Monitoring response to hepatitis B and C in EU/EEA: testing policies, availability of data on care cascade and chronic viral hepatitis-related mortality – results from two surveys (2016)

Objectives: The World Health Organization (WHO) developed a European Regional Action Plan (EAP) to fast-track action towards the goal of eliminating viral hepatitis. Robust monitoring is essential to assess national programme performance. The purpose of this study was to assess the availability of selected monitoring data sources in European Union/European Economic Area (EU/EEA) Member States (MS). Methods: Availability of data sources at EU/EEA level was assessed using two surveys distributed to 31 EU/EEA MS in 2016. The two surveys covered (A) availability of policy documents on testing; testing practices and monitoring; monitoring of diagnosis and treatment initiation, and; (B) availability of data on mortality attributable to chronic viral hepatitis. Results: Just over two-thirds of EU/EEA MS responded to the surveys. 86% (18/21) reported national testing guidance covering HBV, and 81% (17/21) covering HCV; while 33% (7/21) and 38% (8/21) of countries, respectively, monitored the number of tests performed. 71% (15/21) of countries monitored the number of chronic HBV cases diagnosed and 33% (7/21) the number of people treated. Corresponding figures for HCV were 48% (10/21) and 57% (12/21). 27% (6/22) of countries reported availability of data on mortality attributable to chronic viral hepatitis. Conclusions: The results of this study suggest that sources of information in EU/EEA Member States to monitor the progress towards the EAP milestones and targets related to viral hepatitis diagnosis, cascade of care and attributable mortality are limited. Our analysis should raise awareness among EU/EEA policy makers and stimulate higher prioritisation of efforts to improve the monitoring of national viral hepatitis programmes

Towards Age-Friendly Work in Europe: A Life-Course Perspective on Work and Ageing from EU Agencies

[Excerpt] The European population is ageing owing to decreasing birth rates and increasing longevity. Population ageing is associated with a decrease in the size and ageing of the workforce. The majority of the EU Member States have reacted to this development by, among other measures, increasing retirement ages and limiting early access to pensions. Nevertheless, a large percentage of workers in the EU do not stay in employment until the official retirement age. The reasons for this are diverse, and will be examined in more detail in this report. Policy-makers are faced with the challenge of addressing this demographic change and its implications for employment, working conditions, living standards and the sustainability of welfare states. The working conditions of older workers and their participation in the labour market are affected by various policy areas (see also Table 1). This report aims to outline various aspects of the working conditions of the ageing workforce and related policies

Social inclusion and valued roles : a supportive framework

The aim of this paper is to examine the concepts of social exclusion, social inclusion and their relevance to health, well-being and valued social roles. The article presents a framework, based on Social Role Valorization (SRV), which was developed initially to support and sustain socially valued roles for those who are, or are at risk of, being devalued within our society. The framework incorporates these principles and can be used by health professionals across a range of practice, as a legitimate starting point from which to support the acquisition of socially valued roles which are integral to inclusio

A Review of Dietary Zinc Recommendations

Background. Large discrepancies exist among the dietary zinc recommendations set by expert groups. Objective. To understand the basis for the differences in the dietary zinc recommendations set by the World Health Organization, the U.S. Institute of Medicine, the International Zinc Nutrition Consultative Group, and the European Food Safety Agency. Methods. We compared the sources of the data, the concepts, and methods used by the four expert groups to set the physiological requirements for absorbed zinc, the dietary zinc requirements (termed estimated and/or average requirements), recommended dietary allowances (or recommended nutrient intakes or population reference intakes), and tolerable upper intake levels for selected age, sex, and life-stage groups. Results. All four expert groups used the factorial approach to estimate the physiological requirements for zinc. These are based on the estimates of absorbed zinc required to offset all obligatory zinc losses plus any additional requirements for absorbed zinc for growth, pregnancy, or lactation. However, discrepancies exist in the reference body weights used, studies selected, approaches to estimate endogenous zinc losses, the adjustments applied to derive dietary zinc requirements that take into account zinc bioavailability in the habitual diets, number of dietary zinc recommendations set, and the nomenclature used to describe them. Conclusions. Estimates for the physiological and dietary requirements varied across the four expert groups. The European Food Safety Agency was the only expert group that set dietary zinc recommendations at four different levels of dietary phytate for adults (but not for children) and as yet no tolerable upper intake level for any life-stage group

Health promotion evaluation: recommendations to policy-makers

"In June 1995, the WHO Regional Office for Europe established a Working Group on Health Promotion Evaluation in cooperation with three government agencies: the Centers for Disease Control and Prevention, United States, Health Canada, Health Education Authority, United Kingdom. The Working Group had three objectives: to provide guidance to policy-makers and practitioners to foster the use of appropriate methods for health promotion evaluation, to examine the current range of evaluation methods, both quantitative and qualitative, and to provide guidance to policy-makers and practitioners to increase the quality of health promotion evaluations." - p. 3report of the WHO European Working Group on Health Promotion Evaluation.Publisher's no. EUR/ICP/IVST 05 01 03

Validation instruments for health promotion in the community pharmacy setting

The developments during the past fifty years have resulted in a complete shift in the role of the community pharmacist from that of mainly compounding of medicines to becoming an advisor on health-related issues (Schaefer, 1998). This shift resulted in highlighting the intervention of the pharmacist as the initial contact point for the provision of primary health care. An initiative undertaken in the United Kingdom in 1995, 'Pharmacy in a New Age', identified health promotion as one of the areas that community pharmacists should focus more on (Royal Pharmaceutical Society of Great Britain, 1996). In this day and age of cost containment. evidence-based practice is required to confirm the provision of professional services, including the provision of health promotion (Rupp, 1997). This prompted the development of the Validation Method for Community Pharmacy, which is a process carried out to confirm the effectiveness of the pharmacist in the community setting (Azzopardi, 2000).peer-reviewe

Mucosal vaccines and technology

There is an urgent and unmet need to develop effective vaccines to reduce the global burden of infectious disease in both animals and humans, and in particular for the majority of pathogens that infect via mucosal sites. Here we summarise the impediments to developing mucosal vaccines and review the new and emerging technologies aimed at overcoming the lack of effective vaccine delivery systems that is the major obstacle to developing new mucosal vaccines

Monitoring of congenital anomalies in Latvia

Publisher Copyright: © 2014, Czech National Institute of Public Health. All rights reserved.Objective: This study provides a description and analysis of characteristics of the monitoring system for congenital anomalies at birth and prevalence trends in Latvia using retrospective analysis of congenital anomalies at birth with cross-sectional data on prevalence (national data from Latvia, 2000-2010). Methods: There are three main monitoring systems on congenital anomalies among newborns and infants: the Medical Birth Register with data on live births with one or more congenital anomalies at birth, the Register on Congenital Anomalies with genetically approved cases for live births and the National Causes of Death Register with data on stillbirths. Methodological problems were analysed by calculating different prevalence rates. The main outcome measures are as follows: prevalence rate, live birth prevalence rate, major congenital anomalies live birth prevalence rate, and stillbirth rate. Results: The live birth period prevalence was 319.7/10,000 live births, and the major congenital anomalies live birth prevalence was 211.4/10,000. The period total prevalence rate of births was 323.7/10,000 live births and stillbirths. The stillbirth rate due to congenital anomalies was 6.1/10,000 live and stillbirths. The live birth prevalence with congenital anomalies decreased slightly from the year 2000 to the year 2010. Conclusions: The present system of congenital anomaly registration requires improvements for better completeness. Latvia should use the experience of Nordic countries and introduce a mother’s and children’s identification number to the Medical Birth Register. It would be helpful to link the information from hospitals and perinatal centres together to validate the congenital anomaly diagnoses of newborns after their discharge from the maternity unit. The monitoring system should also include information on pregnancies with congenital anomalies which do not end in birth, especially terminations of pregnancy.publishersversionPeer reviewe

Does the development of new medicinal products in the European Union address global and regional health concerns?

<p>Abstract</p> <p>Background</p> <p>Since 1995, approval for many new medicinal products has been obtained through a centralized procedure in the European Union. In recent years, the use of summary measures of population health has become widespread. We investigated whether efforts to develop innovative medicines are focusing on the most relevant conditions from a global public health perspective.</p> <p>Methods</p> <p>We reviewed the information on new medicinal products approved by centralized procedure from 1995 to 2009, information that is available to the public in the European Commission Register of medicinal products and the European Public Assessment Reports from the European Medicines Agency. Morbidity and mortality data were included for each disease group, according to the Global Burden of Disease project. We evaluated the association between authorized medicinal products and burden of disease measures based on disability-adjusted life years (DALYs) in the European Union and worldwide.</p> <p>Results</p> <p>We considered 520 marketing authorizations for medicinal products and 338 active ingredients. New authorizations were seen to increase over the period analyzed. There was a positive, high correlation between DALYs and new medicinal product development (ρ = 0.619, p = 0.005) in the European Union, and a moderate correlation for middle-low-income countries (ρ = 0.497, p = 0.030) and worldwide (ρ = 0.490, p = 0.033). The most neglected conditions at the European level (based on their attributable health losses) were neuropsychiatric diseases, cardiovascular diseases, respiratory diseases, sense organ conditions, and digestive diseases, while globally, they were perinatal conditions, respiratory infections, sense organ conditions, respiratory diseases, and digestive diseases.</p> <p>Conclusions</p> <p>We find that the development of new medicinal products is higher for some diseases than others. Pharmaceutical industry leaders and policymakers are invited to consider the implications of this imbalance by establishing work plans that allow for the setting of future priorities from a public health perspective.</p