bluuebunny/crossref_metadata_2025 huggingface dataset:
Benchmarking between two different hospitals on health risk management in the covid-19 emergency
Authors: Nasi G , Brandimarte G , Marrone R , Sponzilli A , Sorbara D , Benedetti P , Grande D , Brando C , D'Avino A , Parrocchia S
Published: October 2021

Iusse

The strategies adopted during COVID19 emergencies by two different hospitals in the Lazio Region are presented: S. Maria Goretti Hospital (SMGH) directly managed by the ASL Latina, hub and centre of the Emergency Department, and Cristo Re Classified Hospital (CRH), accredited in the territory of the ASL Roma1.

Description of the problem

SMGH has been identified as COVID19 Intervention Hospital. CRH initially was a No-COVID support structure, then included in the COVID19 network. During the COVID19 emergency, the directors of both hospitals had to simultaneously ensure activity as usual, COVID19 recovery and risk management.

Results

SMGH, while continuing the emergency, oncological, pregnancy, paediatrics and outpatient activities, COVID19 patients was isolated on 7 different floors/areas. Moreover was defined: chain of command; clinical admission criteria; COVID19 multi-professional and support teams, roles, skills and specific training; health surveillance; environmental hygiene, safety paths/procedures, vaccinal center and much more. CRH, while continuing minimum programmed activities to reduce waiting lists, in the first epidemic phase was created 4 tensile structures for Pre-triage and COVID pathways, respiratory isolation area for supsected patient; transfer admission for emergency networks, clean-dirty pathway. Moreover in the second phase, was activated beds of COVID19 network and 4 technical beds OBI; the ‘Walk-in' for antigenic testing, with molecular confirmation <24h and infectious counselling; multi-disciplinary and specialist support teams, training courses, health surveillance, vaccinal center and much more.

Lessons

During COVID19 pandemic, risk management skills linked to the technical-organisational strategy of hospital directors, making it possible to reprogramme their structure in a short period of time with flexibility and resilience of the whole organization.

Key messages

Specific skills and roles, both hygienic and organizational, are essential to risk management in hospitals during epidemic emergencies. The multidisciplinarity, flexibility and modularity of the hospital structure are the organizational bases in cases of pandemics.
Leisure Time & Risk Sexual Behaviour - Croatian adolescents’ perspective
Authors: Belošević M , Ferić M , Mitrić I
Published: October 2021

The project ‘Quality of leisure time as a protective factor for the development of behavioural problems' aims to investigate the influence of structured leisure time on mitigating adolescents' involvement in risk behaviours. Leisure can be a powerful context for positive youth development, but it can also be a context for youth engagement in risk behaviours. Therefore, the research question is: How does participation in structured leisure time activities influence risk sexual behaviour from the perspective of Croatian high school students? The sample consists of a total population of high school students from one county in Croatia (2,977 students, from 9 high schools). The age of the participants ranged from 14 to 20 years (51% female). The following questionnaires were used: (1) Adolescent Leisure Time Questionnaire; (2) Youth Experience Survey; (3) Risk Sexual Behaviour of Adolescents Questionnaire. Preliminary data show that 57% of adolescents currently participate in structured leisure activities. Before the pandemic COVID 19, 23% of adolescents participated in structured leisure activities twice a week, while during the pandemic COVID 19, only 15% did. Moreover, 35% of adolescents did not participate in structured leisure activities during the pandemic because they were anxious. Regarding risk sexual behaviours, 29% of adolescents had sexual intercourse, and of those 16% reported having experienced it before the age of 14. Unprotected sexual intercourse in the past 6 months under the influence of alcohol was reported by 15%, and under the influence of cannabis by 6% of adolescents. In presenting this work, the influence of structured leisure time activities on adolescents' risk sexual behaviour will be emphasized. The broader perspective and understanding of adolescents' leisure time and how it influences adolescent's behaviour and/or developmental outcomes is important for planning evidence-based strategies and interventions in the field of prevention science.

Key messages

The findings of this study can be an important resource for evidence-based intervention planning aimed at promoting positive youth development/prevention of youth risk behaviours. It is important to focus on creating opportunities in the community for quality leisure time use and educating key stakeholders about the importance of investing in quality leisure for youth.
Development and validation of an Italian version of the PMOS-30 questionnaire at hospital level
Authors: Schiavone S , Cioffi A , Magrelli J , Attena F
Published: October 2021

Background

An important challenge for health systems worldwide is to ensure that health professionals can carry out their mission to treat, rehabilitate and prevent diseases safely. The Patient Measure of Safety (PMOS) questionnaire is an instrument that allows the systematic collection of patients' feedback about their care to understand and assess the level of safety in hospital. The PMOS-30 questionnaire was recently developed as shorter version of the 44-item PMOS. The objectives of this study are to develop and validate an Italian version of the PMOS-30 questionnaire so that this instrument can be utilised in hospital routine for the continuous improvement of patient safety.

Methods

A cross-sectional study was carried out on patients in a hospital in Italy. A confirmatory factor analysis was conducted after the development of an Italian version of the PMOS-30 questionnaire. Maximum Likelihood (ML) estimation was used to perform CFA. The quality of the model fit was evaluated on the basis of the Comparative Fit Index (CFI), Tucker Lewis Index (TLI) and Root Mean Square Error of Approximation (RMSEA).

Results

A total of 435 patients filled in the Italian version of the PMOS-30 questionnaire. The CFI did not achieve the fit value (CFI= 0.802). But RMSEA suggests a reasonably good fit value (RMSEA=0.076). Internal consistency analysis showed that the Cronbach's alpha value was more than 0.6 in all domains except for the domain “organisation and care planning” that had a value of 0.525.

Conclusions

Patients feedback about their safety in hospital is an important source of information for the routine hospital life. Since patient safety is an intrinsic part of patient care, it deserves every possible new approach in the continuous improvement of care. The PMOS-30 questionnaire is a validated instrument for hospital settings and future research in other Italian hospitals may increase the routine use of this instrument to improve patient safety.

Key messages

The use of the Italian version of the PMOS-30 questionnaire can support the identification of vulnerable areas in the hospital through patient feedback and therefore improve patient safety. The PMOS-30 questionnaire offers the opportunity to enable Italian hospital managers to track changes in safety over time through repeated assessments in the wards and avoid future patient incidents.
Health promotion research in the Nordic countries - a scoping review of PhD dissertations 2008-2018
Authors: Eriksson C , Andersen H M , Eriksson A , Johannessen A , Simonsen N , Thualagant N , Torp S , Haglund B J A
Published: October 2021

Background

The Nordic countries are welfare states that also have been claimed to be in the forefront in developing health promotion, in relation to theory, research, policy and practice. This scoping review was performed by members of the Nordic Health Promotion Research Network with the objectives to collect and identify the scope and theoretical basis of doctoral (PhD) dissertations on health promotion in a Nordic context.

Methods

Searches for dissertations, published 2008-2018, were performed in several databases in Denmark, Finland, Iceland, Norway, and Sweden. Those labelled “health promotion” present in titles, abstract or key words were included in the scoping review. Data was extracted based on a common template including title, aims, university, individual-national level, setting, type of study and collaboration.

Results

The search strategy had to be modified to include manual searches at university sites as no national data base was available. In total, 353 health promotion dissertations had been published at 41 different universities. Most dissertations were Swedish (193), while 56 came from Denmark, 53 from Norway and 51 from Finland, but non from Iceland. The main content was lifestyle (28%), mental or psychosocial health (14%), critical health promotion (8%), empowerment (7%) or refugee and immigrants (5%). The most common approach was settings (31%), including health care setting (14%), followed by societal (28%) and individual (28%) approaches. Mixed methods approach was most common research method (45%) followed by quantitative (32%) and qualitative methods (23%). Large country variations were seen in the health promotion.

Conclusions

Health promotion research in the Nordic countries can be characterised by focusing on lifestyle, settings approach, and primarily using a mixed methods approach. However, there are large variations between different health promotion PhDs, also including dissertations on critical health promotion and empowerment.

Key messages

Analysis of PhD dissertations can contribute to more comprehensive insight in disciplinary development. The research training will have implications for the future public health workforce. The Nordic collaboration enabled an extensive scoping review of PhD dissertations on health promotion research in the Nordic countries and shows what has characterized the field of research.
Improving provider, patient and health systems outcomes: a qualitative analysis of Project ECHO
Authors: Jenkins C , Diffin J , McTernaghan T , Watson M
Published: October 2021

Background

Project ECHO (Extension for Community Healthcare Outcomes) is an internationally recognised tele-mentoring intervention that has been implemented in over 40 countries. The model connects specialist healthcare providers (hubs) with providers in primary and community practice (spokes), often in rural and isolated areas.

Objectives

Project ECHO aims to improve healthcare provider's skills, confidence and knowledge, and to create a community of practitioners using the hub and spoke model. Analysing interview data from 27 Project ECHO network leads and participants in Northern Ireland, this study sought to assess the impact of Project ECHO on improving provider, patient and health system outcomes.

Results

Having access to a specialist, a space to share experiences, and being able to disseminate up-to-date best practice were all cited as improving provider knowledge. Providers described improved outcomes for patients such as receiving a new treatment or an efficient referral. Providers reported being more confident in managing patients and thus were less likely to refer unnecessarily, and links between providers at primary and secondary levels being improved. ECHO was deemed an acceptable methodology in terms of format and in improving access to education and training by removing geographic barriers and reducing time barriers.

Conclusions

This is one of the first studies to qualitatively analyse outcomes across a number of different ECHO networks, and involving both health and social care networks. The results indicate the benefit of ECHO in improving provider, patient and healthcare outcomes. This has implications for future resourcing decisions, particularly within the context of COVID-19 in which virtual and online training is necessitated by social distancing requirements. This study has implications for wider international contexts in which ECHO may be piloted to address similar challenges.

Key messages

Participants across our study described Project ECHO as having a positive impact on provider, patient and health systems outcomes. Project ECHO was described as an acceptable approach to training and education that improved access through removing geographic barriers.
Usability and applicability of research knowledge translation models in a national health service
Authors: Minnogue V , Morrissey M , Matvienko-Sikar K , Gorman G , Terres A , Hayes CB
Published: October 2021

Background

The Health Service Executive in Ireland aims to facilitate the translation of research and innovation into policy and practice and increase dissemination of research. Previous HSE surveys showed that a high volume of research was undertaken but the impact on practice and policy was unclear. Researchers reported sharing their research in publications, conferences, and through education and training but identified problems in engaging with practice and policy stakeholders. Survey respondents requested help with dissemination and getting research into practice. An organisation-wide project to identify frameworks to support knowledge translation (KT), dissemination, and impact identified a recommended methodology, created guidance, and training for knowledge creators and users.

Objectives

Provide a series of six guides, tools and templates, to support knowledge creators and users across the organisation Provide online training to support translation and dissemination of research knowledge Underline the importance of planning KT and impact at research commencement and identify the planned outcomes Develop user-friendly training to explain the elements of KT and dissemination.

Results

Two pilot studies were undertaken to test the guidance which, although positively received, resulted in changes to the format, design, and language to increase useability. An explainer video and six online training modules were developed, based on the guidance and pilot feedback to be rolled out from July 2021. Learning was enhanced through transfer of complex information and models into short training modules to be accessed by researchers with a range of experience and understanding.

Conclusions

KT is a complex area and developing education and training for it requires understanding the different learning needs of knowledge creators and users. Education and training should focus on the need for KT and impact from the start of a project.

Key messages

Practical guidance to assist researchers in translation of their research findings into practice and improving dissemination enhances service user impact. Education and training should focus on the need to plan for KT from the start of a project.
Evidence-based practice among health students: attitudes, knowledge, skills and perceived barriers
Authors: Bannour R , Tarchoun S , Dhouib W , Ben cheikh A , Bhiri S , Ghali H , Tlilli MA , khefacha S , Said Latiri H , Ben Rejeb M
Published: October 2021

Introduction

Evidence-based practice (EBP) is a worldwide approach in optimizing quality of healthcare. As healthcare providers are increasingly more involved in clinical decision making, it is becoming important for them to use the best evidence to make effective and justifiable decisions. EBP is an important competency of undergraduate healthcare students that remains little known among Tunisian future healthcare professionals. This study aimed to describe health sciences students' attitudes. Knowledge and skills in EBP; to determine factors associated with these competencies and to identify perceived barriers regarding EBP.

Materials and Methods

A descriptive cross-sectional study was conducted at the Higher School of Health Sciences and Techniques of Sousse among 365 health sciences students enrolled during the second semester of the academic year 2017-2018. Data was collected using a self administrated questionnaire including a validated EBP-COQ questionnaire and focusing on identifying the perceived barriers to the usage of EBP.

Results

The response rate was 93.11%. Approximately, 61.6% of students were familiar with the term ‘EBP'. The overall score of EBP-COQ questionnaire was 3.26 ±0.53 out of 5. The mean scores of attitude, skills and knowledge subscales were 4.04 ±0.41; 3.05 ±0.77 and 2.70 ±0.74 respectively. A significant statistical association was found between the competencies in EBP and age; gender, academic degree, year of study for license degree, students' English-language reading skills, students' education in research methodology and statistics (p < 10-3). The top reported barriers hindering their adoption of EBP were: lack of training in EBP, difficulty in obtaining full-text papers and lack of time.

Conclusions

The strategic position of healthcare students may influence the adoption of EBP. It is necessary to understand students' attitudes, knowledge and skills in the subject to be able to develop effective strategies for EBP curricula.

Key messages

Evidence-based practice is a worldwide approach in optimizing quality of healthcare. It is necessary to understand students' attitudes, knowledge and skills to develop effective learning strategies.
Infectious diseases other than Covid-19 in 2020, a report from Lombardy Region
Authors: Maffeo M , Mazziotta F , Pierini E , Della Valle PG , Gramegna M , Tirani M , Crottogini L , Odone A , Castaldi S , Cereda D
Published: October 2021

Background

Non pharmaceutical interventions (NPIs) put in place to reduce the spread of Sars-Cov-2 had an impact also on other infections. Aim of this research is to describe the incidence of other infections and vaccination coverage rate (VCR) in Lombardy region from 2018 to 2020.

Methods

We analysed data coming from the regional surveillance system of notifiable infectious diseases and vaccination registry from 2018 to 2020.

Results

13206 infectious diseases' cases were notified in 2020 compared to 36847 in 2019 and 42610 in 2018, this corresponding to, respectively, a 64.1% and 69% decrease. Some interesting data:

measles; 24 cases in 2020, 542 in 2019 and 220 in 2018, with an incidence rate (IR) per 100.000 respectively of 0,2; 5,4 and 2,2; chicken pox; 2357 cases in 2020, 13478 in 2019 and 19463 in 2018 (IR 23,5; 134,3; 193,9) tubercolosis; 586 in 2020, 857 in 2019 and 945 in 2018 (IR 5,8; 8,6; 9,4) invasive bacterial diseases; 378 in 2020, 890 in 2019 and 882 in 2018 (IR 3,7;8,8;8,7) infectious diarrhea; 2080 in 2020, 3716 in 2019 and 4347 in 2018 (IR 20,7; 37,1; 43,3) legionellosis cases; 806 in 2020, 1051 in 2019 and 1096 in 2018 (IR 8; 10,5; 10,9) arbovirus infections (chikunguya, dengue, west nile, zika) were 118, in 2020, 126 in 2019 and 8 in 2018 (IC 1,2; 1,3; 0,1)

In 2020 VCR at 24 months of age remained above 95% for hexavalent and measles-mumps-rubella vaccination while there was a decline for others vaccines.

Conclusions

During the COVID-19 outbreak in 2020 there was a decline in all notified infectious diseases compared to the previous years, likely due to massive NPIs adoption, as well as, possibly, to decreased access to care and preventive services that caused difficulties to the surveillance system to detect notifiable infectious diseases. VCRs were still high for most important vaccines while there was a decline for other vaccines as evidence of the impact of the pandemic on vaccination activities.

Key messages

NPIs had a deep impact on the reduction of airborne diseases. The decline for non-airborne infections is likely due to NPIs and limitations in the access to the healthcare system.
Speech disorders in preschool children in Republic of North Macedonia – cross sectional study
Authors: Grigorova E , Ristovska G
Published: October 2021

Background

Speech communication is a complex process based on the function of the central nervous system, and also on speech mechanisms conditioned and controlled by auditory perception, verbal memory, intellectual activity and peripheral speech apparatus. The aim of this study was to determine the prevalence of the most common phonological articulation disorders in preschool children, from 4-6 years old.

Methods

A cross-sectional study was conducted during 2018 year on a representative sample of 550 preschool children aged 4 - 6 years, who attend preschool institutions-kindergartens in the city of Skopje. The study used standardized articulation tests: the Global Articulation Test (GAT) and the Triple Test (vocals, plasia, africative, fricative, nasal, and lateral), and a questionnaire filled out by a social worker at the kindergarten for socioeconomic status and the child's health condition.

Results

Using GAT, we found that 260 (47.3%) children didn't have a phonological articulation disorders, and 290 (52.7%) had disorders. The analysis of gender-based data showed a higher percentage of speech disorders in 57% of boys and 46.9% of girls. The highest percentage of speech disorder is sigmatism with 24.5% in boys and 20.4% in girls, rhotachism was found in 17.8% in boys and 16.5% in girls. Lambdacism with 8.3% was found in boys and 4.2% in girls. A mixed form (sigmatism, rotacism, and lambdacism) was also found in 2.4% of boys and 3.5% of girls.

Conclusions

The prevalence of phonological articulation disorders in preschool children is 52.7%, 57.9% in boys and 46.9% in girls, or every second child in kindergarden at age 4-6 years has speech disorder. These findings indicate that the treatment of speech disorders should be started in appropriate services as soon as possible, because early detection and treatment of speech disorders enable to child normal intellectual development.

Key messages

Speech disorders are important public health issue because these children will require in some cases emotional and behavioral support, not only speech-related intervention. The treatment of speech disorders should be started in appropriate services because early detection and treatment of speech disorders gives the child more confidence to build his intellect.
Willingness to reprimand smoking among pregnant women
Authors: Klimiuk K
Published: October 2021

Introduction

Even though smoking can cause numerous threats to the developing foetus, it is nevertheless the most common addiction in Polish women of reproductive age. Pregnant women feel an intense conflict when someone smokes in their surroundings and little research has been done to assess the relations and support in an exclusive group of pregnant women. Most studies undertake to examine the subject using focus methodology of opposing second-hand smoking or creating tools to reprimand pregnant women more effectively. The aim of our study was to determine the profile of a pregnant woman who is willing to oppose smoking of another pregnant woman.

Methods

The survey was shared on Polish websites for expecting parents with a request for completion that was addressed at pregnant women, regardless of pregnancy trimester, Study was conducted from November 2016 to April 2017. Participants: Complete questionnaires were collected from 11,448 pregnant women. The cross-cutting research was conducted using an original questionnaire. A computer-assisted web interviewing (CAWI) was used to reach the respondents. The snowball sampling method was used to collect the questionnaires. The logistic regression model was used to determine the probability.

Results

Predictors of drawing other pregnant women attention to the fact that smoking is harmful were: mental work (OR1,1136) and study (OR1,363), involvement of the child's father (OR1,377), contact with social campaigns (OR1,150) and knowledge about the consequences of smoking, as well as talking to the midwife about the harmfulness of cigarettes during pregnancy (OR1,655).

Conclusions

Interpersonal relationships leave scope for public health interventions. It is worth enhancing criticism against smoking by specialists through information and education campaigns.

Key messages

The conducted research shows that actions aimed at raising awareness of the harmfulness of smoking in pregnancy have a positive effect. Interpersonal relationships leave scope for public health interventions.
Parental alcohol use and self-reported health among Swedish adolescents aged 10-18 years
Authors: Wahlström J , Magnusson C , Brolin Låftman S , Svensson J
Published: October 2021

Background

Including harm that is inflicted upon the drinker's social environment is vital when calculating the cost of harmful alcohol use to society. Knowledge about the true damage of alcohol is important in order to implement adequate public health responses. Research on children of alcoholics has demonstrated that parental alcohol misuse may affect offspring negatively in several ways. Studies on the general youth population have found that parental drinking is associated with offspring alcohol use. However, the links to offspring health are less explored. The aim of the study was to examine the associations between parental drinking and children's psychological complaints, somatic complaints, and perceived stress.

Methods

Data were obtained from the nationally representative Swedish Level-of Living survey of 2010. Parents and children (aged 10-18) living together completed surveys independently. The study sample consisted of 905 children, with information from at least one parent, in 627 households. Children's self-reports of psychological complaints, somatic complaints, and perceived stress were coded into binary measures and used as dependent variables. Based on self-reports of frequency and quantity of alcohol use, parents were categorised into abstainers, low consumers, moderate drinkers, and heavy drinkers. Gender, family structure, and parent-reported socioeconomic conditions were included as control variables. Binary logistic regression analyses were performed.

Results

In the fully adjusted models, children with heavy drinking parents were more likely to report psychological complaints (OR 2.52, p < 0.01), somatic complaints (OR 1.96, p < 0.01), and feeling stressed (OR 1.68, p < 0.05), compared to children whose parents were classified as moderate drinkers.

Conclusions

The study showed that children living with heavy drinking parents were more likely to report adverse health. Implementing policies that aim to protect these children may be beneficial.

Key messages

Children living with heavy drinking parents were more likely to report psychological complaints, somatic complaints, and perceived stress. Living with heavy drinking parents may affect children’s health negatively, and measures to mitigate the harms these children experience ought to be considered.
Changing pattern of smoking behavior among Mongolian adolescents: Results from the GYTS (2003-2019)
Authors: Badarch J , Paulik E
Published: October 2021

Background

Tobacco use has become a global health concern. Most part of smokers initiate smoking during their adolescence. This study aims to analyze the changing pattern of cigarette smoking among adolescents in Mongolia.

Methods

The retrospective data analysis is based on four repeated national cross-sectional Global Youth Tobacco Surveys (GYTS) conducted in 2003, 2007, 2014 and 2019. Data were collected by self-administered questionnaires. The sample represented the students aged 12-16 years. Pearson's chi-squared tests and logistic regression analyses were performed by using IBM SPSS version 24 software.

Results

Altogether, 17,458 students participated in the four surveys. There was an overall decrease in the prevalence of ever smokers (40.4% in 2003, 21.2% in 2019; p < 0.001), current smokers (9.2% in 2003, 4.4% in 2019), and planning of cessation (84.0% in 2003, 62.9% in 2019; p < 0.001). Smoking related knowledge has been changed, e.g., the prevalence of students who thought smoking helps people feel more comfortable decreased from 28.3% to 7.2%. From the point of the media effects the percentage of students who saw anti-tobacco message in the media significantly decreased (from 84.0% to 62.9%, p < 0.001). Additionally, the percentage of participants who were exposed to tobacco smoke at home decreased from 64.1% to 42.6% (p < 0.001) between 2003 and 2019. The multivariate logistic regression analyses by years showed that males, those who were exposed by smoke at home, who thought that smoking makes people more comfortable were more likely to be current smokers; no association was found with anti-tobacco messages.

Conclusions

Despite of the implementation of tobacco control policies, smoking is a major problem in the Mongolian population. The findings of GYTSs provide information to the development of an adolescent specific national tobacco control program, which will help to combat the tobacco epidemic.

Key messages

A positive trend of smoking behavior among adolescents has been demonstrated in Mongolia. The findings help to develop a comprehensive adolescent specific school-based tobacco control program.
Meaningful activities during COVID-19 lockdown and association with mental health in Belgian adults
Authors: Cruyt E , Van de Velde D , De Vriendt P , Vlerick P , De Letter M , Oostra K , Calders P , De Pauw R
Published: October 2021

Background

The spread of COVID-19 has affected people's daily lives, and the lockdown may have led to a disruption of daily activities and a decrease of people's mental health.

Aim

To identify correlates of adults' mental health during the COVID-19 lockdown in Belgium and to assess the role of meaningful activities in particular.

Methods

A cross-sectional web survey for assessing mental health (General Health Questionnaire), resilience (Connor-Davidson Resilience Scale), meaning in activities (Engagement in Meaningful Activities Survey), and demographics was conducted during the first Belgian lockdown between April 24 and May 4, 2020. The lockdown consisted of closing schools, non-essential shops, and recreational settings, employees worked from home or were technically unemployed, and it was forbidden to undertake social activities. Every adult who had access to the internet and lived in Belgium could participate in the survey; respondents were recruited online through social media and e-mails. Hierarchical linear regression was used to identify key correlates.

Results

Participants (N = 1781) reported low mental health (M = 14.85/36). In total, 42.4% of the variance in mental health could be explained by variables such as gender, having children, living space, marital status, health condition, and resilience (β= -.33). Loss of meaningful activities was strongly related to mental health (β= -.36) and explained 9% incremental variance (R2 change= .092, p<.001) above control variables.

Conclusions

The extent of performing meaningful activities during the COVID-19 lockdown in Belgium was positively related to adults' mental health. Insights from this study can be taken into account during future lockdown measures in case of pandemics.

Key messages

Performing meaningful activities during COVID-19 lockdown contributes to better mental health. The lockdown has led to a disruption of daily activities and a decrease of people’s mental health.
Mental Health Forums for young healthcare professionals (lessons learned from Serbia)
Authors: Jevtic M , Vlaski T
Published: October 2021

Issue/problem

Mental health is an important subject for all healthcare professionals. Challenges of the current pandemic have affected the teaching process at the universities, especially on the faculties of healthcare professions.

Description of the problem

Taking care of the patients' mental health does not diminish the need to care about the healthcare workers. The pandemic crisis posed new questions and brought out existing obstacles that future healthcare workers face.

Results

The Mental Health Forum (MHF) was organized within the course “Principles of Public Health Issues” for Ph.D. students of Public health to commemorate the European week of public health 2020. The activity kept going due to students showed interest in using the practice of free associations to discuss subjects important for mental health in the community, working with patients and interpersonal relationships. MHF were hosted by a professor who facilitated the meetings while the undergraduate and PhD students of different programs deliberated on subjects of importance for mental health, both for patients and the healthcare workers. The pandemic crisis, which is still going and demands constant adjustments to be made, raised a number of questions related to individual and professional aspects of life.

Lessons

Student focus groups formed on the MHF ponder upon substantial issues related to mental health and mental hygiene. The importance that the education process and acquiring skills have on self-confidence and mental health is emphasized, as well as challenges that the pandemic created in finding a way for a young healthcare worker (doctor, dentist, nurse, pharmacist) to get the necessary skillset for dealing with patients in an assuring manner. MHF raised questions about the positions of the elderly and of the children, mental health of the patients, the link between mental health in the community and opinions about vaccination, preventive measures and evidence-based research.

Key messages

MHF represents a place to discuss the obstacles in mental health, both in the community and between students. MHF offers support and empowers students to pursue their goals in these troubling times.
Community nurses’ roles in hoarding prevention and management: literature review
Authors: Aso Y
Published: October 2021

Background

COVID-19's high infectivity and fatality rates have generated a plethora of mental health problems worldwide. Hoarders accumulate products such as masks and daily necessities due to anxiety and restrictions on going out, which further exacerbate their symptoms. Since community nurses often visit patients' homes, they can identify hoarding symptoms in the early stages and provide support. Community nurses' knowledge pertaining to the prevention and management of hoarding can provide insight for mental health professionals.

Methods

The terms ‘hoarding', ‘prevention', and ‘public health nurse/community nurse/home nurse' were searched on PubMed, ProQuest, Science Direct, CINAHL, Medline Complete, and six Japanese databases (Ichushi Web, NDLonline, CiNii, J-stage, J-DreamIII, Saishin-kango-sakuin web) in April 2021.

Results

I selected 13 articles on community nurses' roles from the abstracts of 302 academic articles identified by the search results. The articles were categorised based on research objectives, research methods, and community nurses' roles. It was suggested that prevention requires supporting mothers, who are at risk for hoarding. Research on measures to prevent hoarding behaviour from becoming severe found that family-based interventions (harm reduction approach), education programs for collaborators, and group reminiscence therapy for elderly individuals with dementia are effective. It was also suggested that cooperation and hoarding education among non-medical providers are important.

Conclusions

Community nurses' roles in treating hoarding should be based on support and health education through cooperative relationships with families, neighbours, and establishment of related organisations.

Key messages

In the COVID-19 pandemic and aftermath, it is important to learn various practical activities for mental health. Community nurses may be able to help prevent hoarding behaviour to reduce psychological stress among hoarders, their families, and neighbours, thus prevent further hoarding deterioration.
What are the determinants of stress, anxiety and depression among university students?
Authors: Ketata N , Ben Ayed H , Maamri H , Yaich S , Baklouti M , Feki H , Damak J
Published: October 2021

Introduction

University students (US) are supposed to face academic, living conditions and mental challenges during their cursus. These challenges with stressful events of graduate education could potentially cause depression, anxiety and stress. The main objectives of the present study were to explore the prevalence of depression, anxiety and stress among US and to identify their determinants.

Methods

A cross-sectional-questionnaire based study was conducted among a randomized sample of 1071 US in Sfax Universities, on April 2021. Data collection was performed using an anonymous questionnaire including a short version of depression, anxiety and stress scales (DASS-21).

Results

A total of 1071 US participated in the study with a mean age of 22.2 ± 2.5 years. The prevalence of depression, anxiety and stress were 69.2%, 75.4% and 45.5%, respectively. Severe or extremely severe depression, anxiety and stress were noted among 312 (29.1%), 468 (43.7%) and 195 (18.2%) US, respectively. Both depression and stress were significantly more frequent among US having a low monthly income (OR = 1.5; p = 0.045 and OR = 2.2; p = 0.042, respectively) and those who were not satisfied of their university (OR = 2.1; p = 0.002 and OR = 2.2; p = 0.008, respectively). Tobacco use was associated with higher score of depression (OR = 3.8; p = 0.046) and higher score of anxiety (OR = 1.53; p = 0.007). In addition, having a chronic disease was statistically associated with stress, anxiety and depression (OR = 2.8; p < 0.001; OR = 2.2; p < 0.001 and OR = 2.3; p < 0.001, respectively).

Conclusions

A substantial proportion of US are suffering from depression, stress and particularly from anxiety. These findings suggested an urgent need for establishment of preventive measures and interventions to learn how to cope with these conditions positively to improve the mental health of students.

Key messages

Stress, anxiety and depression. University students.
A survey on psychological distress and problematic smartphone use: two sides of the same coin?
Authors: Covolo L , Della Vedova AM , Muscatelli M , Loscalzo Y , Giannini M , Gelatti U
Published: October 2021

Background

Problematic smartphone use (PSU) is defined as a maladaptive smartphone use causing significant impairment in several areas of the individual and interpersonal functioning. Smartphones allow people to access the internet and social media at all times, providing the illusion of being in constant connection with the world. Literature has shown that maladaptive smartphone use is more frequent in young adults, and it is associated with psychological difficulties such as depression, anxiety, and feelings of tension and emotional discomfort, which can generally be referred to a condition of psychological distress.

Aim

The aim of the study was to investigate the role of psychological distress and possible risk factors associated with PSU, as well as to evaluate the factor structure of the Smartphone Addiction Scale - Short Version (SAS-SV) test Italian translation in a sample of students.

Methods

A sample of 2260 students (aged 18-25 years) filled in a web-based survey that included a sociodemographic questionnaire, also investigating time spent using smartphone and the preferred social media; the SAS-SV, the Internet Addiction Test and the Matthey Generic Mood Questionnaire were also part of the survey.

Results

A multiple logistic regression analysis showed that moderate-high perception of psychological distress, time spent using smartphone overnight and during the day, education, and sex are independent predictors of potential smartphone addiction, as measured by the SAS-SV. An Exploratory Factor Analysis followed by a Confirmatory Factor Analysis showed a reliable two-factor structure of SAS-SV.

Conclusions

The results of the study highlighted predictors that can be useful in prevention, confirming the impact of the extent of time spent using the smartphone, especially at night, and underlining the role of psychological distress in maladaptive smartphone use.

Key messages

The findings raise concerns about the potential spread of smartphone addictive behaviour in Italian young adults. Perceiving a psychological distress condition was associated with potential smartphone addiction. It is important for prevention to have reliable screening tools that are quick and easy to fill out.
Organization of mental health services to face COVID-19 in Brazil
Authors: Nascimento Monteiro C , Freire Sousa AA , Teles de Andrade A , Eshriqui I , Moscoso Teixeira de Mendonça J , do Lago Favaro J , Menon Pelissoni A , Bonfim D , Ferreira Martins AC , Costa Palacio D
Published: October 2021

Issue/problem

Covid-19 pandemic requires rapid responses. The reconfiguration of the psychosocial care network was needed to ensure access to all patients during this period.

Description of the problem

Psychosocial Care Centers (PCC) are strategic equipment for strengthening the mental health policy in Brazil. These services work with a multi and interdisciplinary team, aiming to assist crisis and rehabilitation processes of people with severe and persistent mental disorders or those with impairments due to the use of psychoactive substances. This work shares the experience of two PCC over the COVID-19 pandemic in São Paulo, Brazil. In April 2020, in front of the increasing Covid-19 cases and hospitalization, lack of hospital beds for mental health care, suspension of PCC group activities, and restriction of face-to-face assistance, it was necessary to adjust the PCC work process and physical structure.

Results

Telemedicine was implemented to assure assistance and monitoring. An internal flow was implemented to identify and assess patients seeking the service with respiratory symptoms and proceed with case notification if confirmed. A station for respiratory symptoms screening was settled outside the PCC, an isolation room to symptomatic respiratory patients was defined to medical assessment, and referral criteria to the emergency care established. To reinforce beds for hospitals in the region, inpatient beds were created in the PCC to attend hospitalization of acute crisis cases. Further, professionals from Primary Health Care were relocated and trained to support PCC assistance.

Lessons

This experience reaffirms the role of PCC as an articulator of the psychosocial network. Reorganization of PCC work process enabled the continuity of mental health outpatient care as well as rearguard from inpatient beds.

Key messages

The COVID-19 pandemic reinforce the necessity of integrated healthcare networks to provide care access and continuity of care. This experience reaffirms the role of PCC as an articulator of the psychosocial network.
Parental stress and depression of children with learning disabilities: preliminary results from Crete
Authors: Lioliou S , Pedioti N , Kargiotaki A , Kounali V , Loukadakis E , Papaiosif M , Papanikolaou M , Pitsikaki S , Spyridaki A , Papadakaki M
Published: October 2021

Past research has identified high levels of stress among parents of children with learning disabilities, which negatively affects children's well-being. The current presentation aims at reporting on parental stress experienced by individuals who utilised the newly introduced services of a mobile unit offering diagnostic and counselling services to children with learning difficulties in the region of Crete. Individuals in the current study represent a non-clinical sample from community settings across a region of 600.000 residents. More specifically, a university mobil unit was set in mid 2020 with funds raised by the Region of Crete, aiming at diagnosing learning difficulties in children aged 8-12yrs old as well as offering tailor-made biopsychosocial counselling to their families, at no cost. The mobil unit employs a pioneering child-in-environment perspective aiming to improve child's well-being through interventions targeting the family system. The staff consists of special education tutors, child and school psychologists, social workers, speech therapists and nurses offering a full range of diagnostic services, with up to date psychometric tools and literacy tests. Upon detection of stress/depression symptoms (Beck Anxiety Inventory,BAI; Beck Depression Inventory,BDI), parents receive a brief CBT or family therapy intervention of 4 sessions with a psychologist and/or a social worker via teleconference. Preliminary analysis of parental records (53 BDI,46 BAI) indicates 12 (22,6%) being above the cut off point for depression (7 mild to moderate, 5 moderate to severe) and 13 (28,2%) meeting the criteria for moderate anxiety disorder. 9 cases scored within the clinical range for both disorders. Symptoms of anxiety disorder were recorded only in parents of males. Comparisons between individuals with and without symptomatology will be presented in terms of personal and family profiles. The study has serious implications for health and educational policy.

Key messages

Coping with parental stress can be a challenge, but is also a skill that can be learned. Strength-based family support services should be considered at community level.
A snapshot of Malta’s Covid-19 acute and post-acute symptoms
Authors: Cuschieri S
Published: October 2021

Background

The end of the year 2019 saw the emergence of a novel coronavirus (Covid-19) with patients presenting with severe pneumonia in China. Infected individuals with Covid-19 were noted to present with different symptoms, if at all. Some remained with symptoms even after testing negative for Covid-19. The aim was to explore for the most common acute and post-acute Covid-19 symptoms among adult residents in Malta.

Methods

Using Google forms, an anonymous survey was distributed on social media (1st to 26th February 2021) targeting the adult residents of Malta. The survey assessed for previous/current Covid-19 infection and for acute and post-acute (>4 weeks after negative test) symptoms. Quantitative and qualitative analyses were performed.

Results

Out of the 1,034 participants, 6.38% (CI95%: 5.04-8.95) reported to have been positive for Covid-19, with a female predominance (71.21% CI95%:59.30-80.79; p = <0.01). Various combination of symptoms was reported. However, asymptomatic (13.64% CI95%: 7.12-24.15) dominated followed by the combination of fever, cough, headaches, fatigue, loss of taste and smell, aches and pains, and diarrhoea (10.61% CI95%:4.94-17.60). Although the majority did not report post-acute symptoms, a proportion reported the continuation of aches and pains with fatigue or the loss of taste and smell (6.06% CI95%:1.94-14.01; respectively).

Conclusions

Although small case numbers were evaluated in this study, it is clear that Covid-19 is affecting a proportion of the population. Asymptomatic Covid-19 is common, enforcing the fact that infectivity rate is higher than reported. However, multi symptomatic representation is also common, possibility requiring medical attention. Within this cohort, post-acute symptoms did not appear to be dominating. Health system resilience is essential to continue caring for both acute Covid-19 and other conditions including long Covid-19 patients.

Key messages

Covid-19 community spread is higher than reported due to a substantial proportion of asymptomatic individuals. Preventive mitigation measures should continue to be encouraged as well as strengthening health systems to care for acute and long Covid-19 along with other co-existing conditions.