bluuebunny/crossref_metadata_2025 huggingface dataset:
Positive Health and palliative care: an exploration among nurses
Authors: De Bot C , Dierx J , Echteld M
Published: October 2022

Background

The current WHO definition of health seems to no longer meet the changes in the current Dutch health system. An alternative approach which puts emphasis on health, not disease, is Positive Health (Huber et al, 2011). This focus shifts the emphasis on improving resilience and well-being rather than the perspective on what is lacking in health.In this study, the attitudes towards the concept of Positive Health of palliative care nurses are examined.

Methods

A mixed-methods approach design was used for this study. This involved the collection of both quantitative and qualitative data. Among the nurses, 134 questionnaires were administered. SPSS was used to analyze these results. For this study, six interviews were conducted and analyzed through thematic coding.

Results

The quantitative analysis shows that the respondents are look positively about the Positive health description. Nurses find it important that it emphasizes that someone is more than his illness. In addition, the emphasis is on personal control. However, the question is also raised whether every patient can handle this. Nurses find the most important dimension ‘quality of life'. This is followed by the dimension ‘mental well-being’ and ‘spiritual existential'. The dimension ‘daily functioning’ is found to be the least important. The qualitative analysis also shows that the concept of Positive Health is viewed positively. The concept is considered positive, because it covers several areas of health. However, it was also indicated that the concept is still too broad. However, all respondents found that the concept can be applied in practice.

Conclusions

This study shows that palliative care nurses have a positive attitude towards Positive Health. Nurses consider the all the dimensions important and also embed the aspects of it in their daily practice. However, the implementation of new concept should be explored.

Key messages

• Palliative care nurses have a positive attitude towards Positive Health.

• The implementation of Positive Health in palliative care should be explored.
Parents’ evaluations on the service delivery and communicatıon skills of the pediatric dentists
Authors: Karamüftüoğlu N , Uğraş Dikmen A , Atabek D , Korkmaz Öner FS , Özkan S
Published: October 2022

Aim

In the study,it was aimed that parents who need oral health services for their children for any reason should evaluate pediatric dentists in terms of service provision and communication skills.

Methods

The study was conducted with 123 parents who applied to a private oral health clinic in Ankara between 20/06/2021-20/07/2021.For parents,10 descriptive and 20 face-to-face questionnaires questioning service delivery and communication skills on a 5-point Likert scale were applied.

Results

The mean age of the participants was 40.9±5.9 years.Only 34.1%(n = 42) of the parents who needed oral health services for their children directly applied to the pediatric dentist,while the others 65.9%(n = 81) applied to dentists who were not pediatric dentistry specialists.The mean score of evaluation of parents’ pediatric dentists in terms of service delivery and communication skills is 4.16±0.44.When pediatric dentists were evaluated in terms of service delivery and communication skills.74.8%(n = 92) made the explanations in a way that they could easily understand,67.8%(n = 82) did not speak fast enough to prevent them from understanding the words,66.9%(n = 79) stated that they created an environment that respects privacy and 72.6%(n = 85) stated that they allocated enough time as “always”.

Conclusions

As a result, it has been determined that the frequency of parents applying to physicians who are not pediatric dentists for their children’s oral health problems is high. However,the parents who applied to the pediatric dentist found the pediatric dentist to be more competent in terms of service delivery and communication skills.It is necessary to increase the awareness of the parents about the pediatric dentistry expertise.

Key messages

• Parental evaluations of pediatric dentists regarding service delivery and communication skills are important.

• Oral health literacy of parents should be developed.
LärMiljö (Learning Environment) - study protocol: movement, outdoor learning and well-being in school
Authors: Simonsen N , Wackström N , Ray J
Published: October 2022

Background

Outdoor education (OE) is a teaching method aiming to promote children’s learning, physical activity (PA) and wellbeing. OE in green areas may further increase positive effects. There is little knowledge on use of OE and its possible effects in a Finnish context. Also, there is a need to evaluate OE from a teacher perspective. The aim of the LärMiljö-study is to: a) survey the use of OE in Swedish-language primary schools and investigate factors related to its use; b) investigate the associations between OE and PA, wellbeing, nature relations and learning among children aged 9-13 years, considering other related factors.

Methods

The self-determination theory (SDT) is used as theoretical framework. Data is collected via electronic surveys in Swedish-language primary schools, including: a) national surveys among principals and teachers; b) surveys among children and guardians. Children’s PA is measured for a 7-day period via accelerometers and a diary is kept. Teachers keep a class diary on OE provided. Academic tests are performed. Data will be analyzed using quantitative methods.

Results

This abstract describes the study protocol. The investigation of associations between OE and outcomes among children is mainly done by comparing classes that regularly use OE with classes that do not. Main outcomes are PA, psychosocial wellbeing, academic performance and nature connectedness; secondary outcomes are school motivation, social relations and sleep. Teachers’ experience and use of OE is explored, as is perceived effects of and barriers to OE use. Based on SDT, associations between OE and need satisfaction at work, competence, motivation and work engagement are studied.

Conclusions

The study represents a unique opportunity to explore OE use in primary schools, its effects among children and teachers, and what the supporting and hindering factors for its use are. The study contributes knowledge that can be used to promote learning and wellbeing in school.

Key messages

• Outdoor education in primary school may promote schoolchildren’s learning, physical activity, wellbeing and nature relation, but more knowledge is needed, including the perspective of teachers.

• The LärMiljö-study will broaden the understanding of the potential effects of OE in primary education and school health promotion, and on factors supporting and hindering its use.
A health promotion intervention for vulnerable schools (BeE-school): a cluster-randomized trial
Authors: Rosário R , Pereira B , Novais P , Antunes H , Silva MJ , Augusto C
Published: October 2022

Background

Noncommunicable diseases (NCDs) share key determinants like unhealthy diet, unhealthy 24h- movement behaviour (sleep, sedentary behaviour and physical activity), leading to other risks including overweight, obesity and raised blood pressure. Although the manifest of the NCDs in childhood is rare, risk behaviours, obesity, and raised blood pressure that accelerates their development begin during childhood. The current study aims to analyze the effectiveness of the intervention program based on the promotion of health literacy and lifestyles, on children’s health literacy, lifestyles (e.g. dietary intake, 24hmovement behaviour) and overweight and obesity.

Methods

478 children (6 schools) aged 6-12years old will participate in this cluster-randomized trial, having schools as the unit of randomization, assigned into intervention (239-3schools) and the control arm (239-3schools). This project is currently performing social listening (online and offline) and stakeholders’ involvement. Data collection includes sociodemographics, health literacy and infodemic resilience, dietary intake and children’s 24-h movement behaviour (e.g. accelerometry), anthropometry (e.g. weight, height and waist circumference) and blood pressure. It will occur at baseline and after the intervention (follow-up, 6 months after the beginning of the intervention).

Results

Expected outputs and outcomes include the 1-creation of a model for characterizing NCDs and health topics based on artificial intelligence techniques (e.g. deep learning, social network analysis methods).2- improved health literacy and infodemic resilience of children, families and teachers.3- enhanced children’s lifestyles. 4- reduce NCDs’ physical risk factors (e.g. overweight, raised blood pressure).

Conclusions

A feasible intervention program for school-aged children with vulnerabilities enhances tailored policies about health promotion and NCDs’ prevention, respecting the contextś singularities.

Key messages

• Health promotion and NCDs prevention are crucial for the well-being of our societies.

• Feasible intervention programs advocates for evidence-based policies that respect local singularities.
Codevelopment and evaluation of a multicomponent intervention to improve HPV vaccination in France
Authors: Bocquier A , Bonnay S , Bruel S , Chevreul K , Gagneux-Brunon A , Gauchet A , Giraudeau B , Le Duc-Banaszuc AS , Mueller JE , Thilly N
Published: October 2022

Background

HPV vaccine coverage (VC) in France has always been lower than in most high-income countries. The French authorities launched in 2018 the PrevHPV national research program aimed at codeveloping with stakeholders and evaluating the impact of a multicomponent intervention to improve HPV VC among French adolescents.

Methods

We identified three components to address main barriers to HPV vaccination in France: adolescents’ and parents’ education and motivation (component 1); general practitioners (GPs)’ training (component 2); and access to vaccination at school (component 3). We developed the intervention using the UK Medical Research Council framework for developing complex interventions as a guide. We used (i) findings from published evidence; (ii) primary data on knowledge, attitudes, behavior and preferences collected through a mixed methods approach (quantitative/qualitative studies, discrete choice experiment); (iii) the advice of stakeholders (e.g., adolescents, parents, school nurses, GPs) involved in working groups. We will evaluate the effectiveness, efficiency and implementation of the components (applied alone or in combination) through a pragmatic cluster randomized controlled trial. The primary endpoint is the HPV VC (≥ 1 dose) among adolescents aged 11-14 years, 2 months after the end of the intervention, at the municipality level.

Results

Primary data highlighted the need to improve adolescents, parents and school staff knowledge on HPV and to help GPs communicate with patients on this topic. They provided guidance on the most effective communication contents. For each component, we codeveloped tools with a participatory approach (e.g., eHealth tools for adolescents, a decision aid tool for GPs). The trial will end in June 2022; 90 middle schools (i.e., about 40,000 adolescents) and 46 GPs accepted to participate.

Conclusions

Should the intervention prove effective, results from the implementation evaluation will help us refine it before scaling it up.

Key messages

• The PrevHPV study is supported by the French health authorities and conducted by a multidisciplinary consortium to tackle a long-lasting public health concern in France.

• It will add to the small number of studies that compared the effectiveness of various strategies to promote HPV vaccination and will provide key results on cost-effectiveness and implementation.
Attitudes of university students towards mandatory COVID-19 vaccination: a cross-sectional survey
Authors: Sciurti A , Baccolini V , Renzi E , Migliara G , De Vito C , Marzuillo C , Villari P
Published: October 2022

Background

Vaccination is an effective public health measure to control the COVID-19 pandemic. In Italy, vaccination against SARS-CoV-2 was made compulsory by law for some job categories, such as healthcare and education workers. Although students required a valid COVID-19 certificate to access university, they were never subjected to mandatory vaccination. In this context, we investigated their attitudes towards mandating COVID-19 vaccination to be able to access schools and universities.

Methods

We conducted a cross-sectional survey from September 2021 to February 2022. A multivariable logistic regression model was built to identify predictors of positive attitudes towards the outcome. Adjusted odds ratio (aOR) and 95% confidence intervals (CIs) were calculated.

Results

We collected 5287 questionnaires, grouped into three periods (September-October 2021, November-December 2021 and January-February 2022). The highest proportion of students supporting COVID-19 mandatory vaccination (62.5%) was found between November and December 2021. Multivariable analysis showed that November-December and January-February participants had higher odds of having a positive attitude towards the vaccine mandate than September-October respondents (aOR=1.26, 95% CI:1.09-1-48; and aOR=1.22, 95% CI:1.01-1.48). Other positive predictors were age (aOR=1.01, 95% CI:1.01-1.03), higher levels of perceived COVID-19 severity (aOR=1.09, 95% CI:1.05-1.14), concern for the emergency (aOR=1.09, 95% CI:1.05-1.14), getting vaccinated for fear of infecting other people or being infected (aOR=1.08, 95% CI:1.04-1.12; and aOR=1.07, 95% CI:1.03-1.10) and believing that vaccines could end the pandemic (aOR=1.49, 95% CI:1.41-1.56).

Conclusions

Attitudes towards COVID-19 mandatory vaccination changed over time, probably in relation to the pandemic trends. Moreover, feeling involved in the pandemic situation seems to be related with a positive attitude.

Key messages

• Pandemic trends may affect the attitude towards vaccine mandates. Mandating vaccines to access universities could be taken into account in emergency situations to ensure a safer learning environment.

• Involvement in the pandemic situation seems related with a supportive attitude towards vaccine mandates, suggesting that awareness is a key factor to be addressed to implement mandatory vaccination.
The effect of social desirability bias on the measurement of subjective health literacy of children
Authors: Bollweg T , Okan O
Published: October 2022

Background

When measuring children’s health literacy (HL) with self-report questionnaires, there is doubt whether high scores reflect good HL, or if they are caused by social desirability bias, meaning that children present themselves favorably. This study explores how the tendency to answer in a socially desirable way impacts HL scores.

Methods

A cross-sectional study was conducted among fourth-graders in North-Rhine Westphalia, Germany. The study was designed as a representative survey starting in 12/2020, which could not be realized due to pandemic-related constraints. Data collected between 07/21 and 11/21 is included here. Subjective HL was assessed with the HLS-Child-Q15 and a validated 10-item scale (AFS) was used for social desirability bias. Also included in linear regression explaining HL scores are age, sex, country of origin, home language, family affluence (FAS), interest in learning new things about health, the belief that parents are able to answer own questions about health and frequency of conversations with parents about health. Variables were dichotomized where necessary.

Results

n = 364 students are included (49.5% female). Mean age is 9.5 years (SD=.69). In the regression model (F(9, 271)= 6.724, p<.001), which explains 15.5% of variability in HLS-Child-Q15 scores, frequency of communication about health at home (β = .147, p<.01), interest in learning about health (β=.268, p<.001), and the belief that parents are able to answer own questions about health (β =.209, p<.001) are the only significant predictors. Sociodemographic variables and the tendency to answer in a socially desirable way don't have a significant effect on HL.

Conclusions

Our findings suggest that social desirability is not a significant source of bias when measuring children’s HL with the HLS-Child-Q15. Communication about health at home and children’s interest in health seem to be much more important for children’s HL. Further research is necessary to verify these findings.

Key messages

• Social desirability doesn’t seem to be a source of bias when measuring children’s HL with the HLS-Child-Q15.

• Speaking about health at home and children’s interest in health are important predictors of HL.
Longitudinal relationships between youth assets, seat belt use as a rider, and the environment
Authors: Tolma E , Vesely S , Oman R , Boeckman L , Aspy C
Published: October 2022

Background

Positive youth development theory can provide an alternative approach to promote Seat Belt Use while Riding in a Car (SBURC) among youth. The study aims to explore the relationship between youth assets, and the neighborhood environment in predicting SBURC.

Methods

The Youth Asset Study (YAS) is a 4-year (5 waves) longitudinal study of a random sample of 1,111 youth (12-17 years old) and their parents, taking place in a Midwestern city, USA from 2003-2008. Seventeen youth assets were developed. The environment was measured objectively via the broken windows survey and subjectively via parents’ interviews. Assets and environmental factors at Waves 1-4 predicted SBURC at Waves 4-5 while controlling for demographics. Data were analyzed via marginal logistic regression and generalized estimated equations analyses.

Results

The sample consisted of 1001 youth: 53% female; mean age=14.36 (SD = 1.59); 50% with income <$35,000; and 69% two-parent families. The proportion of youth not wearing a seat belt while riding in a car decreased from wave 4 to 5 among all youth. Individually, most assets had a positive relationship with SBURC (ORs ranged from 1.4 to 2.0), with parental monitoring, responsible choices, general aspirations for the future and good health practices having the largest ORs [2.0, 95% CI (1.5, 2.7); 1.9, 95% CI (1.5, 2.6); 1.8, 95% CI (1.2,2.8); 1.8, 95% CI (1.5,2.3)] respectively. Youth with a higher (≥ 12) number of assets were almost twice as likely to use a SBURC than those with a lower (<12) number [OR = 1.9, 95% CI (1.5, 2.3)]. Only one environmental factor, had a significant effect on SBURC [(OR = 0.64, 95% CI (0.45, 0.90)]. Assets retained their impact on SBURC, controlling for the environmental and demographic factors.

Conclusions

Youth assets can be an alternative approach to promote SBURC among teens with emphasis on promoting parental monitoring, responsible choices, general aspirations for the future, and good health practices.

Key messages

• Building youth assets can be another mechanism to promote seat belt use while driving among youth.

• The neighborhood environment might not be as important as other factors are in the promotion of seat belt use while driving.
Promoting migrant health literacy in adult education, from research to practice
Authors: Harsch S , Bittlingmayer U
Published: October 2022

Background

As migration affects health, migrants need context-appropriate health literacy (HL) to maintain and promote health. Possible venues to improve HL are adult education programs, i.e., language courses (LC). However, empirical evidence on these courses and their contribution to HL is scarce. Moreover, general HL recommendations and conceptually developed HL programs often proved unsuitable in practice as they insufficiently incorporate the multiple influences. This paper’s purpose is to show, using key findings, how ethnographic research can contribute to developing appropriate programs and how the transfer from research to practice can succeed.

Methods

The SCURA project conducted extensive ethnographic research on HL in second LC, i.e., 100 h participant observation in 2 classes, 40 teacher interviews, analysis of 24 textbooks, and teacher training. On this basis, we designed programs and drew lessons from comparison with other programs.

Results

The study revealed that health and HL as a situational social practice play a key role in LC e.g., as prerequisites for attendance and learning, part of the syllabus, and an occasion for informal conversations. Multiple concepts of health and HL coexist and influence HL promotion. Besides the setting and course conditions, teachers strongly shape HL activities and students show varying degrees of HL practice. We exposed the complexity and diversity of HL situations, meaning-making processes, strategies to acquire and promote HL, and actual space of action. Then, we developed participatory practicable approaches to promote HL in the educational offer. Compared to other programs, the ethnographic study allowed us to address the major factors, tap into the actual space of action, and increase acceptance, uptake, and sustainability.

Conclusions

Improving HL in existing offers requires a profound understanding of the logic of the field. Ethnographic studies facilitate describing these peculiarities and tailoring interventions.

Key messages

• Ethnographic studies allow understanding the relevant factors, actors, situations, contexts, processes, strategies, the logic within and the scope for action.

• The empirical evidence gained in ethnographic studies enable researchers to develop promising, accepted, and sustainable interventions.
Assessing sun protection practices for children: knowledge and behaviours of parents
Authors: Nemes D , Coman MA
Published: October 2022

Background

The development of melanoma in adulthood is strongly associated with sunburns during childhood. Parental knowledge and behaviours play a key role in sun protection behaviour from which children can acquire general and integrated learning patterns. With this being known, numerous positive preventive health behaviours can be initially shaped in the family, with children having parents as a model.

Methods

A cross-sectional approach (web-based questionnaire) was conducted to gather information regarding parents’ knowledge and behaviours of children’s sun protection, alongside the predictors that might influence the adoption of these behaviours, between April and May 2021. The survey was disseminated to 53 primary school teachers from 9 schools in Cluj-Napoca Romania, and the data set included 355 valid surveys (parents with at least one child aged between 0 to 12 years old) out of 476 total surveys. Descriptive statistics, Chi-square tests of association and logistic regressions were computed.

Results

The study showed differences in children’s sun exposure patterns, their sunburn and parental sun protection behaviour. Overall, parents reported fair sun protection behaviours and children’s sunburn frequency was overall moderate among all children in the previous summer season. However, an increase in children’s age generates an increase in parents’ sunscreen application for their children in both planned and incidental situations. There were statistically significant associations between parents’ sex and their knowledge about the fatal consequences of skin cancer or their level of education and the damage produced by tanning bed usage or sunscreen efficiency measures.

Conclusions

These results are a starting point for various program interventions that can be done for parents in order to increase their knowledge on sun protection practices for their children.

Key messages

• Skin cancer is substantially preventable if unprotected exposure to ultraviolet radiation is reduced during the first years of a child’s life.

• Parental knowledge and behaviors play a key role in sun protection behavior from whom children can acquire general and integrated learning patterns.
Appraising the quality of guidelines for caries management using AGREE II: a systematic review
Authors: Lamloum D , Ferrara P , Arghittu A , Castiglia P , Gaeta M , Odone A , Campus G
Published: October 2022

Background

Caries is one among the most prevalent dental disease and its prevention and treatment are crucial from both dental care and public health perspectives. Yet, caries’ management greatly varies across contexts according to the availability of specific Clinical Practice Guidelines (CPGs). Here, we present the results of a systematic review aimed at the appraisal of the current available CPGs on caries prevention and treatment.

Methods

A literature search was performed in PubMed, EMBASE, SCOPUS, and seven relevant guidelines databases up to March 2022, exploring CPGs published from 2012. The literature review was conducted in accordance with PRISMA guidelines. The Appraisal of Guidelines, Research and Evaluation (AGREE) II checklist was used to measure the methodological rigour and quality of the retrieved CPGs.

Results

The systematic search resulted in a total of 1403 records, and 21 CPGs met the inclusion criteria. Overall, these considered different aspects of caries prevention and treatment. Regarding the appraisal through the AGREE II tool, the overall median score was 60.2% and 11 out of 21 CPGs were classified as “Recommended”, while the others as “Recommended with modification”. The domain analysis showed that the highest median scores were reached for Scope and Purpose (88.9%), Clarity of Presentation (86.9%), and Rigor of Development (67.8%), while the lowest were seen for Stakeholder Involvement (63.3%), Applicability (17.5%), and Editorial Independence (50%).

Conclusions

This systematic review showed that the rigor of CPGs for caries prevention and treatment remained suboptimal according to AGREE II evaluation, and highlighted that more efforts are needed to improve their quality. The AGREE II checklist is a comprehensive and easy-to-use tool for the development of CPGs, and its use ensures that evidence-based approaches are incorporated into consistent recommendations for the translation of evidence into practice.

Key messages

• The rigor of CPGs for caries prevention and treatment is suboptimal according to AGREE II evaluation, however, more efforts are needed to improve their quality.

• The AGREE II checklist is a comprehensive and easy-to-use tool for the development of CPGs.
Exploring behavior change motivation in an outpatient sample with more than one health risk behavior
Authors: Voigt L , Ullrich A , Ulbricht S
Published: October 2022

Background

Evidence from western countries shows that the majority of adults have two or more health risk behaviors. The motivation to engage in a health behavior change (HBC) is the most proximal determinant of behavior change in the future. The aim of this study was to investigate the intention to increase physical activity and to quit smoking in an outpatient sample that show both health risk behaviors.

Methods

We used baseline data (n = 109) of an intervention study (Germany, 2016-2019) on physical activity and smoking cessation. Eligibility criteria were: aged 40 to 65 years, systolic blood pressure ≥130 mmHg, no history of cardiovascular event or vascular intervention. We collected information on HBC motivation, sex, age, and self-rated health (SRH) and identified 32 physically inactive smokers. Descriptive analyses and Fisher’s exact test were used to explore the proportion of those motivated for HBC and differences according to sex, age (45-55 vs. 56-65 years), and SRH (excellent-good vs. poor-very poor).

Results

Participants (50% female) were on average 52.6 years old and 78% had school education ≤10 years. Overall, 44% intended to change physical inactivity only, 34% intended to change both behaviors, 13% wanted to change neither, and 9% intended to change smoking only. There was no difference in HBC motivation according to sex and age. But, there was a significant difference according to SRH (Fisher’s exact = 0.048); e.g., there were more individuals motivated to change both behaviors among those with lower SRH (64%) compared to those with higher SRH (19%).

Conclusions

In this baseline sample of an intervention study, the majority of participants intended to change physical inactivity but not smoking. Among those with lower SRH, almost two-thirds intended to change both behaviors. Thus, individuals with more than one health risk behavior differ in their HBC motivation. Lower SRH may offer a window of opportunity to promote HBC interventions.

Key messages

• Physically inactive smokers with a systolic blood pressure ≥130 mmHg differ in their motivation to change these behaviors.

• Lower self-rated health may offer a window of opportunity to promote interventions to change health behavior.
Assessing the impact of the COVID-19 infodemic on older people in the region of Crete
Authors: Vagionaki K , Papadakaki M , Petelos E , Lionis C
Published: October 2022

The COVID-19 pandemic has been accompanied by an unprecedented infodemic, a key global public health challenge. Older people are more susceptible to COVID-19 and to misinformation, with WHO indicating the need for research on how people process and manage information in physical and digital environments to better understand how this phenomenon affects individuals. A qualitative study was developed in to explore the infodemic impact on elderly groups (eligible beneficiaries, aged 60-75 y, users of social services in the Heraklion Regional Unit, Crete Greece). Preliminary results indicate low trust levels for information delivered online and through media. Physicians remain the most trusted and preferred source of information, yet participants questioned their expertise level given the various issues emerging during the pandemic. Most of them report poor quality, incomplete information and point out the misleading role of media pluralism. Key topics of concern include the origin of SARS-CoV-2 and the safety and effectiveness of COVID-19 vaccines. The majority strongly believes that coronavirus is of lab origin, as they have read on the Internet. They are also susceptible to fake news and myths surrounding COVID-19 vaccines. Many of them also suffer from “pandemic fatigue”, i.e., information overload, preferring not to further follow COVID-19 updates. Fear about their vulnerability was the major factor mentioned regarding scientific evidence, stating they prefer information to be conveyed clearly and in an understandable manner. Some exchange information with relatives and friends whilst others prefer not to discuss COVID-19, unless they consider the other person knows more than they do. Nevertheless, they all believe they make the best choices on how to protect their health, whilst having mixed feelings about the manner and content of communication received both in physical and digital environments.

Key messages

• COVID-19 care for the elderly should encompass infodemic management elements, incl. information presented using simple terms, from updated and regularly verified sources, ideally in printed form.

• Health and social care professionals’ training should include media discourse, compassionate care, and motivational communication techniques rather than directional speeches of coercion and fear.
A study on doctors’ health status living in Turkey
Authors: Sengelen M , Erisgen G
Published: October 2022

Background

Health is a human right for every individual independent from his/her occupation. If provided, physicians’ wellbeing might also have a positive influence on the patient care and the population health. In this paper, health (or risky) behaviors, and health status of a group of doctors in Turkey were presented based on the results of a descriptive study.

Methods

Study population was accessed via google form created by the Turkish Medical Association. 626 physicians participated in the study. Perception of health status, nutritional status, tobacco use, and physical activity status of the participants were recorded. Doctors were also asked about their chronic disease existence. Ethical approval and institutional permission were obtained before the study. Study was conducted between 2020 and 2021. Logistic regression analysis was performed for further analysis.

Results

Of the 626 physicians participating in the study, 374 (59.7%) were male and 252 (40.3%) were female. Mean age of the physicians was 45.3±10.7. 58.3% (n = 359) of the physicians perceive themselves as healthy and very healthy. 57.8% (n = 362) of the physicians stated their eating habits as healthy. Majority of the physicians (n = 516, 82.4%) were not doing enough physical activity as recommended by the World Health Organization. 28.0% of the physicians (n = 175) used tobacco products. 48.1% of the physicians (n = 301) had a chronic disease. The three most frequently mentioned chronic diseases have been cardiovascular diseases (n = 141; 46.8%), diabetes mellitus (n = 67; 22.2%) and mental diseases (n = 42; 13.9%). Young age, positive perception of health, not using tobacco decreased the chronic disease risk in the logistic regression model.

Conclusions

Physicians were not good in performing healthy life behaviors and almost one out of two doctors had a chronic disease. Our results emphasized a strong need to enhance a program for the doctors to integrate healthy life skills into their life practices.

Key messages

• Doctors have poor health which can also influence population health.

• Medical associations may lead to enhance healthy life practices among doctors.
Multiprofessional teamwork in Finnish health and social service centers, experiences of managers
Authors: Sinervo T , Hietapakka L
Published: October 2022

Background

Health and social service centers are developed for the first contact points in Finland. Long waiting times, shortage of staff and lack of coordination have been major problems in primary care. As a solution, multiprofessional teams and better collaboration between professionals have been built. This study explores, how the teams work and what challenges they have.

Methods

The study is based on 16 interviews (25 managers) in 5 health and social services centers. County provided specialized care in the whole area as well as primary services in two centers, one center was provided by a municipality, and two by a private firm. The managers were asked about work organization, their experiences of the team model and about well-being of employees. The interviews were analyzed using content analysis.

Results

The managers saw the team work as functioning rather well. They also highlighted effective digital services and task shifting. Easy consultation of GP’ was important as nurses were the first contact for clients in phone. In this call, the client’ case was tried to be handled as far as possible. The competences of new professionals, such as social workers or psychiatric nurses had high value for the team. But the service processes and team-building were in progress. Working in mutual facilities and easy consultation of professionals was seen important. In most organizations clients were separated to different teams based on their service needs (acute or chronic conditions), or earlier clientele. As a result, some teams gained a more burdensome clientele, which increased stress.

Conclusions

Multiprofessional work can streamline and improve the treatment process, but this requires more information which ways to collaborate work best for the clients and professionals.

Key messages

• Multiprofessional team work, task shifting and digital services may increase efficiency and well-being of workers at health and social centers.

• Easy consultation of GP’s is required for task shifting.
Developing and implementing a methodology for forecasting of medical doctors in Slovenia
Authors: Albreht T , Ogrin-Rehberger P , Povž B
Published: October 2022

Issue/problem

Modelling and forecasting the number of health professionals in Slovenia, in particular medical doctors, and nurses, has been a serious challenge for health policy for decades. No serious methodology has ever been implemented to support this process.

Description of the problem

Methodology was developed with the support of the EU SRSS (Structural Reform Support Service) mechanism and further adapted according to the specifics of the Slovenian health system and of the needs of the MoH. The project took two years and was developed jointly with the relevant stakeholders - MoH, National Health Insurance, Medical and Nursing Chambers, Association of Public providers of health care. It was building on the experiences of Austria and Germany. Methodology included the supply and demand side of retrospective data and forecasting data on the population demographic structure as well as the current numbers of doctors and nurses in training.

Results

We have developed a model for forecasting the needs for medical specialists and we tested it on the example of paediatrics, gynaecology, orthopaedics, general surgery, neurology, infectious diseases, and urology. We calculated the forecasted needed numbers for the year 2035 for each of the specialties, where we also indicated the increases and decreases in demand expected based on the demographic, epidemiological and service use projections.

Lessons

Most importantly, the report was endorsed by all the participating stakeholders in the process. The MoH adopted the methodology as a part of the planning mechanism for prospective and current needs for medical specialists in training. Some flaws in the processes identified together with the inadequacies in the updating of data on health professionals led to the MoH’s recommendations to providers on regularly updating their data in the national health providers’ registry.

Key messages

• Methodology developed in the project was implemented as a part of the requirement for the planning of medical specialists.

• Processes enacted in the project contributed to the improvements in the national health providers registry.
The effect of the SARS-CoV-2 pandemic in the compliance of hand hygiene in ICU in a tertiary hospital
Authors: Russo Sanjuanbenito M , Urquijo Valdovinos MJ , Sánchez de la Ventana AB , Ibáñez Rebe M , Carnicer Gil I , Blanco Maestro T , Mascaraque Sánchez L , Fuentes Ferrer M
Published: October 2022

Background

Hand hygiene (HH) is one of the main preventive methods for healthcare-associated infections. Our aim is to compare the level of HH compliance in 2021, SARS-CoV-2 pandemic period, with the previous 2019 period.

Methods

Descriptive cross-sectional study of direct observation on compliance of HH in adult intensive care unit (AICU) and neonatal intensive care unit (NICU) in a third-level hospital in Madrid during the years 2019 and 2021. Trained healthcare workers observed and recorded hand hygiene opportunities (HHO) among staff (nurse, nurses’ aide, physicians and orderly) using the World Health Organization's “My Five Moments for Hand Hygiene” tool. All observations of professional that attended patients in SARS-CoV-2 isolation units were excluded.

Results

Overall, there was a total of 1199 HHO, 961 in AICU (2019:466; 2021:495) and 238 in NICU (2019:122; 2021:116). HH compliance in AICU improved from 57.5% in 2019 to 65.9% in 2021 (p = 0.008) and remained unchanged in NICU (2019:90.2% vs 2021:88.8%; p = 0.730). In AICU all professional categories, except nurse’s aide, improved HH compliance being statistically significant in physicians (2019:33.8% vs 2021:50.0%; p = 0.009). In relation to the 5 moments, an increase in HH compliance was observed in: before and after touching a patient/after touching patient surroundings, being only statistically significant in moment after touching a patient (2019:69.4% vs 2021:83.7%; p = 0.001). In NICU there were no significant changes between the two periods regarding to the professional category or the five moments of HH. In NICU there were no significant changes between the two periods regarding to the professional category or the five moments of HH.

Conclusions

The increase in compliance of HH within the adult ICUs demonstrates this adaptation, stating a behavioural change in the habits of professionals. This increase was no observed in the NICU since their compliance was already extremely high.

Key messages

• There has been an increase in HH compliance in the AICU.

• The HH method has varied, becoming COVID-19 specific.
Antimicrobial stewardship programs in Italy: structure, process and outcome indicators, 2017-2019
Authors: Vicentini C , Blengini V , Libero G , Raso R , Zotti CM
Published: October 2022

Background

The increasing spread of antimicrobial resistance (AMR) represents a global public health threat, and a significant challenge for healthcare delivery. Antimicrobial stewardship (AMS) programs have proven to be effective and cost-effective strategies for optimizing antimicrobial use. We aimed to assess key aspects of AMS programs implemented in acute-care trusts of the region of Piedmont, and to evaluate changes in antimicrobial usage against a score we attributed to structural and functional elements of AMS programs.

Methods

AMS programs operating in acute-care trusts in the region of Piedmont were investigated via a survey addressing program characteristics, divided into structure and process quality indicators. All public health trusts of the region of Piedmont were invited to complete the survey. The indicators were selected based on core elements identified by international guidelines and were reviewed by a multi-disciplinary panel. Antimicrobial usage was expressed as defined daily doses, DDD per 1000 patient-days. The annual means for the years 2017-2019 were considered, as well as the percentage change between 2017 and 2019. Variables were investigated in relation to structure and process scores using Spearman correlation. Analyses were performed using SPSS v. 27.0 (SPSS Inc., Armonk, NY).

Results

In total, 25 AMS programs were surveyed. Higher scores were achieved for process rather than structure indicators. Improvements in total antimicrobial usage (-4%) were found between 2017 and 2019. A moderate correlation was found between structure score and percentage change in antimicrobial usage (Spearman’s ρ -0.603, p 0.006).

Conslusions

This study highlighted important areas for improvement, such as accountability, microbiological laboratory quality management and feedback. Repeated measurements of structure, process and outcome indicators will be important to guide continuing quality improvement efforts.

Key messages

• Results of this study support the effectiveness of AMS programs in reducing antimicrobial use.

• Important areas for improvement were identified. Improving the organization of AMS programs in particular should be prioritized.
Understanding barriers to dTap vaccination recommendations during pregnancy among healthcare workers
Authors: Bianco A , Angelillo S , Riillo C , Nobile CGA , Campione C , Freccia S , Romeo M , Licata F
Published: October 2022

Background

Diphtheria, tetanus and pertussis (dTap) vaccination is heavily endorsed during pregnancy. However, maternal dTap immunization rates in Italy remain low. Lack of healthcare workers (HCWs) recommendation to get vaccinated represents one of the main barriers to immunization during pregnancy. Therefore, this study aimed to investigate what HCWs know about dTap vaccination, practices and potential barrier to recommending immunization during pregnancy.

Methods

This cross-sectional study was conducted among obstetricians-gynaecologists (OBs), midwives and general practitioners (GPs) in 2 regions of Southern Italy. An anonymous self-administered questionnaire was used to collect data on professional information, knowledge, risk perceptions and practices regarding dTap vaccination during pregnancy.

Results

Until now 94 HCWs were recruited (36.2% OBs, 35.1% GPs and 28.7% midwives). Overall, 63.8% knew that dTap vaccination has to be administered during the third trimester of gestation and 94.7% that it is able to protect newborns against pertussis before active immunization. One-third of the HCWs believed that vaccines in pregnancy were more dangerous than safe. Seven out of ten HCWs routinely recommended dTap vaccine and provided information about dTap vaccination to all pregnant women. Most frequent reported reasons for not recommending dTap vaccination during pregnancy were that it was outside the scope of their practice (72.4%), that women are more vaccine hesitant during pregnancy (42.9%), lack of time (28.6%), lack of knowledge on the topic (28.6%) and the belief that the vaccine could interfere with the development of the fetus (14,3%).

Conclusions

Lack of knowledge, unsatisfactory recommendation of dTap immunization during pregnancy and uncertainty over their responsibility around vaccination suggest that public health organisations should strengthen dissemination and implementation of evidence-based recommendations.

Key messages

• Barriers to recommending dTap immunization during pregnancy remain among healthcare workers.

• Strategies (e.g. electronic reminders) to facilitate HCWs in recommending and informing on dTap immunization should be implemented and evaluated to improve vaccination coverage in pregnant women.
Self-reported vaccination against SARS-CoV-2 and adverse events in multiple cohorts
Authors: Klett-Tammen CJ , Heise JK , Soja SM , Janzen I , Jenniches F , Kemmling Y , Behrens G , Schulz TF , Wegener R , Castell S
Published: October 2022

In two studies (“App-based infection assessment in RESIST (iAR)” and “Digital infection monitoring in persons living with immunodeficiency (DIMI)” ), we monitor health related items, as vaccination against SARS-CoV-2 and conduct syndromic surveillance of acute respiratory infections in high-risk populations, i.e. elderly persons and persons living with HIV, respectively. In a third very similar study (“Sensors for measuring aerosols and reactive gases to deduce health effects (SMARAGD)”) mainly healthy adults participate. To record incident or recurring transient health events, risk factors and further health data in real-time, we developed the eResearch system “PIA - Prospective Monitoring and Management App”. Recruitment for RESIST, SMARAGD and DIMI started in March 2021 and is ongoing. The questionnaire was presented in April 2022. Preliminary results include 86 participants from the three cohorts. In total, one indicated to be not vaccinated, none were vaccinated once, three (3.5%) twice, 63 (73.3%) three times and 19 (22.1%) four times. Participants reported the following adverse events after immunization (AEFI): after 40 applied doses with Vaxzevria® 24 AEFI (60%); after 158 doses of Comirnaty® 41 AEFI (26%); after 62 doses of Spikevax® 19 AEFI (30.7%); and after three doses of Janssen®, one AEFI (33.3%). In these cohorts, 20 (23.36%) participants stated having had a SARS-CoV-2 infection, of these 16 (80%) after the last vaccination dose, three (15%) before the first dose and one (5%) in between doses. Most participants were vaccinated three times, with Comirnaty being the most applied vaccine, as in officially reported numbers. AEFI varied according to vaccine and were higher than in the German surveillance system (1.64/1000 doses). Most infections were indicated to have been diagnosed after the booster vaccination. The results are limited by the small sample size and possible bias through self-reporting and social desirability regarding vaccination status.

Key messages

• Overall, most participants were vaccinated with Comirnaty and had three doses of vaccine. Of the participants with a diagnosed SARS-CoV-2-infection, most got infected after the booster vaccine.

• The number of reported AEFI was higher than in the official surveillance in Germany.