bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health Communication needs of health professionals in Europe – the H-COM cross sectional study
Authors: Zota K , Karnaki P , Veloudaki A , Tsiampalis T , Linos A 
Published: November 2019

Abstract

Background
Effective communication between Health Professionals (HP) and patients is crucial for the overall functioning of the healthcare system with positive impacts on readmission rates, treatment outcomes, adherence and costs. However, health communication training is limited especially during medical training. In the framework of the EU H-COM project an exploration of health communication needs and gaps and preferred training methods was performed among HP.

Methods
A cross-sectional online survey was conducted among 702 health professionals (Physicians: n = 315; Nurses: n = 258; Other: n = 129) through a purpose made questionnaire available in English, Greek, Polish, Spanish and German.

Results
Health communication training is considered necessary for physicians (89.8%) and nurses (89.7%), although 42.4% of them never received relevant training in the past. Professional status (p &lt; 0.001), age (p = 0.079), gender (p = 0.090) and years of experience (p = 0.012) affected the likelihood of not having received such training, with physicians, HPs aged 45-54 years old, males and those having 6-10 years of experience being most in need. At least 50.0% reported encountering problems in communicating with their patients and facing several barriers either in primary health care settings and hospitals or in private practice. The ability to listen and answer patients, deliver bad news and obtain medical history were the most important communication skills identified, while the most suitable training method was learning relevant practical skills. The availability of such trainings is reported as being fair or poor at all educational levels by the majority.

Conclusions
Health communication training is considered important although currently not available to the extent needed. This research provides evidence concerning the preferred type, frequency and mode of health communication training providing also insight on differences between various HPs.

Key messages
Health communication training is crucial but inadequate in Europe. There are specific training needs and preferences among HP which need to be considered. Health communication training needs to be adapted and tailored to professionals’ age, experience and status.
Engaging a wider public health workforce: bringing public health into architecture education
Authors: Marsh R , Pilkington P , Marco E , Rice L 
Published: November 2019

Abstract

Background
Current public health challenges necessitate the closer working of public health with built environment professionals. Despite growing evidence of benefits, there remains little progress in practice. Architects can play a key role in ensuring urban and building design is health promoting, however there is no requirement to teach health by architectural accreditation bodies across Europe.

Objectives
In the United Kingdom in 2010, the Public Health Practitioner in Residence programme (PHPiR) was established to address this situation. Public health professionals are embedded within the Faculty of Environment and Technology at the University of the West of England, and contribute to research, pedagogic programme development, teaching and mentoring. The aim was to embed public health concepts and issues into architecture training, to empower the profession as part of the wider workforce, to improve health and wellbeing when designing buildings and places. The PHPiR was evaluated using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework. Data was collected (questionnaires, focus group, semi-structured interviews, programme documentation) on a Masters of Architecture cohort (N = 34) at intervals from 2011-2019 to see if the PHPiR has long lasting effects as students enter practice.

Results
Public health concepts including; inequalities, life course approach, and social capital, became embedded into the architecture curriculum. Projects produced had increased reference to wider health promoting issues and participants thinking shifted from the building itself to who would use the building, suggesting the intervention achieved its aims.

Conclusions
The PHPiR offers a novel approach for built environment professions to better understand public health issues and the relevance to their chosen fields. This model could be applied to other courses and replicated in educational institutions and public health training programmes across Europe.

Key messages
The PHPiR influenced the architecture curriculum, improved architects understanding and public health issues and concepts, and empowered them to create more health promoting environments. Embedding public health professionals into training for other disciplines may be an effective, sustainable method for increasing the wider public health workforce.
Human Resources for Health challenges during health emergencies—low number of workers in El Salvador
Authors: Amaya MP Amaya 
Published: November 2019

Abstract

El Salvador is one of the 57 countries considered to be in Human Resources for Health (HRH) crisis according to the World Health Organization (WHO). El Salvador’s healthcare worker density is 1.95 health professionals per 1,000 population, with even lower numbers in certain departments of the country. There have been improvements in the distribution of healthcare workers since 2010; however, on average it has remained “in crisis” based on the 2006 World Report definition. The increase in vector borne diseases in the region, has resulted in an overwhelmed vector control system and public health sector in many Central American countries. This study aims to analyze whether the healthcare workers identify the numbers of HRH as a factor that affects the health system response during health emergencies.
Through an extensive review of scientific literature, country reports, 16 meetings and 34 in depth semi-structured interviews with key stakeholders; this paper explores the challenges healthcare workers faced and how they were influenced by the numbers of available HRH during recent arboviral epidemics in El Salvador, using the recent Zika epidemic as a point of comparison.
The study findings suggest that some of the barriers that the health workforce identified during health emergencies include factors related to the low availability of HRH such as feelings of tiredness, being overwhelmed, as well as a need to rely on doctors in their social year in some areas of the country. Despite this, they also recognize that the recent intersectoral work done by the government and the Ministry of Health, has helped to overcome the obstacles of a low healthcare workforce by involving other sectors of society into the emergency response. Therefore, there is not a clear consensus on how the low number of HRH affect the health emergency response.

Key messages
The study findings suggest that some of the barriers that the health workforce identified during health emergencies include factors related to the low availability of HRH. They also recognize that the recent intersectoral work done by the government and the Ministry of Health, has helped to overcome the obstacles of a low healthcare workforce.
Informal carer in Portugal: moving towards political recognition in Portugal
Authors: Fronteira I , Simoes J , Augusto G 
Published: November 2019

Abstract

Informal care represents around 80% of all long term care provided in EU countries. Nevertheless, the needs for this type of care are expected to increase in the coming years in all OECD countries.
Portugal is among the OECD countries with the highest ageing index (21.5% of the population was older than 65 years in 2017) due to high life expectancy and low fertility rates. As this demographic trend establishes, Portugal is expected to have more than 40% of the population over 65 years in 2037, and the expected prevalence of dementia is 3%, in 2050. In 2015 there were 2.1% of people over 65 receiving long-term care, representing 52% of all long-term care users. Around 38% were receiving care at home. It is estimated that 287,000 people in Portugal depend on informal carers.
The agenda towards the official recognition of informal cares has been push forward in the country. Since 2015, several recommendations have been issued by the Parliament as well as legislative initiatives and a proposal for a Status of the Informal Carer is currently under discussion. We analyse the process of formulation of this policy in terms of sectors and stakeholders involved, definition and scope of informal carer, rights and obligations, role of the person being cared for, formal protection (e.g., labor, social, financial, training) and implementation.
Recognition of the informal carer is a sector wide approach. One of the main features is the economic, social and labor protection mainly through reconciliation between work life and caring activities and promotion of the carer’s well being. Notwithstanding, and from a health system perspective, community health teams are to be the focal point for informal carers, supporting and providing specific training whenever needed. Despite its relevance, informal care should not be professionalized and responsibility of care should not be shifted from health services to informal carers.

Key messages
Needs for informal care are expected to increase in the coming years in OECD countries. Recognition of the informal carer is a sector wide approach.
Attitudes of social welfare professionals of the concept of positive health in the Netherlands
Authors: van der Meer N , Dierx J A J 
Published: November 2019

Abstract

The current definition of health from the World Health Organisation seems to no longer meet the changes in the current Dutch health system. An alternative approach which puts emphasis on health, not disease, is Positive Health. The current and future developments in the health care system in the Netherlands are demanding different mentality and practice methods of social work and welfare professionals. In order to measure the extent to which there is support for positive health among the social welfare professionals, research must be carried out into the attitude of the professionals. In this study, the attitudes towards the concept of Positive Health of social welfare professionals are examined.

Methods
A mixed-method study was used, in which both quantitative and qualitative data were collected. By means of a survey (n = 128) and semi-structured interviews (n = 9), the attitude and working method of social workers were explored.

Results
Social welfare professionals find that the concept Positive health can contribute to an increase in resilience and self-management in citizens and patients. However, social welfare professionals wonder if all citizens and patients have the ability to self-manage skills. In addition, social welfare professionals think all domains of the positive health concept are regarded as important in defining health.

Conclusions
The concept of positive health is in line with the attitude of social welfare professionals and has support for implementation. In order to introduce the concept Positive Health further and to make it stand out in the social welfare domain, more attention needs to be paid to disseminating the concept, broadening the knowledge of the professionals and practical tools for practice.

Key messages
Positive Health concept connects professionals in health care and welfare. The concept of positive health is in line with the perceptions of health of the social welfare professionals.
Parental mental vulnerability and use of healthcare services in infants
Authors: Heuckendorff S , Johansen M B , Overgaard C , Johnsen S P , Fonager K 
Published: November 2019

Abstract

Background
Parental mental illness has been associated with a number of consequences for the health and use of healthcare services of the child. However, most research has focused on maternal depression. Research examining the impact of paternal mental vulnerability (MV) as well as different degrees of MV are needed to plan interventions. Therefore, the aim of this study was to examine the association between different categories of individual and combined parental MV and the child’s use of healthcare services the first year of life.

Methods
A population-based birth cohort study was conducted including all Danish children born from 2000-2016 using the Danish national registers. Exposure was parental MV of three categories according to the degree of MV: Group 1 “minor MV” with mental related contacts to primary healthcare and/or prescribed psychopharmaceuticals, group 2 “moderate MV” and group 3 “severe MV” both with contacts to psychiatric hospital. Outcome was contacts to GP the first year of life expressed as incidence-rate ratios (IRR) using Poission’s regression analyses.

Results
The analyses included 952,709 children. 21% of the mothers and 11% of the fathers were in the MV groups. Parental MV (any parent, any MV-group) was associated with an increased risk of GP contacts daytime and out-of-hour contacts. If both parents were classified as group 1 MV, IRR were 1.21 (CI95 1.20-1.22). IRR were 1.18 (1.17-1.18) resp. IRR 1.05 (1.04-1.06) if only the mother resp. father were in MV group 1. The same pattern were seen for out-of-hour contacts; IRR 1.28 (1.26-1.31) for both parents in group 1 and IRR 1.19 (1.18-1.20) resp. IRR 1.09 (1.08-1.11) for the mother resp. father.

Conclusions
Maternal and paternal MV were associated with an increased risk of GP contacts daytime and out-of-hour contacts although maternal MV had the highest risk. Even minor MV had an impact on healthcare contacts and the risk increased further if both parents were classified as minor MV.

Key messages
Both maternal and paternal mental vulnerability has an impact on the child’s healthcare contacts. Our results indicate the need for a focus also on minor mental vulnerability in the planning of interventions.
The effectiveness of a web-based Dutch parenting program to prevent overweight in children age 9-13
Authors: Ruiter E L M , Molleman G R M , Fransen G A J , van der Velden K , Engels R C M E 
Published: November 2019

Abstract

Background
We developed a web-based parenting program for parents entitled “Making a healthy deal with your child”. This e-learning program can be incorporated into existing prevention programs, thereby improving these interventions by reinforcing the role of parenting and providing parents with practical tools for use in everyday situations in order to stimulate a healthy lifestyle.

Methods
The effectiveness was studied in a two-armed cluster randomized controlled trial. We recruited 548 parent-child dyads of children 9-13 years in the Netherlands who participated in an existing school-based overweight prevention program. Primary outcomes included the child’s dietary and sedentary behavior, and level of physical activity. Secondary outcomes included general parenting style, specific parenting practices (set of rules, modeling, monitoring), and parental self-efficacy. Multilevel multiple regression analyses in Mplus were conducted.

Results
87% of the parent-child dyads participated in the study and 47% of the parents in the intervention group completed 2 or more episodes of the e-learning. The score that parents gave to the e-learning is a 7.Main effect analyses showed in the intention-to-treat analyses that the the parents in the intervention group have more strict rules regarding eating snacks (0.046) and children of parents in the intervention group drink more milk (p = 0.018) and less sugar sweetened beverages (p = 0.024). The completers only analyses showed that the children of parents in the intervention group eat more vegetables and fruit, drink more water and less sugar sweetened beverages, and had less screentime than the children in the control group.

Conclusions
The e-learning program showed small indications to be effective. A second effectiveness study is currently being investigated. If the e-learning proves to be effective it can be easily incorporated into existing overweight prevention programs for children, as well as activities regarding Youth Health Care.

Key messages
The e-learning can easily incorporated into existing overweight prevention programs for children. www.gezondeafsprakenmetjekind.nl
Early socioeconomic circumstances and cardiometabolic health in 10-year-old children
Authors: Soares S , Santos A C , Peres F Soares , Barros H , Fraga S 
Published: November 2019

Abstract

Background
Social adversity is thought to become biologically embedded during sensitive periods of development, setting children on a trajectory of increased risk for later chronic diseases. Thus, social differences are expected to be expressed as biological alterations and might have their origins in early life. Therefore, we aim to estimate the association between early socioeconomic position (SEP) and cardiometabolic health during childhood.

Methods
Data from 2962 participants in the population-based birth cohort Generation XXI, from Porto, Portugal, was collected following standardized procedures at all study waves. Early SEP definition included household income, parental education and occupation at child’s birth. Cardiometabolic health was characterized at the age of 7 and 10, considering the triglycerides, cholesterol, fasting glucose, body mass index, systolic and diastolic blood pressure. Logistic regression was used to estimate the association between early SEP and a favorable cardiometabolic health profile.

Results
A favorable cardiometabolic profile was observed in almost half of participants at both ages, particularly among high SEP children who remain more frequently without alterations. For girls, higher paternal education at 7 years (OR:1.49;95%CI:1.03-2.15) and higher SEP at 10 were associated with better cardiometabolic health profile. In boys, a better cardiometabolic health profile was observed with increasing levels in maternal and paternal education and occupation, but at the age of 10, social differences were more evident according to parental education.

Conclusions
We provide evidence that children from more advantaged SEP at birth have an increased likelihood of presenting better cardiometabolic health at early ages. Social differences in cardiometabolic health biomarkers are already found in childhood, suggesting that the short-term impact of early life SEP on the physiology dysregulation takes place already in the first decade of life.

Key messages
Social differences in cardiometabolic health are already established in the first decade of life, with children from higher SEP presenting a better cardiometabolic health. Cardiovascular events are not expected to develop during childhood, however the underlying atherosclerotic process might already be in course as social differences appear to widen with age.
Social-emotional problems among Swedish three-year-olds: an Item Response Theory Analysis
Authors: Vaezghasemi M , Eurenius E , Sundberg L R , Ivarsson A , Silfverdal S-A , Lindkvist M 
Published: November 2019

Abstract

Background
Young children’s social-emotional problems can have a long-term effect if not treated early. In order to deepen our knowledge about children’s social and emotional functioning, we utilized the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE) among 3-year-olds in Sweden aiming: 1) to identify ASQ:SE items that are most commonly endorsed by children with high level of social-emotional problems; and 2) to assess whether certain ASQ:SE items differs between boys and girls at the same level of social-emotional problems.

Methods
During 2014-2017 data was collected from 7179 three-year-old children through Child Health Care in a northern county of Sweden within the Salut Child Health Promotion Programme. Item Characteristic Curve (ICC) and Differential Item Functioning (DIF) were used to identify the characteristics of children with high social-emotional problems and to determine whether an item exhibit uniform between boys and girls at the same level of social-emotional problems.

Results
Items regarding interest in sexual words, too little sleep, disinterest in things around, unhappiness and self-injury were more commonly endorsed by children with high levels of social-emotional problems. Additionally, on the same level of social-emotional problem girls were more likely to score high in items regarding difficulties to occupy herself, clinging behaviour and repetitive behaviour while boys were more likely to score high in items regarding difficulty to name friends, difficulty to express feelings and destruction of things on purpose.

Conclusions
This study has increased our knowledge about Swedish young children’s social emotional functioning already at the age of three by detecting which items are most closely connected to high level of social-emotional problems and differences between boys and girls. However, whether the results detected in this analysis are reflecting their parents’ expectations more than child behaviour requires further investigations.

Key messages
Children with high level of social-emotional problems were rated high on items regarding interest in sexual words, too little sleep, disinterest in things around, unhappiness and self-injury. On equal levels of social-emotional problems, girls were more often reported with internalizing problematic behaviours and boys were more often reported with externalizing problematic behaviours.
Study on Children’s Health Program and Maternity Health Program, Bulgaria
Authors: Stefanov S 
Published: November 2019

Abstract

Introduction
The survey was conducted to establish the level access to the Children’s Health Program and the Maternal Health Program of the National Health Insurance Fund by marginalized groups. The survey was conducted in the period September-December, 2018 and covered 315 women from Nadezhda neighbourhood (Roma community),Sliven.The methodology used is social accountability and legal empowerment.

Methods
The survey was conducted through a face-to-face survey. A questionnaire was used with closed and open questions. Consultation with those people was anonymous. We used a “cold contact’ and a “snowball’ method.

Results
Almost all respondents - 97.7% - have a GP.All (who have the contact of their GP) can easily contact their doctor, although only 7 (2.3%) have the phone number of their GPs. Almost 90% pay part of the cost of treatment, few are cases of full payment or no payment.Quite low - 40.9% - are the rates of visits to the GP in the first month after birth and the appointed (mandatory and due) examinations. Only 45% were examined in the first month after birth by the testimonies of the respondents. It is imperative to take steps to raise the percentage of mothers who visit doctor’s office and receive an examinations.74.2% say they adhere to the children’s food-hygiene regime. The remaining 20.95% point out the lack of funds and the poor living conditions in the neighborhood (noise, stopping water, etc.) as reasons for not adhering to the regime. While only about 20% claim to have faced discriminatory treatment (just over 30% say they have not experienced it, and nearly half do not respond), there are indicative responses to discriminatory treatment - division in the maternity ward, offensive speech, etc.

Conclusions
The study achieves its goals - to provide an adequate picture of maternal access to prenatal and pediatric medical care, as well as the difficulties to ensure maximum care for children.

Key messages
Roma children are not treated equally under the Children’s Health. Roma mothers do not have equal access to the Maternity Health Program.