URBANE addresses an important and timely question: how does the urban environment impact the developmental origins of multimorbidity? Neurodevelopmental, cardiometabolic and respiratory adverse health outcomes are increasingly prevalent at young ages, with diseases such as obesity and asthma affecting up to four out of ten children in Europe. Multimorbidity, the co-occurrence of two or more health conditions, in childhood is thus becoming a major public health problem with short- and long-term consequences. Although it is well known that environmental hazards play a role in the development of diseases, the contribution of the complex environment in which we grow up and live on the development of multimorbidity remains unclear. URBANE addresses this knowledge gap. The project will leverage the resources of the Portuguese population-based birth cohort Generation XXI and follow an exposome-wide approach to the study of urban environmental impact on childhood multimorbidity. For that, the project will use a wide range of geospatial urban exposure data (e.g., air pollution, and characteristics of the urban natural and built environment) and multiple adverse health outcomes (e.g., high blood pressure, obesity, asthma, behavioral problems) collected at the vulnerable early stages of the lifecourse (pregnancy and childhood). The project will explore socioeconomic status and gender differences and also assess whether DNA methylation changes and dysregulation of hormone leptin explain the urban environmental impact on multimorbidity. URBANE will contribute to the discovery of urban environmental priorities, vulnerable subpopulations and aid in the identification of underlying mechanisms. URBANE is highly interdisciplinary, and fosters knowledge exchange. The project aligns with major EU strategies related to the urban environment and non-communicable diseases prevention, and thus its results are expected to be of high relevance for researchers, policy makers, and society.
In 2016, the World Health Assembly launched the WHO’s ‘End TB strategy’; an ambitious project to reduce TB incidence by 90% before 2035 and progress to 1 TB case per million in 2050 worldwide. Effective routes to TB elimination are, among others, optimized treatment regimens to shorten treatment duration and better diagnostic methods. Unfortunately, advances are very slow due to a huge lack of funding and clinical research capacity to conduct trials. The TB research community needs to be both creative and innovative to build and strengthen existing capacity as well as to expand clinical trial networks to perform more cost- and time effective drug- and diagnostic trials. With this RISE proposal we aim to strenghten the European-Latin American TB Research Collaboration Network (EUSAT-RCS), offer capacity building for Paraguayan and European TB professionals and build up a Latin American TB clinical hub. A group of ESRs, ERs, TECH and other professionals are brought together to carry out clinical research spanning epidemiology of TB in populations to GWAS and the validation of an innovative eNose device for point-of-care diagnostic value.
Oral diseases and conditions affect more than 3.5 billion people worldwide. They are the 3rd most expensive diseases to treat in the EU and disproportionally affect vulnerable groups. In deviation from the UN and WHO goal of Universal Health Coverage, many EU citizens do not have access to quality oral care without financial hardship. To this end, the DELIVER (DELiberative ImproVEment of oRal care quality) project aims to enhance the quality of oral care through deliberative dialogue and action involving citizens, patients, providers, payers and policymakers. DELIVER will create a synergistic problem-solving ecosystem to convert deliberative dialogues into meaningful improvement of oral care quality. DELIVER brings together top investigators from prestigious universities, civil society and patient organizations, health professionals, policymakers, and SME/industry to achieve a step change in collective problem solving. Given the comprehensiveness of the topic, DELIVER uses a targeted approach that is entirely focused on five major root-causes underlying the current limitations of oral care systems. Using a mixed-methods research approach, DELIVER will co-develop and co-produce new quality improvement approaches in three phases. The 1st phase involves situational analysis, consenting of core quality indicators, and development of a EU-wide monitoring framework. The 2nd phase involves in-depth analysis of select quality improvement approaches: (i) PROMs/PREMs-based quality improvement in dental practices; (ii) community-based quality improvement for vulnerable groups; (iii) quality-oriented commissioning of oral health services. The regulatory determinants of oral care quality improvement will be scrutinized. In the 3rd and final phase, the knowledge gained in the 1st and 2nd phases will be merged into the DELIVER Quality Toolkit with manuals and digital tools for concretely actionable and context-adaptive approaches for oral care quality improvement.
Mental health has been identified as an urgent priority in Europe, but is under critical threat because of climate change, digitalization, socio-economic inequities, migration, aging populations, and COVID-19. Protecting the mental health of vulnerable populations in these times of change requires innovative solutions beyond treatment in the clinical healthcare system. ADVANCE is a wide-ranging project which will deepen the understanding of the mental health promotion and prevention field. It will provide specific programmes which can be replicated for key groups in diverse countries in Europe and create the guidance and methodologies required to ensure that effective mental health programmes can be developed, adapted, implemented, assessed, and scaled. We propose an ambitious mixed-methods project with overarching interdisciplinary focus on social justice. Our study encompasses: (1) a rigorous co-creation process with end-users, practitioners, and policy makers; (2) an interrelated set of intervention studies with diverse vulnerable populations (from youth to old age); and (3) scaling-up strategy development. We will conduct five trials and an implementation study. Participants will be youth affected by climate change in Germany; socio-economically disadvantaged young adults in Lithuania; working adults in highly digitalized work environments in the Netherlands; migrants in Italy and Denmark; and older adults in Switzerland. All intervention studies will include adaptation through human-centred design; participatory process evaluations; stigma prevention; and scaling strategy development. We will deliver situational analyses, intervention packages, and scaling strategies in 7 countries. Based on our research across a range of developmental stages, risks, and settings we will be able to deliver 5 higher-level (synthesis) guidelines widely applicable in Europe – collected in the public-facing, openly accessible ADVANCE resource package.
Oral diseases and conditions are the 3rd most expensive diseases to treat in the EU. They affect about half of the EU population. As highlighted in the 2021 WHO Oral Health Resolution, there are major challenges in the financing of oral health care: in deviation from the UN and WHO goal of Universal Health Coverage, many EU citizens do not have access to essential oral health care without financial hardship. This causes detrimental impacts for the individual citizen, while increasing costs and wasting resources on the macro level. Research-policy gaps and research-practice gaps keep triggering inertia and inaction instead of addressing the persistent, albeit largely preventable, burden of oral diseases. To this end, the PRUDENT (Prioritization, incentives and Resource use for sUstainable DENTistry) project aims to develop and implement an innovative and context-adaptive framework for optimized financing of oral care. PRUDENT brings together top investigators from prestigious universities, public authorities and policymakers, civil society and patient organizations, health insurers, and health professionals, to achieve a step change in collective problem solving. Given the comprehensiveness of the topic, PRUDENT uses a targeted approach that is entirely focused on four major root-causes underlying the current limitations of oral care financing. Using a mixed-methods research approach, PRUDENT will: (i) co-develop oral health system performance indicators and implement them in EU-wide monitoring framework; (ii) conduct real-world and lab experiments to identify improved oral care financing mechanisms; (iii) leverage regulatory learning, needs-adaptive resource planning and deliberative priority setting to enhance the improvement of oral care financing. The knowledge gained will be merged into the PRUDENT Financing Companion with policy briefs and decision aid tools for concretely actionable and context-adaptive improvement of oral care financing.