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

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.

Do uncertainty analyses reveal uncertainties? Using the introduction of DNA vaccines to aquaculture as a case.

The Walker and Harremoës (W&H) uncertainty framework is a tool to systematically identify scientific uncertainty. We applied the W&H uncertainty framework to elicit scientists' judgements of potential sources of uncertainty associated with the use of DNA vaccination in aquaculture. DNA vaccination is considered a promising solution to combat pathological fish diseases. There is, however, lack of knowledge regarding its ecological and social implications. Our findings indicate that scientists are open and aware of a number of uncertainties associated with DNA vaccination e.g. with regard to immune response, degradation and distribution of the DNA plasmid after injection and environmental release, and consider most of these uncertainties to be adequately reduced through more research. We proceed to discuss our experience of using the W&H uncertainty framework. Some challenges related to the application of the framework were recognised. This was especially related to the respondents' unfamiliarity with the concepts used and their lack of experience in discussing qualitative aspects of uncertainties. As we see it, the W&H framework should be considered as a useful tool to stimulate reflection on uncertainty and an important first step in a more extensive process of including and properly dealing with uncertainties in science and policymaking.

Sustaining success: aligning the public health workforce in South-Eastern Europe with strategic public health priorities.

OBJECTIVES: To map out the Public Health Workforce (PHW) involved in successful public health interventions. METHODS: We did a pilot assessment of human resources involved in successful interventions addressing public health challenges in the countries of South-Eastern Europe (SEE). High-level representatives of eight countries reported about success stories through the coaching by experts. During synthesizing qualitative data, experts applied triangulation by contacting additional sources of evidence and used the framework method in data analysis. RESULTS: SEE countries tailored public health priorities towards social determinants, health equalities, and prevention of non-communicable diseases. A variety of organizations participated in achieving public health success. The same applies to the wide array of professions involved in the delivery of Essential Public Health Operations (EPHOs). Key enablers of the successful work of PHW were staff capacities, competences, interdisciplinary networking, productivity, and funding. CONCLUSIONS: Despite diversity across countries, successful public health interventions have similar ingredients. Although PHW is aligned with the specific public health success, a productive interface between health and other sectors is crucial for rolling-out successful interventions.

Making the EU "risk window" transparent: the normative foundations of the environmental risk assessment of GMOs.

In Europe, there seems to be widespread, morally based scepticism about the use of GMOs in food production. In response to this scepticism, the revised EU directive 2001/18/EC on the deliberate release into the environment of genetically modified organisms stresses the importance of respecting ethical principles recognized in the Member States. However, the directive fails to reflect the critical role of value judgements in scientific risk assessment and any subsequent approval procedure. In this paper we argue that it is important to make all ethically relevant assumptions involved in the approval procedure transparent and thus available for public scrutiny. Mapping the value judgements that are made in an environmental risk assessment and approval procedure, we describe the political liberal nature of the EU legislation. We then look more closely at the prescriptions for environmental risk assessment and approval of GMOs outlined in the directive. An environmental risk assessment views the world through a "risk window" that only makes visible that which has been predefined as a relevant risk. The importance of the value judgements that define the risk window consists in limiting the information the risk assessment can provide. In the penultimate section of the paper, the significance of the risk window is demonstrated through a case study of the approval of glyphosate resistant fodder beets (Beta vulgaris L. ssp. vulgaris) in Denmark.