Vienna Summer Meeting 2019

For the first time in EuroNet history a meeting will be organized in the Austrian Capitol of Vienna. The Vienna Organizing Committee would like to invite you to join us at the EuroNet Summer Meeting where we will focus on vulnerable communities.

Next to new things you will learn, the meeting is a great opportunity to meet and network with fellow residents from around Europe. The meeting and participation will help in strengthening the position of the public health residency program in Austria and increasing the visibility of the program and public health work in Austria.

And if that isn’t enough, join us and enjoy the great culture, music and cool urban vibes of one of the most hospitable cities on the planet!

Location / Venue

The meeting will be held at the Center for Public Health, Kinderspitalgasse 15, 1090 Vienna, location on the U6 line (underground, brown line) by the doorstep of U6 ALSER STRASSE station.

Schedule

There’s a draft available here.

Casa EuroNet / Where to stay

Hostel bookings are welcome at 1070 Vienna Hostel. With the code “Symposium 2019”, when booking through their website, they can make sure EuroNet participants will be staying in the same dormitories (Casa EuroNet style!). Price for a night, including sheets and breakfast buffet, is 20eur/person in a dormitory (or 23.50eur for a bunk bedroom for 2 people).

Transportation

Vienna boasts one of the best public transportation systems in the world (bus, tram, underground and in-city-train) and that basically you are 30-40 min away from any point in this city from wherever you are. The hostel is within walking distance from the venue (15 minutes), however if you want to take public transportation the single tickets price is 2,40€. Taking the train between the Vienna airport and the city centre costs around 4,80€.

Social Programme

A social programme is being organized, and you’ll have to wait a bit longer to get insight on it… but, for a taste of it: there will be a three course dinner (costing 23,50€, drinks not included).

 

[Registration is closed!]

Looking forward to see you in Vienna,
The Vienna Organizing Committee

 

Torino Spring Meeting 2019

Between the 11th and 13th of April we had our Spring Meeting in the lovely city of Turin, Italy.

There were interactive workshops, plenary sessions, working group meetings and a rich social programme! All that can be expected from a EuroNet meeting 🙂 It was a wonderful event, and we're so grateful to have shared these moments with all the attendees. See you soon for the Summer Meeting! Stay tuned for dates and location... soon...

Meanwhile, below you may see some of the pictures taken during the meeting. A big thank you to Jona Blatnik, a Slovenian resident, for her pictures.

Colorectal cancer screening: a Public Health priority in Portugal

In Portugal, as in the rest of Europe, the incidence of cancer has been steadily increasing at a rate of about 3% per year.1,2 This increase is mainly related to the aging of the population and with changes in habits and lifestyles.3

According to the 2018 edition of Health at a Glance: Europe report (Organization for Economic Co-operation and Development – OECD), Portugal has one the lowest avoidable mortality rates in Europe, reflecting greater efficacy in the treatment of patients.4

However, cancer disease remains the second leading cause of death in Portugal after cardiovascular disease5,6, and the leading cause of premature death (defined as death before the age of 70).7

Colorectal cancer is currently one of the major forms of cancer in the world, with significant mortality and morbidity associated. In general, it is more common in older people (most patients are over 60 years at the time of diagnosis, being unusual in people with less than 40 years), in males and in urbanized regions.

According to the latest data from the International Agency for Research on Cancer (World Health Organization), colorectal cancer is currently the third most frequent type of cancer in the world and the second largest cause of death by cancer.

In Europe, it is the second most common type of cancer and the second deadliest. In Portugal, it is the second most frequent type of cancer in males (18,8% of the new cases, after prostate cancer) and females (16,2% of the new cases, after breast cancer) but ranks first in the most prevalent types of cancer for both genders.8

In 2018, Portugal has diagnosed 10 270 new cases of colorectal cancer (more than 20 cases per day), corresponding to 17,6% of the total number of new cases of cancer in the country.8 Despite the increasing therapeutic success in oncological disease, the number of deaths caused by this type of cancer has been increasing, especially in the most advanced ages.5,6 It is currently the second most deadly type of cancer (following lung cancer), accounting for approximately 4214 deaths (about 12 individuals per day)8 and about 12 years of potential life lost.9

The reduction of the mortality and morbidity associated with oncological disease depends mainly on preventive strategies and the early detection of the disease. However, the early stages of colorectal cancer are usually asymptomatic or produce little symptoms. The first manifestation of disease is often the asymptomatic loss of small amounts of blood in the stool, not visible to the naked eye, making the early detection difficult. For this reason, many countries now offer systematic population screening programs.

Most cancers of the colon and rectum develop from polyps or adenomas. These lesions are benign but have a significant risk of developing dysplasia, and therefore are considered pre-malignant. The screening programs aim to detect cancer in its initial phase but also to identify and remove these precursor lesions.

Due to the increasing number of cases, the screening for colorectal cancer is now considered a Public Health priority in Europe, and Portugal makes no exception.

Although the significance of the colorectal cancer screening program is unanimously proven (it has the potential do reduce mortality rates by at least 20%)3, there is no international consensus on the methodology that should be used. The strategies vary according to the human and financial resources available and the characteristics of each country. The most validated diagnostic exams currently in use are fecal occult blood tests (FOBT), rectosigmoidoscopy and complete colonoscopy. The fecal immunochemical test (FIT) is currently the most commonly used primary screening test worldwide and has been shown to contribute to increased participation rates, with appropriate sensitivity and cost-effectiveness10.

Portugal follows the European guidelines and has been developing the foundations for the implementation of a comprehensive population screening program. Thus, in Portugal, screening should be offered to the asymptomatic population aged between 50 and 74 years. As in most European countries, the primary screening test is the FIT, performed every 2 years. The convocation of patients for screening is ensured through their General Practitioners11.

In case of a positive result in the FIT (cut off of 100 ng/mL), the patient should be referred for colonoscopy, under informed consent and within the scope of the Portugal National Health Service, in an average period of no more than 30 days.

The referral algorithm after colonoscopy varies depending on the result of the exam and is performed according to the recommendations of the European Society of Gastrointestinal Endoscopy (ESGE)11.

Population-based screening programs for cancer have evolved significantly in Portugal during the last few years, with expansion of the geographic coverage, increased numbers of patients screened, and significant improvement in adherence rates. However, screening for colorectal cancer continues to present low countrywide coverage (about 19%)1, with significant regional asymmetry.

Portugal is currently making efforts to extend colorectal cancer screening throughout the country and to create the channels to adequately screen all the eligible individuals. As a result of the acknowledgement as a Public Health priority and the ongoing efforts, it is expected that in a few years, Portugal will be able to effectively reduce this problem.

Fábio Ricardo Elias Sousa Gomes

PH resident Aveiro, Portugal

References:

  1. Portugal. Ministério da Saúde. Direção-Geral da Saúde. Programa Nacional para as Doenças Oncológicas 2017. Lisboa: Direção-Geral da Saúde; 2017.
  2. Portugal. Ministério da Saúde. Direção-Geral da Saúde. Direção de Serviços de Informação e Análise. A Saúde dos Portugueses 2016. Lisboa: Direção-Geral da Saúde; 2016.
  3. Portugal. Ministério da Saúde. Direção-Geral da Saúde. Relatório de Monitorização e Avaliação dos Rastreios Oncológicos 2016. Lisboa: Direção-Geral da Saúde; 2017.
  4. Organisation for Economic Co-operation and Development. OECD Health Division. Health at a Glance: Europe 2018. Paris: OECD Publishing; 2018.
  5. Portugal. Instituto Nacional de Estatística. Causas de morte 2016. Lisboa: Instituto Nacional de Estatística; 2018.

A National Immunisation Information System in Italy

The Ministry of Health has recently established a National Immunisation Information System (IIS), through the Ministerial Decree of 17 September 2018 published in the Gazzetta Ufficiale n. 257/20181. The aim of the electronic registry is to facilitate estimation of vaccine coverage, monitor the nation-wide implementation of the National Immunisation Plan (NIP) throughout the national territory; and to provide information both to the international bodies and for administrative tasks.

The need to create a single IIS from 21 regional registers was agreed upon in the State-Regions Conference of 19 January 2017, and highlighted on the National Immunisation Plan 2017-20192. The Ministerial Decree of 17 September 2018 defines the information that all Italian regions and autonomous provinces must provide to the Ministry of Health, including:

1) vaccinated individuals;

2) individuals to be vaccinated;

3) subjects already immunised after natural infection;

4) subjects temporarily or permanently exempted for health reasons;

5) doses and timing of administrated vaccines.

The IIS should be linked to the national databases of communicable diseases and adverse events.

The national IIS will aggregate individual records from the regional registries and, through a more precise estimate of vaccination coverage, will improve the monitoring activities of the programs in place, and identify areas where extraordinary interventions are required. Furthermore, in order to maintain updated regional vaccine registries, the national IIS will make available to the Regions information related to citizens who will modify their residence. The Ministry of Health will have access only to anonymised information. The first upload of files from the regional authorities is expected by April 2019.

The last update of Italian regional IISs characteristics and functionalities are presented elsewhere3.

 

Vincenza Gianfredi

PH resident,  University of Perugia, Italy

 

References:

1. Ministero della Salute [Ministry of Health]. Decreto del Ministero della Salute: Istituzione dell’Anagrafe nazionale vaccini [Decree of Ministry of Health: Establishment of a National Immunisation Information System] 17 September 2018 published in the Gazzetta Ufficiale n. 257/2018

2. Ministero della Salute [Ministry of Health]. Piano Nazionale di Prevenzione Vaccinale 2017-2019 [National Plan of Vaccination Prevention 2017-2019]. 3 Apr 2018. Rome: Ministry of Health; 2018. Available from: http://www.salute.gov.it/imgs/C_17_pubblicazioni_2571_allegato.pdf

3. D’Ancona F, Gianfredi V, Riccardo F, Iannazzo S. Immunisation Registries at regional level in Italy and the roadmap for a future Italian National Registry. Ann Ig. 2018 Mar-Apr;30(2):77-85. doi: 10.7416/ai.2018.2199.

Internships Team 2019 – Call for action!

Dear EuroNetters,

A new year has just begun and the new board is working hard to make 2019 another amazing one for EuroNet!

I want to start this first communication as new Internships Lead by thanking my predecessor Julio and all the people that have been working hard on the Internships projects during 2018, your work has been precious for the development of the 2019 plan, and any future collaboration on the new projects will always be truly appreciated.

The main goals for 2019 are resumable in the following points:

  • To increase the number of Internships applications
  • To develop new communication and application strategies about internships and mobility for Public Health residents inside the EU
  • To strengthen and expand collaboration with partners and with the National Associations of Public Health residents

The main actions to achieve these goals will require a strong involvement of endeavoured residents, not only those who already are actively participating to EuroNet activities (members of National Commissions), but also of those who still are not fully engaged, but play a role inside their National Associations or simply are interested in working on mobility and helping their colleagues achieving internships periods.

Another important action, in order to try to raise the number of possible positions, is to engage in new partnerships that could provide internships and trainings or grants for summer schools and similar projects. At the same time, strengthening the already existent collaborations, in continuity with the previous board´s excellent work, might also lead to new opportunities of this kind.

The main actions to achieve these goals will require a strong involvement of endeavoured residents, not only those who already are actively participating to EuroNet activities (members of National Commissions), but also of those who still are not fully engaged, but play a role inside their National Associations or simply are interested in working on mobility and helping their colleagues achieving internships periods.

Another important action, in order to try to raise the number of possible positions, is to engage in new partnerships that could provide internships and trainings or grants for summer schools and similar projects. At the same time, strengthening the already existent collaborations, in continuity with the previous board´s excellent work, might also lead to new opportunities of this kind.

The results of this work can contribute to the formation of a working group, to the creation of workshops about this theme or can be used for whatever other useful scopes that will cross our path.

So, to be short, the plan is settled, now I need YOU!!!

If you are interested in joining the Internships Team, just send me an email (internships@EuroNetmrph.org), I will be extremely pleased to welcome you in the team and we can start working together.

There is of course a lot of room for plan improvement and for you to add new ideas, the work to do is not little but it´s going to be fun, interesting and never overwhelming!

And keep in mind that during the meeting in Torino we will have time to know each other and have the chance to organize the main part of the work.

This call for action is of course open to any PH resident, whether this is the first time you are reading the newsletter or not, just join if interested or simply curious!

Join the Internships, Stay for the Net!

Internships Lead

Robin Thomas

 

The Spring Meeting is coming!

Dear EuroNetters,

As the Spring Meeting approaches (Torino, 11-13th of April), we’d like to share some you some practical information about the meeting venues and the programme.
But first things first, so let’s start with a brief introduction of what EuroNet meetings are and what to expect if you join us.
Most of you reading this newsletter will probably already know that EuroNet meetings are a wonderful opportunity to meet public health residents from other EU countries, creating valuable networks for our present formation and future careers; moreover, it provides to the participants the chance to actively get involved in the different projects that the working groups inside EuroNet carry on throughout all the year.
Another important point that helps to make EuroNet meetings so special is the social programme; even those of you who still have not joined a meeting might have heard about some legendary stories about very big data, pineapples, absinthe voids, huge paellas, not-so-hot tubs in the snowy Slovenian mountains and many more which are better not to be shared on this occasion.
If you want to know more about previous meetings, take a look at our newsletters on http://EuroNetmrph.org/.
Coming to Torino, the meeting opening session will probably take place in the “Aula Magna del Rettorato” (Via Po 15) on Thursday 11 April.
The meeting should start by 14:00 and it will include a brief introduction of the meeting, a presentation of the new board and leads and their action plan for 2019 and a first session to allow the different Working Groups to update and work on their projects.
The following day and on Saturday morning the meeting venue will be the “Aula Magna di Igiene” (Via Santena 5 bis) and the two sessions (morning and afternoon) will be about the two most voted topics during the poll in January: Data Science and Public Health policies regarding fake news, alternative medicine and anti-scientific issues.
For the first topic we will have as our guests some experts from the Institute for Scientific Interchange (ISI Foundation) of Torino and from the Politecnico di Torino, while for the second topic we are waiting for confirmation by guests, although the idea is to use the formula of discussion groups: on these premises, if any of the participants want to share some issues related to PH policies, at a national or international level, and their impact on society and on the clumsy world of anti-scientific movements, please let us know (contacts at the bottom of the article). Examples of these would be how to cope with vaccination coverages, how
to deal with alternative treatments, what can be done on a more training and educational level for PH residents and how we think such issues should be addressed – both as residents and as future professionals.
On the last morning the General Assembly will take place, together with another WGs session, then all free to enjoy what Torino has to offer!
And this allows us to get through a crucial topic: Social Programme!
On one of the two meeting evenings (Thursday or Friday) we will have a world famous “Aperitivo”: this usually consists of a formula where with the first drink you get access to a buffet including a wide range of food, from starters to sweets, served hot and cold; we will choose the location after the subscription form will be closed, options include the beautiful locations of Piazza Vittorio Veneto or a terrace on the Po river. On the other night we will have a more regular dinner in one of the restaurants or trattorie in the city center. For Alberto and for those who call themselves brave, a steaming-hot Bagna Cauda is already waiting.
For those who are staying for the weekend, you can choose whether to have lunches and dinners all together or consider yourself free to enjoy a short holiday, we will ask this via the form just to have an idea.
Anyway, both Angelo and Robin will be fully available all weekend to take you around the city for sightseeing, visiting famous monuments and wineries, buying the best chocolate to take back to those you really care about.
The night will of course be the moment to get into the Torino nightlife, crazy bars and venues are already waiting for the EuroNet invasion!
We have arranged an agreement with the Tomato Backpacker hostel (https://www.tomato.to.it/) for cheaper fares, but the number of places is limited. We will give you the details on how to book in the registration’s opening mails. In case you won’t be able to find accomodations at Tomato, the area delimited by Via Po, the Po river, Corso Dante and Via Nizza, along the metro line or the bus line 18, is the best in terms of transports and proximity to city center (you can find the map on the EuroNet website).

Can’t wait to meet you there!!

The Organisation Team

Contact info: robin.thomas@unito.it, a.dambrosioMD@gmail.com

Which Social Platform is preferred between Turkish Public Health Residents’ for Communication?

I suppose that this is the first article from Turkey in EURONET-MRPH Newsletter. So, I want to share our experience for communication as first. It is very exciting and important to communicate between European students for us. It is also very important to provide a good communication medium between Turkish residents.

However, it is very difficult to choose best social medium, especially if there are hundreds of residents. For example, it is estimated that there are about 500 public health residents in more than 50 medical schools in Turkey. We use google mail group and whatsapp application to get in contact. Well, most of the residents have hesitations to write or to ask to the mail group, and they find whatsapp more practical then the mail group.

They think that they could get answers to their questions rapidly in whatsapp. Although, whatsapp is preferable for notifications, all residents couldn’t participate to residents’ group due to participant limitation.

As a representative of residents in HASUDER (Turkish Society of Public Health Specialists), i had carried out an online survey to choose the best social medium / media which had continued for ten days in November 2018. Then, we discussed the results to decide communication media in Medical Residents Session of 20th National Public Health Congress, Antalya.

Figure 1. Social Media Use of Public Health Residents for Academic Purposes

Total 156 residents completed the online survey (about 1/3 of all residents). Mean age of participants was 29.3±3.2 years and mean duration of residency was 23.5±15.6 months. About three quarters of the residents (73.7%) was female. Please don’t worry; it is not an error, there is apparently female predominance in Turkish public health residents. Most of the participants (84.5%) specified that they used social media every day. More than 90.0% of residents could interest in social media several times in a week. However, only 76.3% of residents specified that they could interest in social media for academic purposes several times in a week.

Youtube, mail groups and whatsapp application were the most used media for academic purposes (Figure 1).

Residents preferred to communicate mostly with mail groups, whatsapp, telegram and instagram for academic communication (Figure 2).

Figure 2. Social Media Communication Preferences of Public Health Residents for Academic Purposes

Youtube, researchgate, linkedin and academia.edu  were excluded for academic communication preferences. Because, they were not suitable for mutual and group communication. Few residents chose medscape and discord under the title of “others” for both in Figure 1 and 2.

It could be concluded that mail groups and whatsapp are trending media. In public health conference , we discussed that whatsapp was not enough, maybe it would be better to change it to telegram according to survey results. Instagram was a surprise in this survey. Perhaps, it might have a function in the future in terms of the public health.

Ferhat Yildiz
MD, Representative of Residents, HASUDER, Turkey

Aydin Adnan Menderes University, School of Medicine

Department of Public Health

Merhaba (Hello)!

References and Social Media resources used

  1. Facebook, www.facebook.com (Accessed in 19th Nov 2018)
  2. Twitter, www.twitter.com (Accessed in 19th Nov 2018)
  3. Instagram, www.instagram.com (Accessed in 19th Nov 2018)
  4. Youtube, www.youtube.com (Accessed in 19th Nov 2018)
  5. Linkedin, www.linkedin.com (Accessed in 19th Nov 2018)
  6. Researchgate, www.researchgate.net (Accessed in 19th Nov 2018)
  7. Academia.edu, www.academia.edu (Accessed in 19th Nov 2018)
  8. Google groups, https://groups.google.com/forum/#!overview (Accessed in 19th Nov 2018)
  9. Whatsapp, www.whatsapp.com (Accessed in 19th Nov 2018)
  10. Telegram, https://telegram.org (Accessed in 19th Nov 2018)
  11. Medscape, www.medscape.com (Accessed in 19th Nov 2018)
  12. Discord, https://discordapp.com (Accessed in 19th Nov 2018)

Perspectives: Public Health Workforce Development in Slovenia and Wider

Introduction

History of modern society is riddled with public health breakthroughs. Advances based on the notion of prevention of disease and promotion of good health allowed for better living conditions, safe transportation, diverse and nourishing diets, and numerous other standards of developed societies most of us take for granted.

In retrospect, we praise much of those advances as prototypal public health measures. Did ingenious minds behind those actions perceive themselves as public health pioneers? One might even argue that they needn’t identify as such (1). John Snow, Louis Pasteur and Robert Koch transformed the world through their work and for that they only had to subscribe to the ideal of public health – not to the profession. They were inventors that spawned a health revolution. But times have changed. We are faced with globalised world, global warming and regular political tantrums with possibly perilous consequences (2). Nations of the world are putting health high on the agenda with concerted actions such as Millennium Development Goals and Sustainable Development Goals (3). Further advancement of public health demands a different toolset and approaches from those of past eras. This holds true for public health practice on international as well as on an national or even local level (4). Modern challenges of public health require a workforce with capacities to address and overcome them (5,6). Public health practitioners of today and tomorrow need to be leaders as much as scientists and inventors (7). Development of such a workforce is the common theme of following reflections provided by a group of professionals with deep insight into education and training practices in public health.

The collection of reflections starts with an overview of current status and recent initiatives in public health workforce development in the European region written by Robert Otok, Katarzyna Czabanowska, and John Middleton who are all active in Association of Schools of Public Health in the European Region, a key independent European organisation dedicated to strengthening the role of public health by improving education and training of public health professionals for both practice and research.

Alberto Mateo, president of the European Network of Medical Residents in Public Health, further reflects on the topic of international cooperation and on importance of internationally harmonised curricula in public health education. Afterwards authors focus on analysing and reflecting on public health workforce development in Slovenia. Tit Albreht from National Institute of Public Health addresses the challenge of diversification of public health workforce in Slovenia. In his commentary, he stresses the importance of standard education as well as continuous professional development. Recognising the importance of having a modern and comprehensive public health educational programme for medical residents, Lijana Zaletel Kragelj from Faculty of Medicine at University of Ljubljana provides us with a summary of the transformation of Slovenian public health specialty training programme from its conception and offers us with a glimpse of what we can expect in near future. Ivan Eržen from National Institute of Public Health completes the overview of graduate and postgraduate programmes which offer public health topics in their curriculums. Acknowledging the limitations of current landscape of educational opportunities in public health he points out the need for a school of public health which has yet to be established in Slovenia. In the following commentary, Marjan Premik, one of the main protagonists of establishment of school of public health in Slovenia, introduces arguments for school of public health as an integral part of health care system. Putting the emphasis on the wider public health workforce, Mitja Vrdelja from National Institute of Public Health, gives his view on working in public health in Slovenia from a communications expert perspective and complements reflections on workforce developments from previous authors with challenges that could be solved with appropriate education and training of public health workforce. Current Perspectives are rounded up with a playful note by a discussion I had with Damir Ivanković, a former public health resident from Croatia who is presently a researcher at the Academic Medical Center in Amsterdam. Since both of us are a young public health professionals from relatively small countries we take a look at benefits and drawbacks of starting a career in such an environment.

Matej Vinko
National Institute of Public Health of Slovenia, Ljubljana, Slovenia

Keep reading the article at:
http://www.nijz.si/sites/www.nijz.si/files/uploaded/vinko_jz_03-06.pdf

References

  1. Nijhuis HG, van der Maesen LJ. The philosophical foundations of public health: an invitation to debate. J Epidemiol Community Health. februar 1994.;48(1):1–3.
  2. Lomazzi M, Jenkins C, Borisch B. Global public health today: connecting the dots. Glob Health Action. 2016.;9:28772.
  3. Sachs JD. From Millennium Development Goals to Sustainable Development Goals. The Lancet. 9. junij 2012.;379(9832):2206–11.
  4. Birt CA, Foldspang A, Otok R. Meeting the population health challenge: what should you know, and what should you be able to do? Eur J Public Health. oktober 2018.;28(5):789–90.
  5. Bjegovic-Mikanovic V, Foldspang A, Jakubowski E, Müller-Nordhorn J, Otok R, Stjernberg L. Developing the public health workforce. Eurohealth Inc Eur Obs. 2015.;21(1):24–7.
  6. Collyer TA. Three Metaphors to Aid Interdisciplinary Dialogue in Public Health. Am J Public Health. 25. september 2018.;e1–4.
  7. Czabanowska K, Rethmeier KA, Lueddeke G, Smith T, Malho A, Otok R, in sod. Public health in the 21st century: working differently means leading and learning differently. Eur J Public Health. december 2014.;24(6):1047–52.

As published in Revija Javno zdravje