bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

Abstract

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

Abstract

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

Abstract

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

Abstract

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

Abstract

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 &lt; 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

Abstract

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

Abstract

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

Abstract

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

Abstract

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

Abstract

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.