Publications by authors named "Katarzyna Czabanowska"

57 Publications

Aligning Best Practices: A Guiding Framework as a Valuable Tool for Public Health Workforce Development with the Example of Ukraine.

Int J Environ Res Public Health 2021 Sep 1;18(17). Epub 2021 Sep 1.

Center for Public Health of the Ministry of Health of Ukraine, 04071 Kyiv, Ukraine.

At present, in Ukraine, there is an insufficient capacity for up-to-date surveillance of the health status of the general population; public health (PH) promotion and disease prevention activities are scarce. Additionally, there is an urgent need to ensure, develop and support an efficient public health workforce (PHW) and appropriately address existing health issues. Ukraine currently introduces PH system reforms in line with its current burden of disease, the epidemiological profile and the Essential Public Health Services (EPHOs). This analysis aims to propose a pragmatic framework to provide guidance and recommendations related to the development, support and planning of the PHW in Ukraine. We constructed a framework based on a previously published scoping review and analyzed various policy analysis approaches. In line with the recommendations found in the literature and the best practices used elsewhere, this method enabled the construction of a framework for facilitating successful PHW development. In addition, an expert workshop was held, serving as a reality check for identifying crucial areas of the PH system in Ukraine. The proposed framework includes a country's background, the evidence and available policy options, such as the health system (including core functions, organizational resources, regulations and norms), health system capacities (including human resources; PH capacity assessment; datasets and databases; forecasting strategies; licensing, accreditation and quality assurance) and capacity building (including PH education, training, core competencies and ethical and professional codes of conduct). To facilitate and support effective implementation of the framework, we propose (1) implementing strategies to facilitate changes in attitude, behavior and practices among the citizens; (2) implementing strategies to facilitate the necessary behavioral changes in the PHW; (3) implementing strategies to facilitate the necessary organizational and institutional changes; (4) implementing strategies to facilitate system changes and (5) identification of potential barriers and obstacles for the implementation of these strategies. The report highlights the practical tactics and best practices for providing suggestions for PHW support and planning. The employment of prominent analytical tools and procedures in policymaking processes suggests an effective strategy for PHW development in Ukraine.
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http://dx.doi.org/10.3390/ijerph18179246DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8431433PMC
September 2021

Leadership Competencies for Knowledge Translation in Public Health: A consensus study.

J Public Health (Oxf) 2021 Jul 27. Epub 2021 Jul 27.

Department of International Health, CAPHRI - Care and Public Health Research Institute, Maastricht University, The Netherlands.

Background: In 2010, 240 billion US dollars was invested worldwide to conduct research for health; unfortunately, 200 billion was misused in the production and reporting of the evidence researched. Universities could facilitate students to acquire leadership competencies to move well-conducted research findings into practical use; this could be an essential move to reduce the misuse of investment.

Methods: A literature review was done based on the Equator Network and Cochrane guidelines, followed by three Delphi rounds to select competencies.

Results: Eleven papers were analysed out of 1121 items and 39/78 identified competencies were prioritized to be presented in the Delphi. Four out of 12 participants accepted to be involved in this project, and 22 competencies reached consensus and stability after three rounds. This framework conceptualizes competencies as the knowledge, skills, attitudes and values. The competencies were framed in four domains: knowledge management, engage diverse others in public health initiatives, training and capacity building/change management and communication.

Conclusion: This framework offers guidance to universities when instructing students with leadership competencies for KT. This project emphasizes that effective leadership should include personal conscience and self-determination values.
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http://dx.doi.org/10.1093/pubmed/fdab286DOI Listing
July 2021

ASPHER Statement: Towards a Carbon-Neutral Association of Schools of Public Health in the European Region.

Public Health Rev 2021 6;42:1604127. Epub 2021 May 6.

Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.

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http://dx.doi.org/10.3389/phrs.2021.1604127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8135093PMC
May 2021

Employment outcomes and job satisfaction of international public health professionals: What lessons for public health and COVID-19 pandemic preparedness? Employment outcomes of public health graduates.

Int J Health Plann Manage 2021 May 4;36(S1):124-150. Epub 2021 Apr 4.

Association of Schools of Public Health in the European Region (ASPHER), Brussels, Belgium.

The profile of public health professionals (PHPs) and COVID-19 preparedness is assessed against the employment outcomes (EO), precarious employment (PE), and job satisfaction (JS) of the European Public Health Master programme alumni. The study is descriptive, cross-sectional, conducted from May-October 2020. A survey was developed to assess the EO, PE and JS. Participants were recruited by email. SPSS statistics 26 version was used to perform descriptive analysis. A total of 189 PHPs participated (65% response) with majority women (66%), the mean age was 36 years. Participants were employed (80%), in non-governmental organisations (20%), and academia (19%). Common employment positions were managerial (37%) and consultancy (18%). Majority of PHPs were exposed to PE (81%), the most frequent elements were 'temporary employment' (54%), and 'the lack of labour union' (53%). The JS of PHPs was 'satisfied'. A blend of scientific public health knowledge and interpersonal competencies, reforms in current employment conditions, development of professional entities to safeguard PHPs' rights, and continuous investment in public health is necessary for PHPs to strengthen COVID-19 pandemic preparedness. Furthermore, monitoring and evaluation of EO and JS are crucial to prepare PHPs according to the needs of the employment market and to be aware of PHPs' needs.
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http://dx.doi.org/10.1002/hpm.3140DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251052PMC
May 2021

Problematic usage of the internet and eating disorder and related psychopathology: A multifaceted, systematic review and meta-analysis.

Neurosci Biobehav Rev 2021 06 10;125:569-581. Epub 2021 Mar 10.

Department of International Health, Care and Public Health Research Institute, Maastricht University, the Netherlands; Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Krakow, Poland.

Eating disorders are widespread illnesses with significant impact. There is growing concern about how those at risk of eating disorders overuse online resources to their detriment. We conducted a pre-registered systematic review and meta-analysis of studies examining Problematic Usage of the Internet (PUI) and eating disorder and related psychopathology. The meta-analysis comprised n = 32,295 participants, in which PUI was correlated with significant eating disorder general psychopathology Pearson r = 0.22 (s.e. = 0.04, p < 0.001), body dissatisfaction r = 0.16 (s.e. = 0.02, p < 0.001), drive-for-thinness r = 0.16 (s.e. = 0.04, p < 0.001) and dietary restraint r = 0.18 (s.e. = 0.03). Effects were not moderated by gender, PUI facet or study quality. Results are in support of PUI impacting on eating disorder symptoms; males may be equally vulnerable to these potential effects. Prospective and experimental studies in the field suggest that small but significant effects exist and may have accumulative influence over time and across all age groups. Those findings are important to expand our understanding of PUI as a multifaceted concept and its impact on multiple levels of ascertainment of eating disorder and related psychopathology.
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http://dx.doi.org/10.1016/j.neubiorev.2021.03.005DOI Listing
June 2021

Postgraduate Employment Outcomes of Undergraduate and Graduate Public Health Students : A Scoping Review.

Public Health Rep 2021 Mar 5:33354920976565. Epub 2021 Mar 5.

82246 Care and Public Health Research Institute (CAPHRI), International Health Department, Maastricht University, Maastricht, The Netherlands.

Objectives: A key goal of schools and programs of public health is to prepare graduates for careers in the public health workforce after graduation, but are they achieving this goal? We assessed how the employment outcomes of students earning public health degrees are collected and described in the literature.

Methods: Using the Kirkpatrick model of training evaluation as a framework, we conducted a 6-step scoping review: (1) formulating the research question, (2) identifying relevant studies, (3) selecting studies, (4) charting the data, (5) collating and summarizing the results, and (6) consulting stakeholders. We included articles published from January 1, 1993, through July 4, 2020, that provided data on employment status, employment sector/industry, job function, or salary of public health graduates. We excluded articles that were not written in English and were about dual-degree (ie, doctor of medicine-master of public health) students. We found and reviewed 630 articles.

Results: We found 33 relevant articles. Most articles focused on a single school and combined multiple graduating classes, focused on subspecializations of public health, or focused on graduates' satisfaction with their curriculum but not employment outcomes. Data were inconsistently categorized, and studies were difficult to compare.

Conclusions: Research on public health graduates' employment outcomes is scarce and does not follow consistent protocols. New standards should be adopted to systematize the collection of data on employment outcomes of public health graduates.
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http://dx.doi.org/10.1177/0033354920976565DOI Listing
March 2021

Labour market competition for public health graduates in the United States: A comparison of workforce taxonomies with job postings before and during the COVID-19 pandemic.

Int J Health Plann Manage 2021 May 24;36(S1):151-167. Epub 2021 Feb 24.

Division of Health Policy and Management, School of Public Health at the University of Minnesota, Minneapolis, Minnesota, USA.

A strong public health workforce (PHW) is needed to respond to COVID-19 and public health (PH) issues worldwide. However, classifying, enumerating, and planning the PHW is challenging. Existing PHW taxonomies and enumerations focus on the existing workforce, and largely ignore workforce competition for public health graduates (PHGs). Such efforts also do not utilize real time data to assess rapid changes to the employment landscape, like those caused by COVID-19. A job postings analysis can inform workforce planning and educational program design alike. To identify occupations and industries currently seeking PHGs and contrast them with existing taxonomies, authors matched existing PHW taxonomies to standardized occupational classification codes, then compared this with 38,533 coded, US job postings from employers seeking Master's level PHGs from 1 July 2019 to 30 June 2020. Authors also analysed 24,516 postings from March 2019 to October 2019 and compared them with 24,845 postings from March 2020 to October 2020 to assess changing employer demands associated with COVID-19. We also performed schema matching to align various occupational classification systems. Job postings pre-COVID and during COVID show considerable but changing demand for PHGs in the US, with 16%-28% of postings outside existing PHW taxonomies, suggesting labour market competition which may compound PHW recruitment and retention challenges.
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http://dx.doi.org/10.1002/hpm.3128DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8014097PMC
May 2021

Public health competences through the lens of the COVID-19 pandemic: what matters for health workforce preparedness for global health emergencies.

Int J Health Plann Manage 2021 May 17;36(S1):14-19. Epub 2021 Feb 17.

Department of Rheumatology and Clinical Immunology, Hannover Medical School, Hannover, Germany.

The COVID-19 pandemic is raising new questions on public health competences and leadership and on health workforce preparedness for global public health emergencies. The present commentary aims to highlight demand and opportunities for innovation through the disruptions caused by the COVID-19 crisis. We review the public health competency framework recently launched by WHO and ASPHER through the lens of COVID-19. The framework provides guidance for aligning public health and global health competences across sectors and professional groups. Five critical competency areas can be identified in relation to public health emergencies: (1) flexibility, adaptation, motivation, communication, (2) research, analytical sensitivity, ethics, diversity, (3) epidemiology, (4) preparedness and (5) employability. However, this may not be enough. New models of public health leadership and changes in the health workforce are needed, which transform the silos of professions and policy. Such transformations would include learning, working, leading and governing differently and must stretch far beyond the public health workforce. To achieve transformative capacity, critical public health competences must be considered for all healthcare workers on all levels of policymaking, thus becoming the 'heart' of health workforce resilience and pandemic preparedness.
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http://dx.doi.org/10.1002/hpm.3131DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8013956PMC
May 2021

Climate Action at Public Health Schools in the European Region.

Int J Environ Res Public Health 2021 02 5;18(4). Epub 2021 Feb 5.

Department of International Health, Care and Public Health Research Institute CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Duboisdomain 30, 6229 GT Maastricht, The Netherlands.

Climate change is putting the achievement of all Sustainable Development Goals at risk and leads to negative impacts on human health and well-being. Consequently, tremendous social responsibility lies with public health professionals and their associations. Therefore, this study addressed the following question: "How can the Association of Schools of Public Health in the European Region (ASPHER) best support the goals of the European Green Deal through its network of public health schools and departments?" This study looked at the implementation of climate education in public health schools in the European region and climate action taken by these public health schools. An online survey among ASPHER members with a 51% overall response rate (excluding non-European members) shows that 64% of the responding schools provide climate-health educational offerings, while 63% consider these for the future. Additionally, most climate actions taken by the schools were ad hoc actions. These findings show that a systematic approach is missing, and there is a general lack of strategy in most schools. We consequently recommend that schools invest in climate and health education in their curricula and become exemplars for climate action to actively contribute to the achievement of Europe's climate goals.
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http://dx.doi.org/10.3390/ijerph18041518DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7914969PMC
February 2021

Nurse teacher's perceptions on teaching cultural competence to students in Finland: a descriptive qualitative study.

Nurse Educ Today 2021 Apr 23;99:104787. Epub 2021 Jan 23.

Department of International Health and Care and Public Health Research Institute (CAPHRI), Maastricht University, the Netherlands; Department of Health Policy and Management, Institute of Public Health, Faculty of Health Sciences, Jagiellonian University, Krakow, Poland; National Institute of Public Health, Warsaw, Poland. Electronic address:

Background: Cultural diversity in healthcare settings requires that care professionals are able to provide culturally competent care. This means that educational institutions have a crucial role to play in equipping students with the skills to deal with diversity in cross-cultural and multicultural contexts. Ensuring that cultural competence is part of the educational curriculum is therefore essential.

Purpose: This study aims to examine what elements influence the implementation of cultural competence content in nursing education from a nurse teacher's perspective.

Methods: A descriptive qualitative design was used consisting of semi-structured interviews with nurse teachers (n = 12). Inductive content analysis was applied to explore their perceptions on teaching cultural competence at a University of Applied Sciences (UAS) in Southern Finland.

Results: Analysis from the open coding of interviews indicated that there are three main categories of importance regarding students' cultural competence education: exposure to diversity in the teaching environment; teacher's experience and understanding of cultural competence; and integrating cultural competence into the curriculum.

Conclusions: The findings suggest that more transparency and cooperation between nurse teachers and the university administration is necessary to ensure the inclusion of cultural competence in nursing education. For instance, teachers should receive training related to cultural competence and evidence-based teaching methods. The curriculum should include a course or workshop about cultural competence with clear learning objectives and evaluation criteria for the purpose of grading. Finally, the educational institution should commit to developing a culturally competent organisation through internationalization and the maintenance of a diverse environment.
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http://dx.doi.org/10.1016/j.nedt.2021.104787DOI Listing
April 2021

Inclusive education in the European Union: A fuzzy-set qualitative comparative analysis of education policy for autism.

Soc Work Public Health 2021 Feb 3;36(2):286-299. Epub 2021 Feb 3.

Department of International Health, School CAPHRI, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

Children with special education needs (SEN), such as children with autism, benefit from being included in education along with typical peers. However, development and implementation of inclusive education (IE) is considered difficult. This paper identifies conditions that facilitate IE development for children with autism in the European Union and benchmarks to track IE policy development. Education policy data from 30 legislative regions in the European Union were analyzed through a qualitative comparative analysis using eight conditions: a definition of SEN, the right to education for children with SEN, support for teaching staff, support services for children with SEN, individualized learning outcomes, parental involvement, and mixed mainstream classes. The right to education for children with SEN is implemented in all regions under study. Seven of the examined conditions were associated with IE: an established definition of SEN, support for teaching staff, support services for children with SEN, individualized learning outcomes, parental involvement, IE policies, and mixed mainstream classrooms. Mixed classrooms and support services for children with SEN were identified as necessary for IE. IE policies and support for teaching staff were present in all scenarios that facilitated IE. While the analysis was initially focused on autism, the policies consisted predominantly of general SEN policies, allowing the results to be interpreted in a wider context, beyond autism. Ultimately, mixed mainstream classrooms and support services for children with special needs were found essential for consistent IE development. Support for teaching staff and IE policies facilitate IE and should be further explored and implemented.
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http://dx.doi.org/10.1080/19371918.2021.1877590DOI Listing
February 2021

Eating disorders with over-exercise: A cross-sectional analysis of the mediational role of problematic usage of the internet in young people.

J Psychiatr Res 2021 01 4;132:215-222. Epub 2020 Nov 4.

Department of Psychiatry, University of Cambridge, UK; Cambridge and Peterborough NHS Foundation Trust, Cambridge, UK; Department of Psychiatry, University of Southampton, UK, Southern Health NHS Foundation Trust, UK. Electronic address:

Eating disorders are widespread illnesses with significant global impact. There is growing concern about how young people overuse online resources leading to mental health sequelae. We gathered data from 639 individuals from a population cohort. Participants were all young adults at the point of contact and were grouped as having probable eating disorder with excessive exercise (n = 37) or controls (n = 602). We measured obsessionality, compulsivity, impulsivity, and problematic internet use. Group differences in these domains were evaluated; and structural equation modelling (SEM) was used to assess structural relationships between variables. Cases had higher scores of obsessional thoughts of threat (Cohen's d = 0.94, p < 0.001), intolerance towards uncertainty (Cohen's d = 0.72; p < 0.001), thoughts of importance and control (Cohen's d = 0.65, p < 0.01), compulsivity (Cohen's d = 0.72; p < 0.001), negative urgency (Cohen's d = 0.75, p < 0.001), and higher problematic usage of the internet (Cohen's d = 0.73; p-corrected <0.001). Our SEM showed significant partial mediation of problematic internet use on both the effect of obsessionality latent factor on cases (z-value = 2.52, p < 0.05), as well as of sensation seeking latent factor on cases (z-value = 2.09, p < 0.05). Youth with eating disorder and heightened exercise levels have increased obsessive thoughts of threat, compulsivity traits and sensation seeking impulsivity. The association between obsessive thoughts and eating disorders, as well as sensation seeking and eating disorders were partially mediated by problematic internet use. Problematic internet use may be playing a role in the development or maintenance of eating disorder symptoms in the background of obsessional thoughts and sensation seeking impulsive traits.
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http://dx.doi.org/10.1016/j.jpsychires.2020.11.004DOI Listing
January 2021

Autism and education-international policy in small EU states: policy mapping in Malta, Cyprus, Luxembourg and Slovenia.

Eur J Public Health 2020 12;30(6):1078-1083

Department of International Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

Background: Special education provides an array of support that can advantageously meet special education needs (SEN) of children with autism. This report maps autism and SEN policies, and tension of international legislation in Malta, Cyprus, Luxembourg and Slovenia.

Methods: A policy path analysis was performed using a scoping review as fundamental methodological framework.

Results: Education for children with SEN developed from limited education towards segregation, and further to integration, and inclusion in mainstream education. International policy has greatly influenced the education systems under study. The rights to education and to have SEN addressed have been adopted in all countries. Inclusion is seen to be gradually incorporated by Malta, Cyprus and Luxembourg-closely following values of international documents through concise SEN policies. Slovenia's education system remains segregated, indicating potential tension.

Conclusions: It appears that mainstream schools offer SEN services until no longer feasible for the child in the majority of investigated countries. Inclusion has become a guiding principle for most education systems under study. Finally, small states either commit to the implementation of inclusion or delay it and attempt to improve the education system for children with SEN in different ways.
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http://dx.doi.org/10.1093/eurpub/ckaa146DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7733051PMC
December 2020

Autism and education-Teacher policy in Europe: Policy mapping of Austria, Hungary, Slovakia and Czech Republic.

Res Dev Disabil 2020 Oct 3;105:103734. Epub 2020 Aug 3.

Department of International Health, Maastricht University Faculty of Health Medicine and Life Sciences, Maastricht, the Netherlands; Institute of Public Health, University of Cambridge, Cambridge, United Kingdom; Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.

Background: This report maps autism and special education needs (SEN) policies, alongside teacher responsibilities in the education of children with SEN in Austria, Hungary, Czech Republic, and Slovakia.

Methods And Procedure: A policy path analysis using a scoping review as an underlying methodological framework was performed.

Outcomes And Results: The end of communism and accession to the European Union were critical for the countries under study. They passed crucial policies after international policies and adopted a three-stream approach towards providing education: (1) special schools; (2) special classes in mainstream schools; or (3) mainstream classes. Special schools remain for children that cannot participate in mainstream schools. Teachers are given high levels of responsibility.

Conclusion And Implications: Changes in international guidance greatly impacted Austria, Hungary, Slovakia and the Czech Republic. The education systems aim for inclusion, though segregation remains for children that cannot thrive in mainstream schools. Teachers are pivotal in the education of children with SEN, more so than with typical children.
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http://dx.doi.org/10.1016/j.ridd.2020.103734DOI Listing
October 2020

"I Just Can't Take It Anymore": How Specific Work Characteristics Impact Younger Versus Older Nurses' Health, Satisfaction, and Commitment.

Front Psychol 2020 27;11:762. Epub 2020 May 27.

Department of International Health and Care, Public Health Research Institute, Maastricht University, Maastricht, Netherlands.

Given the increasing shortage of active nurses in industrialized countries throughout the world, it is of utmost importance to protect their health, satisfaction, and commitment so that they can continue working in their healthcare institution. Building upon the proposed pattern of specific relationships developed by Houkes et al. (2003), we investigated a model of relationships among working conditions (quantitative, emotional, and physical demands), labor relations (quality of interpersonal relations and psychological support), work content (meaning of work, influence at work), and employment conditions (opportunities for development) on the one hand, and health, job satisfaction, and institutional affective commitment on the other hand, for younger versus older nurses. We used data of 3,399 nurses from the Netherlands and 3,636 nurses from Poland from the larger European Nurses' Early Exit Study (NEXT) and performed longitudinal structural equation modeling (SEM) and multi-group analyses. The results showed that the proposed pattern of relationships generally holds, but that the nurses' level of commitment is more determined by meaning of work than by opportunities for development and that psychological support is associated with job satisfaction (and not only with burnout as hypothesized, in both the Netherlands and Poland). Comparing younger (<40 years) versus older (≥40 years) nurses, we found ample support for differences in the proposed model relationships across age category, some being in line with and some being contradictory to our expectations. We argue that a non-normative, tailor-made approach to aging at work might help us to protect the nurses' career sustainability across the life span. This study provides evidence-based practical recommendations on how to enhance the health, job satisfaction, and commitment of nurses throughout their working life.
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http://dx.doi.org/10.3389/fpsyg.2020.00762DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7267024PMC
May 2020

Quotas, and Anti-discrimination Policies Relating to Autism in the EU: Scoping Review and Policy Mapping in Germany, France, Netherlands, United Kingdom, Slovakia, Poland, and Romania.

Autism Res 2020 08 22;13(8):1397-1417. Epub 2020 May 22.

Department of International Health, School CAPHRI Care and Public Health Research Institute, Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

The low employment rates of persons with Autism Spectrum Conditions in the European Union (EU) are partly due to discrimination. Member States have taken different approaches to increase the employment rate in the recent decades, including quota and anti-discrimination legislation, however, the implications for people with autism are unknown. The purpose of this scoping review was to provide a comprehensive overview of the history of these employment policies, from seven EU Member States (Germany, France, the Netherlands, the United Kingdom [prior to exit], Slovakia, Poland, and Romania), exploring the interdependence on international and EU policies, using a path dependency analysis. The results indicate that internationally a shift in focus has taken place in the direction of anti-discrimination law, though employment quotas remained in place in six out of the seven Member States as a means to address employment of people with disability in combination with the new anti-discrimination laws. LAY SUMMARY: Discrimination is partially responsible for the low employment of people with autism. Several approaches have been taken in recent years, such as anti-discrimination laws and setting a mandatory number of people with disabilities that need to be employed. This study finds that, internationally and in the European Union, the focus was initially on the use of quotas and gradually moved to anti-discrimination, with both being used simultaneously. Autism Res 2020, 13: 1397-1417. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/aur.2315DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7496597PMC
August 2020

On codes, cookbooks and competences of ethics.

J Public Health (Oxf) 2021 Sep;43(3):e487-e488

Department of International Health, CAPHRI - Care and Public Health Research Institute, Maastricht University, The Netherlands.

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http://dx.doi.org/10.1093/pubmed/fdaa005DOI Listing
September 2021

The Future of Careers at the Intersection of Climate Change and Public Health: What Can Job Postings and an Employer Survey Tell Us?

Int J Environ Res Public Health 2020 02 18;17(4). Epub 2020 Feb 18.

Columbia University Mailman School of Public Health, 722 W. 168th St., 1003, New York, NY 10032, USA.

Climate change is acknowledged to be a major risk to public health. Skills and competencies related to climate change are becoming a part of the curriculum at schools of public health and are now a competency required by schools in Europe and Australia. However, it is unclear whether graduates of public health programs focusing on climate change are in demand in the current job market. The authors analyzed current job postings, 16 years worth of job postings on a public health job board, and survey responses from prospective employers. The current job market appears small but there is evidence from job postings that it may be growing, and 91.7% of survey respondents believe the need for public health professionals with training in climate change may grow in the next 5-10 years. Current employers value skills/competencies such as the knowledge of climate mitigation/adaptation, climate-health justice, direct/indirect and downstream effects of climate on health, health impact assessment, risk assessment, pollution-health consequences and causes, Geographic Information System (GIS) mapping, communication/writing, finance/economics, policy analysis, systems thinking, and interdisciplinary understanding. Ensuring that competencies align with current and future needs is a key aspect of curriculum development. At the same time, we recognize that while we attempt to predict future workforce needs with historical data or surveys, the disruptive reality created by climate change cannot be modeled from prior trends, and we must therefore adopt new paradigms of education for the emerging future.
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http://dx.doi.org/10.3390/ijerph17041310DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7068354PMC
February 2020

Autism and family involvement in the right to education in the EU: policy mapping in the Netherlands, Belgium and Germany.

Mol Autism 2019 9;10:43. Epub 2019 Dec 9.

3Autism Research Centre, Department of Psychiatry, University of Cambridge, 18B Trumpington Road, Douglas House, Cambridge, CB2 8AH UK.

Introduction: In recent years, the universal right to education has been emphasised by the Universal Declaration on Human Rights and the Convention on the Rights of Persons with Disabilities. In this paper, we mapped policies relevant to special education needs and parental involvement of children with autism at an international level and in the Netherlands, Germany and Belgium.

Methods: A policy path analysis was performed using a scoping review as an underlying methodological framework. This allowed for a rapid gathering of available data from which a timeline of adopted policies was derived.

Results And Discussion: Internationally, the universal right to education has been reinforced repeatedly and the values of the Universal Declaration of Human Rights have been reiterated with every reinforcement. Also, the additional support that a child with special education needs requires is acknowledged and measures are taken to facilitate access to any education for all children. There are slight cross-country differences between the countries under study, attributable to differences in national regulation of education. However, all countries have progressed to a state where the right to education for all children is integrated on a policy level and measures are taken to enable children with special needs to participate in education. Recently, an attempt to implement a form of inclusive education was made as a form of special needs provision. Nevertheless, nowhere has this been implemented successfully yet.

Conclusion: The Universal Declaration of Human Rights was a critical juncture in international policy and created an environment where the universal right to education has been implemented for all children in the countries under study.
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http://dx.doi.org/10.1186/s13229-019-0297-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6902602PMC
June 2020

Education and training in public health: is there progress in the European region?

Eur J Public Health 2020 08;30(4):683-688

Department of International Health, Faculty of Health, Medicine and Life Sciences, Care and Public Health Research Institute (CAPRHI), Maastricht University, Maastricht, The Netherlands.

Background: The Association of Schools of Public Health in the European Region (ASPHER) is confronted with challenges to improve education for public health professionals. In this article, we attempt to answer the question: Did ASPHER members improve their organization and programmes to enable their graduates to acquire the competences to tackle the diverse areas of public health defined in the Ten Essential Public Health Operations (EPHOs)?

Methods: ASPHER run two surveys among its membership: In 2011, 66 Schools and Departments of Public Health (SDPHs) took part (82.5%), while in 2015-16, 78 SDPHs (81.3%). The performance of graduates was estimated using a Likert scale.

Results: In 2015-16, the SDPHs delivered 169 academic programmes (2.2 on average per SDPH). Among the SDPHs participating in both surveys, significant differences could not be determined, neither for the organization (except increasingly using social media) nor for teaching areas. The performance of graduates did not show significant differences except for the deterioration of EPHO-8 ('assuring sustainable organizational structures and financing'). However, the qualitative data revealed progressive dynamics regarding innovations in the organizational set-up, digitalization, teaching/training, introduction of new modules and research.

Conclusions: The results generated do not allow us to state that the innovative elements introduced after the first survey in 2011 have had a clear impact reflected in the second survey carried out in 2015-16, but perhaps this is due to the need for a broader follow-up in order to objectify the potential consequences derived from the boost generated by the changes introduced.
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http://dx.doi.org/10.1093/eurpub/ckz210DOI Listing
August 2020

Mapping novel psychoactive substances policy in the EU: The case of Portugal, the Netherlands, Czech Republic, Poland, the United Kingdom and Sweden.

PLoS One 2019 26;14(6):e0218011. Epub 2019 Jun 26.

Care and Public Health Research Centre, Department of International Health, University of Maastricht, Maastricht, The Netherlands.

Introduction: The rapid rise in trade and use of NPS and the lack of information concerning their potential toxicity pose serious challenges to public health authorities across the world. Policy measures towards NPS taken so far have a special focus on their legal status, while the implementation of a public health strategy seems to be still missing. The aim of this study is to perform a general assessment of NPS-related policy (including regulatory measures and public health strategies) implemented by six European countries: Portugal, the Netherlands, Czech Republic, Poland, the United Kingdom and Sweden.

Methods: Six EU countries were included in this scoping review study. Drug policies (including legal responses and public health strategies) were analysed. UNODC drug policy classification system was used as a benchmark, while path dependency approach was used for data analysis; a net of inter-dependencies between international, EU and national policies was highlighted.

Results And Discussion: The countries included in this study can be placed in a wide spectrum according to their formulation of drug policy, from Portugal and the UK that have specific legal responses to NPS but have differently focused on harm reduction strategies at one end, to Sweden whose drug-free society goal is not translated into a specific regulation of NPS at the other end.

Conclusion: The findings of the study reveal limited development towards harmonisation of national drug policies-particularly with regard to NPS. To tackle the challenge presented by NPS, EU Member states have formulated legislation and public health strategies independently. National approaches to NPS are therefore in line with their already existing drug policies, reflecting cultural values towards substance abuse and national political interests, while the homogenization at an international level has so far mostly been focused on law enforcement and drugs use preventive strategies.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0218011PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6594604PMC
February 2020

Trend and Correlates of Leadership Competencies Among Female Health Professionals in Albania.

Front Public Health 2019 30;7:109. Epub 2019 Apr 30.

Department of International Health, School CAPHRI (Care and Public Health Research Institute), Maastricht University, Maastricht, Netherlands.

Our aim was to assess the trends and correlates of the leadership competency level of female health professionals in Albania, a transitional country in the Western Balkans, based on a standardized international instrument. Two nationwide cross-sectional studies were conducted in Albania in 2014 (first wave; = 105 women) and subsequently in 2018 (second wave; = 121 women). A structured questionnaire was administered to all female participants aiming at self-assessing the level of leadership competencies and the (desirable) level of leadership competencies for their current job position. The questionnaire consisted of 52 items pertinent to eight domains. Answers for each item of the instrument ranged from 1 ("minimal competency level") to 5 ("maximal competency level"). Overall summary scores (range: 52-260) were calculated for both the current and the required leadership competency levels in both survey rounds, based on which the gap in leadership competency level was also computed (required current competency level). Binary logistic regression was used to assess the correlates of the gap in leadership competency level among study participants. In multivariable-adjusted logistic regression models, there was evidence of a positive association between the gap in leadership competency level and: workplace in urban areas (OR = 3.2, 95%CI = 1.6-6.6); work experience (OR = 1.1, 95%CI = 1.0-1.2); first round of the survey conducted in 2014 (OR = 2.1, 95%CI = 1.0-4.3); and, particularly, a high managerial job position/level (OR = 3.8, 95%CI = 1.6-9.3). Conversely, there was an inverse relationship with the age of women (OR = 0.9, 95%CI = 0.8-1.0). Our study provides useful evidence about trends over time and selected correlates of the gap in leadership competencies among female health professionals in Albania. Policymakers and decision-makers in Albania and other countries should be aware of the unmet need for leadership training of female health professionals at all levels.
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http://dx.doi.org/10.3389/fpubh.2019.00109DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6503110PMC
April 2019

Women, healthcare leadership and societal culture: a qualitative study.

J Healthc Leadersh 2019 12;11:43-59. Epub 2019 Apr 12.

Department of International Health, Care and Public Health Research Institute (CAPHRI), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands,

Purpose: Women leaders encounter societal and cultural challenges that define and diminish their career potential. This occurs across several professions including healthcare. Scant attention has been drawn to the discursive dynamics among gender, healthcare leadership and societal culture. The aim of this study is to assess empirically gendered barriers to women's leadership in healthcare through the lens of sociocultural characteristics. The comparative study was conducted in Greece and Malta. The interest in these countries stems from their poor performance in the gender employment gap and the rapid sociocultural and economic changes occurring in the European-Mediterranean region.

Subjects And Methods: Thirty-six individual in-depth interviews were conducted with health-care leaders, including both women and men (18 women and 18 men). Directed content analysis was used to identify and analyze themes against the coding scheme of the Barriers Thematic Map to women's leadership. Summative content analysis was applied to quantify the usage of themes, while qualitative meta-summative method was used to interpret and contextualize the findings.

Results: Twenty and twenty-one barriers to women's leadership were identified within the Greek and Maltese healthcare settings, respectively. Prevailing barriers included work/life balance, lack of family (spousal) support, culture, stereotypes, gender bias and lack of social support. Inter-country similarities and differences in prevalence of the identified barriers were observed.

Conclusion: The study appraised empirically the gendered barriers that women encounter in healthcare leadership through the lens of national sociocultural specificities. Findings unveiled underlying interactions among gender, leadership and countries' sociocultural contexts, which may elucidate the varying degrees of strength of norms and barriers embedded in a society's egalitarian practices. Cultural tightness has been found to be experienced by societal dividends as an alibi or barrier against sociocultural transformation. Findings informed a conceptual framework proposed to advance research in the area of women's leadership.
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http://dx.doi.org/10.2147/JHL.S194733DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6469472PMC
April 2019

[Rational Use of Antibiotics Among Turkish Migrants In Germany: Knowledge, Attitudes and Interaction With Physicians and Pharmacists].

Gesundheitswesen 2020 Jul 31;82(7):594-600. Epub 2019 Jan 31.

Fakultät für Gesundheit/Department für Humanmedizin, Universität Witten/Herdecke, Witten.

Objectives: Due to strong transnational ties, the use of and demand for antibiotics among Turkish migrants in Germany may be influenced by cultural aspects of antibiotic use in Turkey. Research on the use of antibiotics among Turkish migrants in Germany, however, is scarce. The aim of this study was to find out how Turkish migrants in Germany use antibiotics, whether and how knowledge, underlying motives and attitudes influence demand and how Turkish migrants interact with medical professionals.

Materials And Methods: Using a qualitative approach, behavioural patterns and logic of action of adult Turkish migrants were identified. We carried out semi-structured focus group interviews with adults of Turkish origin residing in Germany and expert interviews with family physicians and pharmacists. The interviews were analysed by means of content analysis.

Results: While younger migrants had a generally positive, but cautious attitude towards the use of antibiotics, older migrants often showed exaggerated, unrealistic expectations resulting from a lack of factual knowledge. Overall, participants adopted a passive role in the patient-provider relationship. This led to a perpetuation of significant knowledge gaps.

Conclusions: Older Turkish migrants who have less factual knowledge show exaggerated expectations concerning the effectiveness of antibiotics. In conjunction with a passive patient role, resulting in information needs not being satisfied, this can affect the patient-provider relationship. A more active communication by physicians and information materials sensitive to the needs of migrants can positively influence the interaction between migrant patients and medical professionals.
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http://dx.doi.org/10.1055/a-0820-4397DOI Listing
July 2020

Is there a golden recipe? A scoping review of public health workforce development.

Eur J Public Health 2019 06;29(3):401-408

Division of Health Systems and Public Health, Public Health Services, WHO Regional Office for Europe, Copenhagen, Denmark.

Background: This study intended to design a suitable and comprehensive approach for a public health workforce development plan with the ultimate goal of meeting the health objectives in different European Region countries.

Methods: We performed a scoping review, including an accurate and exhaustive country-specific hand-search process, mapping the key concepts and practices used in public health workforce development based on the available evidence worldwide.

Results: We identified nine comparative measures, based on common features from a scoping literature review, for the assessment of public health workforce development plans available in selected countries. This list of nine comparative measures includes: (i) Alignment between the 10 Essential Public Health Operations (EPHOs) or core public health functions and organizational resources and public health priority areas; (ii) Regulations and Norms; (iii) Capacity Assessment; (iv) Datasets and Databases; (v) Workforce Development Strategies, Planning and Management; (vi) Education, Training, Core Competencies and Models; (vii) Licensing, Accreditation and Credentialing; (viii) Forecasting Strategies for Enumerating and Quotas and (ix) Ethical and Professional Codes of Conduct. These measures are essential to develop, sustain and modernize the public health workforce effectively.

Conclusion: We propose a well-balanced set of measures for countries aiming to improve or develop their public health workforce based on instruments that are successfully used and applied in a wide range of countries with different public health systems. However, the implementation should be tailored and adopted according to the specific country context and available recourses.
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http://dx.doi.org/10.1093/eurpub/cky247DOI Listing
June 2019

Application of EASY-Care Standard 2010 instrument in a population-based survey in transitional Kosovo.

Eur J Public Health 2019 04;29(2):367-371

Department of International Health, School CAPHRI, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.

Background: The aim of this study was to assess the health needs and priorities of older people in Kosovo, the newest state in Europe striving for a functional democracy after the breakdown of former Yugoslavia and the following war in the region.

Methods: A cross-sectional study was conducted in Kosovo in 2011 including a nationwide representative sample of 1890 individuals aged ≥65 years (949 men, mean age: 73 ± 6 years; 941 women, mean age: 74 ± 7 years; overall response rate: 84%). All individuals were administered the full version of EASY-Care Standard 2010 instrument, inquiring about the need for support in activities of daily living ('independence'), the 'risk of breakdown in care' (leading to emergency admission to hospital) and the 'risk of falls'.

Results: The degree of 'independence' was lower, whereas the 'risk of breakdown in care' and the 'risk of falls' were significantly higher in: older women; the oldest individuals (≥85 years); rural residents; participants living alone; those perceiving themselves as poor; participants who could not access medical care; those who perceived their general health status as poor; and older people who reported at least one chronic condition.

Conclusions: This is one of the very few reports from Southeast European region informing about the health needs and priorities of older people in a large and representative population-based sample of older men and women. The poor health status of older people, especially evident in the socio-demographic disadvantaged categories, should raise the awareness of policymakers and decision-makers for appropriate health and social care of elderly in Kosovo and in other European countries.
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http://dx.doi.org/10.1093/eurpub/cky172DOI Listing
April 2019

Is blended learning and problem-based learning course design suited to develop future public health leaders? An explorative European study.

Public Health Rev 2018 1;39:13. Epub 2018 Jun 1.

6Department of International Health, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, PO Box 616, 6200 MD Maastricht, the Netherlands.

Background: Public health leaders are confronted with complex problems, and developing effective leadership competencies is essential. The teaching of leadership is still not common in public health training programs around the world. A reconceptualization of professional training is needed and can benefit from innovative educational approaches. Our aim was to explore learners' perceptions of the effectiveness and appeal of a public health leadership course using problem-based, blended learning methods that used virtual learning environment technologies.

Case Presentation: In this cross-sectional evaluative study, the Self-Assessment Instrument of Competencies for Public Health Leaders was administered before and after an online, blended-learning, problem-based (PBL) leadership course. An evaluation questionnaire was also used to measure perceptions of blended learning, problem-based learning, and tutor functioning among 19 public health professionals from The Netherlands ( = 8), Lithuania ( = 5), and Austria ( = 6).Participants showed overall satisfaction and knowledge gains related to public health leadership competencies in six of eight measured areas, especially Political Leadership and Systems Thinking. Some perceptions of blended learning and PBL varied between the institutions. This might have been caused by lack of experience of the educational approaches, differing professional backgrounds, inexperience of communicating in the online setting, and different expectations towards the course.

Conclusions: Blended, problem-based learning might be an effective way to develop leadership competencies among public health professionals in international and interdisciplinary context.
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http://dx.doi.org/10.1186/s40985-018-0090-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5984399PMC
June 2018

Exploring the Added Value of Women Health Care Managers in Poland.

Mater Sociomed 2017 Dec;29(4):280-285

Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA and Department of International Health, Faculty of Health, Medicine and Life Sciences, CAPHRI, Maastricht University, Maastricht, the Netherlands.

Introduction: Female managers in the Polish health care system are seldom a subject of scientific investigation.

Material And Methods: This study describes the share and profile of women in health care management positions and explores how and why Polish female health care managers add value to the leadership of health care organizations. Three data collection methods were used including: scoping review, analysis of data from governmental information bases and in-depth interviews with female health care managers.

Results: Men comprise nearly twice the number of hospital directors in Poland as compared to women, or 67% of the total representation. Traits often attributed to women including strength, perseverance, multi-tasking, empathy, emotional intelligence and intuition add value in leadership roles. Polish women managers value the complementarity of genders in professional roles and their contribution to constructive collaboration.

Conclusion: The study contributes to the scarce literature on Polish female health care managers.
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http://dx.doi.org/10.5455/msm.2017.29.280-285DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5723166PMC
December 2017
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