bluuebunny/crossref_metadata_2025_split huggingface dataset:
Educational requirements for Health Information Systems: A scope review of the literature
Authors: Beja A , Nogueira P , Lapão L V 
Published: November 2019

Abstract

Background
Sound and reliable information is fundamental to decision-making across all health system. New information technologies can contribute to a more accurate and efficient public health action, requiring new and more sophisticated skills to support this change. Considering the European context, where public health professionals vary by country and cover different areas, and the need for a skilled workforce, the objective of this study is to identify the basic educational components required for a public health information specialist. This study is part of the ongoing research under INFACT Joint Action.

Methods
A scope review (Pubmed/Ebsco, free access texts, no time restrictions) was carried out in order to answer the following question: Considering the set of activities of public health, what are the main topics and trends of the literature on both Human Resources and Health Information Systems (HIS) training? Abstracts were read by two reviewers and the select texts analyzed using HOT-FIT framework for HIS.

Results
Among the 53 records, it was possible to identify different study designs and elements related to different contexts and HIS. There is a trend for new publications, with a significant increase since 2014. The content analysis showed more frequent themes in three main categories - Human, Organization and Technology, allowing identifying a wide range of public health professionals and their educational needs.

Conclusions
Results reinforce the link between information systems and public health, showing the importance of regular HIS as data source for monitoring population health, specific events and determinants, management and research activities and during the stages of the planning cycle of public health activities. The proper workforce capacitation emerges as a success factor for HIS implementation, as well as several professional profiles that carry out public health activities and the areas where it is necessary to strengthen their training.

Key messages
There’s growing interest in the use of technologies for the development of public health information systems. Workforce needs to develop specific skills for the technological challenges in Public Health.
Community hygiene against lassa fever disease and its predictors in a Nigerian rural settlement
Authors: Gobir A A , Ejembi C L , Aliyu A A , Garba M B , Igboanusi C J C , Usman B , Umar Z Z , Istifanus I A 
Published: November 2019

Abstract

Background
Lassa fever disease (LFD) is a viral haemorrhagic fever that is endemic in some West african countries where an estimated 300,000 to 500,000 cases and 5000 deaths occur yearly. The World Health Organization described it as a global health threat. At community level, its prevention relies on promoting good “community hygiene”. This study was conducted to assess practice of community hygiene measures against LFD and its associated factors.

Methods
A cross-sectional, community based descriptive study conducted during a LFD epidemic in a a rural community of Nigeria. An interviewer-administered questionnaire was used to collect data from 556 adult respondents, selected using systematic random sampling technique. Data was analyzed using SPSS.

Results
A majority of the respondents were females (52.9%). Educational attainment was significantly associated with safe food storage at the multivariate level (aOR= 1.31, 95% CI: 1.10-1.54,P= 0.002) while having a good knowledge of LFD was a significant predictor of maintaining good housing standards (aOR= 3.73, 95% CI: 1.09-12.80,P=0.036).

Conclusions
Predictors of practice of community hygiene against LFD include education and having an excellent knowledge of LFD. To improve community hygiene practices in the community, there is need for a comprehensive LFD behavior change communication intervention.

Key messages
Cubing the global threat of LFD depends on its effective prevention in endemic West African communities. This study shows that such preventive measures are poor and there is need for more response to address the problem.
Sentinel physicians network in Reunion: an essential and key actor for epidemiological surveillance
Authors: Daoudi J 
Published: November 2019

Abstract

Issue/Problem
The surveillance of seasonal infectious diseases in Reunion is based on a Sentinel physician’s network of 52 volunteers, which is coordinated by the Indian Ocean regional office.

Description of the problem
The main objectives are to identify and monitor outbreaks of infectious diseases like influenza-like-illness (ILI) gastroenteritis, dengue, and conjunctivitis. A virological surveillance set up to characterize circulating respiratory viruses from a nasal swab collected by the physicians. Swabs are tested by RT-PCR for influenza in the reference laboratory.

Results
The surveillance demonstrated that the influenza season during the 2018 austral winter ran from September to October. More than 55 000 consultations related to ILI were estimated. The virological surveillance confirmed the circulation of A (H3N2) principally in 2018. The physician’s network identified the first cases of chikungunya in Réunion Island in 2005 and data collected by this physician’s network provide the epidemic trends with weekly estimation’s of total numbers of consultations in the Reunion Island. More than 25 000 community consultations of dengue-like-illness have been estimated. The physician’s network took part in the surveillance of conjunctivitis outbreak in 2016 and identified an outbreak of norovirus gastroenteritis in Reunion Island in 2007 and 2012.

Lessons
This network is an essential tool for disease surveillance and control activities.

Key messages
The network provides provisional virological and severity data on circulating influenza several months before the onset of influenza season in mainland France. The network is engaged and active which enables the early detection of any emergent diseases.
Situation analysis on evidence-informed health policy-making in Poland
Authors: Dubas-Jakóbczyk K , Kocot E , Domagała A , Mikołajczyk T , Adamski J , Kuchenmüller T 
Published: November 2019

Abstract

Background
Over the last few years, increased international attention has been paid to bridging the gap between health research and policy-making. The situation analysis on evidence-informed policy-making (EIP) in Poland aims to increase understanding of interactions among a country’s research and policy-making communities, to determine where and how to best establish a knowledge translation platform (KTP), i.e. an organization or network that through its structure and functioning brings the worlds of research and policy together.

Methods
The methods were guided by the EVIPNet Europe Situation Analysis Manual and included a literature review, key-informant interviews and survey data analysis.

Results
In Poland, the existence of incentives or requirements stipulating the use of research evidence in health policy varies, depending on the type of policy. The use of evidence is a standard practice in drug policy, and in decisions related to the inclusion of services in the health benefit package. In other areas, some good practice examples of using evidence in policy can be identified. Yet these are rather individual, isolated and bottom-up initiatives, which neither occur systematically, nor routinely. Key challenges in view of strengthening a systemic approach to EIP relate to: overlapping mandates of key health system and research institutions, generally low research capacity and lack of knowledge translation skills.

Conclusions
Establishing and operationalizing a KTP can be an effective means of supporting sustainable EIP. Building such infrastructure, however, is a longer-term and complex process that needs to be based on the current characteristics of the country’s EIP landscape. The proposed model of a future KTP in Poland is a network with a joint secretariat within the Ministry of Health. Such form can take advantage of existing organizations’ competencies via information exchange and cooperation.

Key messages
Although systemic mechanisms for evidence-informed health policy are missing in Poland, its importance is recognized among major health system stakeholders. The proposed model of a future knowledge translation platform in Poland is a network with a joint secretariat within the Ministry of Health.
Validation of a Screening Tool for Social Vulnerability in Pediatrics
Authors: Laporte R , Jouve E , Daguzan A , Gentile S 
Published: November 2019

Abstract

Background
Screening for social vulnerability is emphasized improve access and quality and of healthcare. In pediatrics although some specific tools exist, a global screening tool for social vulnerability and access to healthcare was missing. A Vulnerable Child Scale (VUCHIS) was developed with expert focus groups. It included short evaluation about several issues: medical follow-up, health assurance, children schooling, housing, close entourage, comorbidities, recent migration, language comprehension and food insecurity. Fifteen items were addressed in a short and easy to translate interview. The aim of this study was to validate this tool.

Methods
This multicenter study was conducted in two pediatric emergency departments in France. VUCHIS questionnaire was completed by the emergency department caregiver. Another blinded interview with a social worker, expert in social vulnerabilities diagnosis, was conducted to assess the need for care in a clinic for socially vulnerable children. Clinical exam was recorded. The main criteria for this study was the clinimetric properties of VUCHIS compared to the expert caregiver opinion.

Results
480 children were included. Their mean age was 8.3 years (SD = 3.8); 264 (55.0 %) were boys. The expert evaluation identified 57 (11.9 %) children with social vulnerabilities. VUCHIS ranged from 0 to 79 (mean = 6.9; SD = 14.7). ROC curve area was 0.83 (SD = 0.04). The selected diagnostic threshold was 10. This showed sensitivity = 0.70; 95% confidence interval (CI) = [0.56; 0.81]; specificity = 0.89; CI = [0.86; 0.92]; positive likelihood ratio = 6.60; CI = [4.77; 9.12] and negative likelihood ratio = 0.33; CI = [0.22; 0.50].

Conclusions
VUCHIS has good clinimetric qualities that will promote the screening of social vulnerability in pediatric clinical practice.

Key messages
Pediatricians need global and easy-to-use tools to implement social vulnerabilities in their clinical routine, especially in emergency departments. Implementing tool-mediated screening for social vulnerabilities in pediatrics prevent inappropriate orientation and prescriptions and poor therapeutic adherence.
Can nurses improve self-management among pediatric patients? A systematic review and meta-analysis
Authors: Mele A , Nardi A , Prencipe G P , Migliara G , Massimi A , Rega M L , Anderson G , Casasanta D , De Vito C , Damiani G 
Published: November 2019

Abstract

Background
Few studies report educational interventions for pediatric patients with asthma or diabetes type 1 as a fundamental instrument to engage them and improve their health. The aim of this systematic review and meta-analysis was to synthesize evidence about behavioral changes in life style, disease management and clinical outcome in pediatric patients after a structured educational intervention delivered by nurses.

Methods
A systematic review of the literature was carried out in MEDLINE, Scopus and CINHAL including only RCTs. Methodological quality of the studies was assessed using Cochrane tool. Meta-analyses on HbA1c reduction for diabetes and hospitalization, emergency department (ED) visits and medication for asthma were carried-out.

Results
Of the 3559 papers initially retrieved, 5 regarding diabetes and 19 asthma met the inclusion criteria for the systematic review and 14 for the meta-analyses. Included studies were highly heterogeneous in terms of type of intervention and follow-up duration. Almost all the studies showed an improvement but only few were statistically significant. All studies regarding diabetes showed a low risk of bias (only one RCTs had a high risk of bias in one domain), while almost all RCTs on asthma showed a high risk of bias. The pooled mean differences in favor of the experimental groups were: HBA1c -0.02 (IC95%: -0.26 - 0.22), Hospitalization 0.58 (IC95%: 0.19 - 1.78), Medication -0.10 (IC95%: -0.43 - 0.23), ED Visits 0.82 (IC95%: 0.44 - 1.54).

Conclusions
There is a general agreement about the central role of educational intervention delivered by nurses to pediatric patients and the assessment of the behavioral changes after educational interventions is strongly recommended in pediatric population. However, more efforts are requested in designing studies on patients with asthma and to program more appropriate follow-up and periodic recall in order to engage pediatric patients in the management of their own chronic disease.

Key messages
educational intervention delivered by nurses to pediatric patients with asthma or diabetes type 1 as a fundamental instrument to engage them. more efforts are requested in designing studies on patients with asthma and to program more appropriate follow-up and periodic recall in order to engage pediatric patients.
Exposure to car smoking among youth in seven countries of the European Union
Authors: Mlinarić M , Schreuders M , Mons U , Kunst A E 
Published: November 2019

Abstract

Background
In the USA and Canada, cars are a major source of secondhand smoke (SHS) exposure among youth. Little is known about the magnitude of this public health problem in European countries. In this report, we study SHS exposure in vehicles among adolescents across 7 member states of the European Union (EU), with a particular focus on socio-economic characteristics and adolescents’ smoking environment.

Methods
Data on self-reported SHS exposure in cars during the past seven days was obtained from the 2016/17 cross-sectional SILNE-R study from 14-17-year old adolescents in EU seven countries (N = 10,481). We applied two multivariate logistic regression models with sociodemographic characteristics and mediating smoking-related factors.

Results
SHS car exposure varied widely across the 7 EU countries: 6% in Finland, 12% in Ireland, 15% in the Netherlands, 19% in Germany, 23% in Portugal, 36% in Belgium and 43% in Italy. Low paternal educational levels were strong correlates of SHS exposure in cars as well as migration background. Other correlates were one’s own smoking status and the relation to the family and peer smoking environment, such as parental smoking, permissive smoking rules at home, and best friends smoking.

Conclusions
In most of these seven countries, a considerable proportion of youth, particularly those from disadvantaged backgrounds, is exposed to SHS in cars. There is a need to ensure adoption and sustained enforcement of smoke-free car legislation. Given the long-term effectiveness of smoke-free car policies, our finding suggests that such policies can contribute towards reducing smoking inequalities.

Key messages
We assessed adolescent secondhand smoke (SHS) exposure in cars in 7 EU countries, which varies widely, ranging from 6% in Finland to 43% in Italy. The findings point to a social gradient, environmental factors in SHS car exposure and call for the rapid implementation of smoke-free car legislation.
The development of a monitoring instrument to measure the strength of health promoting systems
Authors: Fransen G , Wagemakers A , Molleman G 
Published: November 2019

Abstract

Background
In the region of the Municipality Health Services Gelderland-South, each municipality has its own health broker. He or she advises the local policy makers, signals/pleads for addressing health problems, and facilitates effective approaches. By doing this health brokers try to strengthen the local health promoting system. To show the results of health brokers and to monitor changes of the local health promoting system, the MHS needs a monitoring instrument. The aim of this study was to develop this instrument and to test it in practice.

Methods
Participatory action (qualitative) research is used to develop an online questionnaire. Structured group processes with the health brokers has led to the identification and definition of eight variables, reflecting the health promoting system: collaboration, support, integrated approach, visibility of results, health monitor data assessment, consistency, reach of the target population and sustainability. A literature study identified appropriate instruments. The online questionnaire is expanded to test the reliability, to evaluate the usability and to gain insight into the strength of the health promoting system in 16 municipalities.

Results
The questionaire is based on validated questionaires like the Coordinated Action Checklist, and contains 28 items. Sumscores per variable ranged from 0 (weak) to 100 (strong). Health brokers and their partners (N = 147, 4-9 per municipality) filled out the questionnaire. Support and collaboration had the highest mean scores (70,5 resp. 69,8), and visibility of results and sustainability the lowest (61,3 resp. 59,4). Differences between municipalities were identified and can be used to know which variables can be improved. The test-retest reliability (mean r = 0,713) and the Crohnbachs alphas (all &gt; 0,70) were reasonable good.

Conclusions
The questionnaire can help to provide useful insights in the strengths and weaknesses of the local health promoting system.

Key messages
Eight variables reflect the health promoting system: collaboration, support, integrated approach, visibility of results, health monitor data assessment, consistency, reach and sustainability. The questionnaire can help to provide useful insights in the strengths and weaknesses of the local health promoting system.
Healthcare costs and outcomes: a value-based assessment tool for Clinical Governance
Authors: Specchia M L , Arcuri G , Di Pilla A , Ricciardi G , Bellantone R 
Published: November 2019

Abstract

Issue/problem
Health systems sustainability is a critical public health issue. A value-based approach is essential to improve patient-centeredness, appropriateness, quality and funding allocation in healthcare.

Description of the problem
This project was aimed to develop an innovative transferable tool to assess value-based activities in Hospital by monitoring care pathways costs and outcomes. Main questions were to: assess cost and outcome variance in homogeneous groups of patients; evaluate clinical activities contribution to the hospital budget; identify and monitor critical points. In 2018 a Business Intelligence system fed by different Hospital datasets was developed and tested in a Teaching Hospital in Rome to quantify and integrate data on pathways efficacy and costs. It was based on an algorithm of 20 indicators related to Women and Child Care Pathways.

Results
Preliminary results showed a great variance for the same intervention/procedure concerning length of stay (3-8 days), waiting times (1-4 days), innovative technologies costs (2000-6000€) and obsolete reimbursement rates (2000-5000€) that do not guarantee adequate economic contribution margins. Improvement actions were defined concerning pathways’ workflow and organizational appropriateness. The need for negotiations with Ministry of Health was highlighted, aimed to update reimbursement rates.

Lessons
The tool, built on a value-based process view, allowed analyzing online outcomes and costs data aggregated by path, benchmarking results, identifying critical issues and providing improvement solutions. It turned out to be an innovative methodology - also applicable in other settings/countries - to trigger changes in health management and pursue quality and efficiency in healthcare.

Key messages
Value-based healthcare is the new public health paradigm. Assessing simultaneously Hospital costs and outcomes is a valuable way to derive overall healthcare value, improve quality and rationalize resources allocation.
The Bundle approach to reduce SSI rate of colon surgery, Piedmont (Italy): experience of 2012-2017
Authors: Scacchi A , D’Ambrosio A , Rainero E , Vicentini C , Furmenti M F , Zotti C 
Published: November 2019

Abstract

Background
According to ECDC, Surgical Site Infections (SSI) are the second most frequent type of Healthcare Associated Infections (HAI) in Europe and in USA, and 9.5% of colon surgical procedures develop SSI. SSIs are associated with prolonged hospital stay, higher costs burden and higher attributable morbidity and mortality. Interventional programs can reduce the risk of SSI. Care bundles are a complex of EBM-based interventions on a specific population and setting, in order to improve clinical outcomes. A bundle is successful only if all its items are properly applied, through the ‘all-or-none’ method. Application of a bundle does not exclude other good clinical practices.

Methods
Data from 37 hospitals participating in the Regional SSI surveillance of Piedmont (Italy) were collected from 2012 to 2017. In hospitals applying the bundle, 4 bundle items had to be used in all the procedures: Temperature control, preoperative shower, trichotomy, antimicrobial prophylaxis. 6909 patients undergoing colon surgery were followed for 30 post-operative days to detect SSI events (According to ECDC 2016 Protocol). For some procedures, compliance to Bundle item application was ≤ 75%.

Results
6909 procedures were assessed: 3631 with no bundle application and 3278 with bundle application; in particular 974 were compliant to all bundle items (100%), while 2304 were compliant to 3 items or less (≤ 75%). We report a SSI risk of 11.20% for surgical procedures performed without bundle application; this risk decreases to 5.63% (OR: 0.49, 95% CI: 0,36-0,67; p &lt; 0.001) when compliance to bundle is 100%. When compliance to bundle is ≤ 75% instead of 100%, SSI risk raises to 8.47% (OR: 1.49, 95% CI: 1.07-2.04; p = 0.002).

Conclusions
Care bundle, if properly applied, is associated to statistically significant reduction of SSI rate (51%) for colon surgical procedures. Bundle programs should be encouraged and improved in hospitals to reduce healthcare costs and burden of HAIs.

Key messages
The use of the 4-item Surgical Care Bundle is associated to statistically significant reduction (51%) of SSI rate for colon surgical procedures. Surgical Care Bundle programs should be recommended and improved in every hospital to reduce healthcare costs and burden of HAIs.