bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Infrastructure and Organizational Resilience - A Theoretical Model
Authors: Pfaff H
Published: October 2024

Background

Considering resilience as a necessity for health care organisations (HCOs), many researchers argue that fluidity is a must and that organisational structures (formal and informal) hinder the adaptability and resilience of health care organisations. Contrary to this statement, my thesis posits that fundamental adaptive processes leading to new equilibria depend on a stable core that persists amidst change, enabling and catalysing these transformations.

Methods

The phenomenon of resilience within healthcare organisations is examined through the lens of sociological systems theory. Rooted in Talcott Parsons’ assertion that social systems, including healthcare organisations, must perform four basic functions (Adaptation, Goal Achievement, Integration, Latency: AGIL) to survive and function, our research uses the deductive method to derive the necessary structural social components required to cope with external demands.

Results

The application of the methods yields four complex basic structures rooted in the social structure of healthcare organisations: adaptive structures (flexible structures & resource generating structures), goal achievement structures (governance enabling collective goal setting, decision making and persistence), integrative structures (social capital and social networks) and sustainability structures (socialisation structure, knowledge base, organisational culture).

Conclusions

As the core of stability, this ‘four-component social infrastructure’ is essential for facilitating higher-order forms of resilience, such as new equilibria. In its absence, healthcare organisations would flounder during change, posing risks to the resilience of these HCOs. Thus, structure is indeed inherent in the chaos of resilience activities. In other words, there is order in the chaos of resilience, and it is essential.

Key messages

• Fundamental adaptive processes leading to new equilibria depend on a stable core that persists amidst change, enabling and catalysing these transformations.

• There is order and structure in the chaos of resilience.
Living alone and care levels’ distribution in first-time recipients of long-term care in Germany
Authors: Haeger C , Schnitzer S , Baldenius T , Jürchott K , Kuhlmey A , Schwinger A , Blüher S
Published: October 2024

Background

As demographic shifts occur, along with longer life expectancies and advancements in medical care, there is a noticeable rise in the population requiring long-term care. In Germany, the Medical Service oversees the assessment for long-term care needs, which specifically evaluates the extent of limitations in maintaining independent living. These limitations are categorized into care levels ranging from 1 (indicating minor limitations) to 5 (denoting the most severe limitations).

Methods

Data from the long-term care assessment conducted nationwide in Germany are utilized for the analysis presented. The study focuses on individuals aged 60 and above with a first-time recognition of need of long-term care. Descriptive analysis is conducted on the distribution of care levels and living arrangements.

Results

The analysis encompassed 339,486 individuals, with an average age of 79.6 years (standard deviation: 8.4), of whom 59.0% were female. Approximately half of the sample were categorized under care level 2, while 32.4% fell into care level 1. Higher care levels (3-5) were less frequent (16.2%, 4.8%, 1.7% respectively). Individuals living alone were predominantly found in the lower care levels, whereas those not living alone were more commonly represented in care levels 3-5. Additionally, older individuals were more frequently assigned higher care levels.

Conclusions

Over 75% of initial applicants are classified within the lowest care levels (1 and 2) with a higher proportion of those living alone. One possible explanation is that within partnerships, the presence of a partner may serve as a form of support during the early phases of long-term care, with external assistance becoming necessary only as care needs escalate to higher levels. Further research should focus on examining the role of living alone in the need for long-term care.

Key messages

• Initial applicants of long-term care in Germany living alone are more often classified in lower care levels (indicating minor limitations) than in higher care levels (indicating severe limitation).

• Partnerships may delay higher long-term care needs; research should explore living alone’s impact on long-term care.
Optimizing vaccination to reduce waste and boost coverage in Primary Health Care Units
Authors: Ribeiro D , Schimdt D , Rangel M
Published: October 2024

Background

In immunization, vaccine consumption typically exceeds the number of recipients. The number of doses per vial influences wastage and vaccination coverage goals. In Brazil, 48% of the National Immunization Program’s vaccines are multidose, with 4 having limited shelf-life post-opening. Strategies to reduce wastage aim to optimize dose utilization, enhance process quality, and broaden coverage effectiveness. The objective was to outline strategies for reducing wastage and expanding coverage for children under 5 in 14 São Paulo city Primary Health Care Units (PHCUs).

Methods

The Lean Six Sigma approach guided the stages. A group conducted contextual analysis to identify PHCU barriers. Data on wasted doses and vaccination were gathered. Weekly meetings for data analysis began in May 2023, following DMAIC phases: Define, Measure, Analyze, Improve, Control. An action plan stemmed from these phases for PHCU implementation.

Results

Data analysis, from January 2022 to June 2023, revealed a significant vaccine wastage trend, reaching 59% from January to December 2022 and increasing to 63% from January to June 2023. This wastage incurs an average annual cost of R$614,416.26, due to lost doses from expiration after vial opening and expiration of shelf life. The vaccines analyzed were BCG, Oral Polio Vaccine (OPV), Measles, Mumps, and Rubella (MMR), and Yellow Fever. At the project start in May 2023, vaccination coverage was 90%, increasing to 93% afterward. This rise resulted from actions taken and improved data monitoring. Post-project, vaccine wastage reduced by 7 percentage points (from 62% to 56%).

Conclusions

Addressing vaccine wastage and expanding vaccination coverage for children under 5 are critical in healthcare. Utilizing Lean Six Sigma, key issues in PHCUs were identified, leading to an action plan that reduced wastage, increased coverage, and standardized processes.

Key messages

• Vaccines are valuable resources and wasting them means reducing financial resources in health.

• Vaccination coverage is crucial to protect the population’s health, prevent disease outbreaks, and maintain the country’s economic health, reducing costs for treating preventable diseases.
Systematic review of reviews: occupational exposures and work disability
Authors: Salonen L , Hartikainen E , Undem K , Solovieva S
Published: October 2024

Background

Occupational exposures significantly impact workers’ health and may lead to temporary or permanent work absence. Although the effect of occupational exposures on work participation has been studied extensively, research remains fragmented in covering different exposures and outcomes. This review investigates the evidence on the associations between occupational exposures and work disability.

Methods

Following PRISMA guidelines, a systematic review of reviews was conducted using PubMed, Scopus, and Web of Science. Reviews and meta-analyses of observational studies examining associations between occupational exposures and self- or physician-assessed sickness absence or disability retirement, published until 2023, were included. The review findings were supplemented with an additional search for original studies published after 2012 focusing on exposures less covered by the reviews. Quality assessment was performed using AMSTAR and the NH quality assessment tools.

Results

A total of 21 reviews and meta-analyses and 35 complementing original studies were included. While 10 reviews covered psychosocial exposures and 19 reviews focused on temporary work disability, fewer examined other exposures like chemicals (3 reviews, 7 original studies) or permanent work disability (8 reviews, 17 original studies). Next, we’ll further synthesize these studies to evaluate the levels of the evidence.

Conclusions

Our review found that published studies primarily focused on work-related psychosocial exposures and temporary work disability, revealing gaps in research on other occupational exposures like chemicals and permanent work disability.

Key messages

• There’s a need to explore a wider range of occupational exposures and their impact on work disability beyond psychosocial exposures.

• The focus of prior reviews on occupational exposures and temporary work disability underscores the importance of studying the impact of these exposures on permanent work disability in future research.
Mental health literacy in German teachers – What do they know? What do they need?
Authors: Piloth J , Edelmann A , Eppelmann L , Wessa M
Published: October 2024

Background

Preventing mental health problems and promoting mental wellbeing is the aim of school-based mental health literacy (MHL) programs. Previous research suggests that good MHL (knowledge and skills regarding mental health, resilience, and help-seeking) helps people to take good care of their own and others’ mental health and use support-services. In this context the MHL of teachers is highly relevant, as they act as role models and interact with affected pupils on a regular basis, for which certain knowledge and skills are necessary. In this study, we therefore seek to investigate the level of MHL in German high-school teachers as well as their exposure to impaired students and their desire for further education on pupils’ mental health.

Methods

The data are collected as part of an effectiveness study of a school-based intervention to strengthen MHL (BEWARE), which was developed by our working group. We collect data from teachers who are involved in BEWARE as coaches as well as from those not directly involved (n ≈ 300). Data collection takes place online at three measurement timepoints (6 months apart each). For the analysis presented here, data of the first measurement timepoint with respect to MHL, skills in handling affected students and wishes for additional education on pupils’ mental health are included.

Results

As the data collection is still ongoing, statistical analyses are not yet completed. We will present data on the current state of knowledge on MHL in German teachers as well as their abilities to deal with affected pupils and their wish for further education. In addition, we will relate the number of affected pupils they teach to depict the relevance in their daily life at school to the above-mentioned measures.

Conclusions

The acquired data and respective analyses will give us important insights about the objective and subjective need of MHL training in schoolteachers (based on assessed knowledge and their reported wish of additional education).

Key messages

• Our study will give us important insights about the objective need of MHL training in high-school teachers based on assessed knowledge.

• Our results will depict which formats of training teachers would prefer for additional education on pupils’ mental health, which will be a valuable basis for the development of future programs.
Public Health Literacy: a concept to develop – Qualitative study among public health professionals
Authors: Noureddine R , Arsandaux J , Hardouin J B
Published: October 2024

Background

Health literacy can be defined as individuals’ motivation and skills to access, understand, evaluate, and utilize information to make decisions about their health. Despite Sorensen’s widely used definition encompassing both individual and population levels, also known as Public Health Literacy, it remains poorly detailed and is rarely taken into account by measurement tools. As evidenced by the Covid-19 health crisis, limited public health literacy impacts reluctance to accept government recommendations, vaccine hesitancy, and fosters mistrust of science and conspiracy theories in the health field. The main objective of this study was to derive specific public health knowledge and skills from public health professionals for the general population constituted the first step of the development of a public health literacy measurement tools.

Methods

A qualitative study, based on ten semi-structured interviews with public health professionals from various settings (academic, hospital, health prevention, and promotion), working across various public health fields (nutrition, sexual health, mental health), has been conducted since March 2024.

Results

Preliminary analysis identified three main themes: (1) fundamental concepts including identification of health determinants, epidemiology and the purpose of public health interventions, (2) critical skills including the assessment of the level of evidence and reliability of public health information, and (3) civic orientation including environmental impact on health and community approach to interventions.

Conclusions

These detailed insights will guide the creation of a valid measurement tool for public health literacy. This will facilitate the investigation of specific impacts on people’s adherence to public health interventions or messages and the development of actions targeting literacy in a more holistic manner.

Key messages

• Specific public health dimensions have been identified to enrich the existed definition of health literacy.

• Public health concepts, reliability of public health information and community approach constitute the core of public health literacy.
Mental Health Arts Festival as a tool for mental health promotion
Authors: Zakarauskaite K , Jakubauskiene M
Published: October 2024

Background of the problem

1 in 4 people experience mental health problems each year, and that number is only growing. Stigma and discrimination of mental health are widespread and affect the quality of life at the individual and societal level. The WHO identifies mental health arts festivals as an effective way to reduce stigma and improve mental health.

Description of the problem

We are not comfortable talking about mental health difficulties and the care we need. Consequently, individuals often withhold personal experiences to shield themselves from potential bias and harsh judgement.

Methodology

The Mental Health Arts Festival (MHAF) Bonds https://www.rysiaifest.lt/, https://www.facebook.com/Rysiaifest) seeks to contribute to the human rights based mental health knowledge creation across the partner organisations, involved communities and audiences, as well as contribute to local creation of artworks on the topic of mental health in open, accessible, safe space where every voice matters. The biannual MHAF brings together recognised artists, arts institutions, scientists, policy makers and communities of people with mental health issues (over 80 events, attracting about 4,500 spectators) for group exhibition, films, contemporary dance and live performances, literary readings, open microphones, followed by discussions and workshops. Qualitative study methodology is applied to assess the potential impacts of the MHAF.

Lessons

• Visual identity that seeks to challenge existing stigmatising views.

• The festival has become the production or premier place of new artworks on the topics of mental health, spanning addiction, war-related trauma, transgenerational trauma, neurodiversity.

Key messages

• Mental health arts festivals promote mental health literacy and reduce negative attitudes towards health-seeking behaviour.

• Art festivals should be an integral part of national programs to address stigma and promote mental health and well-being.
Leveraging Social Marketing to Increase Vaccination Rates: A Systematic Review
Authors: Chong CZY , Chong RJR , Chng JJH
Published: October 2024

Introduction

Vaccinations are crucial for protecting individuals from preventable diseases, serving as a cornerstone of public health, safeguarding entire populations. Low vaccination rates can have devastating consequences, leading to outbreaks of preventable diseases. Social marketing has had an increasing role to play in public health. This systematic review seeks to investigate social marketing effectiveness in boosting vaccination adherence.

Methods

A literature search was conducted in PubMed, Scopus and Cochrane Library, using keywords “social marketing”, ‘campaigns”, “vaccination”, “vaccination uptake”. The search was limited to English-language studies, including studies discussing social marketing campaigns and its impact on vaccination uptake. Prior to inclusion, the studies were evaluated for relevance and applicability to the research question. Included studies were analysed for methodology, sample size, data collection methods, and key findings.

Results

Of 198 articles identified, 26 studies met inclusion criteria. All studies reported demonstrable improvement in vaccination adherence and hence higher vaccination rates with the use of social marketing campaigns. Targeted messaging on social media allows communication to be tailored to specific demographics and address their unique concerns. Community engagement combats vaccine hesitancy by dismantling misinformation and rebuilding trust. Additionally, these campaigns leverage social influence and mobilise communities to cultivate pro-vaccine attitudes. By addressing personal choice, knowledge gaps, and hesitancy, social marketing paves the way for greater vaccination uptake.

Conclusions

Social marketing has been proven to be an effective tool in promoting vaccination adherence in public health. As vaccination remains a critical aspect of public health, the continued use of social marketing interventions is essential for improving vaccination rates and ultimately enhancing overall population health.

Key messages

• Social marketing campaigns lead to higher vaccination rates across various populations.

• By addressing vaccine hesitancy, social marketing paves the way for increased vaccination uptake.
Characteristics of users of oral nicotine products according to smoking status in Denmark
Authors: Toxvaerd C , Pisinger C , Bergman Rasmussen S , Juel Lau C , Helene Jacobsen M , Gøtzche N , Holm Eliasen M
Published: October 2024

Background

Oral nicotine products e.g., snus, chewing tobacco, and tobacco-free nicotine pouches gain increasing popularity. The aim of the study was to estimate the prevalence of use of oral nicotine products in the Capital Region of Denmark in 2021, to describe associations with socio-demographic characteristics and to explore if smoking status moderated these associations.

Methods

The study was based on the Danish Capital Region Health Survey 2021 including 56,245 persons aged ≥16 years old (response rate 54.9%) which included self-reported information on use of oral nicotine products and smoking status. Information on socio-demographic characteristics were assessed in national registries. Descriptive analyses and multivariate logistic regression models including interaction terms with smoking status and weighted for survey-sampling and non-response were performed.

Results

In total, 3.5% used oral nicotine products. Men showed higher odds of using oral nicotine products compared with woman (OR = 3.70) while there were no associations with education and occupational affiliation when adjusted for sex and age. The associations with age and place of residence were moderated by smoking status. Among smoking participants, young persons aged 16-19 years showed the strongest association with use of oral nicotine products (sex-adjusted OR = 21.71) while persons aged 20-24 years showed the strongest association in non-smoking participants (OR = 11.08).

Conclusions

Especially men and young age were strongly associated with use of oral nicotine products. For age, the association was moderated by smoking status. Interventions should address these high-risk groups and pay attention to smoking status.

Key messages

• Sex and age play a siginificant role in use of oral nicotine products.

• Interventions and public health campagins should adress high-risk groups
Co-Creating Tailored Solutions to Combat Sedentary Behaviour: Insights from Scottish SMEs
Authors: Vogelsang M , McCaffrey L , Ryde G , Verloigne M , Dall P
Published: October 2024

Background

Prolonged sedentary behaviour (SB) poses health risks for office workers, especially in small-to-medium-sized enterprises (SMEs) often overlooked by current interventions. This abstract aims to report and examine solutions developed through co-creation for SB in SMEs.

Methods

Three Scottish SMEs, a construction company (n = 150) and two charities (n = 100; n = 30), participated in a co-creation process to create SME-specific actions on SB. Each formed an action group of employees (n = 9-12) as co-creators. The process consisted of between 6-8 workshops (each 1.5h) depending on the company, with workshops improved during the process based on formative reflection from co-creators. The co-creation workshops, facilitated by two researchers, initially involved jointly mapping the company’s current situation and building knowledge and awareness of SB. Further workshops focused on action planning, including brainstorming, feasibility, piloting, and final action(s) development. Following the co-creation of actions, researchers identified the Behaviour Change Techniques (BCTs) underlying the developed actions.

Results

Each company created a set of actions unique to them, e.g. standing desk promotion, a games room, and innovative meeting strategies. Regarding the BCTs, all companies included adding objects to the environment, physical restructuring, prompts or cues, and addressing health or social and environmental consequences. Additionally, they all incorporated ‘step challenges’ with behaviour self-monitoring and feedback techniques. Two companies offered incentives or rewards; one emphasized role modelling, and another included social support.

Conclusions

The three companies created tailored actions through the co-creation process. While there were some commonalities, the differences in actions and BCTs among companies underscore the necessity for solutions tailored to the organizational context and the importance of involving employees in creating solutions.

Key messages

• Co-created actions to combat SB used diverse strategies, emphasising a multifaceted approach to address workplace SB.

• Variability among SMEs’ co-created actions underscores the importance of stakeholder involvement to tailor solutions to organisational contexts.
Sexual health education in Italian schools: preliminary results of EduForIST3 national project
Authors: Chinelli A , Martinelli D , Paparatto G , Bonaldo L , Di Nino M G , Ubbiali M , Farinella M , Ciardullo S , Suligoi B , Tavoschi L
Published: October 2024

Background

School-based comprehensive sexuality education (CSE) is the best approach to disseminate scientific evidence and promote healthier sexual behaviours among young people. However, in Italy, CSE is not included in schools curricula. This study, funded by the Ministry of Health, seeks to investigate information uptake and attitudes towards sexuality among adolescents included in a pilot CSE intervention in 6 Italian regions, from December 2023 to June 2024.

Methods

A 10-hours education intervention was implemented in a convenient sample of 26 upper and lower secondary schools (U/LSS), covering topics such as changes in adolescence, relationships and consent, sexual identity, sexually transmitted infections (STIs), contraception and sexual health services. Students’ evaluation comprised pre/post tests assessing knowledge, attitudes towards sexuality and satisfaction. A Solomon 4-group design study was used to compare intervention and control classes. A follow-up test will be conducted 4-6 months post-intervention.

Results

Preliminary analysis of available data as of 30 April, 510 pre-tests and 266 post-tests, showed incremented correct answers in all items. A significant increase (p<.05) was found in 12/21 items for USS and in 9/19 items for LSS, especially in the domain STIs symptoms and prevention, among those mostly appreciated. Over 90% of students considered schools as suitable setting to receive CSE, preferably by external experts. Ongoing qualitative and long-term analysis will provide further insights of the overall impact of the activity.

Conclusions

The pilot CSE intervention increased the knowledge and attitudes of the students involved. Additional insights will be available after study completion. Findings from this study will contribute to evaluate the effects of CSE initiatives on sexual health knowledge and attitudes among Italian secondary schools students, as well as the effectiveness of such programs in fostering healthier behaviours.

Key messages

• Providing evidence-based, relevant information and education on sexual health to young people in secondary schools increases their knowledge and improves attitudes towards sexuality.

• CSE should be included in Italian school curricula in order to promote an incremental uptake of information and to improve young people’s sexual health.
School teachers’ perceptions of intersectoral working with health in the COVID-19 pandemic
Authors: Gray N J , Manandhar S , Chabot C , Tsai M-C , Jourdan D
Published: October 2024

Background

The COVID-19 pandemic highlighted the challenge for teachers to integrate protective health measures into their academic daily responsibilities. The aim of this abstract is to analyse how school teachers’ views on intersectoral collaboration with health professionals during COVID-19 vary by country, seeking insights for future directions.

Methods

In 2021, an online survey was conducted in 6 languages with education and health professionals, followed by optional online semi-structured interviews. We explored the: 1-effect of the pandemic on schools/pupils/teachers; 2-reorganisation of schools; 3-experience of implementing infection control measures in schools; 4-intersectoral working; 5-important resources for keeping schools open. Interviews were transcribed verbatim and translated into English. Analysis of a survey question seeking professionals’ rating of intersectoral working led to a directed content analysis of transcripts and free-text survey responses regarding intersectoral working experiences.

Results

Data were analysed from 1046 school teacher survey responses from 6 countries/territories and 21 follow-up interviews. Ratings varied considerably across countries. A large majority of teachers in Taipei (83%) reported excellent or good collaboration with health professionals, about half in China (53%) and Portugal (51%), and far fewer in Brazil (38%), Morocco (29%) and France (15%). Taipei respondents cited the key role of school nurses as a positive factor; others added clear national guidelines and local protocols. Negative ratings related to health professionals’ rare visits or absence.

Conclusions

The direct support of health professionals in schools was offered as explanation for teachers’ positive ratings of intersectoral working in the pandemic. Policy and practice varied geographically; thus, understanding contextual factors that influence the effectiveness of intersectoral working in schools is crucial to orient future public health strategies.

Key messages

• This highlights the importance of understanding contextual factors that influence the effectiveness of intersectoral working in implementing protective health measures in schools.

• This suggests that policy support and the presence of dedicated health personnel within schools play a pivotal role in ensuring effective collaboration between the education and health sectors.
Development and Implementation of Health Education Tools for Excluded Areas in the Czech Republic
Authors: Maršálková H , Volevach E , Ely M
Published: October 2024

Background

Reducing health inequalities among population groups is imperative, however, health communication strategies tailored to ethnic minorities remain under-researched. To address this issue, various health communication strategies were developed and tested within the 3 year Saste Roma project, focused on improving health literacy and disease prevention in the excluded Czech Roma population.

Methods

A planning group comprising of doctors, sociologists, psychologists, NGOs and community health workers was established to create tailored health communication tools. The tools were developed with consideration of the sociocultural specifics of the Roma community, using focus groups, in-depth interviews, and the Delphi method. A PR agency was hired to implement the tools. Reach, engagement and Price Per Click = PPC were measured for online tools; feedback on offline tools was collected via surveys and interviews.

Results

From April 2021 to March 2024, 12 online and offline tools addressing 10 diseases were developed for various age groups and implemented. These tools, such as health literacy brochures and leaflets (78,500 pcs distributed), music videoclips (viewed 150,000 times), a mobile application (with over 500 users), social media profiles dedicated to health (with 140 followers), preventative events, school-based e-learning modules (implemented in 86 elementary schools in excluded areas), online campaigns (reaching 556,337 people; PPC of 0.85 EUR in case of in-house campaign Vs. PPC of 3.21 EUR by PR agency) or poster campaigns (engaging 3,046 individuals) focusing on excluded areas.

Lessons

This project represents the first extensive use of diverse communication tools targeting the Roma population. The involvement of community representatives (patients, artists, actors, and residents) in tool development is crucial. Training and support for health community workers are essential to achieve effective engagement with the community.

Key messages

• Tools must be delivered in a culturally sensitive and comprehensible manner by members of the communities.

• Commercial PR agencies failed with this specific campaign. Cooperation with Roma artists and influencers is essential.
Combined HIV prevention: knowledge and attitudes among higher education students in Portugal
Authors: Holzmann A P , Forte Camarneiro A P , Aparec Barbosa D , Cunha-Oliveira A
Published: October 2024

Introduction

Combined Prevention is a strategy that combines different methods of HIV prevention that can be used simultaneously or sequentially, depending on the characteristics and life stage of everyone. Among the methods are condom use, regular HIV testing, pre-exposure prophylaxis (PrEP), and post-exposure prophylaxis (PEP). Combined prevention is particularly important for more vulnerable groups, such as adolescents and young adults.

Objectives

To investigate the knowledge and attitudes related to combined HIV prevention among college students.

Methods

A cross-sectional study was conducted with college students from two institutions in a Portuguese city in the year 2022. Sampling was non-probabilistic, by convenience. Students aged 18 to 29 who had initiated sexual activity were included. The data collection instrument was a structured questionnaire sent to students online. Data were analyzed descriptively. Ethical aspects were respected.

Results

A total of 424 students participated in the study; majority were female (79.2%), white (92.9%), single (96.7%), Catholic (67.2%), with a mean age of 20.8 years (SD = 2.3). The number of sexual partners in the last semester ranged from none to 19, with an average of two partners (SD = 1.9). Nearly all students (94.3%) agreed that condoms are the main form of HIV prevention, however, 45.2% did not use condoms in their last casual sexual encounter. Only 15.5% and 13.9% of participants reported knowing about pre- and post-exposure prophylaxis, respectively. The majority had never been tested for HIV (81.8%) and did not know where tests could be done for free (70.9%).

Conclusions

Despite higher education, students are vulnerable to HIV and have unsatisfactory knowledge about combined prevention measures.

Key messages

• College students are young individuals with high vulnerability to contracting HIV and other sexually transmitted infections.

• Universities should assume their role as promoters of health and develop strategies that contribute to students’ knowledge and reflection on HIV and its prevention methods.
ISCO-08 Classification and scope of practice of nurses: Survey among WHO-Europe member states
Authors: Kurt S , Sermeus W
Published: October 2024

Background

The expansion of nurse’s roles in the delivery of care needs transparent defining of roles, extra education/training opportunities, and complementary legislative regulations.

Methods

This cross-sectional study was planned to explore status of nursing and midwifery workforce in WHO Europe member states. Data were collected from December 2020 until September 2023.

Results

ISCO-08 2221 is used to classify for only bachelor prepared-nurses in 2 of countries (Bulgaria and Spain). Besides, it is used only for vocational prepared-nurses in 2 of countries (Kyrgyzstan and Tajikistan). Those countries only have vocational or bachelor education. ISCO-08 2221 is used in 1 of countries which have two entry levels with vocational and bachelor prepared-nurses (Georgia). ISCO-08 3221 is referred to vocational training in 5 (20%) countries (Armenia, Finland, the UK, Croatia, Hungary). ISCO-08 2221 is main classification for all levels prepared nurses in 18 countries including Switzerland, Cyprus, Czechia, Germany, Denmark, Ireland, Israel, Iceland, Kazakhstan, Lithuania Latvia, Malta, Poland, Portugal, Romania, Sweden, Slovakia, Türkiye. Scope of practice of vocational and bachelor prepared nurses is defined by law/legislation in 25 of member states. Scope of practice vocational versus bachelor depends on conduct scientific tasks (Switzerland), being broader (Kazakhstan), competency level (Hungary, Croatia, Portugal) exceptionally there is no difference in Malta. Scope of Registered Nurse, Specialist Nurse and Advanced Nurse Practitioner differ in 22 of countries of those which on activities/practice/roles, expanded authority, working with determined care group. As a result, while scope of practice of professional nurses varies in line with their education level, ISCO-08 2221 is used for nurses’ classification from all education levels in member states.

Key messages

• There is no classification for postgraduate trained nurses (as is the case for physicians), even though scope of practice is different across education levels.

• When revising the ISCO-08 classification, it should be recommended that a common terminology is needed to define postgraduate nurses in region.
The Population-Centered Medical Model: a method of practice for public health physicians
Authors: Ranade S , Freeman T , Thind A , Brown J B
Published: October 2024

Background

Public Health Physicians (PHPs) in Canada occupy a liminal space between medicine and public health. Current practice frameworks for the care of individual patients by physicians do not account for the complexity of working with communities and populations for health. Similarly, frameworks for public health practice do not account for the roles and responsibilities of physicians in public health. A method of practice that outlines how public health physicians care for populations is vital for training and development of practice for this specialty group within medicine and public health.

Methods

Constructivist Grounded Theory methods were used in this study. Ethics approval was obtained through The Western University Health Sciences Research Ethics Board. Semi-structured interviews were conducted with eighteen (18) currently practicing PHPs across Canada. Data was analysed iteratively using constant comparison, multi-level coding, and memo writing. Thick description and reflexivity were employed to enhance rigour.

Results

The key finding is the elucidation of the Population-Centered Medical Model. In this empirically grounded model, PHPs bring values, knowledge and stances to their practice of Public Health Medicine. PHPs consider the population as patient, along with ethical obligations that flow from the physician to the population as a consequence. The process of caring for populations involves both diagnosis and intervention, with a focus on systems and prevention. It relies on knowledge sharing and relationship building between the physician and the population.

Conclusions

This is the first empirical model to describe the practice of PHPs. The model firmly grounds PHP practice in both medicine (diagnosis and intervention, the construction of a patient) and public health (focus on populations, systems and prevention). It also presents an opportunity to develop a general model of medical practice for n patients, where n can range between 1 and N.

Key messages

• The Population-Centered Medical Model is an empirically grounded model that describes the work of Public Health Physicians in Canada and grounds practice firmly in medicine and in public health.

• Public Health Physicians consider populations as patients. They diagnose and intervene for health, with a focus on systems and prevention, by building relationships and sharing knowledge.
The pivotal role of positive emotions in maintaining nurses’ trust and preventing pandemic fatigue
Authors: Bord S , Sharabani S , Admi H
Published: October 2024

Background

Nursing is a challenging profession that demands quick adaptation to changing conditions. The COVID-19 pandemic has placed unprecedented pressure on nursing teams, leading to high-stress levels and uncertainty. This study examines how nurses’ emotional response at the start of the pandemic predicts their trust in the healthcare system and pandemic fatigue after three morbidity waves.

Methods

This study included collecting self-reported data among Israeli nurses in three time periods: 346 nurses during March-May 2020 (T1), 260 nurses during June-July 2020 (T2), and 91 nurses during February 2022 (T3). Change in the study variables was assessed using repeated-measure ANOVA. Two multiple linear regression models were calculated for trust and pandemic fatigue at T3, with the emotions at T1 and professional seniority as predictors.

Results

A significant increase in negative emotions was observed between T1 and T2 (M = 2.65, SD = 1.12 and M = 3.20, SD = 1.29 respectively). Furthermore, there was a significant decrease in trust levels between T1 and T3 (M = 4.68, SD = 1.14 and M = 4.07, SD = 1.08 respectively). The regression model for trust was significant, with 20% of the variance explained in it, revealing that higher positive emotions at T1 predicted higher trust at T3. Similarly, the regression model for pandemic fatigue was significant (R2=22%), showing that lower professional seniority and lower positive emotions at T1 were predictors of higher pandemic fatigue at T3.

Conclusions

During a crisis, nurses may experience intense negative emotions like fear and anxiety. However, positive emotions, such as pride and a sense of mission, are crucial in maintaining their trust and preventing the onset of pandemic fatigue. Healthcare organizations should promote emotional support and provide emotional resources so that nurses can continue to deliver high-quality care even during challenging times.

Key messages

• During times of crisis, it’s crucial to foster positivity and encourage a sense of pride and accomplishment in nursing staff.

• Healthcare organizations must provide emotional support to nursing teams in routine and crisis situations to prevent burnout and maintain trust and long-term functioning.
Workshops: Enhancing communication for nursing students with patients with hearing disabilities
Authors: Tannenbaum-Baruchi C , Izhak L , Levi D , Debre D
Published: October 2024

Background

Nursing students need guidance on effective communication strategies for interacting with patients with hearing disabilities, emphasizing the importance of addressing this gap in their education as future healthcare professionals.

Methods

A cross-sectional survey was conducted among nursing students at seven institutions before and after workshops led by guides with hearing disabilities from a non-profit organization Ma’agalei Shema and funded by the National Insurance Institute. Data was collected from 2023 to March 2024 and analyzed using SPSS software.

Results

279 participants completed the survey before the workshops. and 136 responding afterward. Almost 80% were female. Before the workshops, 68.46% of students expected to gain communication tools for patients with hearing disabilities. About one-third believed the healthcare system offers accessible treatment to these patients, while only 22.22% foresaw no barriers. One-third reported no clinical contact with such patients. Among those who did, lip-reading (25.53%), writing (17.73%), assistance from family members (15.6%), and sign language (9.22%) were commonly used. Only 2.84% used professional sign language interpreters, and 20.57% reported never meeting a patient with hearing disabilities (8% reported “other”). Post-workshop surveys showed that around 82.48% of participants felt the workshops would significantly enhance their communication skills with such patients, with only 5.11% reporting a lack of practical tools received.

Conclusions

Practical workshops can significantly enhance communication skills and improve patient care. This study underscores the potential impact of minor adjustments in communication strategies on patient care, such as increasing the use of professional interpreters. Main messages: Providing training to nursing students in effective communication with these patients can streamline interactions, diminish reliance on family intermediaries, and enhance medical care.

Key messages

• Nursing students need guidance on communicating with patients with hearing disabilities to improve future healthcare interactions.

• Practical workshops enhance communication skills, stressing the importance of minor adjustments for better patient care.
“We want to get out” – A qualitative study on reasons for nurses’ early retirement intentions
Authors: Kaihlanen A-M , Aktas E , Sadauskas M , Sezgin D
Published: October 2024

Background

Nurses, the largest workforce in healthcare, play a central role in health systems. There is a severe global shortage of nurses, which is expected to worsen as a significant portion approaches retirement age. Early retirements can harm care quality and healthcare access, thus significantly impacting public health. Identifying reasons is crucial to prevent this trend. This study examined factors behind nurses’ early retirement intentions.

Methods

A descriptive qualitative study was conducted in an Irish hospital (July to September 2023) including individual interviews with 10 nurses aged 55 and over. A thematic analysis was conducted collaboratively by three researchers to identify key factors influencing nurses’ intentions to retire early.

Results

Five main themes emerged: 1) Health concerns, encompassing physical strain and psychological stress, significantly influencing early retirement intentions; 2) Struggling to balance job demands with personal responsibilities such as caring for ageing parents due to inflexible work schedules; 3) Need for more support from senior leaders to address staffing shortages and investment in aging nurses’ career and retirement planning to make staying more desirable and easier; 4) Feelings about nurses’ experience being undervalued in the evolving healthcare; and 5) Facing constant heavy responsibility in guiding new nurses, while simultaneously fearing patient safety risks and encountering generational differences.

Conclusions

Developing support systems for ageing nurses, encompassing strategies to ease workload strain, enhancing career opportunities, and promoting intergenerational collaboration are critical for reducing early retirement trends and sustaining a resilient healthcare workforce. By implementing tailored approaches, such as flexible scheduling and mentorship programs for ageing nurses, healthcare organisations can promote workforce longevity and enhance public health outcomes through improved care delivery.

Key messages

• Health challenges and struggles in work-life balance influence early retirement intentions among nurses, urging flexible work arrangements and improved recognition and leadership in healthcare.

• To extend work careers, organisations must invest in ageing nurses’ career and retirement planning, value experience, and acknowledge potential challenges and benefits in intergenerational nursing.
Preferences regarding the Booster Dose of Covid-19: a cross-sectional study in Central Italy
Authors: Guarducci G , Mereu G , Gemmi F , Galletti G , Guerreschi E , Sergi A , Nante N
Published: October 2024

Background

Examining information sources, communication channels, and preferred content formats is crucial for adapting and improving future communication strategies in vaccination campaigns. This study aims to evaluate the information and communication preferences regarding the booster dose of Covid-19 among employees of the Central Tuscany Local Health Authority (CT-LHA).

Methods

From July to October 2022, a questionnaire was administered to 7,000 out of approximately 15,000 CT-LHA employees. The questionnaire analyzed communication, organizational, and access aspects regarding preferences for the Covid-19 booster dose. The sample was stratified into healthcare workers (HCWs) and non-healthcare workers (NHCWs). Chi-squared tests were performed using STATA, with the significance level set at 95%.

Results

The returned questionnaires were 1,885 (26.9%), with the majority being HCWs (64.4%). HCWs rated the quality of communication significantly lower compared to NHCWs, who rated it very high (p < 0.05). HCWs also rated the ease of booking the Covid-19 booster dose and access modalities to vaccination significantly lower than NHCWs (p < 0.05). NHCWs expressed a preference for receiving scientific information from Ministry of Health tutorials, while HCWs preferred information from their general practitioner (p < 0.05). HCWs preferred to receive organizational information from healthcare management, while NHCWs preferred information from vaccination physicians (p < 0.05). Additionally, HCWs preferred company operating procedures for disseminating information, whereas NHCWs preferred corporate communications circulars (p < 0.05).

Conclusions

HCWs and NHCWs showed differences in perceived quality of communication, ease of access to vaccination services, and preferred sources of information. HCWs rated the quality of communication and access to vaccination services lower than NHCWs. This results suggest the need for tailored communication strategies to effectively reach both groups.

Key messages

• Health organizations need to develop targeted communication approaches that address the specific needs and preferences of their employees.

• Flexibility and adaptability are crucial to adapt communication methods and channels to strengthen vaccination initiatives and promote public health outcomes.