bluuebunny/crossref_metadata_2025_split huggingface dataset:
1st European Academy for Healthcare Leaders: high training on leadership to manage health systems
Authors: Villani L , Frisicale E M , Parente P , Cacciatore P , Carini E , Gentili A , Grossi A , Pezzullo A M , Favaretti C , Ricciardi W 
Published: November 2019

Abstract

Background
Nowadays having leadership skills is critical to manage healthcare systems. The World Health Organization Collaborating Centre on Health Policy, Governance and Leadership organized the 1st European Academy for Healthcare Leaders in Rome from 15th to 17th November 2018. Senior officials of the Ministries of Health of 16 Members Countries of the WHO European Region attended and actively participated to the event, led by experienced Italian and European experts. The Academy could be considered a moment of high training on leadership and governance of health systems.

Objectives
The event was aimed at creating effective networks among participants to share ideas and strategies to improve leadership skills, providing practical tools to be applied in healthcare systems and to develop a common and transferrable leadership framework in Europe. Frontal lectures and interactive workshops covered three main areas: leadership skills, current challenges of health systems and sustainability of health systems today.

Results
The 3-days event gave the opportunity to discuss the main issues in Public Health highlighting how to be an effective leader in healthcare. Leadership should enable the translation of knowledge into productive action pathways, providing health equity and improving population’s health. At the end of the event, participants filled a survey and the results showed high satisfaction about contents (100% out of 16 participants).

Conclusions
Health systems need to change in order to face the formidable challenges of our times. This event empowered the participants in order to support the creation of strategies and to develop leadership tools to apply at country level. The experiences, ideas and good practices shared during this event strengthened a collaborative network and have been useful to identify common goals and solutions.

Key messages
These kinds of events are fundamental to improve knowledge about leadership in healthcare. Leadership should have a major role to play in healthcare worldwide.
Personalized Care Plan for non dependent old persons decrease significantly caregivers’ burden
Authors: Arlotto S , Gentile S , Durand A C , Bonin Guillaume S 
Published: November 2019

Abstract

Objectives
Informal care provided by family caregivers in old persons is associated to a high risk of burden and poor health status. This study aimed to analyze the impact of a Personal Care Plan (PCP) attributed to non dependant old persons living in the community on caregiver burden, satisfaction and frailty.

Methods
This non interventional longitudinal study was performed in the south East area of in France: olds persons asking for a PCP (&gt;70 years old, with no disability and no severe chronic disease, living at home) and their caregiver were included with a 6-months follow up. Dyads were visited at home by social workers. Caregivers Burden has been assessed with Mini-Zarit and frailty status with FiND (Frail Non-Disable).

Results
876 dyads (old persons: female 77.6%, aged 82.2 ± 5.8 years old; caregivers: 64.5% female, 29% spouse, 61% children; 64% with frailty and 38% with high burden; high burden being significantly associated with frailty) were eligible for a PCP. Among them, 564 PCP were financed, mainly: housekeeping and meal preparation. For those old persons who had PCP, near half of their caregiver decreased the time spent to these activities. With the PAP, 88% of the caregiver had a lower burden level, only 6% had a persistent high burden; 61,5% were totally satisfied. Frailty status was not modified.

Discussion
Our study highlight that the burden occurs also in non dependent old persons’s caregivers. Social support implementation for activity of daily living had a major impact on the burden but not on the caregiver frailty, which means that determinants of caregiver’s frailty are more complex and further studies are needed.

Key messages
Social support implementation for activity of daily living have a major impact on the burden; the burden occurs also in non dependent old persons’s caregivers. Personalized plan implemented to support activity of daily living improve caregiver burden even in non-dependent old persons.
Predictors of nursing-home entry for elders in Belgium
Authors: Berete F , Demarest S , Charafeddine R , Tafforeau J , Van Oyen H , Bruyère O , Van der Heyden J 
Published: November 2019

Abstract

Background
Due to the aging of the population the demand for long-term care services is expected to rise during the coming years. For a better planning of health care resources policy makers have to be aware of risk factors associated to nursing home entry (NHE). The present study aims to identify predictors of NHE in a representative sample of Belgian community dwelling older residents.

Methods
Date from the participants of the Belgian health interview survey (BHIS) 2013 aged 65 years and over were individually linked with longitudinal data from the Belgian compulsory health insurance data (BCHI) over a 5-year period (2012-2017). Institutionalized BHIS participants were excluded, resulting in a final database of 1,927 individuals. A multivariate Cox proportional hazards model was fit to estimate the hazard of NHE. The model examined the hazard of NHE over the follow-up period in function of predisposing, enabling and need variables observed at baseline. All analyses were done using SAS 9.3 taking into account the survey design settings.

Results
Over the follow-up period, 169 out of 1,927 individuals entered in NH (56% males, mean age =74.7±0.25). Significant predictors of NHE were older age (hazard ratio (HR) =2.40, CI = 1.23-4.67 and HR = 6.19, 95% CI = 2.75-13.92, respectively for 75-84 years and 85+ years compared to 65-74 years), living condition (HR = 4.28, 95% CI = 1.01-18.19 for living alone), severity of limitation in ADLs (HR = 2.61, 95% CI = 1.39-4.88 for moderate limitation and HR = 2.40, 95% CI = 1.10-5.26 for severe limitation, compared to those without limitation).

Conclusions
Apart from age and living condition, the ADLs limitations were the strongest predictors of NHE. Public health action to reduce NHE of older people should first of all focus on preventive action at middle age which will reduce activity limitations at later age.

Key messages
Risk profiles for NHE are highly dependent individuals. NH should be more specialized with qualified professionals.
Access to emergency care units by socially vulnerable patients: a qualitative research
Authors: Vieille M , Rotily M , Apostolidis T , Persico N , Galinier A 
Published: November 2019

Abstract

Background
The increasing prevalence of chronic diseases, the decline in medical demography, the ramp up of new information and diagnosis technologies, together with the growing health social inequalities urge decision makers to rethink the access to emergency care units (ECU) and reduce the rate of multiple admissions, especially for people living in vulnerable conditions. Beyond the medical causes of access to ECU, it is crucial to understand the psychosocial representations of patients and health professionals.

Methods
23 socially vulnerable patients who have already been admitted within the last 3 months and ECU health/social professionals were interviewed face-to-face by a psychosocial scientist using a semi-directed approach, in 3 hospitals. The thematic content of data was analyzed in order to identify salient social representations of access to ECU.

Results
27 themes emerged to understand the issue of the access to ECU, joining into 5 main categories: perceived needs for access to ECU, perception of precariousness, the relationship of patients and professionals with the healthcare system, the shared experience of aggressiveness in ECU, expectations in post-emergency support. As regards the needs for access to ICU, several issues were identified: exemption from making upfront payments, needs for listening, support, reinsurance, privacy and consideration of emergency professionals, referral by general practitioners (GP), difficult access to GP, needs for immediacy and timely healthcare services, permanent opening of ECU. As regards the experience of ECU professionals: ambivalent emotions towards socially vulnerable patients, a recurrence of passages leading to a reduced medical attention, a feeling of failure to care for vulnerable patients, coping strategies in caring for these patients.

Conclusions
Our results bring several leads to improve the organization and the management of healthcare in ECU and in primary care for socially vulnerable patients.

Key messages
To identify the psychosocial rationales of access to emergency care units provides several leads to build a more efficient healthcare policy and reduce the burden of overloaded services. To reduce the overburden of emergency services can only be achieved by a global approach of the access to both emergency and primary care and a better support after emergency discharge.
Effective elements of Dutch care-physical activity initiatives for low socioeconomic status adults
Authors: Mulderij L S , Wolters F , Wagemakers M A E , Verkooijen K T 
Published: November 2019

Abstract

Background
In care-physical activity (care-PA) initiatives, primary care and sports collaborate to stimulate PA among adults at risk of lifestyle related diseases. Preliminary results of Dutch care-PA initiatives for low socioeconomic status (SES) adults indicate that these initiatives successfully lower participants’ body weight and improve quality of life. However, insight into elements that make these initiatives work is lacking. Therefore, this research aims to unravel the effective elements of care-PA initiatives for low SES adults.

Methods
Concept Mapping (CM) was used as tool to identify and cluster the effective elements. Nineteen Dutch health promotion experts individually listed as many elements as they felt were of importance to the effectiveness of care-PA initiatives. Next, each expert was asked to cluster the elements and to score them on importance. Then, CS Global MAX software was used for multidimensional scaling and a hierarchical cluster analysis to develop a cluster map. Finally, the cluster map was presented, discussed, and refined in a group meeting with 11 of the experts.

Results
The experts came up with 113 unique effective elements of care-PA initiatives for low SES adults, clustered into 11 clusters: 1) approach of professionals, 2) barriers experienced during the programme, 3) local embedding, 4) customisation of the programme to target population, 5) social support, 6) methods within the programme, 7) competencies of professionals, 8) accessibility of the programme, 9) actions within the programme, 10) recruitment of participants, and 11) intersectoral collaboration.

Conclusions
A valuable overview of the effective elements of care-PA initiatives for low SES adults was created. The results can be used to improve existing care-PA initiatives and to develop new ones targeted at low SES adults at risk of lifestyle related diseases. This may eventually help to reduce health inequalities between low and high SES adults.

Key messages
Concept mapping has been a useful group-based tool to obtain information on the effective elements of care-PA initiatives, in which individual input from health promotion experts has been collected. The overview of effective elements of care-PA initiatives for low SES adults as presented in this study is valuable for the development of care-PA initiatives specifically targeted at low SES adults.
Understanding racism in Swedish healthcare
Authors: Hamed S H , Ahlberg Beth , Bradby Hannah , Thapar-Björket Suruchi 
Published: November 2019

Abstract

Background
Despite the removal of the term ’race’ from statutory documents in Sweden, after the Second World War, racism continues to exist in various institutions including healthcare. Racism can persist in the absence of a biological notion of ’race’ but becomes harder to explain when there is no official recognition. There is evidence of discrimination by patients and healthcare professionals, although fragmented and under-researched. As healthcare should be built on equity and solidarity, accounts of racism constitute a serious breach. Our research focuses on conceptualising racism in healthcare in Sweden to develop means of improving equity in care for populations characterised by migration-driven diversity.

Methods
Data from 28 qualitative interviews with both patients and healthcare professionals in Sweden was collected.

Results
Preliminary results indicate that patients from minority ethnic groups report that healthcare providers deem their symptoms as insignificant, due to their ethnicity. Consequently, they experience a loss of integrity and trust in healthcare, often leading them to avoid seeking healthcare. Healthcare professionals conceptualise racism in varied ways, ranging from denying racism, normalising and individualising racism to viewing racism as a structural problem. Patients did not report their experiences of racism, as racism was often subtle. Likewise, healthcare professionals mostly chose not to report their experiences for fear of being constructed as difficult colleagues.

Conclusions
The lack of space for discussing racism within healthcare constitutes a problem for healthcare professionals and patients and contributes to rendering experiences of racism invisible. This may be detrimental for achieving responsive healthcare and creates an unhealthy working environment for some healthcare professionals.

Key messages
Promoting a constructive dialogue on racism in healthcare. Aiding in developing anti-racist practices in healthcare.
Variation in uptake of Healthy Start Food Vouchers in the Six Health and Social Care Partnerships
Authors: Salim E , Scott S 
Published: November 2019

Abstract

Background
The primary aim of this study was to assess the difference in uptake levels of Healthy Start Food Vouchers, a means tested benefit to afford nutritious food, between 6 Health and Community Partnerships (HSCP) in Greater Glasgow and Clyde (GGC). Our secondary aim was to explore possible reasons for the observed variation.

Methods
Routinely collected Healthy Start data for the months of August to September 2017 were obtained from the UK Department of Health. Postcode sectors were matched up with their corresponding HSCPs in GGC. Analysis looked for associations between uptake rates and various HSCP area-based characteristics.

Results
Large variations were observed within GGC. Chi-square test showed a significant association between uptake and HSCP area (P &lt; 0.0005). Trend analysis of uptake with area deprivation (P = 0.001) and resource allocation (P &lt; 0.001) was also significant. Subjective analysis of trend direction suggested that uptake increased with deprivation and resource allocation of the HSCP.

Conclusions
Significant trends were found and the observed patterns suggested that the relationship between uptake rates and HSCP area is more complex than the geographical characteristics alone. Future studies need to look at the difference in management and awareness of the voucher scheme between Maternity teams in HSCPs.

Key messages
There is significant variation in the uptake of means tested benefits with some areas having a nearly forty percent of eligible individuals not receiving available support. A qualitative approach is required to determine the causes of low uptake rates of benefits and improve the effectiveness of maternity teams in different areas.
Intrapersonal/interpersonal factors related to alcohol use and smoking cigarettes among juveniles
Authors: Gajdosova B , Orosova O , Janovska A 
Published: November 2019

Abstract

Background
While there is consistent evidence that an early initiation of smoking and alcohol consumption is associated with a whole range of future negative outcomes, relatively little attention has been directed at a specific population of very young adolescents (10-12 years old). This study aimed to explore the relationships between alcohol use, smoking and intra/interpersonal factors among primary school pupils.

Methods
In this study (APVV-0253-11, APVV-15-0662) a representative sample of 572 early adolescents from a stratified random sample of 12 primary Slovak schools (50.1% boys, Mean age=12.49; SD = 0.59) was used. The respondents indicated their lifetime prevalence of smoking SM and alcohol use AU (dichotomized: 0-not used, 1-used) which was used as an outcome variable. Expectations of the effect of smoking and alcohol use (positive or negative), self-control and cigarette and alcohol refusal were used as the independent variables. Binary logistic regressions were performed and carried out separately for boys and girls.

Results
All 4 models were statistically significant for males (AU = 15.318, p &lt; 0.01, 9.8%, SM = 17.807, p &lt; 0.01, 9.8%) and also for females (AU = 25.204, p &lt; 0.001, 16%, SM = 47.05, p &lt; 0.001, 24.7%). The models showed that for boys there were significant associations between smoking refusal and smoking cigarettes 95%CI=0.845-0.97 and alcohol refusal and alcohol prevalence 95%CI=0.78-0.95. For girls, significant associations were found between smoking refusal and smoking cigarettes 95%CI=0.75-0.92, alcohol refusal and alcohol prevalence 95%CI=0.72-0.95, positive expectations 95%CI=1.04-1.20, negative expectations 95%CI=0.78-0.94, self-control 95%CI=0.91-1.00 and alcohol prevalence.

Conclusions
This study supports the importance of the specific role of refusal skills for both genders as well as the importance of the role of expectations and self-control with respect to gender differences.

Key messages
Implementation of the findings regarding the importance of specific refusal skills towards alcohol use and smoking among both genders might be important for effective targeting of prevention programs. The results show a similar trend regarding smoking which was observed among both genders but this was not seen in alcohol use.
Adolescent suicide behaviour profiles: comparing unplanned attempts, planned attempts and ideation
Authors: van Duin C , Catunda C , Heinz A , Willems H 
Published: November 2019

Abstract

Background
Suicide is the second leading cause of death for young people worldwide. A significant amount of suicide attempts is known to be unplanned, but research on unplanned attempts among adolescents is limited. As knowledge on the profile of unplanned suicide attempts is crucial for effective prevention efforts, this study aims to characterize and compare three suicide behaviour profiles among adolescents: planned attempts, unplanned attempts and ideation without attempt.

Methods
Data from the 2014 Luxembourgish Health Behaviour in School-aged Children study was used. 879 adolescents aged 12 to 18 years old are included in this study. Data was gathered using paper questionnaires. ANOVAs with Games-Howell post-hoc tests were conducted for 18 independent variables, using the suicide behaviour variable as the dependent variable.

Results
Unplanned attempters report higher levels of parental and classmate support (p &lt; 0.01), fewer health complaints (p &lt; 0.001), higher life satisfaction (p &lt; 0.01) and a more positive body image (p &lt; 0.01) than planned attempters and ideators. Unplanned and planned attempters are younger than ideators (p &lt; 0.01) and report more substance use and physical fighting than ideators (p &lt; 0.01).

Conclusions
Unplanned attempters report better health (behaviour) and more social support than planned attempters and ideators. Unplanned attempters and planned attempters have higher levels of risk behaviour than ideators. Prevention efforts should be mindful of similarities and differences between the behaviours, and identify and address at risk adolescents accordingly.

Key messages
Unplanned attempters have better health (behaviour) and more social support than planned attempters and ideators. Results are incorporated in the Luxembourgish national plan for suicide prevention.
Social capital and students’ health: results of the splash study
Authors: Backhaus I , Kawachi I , Ramirez A , Jang S , Khoo S , Al-Shamli A , Po-Hsiu L , Begotaraj E , Fischer F , Torre G La 
Published: November 2019

Abstract

Background
Universities around the world are challenged with rising rates of mental health problems among their students. Cumulative evidence demonstrated that aspects of the social environment, including social capital, play an important role in mental health. This study aimed to determine the prevalence of depressive symptoms among university students from across the globe and to investigate whether social capital was associated with depressive symptoms in university students.

Methods
A cross-sectional study was conducted in Albania, Brazil, Germany, Italy, Malaysia Oman, South Korea, Switzerland, Taiwan and the USA in 2018/2019. Data were obtained through self-administered questionnaire, including questions on sociodemographic characteristics and depressive symptoms. The BDI-S was used to assess the presence of depressive symptoms. Multilevel analyses were conducted to assess the relationship between social capital and depressive, adjusting for individual covariates (e.g. perceived stress and health behaviours) and country-level characteristics (e.g. democracy type).

Results
A total 3894 students participated. Out of all participants almost 47% presented clinically relevant depressive symptoms. The prevalence of depressive symptoms was highest among students identifying as other than male or female (48.7%), among students with low socioeconomic status (59.5%) and among students with low levels of cognitive (65.3%) and behavioural social capital (57.0%). Even after adjustment in multilevel logistic regression analyses, depressive symptoms remained significantly associated with low levels of cognitive social capital (OR = 1.49, 95% CI: 1.06 to 2.10) and low level of behavioural social capital (OR = 1.36, 95% CI: 1.08 to 1.71).

Conclusions
Social capital may play an important role in mental health problems in the university setting. The study identified significant opportunities for future research and health promotion strategies among students.

Key messages
Key factors associated with depressive symptoms among university students were low levels of behavioural and cognitive social capital. Health promotion programs targeting young persons with depressive symptoms should include effective components of social epidemiology such as social capital.