Recognition of COVID-19 with occupational origin: a comparison between European countries.

OBJECTIVES: This study aims to present an overview of the formal recognition of COVID-19 as occupational disease (OD) or injury (OI) across Europe. METHODS: A COVID-19 questionnaire was designed by a task group within COST-funded OMEGA-NET and sent to occupational health experts of 37 countries in WHO European region, with a last update in April 2022. RESULTS: The questionnaire was filled out by experts from 35 countries. There are large differences between national systems regarding the recognition of OD and OI: 40% of countries have a list system, 57% a mixed system and one country an open system. In most countries, COVID-19 can be recognised as an OD (57%). In four countries, COVID-19 can be recognised as OI (11%) and in seven countries as either OD or OI (20%). In two countries, there is no recognition possible to date. Thirty-two countries (91%) recognise COVID-19 as OD/OI among healthcare workers. Working in certain jobs is considered proof of occupational exposure in 25 countries, contact with a colleague with confirmed infection in 19 countries, and contact with clients with confirmed infection in 21 countries. In most countries (57%), a positive PCR test is considered proof of disease. The three most common compensation benefits for COVID-19 as OI/OD are disability pension, treatment and rehabilitation. Long COVID is included in 26 countries. CONCLUSIONS: COVID-19 can be recognised as OD or OI in 94% of the European countries completing this survey, across different social security and embedded occupational health systems.

Higher Education in Public Health as a Tool to Reduce Disparities: Findings from an Exploratory Study among the Bedouin Community in Israel.

The Bedouin community is a minority disadvantaged population in Israel that suffers from a variety of health and socioeconomic disparities and limited access to higher education. The current study aimed to examine perceptions, successes, and challenges experienced by Bedouin students during their studies and to assess an internship program developed on the principles of a community-based participatory research approach to public health. In-depth interviews were conducted with 34 Bedouin students studying in the public health academic track between January and April 2023. Grounded Theory was used to analyze the data. Three main themes emerged from the analysis: (1) facilitators for the decision to pursue higher education in public health, (2) challenges and coping strategies, and (3) experiences of success. The internship program included eleven Bedouin students who conducted six community intervention projects covering a range of topics with different target Bedouin populations. Higher education is crucial for empowering minorities, producing leadership, and reducing socioeconomic and health gaps. The field internship enabled the necessary alignment between academia and public health practice. It is important to further reflect on the integration of minority groups in public health studies and its role in decreasing health inequity.

Patients' and oncologists' perceptions towards the discussion on high-cost innovative cancer therapies: findings from a qualitative study.

OBJECTIVES: In the last decades, innovative technologies for cancer treatment were developed rapidly. In most cases, their price is high, with no funding offered by public health systems. The present study examined the perceptions of oncologists, patients and family members regarding the challenges in discussing innovative cancer treatments. DESIGN: Qualitative study, using in-depth semistructured interviews. Interviews examined public versus private financing, therapist-patient-family discourse, modes of decision making and implications on health policy and inequalities. PARTICIPANTS: Sixteen cancer patients, six family members of cancer patients and 16 oncologists participated in the study. RESULTS: Four themes emerged from data analysis: the economic consideration in the decision on cancer treatment, the options of funding high-cost private treatments, psychosocial aspects of the discussion on treatment costs and health policy in oncology and its social aspects. CONCLUSIONS: Findings emphasise the importance of considering costs when recommending expensive care and addressing the emotional element of innovative treatment, as most patients expect. The findings present various psychosocial aspects taking part in the complicated decision to use unfunded cancer treatment and its broad implications, which may use as a basis for developing a guided framework for oncologist-patient discourse.

Emerging lessons from the COVID-19 pandemic about the decisive competencies needed for the public health workforce: A qualitative study.

The global COVID-19 crisis exposed the critical need for a highly qualified public health workforce. This qualitative research aimed to examine public health workforce competencies needed to face COVID-19 challenges and identify the gaps between training programs and the competency demands of real-world disasters and pandemics. Through a sample of thirty-one participant qualitative interviews, we examined the perspectives of diverse stakeholders from lead public health organizations in Israel. Grounded Theory was used to analyze the data. Six themes emerged from the content analysis: public health workforce's low professional status and the uncertain future of the public health workforce; links between the community and Higher Education institutions; the centrality of communication competencies; need to improve health promotion; the role of leadership, management, and partnership, and innovation in public health coherence. Increasing the attractiveness of the profession, professional and financial support, and improving the working conditions to ensure a sustainable and resilient PH system were deemed necessary. This paper describes and cultivates new knowledge and leadership skills among public health professionals, and lays the groundwork for future public health leadership preparedness programs.

Identifying the Gaps Between Public Health Training and Practice: A Workforce Competencies Comparative Analysis.

Objectives: The study aimed to generate insights on how best to enhance the compatibility between Public Health training program competencies and the implementation of competencies required by employers to address current and emerging public health needs. Methods: A survey adapted from the WHO-ASPHER Competency Framework for the Public Health Workforce was conducted online among Israeli public health managers from August to November 2021. The survey was formulated to mirror Essential Public Health Operations. Forty-nine managers participated (37.6% response rate) in an assessment of 44 public health competencies and the core organizational public health operations. Results: Analysis of Essential Public Health Operations revealed a notably high deficiency reported for Advocacy Communication and Social Mobilization for health competencies. Collaborations and Partnership and, Leadership and System Thinking were the most reported insufficient competencies, particularly in health departments and research institutes. Governmental offices reported Organizational Literacy and Adaptability competencies being deficient. Deficiencies were more impactful as the level of expertise increased. Conclusion: There is a clear need for public health professionals to acquire versatile and innovative competencies in response to the ever-changing health threats.

The Future Public Health Workforce in a Changing World: A Conceptual Framework for a European-Israeli Knowledge Transfer Project.

Health services quality and sustainability rely mainly on a qualified workforce. Adequately trained public health personnel protect and promote health, avert health disparities, and allow rapid response to health emergencies. Evaluations of the healthcare workforce typically focus on physicians and nurses in curative medical venues. Few have evaluated public health workforce capacity building or sought to identify gaps between the academic training of public health employees and the needs of the healthcare organizations in which they are employed. This project report describes the conceptual framework of "Sharing European Educational Experience in Public Health for Israel (SEEEPHI): harmonization, employability, leadership, and outreach"-a multinational Erasmus+ Capacity Building in Higher Education funded project. By sharing European educational experience and knowledge, the project aims to enhance professionalism and strengthen leadership aspects of the public health workforce in Israel to meet the needs of employers and the country. The project's work packages, each jointly led by an Israeli and European institution, include field qualification analysis, mapping public health academic training programs, workforce adaptation, and building leadership capacity. In the era of global health changes, it is crucial to assess the capacity building of a well-qualified and competent workforce that enables providing good health services, reaching out to minorities, preventing health inequalities, and confronting emerging health challenges. We anticipate that the methods developed and the lessons learned within the Israeli context will be adaptable and adoptable by other countries through local and cultural adjustments.

Recommending Unfunded Innovative Cancer Therapies: Ethical vs. Clinical Perspectives among Oncologists on a Public Healthcare System-A Mixed-Methods Study.

Over the past decade, there has been a growing development of innovative technologies to treat cancer. Many of these technologies are expensive and not funded by health funds. The present study examined physicians' perceptions of the ethical and clinical aspects of the recommendation and use of unfunded technologies for cancer treatment. This mixed-methods study surveyed 127 oncologists regarding their perceptions toward using unfunded innovative cancer treatment technologies, followed by in-depth interviews with 16 oncologists. Most respondents believed that patients should be offered all treatment alternatives, regardless of their financial situation. However, 59% indicated that they often face dilemmas regarding recommending new unfunded treatments to patients with financial difficulties and without private health insurance. Over a third (38%) stated that they felt uncomfortable discussing the cost of treatment with patients. A predictive model found that physicians facing patients whose medical condition worsened due to an inability to access new treatments, and who expressed the opinion that physicians can assist in locating funding for patients who cannot afford treatments, were more likely to recommend unfunded innovative therapies to patients (F = 5.22, R2 = 0.15, p < 0.001). Subsequent in-depth interviews revealed four key themes: economic considerations in choosing therapy, patient-physician communication, the public healthcare fund, and discussion of treatment costs. Physicians feel a professional commitment to offer patients the best medical care and a moral duty to discuss costs and minimize patients' financial difficulty. There is a need for careful and balanced use of innovative life-prolonging technologies while putting patients at the center of discourse on this complex and controversial issue. It is essential to develop a psychosocial support program for physicians and patients dealing with ethical and psychosocial dilemmas and to set guidelines for oncologists to conduct a comprehensive and collaborative physician-patient discourse regarding all aspects of treatment.

Establishing undergraduate public health education: process, challenges, and achievements in a case study in Israel.

BACKGROUND: In this paper, we describe the development process of the first undergraduate public health baccalaureate program, in the Ashkelon Academic College in Israel. Expansion of degree-granting colleges in Israel is part of the democratization of higher education providing access to and increasing educational opportunities for groups underrepresented in universities. The main objectives of the program at Ashkelon Academic College have been to open accessible and affordable career opportunities for current workers in the health system and for new entries to health careers for academic advancement in a peripheral and relatively poor region of the country. CASE PRESENTATION: The program focuses on well-established and literature-based learning goals of public health education but also includes basic medical sciences, incorporation of arts and sciences into public health, development of critical thinking and quantitative skills, experiential field learning, and integrative learning for facing global health challenges. The curricula of the program is composed of seven modules including introductory courses, methodology courses, health organization courses, epidemiology courses, courses related to core content of public health, elective courses and practicum. The first class will graduate in 2017; this will allow for final approval of the Council of Higher Education of Israel and possible revision of curriculum. A second BA program is now seeking approval in Israel and cooperation with post-graduate schools of public health is developing. CONCLUSIONS: Our program is in keeping with trends in Europe and the USA to broaden public health education, to reduce inequality of career opportunity, to expand the workforce, and to promote public health.