bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing regional Diabetes Registries in Italy: pilot projects implementation within JACARDI
Authors: Armocida B , Cappai G , Di Martino M , Gnavi R , Monasta L , Pompili M , Galeone D , Mariani L M , Formenti B , Onder G
Published: October 2024

Issue/Problem

In Italy a National Diabetes registry is planned but not yet set up at the Ministry; JACARDI is contributing to speed up the process so that critical gaps in health data availability can be filled. While some regional registries exist, the lack of cohesion and standardization hinders the tracking of prevalence, incidence, and sequelae, crucial for evidence-based policymaking amidst rising diabetes rates.

Description of the Problem

The JACARDI project, supported by EU funding and running for four years, engages 76 partners from 21 countries and includes 142 national-level projects. Among its focus areas is enhancing data availability, aiming to establish harmonized regional Diabetes registries in Italy to tackle this issue. These efforts aim to create a scalable model enabling data linkage, diabetes type differentiation, and socio-demographic integration. Collaboration with health authorities and societies, drawing insights from existing registries, informs the development process.

Results

A total of 11 regional Diabetes registries are currently in the design phase of implementation. They adhere to a clearly defined methodology, with established essential parameters and data linkage. Consensus on these parameters and linkage was reached through stakeholder discussions, drawing on past registry experiences. The primary goal of the registries is to monitor diabetes prevalence, stratify incidence by demographics, and track sequelae to inform targeted interventions and resource allocation. While scalability beyond Italy may encounter administrative challenges, standardized protocols facilitate transferability. Data Protection stands out as a significant implementation obstacle.

Lessons

Standardized data collection, stakeholder collaboration, and sustainability are vital in registry development. Leveraging data availability for surveillance demonstrates adaptability and scalability, offering valuable insights for enhancing diabetes management.

Key messages

• Standardized data collection and stakeholder collaboration are pivotal in establishing effective diabetes registries, fostering equity and improving health outcomes.

• Leveraging data availability for surveillance offers a scalable and sustainable approach to diabetes management, facilitating informed policymaking and interventions.
Plan for the crisis!
Authors: Sturm N , Kretschy S , Prauhart N , Hofmann R , Stelzhammer D , Tacha S , Hirsch T
Published: October 2024

Background

The COVID-19-crisis has posed major challenges for organisations providing care in terms of fulfilling their contracts as well as maintaining their quality standards. This project aimed to analyse the implementation of gender and diversity sensitive crisis preparedness in health and social care organisations in Austria. The innovation of this project lies in the organisational crisis preparation including the interfaces of all organisations and actors involved in the care of a vulnerable person.

Methods

A comprehensive survey and analysis of existing structures and processes was carried out. A participatory approach was used to develop modular guidelines tailored to different crisis scenarios. This was followed by a detailed process analysis, integration of good practices and the creation of assessment tools for practical evaluation. Staff training and technology needs were identified, followed by an assessment of the applicability of the findings to other social sector organisations.

Results

This project created guidelines with modular structures that enable preparation for crises and their consequences. Thereby strategies for risk mitigation and good practice examples, e.g. from the COVID-19 pandemic, were developed. A self-assessment of the status of crisis preparation as well as the continuous monitoring with special consideration of the intersectional diversity of the target groups and their vulnerability was developed and made available on the web.

Conclusions

The project results in guidelines as well as a self-assessment and monitoring tool directly benefiting the participating organisations. Through its transferability to other organisations the project promotes overall crisis resilience and sustainably strengthens the care for vulnerable groups in times of crisis. In addition, solidarity-based help in crisis situations is promoted. The project promotes not only organisational, but also individual as well as macro-social and economic benefits.

Key messages

• The project developed guidelines for gender and diversity sensitive crisis preparedness for health and social care organisations, including risk mitigation strategies and self-assessment/monitoring.

• Crisis preparation must be systematically implemented in health and social care organisations involved in care of vulnerable persons.
Identifying gaps in health system governance to eliminate informal patient payments
Authors: Tambor M , Koufopoulou P , Bygvraa D A , Eklund Karlsson L , Buch Mejsner S
Published: October 2024

Background

Informal patient payments continue to exist in many European countries. These payments might take various forms but can be broadly defined as any payments in addition to formal fees determined by the terms of entitlement. Poor health system governance is considered one of the main factors contributing to their presence, although different aspects of governance might be relevant in each country. The aim of this study was to develop an assessment instrument to help identify gaps in health system governance that contribute to informal patient payments.

Methods

The study has been performed in 2022-2023 in three stages. In the first step, relying on the TAPIC framework and available literature on informal patient payments, we developed a list of questions for each domain of governance: Transparency, Accountability, Participation, Integrity, Capacity. In the second step, the questionnaire was assessed by external experts to ensure it covers the full range of relevant aspects. We then applied the instrument to three European countries, i.e. Denmark, Greece, and Poland, where informal payments differ in scale.

Results

The developed instrument includes 22 questions in the five TAPIC domains. They particularly refer to the role of governance in eliminating underlying reasons for informal patient payments (poor quality of health care) and effective penalization of these payments. The application of the instrument showed that in two countries where informal payments are more common, i.e. Greece and Poland, quality and waiting time guarantees are poorly defined, monitored, and incentivized, while existing mechanisms only penalize payments proven to be bribes.

Conclusions

There is a broad range of health system governance aspects that can be directly or indirectly linked to informal patient payments. The proposed instrument can facilitate the development of long- and short-term policies to eliminate informal payments in European countries.

Key messages

• Policy makers need to take greater account of the role of governance in ensuring health care quality to eliminate informal patient payments.

• The lack of mechanisms to penalize all types of informal payments may contribute to the commonness of these payments in Europe.
Leaders’ perceptions of integrating health and social services after a structural reform in Finland
Authors: Paatela S , Karreinen S , Huhtakangas M , Tynkkynen L K
Published: October 2024

Background

Health and social service system was reformed in Finland at the beginning of 2023. The responsibility for organizing health and social services was transferred from c. 300 municipalities to 22 well-being services counties (WBSCs). One aim of the reform was to support integration between and within health and social services. The purpose of this study is to describe strategic leadership approaches to implementing integrated care. The study highlights the issues that should be paid attention to when integrated care practices are implemented.

Methods

The qualitative study utilized semi-structured interviews collected from the upper-level leaders of the WBSCs (n = 25) responsible for the implementation of the reform. The interviewees represented 11 WBSCs. The data were collected in May-August 2023. Inductive content analysis was used for data analysis.

Results

Four strategic leadership approaches to implementing integration were identified: 1) service user-based leadership approach, 2) partnership-based leadership approach, 3) service system-based leadership approach, and 4) knowledge-based leadership approach. Most of the interviewees combined several different leadership approaches in their talk. Each approach emphasized different aspects of implementing integration and the contextual factors that have to be addressed at different levels of the health and social service system.

Conclusions

While the macro level reform toward more integrated health and social service system was implemented, the findings reveal that more efforts are required at the meso and micro levels of the system to fulfill the goal of integrated services. The paper highlights the importance of strategic leadership and its different aspects in implementing integrated care at different levels of the system.

Key messages

• The paper provides a way of comprehending integration from the perspective of strategic leadership.

• The conceptualization through the different leadership approaches may facilitate forming a shared vision for integration among leaders and managers.
Tackling health inequalities by creating new practices of integrated health access
Authors: Mejsner S , Fehsenfeld M , Burau V
Published: October 2024

Background

Health inequalities often emerge in-between health and social care sectors, as part of transitions between providers across the two sectors. Integrated health access is important for addressing these inequalities. Therefore, we need to understand processes of organising integrated health access and how these shape pathways of accessing care. We draw on sociological understandings of organising as practice that emerges as part of interactions between professionals and users.

Methods

We did observations of interactions between professionals and users (n = 18 days) and semi-structured interviews with users, professionals, and managers (n = 33) in the specialised mental health services in Central Denmark Region and FACT-inspired teams in 3 municipalities. We also conducted 3 focus groups with regional and municipal professionals from these teams. Data was analysed through a qualitative thematic analysis.

Results

Each team had distinct cultures of collaboration and different levels of cross-sectoral collaboration. Creating new, more integrated practices seemed to rely on both, supportive organisational structures and committed engagement in inter-sectoral spaces to change professional meaning systems. When teams were able to collaborate closely, it was easier to retain hard-to-reach users in treatment. However, professional differences could easily create division and therefore maintaining and building relationships were highly important. These mechanisms illustrate the importance of ensuring meaningful spaces for cross-sectoral work, where professionals can interact and create the needed changes.

Conclusions

Organising integrated health access is not merely about providing structures but is also highly dependent on interactions between professionals and users. Analysing interactions between professionals from across sectors, is important to understand the sustainability of integrated health access. In turn, this could help to tackle social inequalities in health.

Key messages

• Introducing integrated health access is highly dependent on interactions among professionals.

• Integration of professional practices across sectors helps retain hard-to-reach users in treatment.
Effectiveness of a policy to reduce non-urgent night-time consultations in out-of-hours services
Authors: Ramerman L , Rijpkema C , Verheij R
Published: October 2024

Background

The utilization of Out-of-Hours General Practice (OOH-GP) services in the Netherlands has been increasing steadily. This has placed significant pressure on triagists and GPs to provide accessible and high-quality care, particularly because of patients with low-urgency health problems, who can wait to visit their GP during regular working hours. To alleviate the strain on OOH services during the night, the “spoed=spoed” policy has been implemented. This policy stipulates that only patients with urgent health problems can consult with a GP during the night (11 p.m. to 8 a.m.). However, it remains unclear whether this policy has effectively reduced consultations during the night.

Methods

For this study, we used pseudonymised data from electronic health records of 2/3 of Dutch OOH services (catchment area of 12.3 million), from Nivel Primary Care Database, from 2020-2023. We analysed the effects of the policy on contact rates and proportion of high-urgency health problems, by comparing OOH services that did and did not implement the policy, by comparing 6 months before and after implementation and by analysing variances across OOH services.

Results

Overall, there were no differences in the number or proportion of high-urgency consultations across OOH services that did and did not implement spoed=spoed. In those that did, there were no differences before and after implementation. However, certain OOH services exhibited a decrease in consultation, while also showing a higher proportion high-urgency health problems.

Conclusions

There is currently no definitive evidence regarding the effectiveness of “spoed=spoed”. However we should learn from the varied effects and experiences in different OOH-services, to facilitate further implementation or adaptation of the policy.

Key messages

• OOH services can and should learn from each other on what solutions are implemented to lower the care-burden during the night.

• Policies aimed at reducing the utilization of OOH serviced should consider the conaxt from the patient, health care provider and organization.
Health literacy in the evolving era of personalised medicine and digital health
Authors: Beccia F , Causio F A , Porcelli M , Proto L , Van El C , Calabrò G E , Pastorino R , Boccia S
Published: October 2024

Health literacy is pivotal for advancing public health, empowering individuals to grasp health information and make informed decisions. However, health literacy levels are often influenced by social and economic factors, with lower levels correlating with reduced disease-specific knowledge and underutilization of preventive health services. As healthcare technology rapidly evolves, particularly with the advent of personalised medicine (PM) and novel genetic testing methods, there’s an increasing demand for heightened health literacy to effectively navigate these transformative innovations and optimize health outcomes. The European ExACT project aims to assess the understanding of PM and related technologies across the EU. In this context, through a survey conducted in several European countries, including Italy, France, Spain, Poland, the Netherlands, Romania, Hungary, and Germany, demographic data and attitudes towards PM, genetic testing, health portals, and big data were gathered. Logistic regression analysis identified factors influencing knowledge and attitudes. Among 6581 respondents, the results highlight a broad awareness of genetic testing (81%) and health portals (54%) yet a lesser familiarity with PM (48%) and big data (37%). Education level, age, and gender influenced awareness, with Hungary showing significant awareness across all topics (OR 2.09 95%CI 1.46-2.98), Spain excelling in big data (OR 1.88 95%CI 1.55-2.27), and Poland leading in genetic testing knowledge (OR 2.68 95%CI 1.82-3.96). Differences between countries may indicate successful policies and factors that can be replicated. Overall, the study emphasizes the importance of enhancing health literacy and sheds light on the predicting role of sociodemographic factors. It underscores the significance of bolstering health literacy to effectively navigate the advancements in PM and digital health, improving health outcomes in light of these evolving healthcare landscapes.

Key messages

• In Europe, awareness of personalised medicine, health portals and big data is lacking. Educational initiatives are crucial for effective navigation of innovations, considering regional differences.

• Social and economic factors affect health literacy levels, impacting disease-specific knowledge and healthcare utilization.
How to improve informal caregiver’s quality of life and health literacy? – a NGT approach
Authors: Pedro A R , Brandão D , Raposo B , Cunha A S , Escoval A
Published: October 2024

Background

Previous studies revealed that informal caregivers have a large number of unmet needs, reinforcing the necessity of national policies that ensure an adequate sustainability of the provision of informal care and takes into account the needs of caregiving dyads in the planning process. This study aimed to identify and consensualize initiatives and action strategies to improve the Portuguese Informal Caregiver’s reality and health literacy levels.

Methods

A Nominal Group Technique (NGT) was conducted with 10 experts. The NGT panel was asked about feasible action strategies to improve informal caregiver’s reality, consensualized and voted them according to perceived relevance in a semantic differential (1 pts to nothing relevant and 6 pts to very relevant), allowing a score calculation.

Results

Thirty-two initiatives emerged from the NGT. The five most relevant initiatives were identified based on an average score namely: 1) Pressure political decision-makers on the need for an effective implementation of the Informal Caregiver status, which is not being done (score=56); 2) Creation of a specific emergency social line for informal caregivers, as a measure of greater equity (score=52); 3) Raise employers awareness about caregiving demands (score=52); 4) Creation of a proximity social manager, linked to primary care services, that facilitates caregiver connection to health and social care services (score=51); 5) Decentralization of respite care services support, with multidisciplinary teams (score=49).

Conclusions

The informal caregiver’s role needs to be recognised and understood by healthcare and social care providers. (Re)design political, economic and social policies that address both caregiver and care recipients’ needs is critical to enable the continuity of informal care provision.

Key messages

• Informal caregivers play a fundamental social role but still have many needs to be addressed, particularly at the level of the official definition of their role.

• (Re)design political, economic and social policies targeted to informal carers is imperative to enable the continuity of informal care provision.
Evaluation of the Beneficial Parenting Partnership Model Assimilation in Parent-Infant Centers
Authors: Bord S , Paldi Y , Baruch R , Stolerman E , Yeudai-Yadid M , Zimmerman D , Gens I , Schuman Adatto I , Yaari M
Published: October 2024

Background

The Beneficial Parenting Partnership (BPP) model is being implemented in Parent-Infant Centers (PIC) across Israel to improve the partnership skills of PIC nurses when working with parents, promote child development, and enhance parental well-being. This initiative is being led by the Israeli Ministry of Health, Goshen NGO, and Lotem company and is supported by the Yad Hanadiv and Bernard van Lear foundations.

Methods

The first data collection (T1) was held from December 2022 to January 2023 among 706 parents of children aged two weeks to 36 months (M = 8.17 months, SD = 7.48) who visited one of 18 PICs. Research assistants approached the parents and asked for their agreement to fill in the study questionnaire. Of these, 328 parents agreed to participate in the follow-up study (T2) held in January-February 2024 using a telephone survey. Differences in the parent’s satisfaction, visit experience, and parental well-being were assessed using parried sample T-tests. A linear regression model was calculated to assess the factors predicting the increase in the parent’s visit satisfaction.

Results

Significant differences were measured between T1 and T2 in parental satisfaction (M = 4.51 and 4.71 retrospectively, P < 0.001), parental positive visit experience (M = 4.58 and 4.68 retrospectively, P = 0.019), and parental well-being (M = 3.81 and 3.97 retrospectively, P < 0.001). Findings suggest a marked improvement in satisfaction, visit experience, and reported well-being after a year of BPP model assimilation among PIC nurses. The regression model, explaining 42% of the variance in increased parental satisfaction, indicated that a higher increase could be predicted by a higher increase in positive visit experience and a higher trust level in the PIC nurse at T1.

Conclusions

The BPP model’s assimilation among Israeli PIC nurses was successful, resulting in improved parent experience, satisfaction, and well-being.

Key messages

• The Beneficial Parenting Partnership model is well-suited for implementation among nurses working with parents of babies and toddlers to promote collaborative nurse-parent communication.

• During routine meetings at Parent-Infant Centers, nurses can act as a catalyst for promoting parental well-being.
Inequalities in access to early child services in Bulgaria
Authors: Nedelcheva S , Dokova K
Published: October 2024

Background

Children’s health has been a major focus of European health policy since 2000, with particular emphasis on early childhood and integrated services for children with chronic diseases. However, research on early child care in Bulgaria is sparse, mainly focusing on the role of nurseries, kindergartens and nursing care. Our aim is to investigate whether there are disparities in access to early childhood health services in Bulgaria.

Methods

A survey was conducted among mothers of children up to 7 years old between April and June 2022. The questionnaire, containing 49 questions, was based on the theoretical framework from the EU project ‘Models of child health appraise’, covering topics as: geographical and financial access to services, equity, quality, responsiveness to children and family needs, considered key features of outpatient child medical care. Statistical analysis utilized Chi-square, Fisher’s exact and ANOVA tests.

Results

A total of 413 Bulgarian women, with a mean age of 34.3 (±5.1), participated in the study. Almost all women (91.3%) reported that their children had a primary care provider. The mean time to reach the GP/pediatrician’s office was 16 minutes (95% CI 14.6 - 16.7), longest for residents of small towns and villages (21 minutes), p = 0.004. Parents from small towns (including villages) were six times more likely to experience financial difficulties related to their children’s healthcare services compared to those from the capital city (p = 0.047), as well as parents with low-income (p = 0.031). Emergency healthcare was the most demanded service by families with children under 7 years old, possibly due to its free availability. Parents with secondary education and from small towns lack access to non-medical health-promoting or preventive services such as breastfeeding consultations, speech therapy and others.

Conclusions

Significant financial and geographic disparities in access to early child health services exist in Bulgaria.

Key messages

• There are serious social health inequalities related to the access to outpatient child health services in Bulgaria.

• There is an urgent need for specific child and family health strategy based on the principles of proportionate universalism.
A Framework for Bariatric Surgery Patient Care: Patient and Professional Perceptions
Authors: Mendes C , Carvalho M , Gregório J
Published: October 2024

Introduction

A multidisciplinary health team for perioperative care of the bariatric patient, sustained in a viable framework to support a long-term follow-up service, may decrease rates of complications, help the recognition of the complexity of this chronic disease, and provide a comprehensive bariatric surgery process analysis. This study aimed to analyze patients’ and professionals’ experiences with the perioperative care process and identify their perceptions of the bariatric surgery process to support the long-term management of obesity surgical treatment.

Methods

This qualitative study was conducted in a bariatric surgery center in south Portugal. Seven health professionals participated in one focus group, and sixteen patients participated in one of the three focus groups. Patients’ focus group script had eleven open main questions with follow-up questions to probe for more information, addressing motivations, experiences with the pre-surgery and post-surgery process, and perceptions of lifestyle changes.

Results

Participants reported the need for a reference professional in the hospital to contact, the importance of psychological support to help patients deal with the ‘ups and downs’ of post-surgery life, and the financial support for physical activity programs.

Conclusions

This research helped identify a need for a framework for long-term follow-up and showed priorities to tailor health services for managing bariatric surgery patients. New bariatric surgery programs should incorporate a diverse health team, focusing on patient support in the long-term follow-up. This team should be led by a dedicated case manager and include physical activity specialists.

Key messages

• The positive effects of bariatric surgery go beyond weight loss, reinforcing the importance of developing a new conceptual framework based on a patient-centered care model.

• A case manager specialist on the bariatric surgery process may be the key to improving the long-term benefits of bariatric surgery.
Hospital satisfaction among older adults by European Union health system clusters
Authors: Pasupathy R , Hossein R , Queen C
Published: October 2024

Background

Health systems are influenced by political, historical, cultural and socio-economic factors and differ across countries. Classification of EU health systems into 5 clusters has allowed for international comparison and policy recommendations. This study is based on the Andersen’s Behavior Model, that predicts that a sequence of predisposing, enabling and need factors influence satisfaction and utilization of healthcare services.

Aim

Examine the nature and relationship of predisposing, enabling and need factors associated with hospital satisfaction of older adults across EU nations by health system classification clusters.

Methods

Data from Wave 9, of the Survey of Health, Ageing and Retirement in Europe (SHARE) were examined using a sample of older adults from 10 EU countries. Analysis: Non-parametric one-way ANOVA (Kruskal- Wallis test) and Multinominal Logistics regression were performed to test the null hypothesis that (1) hospital satisfaction is equal across all clusters, and (2) predisposing, enabling, and need factors, are not predictors of hospital satisfaction.

Findings

There was a statistically significant difference in hospital satisfaction by cluster [Chi Square= 231.44, df = 21; p< .001]. Age, mental health, technology and chronic disease are predictors of healthcare facilities satisfaction. [Chi Square 50.94, df = 3, p< .001], Among those that reported to be highly unsatisfied with healthcare facilities, [chronic disease (Beta = -2.64) and mental health (Beta = -4.41) df = 1 p< .001] significantly predicted hospital satisfaction. Implications for Policy and Practice: Initiatives for the care of older adults should not only aim to increase access to care but also provide targeted services for sub populations such as older adults with mental health and chronic diseases. Further, significant investment is required in technology infrastructure within hospitals and technological assistance or training should be provided to older adults.

Key messages

• Older adults satisfaction with hospitals varies by health system clusters and is predicted by age, mental health, use of technology and chronic disease.

• Chronic disease and mental health are strong predictors of hospital dissatisfaction among older adults.
Semmelweis University’s innovative Center of Preventive Services in support of healthy ageing
Authors: Fazekas-Pongor V , Fehér Á , Fekete M , Varga P , Ádány R , Moizs M , Torzsa P , Purebl G , Ungvári Z
Published: October 2024

Issue/problem

Europe’s aging population presents substantial hurdles for healthcare sustainability. To alleviate the social and economic impacts of age-related diseases, promoting healthy aging is imperative. However, motivating individuals to adopt a healthier lifestyle proves challenging.

Description of the problem

Semmelweis University, a leading institution in medicine, health sciences, and health care in Hungary and Central Eastern Europe, has addressed this challenge by establishing the Center of Preventive Services (CPS), serving 12,500 Semmelweis University employees. The CPS conducts comprehensive health risk assessments and offers consultations with specialists in preventive medicine, public health, dietetics, physiotherapy, and health psychology. Motivational interviewing is used to enhance patient engagement and commitment to healthy lifestyle changes.

Results

The CPS has effectively integrated preventive services into the university’s healthcare system, reaching a significant number of employees. Early results show improvements in participants’ lifestyle and health behaviors due to the effective use of motivational interviewing. According to the first preliminary result, a study on step count conducted within the CPS found that those taking part in motivational interviewing session were able to increase their average daily step count by 1074 (95% Confidence Interval: 116-2033) steps more than controls.

Lessons

The Semmelweis University’s CPS provides valuable lessons for integrating healthy aging-focused preventive care into healthcare systems: 1. Effective preventive care requires targeted interventions based on detailed risk assessment and motivational interviewing; 2. Embedding preventive services within existing health infrastructure improves accessibility and utilization; 3. Collaborative and multidisciplinary approaches are essential to comprehensively address the needs of ageing populations.

Key messages

• Motivational interviewing boosts the effectiveness and engagement of preventive health services, which is essential to meet the challenges of ageing populations.

• The Semmelweis University’s model program shows that embedding preventive services into the infrastructure of existing institutions like universities is scalable for better public health.
A socially interactive communication skills training for competent health educators
Authors: Middleton N , Papapetrou M , Moore M , Nicolaou C , Karanikola M , Kyranou M , Kassianos A , Hadjigeorgiou E , Orpahnides-Eteokleous I , Kolokotroni O
Published: October 2024

Background

Every contact with expectant and new parents can be a “teachable moment” for promoting the health of mother-baby-family; yet, healthcare providers may not effectively perform their educational role. Previous studies have described various setting-specific challenges. Procedural knowledge, resulting in lack of confidence and avoidance, is a universal theme, challenging current communications skills training. Given the evolving role of midwives under the new Cyprus National Healthcare System, there is need for innovative practices.

Objectives

“Baby Buddy Communicators” designed, implemented and piloted tested a socially interactive digital environment on the Edubreak platform, where practicing (N = 8) and in-training (N = 7) Midwives completed an 8-week iterative hybrid communication skills course along with service-users.

Results

Four situational-based scenarios were co-created with ‘holders of the experience’ tapping on key priorities (elective caesarean, breastfeeding challenges, baby in NICU, postnatal depression). Participants produced video artefacts of role-play consultations and engaged in peer-to-peer and service-user feedback via the in-built video annotations and blog writing tools. Deductive content analysis of the rich material using the 18-item Health Professionals Communications Skills (HPCS) scale identified recurrent patterns tapping on both informational aspects (e.g. incomplete information gathering, overload without assessing comprehension) as well as social skills (e.g. agenda setting, early reassurance, assertiveness).

Conclusions

This cross-sectoral transfer of social video from sports training to healthcare is a “proof of concept”. Inverted (i.e. making current practices visible) and experiential learning (e.g. feedforward) with cross-sectoral (service-user involvement) and cross-module dimensions (i.e. communication skills and evidence-based practice) provided the basis for evaluation and a source of shared learning and reflection.

Key messages

• Several areas of improvement in communication skills of maternal healthcare providers were identified while peer-to-peer and service-user feedback was a source of reflection.

• The use of digital technology and social video allowed immersive role-playing, observation and constructive feedback loops providing a new paradigm in health communication skills training.
Strategies for primary healthcare in Ukraine: An integrated response to gender-based violence
Authors: Gheorghita S , Skipalska H , Piven N , Bruni E , Goncharuk V , Castillo T
Published: October 2024

Issue/problem

Survivors of gender-based violence (GBV) and conflict-related sexual violence (CRSV) in Ukraine face significant challenges in accessing appropriate healthcare services. Despite governmental commitment, acknowledgment and regulatory frameworks, including the ratification of the Istanbul Convention, gaps persist in integrating comprehensive GBV/CRSV services into primary healthcare (PHC) settings, exacerbated by the ongoing conflict with Russia.

Description of the problem

An analysis of healthcare providers’ knowledge has revealed deficiencies in effectively supporting GBV/CRSV survivors. Barriers include workload pressures, lack of inter-sectoral cooperation and case-management protocols, and insufficient training opportunities on survivor support. In collaboration with the World Health Organization, the global Clinical Management of Rape (CMR) guidelines was adapted for Ukrainian context. Among findings from CMR trainings attended by 443 PHC providers in 2022-2023 (213 participants in 2022 and 230 participants in 2023), the results underscore gaps in PHC workers’ basic knowledge and readiness to effectively support survivors during the war.

Results

Data from WHO training sessions underscored significant gaps in knowledge among healthcare professionals regarding legal protocols, available resources, and best practices in PHC service delivery. Identified barriers emphasized the urgent need for targeted interventions to enhance PHC workers’ capacity in GBV/CRSV response.

Lessons

Recommendations focus on systemic enhancements including revising regulatory frameworks, developing standardized protocols, and institutionalizing and providing comprehensive training programs. Innovative approaches like online courses, mentoring programs, and integrated service models are crucial for addressing multifaceted challenges.

Key messages

• A holistic GBV/CRSV response is an essential component in PHC.

• This intersectoral survivor-centered approach provides safe spaces that can be adapted to other contexts in Europe.
Reorganisation of the emergency network in the province of Verona
Authors: Dragoni L , Palladini F , Signorelli D , Valerio A , Messina G , Nante N
Published: October 2024

Background

In recent years, in the provincial context of Verona, has been perceived an increasing pressure on the Emergency Room (ER). There was therefore a need to identify possible actions to optimize the emergency network. The aim of the study was to evaluate the impact of the first corrective measure implemented: the redistribution of the municipalities’ afferences.

Methods

Data on the actual number of beds in each facility and on the emergency equipment were obtained from the various medical directions. Once the population/bed index had been calculated, it was adjusted according to the characteristics of the various facilities. Based on these data, the redistribution of afferences was carried out. The period monitored in the study covers the first three months after the reorganisation (January 2024) in comparison with the same period in 2023. The data collected were used to calculate both activity indicators for the PS and the Urgent Emergency Medical Service (UEMS).

Results

With a stable number of calls recorded in the two periods examined (20,366 in 2023 and 20,255 in 2024), with regard to the locations affected by the redistribution of municipalities, there is a decrease in the number of ambulance calls in San Bonifacio (-7.5%) and Villafranca (-16.2%) and an increase in Peschiera (+13.6%) and Negrar (+16.5%) compared to the quarter of the year 2023. There is no significant increase in Borgo Roma.

Conclusions

The organizational structure of the emergency services in the province of Verona is part of a highly complex framework. In any case, this first change has proved to be effective in addressing some of the factors influencing the contribution of the ER, but the overall impact and extent of the change will have to be studied in depth in order to optimize the network as much as possible.

Key messages

• The reorganisation of such a complex area is a very difficult challenge, but the path we are taking seems to be the right one.

• It will also be necessary to act at the level of the internal processes of each ER in order to successfully complete the reorganization.
A national job profile for infection control nurses in public health: the development and content
Authors: Noorland S A , De Groot K , Francke A L , Batenburg R S
Published: October 2024

Background

The COVID-19 pandemic emphasized the crucial role of infection control nurses (ICNs) in public health. ICNs working in multidisciplinary infection control teams face challenges, such as new infectious disease outbreaks and vaccination hesitancy. Recognizing the complexity in this domain, Dutch ICNs in municipal public health services expressed the need for a national job profile describing their tasks and responsibilities.

Methods

A mixed methods approach was used to develop a job profile. National and international documents on infection control professionals were studied by desk research. Insights from Dutch infection control professionals and experts were collected through a survey (n = 171), two interactive discussion meetings (18-22 participants) and meetings with an advisory group of stakeholders, including representatives of the Dutch nurses’ association. Descriptive statistics and deductive content analysis were used to analyze the data.

Results

The diverse methods facilitated the development of a job profile for Dutch ICNs. The profile describes that, within infection control teams, ICNs play a key role in coordinating and monitoring infection control measures. They facilitate collaboration among (at-risk) individuals, the infection control team, and the collaborating partners. Additionally, ICNs identify emerging risks for infection control and coordinate infection prevention activities in collaboration with the infection control team. During large-scale outbreaks, ICNs take a leading role and, where appropriate, delegate tasks such as contact tracing to crisis workers.

Conclusions

We developed the first job profile that outlines the tasks and responsibilities of ICNs in Dutch public health services. It contributes to strengthening infectious control services to face future challenges. Findings emphasize the ICNs’ pivotal role in coordinating and monitoring infection control efforts, while enhancing collaboration, even during large outbreaks.

Key messages

• In close collaboration with infection control professionals a robust job profile was developed, describing the tasks and responsibilities of infection control nurses in the Netherlands.

• The new job profile contributes to strengthening the position of infection control nurses working in municipal public health services and infection control teams.
Preventive Resilience: The Role of Long-Term Care Organizations’ Collective Agency Capacity
Authors: Pfaff H , Pförtner T , Hower K
Published: October 2024

Background

The COVID-19 pandemic has intensified pressure on healthcare organizations (HCOs), particularly long-term care organizations (LTCOs. An HCO’s resilience is closely linked to its proactive ability to address and manage both novel and persistent stressors. This proactive approach, termed ‘preventive resilience,’ involves preemptively averting stressors to safeguard the organization’s resilience mechanisms.

Objectives

The aim of this presentation is to examine the hypothesis asserting that preventive resilience is, to a significant extent, nurtured by the collective capacity of a Long-Term Care Organization (LTCO) to act and react as a cohesive social system. This collective agency capacity of an LTCO is posited to play a pivotal role in fortifying preventive resilience of HCOs.

Methods

We conducted a pooled cross-sectional study on long-term care organizations in Germany during the initial (April 2020) and subsequent waves of the pandemic (December 2020-January 2021). Our sample comprised 503 leaders during the first wave and 294 leaders during the second wave from various long-term care organizations. The study involved top managers of these facilities reporting their perceptions of the collective agency capacity of the LTCO, assessed using the AGIL short scale. Additionally, they were asked to gauge the facility’s exposure to both general non-pandemic demands and pandemic-specific demands.

Results

We discovered a notable inverse relationship between leaders’ perceptions of the collective agency capacity within their Long-Term Care Organizations (LTCO) and their assessments of general demands. However, no significant association was observed between the agency capacity and the magnitude of pandemic-specific demands.

Conclusions

The findings tentatively endorse the notion that cultivating the collective agency capacity of nursing facilities enhances their resilience to familiar general demands, particularly during periods of exceptional stress.

Key messages

• Cultivating the collective agency capacity of nursing facilities enhances their resilience to familiar general demands.

• The collective capacity to act and react in a cohesive way is a general resistance resource of healthcare organizations.
Pertussis on the territory of Serbia in 2024 - challenges and opportunities for the future
Authors: Jovanovic V , Grego E , Pavlovic L J , Jovanovic S , Gospodinovic H , Ivanovic J , Ivanovic M , Veljkovic M , Cabrilo M
Published: October 2024

Introduction

Surveillance of pertussis in Serbia is passive surveillance and every 3 to 4 years an increased number of positive cases are registered in the population. The last quarter of 2023 and the first quarter of 2024 are characterized by an increased number of pertussis cases.

Methods

Descriptive study of cases with confirmed pertussis in the territory of the Republic of Serbia based on the evidence by the Public Health Service System of the Institute of Public Health of Serbia

Results

According to data from the Public Health Service System in the Republic of Serbia, a total of 1348 confirmed cases of pertussis were registered by the end of April 2024 (incidence rate 20.2 per 100,000 inhabitants).

Conclusions

The largest number of cases was registered in the age groups of people older than 20 years, that is, aged 10 to 14 years, while the highest age-specific incidence rate was recorded in the age group of infants younger than 12 months and in children aged 10 to 14 years. Of the total number of reported cases, 120 (8.9%) were hospitalized, with the largest number of those hospitalized being in the age group younger than 12 months (85, ie 70.8% of hospitalized cases). As for the territorial distribution, the largest number of pertussis cases in relation to the place of residence was reported from the territory of two districts, Južnobački District and the City of Belgrade, where the highest incidence rates were also registered. The postponement of timely vaccination against pertussis and the impossibility of vaccinating newborns up to 2 months of age have influenced the increase in the number of infected persons. Also, advanced PCR diagnostics during Covid and the possibility of applying PCR diagnostics in pertussis helped the timely diagnosis of pertussis. The introduction of vaccination with another dose of acellular pertussis vaccine and vaccination of pregnant women would be a desirable public health intervention to prevent pertussis infection.

Key messages

• Protection of the target population before starting school and at the age of 14 will contribute to stopping the occurrence of new cases of pertussis. These are public health challenges.

• PCR diagnosis of pertussis influenced the timely diagnosis of this infection and the possibility of its adequate and timely treatment.
Factors associated with over-the-counter drug misuse among young people: a narrative review
Authors: Tushar M I , Kersbergen I
Published: October 2024

Background

Over-the-counter (OTC) medications are sold directly to customers without requiring a doctor’s prescription. Misuse of OTC drugs is higher in adolescents and young adults than in the general population. This review is the first to narratively synthesize the factors associated with OTC drug misuse among adolescents and young adults (14-25 years old).

Aim

To identify the factors that are associated with OTC drug misuse among adolescents and young adults (14-25 years).

Methods

A comprehensive search of three electronic databases, including MEDLINE, PsycINFO and Web of Science, was conducted to retrieve publications between 1 January 1997 and 31 July 2023. The AXIS tool was used to aid critical appraisal. Papers were analysed using thematic analysis.

Results

Eight studies were eligible for inclusion in this narrative review We identified four key themes: motivational factors; health literacy; illicit drug use and socioeconomic status. Sensation-seeking and using OTC drugs for recreational purposes were associated with OTC misuse. Limited health literacy and lack of understanding of OTC drugs were significant factors for misusing OTC drugs. Greater use of OTC drugs at the same time as alcohol and other illicit drugs represented that they were at increased risk for misusing OTC drugs. Finally, adolescents and young adults with low income, from rural areas and with lower educational attainment were most likely to misuse OTC drugs.

Conclusions

Although over-the-counter medications (OTCs) encourage self-medication, their rising misuse has led to a public health problem to which nations worldwide are responding. Therefore, education and awareness among OTC drug users policy will be helpful further on strategies to prevent the misuse of OTC drugs.

Key messages

• This review identifies some of the factors for misusing OTC drugs, and education and awareness among OTC drug users policy may be helpful further in strategies to prevent the misuse of OTC drugs.

• This review also identifies that changing the user habits and availability of OTC drugs policy may also be helpful in further strategies to prevent the misuse of OTC drugs.