bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of participatory interventions in improving clinical coordination in Latin America
Authors: Miranda Mendizabal A , Vargas I , Samico I , Eguiguren P , Mogollón-Pérez A S , López J , Bertolotto F , Vázquez M L ,   for Equity LA II
Published: November 2019

Background

Evaluation of interventions to improve clinical coordination across care levels is scarce in Latin America.

Aim

to evaluate the effectiveness of interventions implemented through participatory action research in improving clinical coordination between care levels in public healthcare networks of Brazil, Chile, Colombia, Mexico and Uruguay.

Methods

Quasi-experimental study (controlled before and after design). Comparable networks, one intervention (IN) and one control (CN), were selected in each country. Baseline (2015) and evaluation (2017) surveys were conducted applying COORDENA® questionnaire to a sample of primary (PC) and secondary (SC) care doctors (174 doctors/network/year). Designed interventions promoted clinical agreement and communication across levels for patients’ follow-up. Outcome variables: a) intermediate: interactional and organizational factors; b) final: experience of clinical management coordination (care consistency and patients’ follow-up) and general perception of coordination between levels. Poisson regression models were estimated.

Results

Intermediate: interactional factors -personal knowledge and trust on the other care level-increased significantly in Brazil’ and Chile’ INs; and organizational factors -managers’ support- in the INs of Colombia and Mexico. Comparing to CN in 2017, INs of Brazil, Chile, Colombia and Mexico showed significant differences in some factors.

Final: care consistency items -agreement over the treatments- improved in the INs of Brazil, Colombia and Uruguay; and patients’ follow-up in the INs of Chile and Mexico. General perception of clinical coordination increased in the INs of Brazil, Colombia and Mexico. Compared to CN in 2017, only Brazil showed significant differences.

Conclusions

Improvements in intermediate and final care coordination results, consistent with expected results, were observed in all the INs. Reduced implementation time and some process and context factors may have limited their impact.

Key messages

First study assessing the effectiveness of participatory interventions in improving clinical coordination between care levels in public healthcare networks of Latin America. Results showed changes in the intermediate and final clinical coordination results in the intervention networks. Longer implementation and evaluation times are expected to achieve greater impact.
The assessment of the functionality of public health specialists’ activities in schools
Authors: Vladickiene J , Barkauskiene J
Published: November 2019

Background

The role of public health specialists (PHS) working at schools is continually growing to assure better health behavior and disease prevention in adolescent age. The aim of the study: to evaluate the functionality of health care activities performed by PHS at schools.

Methods

Anonymous survey of PHS was conducted in April 2018. Participants of the survey represent PHS working at schools in Lithuania. In total 179 forms where distributed, 139 were included into analysis, response rate - 77.7%. The data were analyzed by using χ2 criterion and the statistical significance p.

Results

PHS stated that past 12 months, bullying was the least important problem for children, but according to the prior plans prevention programs for it were organized most often (40.3%) and sports activity program - least often (21.6%), even though it’s the most relevant children health problem these days. 52.3% of PHS claims that schoolchildren learn the most about keeping good health from them. 44.6% of PHS noted that they aren’t able to do all their responsibilities during working hours, because paperwork takes up most of their time, and too little time remains for communication with the school community. One in three thinks, that they provide services for too many schools, one in seven assumes, that they have excessive requirements. Those who have longer work experience and too much workload were more unsatisfied with work in comparison with those with less work experience and proper workload (p < 0.05). Ability to communicate, knowledge and initiative are marked as the most important features, whilst work experience - as the least important, to pursue required activities of PHS.

Conclusions

Health improvement activities of PHS working at schools do not fully meet the most important health problems of schoolchildren. PHS with longer experience and higher workload indicated more problems regarding their work compared with those that have less work experience and accurate workload.

Key messages

The assessment of the opinion of school community’s on the most important children’s health issues should be analyzed prior to preparing health activities plans in municipality level. Workload of public health specialists working at schools should be optimized according to health activities plans.
Impact of an intervention to activate unemployed people on the use of primary health care services
Authors: Hakamäki P , Impinen A , Lounamaa A , Ståhl T
Published: November 2019

Background

Promoting well-being and health is a key policy instrument in municipalities. There are many ways to support the work ability of long-term unemployed people. Short term subsidized employment (300-500 €/person/month) being one widely used measure. The purpose was to study what kind of influence a short term employment has on the use of social and health care services of long-term unemployed people in sparsely populated area. Specifically, the aim was to investigate the use of primary health care services among people in subsidized employment, intervention (n = 67) and control group (n = 85) during five years period (2012-2016).

Methods

Individual-level data were extracted from registers (age: 19-65 years old, gender: 61 % men, 39 % woman, N = 152). The use of primary health care was examined in the case study by means of annual averages, cumulative percentages and regression analysis.

Results

According to preliminary results, there were differences in the prevalence of primary health care services use and how the use of services changed among intervention and control groups. The use of services in intervention group increased until the end of the intervention year, but decreased in the following year, 2016. The use of services in control group increased until 2016. Regression analysis was carried out to study the change; a year and an intervention for 2014-2016 were made as a predictor. It was found out that the number of visits increased each year by looking at both groups together (p = 0.012). The subsidized employment that started in 2014 had a statistically significant reducing effect on the use of services (p = 0.034) in intervention group in 2014-2016.

Conclusions

Municipalities’ health promotion and subsidized employment work can have positive impact on disadvantaged groups such as long-term unemployed people in sparsely populated area. Creating data for the use of services from local registers was very time consuming and challenging process, but possible.

Key messages

Promoting well-being and health is a key policy instrument in municipalities. Municipalities’ health promotion and subsidized employment work can have positive impact on disadvantaged groups such as long-term unemployed people in sparsely populated area.
Using routine data to benchmark quality and outcomes of diabetes care in the EU HEALTHPROS project
Authors: Carinci F , Meza Torres B , Cunningham S G , Mainz J , Groene O , Massi Benedetti M , Klazinga N S , Kringos D , de Lusignan S
Published: November 2019

Background

The EU-funded Marie Curie project HEALTHPROS aims to foster a new generation of “Healthcare Performance Intelligence Professionals” through a cohesive stream of 13 doctoral projects (www.healthpros-h2020.eu). Over 48 months, researchers will investigate key levers of healthcare improvement in 7 different countries, using methods drawn from the diverse fields of biostatistics, medical informatics and health services research.

Objectives

To describe barriers and enablers in the conduction of two doctoral projects aimed at exploring the impact of personal risk factors and organizational arrangements on lower extremity amputations in diabetes, through the use of large-scale databases from England, Scotland, Denmark and Germany.

Results

The research plan included a systematic review, structured comparison of data sources, predictive modelling and software development for automated international comparisons. Barriers encountered by researchers were: knowledge and access to data sources from different countries, dealing with data protection rules and the ability to carry out international comparisons when individual records are not easily allowed to leave national boundaries. Enabling factors included: a targeted educational process for risk modelling in diabetes and a multidisciplinary support team to help doctoral students overcoming the above barriers across different sites. Further clinical insight and contextual knowledge of data systems in place at different locations were needed in addition to the statistical, epidemiological and technical skills initially foreseen by the program.

Conclusions

The success of studies within a general educational program on health systems performance may depend from the continued support of a multidisciplinary team helping students in their educational process as well as with the practicalities of their research. International comparisons using routine data may require prioritisation to meet the tight timelines of doctoral theses.

Key messages

Academic programs for international comparisons in health care may be hampered by different type of barriers including technical aspects, legal regulations and a range of contextual factors. The establishment of multidisciplinary support teams may be essential for training doctoral students aiming to conduct international comparisons using routine data.
Waiting times for diagnosis and surgery in a large obstetric-gynecological hospital in Italy
Authors: Scaioli G , Bert F , Plazzotta C , Corezzi M , Voglino G , La Valle G , Rabacchi G , Falco S , Scarmozzino A , SIliquini R
Published: November 2019

Issue

Diagnostic testing and surgical waiting times are related to quality of healthcare services. An extension of waiting times, indeed, could lead to a diagnostic or therapeutic delay, with potential consequences on patient health outcomes. Several policies have been implemented in different European countries in order to improve these indicators. Our study aims to analyse the waiting times of the largest obstetric and gynaecological hospital of Northern Italy, in order to identify potential issues in women’s health services.

Description of the problem

Data of “Sant’Anna Hospital” (Turin, Italy) about the waiting times in the period 2016-2017 for outpatient and surgical services addressed to women were collected. Specifically, number of health care procedures and mean waiting times (MWT) for “Obstetric-Gynaecological Echography” (OGE), “First Endocrinological Visit” (FEV), “First Gynaecological Visit” (FGV), “Surgical Intervention for Breast Cancer” (SIBC) and “Surgical Intervention for Uterus Cancer” (SIUC) were retrieved. Results were compared with the benchmark identified by the regional law.

Results

A total of 21,735 OGEs were performed, with a MWT of 3 days in 2016 and 5 days in 2017, below the benchmark (11 days). The total number of FEVs was 1,234, with a MWT of 19 and 23 days in 2016 and 2017 respectively, again below the benchmark (30 days). The FGVs were 21,096 with a MWT of 9 (2016) and 24 (2017) days (benchmark 30 days). The number of SIBCs (N = 89) performed within 30 days (benchmark) were 87 (98% of SIBCs), while SIUCs (N = 90) were 84 (93%).

Lessons

The waiting times of the “Sant’Anna hospital” were, for all the performances considered, shorter than the regional benchmarks. This is an indicator of the quickness of diagnosis and treatment and, indirectly, of the quality of care. An international comparison among the main European hospitals should be encouraged in a perspective of continuous improvement of health care provided to European citizens.

Key messages

Diagnostic testing and surgical waiting times are useful to assess the quickness and quality of health care provided in European hospitals. “Sant’Anna hospital”, leader for women’s health care, provides care with waiting times shorter than benchmarks. It would be interesting to compare its results with other large European hospitals.
Inequalities in the utilisation of primary and specialist physicians in Europe - a systematic review
Authors: Schröder S L , Hoebel J , Roick J , Markert J , Spallek J , Knesebeck O v.d. , Richter M
Published: November 2019

Background

The evidence on inequalities in health clearly shows that people with lower socioeconomic status (SES) have poorer health and higher mortality. Nevertheless, generalized evidence for inequalities in healthcare is lacking. So far, the international literature was only summarised with regard to inequalities in the utilisation of disease-specific treatment. Therefore, our aim was to synthetize the literature on socioeconomic inequalities in the utilisation of primary and specialist physicians in the general population.

Methods

This systematic review searched Medline und Web of Science from 2004 to 2018. Articles that reported quantitative data on the association of SES with utilisation of primary or specialist physicians in Europe were included. Title and abstract screening were performed by two independent researchers and 50 full texts are currently sifted whether they fulfil the inclusion criteria.

Results

The studies analysed utilisation of physicians in terms of probability or frequency. The initial check of the studies indicates that socioeconomic inequalities in the utilisation of physicians differ between primary and specialist care. Specialist physicians were found to be visited with a higher probability and more often by the least disadvantaged in most studies. Inequalities in the utilisation of primary physicians revealed to be more diverse with a weak pattern of equally distributed probability of GP visits and more frequent utilisation by the disadvantaged.

Conclusions

The preliminary results indicate that pro-rich utilisation seems to be more pronounced in visiting specialists compared to primary health care. Aiming to reduce inequalities in healthcare, public health actions might primarily focus on reaching a needs-based consultation of specialist physicians.

Key messages

Socioeconomic inequalities in the utilisation of physicians exist and differ between primary and specialist care. Inequalities to the disadvantage of the population with low SES are more pronounced in the utilisation of specialists compared to general practitioners.
Compliance with smoke-free policy at tuberculosis facilities in Armenia: a mixed-methods study
Authors: Grigoryan Z , Hayrumyan V , Sargsyan Z h , Harutyunyan A
Published: November 2019

Background

Smoke-free environments in tuberculosis (TB) facilities promote a tobacco-free lifestyle among patients and healthcare providers and advance their healthy image. Though the national law of Armenia prohibits indoor smoking in healthcare facilities, enforcement of the law is still insufficient. This study aimed to explore compliance with the smoke-free policy in TB facilities in Armenia.

Methods

An exploratory sequential mixed-methods study was conducted. Overall 21 TB physicians and five key informants in the field of TB and tobacco control participated in qualitative interviews. To further quantify and validate the findings, structured observations of smoke-free policy implementation were conducted in 36 facilities.

Results

All physicians expressed a positive attitude towards the smoke-free environment and were satisfied with the level of implementation of a smoke-free policy in their TB facilities. According to the respondents, they already have smoke-free environments established in their facilities. “No smoking” signs, warnings about health consequences and financial penalties, and pictures of damaged lungs were the most common measures against indoor smoking. However, only in 17.1% (n = 6) and 8.6% (n = 3) of observed TB facilities there were posted “No smoking” signs and financial penalties, respectively. In 5.7% (n = 2) of facilities, the research team found ashtrays inside the building, and in 20.0% (n = 7) of facilities, there were smoking patients, physicians, and visitors.

Conclusions

While the qualitative study indicated good compliance, the quantitative findings were controversial with this regard. In fact, in most of the facilities, the smoke-free policy was not properly implemented and enforced. Additional efforts are needed to harmonize the current practices with national policies and recommendations.

Key messages

There was a discrepancy between practices reported by physicians and the actual observed compliance. Further interventions are needed to ensure 100% compliance with smoke-free policy in TB healthcare facilities.
Genetic services for Hereditary Cancer: a systematic review of Patient Reported Outcomes studies
Authors: Pitini E , D’Andrea E , Rosso A , Massimi A , Unim B , De Vito C , Marzuillo C , Villari P
Published: November 2019

Background

Genetic services for Hereditary Breast and Ovarian Cancer (HBOC) have become part of clinical and public health practice. Nevertheless, the evaluation of such services, including genetic testing and counseling, is challenging as they rarely affect health status measures (e.g. mortality and morbidity). A possible way is using Patient Reported Outcomes (PROs) i.e. subjective reports coming from patients, directly attributable to genetic services. We performed a systematic review to explore the use of PROs in HBOC genetic services.

Methods

We searched Pubmed, Scopus, and ISI Web of Knowledge for observational studies using PROs to assess standard genetic counseling (i.e. in person and individual) for HBOC.

Results

We identified ten surveys from various countries (USA n = 5; Europa n = 6), published between 2000 and 2018 and mainly conducted in Teaching hospitals and Cancer Research and Treatment Institutes (n = 9). The majority assessed pre-test counseling (n = 6) with diagnostic or predictive purpose. The most frequently measured outcomes were patient satisfaction (n = 9), adherence to recommended interventions (n = 3), information sharing with relatives (n = 3); disease risk perception (n = 2), and psychosocial distress (n = 2). Six studies adopted standardized PROs collection tools: the most common were the Genetic Counseling Satisfaction Scale and the Hospital Anxiety and Depression Scale. Questionnaires were mainly administered by post, soon after genetic counseling or up to seven years later. Overall, patients seem satisfied with genetic counseling. Nevertheless, more attention to the psycho-social aspects of genetic testing is needed.

Conclusions

PROs are very promising for the assessment of HBOC genetic services. Their routine use could provide important elements to improve the quality and the patient-centeredness of genetic services. Emerging information and communication technologies will help this process by making it easier collecting patient data.

Key messages

Precision medicine, where medical decisions are tailored to an individual’s characteristics, including the patient’s genetic profile, is becoming a paradigm for chronic diseases, particularly cancer. PROs are expected to be increasingly used as a measure of performance in order to drive the changes in how clinical genetic services, and healthcare in general, are organized, delivered and founded.
Health insurance literacy assessment tools: A systematic review
Authors: Quiroga Gutierrez A C
Published: November 2019

Background

Health insurance literacy (HIL), defined as the ability to seek, obtain, understand health insurance, and use it once enrolled, is a concept that has only recently started to gain increasing attention. HIL is likely to influence individual’s usage of health care services and subsequent outcomes. Yet, little is known about its distribution and its associations with health(-related) outcomes, due to the fragmented nature of the field and assessment tools. The objectives of this study are to (1) summarize information on current assessment tools for HIL and related constructs, (2) describe conceptual dimensions assessed, and (3) describe psychometric properties of found tools.

Methods

A systematic literature review was performed using various databases (e.g. PubMed, CINAHL, Econlit), identifying literature that provided a description of tools assessing HIL and related constructs (e.g. health insurance knowledge). In the following, two independent reviewers will screen abstracts and studies included for full-evaluation. The COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) will be used to assess quality of included studies and measures.

Results

Information on found tools will be summarized, including information on type of measure (e.g. objective or self-reported assessment), items and scales, scoring, target population, assessed domains, correlation with other measures. Preliminary results show large variations across tools that have been used to assess HIL and related constructs, with the majority not being rigorously validated.

Conclusions

The resulting summary of this study is intended to work as a basis for the conceptualization of HIL and development and validation of assessment tools, with the aim to homogenize and improve research in the field of HIL.

Key messages

Current knowledge on HIL distribution and its association with health(-related) outcomes is fragmented due to lack of consistency on HIL conceptualization and assessment. This systematic literature review aims to summarize information on current HIL assessment tools to inform the development and validation of HIL assessment tools.
Measuring inequity in using routinely collected data in an emergency setting: a systematic review
Authors: Morisod K , Luta X , Marti J , Brauchli T , Spycher J , Bodenmann P
Published: November 2019

Background

The international literature has highlighted many potential challenges in terms of inequitable access to care. In the last few years, health equity is becoming an increasingly important issue for policymakers, particularly in developed countries. The aim of this systematic review was to find how equity is measured and to identify some of its determinants.

Methods

We conducted a systematic review on all major databases (Medline Ovid SP, PubMed, Embase and Web of Science), following the PRISMA guidelines. We included published observational studies that reported on health equity and using administrative data, with a focus on emergency and unplanned hospital care. Study selection and data extraction were conducted independently and compared by two reviewers.

Results

In total, 223 records were screened and 39 articles met the inclusion criteria. Studies come from the United States (US) (23), United Kingdom (6), Canada (4), Australia (2) and some European countries (4). To measure health inequity, most of the studies used at least one of these 4 indicators: hospitalisations for chronic ambulatory care sensitive conditions (or preventable hospitalisations), emergency hospitalisation rate, readmissions or mortality. The most relevant health equity determinants concerned race/ethnicity (19), poverty (17), health insurance coverage (17) and gender (16). Race/ethnicity and gender are important determinants of inequities. Concerning poverty, despite the use of heterogeneous indicators, most of studies showed a socio-economic gradient of access to care. Health insurance coverage was often used but with conflicting results.

Conclusions

The use of indicators linking primary, emergency and hospital care seems to be particularly relevant to measure health inequity. Race/ethinicity, gender and socio-economic status are clear determinants of inequitable access to care. More studies are needed to explain and analyse the determinants of health equity.

Key messages

Health equity remains a major issue even for high-income countries health care system. Quantitative data about health equity still are needed to support policymaker’s recommendation.
Social aspects of occupational diseases in clothing industry in Bulgaria
Authors: Stoilova I , Georgieva S , Kamburova M , Kostadinova P
Published: November 2019

Background

The clothing industry is traditionally well developed branch of industry in Bulgaria Harmful factors of manufacture are forced posture, monotonous work, noise, vibration, poisons etc. At the beginning of 2016, the persons directly employed in the sector add up to 92 000, representing 6% of the employees in Bulgaria. An impairment of musculoskeletal and peripheral nervous system is frequent among these people in relation with the exposure of their professional experience. The aim of the study is to observe the influence of occupational diseases in clothing industry on social and emotional wellbeing of the employees.

Methods

For the purposes of the study, 103 persons employed in clothing industry, with impairments of the musculoskeletal system and the peripheral nervous system, were investigated. They were admitted to the Department of Occupational Diseases, of the University Hospital in Pleven during the period 2014-2017. Data were collected by interview, documents review and clinical examination.

Results

Analysis of the results revealed a statistically significant inverse association between performance of daily life activities and length of exposure of patients (p < 0.05). This means that increasing length of exposure restrict the abilities of the investigated persons to perform daily life activities. About 62% of the respondents are often and long standing patients, with more than 4 cases of hospitalization and over 30 days of disability per year. In 68% of the subjects the average duration of one illness exceeds 10 days. Long period of disability affect their income, working position and family relationships. More than a half of people surveyed (56%) cannot afford the recommended rehabilitation which retards the process of recovering. All these facts affect their mood and health self-esteem.

Concussion

Occupational diseases in clothing industry affect quality of life, social and professional performance of the employees.

Key messages

In clothing industry many risk factors affect workers’ health. There is a significant association between length of occupational experience in this branch and social aspects of occupational diseases. Occupational diseases in clothing industry affect capability of work and daily routines of employees. They have been associated with long and expensive period treatment and rehabilitation.
Physician-patient communication: A qualitative study of perceptions, barriers, and needs in 4 EU MS
Authors: Dalma A , Zota K , Karnaki P , Veloudaki A , Linos A
Published: November 2019

Background

Good physician-patient communication is an important aspect of patient-centered care and contributes to positive health outcomes. However there is a lack of standard EU communication training policies for physicians. This study explores the barriers to good communication for both physicians and patients across four EU countries as part of the EU-funded Project “H-COM”, Health Communication Training for Health Professionals.

Methods

Eight focus groups were conducted with a total of 31 patients and 38 physicians from Germany, Greece, Spain, and Cyprus. Three themes were covered; perceptions, barriers and needs for health communication.

Results

Commonalities and differences between countries and target groups were identified, with participants discussing attitudinal, emotional, educational, and systemic barriers to good communication. Identified barriers among patients include a deeply embedded hierarchical notion and arrogance among physicians, inadequate or difficult to understand language, busy schedules. Among doctors barriers identified were mostly systemic having to do with busy schedules, large number of patients, and lack of time. Participants especially patients indicated a significant gap in health communication knowledge, skills, and training for physicians, with several regional differences being present especially between Mediterranean and central European countries.

Conclusions

The results imply a strong need for communication training, tailored accordingly in specific countries. Further development of policies related to the inclusion of such training in medical studies across EU would be of great importance.

Key messages

There are differences concerning health communication needs and barriers between EU regions and the development of tailored training. Although identified as important there is a lack of health communication training in certain EU MS and an urgent need to incorporate training in basic medical and nursing education.
An Evaluation of Midwifery Education System in Armenia
Authors: Sahakyan S , Aslanyan L , Hovhannisyan S , Petrosyan V
Published: November 2019

Background

Competencies, knowledge and skills of health care professionals largely depend upon their education. Well-educated and competent midwives can improve women’s and infants’ health related outcomes. The current study evaluated the compliance of the current midwifery education system in Armenia with the global International Confederation of Midwives (ICM) standards.

Methods

The research team used a qualitative cross-sectional study design with deductive content analysis. Through purposeful sampling we recruited five nursing colleges providing midwifery education in Armenia; two in the capital city and three in different regions. The study population included midwifery students, faculty and administrative representatives of the selected colleges (n = 56). During fall 2018, we conducted observations of midwifery education textbooks and equipment and in-depth interviews and focus group discussions with participants.

Results

Despite widely used interactive teaching methodology and more than 60% of teaching time allocated for practical learning, students graduated from the program without obtaining essential competencies. Lack of teaching resources, especially in the regional colleges, and lack of quality clinical learning opportunities in hospitals were barriers for students to develop essential practical skills.

Conclusions

The study recommends the governmental bodies to ensure provision of equity-based distribution of finances and tangible resources between the capital city and regional nursing colleges. The practical component of midwifery education programs need substantial enhancement.

Key messages

The lack of teaching resources and access to hospital sites were barriers to obtaining essential competencies for midwifery students. In order to develop a sufficient professional skillset, midwifery education programs should arrange comprehensive and structured practical experience for students.
Key Aspects of Modernizing Public Health Doctoral Program at The University of Georgia
Authors: Lobjanidze T , Kamkamidze G , Antia K
Published: November 2019

Structured Doctoral Program of Public Health has been modernized from “consultation” to combined “Multi-methods” teaching module at the University of Full PhD program consists of 180 ECTS, 3 years for the full-time, and maximum of 7 years for the part-time. The programme consists of 60 teaching and 120 ECTS Research component. Doctoral student, together with a supervisor, starts working on his/her dissertation from the 1st academic year/semester of enrollment Transition from “consultation” model to the “combined multi-methods” model advances the learning outcomes, straight research skills, internationalization, modern professional communication.

PH PhD Program aims to prepare a public health researcher who will be able to identify and solve public health issue/problem, produce the best evidence possible and make an evidence-based decisions, create a novelty, and expand the knowledge borders of public health. Self-administrated semi-structured questionnaire were used: How much “consultation” model is effective? What kind of skills are is necessary for scientific carrier?Focus-group discussion was conducted with PhD program graduates. Questions discussed: How you applied acquired skills and knowledge to your work/practice?In focus group discussion employers were asked to discuss what skills and knowledge they are requiring from the employees, if they are considering involvement of local and International experts in teaching process.

98 % of questionnaire students underline the Combined multy- methods with intensive theoretical and practical teaching with international activities. The deep knowledge of scientific methods and project writing skills are very important. Results of researches must be presented at the international scientific conferences and published.

Research methods course was improved (amounts of credits was increased 2 times).The frame of teaching is Combined multy-methods with internationalization involvement and with intensive timeline.

Key messages

The learning process consist of Combined multy-method, with deep research methods and internationalization activities. The elements of Research component starts from the 1st semester. Result Internationalization.
The structure and forms of physical activity in the City of Zagreb 2O14/2015
Authors: Puljak A , Zivec M , Polic-Vizintin M , Radasevic H , Sostar Z
Published: November 2019

Background

Physical inactivity is one of the biggest public health problems of the 21st century. It is carried through walking, cycling, job, sports, recreation. The aim of this paper is to evaluate the physical activity of the citizens of Zagreb according to sex, age and the type of physcal activity. Health-Enhancing Physical Activity recommendations are at least 150 of moderate or 75 vigorous minutes activity per week.

Methods

The research has been conducted by analyzing the data gained from the European Health Interview Survey (EHIS 2) from the World Health Organization that was carried out in Croatia during 2014. and 2015. There were collected the data on the frequency, duration and type of physical activity in the City of Zagreb. The target population was aged over 15 and included 446 inhabitants (188 men and 258 women) of the City of Zagreb.

Results

24,5% of the total number of physically active persons exercise between 150 and 300 minutes per week. 45, 0 % respondents walk 10 to 29 minutes daily, 27, 1% walk 30-59 minutes daily, 14, 9% walk 1 or more hours a day. 1,2% respodents spend less then hour, 13, 6% spend 1 hour and 59 minutes, 18, 3% spend 2.00-2.59 hours and 8, 3% spend 3-3.59 hours on sport and recreation per week. 13, 8% of citizens spend 10-29 minutes a day cycling, 30.1% cycling 30-59 minutes a day, 12, 2% cycling 1 hour to 1 hour and 59 minutes and 2.4% spending more than 2 hours a day on a bicycle. When doing a professional job or work at home 43, 7% of respondents mostly sit or stand, 32,3% use moderate physical effort and 1, 5% of people perform hard work. 14.4% of respondents are engaged in sports, 11.9% cycling and 71, 9 % respondents walk 3-7 days a week.

Conclusions

Zagreb’s citizens are not sufficiently engaged in physical activity and carry out physical activity mainly while doing the job and walking. But those who are active meet weekly recommendations for duration of activity.

Key messages

Physical activity is one of the key health factors and one of the most effective ways of preventing chronic non-communicable diseases. There is a need of more public health interventions in order to promote recommended frequency, duration and different types of physical activity.
Patient education in the context of Parkinson disease cared for with deep brain stimulation
Authors: Gaille M , Lancelot M s
Published: November 2019

Background

From the 1960 on, Western societies have developed patient education. In France, patient education is part of the public health Law since 2009. Research on patient education has developed in the field of social sciences and humanities in order to understand the social dynamics on which it is based, its intended implications and actual results. As patient education may contribute to an evolution of health care services, this research gives rise to a knowledge that is important to ground public health policies. Funded by IReSP, the present study is innovative as it explores the contemporary development of patient education in the field of Parkinson disease; analyses the teaching models that grounds patient education in this field; examines the implications of technological care (here, deep drain stimulation) in terms of transmitted knowledge and acquired skills.

Methods

Review of literature. Conceptual analysis of the teaching models (and tools) used in training sessions. Ethnographic work (observations of training sessions; qualitative interviews with health professional and patients) - multi-centric perspective (Paris, Nantes, Toulouse).

Results

Historical reconstitution of the development of patient education in the context of Parkinson disease worldwide, with a focus on the French context, and its actors. Identification and examination of a variety of goals assigned to patient education. Identification and examination of the teaching models (and tools) used in training sessions.

Conclusions

Patient education in the field of Parkinson disease shows a great variety of educational practices and of transmitted knowledge. The analysis of its teaching models (and tools) and of the place devoted to technological care in the training sessions show the necessity to better clarify the goals assigned to patient education (patient autonomy, patient observance, emergence of the expert patient).

Key messages

A clarification of the goals and teaching models of patient education is needed. A specific attention must be paid to patient education in the context of technological care.
The Turkish adaptation of the family and nutrition and physical activity (abfa-tr) screening tool
Authors: Ikiisik H , Ekici E , Ankaralı H , Manav G , Yetim M , Kozan E H
Published: November 2019

Background

Assessing the dieatary and physical activity state of the family is important in determining the causes of obesity in the child. The aim of this study is to adapt The Family Nutrition and Physical Activity Screening Tool (FNPA) to Turkish and evaluate its reliability and validity.

Methods

In this methodological research, mixed probabilistic sampling methods were used. The sample size was not calculated and it was aimed to reach all of the 1126 students and families in the three primary schools with different socioeconomic status (high, medium, low) in Uskudar, Istanbul. A total of 727 students’ and their families’ data were collected. Research data were collected by a two-part questionnaire. Survey forms were composed of an introductory information form and the Turkish version of the (FNPA). The low total score on the scale means high-risk family environment and behavior, and the high total score means a more positive family environment and behavior. Prior to the implementation of the scale in the field, a pilot application was made.

Results

The Cronbach alpha coefficient for the internal consistency of the scale was 0.724. The test-retest reliability coefficient of the scale had a medium to very high level ranged from 0.422 to 0.925. The Kaiser-Meyer-Olkin test result of the 20 questions in the scale was found to be appropriate as 0.771. To evaluate the validity of the content, relationships between the scale score and the answers given the questions about the eating behaviors of the family which were not included in the scale. When these relationships were evaluated, the mean scores of those who had regular breakfast were significantly higher (P = 0.001).

Conclusions

The study shows that the ABFA-TR scale is a valid and reliable measurement tool for Turkish population.

Key messages

It is likely that home environments and parental behaviors with interchangeable risk factors for obesity and overweight may alleviate or aggravate the potential risk of obesity. The development and use of measurement tools related to the family environment as an element of obesogenic environment are among the important steps taken to fight obesity.
“Health Party” intervention on genetic testing for ethnic minority women: study protocol
Authors: Kabeya V , Puthussery S , Furmanski A
Published: November 2019

Background

Culturally appropriate interventions are needed to improve the uptake of genetic counselling and testing among ethnically diverse communities. This study aims to assess the feasibility and preliminary effectiveness of a “Health Party” intervention to increase awareness, knowledge and uptake of genetic testing for breast and ovarian cancer among ethnic minority women in the UK.

Methods

The “Health Party” intervention will include an educational session in a party setting. Participants will be taught by professionals about genetic testing and how to access genetic testing services in the UK National Health Service. We will recruit a sample of 60 women aged 18 years and over from key ethnic minority groups in the UK (Black African, Black Caribbean, Indian, Pakistani, Bangladeshi) and will conduct four community based sessions, each with about 15 participants. The outcomes will primarily relate to recruitment and attrition rates, data collection, study resources and intervention delivery. A quantitative pre-post evaluation with measurements before, shortly after, and at 6 months following the intervention will be conducted to assess the preliminary effectiveness on awareness, knowledge and uptake of genetic testing. We will use three way mixed analysis of variance (MANOVA) to analyse changes pre- and post- intervention. The fidelity of the intervention including facilitation strategies, quality of delivery and participant response will be assessed.

Conclusions

Findings will establish the feasibility of the intervention and will provide insights into its effectiveness to increase the awareness, knowledge and uptake of genetic testing for breast and ovarian cancer among women from ethnic minority groups in the UK.

Impact: Depending on its feasibility and effectiveness, the intervention can be used to help women from ethnic minority groups to make informed choices about genetic testing and improve early diagnosis and treatment of breast and ovarian cancer.

Key messages

“Health Party” may be a feasible intervention for ethnic minority women in the UK. “Health Party” intervention may increase awareness, knowledge and uptake of services.
Developing the Turkish version of the exercise benefits/barriers for the elderly scale
Authors: Erol S , Erdem O , Koç H , Çetin F , Erkek N
Published: November 2019

Objective

The aim of this study was develop the Turkish version of the exercise benefits and barriers scale for elderly people.

Methods

The study was carried out with the methodological research design with a total of N = 300 individuals living in a nursing home (n = 134) and applying to the Family Health Center (n = 131) between October 2017 and May 2018. The study included subjects aged 65 years and older who had no dementia, communication or physical disability. The item pool of the scale consisted of 36 items. Items were structured in five-likert form. Expert opinions of eleven individuals were received for Content Validity Index (CVI). The data of the study were collected with 26-question socio-demographic characteristics form, the Mini Mental Test and the Exercise Benefits/Barriers Scale for the Elderly (EBBSE). Approval and consents were obtained from the relevant Ethics Committee, from the healthcare facility and participants. For the validity and reliability; CVI, exploratory factor analysis (EFA), confirmatory factor analysis (CFA) Hotelling’s T2, paired sample t test have been carried out.

Results

The mean age of the subjects was 72.44±5.94 years. Scale’s CVI was 90. The factor analysis demonstrated that the scale included three sub-dimensions of 18 items in Physical and Psychological Benefits of Exercise, 2 items in Social Benefits of Exercise and 8 items inExercise Barriers accounting for 55.36 % of the total variance of the scale. Cronbach Alpha internal consistency coefficients of the scale was .84. All of the four fit indices obtained in the CFA had desirable magnitudes (RMR=.05;RMSEA=,07;NFI=.81;CFI=.87), indicating a good fit between the model and the data. The item total score correlations ranged from .40 to .69. The scale’s test-retest correlation was .99.

Conclusions

EBBSE is a valid and reliable scale that can be used to evaluate benefits and barriers perceptions in physical activity practices.

Key messages

Developed EBBSE can be used to determine the perceptions of exercise for elderly. Developed EBBSE can be used to change barrier perceptions of exercise.
Effectiveness of the universal substance use prevention program on alcohol consumption among adults
Authors: Dobrowolska-Kulanová M , Štefaňáková M , Orosová O
Published: November 2019

Background

Universal substance use prevention program (PUNAV) is a 24-hour course primarily aimed at developing the competencies of future teachers and prevention trainers. One of the key strategies in the PUNAV is correcting the misperceptions and this way changing normative beliefs about risky behaviour, which, when overestimated, are a predictor of risky behaviour.

Objective

To explore whether the participation in PUNAV has an effect on alcohol use of future teachers and whether this relationship is mediated by descriptive normative belief regarding alcohol use while considering gender as a possible moderator of these processes.

Methods

The sample consisted of university students from Slovakia; n = 277, 78% women, Mage=22.23, SD = 2.12. The PUNAV effect was explored within an experimental design. The potential pre-test effect was rejected based on a comparison within the experimental groups and within the control groups (using Solomon model of four groups). The bootstrapping analysis was used to test for moderated mediation according to gender using SPSS Process macro and linear regressions.

Results

The results showed that participation in the PUNAV has a direct effect on alcohol consumption (AUDIT subscore) only among men (b=-1.88, 95%CI -2.9- -.8). An indirect effect through the descriptive normative beliefs about alcohol use (effect size: -.25, BootCI: -.46 - -.07) was found when the whole sample was taken into account. Participation in PUNAV was found to be related to normative beliefs about alcohol use (β=-.32, p<.001) and these were related to alcohol consumption (β=.20, p<.001).

Conclusions

Participation in the PUNAV, which aims primarily to develop the competencies of future teachers proved useful for prevention showing a significant effect with respect to their alcohol consumption.

Acknowledgement: This work was supported by grant projects APVV-0253-11 and APVV-15-0662.

Key messages

Well-designed and databased prevention programs can affect risk behaviour among adult population. The importance of normative beliefs as a major strategy to achieve effectiveness of prevention programs has been constantly supported by empirical evidence.