As members of an EU-funded research consortium (SoNAR-Global) tasked with assessing vulnerabilities in five European countries, we explored the impacts of the pandemic on vulnerable populations and identified concrete actions that strengthen resilience. Here, we present our action recommendation development process for populations living in precarious conditions such as refugees, migrants and those living below the poverty line in Munich, Germany.

Methods
The process began by interviewing 82 people who were likely to face vulnerability mechanisms, followed by interviews with 19 community representatives. Based on this qualitative research data, we defined challenges and resilience factors, and matched these with a list of action recommendations. This list, named “Provision of social support to people living in precarious conditions in times of a pandemic”, was considered by a panel with ten experts on migration, health, poverty, social support, and inclusion.

Results
Through discussion, we eliminated one recommendation and re-defined three others and achieved consensus on six recommendations. They are: 1) work towards eliminating opportunity inequity in education, 2) streamline bureaucratic processes to improve access to care, 3) establish structures that allow for continuing social support even during a pandemic, 4) refrain from isolating socially vulnerable groups through blanket pandemic mitigation measures, 5) Hybrid (online and live) solutions for inclusion, 6) improving healthcare empowerment.

Conclusions
Through an inclusive process that involved citizens, vulnerable populations, and health- and government experts we identified a set of actions that should be taken now to ensure an equitable and just approach to pandemic preparedness. Our panel identified feasible and achievable goals within those recommended actions.

Key messages
• Vulnerability mechanisms are multi-layered. Therefore, policies that need to be developed should be based on comprehensive approaches, not selective interventions.
• Actions to mitigate vulnerabilities in pandemics must be ambitious in order to prevent further exacerbation of existing issues with potentially catastrophic long-term consequences.
Meeting the governance challenges of integrated health and social care
Authors: Exley J , Glover R , McCarey M , Reed S , Ahmed A , Vrijhoef H , Manacorda T , Stewart E , Mays N , Nolte E 
Published: October 2022

Abstract

Background
Many countries are experimenting with novel ways of organising and delivering more integrated health and social care. Governance is relatively neglected as a focus of attention in this context but addressing governance challenges is key for successful collaboration.

Methods
Cross-country case analysis involving document review and semi-structured interviews with 27 local, regional and national level stakeholders in Italy, the Netherlands and Scotland. We used the Transparency, Accountability, Participation, Integrity and Capability (TAPIC) framework to structure our analytical enquiry to explore factors that influence the governance arrangements in each system.

Results
Governance arrangements ranged from informal agreements in the Netherlands to mandated integration in Scotland. Novel service models were generally participative involving a wide range of stakeholders, including the public, although integration was seen to be driven, largely, from a health perspective. In Italy and Scotland some reversion to ‘command & control’ was reported in response to the imperatives of the Covid-19 pandemic. Policies, budgets, auditing and reporting systems that are clearly aligned at all levels were seen to help with implementing innovations in service organisation. Where alignment was lacking, cooperation and integration was suboptimal, regardless of whether governance arrangements were statutory or not. There was wide recognition of the importance of buy-in. Enablers of greater engagement included visible leadership, time and long-standing working relationships. Lack of suitable indicators and openness to data sharing to measure integration hindered working relationships and thus the successful delivery of integrated services.

Conclusions
Our study provides important insights into how to more effectively and efficiently govern service delivery structures within care systems. We will discuss approaches to governance that help support more resilient integrated care systems.

Key messages
• Different governance arrangements face common challenges to greater integration of care. Enablers include strong leadership, inclusivity and openness to work across traditional boundaries.
• Meeting the governance challenges of integrated health and social care requires clear lines of accountability, aligned policies, budgets and reporting systems.
COVID-19 containment measures impact utilization and provision of healthcare in Europe
Authors: Dratva J , Klein A , Marti S , Wieber F 
Published: October 2022

Abstract

Background
The COVID-19 containment measures, implemented to curb the pandemic, impacted health of children and adolescents by numerous pathways. We present the impact on health care utilization and provision.

Methods
A systematic review on secondary health impact is ongoing (PubMed, PsychInfo, Embase). Literature is screened (title, abstract, full-text) by 2 researchers, and data of interest extracted systematically.. Inclusion criteria are age (0 - 25 yrs.), exposure: containment measures, outcome: secondary health outcome, and European data origin.

Results
Jan. 2020 - Aug. 2021 10112 studies were identified, 337 were included. n = 60 were on health care utilization and provision. Utilization studies relied on objective hospital or registry data, care provision studies more often on survey data (professionals, parents). Data yields a large but varying decrease in emergency department visits during the lockdown: Italy ∼75%, Spain ∼65%, France ∼60%, and Germany ∼64%, and a substantial change in case mix and severity compared to comparable pre-COVID. Specialized and primary pediatric practices report that elective interventions were postponed, state of the art diagnostics withheld, and rehabilitation services disrupted. Vaccinations in infants, children, and adolescents dropped during the lockdown inversely proportional to children's age. Studies repeatedly suggest patients’ health services avoidance out of fear of infection and stay-at-home rules.Results on catch-up utilization and provision to follow (ongoing study).

Conclusions
COVID-19 measures exerted a measurable impact on health utilization and provision in children and adolescents. The utilization was comparatively lower and service provision disrupted across Europe. So far little can be said about a potential recovery in terms of catch-up of visits, diagnostics, or treatments. Analyses of the long-term health impact of the observed effects is recommended and can serve to improve future pandemic preparedness.

Key messages
• COVID-19 confinement measures had measurable secondary health impact on children and adolescents.
• Data on catch-up healthcare is important to establish long term impact and learnings.
The Health and Quality of Life Development Plan as a policy advisory tool for municipalities
Authors: Sequeira R , Pita Ferreira P , Carmezim Pereira S , Quinaz Romana G , Campos Fernandes A , Sousa P 
Published: October 2022

Abstract

Issue
In 2019, the Portuguese government established the autonomy of local authorities and the decentralisation of public administration. Consequently, a process that includes the transfer of health competencies from the central government to the municipalities began. The newly acquired competencies enable local governments to play a crucial role in defining health policies and strategic partnerships with special focus on disease prevention, promotion of healthy lifestyles and active ageing. That said, several municipalities established a collaboration protocol with the National School of Public Health (NSPH) for the development of the Health and Quality of Life Development Plan (HQLDP) as a contribution to their strategic planning.

Results
NSPH has developed a solidified methodology for municipalities to substantiate their health planning and priorities, based on a deep health diagnosis, from existing demographic, economical, health and environmental data in a given timeline. HQLDP is a medium-term reference that will support strategic action in the area of health and social determinants. The general objective of the HQLDP is to contribute to the improvement of the health status, in the different stages of the life cycle, based on the evaluation of the health profile and social determinants and to define a set of strategic objectives that promote the reduction of inequalities, the promotion and protection of health and the prevention of disease. The developed plan also includes public and stakeholders’ scrutiny, to define key areas of action in the health sector.

Lessons
The HQLDP takes into account the vocation of local authorities to act on determinants through policies that intervene in the environmental, socio-economic, educational, urban planning and mobility contexts; assuming an active, influential and local role in health policies. Municipal intervention requires a strong and concerted local action and the definition of territorialized development strategies.

Key messages
• HQLDP has a crucial role on the situational diagnosis and set of priorities of the quality of life and health indicators to assess the priorities at council level.
• HQLDP provides the knowledge for the development of public policies and interventions that comply with the population characteristics by reducing health inequalities and inequities.
WHO RHN Network
Authors: Menne M , Forcellini A 
Published: October 2022

Abstract
The WHO European Office for Investment for Health and Development (Venice Office) works in the thematic areas of health equity, social and economic determinants of health, and investment for health in the context of the 2030 Agenda for Sustainable Development and the European Programme of Work. Within the WHO Venice Office, the the Regions for Health Network (RHN) works to place health and well-being high on the key political agendas, and advocates the needs of local and subnational authorities at the regional and international levels. RHN has been launched in 1993 to help regions to accelerate the delivery of improved population health, and currently has 34 members. It has developed over the decades into a forum that creates synergies between regions and stakeholders in the field of health (mutual learning); strengthens cooperation/collaboration between regional and local actors and international health institutions; increases understanding of the functioning of regional and local health systems; promotes the exchange of experience, and mutual learning. RHN positions itself at the forefront of innovative approaches and aims at becoming a cutting-edge network ready to capture and disseminate effective approaches, policies and strategies that improve population health at the regional level of governance. In past years, RHN has spearheaded collaborative efforts amongst cross-border regions, on different topics, and with technical guidance from WHO. These efforts have led to joint initiatives, publications, study trips, project collaboration and periodic and structured exchanges of experiences.
Healthacross initiative of Lower Austria
Authors: Winkler J 
Published: October 2022

Abstract
Lower Austria is by size the biggest province of Austria and located in the heart of Europe with a 414 km long border to the Czech Republic and Slovakia, and in close proximity to Hungary. Not only through its geographic location but also through its understanding to be a connected region as part of a strong European Union, cross-border health care plays an important issue at the provincial level. Led by the European spirit, all international and cross-border health activities are bundled under the umbrella of the ‘Healthacross initiative”. The initiative is part of the Health Agency of Lower Austria (N&Ouml; Landesgesundheitsagentur), which operates and manages all 27 public hospitals and around 50 care/nursing homes in the region. Via the “Healthacross initiative”, Lower Austria is participating in four transnational networks and since 2008, conducted eight EU co-funded projects in cross-border healthcare, four of them currently running. Healthacross is the coordinator of this session, with support of WHO RHN network. Active networking in various European and international networks is part of the regional strategy of Lower Austria in order to gain excellence to improve the health and quality of life for citizens living in border regions. The premise is to enable equal access to health care services for citizens, regardless of their place of residence. The current epidemiological situation with the COVID-19 pandemic has not only impact on cross-border healthcare, but also on the life, health and well-being of citizens. With the closure of national borders, the exchange of healthcare services came to an interim halt; solely dialog remained - which was incredibly valuable for both commuters and citizens living in the border regions. Lower Austria will take care of the moderation of the session and will be represented by Julia Winkler.
Association of European Border Regions (AEBR)
Authors: Guillermo Ramirez M 
Published: October 2022

Abstract
AEBR is one of the oldest regional associations in Europe (founded in 1971), with a hundred members (border and cross-border regions) in more than thirty European countries. AEBR works for the interest of border regions towards EU and national authorities, developing capacities, increasing awareness, organizing events and implementing projects. AEBR currently implements IVY (Interreg Volunteer Youth) on behalf of the European Commission's DG Regio, within the framework of the European Solidarity Corps, which has deployed more than 700 young Europeans in Interreg programmes and projects during the last four years. It also manages b-solutions to tackle cross-border legal and administrative obstacles and test possible solutions, and takes part in other projects in Europe and other continents. It has recently finished a study for DG SANTE on cross-border patients’ flows in various EU cross-border areas. The association will be presented by it's Secretary General, Martin Guillermo-Ramírez.
8.G. Workshop: European Health Data Space: Dialogue on TEHDAS JA data quality & semantic interoperability proposals
Authors:   Organised by: TEHDAS JA WP6,   Chair persons: Enrique Bernal-Delgado (Spain), Persephone Doupi (Finland)
Published: October 2022

Abstract

The EU Data Strategy foresees the development of shared European data infrastructures, enabling cross-border exchange and availability of comparable and high-quality data. The European Health Data Space (EHDS) is the first of these infrastructures to be launched, making use of the potential of health and social data for the purpose of advancing public health, research and innovation. Quality of digital health data has been the focus of research and debate for a long time and several proposals for improvement have been put forward. While these efforts are ongoing, secondary use or re-use of health data, combined with recent developments in data analytics, AI and real-world data (RWD), have raised new requirements on our understanding of data quality and the means for its assurance. Both the European Commission and Member States have underlined the need to support EU and national authorities, as well as the scientific community to agree on interoperability guidelines addressing data quality and semantic interoperability. The TEHDAS Joint Action has responded to these expectations through work undertaken in the context of WP6 - Excellence in data quality. With expected delivery deadline early 2023, the EUPHA conference offers an excellent platform to present the draft forthcoming proposals to the public health community and engage in meaningful dialogue with participants. Key members of the WP6 team will present the process through which the TEHDAS JA recommendations on data quality and semantic interoperability have been developed, the results achieved thus far and the remaining open questions. The workshop discussion section will allow the JA team to collect direct input and feedback for utilization in the production of the final version of the deliverables.

Key messages
• Increased awareness and understanding of background and rational of forthcoming proposals on data quality and semantic interoperability in the European Health Data Space.
• Opportunity to raise concerns and proposals for improvement and thus have a direct impact on the final TEHDAS JA output on data quality.
Review of data quality assessment frameworks experiences around Europe
Authors: Engsig-Karup T , Doupi P , Mäkinen M , Launa R , Estupiñán-Romero F , Bernal-Delgado E , Sahlertz Kristiansen N 
Published: October 2022

Abstract
In the first phase of its work, WP6 has explored and synthesized existing knowledge and experiences on data quality assurance frameworks (DQAFs) in the context of cross-border sharing of federated secondary use health data. Our aim was to identify good practices within this area and develop a first set of corresponding recommendations. The recommendations reflect the synthesis of results from three parallel lines of work, each utilizing a different methodology: a) thematic workshops and partner meetings, b) analysis of existing data-sharing initiatives, and c) a scoping literature review. Our analysis of literature and existing health data initiatives suggest that currently deployed DQAFs cannot as such serve as platforms or models for an EHDS-wide data quality solution. There is an agreement in principle, that reliability, relevance, timeliness, coherence, coverage and completeness should be incorporated in a DQAF as measurable dimensions of data quality. We aim towards a working definition of data quality, which will be able to reflect the reality of the data, as well as its fitness for purpose from the perspective of potential users.
• We recommend focusing efforts on transparency at the level of data holder institutions across Member States in relation to adoption of regular audits, a well-developed DQAF and clear procedures with regard to processing the data.
• In the medium to longer-term EHDS nodes could promote and support the development of a benchmarking process, which will assist data managers and data holder institutions with alignment against a Europe-wide approach to measuring data quality within and across Member States.
Development of Local interventions within JADECARE – Key learnings from two Next Adopters
Authors: Papa R , Dolecek Z 
Published: October 2022

Abstract
In this third presentation, the NA representatives Roberta Papa (Regional Health Agency Marche Region, Italy) and Zdislav Dolecek (University Hospital Olomouc, Czech Republic), will present the Local interventions and action plans they developed during the pre-implementation phase, pre-final results of their implementation phase and preliminary lessons learned from the implementation.