Intersectoral collaboration in a One Health approach: Lessons learned from a country-level simulation exercise

SimEx Portuguese Team (alphabetical order): Ângela Pista (National Reference Laboratory for Gastrointestinal Infections, Department of Infectious Diseases, National Institute of Health Doutor Ricardo Jorge, Lisbon, Portugal); João Vieira Martins (Directorate of Information and Analysis, Directorate-General of Health, Lisbon, Portugal); Lurdes Clemente (National Reference Laboratory for Animal Health, Laboratory of Bacteriology and Mycology, National Institute of Agrarian and Veterinary Research, Oeiras, Portugal); Nuno Santos Rodrigues (Public Health Unit of ACES South West, Regional Health Administration of Lisbon and Tagus Valley, Portugal); Paula Vasconcelos (Support Unit of National Health Authority and the Emergency Management in Public Health, Public Health Emergencies Operations Centre, Directorate-General of Health, Lisbon, Portugal); Pedro Nabais (Food Risks Unit, Economic and Food Safety Authority, Lisbon, Portugal); Renata Carvalho (Animal Health and Epidemiology Division, Directorate-General for Food and Veterinary).Intersectoral collaboration is an essential component of the One Health (OH) approach, which recognises the interconnectedness of the health of humans, animals, and the environment. The OH European Joint Programme (OHEJP) developed a national foodborne outbreak table-top simulation exercise (SimEx) to practice OH capacity and interoperability across the public health, animal health, and food safety sectors, improving OH preparedness for future disease outbreaks. The Portuguese OHEJP SimEx highlighted strengths and weaknesses regarding the roles and functions of available systems, the constraints of existing legislation, the importance of harmonisation and data sharing, and the creation of common main messages adapted to each target sector. However, there is still a long way to go to ensure cooperation among the Public Health, Animal Health, and Food Safety sectors, as a OH approach relies not only on the awareness of "field experts" but also on political and organisational willingness and commitment.Highlights: - Intersectoral collaboration is an essential component of the One Health approach. - Skilled entities engaged in the system, but lack intersectoral communication. - Need of One Health join national multisectoral guidelines and common databases. - One Health approach needs political and organisational willingness and commitment.This work was supported by funding from the European Union’s Horizon 2020 Research and Innovation programme under grant agreement No 773830: One Health European Joint Programme.info:eu-repo/semantics/publishedVersio

Study for the implementation in Belgium of the Nagoya Protocol on Access and Benefit‐sharing to the Convention on Biological Diversity Final report

Study commissioned by Federal Public Service for Health, Food Chain Safety and the Environment, Directorate‐General for the Environment, Service for multilateral and strategic matters (SPSCAE) Bruxelles Environnement/Leefmilieu Brussel (IBGE‐BIM) Vlaamse overheid, Departement Leefmilieu, Natuur en Energie (LNE) Service public de Wallonie, Direction générale opérationnelle Agriculture, Ressources naturelles et Environnement (DGARNE

Factors affecting attendance rate to continuing medical education activities in health directorate- Iraq 2013

Background: attending to continuing medical education (CME) activities in Kerbala health directorate affected by different motivations & barriers; individual, structural and organizational. So assessment the attending rate will be helpful to highlight on these factors.Objectives:(1)Assessment the attending rate into CME activities in Kerbala health directorate. (2) barriers & motivations to physicians acquiring the skills and engaging in the CME. (3) identify a general suggestions to improve the attendance and propose solutions to better prepare physicians for ongoing self-assessment and lifelong learning.Method: semi-structured descriptive cross sectional study carried out from 22nd of June to 30th of December 2013 at kerbala health directorate, the study sample was 203 specialist doctors, from 6 hospitals &6 administrative departments. Statistical Package for Social Science (SPSS) program version 17 and chi square test used for data analysis, and p-value= 0.05 considered statistically significant. Result:94.1% was regular & irregular attending rate, males more regular than females, hospital working more regular attending, as long as the physicians were approached CME activities with; different strategies, external motivations, uses multiple new technologies to learn,  setting curriculum, presence of assessment & evaluation, fixed policy, budget, minimize structural & organizational barriers the attending rate would be increased.Conclusion: high attendance rate with poor efficiency & competence of specialist doctors in Kerbala health directorate into CME, participation need mixed external & internal motivating factors, different approaches, well organized planning activities by setting curriculum,  assessment, evaluation, budget, fixed policy, minimize managerial barriers with suitable timing, place & provide incentives. Key words: assessment, attending rate, motivations & barriers, postgraduate, CME, policy, lifelong learning, medical educato

Changing clinical activity in Paediatrics in Malta, 1996-2011

Aim: This study reviews the clinical workload in paediatrics in Malta over a 16-year period. Methods: National statistics for live birth rates were obtained from the Directorate of Health Information and Research. Data for paediatric (birth to 14 completed years) and neonatal admissions, day cases, outpatient visits, attendance at Paediatric Accident and Emergency and the Community-based Developmental Unit were obtained from the Annual Reports, Department of Paediatrics, for the period 1996-2011. Results: During the study period, live births fell by 11% from 4,349 in 1996 to 3,857 in 2005, and recovered to 4,283 in 2011. Whereas neonatal admissions to NPICU remained constant at around 340(±22) per annum, inpatient admissions to the general Paediatric wards decreased by 19% (from 3,151 to 2,550), and casualty reviews dropped by 35% (11,831 to 7,773). In contrast, day care reviews increased by 66% (1,347 to 3,928), the total outpatient workload increased by 70% (13,500 to 22,998), and cases reviewed in the Community-based Child Developmental Unit increased by 184% from 413 to 1174. Changes observed in the clinical activity in Gozo General Hospital were similar but less marked. Conclusion: Over a 16 year period, there has been a significant shift in the paediatric workload in Malta from an in-patient bias in 1996 to increased day care and outpatient reviews in 2011. This shift is largely the result of improved hospital and community day health care services, and can be increased further with augmented community care. Health resources and future paediatric health care programmes will need to take heed of these trends.peer-reviewe

Preferred incentives for improving community health worker satisfaction and retention in Bangladesh

Community health workers (CHWs) are critical actors within community health systems, providing a range of reproductive, maternal, child, and primary health information, counseling, and services. To better understand factors that influence CHWs’ work motivation and satisfaction in Bangladesh, the Frontline Health project, implemented with collaborators from Johns Hopkins Bloomberg School of Public Health, and supported by the government of Bangladesh’s Directorate General of Health Services and the Directorate General of Family Planning, conducted a discrete choice experiment (DCE) study. This brief presents key qualitative findings from the DCE study in Bangladesh and implications for program and policy stakeholders

Rodent control to fight plague : field assessment of methods based on rat density reduction

Research funding: Directorate General for International Relations and Strategy. Grant Number: 2018‐SB‐024‐18SSEOC049‐PMG7‐SSA5‐IPMMADAGASCAR ACKNOWLEDGMENTS: We are especially grateful to the health authorities and the population in Miantso and Ankazobe for allowing us to do this work and being so helpful. We thank the staff of the Plague Unit, Institut Pasteur de Madagascar, for helping with the field and laboratory work, especially Alain Berthin Rakotoarisoa and Andrianiaina Parfait Rakotonindrainy. This work was supported by a Directorate General for International Relations and Strategy grant (2018‐SB‐024‐18SSEOC049‐PMG7‐SSA5‐IPMMADAGASCAR) covering the project “Développement de contre‐mesures médicales à la peste à Madagascar” with scientific support of IRBA (French Armed Forces Biomedical Research Institute), within the framework of French MoD's involvement in G7 Global partnership. The French Agency for International Technical Expertise (AFETI) ensures the proper financial execution of the project and contributes to the implementation of cooperation actions under the control of the Directorate General for International Relations and Strategy. This research was also funded in part by the Wellcome Trust [095171/Z/10/Z] and the Institut Pasteur de Madagascar. For the purpose of Open Access, the authors have applied a CC BY public copyright license to any Author Accepted Manuscript version arising from this submission. K.S. was supported by the Biotechnology and Biological Sciences Research Council (BBSRC) under the EastBio DTP (grant number BB/M010996/1).Peer reviewedPublisher PD

The State of Children's Health in Europe

The health status of the European population is supervised constantly through the national public health agencies in their respective countries and monitored by the several nongovernmental organizations dedicated to public health active in Europe.In particular, the European Union (EU) supervises the health of the population in its 28 member nations by means of the Directorate for Health and Food Safety. The Directorate bases its proposals and legislative interventions both on data from the single nations and the statistical analysis provided by Eurostat, the official statistical office of the EU, situated in Luxembourg, whose mission is to provide high-quality statistics for Europe. On February 5, 2019, Eurostat released its most recent general report on children’s health in the EU. The document, which describes the status of health of the population 0-16 years of age, includes reassuring information, which were collected from household members. This commentary briefly discusses the significant positive data reported by Eurostat. Our aim is to share the encouraging information included in the report while emphasizing the importance for pediatricians not to rely exclusively on the family members’ perception to assess the quality of pediatric care. We believe that it is important to never lower one’s guard on children’s health and therefore to regularly follow social and legislative changes to constantly provide adequate children’s care that is focused and organized around the needs and expectations of their families

Antimicrobial consumption at the hospital level in latin america. Similarities and differences according to each country

One of the main problems for health service around the world is the antimicrobial resistance (AMR). Objective: to describe the antimicrobial consumption (AMC) at hospital level in Latin American countries and compare the amount and type of antibiotics usage among them in order to guide local public health actions towards AMR prevention.Design: A descriptive study of antimicrobial consumption at hospital level among six health institution in Latin America with an analytical comparative stage. Antimicrobials included corresponded to the WHO Anatomical Therapeutic Chemical (ATC) classification system subgroups: J01, A07A and P01AB. Methods: WHO GLASS methodology was applied for surveillance of AMC, using the ATC classification based on Defined Daily Dose (DDD) and DDD/100 hospital discharges as standard unit of measurement. Antimicrobials consumed were also classified according to the WHO AccessWatch-Reserve (AWaRe) classification. Results: The quantitative data, measured in DDD/100 hospital discharges, showed a wide range of consumption (182.48 - 2260.95). Qualitative analysis according to the AWaRe classification also showed a wide range in terms of consumption of Access (38.14% - 73.64%), Watch (24.93% - 60 .53%) and Reserve (0.31% - 3.55%) groups expressed as a percentage of the total consumption.Conclusion: Great heterogeneity and arbitrariness exist in the selection of antimicrobials for hospital use. Although this situation might be explained on local antimicrobial resistance, the history of prescription, local pharmaceutical promotion, and pharmacological education of health professional in each country, particular habits and distinctive culture may justify the differential consumption patterns observed in each institution in this study.Fil: Marin, Gustavo Horacio. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata; Argentina. Universidad Nacional de La Plata; ArgentinaFil: Giangreco, Luis. Universidad Nacional de La Plata; ArgentinaFil: Hernández, Yago. Universidad Nacional de La Plata; ArgentinaFil: Dorati, Cristian. Universidad Nacional de La Plata; ArgentinaFil: Mordujovich Buschiazzo, Perla. Universidad Nacional de La Plata; ArgentinaFil: Bay, María Rosa. Hospital Interzonal General de Agudos San Roque - Mb Gonnet ; Gobierno de la Provincia de Buenos Aires;Fil: Gonzalez, Gladys María Adriana. Hospital Interzonal General de Agudos San Roque - Mb Gonnet ; Gobierno de la Provincia de Buenos Aires;Fil: Aldunate, Francisca. Pontificia Universidad Católica de Chile; ChileFil: López Peña, Mónica. Ministerio de Salud y Protección Social; ColombiaFil: Martínez Parra, Adriana. Ministerio de Salud y Protección Social; ColombiaFil: Ching Fung, Shing Mi. Costa Rican social security; Costa RicaFil: Alfonso Arvez, María José. Ministry of Public Health and Social Welfare; ParaguayFil: Mantilla Ponte, Hilda. General Directorate of Medicines, Supplies and Drugs; PerúFil: Marin, Danini. General Directorate of Medicines, Supplies and Drugs; PerúFil: Rojas, Robin. General Directorate of Medicines, Supplies and Drugs; PerúFil: Castro, José Luis. Pan-American Health Organization; Estados Unido

Developing healthy eating promotion mass media campaigns: a qualitative study

Copyright © 2022 Capitão, Martins, Feteira-Santos, Virgolino, Graça, Gregório and Santos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.Background: Involving consumers in the development and assessment of mass media campaigns has been advocated, though research is still lacking. This study aimed to explore opinions and attitudes of citizens, health professionals, communication professionals, and digital influencers regarding the development and implementation of healthy eating promotion mass media campaigns. Methods: We conducted five semi-structured focus groups, where participants were exposed to the first nationwide mass media campaign promoting healthy eating in Portugal. Through criteria-based purposive sampling, 19 citizens, five health professionals, two communication professionals, and four digital influencers were included. Transcripts were analyzed using Charmaz's line-to-line open coding process. Results: Main identified themes were: considerations about informative-centered campaigns, health/nutritional issues to address, campaign formulation, target audiences, dissemination channels, and influencers' involvement. Participants favored campaigns focused on practical, transformative, and useful information with simple, innovative, activating, and exciting messages instead of strictly informative campaigns. Health and communication professionals mentioned the importance of adapting the message and dissemination channels to the target audience, addressing the most vulnerable and hard-to-reach individuals, and highlighted the importance of short video format. Conclusions: Active involvement of the health promotion target audience is crucial for the development and effectiveness of health campaigns. Campaigns need to convey health messages on simple though exciting communication materials, targeted to the most vulnerable subgroups, including deprived, less educated, younger, and older generations.This work was supported by the Portuguese Directorate-General of Health. The Directorate-General of Health had no role in the design, the analysis of this work, and the decision to publish. Researchers affiliated with the Portuguese Directorate-General of Health reviewed and made valuable contributions to the manuscript. The writing of the manuscript was also supported by funds from Fundação para a Ciência e a Tecnologia to ISAMB (ref. UIDB/04295/2020 and UIDP/04295/2020).info:eu-repo/semantics/publishedVersio

Practical guidelines on the application of migration modelling for the estimation of specific migration

The aim of this practical guidance document is to assist the users of the described diffusion models to predict conservative, upper bound specific migration values from plastic food contact materials for compliance purposes. Explanatory guidance tables and practical examples of migration modelling are provided. This document is an updated version of the report "Estimation of specific migration by generally recognised diffusion models in support of EU Directive 2002/72/EC" (Simoneau, 2010) concerning the current legal basis (Regulation (EU) No 10/2011) and the use of migration models for the estimation of specific migration from plastic multi-layers. This document represents the current validity of the models based on constant periodical evaluations of new experimental migration data performed by the Task Force on Migration Modelling chaired by the Directorate General Joint Research Centre of the European Commission on behalf of Directorate General Health and Consumers. The members of the Task Force are R. Brandsch, C. Dequatre, E.J. Hoekstra, P. Mercea, M.R. Milana, A. Schäfer, C. Simoneau, A. Störmer, X. Trier and O. Vitrac.JRC.I.1-Chemical Assessment and Testin