bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving inmates in Norwegian prisons’ oral health
Authors: Evensen K , Næss L 
Published: November 2019

Abstract

Background
Inmates in Norwegian prisons have poorer dental health than the general population. Inmates are a vulnerable group, often not able to take advantage of the dental health services or able to take care of own oral health. Poor dental health may have an impact on general health, in that people with poor oral health often suffer from pain and impairment and often feel restricted in activities at school, work or home. Oral health is declared as a human right by the World Dental Federation, and has gained recognition through the World Health Organization who emphasize on strengthening public dental health programs. The aim of this study was to explore the effect of an intervention based on Motivational Interviewing (MI) on improved dental health across inmates in Norwegian prisons.

Methods
Inmates in Norwegian prisons were offered an oral examination and a small package containing toothbrush, toothpaste and floss- in addition to a short MI-intervention (20 minutes) by a dental hygienist. The participants were interviewed appr. 2 weeks later by a researcher to assess the effect of the intervention. The qualitative data-analyses were guided by thematic analysis.

Results
The findings indicate that the intervention had a positive effect on behavioural change and motivation related to dental health care. The findings indicate that the intervention improved the inmates daily dental health care through better routines and motivation.

Conclusions
The findings suggest that the intervention has a positive impact on inmates’ oral health. The inmates changed routines related to daily dental care and reported higher motivation for taking care of their oral health. This is one of the first studies that explores the effect of an intervention to improve inmates’ oral health and bridges a knowledge-gap in the literature. The findings may increase the understanding of how dental services should be organized and offered to provide dental health care for this vulnerable group.

Key messages
Poor oral health is associated with poor general health, and inmates in Norwegian prisons have poorer dental health than the general population. The aim of this study was to explore the effect of Motivational Interviewing on improved dental health across inmates. Findings: positive effect on the motivation and behavior related to oral health.
Improving diabetes care through educational intervention in primary care in rural China
Authors: Chen S , Burstrom B , Burstrom K , Qian D 
Published: November 2019

Abstract

Background
The burden type 2 diabetes mellitus (T2DM) is increasing in China, especially in rural areas. The New Round of Health Care Reform in China intended to strengthen primary care, and promote the vertical integration between hospital care and primary care, in order to respond to the threat of T2DM. This study aimed to assess the impact of an educational intervention to improve vertical integration and management of T2DM in primary care in rural China, on glycemic control and diabetes knowledge.

Methods
The educational intervention was conducted in cooperation between the county level hospitals and primary care in rural areas (including township health centres and village clinics). T2DM patients in three counties in Jiangsu Province were randomly divided into an intervention group, which received an education-based intervention and follow-up visits, and a control group which received standard care. Questionnaire interviews and medical records were used to collect patient data, including fasting blood glucose (FBG) level and diabetes knowledge, at baseline and follow-up, in 2015 and 2016, respectively. Difference-in difference analysis and Mann-Whitney U test were used.

Results
The FBG level decreased significantly and diabetes knowledge increased significantly in the intervention group compared to the control group. The FBG level and diabetes knowledge score improved significantly in the intervention group in all counties, but there were local variations in levels.

Conclusions
The increased integration between the county level hospital and primary care service with an educational intervention among T2DM patients had a positive impact on the FBG level and diabetes knowledge score in the intervention group compared to the control group after one year. The results are suggesting that the care of diabetes in rural China may be improved through more intense collaboration between hospital care and primary care.

Key messages
The increased integration had a positive impact on the glycemic control and diabetes knowledge among T2DM patients. Diabetes care in rural China may be improved through increased collaboration between hospital care and primary care.
Implementing treatment guidelines for ambulance services in a low- and middle income setting
Authors: Carlsson H , Blaku V , Lidberg H , Hodza-Beganovic R , Berggren P 
Published: November 2019

Abstract

Background
The use of clinical practice guidelines in clinical and organizational decision-making improves the care of patients and patient safety. Guidelines make healthcare consistent and efficient. In many low- and middle income countries healthcare workers depend on guidelines developed in higher income countries. For these to be useful and accepted they need to be adapted to the local setting. The aim of the study was to implement pre-hospital treatment guidelines into an organization that was not currently using guidelines. The study was partnership between a Swedish pre-hospital training organization and local ambulance service organizations in Kosovo.

Methods
An iterative process of implementing the guidelines was used: Identify guidelines appropriate for the local organization.In sets of five, have the guidelines translated into Albanian.Adapt the guidelines to the local conditions and context.Approval of guidelines by an expert group.Begin using the guidelines within the target organization.

Results
The first set of five guidelines was translated, approved, and implemented into the organizations. To improve acceptance, both practitioners and decision-makers were involved in the process. Seven workshops were held, with a total of 104 participants. In follow-up discussions participants said they accepted the guidelines and that they would be useful in their daily work.

Conclusions
It is important to evaluate to what extent the guidelines have been accepted, understood, and used. The success and acceptance is due to the flexible procedure managing the full implementation process. Adapting guidelines to fit with local needs and requirements using local experts made the guidelines accessible and useful. The workshop discussions established justification and approval.

Key messages
Involve local experts in contextualising guidelines to increase acceptance from the start. Support building a robust local implementation organization to assist and administer change.
Public Health Nurse and interprofessional collaboration related to adolescent mental health problems
Authors: Granrud M , Anderzen-Carlsson A , Bisholt B , Steffenak A K 
Published: November 2019

Abstract

Background
Mental health problems among adolescents account for a large portion of the global burden of disease and affect 10 - 20 % of children and adolescent worldwide. The public health nurse in the school health services is in the forefront for adolescents and play an important role in providing mental health. In order to identitfy and help the adolescents in secondary school with mental health problems the public health nurses are dependent on collaboration with other professionals. The aim of this study was to describe the variation in public health nurses perceptions of interprofessional collaboration related to mental health problems among adolescents in secondary school.

Methods
This study has a qualitative design and individual interviews were analyzed with a phenomenographic approach. Eighteen public health nurses working in school health services, strategically selected from different counties, both urban and rural areas, were included to ensure variation in the phenomena.

Findings
The analysis resulted in three descriptive categories: ’The formal structure has an impact on the interprofessional collaboration’, ’The public health nurse is an important but not always self-evident partner in interprofessional collaboration’ and ’The primary players are the teachers in collaboratioń.

Conclusions
The findings demonstrated that public health nurses are important but not always included in interprofessional collaboration and they were dependent especially of teachers to achieve good collaboration. There were variations in how public health nurses perceived interprofessional collaboration from school to school, which may give the adolescents with mental health different services. The knowledge from this study may be essential to strengthen public health nurses positions and presence in the school health service, which will benefit the adolescents with mental health problems.

Key messages
The public health nurse need to work actively to be included in interprofessional collaboration. The public health nurse are dependent on teachers and principals to achieve good collaboration.
Can clinical coordination be improved through Participatory Action Research (PAR) interventions?
Authors: Vargas I , Eguiguren P , Mogollón-Pérez A S , Samico I , López J , Bertolotto F , De Paepe P , Vázquez M L 
Published: November 2019

Abstract

Background
Despite the effectiveness of Participatory Action Research (PAR) in reducing the gap between evidence and practice, its use to improve care integration is rare. The aim is to analyze the factors influencing the implementation of PAR interventions to improve clinical coordination in public health services networks of Brazil, Chile, Colombia, Mexico and Uruguay.

Methods
A qualitative, descriptive-interpretative study was conducted in participating healthcare networks of each country. Focus groups and individual semi-structured interviews were conducted to a criteria sample of participants: members of Local Steering Committee (LSC)(29), professionals’ platform (PP)(28), other professionals (49) and managers(28). Thematic content analysis was performed, segmented by country and themes.

Results
Findings reveal that contextual factors, the PAR process and interventions’ content were determinants in the implementation, interacting over time, and differing among experiences. On the one hand, institutional support (providing the necessary resources) together with the interest of professionals and managers in participating, emerged as influencing factors influenced by other factors related to: the system (alignment with policies; electoral cycle), networks (lack of time due to work overload; precarious employment conditions) and individuals (limited mutual knowledge and mistrust). On the other, some characteristics of the PAR process facilitated institutional support and motivation: professionals’ participation in all activities, design flexibility and shared decision-making - also present when interventions were based on mutual adjustment - the LSC’s leadership and the facilitating role of the research team.

Conclusions
Evidence is provided that when some contextual elements converge the implementation of interventions through PAR processes can turn into a factor of motivation and cohesion, determinant for the adoption of clinical coordination interventions.

Key messages
Contributes to fill the knowledge gap in factors influencing the implementation of PAR interventions in healthcare. Provides a framework for analysis and recommendations for their implementation.
Future Physicians and Cosmetic Medical Interventions
Authors: Erbaydar N P , Cilingiroglu N , Ak M S , Aksakal M F , Bartu A , Gunes Y F , Oney M A , Ozcan A , Tumtas M B , Yilmaz H E 
Published: November 2019

Abstract

Background
International Union of Aesthetic Plastic Surgeons’ survey-2017 showed Turkey is the second country among others in terms of numbers of cosmetic medical interventions (CMI) in Europe and ranks ninth worldwide. Therefore future physicians’ (FT) perceptions are important on this topic as potential implementer and service user.

Objective
Objectives are: To examine FPs (interns) personal CMI experience; practiced/observed CMI; their attitude towards CMI and related factors.

Methods
Study is descriptive with 274 interns. Data collected by online survey contains 22 questions and acceptance of cosmetic surgery scale (ACSS) (Henderson and King, 2005).

Findings
Of the interns, 51.5% were female; 47.8% perceived good economic status; 40.5% had cosmetic-surgery training; 23.0% had CMI (laser on skin and teeth interventions mostly); 39.7% of these interventions were performed in private clinics while some of them are realized in beauty centers; body-perception was found (75.5%) the main motive of CMI. There was a strong relation between CMI and gender. Female interns constituted majority (p = 0.01). Respondents who had CMI had the highest scores of ACSS (p &lt; 0,001). It was found that ACSS is positively related to positive familial and social environment (p = 0,007); negatively related with strong traditional (p = 0,005) and religious beliefs (p &lt; 0,001); positively related with the given importance of body-perception (p = 0,015). Media effect was found important factor on ACSS scores (p &lt; 0,001).

Conclusions
If the awareness of the quality, results, benefits and harms of CMIs is well established, it may be thought that there will be differences in attitude scale and less CMI performance. Therefore, it is necessary to constitute training programs on the different aspects of CMIs in medical curriculum.

Key messages
CMIs are not medically necessary and not a public-health issue and has economic burden. Awareness on the quality, results, benefits and harms of CMIs is should be well-clarified in the society.
Nursing processes analysis in district hospital in Lithuania
Authors: Vladickiene J , Stonkeviciute A 
Published: November 2019

Abstract

Background
The aim of the study - to evaluate the time devoted to the activities of therapeutic profile nursing and wastes in the nursing processes.

Methods
Time-and-motion study was applied for investigation of clinical workflow in nursing at district hospital in neurology and internal medicine departments. A total of four nurses, two nurses from each department, were observed. Duration of observation was 2 940 minutes (49 hrs).

Results
Nurses devote most of their time to administering medicines. It has been noted that there are many additional, unnecessary actions in this process. Likewise nursing staff devotes a lot of time to documentation management work: refills the same dossier when the information is recorded in paper forms, and then transfer it to the computers. For communication with patients, nursing staff spend a very small part of their working time and it is due to insufficient staff and stress and fatigue of the nurses. It is observed that the nurses of neurology and internal medicine departments spent 50.3 percent of their working time for a direct patient care, 19.3 percent of time - for indirect patient care, 22.3 percent for personal time and 8.0 percent for unit-related functions. According to the Lean methodology waste of overproduction, waiting, defects, bureaucracy, transportation, motion and human potential were identified in these departments.

Conclusions
Nurses of neurology and internal medicine departments spend most of their time for direct patient care and the least of their time for unit-related duties. Seven out of eight types of waste prevails in therapeutic departments of the district hospital.

Key messages
Adaptation of the Lean methodology of ’Visual Management’ may aid for optimizing the process of medication administration and diminishing the paper work of nurses. The manifestation of the stress and fatigue of the nurses could be reduced if the workloads of nurses were adjusted and adequately distributed.
Time trends of primary care quality across Portuguese regions: using prevention quality indicators
Authors: Santos J V , Viana J , Souza J , Lobo M , Ramalho A , Gonçalves-Pinho M , Freitas A 
Published: November 2019

Abstract

Background
Primary care quality is one of the main dimensions of primary care performance and can be evaluated by several methods, e.g. studying hospitalizations for conditions that could be treated, or less severe, if appropriately managed in primary care. Accordingly, the Agency for Healthcare Research and Quality (AHRQ) developed prevention quality indicators (PQIs). In this study, we aimed to compare PQIs and their time trends across Portuguese regions.

Methods
We performed a retrospective study, using all adult public hospital discharges in mainland Portugal, between 2011 and 2015. PQI rates for the overall (PQI 90) and composite indicators (i.e. 91 - acute, 92 - chronic, 93 - diabetes) were computed using AHRQ specifications. These rates were compared between the 5 Portuguese NUTS 2 regions of residence.

Results
From the total of 407,792 hospital discharges in mainland Portugal (2011-2015) 11.9% comprised the selected PQIs, the majority related the acute composite PQI, followed by the chronic composite PQI. The hospitalization rate of the overall PQI increased from 999.5 hospitalizations (2011) to 1231,0 hospitalizations/100,000 inhabitants (2015), with an increase in all NUTS 2 regions. In 2015, while Algarve and North had the lowest PQI rates, Centro and Alentejo showed the highest ones.

Conclusions
Between 2011 and 2015, there was an increasing trend of overall and composite PQI rates. Also, important differences between Portuguese regions were found that must be further studied.
The authors thank the support given by the Project ’POCI-01-0145-FEDER-030766’ (1st.IndiQare - Quality indicators in primary health care: validation and implementation of quality indicators as an assessment and comparison tool), funded by Fundação para a Ciência e a Tecnologia (FCT) and co-funded by Fundo de Desenvolvimento Regional (FEDER) through Operacional Competitividade e Internacionalização (COMPETE 2020).

Key messages
Between 2011 and 2015, overall prevention quality indicator rate increased in Portugal. There are great differences between Portuguese NUTS 2 regions regarding prevention quality indicators.
Confraternal talks impact with general practitioners on the prescription for older adults
Authors: Mauillon V 
Published: November 2019

Abstract

Issue
10% patients over 75 and patients aged from 66 to 75 years with a chronic disease take more than 10 concomitant drugs. Polypharmacy is a consistent risk factor of adverse drug events for elderly patients. Adverse drug reactions prevention is a national priority in view of quality of life and healthcare system costs increase.

Description
In Normandy, since November 2015, various interventions such as confraternal talks or letters send to general practitioners (GPs) have been examined to optimize medication use in older adults. More than 16 drugs prescriptions were discussed with the family practitioner and a health insurance fund’s physician-advisor. In addition, a prescription profile in elderly patients was given to this GP. Recommendations for good practices are also reminded.

Results
10 weeks of physicians prescriptions were studied during one year (from september 2015 to september 2016). 686 general practitioners (GPs) had at least one prescription over 16 drugs and 265 GPs had at least two prescriptions over 16 drugs. 166 confraternal talks or phone calls between health insurance doctors and GPs have been leaded with a medication review. 233 letters have been sent to physicians to improve prescribing. 46% of GPs received a physician-advisor led intervention. After these interventions, prescriptions drugs number has decreased (p &lt; 0,001) and the number of GPs having more than 16 prescriptions drugs has also decreased (p = 0,27). There is no significant difference between confraternal talks and letters. However, the physicians are more confortable with the confraternal talks to discuss their prescriptions.

Lessons
Confraternal talks continued in 2017 with medication review and profile’s delivery. A two years follow-up on these accompanying interventions will be made to optimize drugs prescriptions use for elderly patients.

Key messages
The physicians are more confortable with the confraternal talks to discuss their prescriptions. There is no significant difference between confraternal talks and letters.
Demographic forecasting of population projection in Greece: A Bayesian probabilistic study
Authors: Lamnisos D , Giannakou K , Siligari T 
Published: November 2019

Abstract

Background
Demographic aging is an emerging issue in Greece, characterized by low fertility and increased life expectancy. Undoubtedly, demographic aging is a challenge for public health not only due to the financing of public pensions, but also for the increasing utilization of health care.

Methods
The total fertility rate and life expectancy at birth are projected probabilistically using Bayesian hierarchical models and United Nations population data for Greece from the period of 1950 to 2015. These are then converted to age-specific mortality rates and combined with a cohort component projection model. This yields probabilistic projections of total population by sex and age groups, total fertility rate (TFR), female and male life expectancies at birth and potential support ratio PSR (persons aged 20-64 per person 65+) by the year 2100.

Results
The total population in Greece in 1950 was around 7.5 million, increasing to 11 million based on the 2011 population census but is projected to decline to 7.5 million at 2100. TFR has followed a strong downward trend with 1.4 children per woman in 2005-2010 and is projected to have a slight increase to 1.6 and 1.8 children per woman for 2050 and 2100 with all values being below the replacement-level fertility. Life expectancy is expected to increase to 84 years for men and 88 years for women in 2050, and 90 years for men and 94 years for women in 2100. PSR is expected to decline dramatically from 3 in 2011 to approximately 1.5 in 2050 and 2100.

Conclusions
Over the years, Greece has lost its youthful structure and has acquired the characteristics of an aging population, reflecting the population distribution of Western countries. Demographic aging is harmful for the economic growth, the social security system, the social assistance, and it is closely linked to national defense and public health. A long-term multidimensional program is recommended to confront the demographic issue based on the previous international experience.

Key messages
Total fertility rate will be below replacement level and potential support ratio will decline dramatically. A long-term multidimensional program needs to be developed to address the demographic aging.