bluuebunny/crossref_metadata_2025 huggingface dataset:
Measurements of public trust in the health system: mapping the evidence
Authors: Schloemer T , Schröder-Bäck P , Cawthra J , Holland S
Published: October 2021

Introduction

Public trust in the health system is essential to control the Covid-19 pandemic. It can influence the extent to which interventions to combat a pandemic are accepted by citizens. The objective of this review was to map the evidence of measurements of the concept of public trust in the health system with a focus on health system institutions.

Methods

We performed a systematic literature search in the databases Web of Science and Embase in March 2020. Quantitative studies measuring trust on a system level with regard to healthcare were eligible if they addressed the general public and were published in English or German. We excluded studies that measured trust on an interpersonal level, in a single health profession, or a single treatment. We extracted data to map the characteristics of measurements.

Results

Of initially 7137 identified articles, 87 studies were included in the mapping. In 58 (67%) of the studies, trust was the outcome variable. Most studies (69%) measured the level of trust with single items, 27 studies (31%) used scales or indices to measure the concept of trust. Of these, 12 studies measured healthcare system trust, 7 trust in government and political institutions, 4 trust in healthcare organisations, 3 trust in health insurances, and 1 trust in health data management institutions. Most common domains of trust in the healthcare system refer to policies, quality of services, communication and provision of information, relationships with providers and their expertise, and quality of cooperation between providers. Theoretical dimensions of the concept of trust include fidelity, competency, trustworthiness, integrity and global trust.

Conclusions

Few quantitative studies examine dimensions of public trust on a health system level. Future country-specific research on the concept of public trust may support the understanding of context-specific determinants for the tailoring of interventions to promote trust in health systems.

Key messages

Public trust is an important aspect for controlling a pandemic, as it is a precondition for accepting interventions, such as vaccination programmes. Country-specific research may promote the understanding of public trust and the tailoring of interventions to increase health system trust.
Measuring health system resilience: do current global standardised surveys meet our needs?
Authors: Vikna K , Ridde V , Clech L , Franceschin L
Published: October 2021

Background

The study of health system resilience is relatively novel, but paramount in health systems research. It is intended to portray the ability of a health system to withstand, adapt and cope with catastrophic events or ‘shocks' that affect its capacity in delivering safe, high quality health services to its population. These ‘shocks' which cause a sudden and extreme change can pose an acute or chronic impact on certain health system functions at various degrees, or on the entire system as a whole. Given the lack of clarity on quantitative measurement of health system resilience, we aimed to identify existing global standardised surveys that could be utilised for this purpose using a healthcare access perspective.

Methods

A scoping review was conducted using web-based searches to identify global standardised surveys that measured healthcare access in peer-reviewed and “grey” literature. Identified surveys were applied to the Levesque Framework on Healthcare Access 2013, upon which indicators applicable to each of the dimensions within the framework were determined.

Preliminary Results

Of the 5 global surveys identified, all fail to address all 10 dimensions of the framework and all key components within each dimension. Currently, available global standardised surveys fall short in providing a complete picture of health system resilience, leaving crucial gaps in measurement. This is further complicated by the complex nature of incorporating a specific ‘shock' in the analysis whilst accounting for other co-factors that may exist.

Conclusions

Whilst the concept of national health system resilience is becoming increasingly explored today, much work remains on identifying approaches to empirically measure it, and in understanding whether it is indeed possible for a single framework and/or global standardised survey to be applied regardless of the type of ‘shock' experienced by the system.

Key messages

Currently available global standardized surveys do not fully meet our needs to measure health system resilience at a national and regional scale. Effective measurement of health system resilience will enable strategic strengthening of essential health system functions to minimise temporal perturbations and avoid the collapse of a health system.
Role of community pharmacists in pharmacovigilance: pharmacists’ and patients’ perceptions
Authors: Kazaryan I , Sevikyan A , Vardanyan L , Amirkhanyan A , Melikyan M
Published: October 2021

Background

Pharmacists are involved in pharmacovigilance in many countries, their role varies. Some studies show that they are not active enough in reporting adverse drug reactions (ADR). Pharmacists' and patients' awareness about engagement of pharmacists in reporting ADR and other medicines use problems, as well as in counseling on medication safety is essential for improving patient safety. The objective of this work was to study attitude of pharmacy professionals and patients to role of community pharmacy staff in providing patient medication safety in Armenia.

Methods

297 pharmacists and technicians, as well as 2066 patients were interviewed in Yerevan (capital of Armenia) according to designed and pretested questionnaire.

Results

201 (68.0%) pharmacists and technicians consider that community pharmacists in Armenia are engaged in ADR reporting and 198 (66.6%) professionals indicated that they wish to be involved in this activity. 215 (72.4%) professionals supposed that community pharmacists are engaged in providing advices related to medicines safety and indicated that they are interested to be involved. Slightly more than a half of patients reported that they wish that community pharmacy staff would be involved in ADR reporting and would provide advices related to medicines safety: 1171 (56.7%) and 1115 (54.0%), correspondingly. The number of participated patients who think that pharmacists are already engaged in these activities was much less: 726 (35.1%) and 876 (42.4%), correspondingly (p < 0.001).

Conclusions

Most of pharmacy professionals and patients are interested that community pharmacy staff would be involved in ADR reporting and advising on medicines safety. Some pharmacy professionals and most of patients are not aware about this role of pharmacy staff. Special strategies for educating pharmacists and patients should be developed. Lecture on Pharmacovigilance was included in continuing education course curricula for pharmacy professionals.

Key messages

Pharmacy professionals and patients are interested in engaging pharmacists in activity in the area of pharmacovigilance. It is important to improve education of pharmacists and increase awareness of patients about role of pharmacists in this area.
A public health approach for addressing recidivism and addiction using European concepts in Alaska
Authors: Ray R
Published: October 2021

Problem

Criminal activity attributed to substance misuse is a tremendous challenge to public health and public safety. Over 80% of Alaska's incarcerated population has an addiction disorder. These individuals are 129 times more likely to die of a drug overdose within two weeks after reentry. Nearly 83% will likely be rearrested. This complex problem has a costly impact. In 2017, 25,450 Alaskans were victims of crimes directly attributed to substance misuse for a total cost of over $2.3 billion.

Description

The Alaska Recidivism Reduction and Recovery Project is a comprehensive intervention addressing the primary risk factors of ongoing criminal activity and substance misuse within an innovative therapeutic campus model and a mobile health platform. The intervention uses a conceptual framework derived from the European Union's Triple-R Model and the Norway Model of Restorative Justice. Living on a therapeutic campus for an average of 6-18 months, formerly incarcerated adults engage in a suite of services designed to transform criminogenic needs. Services also employ an innovative mobile health platform using Oracle's Intelligent Advisor technology. The project aims to increase access to critical community care, improve participants' quality of life, and improve public health and safety by reducing crime related to substance misuse.

Results

Preliminary results suggest the intervention may significantly improve access to care upon reentry while creating meaningful changes in criminogenic needs. Early indications also suggest substantial cost savings may be achieved. For every 80 successful participants in Alaska, data suggests cost savings and net economic benefits may reach $20 million.

Lessons

European concepts can be successfully replicated in Alaska to create an impactful intervention addressing criminal recidivism and addiction. Given the correlation between crime and addiction, this practice may provide a critical pathway for improving public health and safety.

Key messages

European conceptual frameworks can be successfully replicated in Alaska to create a meaningful community-based intervention for reducing criminal recidivism and substance misuse. An innovative intervention in Alaska addressing the primary risk factors of criminal activity and substance misuse demonstrates the potential to achieve significant social impact and cost savings.
Trends in current alcohol use among Japanese adolescents by sociodemographic groups
Authors: Takakura M , Kyan A , Miyagi M , Kobayashi M
Published: October 2021

Background

Alcohol is the most commonly used substance among Japanese adolescents, although its use has been declining recently. However, little is known whether the declining trend in adolescent drinking can be found across all sociodemographic characteristics. This study explored time trends in alcohol use among Japanese adolescents by sociodemographic characteristics between 2008 and 2016.

Methods

A repeated cross-sectional study was conducted using data from three prefectural-wide surveys of public high schools in Okinawa Prefecture, Japan, in 2008, 2012, and 2016. The study participants comprised 7,807 students in grades 10 to 12 (15-18 years). Alcohol use was defined as drinking one or more alcoholic beverages on at least one day in the past month. Demographic characteristics included grade, sex, and region, and socioeconomic status (SES) was assessed by family structure, parental education, and school type. Time trends in alcohol use over time by each sociodemographic group were assessed by the Cochran-Armitage test for trend.

Results

The overall prevalence of adolescent alcohol use significantly reduced from 20.7% (95% CI 19.1-22.3%) in 2008 to 9.5% (95%CI 8.4-10.6%) in 2016. Similar reducing trends in adolescent alcohol use were found across all of the demographic characteristics as well as the SES groups (all P for trends <0.001). During the survey periods, there were no sex differences in alcohol use prevalence, while alcohol use was more prevalent among old graders. Alcohol use was also more prevalent among low SES groups than high SES groups. However, family structure in 2016 did not show significant differences in alcohol use.

Conclusions

Alcohol use among Japanese adolescents has been declining over time and this downward trend was similar for all demographic and socioeconomic subgroups. Further adolescent drinking prevention efforts should be implemented across all population subgroups. Moreover. monitoring of adolescent alcohol use should be continued.

Key messages

This study found that adolescent alcohol use in Japan has been decreasing over time across all population subgroups. The finding is a desired outcome from the viewpoint of the public health impact.
Healthy behavior – a conscious choice or unwanted trouble? Study among active population in Bulgaria
Authors: Georgieva S , Kamburova M , Mineva-Dimitrova E
Published: October 2021

Background

Official statistics in Bulgaria, as well as a number of empirical studies, show wide spreading of behaviour risk factors and their associated diseases in Bulgarian population. Legislative measures and health promotion programs aim to curb the unhealthy behavior and to incite conscious healthy choices. The purpose of this report is to investigate the attitude of active age people to behaviour change and the barriers they encounter in its implementation.

Methods

Data were collected by direct individual self-administered questionnaire, within a larger research project on health of active population in Bulgaria. It includes 326 employees in a study representing different branches, companies and professions. Questions have asked about distribution of risk factors and attitude to potential behavior change. Data processing was performed by SPSS v.24.

Results

Number of people willing, considering or already making a change depends on the factor studied. Respondents ready to make a change in their diet are 44.6%. Over ¼ of them have already started or trying to confirm this change. In the last 12 months 56.3% have made efforts to improve their physical activity, but in 75.7% of cases the activities were irregular, low-intense and don't fully comply with WHO recommendations. The desire to improve physical activity is significantly higher in people performing intellectual work (p < 0.05). Although 47.5% of the study subjects identify themselves as smokers, 64.1% of them don't have a sense of risky behavior and have no intention to eradicate this habit, 9.8% consider that negative effects will not affect them and 26.1% define behavior change as a long, difficult, expensive and inconvenient process they can't cope with.

Conclusions

Study results confirm high distribution of behavior risk factors in Bulgarian active population. A conscious readiness for behavior change is closely related to the factor, professional characteristics of people and their health knowledge.

Key messages

There is a wide spreading of life-style risk factors in active age population in Bulgaria. Behavior change and adoption of healthy behavior is a necessity and a conscious choice for many people. A conscious readiness for adoption of healthy habits depends on the factor, knowledge about its harmful effect, profession, as well as difficulties that people face in the process of behavior change.
Health-related quality of life according to the presence of insulin resistance in ten years follow-up
Authors: Kažukauskienė N , Podlipskytė A , Varoneckas G , Mickuvienė N
Published: October 2021

Background

Insulin resistance is the primary cause of metabolic syndrome, which in turn reflects a real variety of risk factors, closely linked to each other. Thus, we aimed to investigate health-related quality of life scores according to the presence of insulin resistance among citizens of Palanga in Lithuania, in the survey in 2003 and 2013.

Methods

A randomized epidemiological study was performed out for 835 subjects. All study participants were evaluated according to for socio-demographic characteristics, behavioral factors, health-related quality of life and self-perceived health using questionnaires. Fasting blood samples were draw from all participants for biochemical tests for the glucose and insulin. Insulin resistance was evaluated by the homeostasis model assessment of insulin resistance.

Results

All study participants were stratified into groups without and with insulin resistance in the survey in 2003 and 2013 years follow up. Participants with insulin resistance were more likely to be male, with higher body mass index, had lower than higher education, and with moderate self-related health. In subjects with insulin resistance, after adjusting with various factors, logistic regression analysis showed, that within 10 years, a significantly higher chance of deteriorating health-related quality of life in the areas of: physical functioning (odss ratio [OR] = 1.15, p < 0.001), emotional role limitations (OR = 1.07, p = 0.034), social functioning (OR = 1.26, p = 0.004), pain (OR = 1.09, p = 0.005) and general health perception (OR = 1.07, p = 0.022).

Conclusions

People with insulin resistance are significantly more likely to have a deterioration in their health-related quality of life in the areas of physical functioning, emotional role limitations, social functioning, pain and general health perception after 10 years period.

Key messages

Over the course of ten years, significant changes were observed in domains of physical functioning, social functioning and general health perception in subjects with insulin resistance. Results of this study provide evidence that individuals with insulin resistance have a significantly higher chance of deteriorating health-related quality of life within 10 years.
Is fruit intake associated with common carotid intima-media thickness?
Authors: Koeder C , Hahn A , Englert H
Published: October 2021

Background

Common carotid intima-media thickness (ccIMT) is an established risk marker for cardiovascular events, including myocardial infarction and stroke, which are of high public health relevance. While a higher fruit intake is generally considered beneficial for cardiovascular health, recent studies have shown that a fruit intake of > 2 portions per day may be harmful. Therefore, we tested if there is an association between categories of fruit intake and mean ccIMT.

Methods

We conducted an exploratory, non-prespecified, cross-sectional analysis of baseline values of 167 mostly middle-aged participants of a controlled lifestyle intervention, recruited from the general population in rural northwest Germany (male: n = 58; female: n = 109). Fruit intake was classified into low (<1 portion of fruit/day), intermediate (1-2 portions of fruit/day), and high (>2 portions of fruit/day). Mean ccIMT was measured in accordance with the Mannheim consensus. Between-group differences in mean ccIMT were assessed with analysis of covariance.

Results

Mean age was 57.3 ± 0.7 years (mean ± SEM). Mean fruit intake was 1.6 ± 0.1 portions/day. Average mean ccIMT was 0.679 ± 0.010 mm. There was a significant difference in mean ccIMT between subjects with low (0.676 ± 0.020 mm; n = 50), intermediate (0.653 ± 0.014 mm; n = 72), and high fruit intake (0.724 ± 0.019 mm; n = 45; p = 0.016). But this difference was attenuated when adjusting for age, sex, and homocysteine (p = 0.418).

Conclusions

We found only a non-significant association between consuming >2 portions of fruit per day and ccIMT. Thus, our study could not confirm a negative effect of fruit intake on ccIMT. Age, sex, and homocysteine may confound this association.

Key messages

Current recommendations of 2 portions of fruit per day seem adequate and do not negatively influence carotid intima-media thickness. Future studies should address confounding of the association between fruit intake and cardiovascular risk markers.
Evalution of sleep quality and sleep hygiene information for the employees of one of the company
Authors: Daymaz D , Yıldız AN
Published: October 2021

Background

In this study, it was aimed to determine the sleep quality of the employees at the head office of a company and providing information about sleep health and sleep hygiene to people who had poor sleep quality to evaluate the effect of this intervention on sleep quality.

Methods

The research was carried out in two stages as descriptive and intervention and data were collected under observation in October 2016 and March-April 2017 and information was given in February 2017 in Ankara. Data were collected from 160 of 408 participants who had bad sleep quality and/or sleepiness formed the intervention group.

Results

In this study 58.8% of the participants were male and 74.0% were married. 46.3% of the participants stated that they slept for seven hours or more. It was determined that 36.8% had bad sleep quality and 15.3% had sleepiness. Those who had non communicable disease (p:0,025) and those who indicate that they have sleep problems with the light in the room while sleeping significantly had worse sleep quality. It was found that participants who had bad sleep quality also had higher sleepiness rate (p < 0,001). According to the logistic regression analysis, sleep quality of the participants who had problems in the last month was worse than who had not problems (OR = 2.34, 95%CI = [1,11-4,95]) and who have children under the age of five was worse than who did not have child (OR = 2.27, 95%CI = [1,04-4,99]). Before intervantion, Pittsburg Sleep Ouality Index point average of all participants was 7,6±2,4, after intervantion it was 6,1±2,9 (p < 0,001). While significancy continues for whom attended to the information conference and got at least an e-mail, for people who could not attend to any intervantion, the change of point become unsignificant.

Conclusions

Evaluation of the effects of the intervention revealed that it would be beneficial to incorporate topics on sleep health and sleep hygiene in the mandatory occupational health education in the workplace.

Key messages

At the beginning of the study 36.8% of participants had bad sleep quality and and 15.3% participants had sleepiness. After intervantion Pittsburg Sleep Quality index point average of whom attended to the information conference and got at least an e-mail positively affected.
Participate Brussels, a collaborative research on healthcare personalisation for chronic patients
Authors: Dauvrin M , Lenoble T , Schmitz O , Servais J , Aujoulat I
Published: October 2021

Background

Integrating patients ‘preferences in the management of chronic diseases improves patient compliance and quality of care: this assumption is at the core of the healthcare personalisation. However, it is unclear how healthcare personalisation is negotiated and put into practice by patients and healthcare professionals. The collaborative research Participate Brussels aimed at co-constructing interventions promoting healthcare personalisation for persons living with a chronic disease in the context of the Brussels region, Belgium.

Methods

In a first step (2018-2019), 46 professionals (nurses, physicians, social workers, alternative practitioners…) and 26 adult patients living with a chronic disease participated in comprehensive interviews. Data were analysed using the ground theory approach. Results of these interviews were discussed between patients and professionals during 6 analysis seminaries in 2019-2020 where researchers acted as facilitators of the dialogue by using participative methods. Finally, solutions to improve healthcare personalisation were prioritized and co-created by patients and professionals in 2020-2021.

Results

Eleven interventions to improve healthcare personalisation for persons living with a chronic disease were co-constructed by patients, healthcare professionals, and researchers. Five interventions targeted the patient level, 3 addressed the organisational level and 3 the macro level. All these interventions were adapted to the regional context and 2 were tested into practice by professionals and patients.

Conclusions

The collaborative approach used in this project allowed for the development of interventions tailored to both the needs of patients and professionals. These interventions potentialize each other and contribute to the healthcare personalisation in a health promotion perspective. Despite the challenges of the collaborative approach, this project succeeded in making both patients and professionals actors of the research.

Key messages

Healthcare personalisation helps to integrate patient preferences into healthcare, but it remains unclear how to put it into practice. Co-created interventions have a better potential to improve quality of care for both patients and healthcare professionals.
Acceptability and feasibility of healthy diet, physical activity, and hygiene intervention components
Authors: Orighoye O , Maynard M , Apekey T
Published: October 2021

Childhood malnutrition is a major public health concern. We evaluated components and outcome measures for potential interventions promoting a healthy diet, physical activity (PA), and good hygiene among children in Lagos, Nigeria. This mixed-methods study, informed by the Medical Research Council Framework for development of complex interventions, took place in a semi-urban area. Participants in school and community settings were recruited via town criers and community networks. Acceptability and feasibility of 12 intervention sessions (10 school; 2 community) and the Global School-based Student Health Survey (diet, PA, hygiene knowledge/practices questionnaire and body mass index (BMI) measures) were evaluated in qualitative interviews, completion and data quality, respectively. Participants included 130 children aged 8-15yrs; 3 children and their parents took part in qualitative interviews. All 12 sessions were delivered with 100% participation. Session components and delivery were deemed acceptable; however, parents highlighted the timing of the sessions and integration into the school curriculum as potential barriers to sustainability. Researcher capacity and school timing impacted the completion of the survey and measurements (n = 59; 45% response rate). There were no missing questionnaire data. Questionnaire and measurement outcomes were similar across settings except for the proportion of children reporting no handwashing before eating at school (91% school vs 88% community; p = 0.006). This may reflect the inappropriateness of some questionnaire items for non-school attending children. Interventions addressing diet, PA and hygiene may be acceptable and feasible in low resource school and community settings in Nigeria. Increased researcher capacity and adaptation of outcomes measures for non-school attending children may be needed.

Key messages

Diet, PA and hygiene interventions may be acceptable and feasible in Nigeria. Researcher capacity and questionnaire adaptation may be needed.
Identifying the potentials of the Place Standard tool in municipal health promotion in Europe
Authors: Tollmann P , Kaczmarczyk D , Kuchler M , Köckler H , Leimann J , Mielenbrink V , Rauscher M , Quilling E
Published: October 2021

Background

Municipal health promotion provides the opportunity to promote health equity and to design health-promoting living environments by developing individual strategies. The Place Standard tool is a participatory instrument to identify needs by asking citizens to evaluate their living environment. It is increasingly being implemented and recommended on an international level. The aim of the study was to identify the potential of the Place Standard tool for the development of strategies in a municipal context as well as to identify facilitators and barriers when designing these.

Methods

Within a qualitative study design, nine guided interviews were conducted with international experts who have applied the tool at a municipal level in Europe. The interviews were recorded, subsequently transcribed and analysed using MAXQDA software. The analysis was based on a qualitative content analysis according to Mayring, using a deductively developed category system.

Results

A total of 355 statements were analysed. Some refer to the fact that a comprehensive needs analysis is enabled by the Place Standard tool, empowerment can be promoted and that the development of strategies can only be carried out with follow-up work. Furthermore, some facilitating factors, e.g. participation and intersectoral cooperation, were described. Mentioned inhibiting factors are e.g. lack of support from political decision-makers and the Covid 19 pandemic.

Conclusions

The results of the research indicate that the Place Standard tool can be used to identify priorities for action regarding the needs of the population at a municipal level. They show that a successful strategy development for municipal health promotion strongly relies on the application of the tool in an overall process.

Key messages

The Place Standard tool can be used to analyse needs at a municipal level. In order to develop sustainable strategies for municipal health promotion, it should be applied in an integrated process.
E-cigarettes use associated with lung injury based on Health Belief Model among university students
Authors: Chinwong D , Panya J , Buasathit N , Chinwong S , Klinjun N
Published: October 2021

Background

E-cigarette use was associated with health effects, including lung injury. This cross-sectional study aimed to assess the university students' health belief in e-cigarette use associated with lung injury based on the Health Belief Model (HBM).

Methods

We collected data using an online self-administered questionnaire from December 2020 to February 2021 from university students at two universities in northern Thailand who were currently using e-cigarettes. The HBM was measured using questions with a 4-Likert-scale answer (1=strongly disbelieve,2=disbelieve,3=believe,4=strongly believe), then the answers were categorized into 2 groups (belief and disbelief).

Results

Of 306 students (61% men, the mean age of 21.8 ± 3.0 years), 53% used both e-cigarettes and conventional cigarettes, and 47% used only e-cigarettes. It showed that 74% of students believed that if they used e-cigarettes, they were at risk of lung injury (HBM: perceived susceptibility), and 68% believed that they had a chance to die from lung injury caused by using e-cigarettes (HBM: perceived severity), and 76% believed that quitting e-cigarettes could reduce the chance of death from lung injury (HBM: perceived benefits). Most students (62%) believed that the strongest barrier for quitting e-cigarettes was that it required a high effort and strong intention (HBM: perceived barriers of quitting e-cigarette), and 76% of students perceived their self-efficacy and believed that when they intended to quit e-cigarettes, they would be successful (HBM: perceived self-efficacy). Most participants believed that family members (78%), lovers (75%), and university restrictions (53%) exerted a positive influence in quitting e-cigarettes (HBM: cues to action).

Conclusions

The HBM helps us to understand using e-cigarettes associated with lung injury among university students. The university should initiate health promotion activities concerning reducing e-cigarettes use among adolescents and young adults.

Key messages

Using e-cigarettes is dangerous for health including lung injury, and university students should stop using e-cigarettes. The university should initiate or enhance prevention and health promotion activities concerning reducing e-cigarettes use among adolescent and young adults.
Building back better after COVID-19: public health competencies for health workforce preparedness
Authors: Czabanowska K , Kuhlmann E
Published: October 2021

Background

The COVID-19 pandemic is raising new questions on public health competences and leadership and on health workforce preparedness for global public health emergencies of this magnitude. This study aims to explore the new demand and opportunities for innovation in public health competencies, which were caused by the COVID-19 crisis.

Methods

We draw on secondary sources and critically review the public health competency framework recently launched by WHO and ASPHER through the lens of COVID-19.

Results

The WHO-ASPHER Competency Framework for Public Health Workforce illustrates an interdisciplinary, inter-professional and lifelong learning approach to public health. Five critical competency areas can be identified in relation to global public health emergencies: (1) flexibility, adaptation, motivation, communication, (2) research, analytical sensitivity, ethics, diversity, (3) epidemiology, (4) preparedness and (5) employability. However, this may not be enough. New models of public health leadership and changes in the health workforce are needed, which transform the silos of professions and policy. Such transformations would include learning, working, leading and governing differently and must stretch far beyond the public health workforce. Innovating public health competences stretches far beyond individual competence development. Moreover, it is about resilience and preparedness and calls for learning, working, leading and governing differently. Critical public health competences are not limited to the public heath workforce, but must become relevant for all healthcare professions.

Conclusions

To achieve transformative capacity, critical public health competences must be considered for all healthcare workers on all levels of policymaking, thus becoming the ‘heart' of health workforce resilience and pandemic preparedness.

Key messages

Innovating public health competencies calls for learning, working, leading and governing differently. Public health competences must be considered for all healthcare workers and transform professional silos.
Students as drivers for global health and pandemic preparedness in medical education in Germany
Authors: Kreitlow A , Steffens S , Jablonka A , Kuhlmann E
Published: October 2021

Background

The COVID-19 pandemics has reinforced Germany's role as global health player, but the education system is lagging behind and does not adequately prepare health professionals for the new challenges. This study aims to strengthen global health in undergraduate medical education in Germany. Major objectives include: to review the current situation, explore changing demand for global health and introduce innovative teaching models and the role of student as drivers for change.

Methods

Mixed methods and an explorative approach were applied, comprising a scoping review, online surveys carried out at Hannover Medical School, March/April 2020, and finally a new multi-professional teaching courses initiated by students and developed collaboratively. Target groups of the survey were undergraduate medical students (n = 384) and additionally lecturers (n = 172).

Results

The results reveal that new health policies and Germany's new global political responsibility do not adequately translate into innovation in the education system. At the same time, demand for global health education has increased markedly and students have taken action bottom-up and introduced new courses. However, the transformative power on the level of institutions is limited. There is a need for appropriate funding and comprehensive governance innovation to align health and education institutions, research and education, policy and practice, and students and lecturers.

Conclusions

Implementation of global health programmes illustrates how students can become change agents and enhance institutional innovation bottom-up. However, in order to achieve wider transformative potential, these efforts must be flanked by macro-level policy changes and integrated in future pandemic preparedness strategies.

Key messages

Strengthening global health education is driven by students’ demand and novel teaching models. Innovation driven by students needs institutional support to achieve transformative powers.
Highlights of oncology care training in the Nurse specialty in Medical University – Pleven, Bulgaria
Authors: Gergova P , Georgieva S
Published: October 2021

Background

Training of nurse students at Faculty of Health Care - Pleven should be carried out in accordance with the Faculty mission for building highly qualified health professionals. For ‘Nurse' specialty there is an approved educational documentation in accordance with the latest changes in the national and European regulations for higher education. The aim of the study is to analyze methods of training in oncology care for student nurses and to give recommendations for their updating.

Material and methods

A direct group self-administered questionnaire was conducted amongst 124 students in II, III and IV year of their nursing education. In addition, document analysis of the curriculum and methods of teaching and training have done. Data processing was performed by SPSS v.24.

Results

Almost all (96,78%) respondents consider that oncology care requires special competencies and 85,45% say they need additional training to perform their duties. Students assess as insufficient their skills in: performing emergency actions in extravasation of cytostatic, application of algorithms for behavior in case of hypersensitivity, application of diet in patients undergoing cytotoxic therapy. It was found that the oftenest teaching methods for the acquisition of knowledge are lectures. Ranking of methods for acquiring skills according to the respondents are as follow: lectures (66,13%), practical (63.71%), work in small groups (14,53%) and role games (7,34%). The least represented is the simulation as a training method (6,41%). Four of five students didn't participate in projects with oncological focus during the training period.

Conclusions

Mastering practical skills in the field of oncology care during the basic training of nurses is an important but neglected part of education. The role of interactive methods should be increased because practical training of students in Nurse is theorized. Involving students in practical activities will stimulate their creative activity.

Key messages

Students in Nurse specialty assess their practical skills in the field of oncology care as insufficient, and emphasizes on the necessity of their enhancement. One of the main problems of training nurses in oncological care is a prioritization of theory than practice. Skills acquiring is not effective without application of interactive methods of training.
Dual-duty caregivers: formal and informal care roles and their implications among nursing workers
Authors: Gur A , Halperin D , Mashiach-Eizenberg M
Published: October 2021

Background

A nursing worker who is also a caregiver of an elderly family member, plays a dual-duty role, which is challenging and requires knowledge, skills and professional experience. The interaction between family and work entails a spillover between the two, and affects employees and healthcare organizations. The current exploration study examined differences between nursing employees who hold a dual role and those who do not, while identifying implications of the dual-duty role and the correlations between them at the individual level that might negatively affect the organization.

Methods

A cross-sectional quantitative study was conducted, including 158 staff members from nursing homes in Israel: 41.8% were also informal caregivers for elderly family members, 62.5% were women, and 79.2% were Arabs. A self-administered questionnaire was used to measure workload, family-work conflict, absenteeism, tardiness, and intentions to leave the organization. Participants with a dual role tended to be older, had more children, had worked for longer period, and held part-time positions compared to those who do not.

Results

Preliminary results showed no significant differences between the two groups. Pearson correlations revealed that workload and family-work conflict were positively associated with leaving intentions (dual-role caregivers: r=.30, p<.05, r=.45, p<.01; others: r=.61, p<.01, r=.34, p<.05). Among the dual-role group, workload was related to absenteeism (r=.27, p<.05), and family-work conflict was related to absenteeism and tardiness (r=.24, r=.29, p<.05). Among the other group, only family-work conflict was associated with tardiness (r=.33, p< .01).

Conclusions

As negative consequences were indicated for workers with a dual-duty role, additional research in the healthcare sector should be conducted, leading to intervention programs for helping employees and organizations deal with the dual role and serving as the basis of policies and procedures.

Key messages

Nursing workers often suffer from workload and family-work conflict. Workload and family-work conflict among dual-duty caregivers might result in withdrawal behaviors (tardiness and absenteeism).
Measures for co-medicals in postwar Okinawa: scarcity of the personnel for allocating vaccinations
Authors: Ogawa S , Otani J , Cavaliere P , Dini L
Published: October 2021

Background

The shortage of doctors in postwar Okinawa has led to the creation of co-medicals. They were called medical service personnel and authorized to handle certain medical treatments. This included tasks such as providing injections and vaccinations under the supervision of the doctor in the health center.

Issue/problem

The system of co-medicals only applied in Okinawa and not in Japan. As such, when Okinawa was reverted back to Japan in 1972, it was proposed to abolish the system. In the current emergency of the new coronavirus pandemic, we are facing a similar situation in terms of the shortage of medical personnel.

Description of the problem

In Japan, like many countries, there is a shortage of health resources due to the COVID-19 pandemic. The focus will be on healthcare personnel, those who have taken on the role of COVID-19 vaccinators in Japan, and a comparison of the situation in other countries.

Results

In Japan, vaccinations are legally limited to being administered by doctors and nurses. However, pharmacists have taken on the role of administering vaccinations in the UK, US, Ireland, Canada, and Italy, thus COVID-19 vaccinations could be easily integrated into these routine procedures.Even vaccinations by medical students have been carried out. In addition, non-healthcare volunteers have been trained as vaccinators in UK and Italy. The coverage has reached 50% in the UK, 42% in the US, and 30% in Canada, whereas 1.8% in Japan in April (Our World in Data, 2021).

Lessons

Although the COVID-19 situation is substantially different from the case of postwar Okinawa, it will be necessary to take resilient measures to solve the medical personnel shortage. Additionally, the strict measures of limiting vaccinations by medical doctors may need to be reconsidered in Japan. Establishing a system of allowing co-medicals to have a shared role could offer innumerable benefits for all.

Key messages

Expanding the task of vaccinations to co-medicals has had beneficial results in several countries. Dividing roles of medical doctor need to be considered.
Awareness of knowledge related to administering medication for children by mothers among pharmacists
Authors: Yanagi N , Satoh H , Sawada Y
Published: October 2021

Background

Inappropriate medication use for children by caregivers such as mothers and nursery staff has been reported in Japan. The pharmacists have the responsibility to support adequate medication administration and should consult effectively. However, it is not clear how much pharmacists are aware of the knowledge of medication use by caregivers. This study aimed to examine the knowledge related to administering medication for children among mothers and nursery staff and to evaluate the awareness of that understanding among pharmacists.

Methods

Three online surveys involving 600 mothers living with nursery school children, 558 nursery staff at nursery schools, and 584 pharmacists in Japan were conducted separately (Cross-sectional data, in 2019/2021). Ten statements about the knowledge related to administering medication for children such as “You could give the medicine that has been prescribed before if similar symptoms are shown”, “You should give children the medicine using favorite beverages such as milk and juice, regardless of the kind of medicine” were shown and measured using a 5-point Likert scale. The answer: “disagree”, was considered as correct understanding. The pharmacists were asked how much they think mothers/nursery staff answered correctly using a 5-point Likert scale.

Results

The proportion of correct answers for ten statements by mothers and nursery staff were 35.8%-76.0% and 43.0%-69.9%, respectively. Most answers from pharmacists were in the category range of 40%-59%. Only 11.5%-33.0% of pharmacists chose the correct category in each of ten items with mothers' answers and 24.0%-83.4% of them had lower awareness.

Conclusions

Overall, the pharmacists were less likely to be aware of the mothers'/nursery staff members' knowledge related to administering medication. The pharmacists need to instruct mothers to administer medication after confirming their understanding at the pharmacy.

Key messages

The awareness of knowledge related to administering medication for children by mothers and nursery staff among pharmacists was lower than the answers. The pharmacists need to instruct mothers to administer medication at the pharmacy after confirming their understanding of medication use.
Occupational standards as a tool to bridge the gap between health care practice and education
Authors: Koikov VV , Akanov AB , Baigozhina ZA , Abduazhitova AM , Derbissalina GA , Abdrakchmanova AO
Published: October 2021

Issue/problem

The intensive development of the labor market in the healthcare system (HS) and the active introduction of new technologies, noted in recent years, require the creation of conditions for the continuous provision of the HS with the necessary number of specialists with the appropriate level of qualifications and scope of competencies. To do this, it is necessary to ensure that medical educational programs (EP) correspond to the competencies that are actually necessary for health professionals and meet the requirements of the authorized body (Ministry of health), the expectations of employers, the needs of employees and patients.

Description of the problem

One of the significant problems of the medical education system in the Republic of Kazakhstan (RK) is that the EP of medical universities and colleges do not fully reflect the needs of the HS, and graduates of universities and colleges do not fully meet the needs of the HS. This situation is due to the fact that until recently there were no occupational standards (OPs) that determine the requirements for the competencies of specialists working in the HS.

Results

To solve this problem, the new Code of the RK ‘On the health of the people and the health care system', adopted in 2020, defines the norms that regulate the fact that: medical educational organizations develop EPs in accordance with the requirements for the level of qualifications established in OPs; assessment of the professional preparedness of graduates of EPs is based on OPs; continuous professional development and certification of healthcare workers is based on OPs. In 2020-2021, the development of OPs and their introduction into the medical education system began, which made it possible to bring EPs in line with the needs of practical healthcare.

Lessons

The introduction of OPs into the medical system makes it possible to ensure that the competencies of healthcare workers meet the needs of practical healthcare.

Key messages

The introduction of occupational standards helps to bridge the gap between practical health care and medical education system. Orientation of educational programs to occupational standards allows to ensure healthcare system by specialists corresponding to the needs of practical health care.