bluuebunny/crossref_metadata_2025 huggingface dataset:
Moving a youth trauma support group online: participatory adaption, usability and pilot test
Authors: Perez Aronsson A , Thell M , Lampa E , Gupta Löfving S , Tokes A , Torakai N , Ibrahim K , Aljeshy R , Warner G
Published: October 2022

Background

Posttraumatic stress poses a significant threat to a young person’s development. Internet-based delivery could ameliorate barriers to care, but has mostly been tested with adults. This project aimed to (i) adapt the group intervention Teaching Recovery Techniques for online delivery through a participatory process, (ii) investigate the usability of the online format and (iii) pilot the new format.

Methods

Adaption recommendations were generated through participatory workshops with service users and providers, and consultation with an advisory panel with professionals and parents. Usability testing was conducted with intervention leaders (n = 5) and youth (n = 5). The public involvement in the project was assessed through a multi-method approach including behavioural observations, questionnaires and field notes. A pilot study (n = 14) is ongoing.

Results

The workshops focused on safety, participation and learning. Recommendations included an emergency response protocol, communication strategies, and guidance on intervention delivery. Whilst the advisory panel largely agreed, points of disagreement included workshop ideas around personalisation, where the panel conveyed the importance of consistency in manualised interventions. Usability testing highlighted the need for explicit guidance, particularly on safety processes.

Conclusions

Online delivery of trauma group support requires adaptions to ensure positive group dynamics, learning and safety. Yet, some adaptions resulting from the usability testing were also relevant to the original format, pointing to the need for more extensive use of usability testing across intervention manuals. The young people, parents and professionals involved in the project provided rich and varied perspectives, illustrating the value of broad stakeholder engagement. The ongoing pilot study explores the feasibility of online delivery, including youth perceptions of the format.

Key messages

• The varied perspectives in the participatory process highlighted the importance of broad stakeholder engagement for interventions to be equally evidence-based and adapted to the target population.

• The current pilot study explores the feasibility of online delivery, including youth perceptions of the format, in order to assess the potential for scale up.
Childhood adversity and risk of later labor market marginalization in young employees in Sweden
Authors: Björkenstam E , Helgesson M , Mittendorfer-Rutz E
Published: October 2022

Background

The present study examined the independent and combined effects of childhood adversity (CA) and occupational class on the risk of future labor market marginalization (LMM) in young employees in Sweden. Occupational class (non-manual/manual workers) was also explored as a potential mediator.

Methods

This population-based longitudinal cohort study included 556,793 employees, 19-29 years, residing in Sweden in 2009. CAs included parental death, parental mental and somatic disorders, parental separation, household public assistance, single-parent household and residential instability. Measures of LMM included long-term unemployment (LTU), long-term sickness absence (LTSA) and disability pension (DP). Estimates of risk of each LMM measure, between 2010 and 2016 were calculated as Hazard Ratios (HR) with 95% confidence intervals (CI), using a Cox regression analysis.

Results

Those exposed to CA had an elevated risk for all measures of LMM. Manual workers with a history of household public assistance had the highest risk estimates compared to non-manual workers with no CAs (adjusted HR spanning from 1.59 (LTSA) to 2.50 (LTU). Regardless of occupational class, the risk of LMM grew higher with increasing number of CAs (e.g. adjusted HR of LMM in manual workers with 3+ CAs: 1.87, 95% CI: 1.81-1.94). These patterns persisted after adjustments for a range of confounders, including psychiatric and somatic morbidity. Last, we found a small but significant mediating effect of occupational class in the association between CA and LMM.

Conclusions

Information on CAs are important determinants of LMM in young adults, and especially in manual workers.

Key messages

• Those exposed to childhood adversity had an elevated risk of labor market marginalization, in terms of long-term unemployment, long-term sickness absence and disability pension.

• Information on childhood adversity is an important determinant of labor market marginalization in young adults, and especially in manual workers.
The impact of the COVID-19 pandemic on the incidence of herpes zoster
Authors: Lecrenier N , Parikh R , Wang C , Curran D , Widenmaier R
Published: October 2022

Background

There have been several case reports of herpes zoster (HZ) following COVID-19 disease and vaccination. We conducted a non-systematic literature search to elucidate the global effects of the COVID-19 pandemic on the incidence of HZ.

Methods

The literature search was performed in October 2021 using PubMed and Embase. The search string was herpes zoster AND COVID-19. Publications were manually reviewed; case reports were removed.

Results

Three retrospective studies reported the risk of HZ following COVID-19 disease. One study (Bhavsar, 2021) used two US databases and found higher risk of HZ following COVID-19 disease (relative risk [RR]=1.15) and COVID-19 hospitalisation (RR = 1.21), respectively. A strong association between HZ and COVID-19 disease (RR = 5.27) was also reported in a study of the University of Florida patient registry (Katz, 2021). The third study (Barda, 2021) reported no association between COVID-19 disease and risk of HZ (RR = 0.82). In two of the three observational studies in Israel (Furer, 2021 and Barda, 2021), the incidence of HZ was increased following COVID-19 vaccination. The third study (Shasha, 2021) found no association (RR = 1.07). Other studies included a report in Brazil (Maia, 2021) that demonstrated a 35% increase in HZ diagnoses during the pandemic versus pre-pandemic and a published model (La, 2021) that estimated the declining uptake of recombinant zoster vaccine in the US may result in 63,117 avoidable HZ cases in those who remain unvaccinated in 2021.

Conclusions

Emerging data suggest that the COVID-19 pandemic may have increased the risk of HZ and negatively impacted HZ vaccine uptake. Therefore, there is an important need to increase awareness of HZ and HZ vaccination during the pandemic.

Key messages

• There is a need to increase awareness of HZ and HZ vaccination during the COVID-19 era.

• Further studies are needed to fully understand the impact of COVID-19 on the risk of HZ.
Future trends of overweight and obesity in Belgium using Bayesian age-period-cohort models
Authors: De Pauw R , Claessens M , Gorasso V , Drieskens S , Faes C , Devleesschauwer B
Published: October 2022

Background

Considering the current overweight and obesity epidemic and its associated increase in non-communicable diseases and healthcare costs, the current study aimed to project the trends in prevalence of overweight and obesity in Belgium using a Bayesian age-period-cohort (APC) model to support policy planning.

Methods

Height and weight of 58,369 adults aged 18+ years, collected in six consecutive cross-sectional health interview surveys between 1997 and 2018, were evaluated. Criteria used for overweight and obesity were defined as body mass index (BMI) ≥ 25, and BMI ≥ 30. A Bayesian APC model was applied to evaluate past trends and associated socio-demographic risk factors, and to forecast trends to 2019-2029. All analyses were performed based on integrated nested Laplace approximation (INLA) and took the complex survey design into account.

Results

The prevalence of overweight and obesity has increased between 1997 and 2018. If current trends continue, it is likely to that a further increase in the prevalence of overweight and obesity in the population will be seen by 2029 with a probability of growth of 51.2% and 73.3%, respectively. Forecasts indicated a potential prevalence of 50.1% [16.2%; 84.4%] in 2029 for overweight, and 21.4% [9.0%; 43.4%] for obesity. Among survey participants, middle-aged men with no higher education and a middle income showed the highest risk of overweight and obesity.

Conclusions

We projected an alarming increase in the prevalence of overweight and obesity. A decrease in cases seems very unlikely. There is an urgent need to target younger age groups for prevention and implementation of public educational programs to limit the increasing trend in overweight and obesity.

Key messages

• The occurence of obesity is likely to increase in the following 10 years.

• Projection of trends can serve as a useful tool for policy planning on the mid- and longer term.
The characteristics of caffeine intake in Croatian university students
Authors: Laslo D , Miskulin I , Srb N , Klepo T , Bonet S , Miskulin M
Published: October 2022

Background

Excessive caffeine intake combined with increasing numbers and availability of caffeine-containing products in modern societies are causes for concern. University students may be at increased risk of excessive caffeine consumption due to seeking caffeinated products with well-known wakefulness effects and cognitive benefits. This study aimed to highlight the characteristics of caffeine consumption among Croatian university students.

Methods

This cross-sectional questionnaire study was conducted from May 2020 to April 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, data about caffeine consumption habits, and its sources was self-administered via an online link to a cross-faculty representative student sample of the University of Osijek in Eastern Croatia.

Results

The study sample included 1197 subjects with, median age of 22 years (interquartile range 21-24), 24.1% males, and 75.9% females. The median caffeine intake was 512.0 mg/day (interquartile range 228.0-972.0). The higher caffeine intake was observed in part-time students (p = 0.026), students who were preparing for exams during the participation in this study (p = 0.010), and students who smoked cigarettes (p < 0.001). There was a poor positive correlation between the amount of caffeine intake and academic success connected with caffeine consumption (rs = 0.225; p < 0.001). There were fair positive correlations between the amount of caffeine intake and caffeine consumption because of the avoidance of the withdrawal symptoms (rs = 0.490; p < 0.001) and between the amount of caffeine intake and knowledge of the impact of caffeine consumption on the occurrence of social conflicts (rs = 0.349; p < 0.001).

Conclusions

The study revealed high caffeine intake among Croatian university students. The implementation of specific preventive measures directed toward the protection of students’ health from adverse health effects related to caffeine is needed.

Key messages

• Croatian university students have displayed high caffeine intake in their everyday life.

• There is a need for the implementation of specific preventive measures directed toward the protection of students’ health from adverse health effects related to caffeine consumption.
Non-standard employment and mental health during the COVID-19 pandemic in Spain: a qualitative study
Authors: Padrosa E , Julià M , Bolíbar M , Gutiérrez-Zamora M , Escrig-Piñol A ,   The PWR Consortium
Published: October 2022

Background

The COVID-19 pandemic entailed a deep economic crisis that affected working populations globally. However, non-standard workers (NSW, understood as workers with temporary contracts, not working full-time, self-employed or not paying taxes/making active pension contributions) were more severely hit than workers with more stable and protected jobs. The aim of this study thus was to explore the experiences of NSW during the pandemic and how these affected their mental health in Spain, one of the countries in Europe with the highest shares of temporary and self-employment and the one that applied the most restrictive containment measures during the first waves of the pandemic.

Methods

As part of a larger multi-country study, 41 semi-structured interviews with NSW aged 25-55 were conducted between March-July 2021 and analyzed thematically.

Results

Analyses revealed that job loss or insecurity and subsequent reductions in income were central to the experience of NSW during the pandemic in Spain, which affected their mental health negatively. Both the existing social protection framework and the policies deployed during the pandemic to outweigh these consequences were perceived by NSW as insufficient or could not access them due to their condition of NSW. This was particularly the case for self-employed and temporary agency workers. Moreover, NSW expressed that containment measures and reductions in income prevented them from engaging in activities to cope with such adversities, aggravating their mental health.

Conclusions

These findings suggest that, in Spain, the pandemic intensified but also made more visible the defenselessness of NSW (especially self-employed and temporary agency workers) in terms of social protection in the event of sudden unemployment or reductions in income. This situation had harmful consequences for their mental health. Yet, new policies and measures fall short in fitting the necessities of an increasing share of the workforce.

Key messages

• In Spain, non-standard workers are more vulnerable to and defenseless against sudden unemployment or reductions in income.

• The pandemic intensified this problem and put them at higher risk of suffering from poor mental health.
A whole-of-community approach to promote cardiovascular health: Healthy Communities in Moldova
Authors: Secula F , Berari D , Curteanu A , Nicolaescu S , Prytherch H
Published: October 2022

A low-income country, Moldova is facing a rapidly growing burden of non-communicable diseases with a cardiovascular disease mortality rate of 202.2 per 100'000. Scarce resources require urgent preventative actions and involvement of communities and patients in the definition and design of locally relevant health promoting activities. Our intervention is a holistic, whole-of-community approach to foster local leadership in health promotion for the prevention of cardiovascular risks. The Healthy Life project to reduce the burden of non communicable diseases, funded by the Swiss Agency for Development and Cooperation (SDC), operates since 2016 in rural communities of Moldova. We present a 5-step model towards initiating Healthy Communities in Moldova based on 5 complementary steps:

1. Raising awareness on cardiovascular risk factors through community education seminars tailored to audience needs

2. Building multisectoral community coalitions for health between local elected leaders and community representatives around local health data and locally defined health priorities

3. Fostering community leadership in defining local health solutions through health asset mapping exercises

4. Community-led small projects based on identified needs and assets to improve local cardiovascular health

5. Empowering chronic patients for healthy behavior change through community-based self-management workshops

The Healthy Communities intervention was rolled out to 40 communities in 20 districts, reaching 1332 direct beneficiaries. Important learning emerged from social accountability mechanisms embedded in community coalitions which ensure regular, health-focused dialogue on community health. Using local assets to health problem solving is changing the perspective on the resourcefulness of community actors in health. Progress towards sustainability is achieved by local public authorities and community making a matching contribution to start-up funding to small projects.

Key messages

• Our Healthy Communities model proposes a strength-based vision of health promotion which empowers community coalitions to self-organize for the prevention of cardiovascular risk factors.

• We promote bottom-up approaches that strengthen local health governance and community leadership into defining and addressing local health priorities.
The effect of alcohol marketing on people with, or at risk of, an alcohol problem: A rapid review
Authors: Langley T , Leonardi-Bee J , Barker A , Brown O , Murray R
Published: October 2022

Background

Little is known about the impact of alcohol marketing on people with, or at risk of, an alcohol problem. A rapid review of primary studies was conducted with the aim of exploring the effect of alcohol marketing in this population.

Methods

People with, or at risk of an alcohol problem were defined as people with an alcohol use disorder, in recovery from an alcohol use disorder, and hazardous and harmful drinkers. Searches for relevant literature were conducted through Medline, EMBASE and PsychINFO; reference list scanning and citation tracking of included studies; and grey literature searching of relevant websites. A narrative synthesis of included studies was undertaken.

Results

The review included 11 studies, which focused on participants recovering from an alcohol use disorder (AUD, 6 studies) and those with hazardous or harmful consumption levels of alcohol (5 studies). 7 studies were quantitative and 4 were qualitative. The effect of alcohol advertising on alcohol use was only assessed in one small experimental study of young adult heavy drinkers, which found no apparent effect. Studies looking at other outcomes suggested that a significant proportion of people with or at risk of alcohol problems notice alcohol advertisements and can find them appealing, and that advertisements may have an effect on positive alcohol-related emotions and cognitions. Among people in recovery from an alcohol use disorder, findings suggested that there could be an effect on craving, and that alcohol marketing may be perceived to trigger a desire to drink.

Conclusions

Several studies report effects of alcohol marketing which may translate into effects on consumption. There is also evidence that alcohol marketing is perceived to act as a trigger by people in recovery from alcohol problems. Further longitudinal and experimental research is needed to determine whether alcohol marketing has a causal effect on alcohol use in this population.

Key messages

• The findings of the studies included in the review suggest that an effect of alcohol marketing in people with, or at risk of, an alcohol problem is likely.

• The impact of alcohol marketing on people with or at risk of an alcohol problem should be a concern for marketing regulators and a focus for future research.
Crowdsourcing to Reduce Stigma Around HIV testing Among Adolescents and Young Adults in Kazakhstan
Authors: Mergenova G , Gryazev D , Kuskulov A , Sun Y , Landers S , Tolegenova A , Gulyayev V , Gulyayev P , Davis A ,   JasSpark Study Research Group
Published: October 2022

Background

New cases of HIV infection are increasing among adolescents and young adults (AYA) in Kazakhstan, and now account for over 23% of all HIV infections. Testing is key to reducing new infections, yet HIV-related stigma is a major barrier. Crowdsourcing contests could engage AYA in the development of interventions and increase the likelihood that an effective approach will be developed to reduce stigma and increase HIV testing among Kazakhstan AYA.

Objective

To determine the response to a crowdsourcing approach to collect media content for the development of an intervention focused on HIV testing stigma reduction among AYA in Kazakhstan.

Methods

To organize the crowdsourcing contest we organized a community steering committee; developed platforms to solicit crowd input; engaged AYA to contribute ideas through social media and in-person events. We present data on social media use and contributions.

Results

The contest website was visited by 2,893 people, and 76 AYA submitted 91 works for the contest from all over Kazakhstan. Most AYA (60%) visited the website of the contest via social media. Types of submitted content for the contest included video: 31 (34.0%), pictures: 29 (31.8%), text: 24 (26.3%), and other types of content including a chatbot, online game, and website: 7 (7.6%). Fifty (65.7%) participants were between 13-19 years, and 26 (34.2%) were between 20-29 years. Thirteen (17.1%) submissions were in Kazakh, and the rest in Russian 63 (82,9%). A number of submissions required further guidance due to a lack of understanding about stigma, accurate facts, and copyright issues.

Conclusions

AYA engaged in a crowdsourcing contest and used multiple modalities/types of content, from younger and older AYA, in both Kazakh and Russian, and representation from most regions of the country. Providing clearer guidance about facts and stigma may be helpful prior to submission.

Key messages

• Crowdsourcing approach has a potential to engage adolescent and young adult into development of various types of media content focused on public health issues, such as HIV testing stigma reduction.

• Adolescents and young adults may need additional information and guidance regarding complex concept of stigma around HIV testing.
Promoting the key moments of hand hygiene in a Targeted Hygiene intervention at COP26
Authors: Paskey A , Ackerley L , Buckley C , Cooper S , Bainbridge S
Published: October 2022

The COP26 conference in Glasgow, November 2021 presented a unique public health challenge in the midst of the COVID-19 pandemic. With 38,457 delegates attending, this international event posed a risk for SARS-CoV-2 infection. We used Targeted Hygiene theory to carry out a large event risk assessment process that focused on how spaces were used, referred to evidence from scientific literature, and identified key moments for surface and hand hygiene interventions. We relied on behavioural science evidence to optimize hand hygiene compliance at the event. To do so, we secured the opportunity to use hand sanitizer by determining the most suitable locations for over 500 hand sanitizing stations. To further motivate uptake of personal hygiene, kits were provided for each delegate with hygiene messaging to improve knowledge of the importance of hand hygiene in breaking the chain of infection. A COP26-branded face covering, personal hand gel and wipes were provided in the pack. Training and cleaning protocols centred on Targeted Hygiene were developed for cleaning teams to implement. Compliance monitoring through observation and daily real-time reporting of over 250 adenosine triphosphate (ATP) checks on just-cleaned surfaces provided reassurance for public health agencies that our Targeted Hygiene approach was effective.

The messaging and cleaning interventions were carried out for the duration of the COP26 conference. The number of individuals officially affiliated with COP26 that tested positive was ∼2 in 1,000 as compared to ∼11-12 in 1,000 individuals in Scotland during the same period (6-13 November 2021 as reported by Public Health Scotland). Whilst no single control can be attributed to this achievement, effective hand and surface hygiene interventions contributed by helping to break the chain of infection. This risk-based approach to Targeted Hygiene serves as a blueprint for effective, sustainable and measurable nonpharmaceutical interventions at large scale events.

Key messages

• To mitigate risk of infection at COP26, key moments for surface and hand hygiene were identified and emphasized in cleaning protocols and education.

• Using a risk-based approach to Targeted Hygiene serves as a blueprint for effective, sustainable and measurable nonpharmaceutical interventions at large scale events such as COP26.
Behavioral innovations in the management of obesity and overweight using the COM-B model
Authors: Timkova V , Minarikova D , Katreniakova Z , Mikula P , Husivargova A , Nagyova I
Published: October 2022

Background

Increasing overweight and obesity rates represent one of the global health challenges in the 21st century. Obesity is a gateway to many non-communicable diseases and shorter life expectancy. Understanding individual capability, opportunity, and motivation for health behavior change (COM-B) may help to develop effective public health interventions. However, so far, only a very few studies examined interventions based on behavior change theories. Thus, we aimed to assess the potential facilitators and barriers to behavior change in weight management using the COM-B model.

Methods

We included 146 people with overweight and obesity (66.7% female; mean age 46.62±14.51 years; body mass index 32.46±6.51 kg/m2) from primary care settings. All participants completed the Brief Measure of Behavior Change (COM-B), the General Self-Efficacy Scale (GSE), the Rosenberg Self-esteem Scale (RSE), and the Self-Rated Heath scale (SRH). Multiple linear regression analyses were used to analyze the data.

Results

In univariate analyses COM-B domains were positively associated with female gender, living with a partner, lower body mass index, and higher SRH. However, the associations between sociodemographic and clinical variables and COM-B domains were no longer significant when self-esteem and general self-efficacy were added to the multivariate regression models. Self-efficacy was associated with reflective motivation (β: 0.53; p < 0.001), physical capability (β: 0.43; p < 0.001), and psychological capability (β: 0.44; p < 0.001) the most significantly. Self-esteem was strongly associated with physical capability (β: 0.41; p < 0.01). Total explained variances in the final models varied from 17.7% to 25.0%.

Conclusions

Personal resources may play a significant role in weight management and should be included in tailored public health interventions (Grant support: VEGA: 1/0748/22).

Key messages

• Interventions focused on the enhancement of personal resources may improve weight management.

• Behavioral and cultural aspects should be considered when designing effective public health interventions.
Organizational health literacy and health promotion in health care settings: Results from Germany
Authors: Rathmann K , Salewski LD , Zelfl LV
Published: October 2022

Introduction

Health care organizations (HCO) are increasingly required to provide health literate structures and processes to strengthen organizational health literacy (OHL). So far, little is known about the extent of OHL in HCO in Germany. Aims are therefore 1) to examine the level of OHL in health care organizations, and 2) to investigate the impact of organizations level of health prevention and workplace health promotion on the level of OHL.

Methods

Analyses are based on a nationwide cross-sectional study (online survey) among management staff (N = 564) in HCO (hospitals, nursing homes, facilities for disabled people). OHL was measured by the German version of the ‘Health literate health care organization 10 item questionnaire’ (HLHO-10). Health prevention and workplace health promotion were operationalized by the “Worksite Health Promotion Capacity Instrument’ (WHPCI). Uni- and bivariate analyses were carried out, on an item-basis and as an index (median-split).

Results

Regarding OHL, 55.1 % of the health care organizations reported below-average levels of OHL. On an item-basis, the highest below-average levels were given for the standard ‘communication’ (59.1 %) and the ‘provision of information to patients/residents via various media’ (57.4 %). Regarding the level of health prevention (51.8 %) and the existence of workplace health promotion structures (55.7 %), more than half of HCO reported a below-average level. In addition, results showed that HCO that indicate a below-average level of prevention and few structures of workplace health promotion also revealed a below-average level of OHL.

Conclusions

There is need to strengthen OHL in German HCO.

Key messages

• HCO are required to strengthen HLO, particular in communication and participatory approaches.

• A higher level of prevention and workplace health promotion on HCO can contribute to the implementation of OHL initiatives.
Syllabi collection on diversity and intersectionality in public health: reflecting on the development
Authors: Wandschneider L , Podar D , Wetzel L , Luetke Lanfer H , Skrypnikova O , Razum O , Selig S , Namer Y
Published: October 2022

Background

Highlighting the intersectionalities between different markers of diversity and health inequities encourages the reconsideration of normativities in public health (PH). We developed an open access collection of syllabi on the relevance of intersectionality and diversity in PH together with the Association of Schools of Public Health in the European Region (ASPHER).

Objectives

We developed the syllabi in a participatory, iterative process guided by transformative teaching pedagogy. We reflect on this process and how this can inform the enhancement of the syllabi themselves, as well as future curriculum development.

Results

We recruited a core group of 9 PH researchers, teachers and professionals from all career levels from participants of introductory session presentations in different settings (e.g., 14th EPHC, ASPHER Retreat). The core group met once a month for one year online, and each meeting took the form of co-working sessions in breakout rooms to develop the syllabi based on interest and expertise. We designed a qualitative online survey to evaluate and ensure the scientific rigor and pedagogical value of the syllabi. We invited critical and constructive input from ASPHER member school professionals with expertise in intersectionality, diversity or curriculum development in PH in terms of content and pedagogy.

Conclusions

Drawing from the expertise of the PH community we combined diverse professional and cultural backgrounds, experiences from different career levels and PH education systems, as well as specialisation in the PH field. The transformative pedagogical approach was considered particularly valuable in strengthening competences such as reflexive strategies and self-, social- and global awareness which are key to teaching on diversity and intersectionality issues. The peer-review structure supports the uptake in PH education and a sustainable implementation. The collection will also allow PH faculty to diversify their pedagogical approaches.

Key messages

• Inclusion of health inequities, diversity and social injustice issues is crucial in public health curricula, since an intersectional perspective is increasingly acknowledged in public health research.

• The syllabi collection will equip public health teachers of all career levels to develop their own course material on social identities and their significance for public health.
Towards collaborative action: A project on interprofessional stroke care in the Covid-19 pandemic
Authors: Schloemer T , Schüller A
Published: October 2022

Background

Stroke is one of the leading causes of disability in adulthood. Cooperatively organised stroke care requires a high degree of interprofessional competence of junior professionals.

Objectives

The project aim was to develop interprofessional competences for stroke care, to identify gaps in care as well as approaches to innovation during the pandemic through joint research. The focus was on person-centred care, communication and collaboration, roles and responsibilities, including stroke-navigators. German Bachelor students of occupational therapy, physiotherapy and speech therapy of the 7th semester (n = 22) were accompanied online in 60 teaching units in 2020/2021. The seminars consisted of (a) theoretical introduction to interprofessional stroke care (b) case-based collaboration with problem-based learning (c) applied health services research. The evaluation was based on a central questionnaire and written reflections from all students.

Results

The following themes were identified and investigated in 5 interprofessional groups: (1) Impact of the Covid-19 pandemic on the acute care and rehabilitation of stroke patients, (2) International comparison of interprofessional stroke care based on guidelines to improve current practice, (3) Interprofessional diagnostics in stroke care, (4) Interprofessional patient-centered goal setting in outpatient stroke care, (5) Agreements of actors involved in stroke treatment to best serve the needs of the patient. The response rate to the centralised evaluation was low (14%). The project was rated good to very good in terms of planning and presentation, relevance, and interaction with students.

Conclusions

The students reported central aspects for interprofessional learning: The reflections predominantly described growth in professional competences, in skills for cooperation and problem solving, which can be transferred to professional life. The main point of criticism was the necessity of digital teaching in the pandemic.

Key messages

• Empowering interprofessional cooperation through a joint project of different Bachelor programmes helps to strengthen the students’ professional identity and shared responsibility for stroke care.

• Online teaching can be a valuable facilitator of learning, but should not completely replace face-to-face teaching for stroke care.
Control of Acinetobacter baumannii outbreak in intensive care units in Tunisia, 2022
Authors: Mziou E , Ghali H , Bhiri S , Ben Cheikh A , Bannour R , Ghribi M , Trabelsi S , Khefacha S , Ben Rejeb M , Said Latiri H
Published: October 2022

Introduction

Acinetobacter baumannii is an emerging pathogen that is increasingly resistant to antibiotics and is mainly responsible for pneumopathy in fragile patients. This germ is frequently responsible for epidemics in hospitals. We aimed to describe the steps of the investigation of an outbreak of Acinetobacter baumannii affected our hospital, the measures implemented and the follow-up of the actions.

Methods

Following alerts issued by the microbiology department concerning 5 swabs detecting Acinetobacter of the same strain and the same antibiotic resistance profile in 3 different departments of intensive-care units (ICU), a team of the prevention and healthcare security department went onsite for an investigation in the hospital.

Results

We identified five cases with identical strains of multi-resistant Acinétobacter. The field visit allowed to identify some deficiencies in professional practices. All the patients were hospitalized in ICU (medical and surgical). The synoptic table showed that there was an overlap of hospitalization periods.A crisis cell was set up to validate, coordinate and implement control measures in accordance with CTINILS recommendations. Indeed, we proceeded to a technical isolation of the cases in their hospitalization sector, reinforced the basic hygiene and bio-cleaning measures and sensitized the medical and paramedical. Given that the three ICU departments shared the same medical staff during night shifts, the assumption that the germ was carried by the caregivers was the most likely hypothesis. We proceeded with a swab of the elements of the environment in the services concerned. Results showed that Acinetobacter was found on the nursing cart (visibly clean). A training about bio-cleaning and hygiene standard precautions is programmed.

Conclusions

Continuous surveillance, continuous hygiene trainings, combined with a rapid reaction capacity in case of identification of a new case, is essential to control the spread of nosocomial germs.

Key messages

• Multidrug-resistant Acinetobacter baumannii (MRAB) is an emerging cause of intensive care unit (ICU) outbreaks.

• Enhanced infection control measures limited the outbreak.
Design of a care pathway for Hepatitis C: a pilot study with three University Hospitals from Tuscany
Authors: Corazza I , Ceccarelli L , Moretti G , Tavoschi L , Vainieri M
Published: October 2022

Monitoring and evaluation activities are recognised as key to quality improvement in healthcare performance. The present study is intended to design a performance evaluation system for care pathway for patients with chronic Hepatitis C virus (HCV) infection, to follow them along the continuum of care throughout regional healthcare services, from diagnosis to treatment course completion. Four phases of the care pathway, namely diagnosis, linkage to care, treatment, and outcome were identified. Each phase of the care pathway was populated by a set of observation and evaluation indicators. Data sources were: administrative health data from the Tuscany Regional Healthcare System; patient-reported experience and outcome measures collected by means of questionnaires administered by the health professionals during patients’ consultation in the three University Hospitals of the Tuscany Region. The availability of data, collected from the administrative flows and thanks to the active involvement of health professionals, showed the feasibility of designing a care pathway for HCV. More particularly, using administrative data, three performance indicators were calculated for the prevention phase, two for the linkage to care phase and two more for the treatment and outcome phases, respectively. Moreover, two indicators related to linkage to care and outcome phases were designed, but data require further investigation. On the other hand, using patient-reported experience data, four indicators can be calculated for the linkage to care phase, while regarding patient-reported outcomes, the feasibility of calculation depends on the number of patients that will be involved in follow-up visits. The care pathway designed may be useful to: identify shortcomings of the healthcare services for chronic HCV patients; foster quality improvement actions; inform allocation of resources to accelerate HCV elimination in Tuscany.

Key messages

• The authors propose a care pathway for Hepatitis C, consisting of four distinct phases, populated respectively with diagnosis, linkage to care, treatment, and outcome indicators.

• The care pathway can be used as a management tool for the identification of possible quality improvement actions to be undertaken with respect to the healthcare services provided to HCV patients.
International Health Regulations core capacities monitoring in 2020-2021 at Italian Points of Entry
Authors: Frisicale E , Zichichi S , Di Virginio A , Falvo R , Angeloni U , Rezza G
Published: October 2022

Under the International Health Regulations (IHR) 2005 States Parties (SP) are required to develop and maintain core public health capacities and report related progress to World Health Organization (WHO) annually,including those related to Points of Entry (PoEs).Using an appropriate tool,provided by WHO, Italian PoEs assessments in 2020 and 2021 were conducted to have the status quo,describe any differences among years and promote corrective actions if required. The tool was designed in 2009 to support SP in ascertaining prior capacities in PoEs and monitoring their progress in order to designate PoEs under IHR.The tool was translated in Italian.Coordination and communication among authorities involved in each PoE (C1),core capacity at all times (C2) and at PHEIC (Public Health Emergency of International Concern) (C3) were assessed by cross border health Authorities for 2020 and 2021.For each of these sections the maximum score is 100%. For each year,a descriptive analysis was conducted and any differences in scores between the two years were noted.The presence of a contingency and vectors’ control plans was also investigated.The assessment was completed respectively for 2020 and 2021 by 24 and 25 airports, 53 and 52 ports. C1 in 2020 resulted on average 89% for airports and 95% for ports, in 2021 respectively 90% and 95%; C2 in 2020 resulted on average 64% for airports and 63% for ports, in 2021 respectively 63% and 64%; C3 in 2020 resulted on average 68% for airports and 61% for ports,in 2021 respectively 63% and 58%.Few differences in scores between 2020 and 2021 were noted in some PoEs. 4 PoEs declared the presence of a contingency plan only in 2021.Few PoEs stated to not have a vectors’ control plan in both years.The assessment pointed out a good level of coordination and communication among all the stakeholders involved, including the Italian Red Cross,but it revealed lower scores for the other IHR core capacities. Improvement actions have to be pursued surely.

Key messages

• The specified tool helps cross border and national Authorities to understand strengths and weaknesses in each PoE and leads to develop a specific plan of action to overcome potential gaps.

• Maintaining a good level of core capacities at points of entry is fundamental to protect national public health.
Not just anti covid vaccine in hub! Local Health Authority Rome 4, Lazio, Italy experience
Authors: Fusillo C , Di Carluccio C , Scognamiglio D , Belfiori G , Sinopoli M , Ursino S , Matera C , Matranga C
Published: October 2022

Issue

At the end of December 2020 in Italy was started anti-covid vaccination campaign. For this purpose in the territory of Local Health Authority Rome 4, vaccination Hubs have been set up, one per each of four territory districts. The Hubs were large, never available previously, with routes suitable for welcoming and vaccinating a large number of people. Vaccination Service (SV) has organized anti-covid vaccinations with every day open Hubs, for 12 hours a day and more, without stopping, reaching very high vaccination coverage, but adherence to vaccinations into the calendar for 0-16 years further decreased during the pandemic period, particularly in adolescence.

Description of the problem

At the end of January covid vaccination requests decreased and SV realized a vaccination line dedicated to other vaccinations in each Hub so SV decided to invite the cohort of those born in 2010 that defaulted with the vaccination against human papilloma virus (HPV) and other mandatory/recommended vaccines.

Results

There were 2629 non-compliant adolescents (83% of resident population in 28 company territory municipalities). 2,353 phone calls were made and 232 smart-sms were sent (very recent method). They booked 598 children, who were vaccinated in just 3 days from 8.30 to 12.30 between February and March 2022. Total vaccines performed were 678: HPV9 389; meningococcal (ACWY and B) 278; 11 other. About 38 teenagers vaccinated every hour

Lessons

The way we used to contact resident population was innovative, easy and quick, necessary features to complete the intervention in a short time. This confirmed the importance in recruiting and adhering to vaccinations and leds to a driving effect also in the following days. Hubs as capacious and familiar places for the population, have allowed an excellent organization with a fast vaccination course, facilitated reception, resources optimization of health personnel.

Key messages

• To achieve vaccine prevention goals it is important to take advantage of available opportunities.

• It is very important to apply the experience gained with the Covid vaccination to non covid vaccinations as well.
Falls among elderly: evidence from hospital settings in Georgia
Authors: Pitskhelauri N , Dochviri T , Akhobadze K , Chkhaberidze N , Chikhladze N , Kereselidze M , Peek-Asa C , Adina Coman M
Published: October 2022

Introduction

Falls are one of the major public health problems and a leading cause of injury-related morbidity and mortality globally. Around of 80% of fall deaths occur in low- and middle- income countries. Falls are the most common cause of hospitalization among the population aged 65 years and older. According the data from Global Burden of Disease (GBD) Study in Georgia, DALYs from falls exceed the average in LMICs. The aim of this observational study was to explore epidemiological characteristics of fall-related injury among hospitalized elderly patients in Georgia in 2020.

Methods

This study was designed in the framework of the project iCREATE: Increasing Capacity for Research in Eastern Europe’ funded by the NIH (2D43TW007261). All patients aged 65 and older admitted to hospital settings due fall-related injury in 2020 were identified from the Hospital Registry (included a total of 152 hospitals in the country) of the National Center for Disease Control and Public Health of Georgia.

Results

A total of 7159 injured patients age 65 and above were admitted to hospitals in Georgia, and among them 4213 were hospitalized due to the falls (60%). Males comprised 30,7% of cases and females - 69,3%. The most common source of hospital arrival was ambulance 2791 (65,0%), followed by private/public transport 1432 (33,3%). The highest number of injuries (43,5%) occurred in Tbilisi (capital of Georgia). The leading cause in fall-related hospitalization was fall on same level. Pelvis and the head were the most common body regions injured accounting for 48,0% and 22,9% of cases, respectively. The highest LOS was 2014 (SD 6,161). 111 patients died due to falls related injury during the study period.

Conclusions

This study indicates that fall- related injury prevention among elderly population should become a key priority area in Georgia. There is a need for elaborating relevant preventive interventions of falls injuries in population aged 65 years and older.

Key messages

• Falls are the leading cause of hospitalization of patients 65 years of age and older.

• Fall risk awareness campaigns should be the first step to fall prevention among elderly.
Supply-side contribution to the lack of PBF impact on unmet need for family planning in Burkina Faso
Authors: Hertler C , Lohmann J , Koulidiati JL , Robyn PJ , Somda SMA , De Allegri M , Brenner S
Published: October 2022

Background

In 2020, about one in four women in Burkina Faso faced an unmet need for family planning (FP). Between 2013 and 2017, Burkina Faso implemented a performance-based financing (PBF) program to improve primary health care service provision (including FP) at rural health centers. Our prior work revealed that PBF did not lead to a reduction in unmet need for FP, in spite of FP being an explicitly targeted service. Our current study assesses supply-side factors that have likely contributed towards this lack of effect at population level, by examining changes in facility-based indicators relevant to the provision of FP induced by PBF.

Methods

We used facility-based survey data from 406 PBF and 117 control facilities collected before and after the PBF implementation. To compare changes in FP service provision, we examined changes in a number of relevant indicators including: a. the types of FP methods offered by facilities; b. trainings received by different FP providers; and c. available stocks of modern contraceptives. We relied on a difference-in-differences (DID) regression model to estimate the impact of PBF on these indicators.

Results

We observed a significant positive impact on the number of staff qualified to provide injectables, implants and IUDs (effect size 0.47, p 0.003) as well as the number of facilities offering IUDs (effect size 0.28, p 0.016) and a significant reduction in the number of facilities experiencing stock-outs of female condoms (effect size -0.09, p 0.007) and implants (effect size -0.03, p 0.042).

Conclusions

Given the significant positive impacts on the number of qualified staff, facilities providing IUDs and a reduction in stock-outs of female condoms and implants attributable to the PBF intervention without showing signs of negative effects on the indicators measured supply-side factors might not have been the main reason for the lack of effect of the PBF program on unmet need for FP.

Key messages

• Supply-side factors might not have been the main reason for the lack of effect of the PBF program on unmet need for FP.

• Further research is needed to explore other potential underlying reasons.