bluuebunny/crossref_metadata_2025_split huggingface dataset:
A content analysis of Canadian master of public health course descriptions and core competencies
Authors: Apatu E , Sinnott W , Piggott T , Butler-Jones D , Anderson L N , Alvarez E , Dobbins M , Harrison L , Neil-Sztramko S 
Published: October 2020

Abstract

Background
The Master of Public Health (MPH) is a common graduate-level professional degree that is offered by Canadian Universities. To date, few studies have examined competency-based MPH education in Canada.

Objective
To examine the degree to which MPH programs' course descriptions align with the Public Health Agency of Canada's (PHAC) core competency categories in order to identify strengths and training gaps in such programs across Canada.

Methods
A content analysis of MPH programs in Canada was conducted from July 2019 to November 2019. A sampling frame of programs was obtained from a list from the PHAC website. Program information, including mandatory and elective course descriptions was extracted from each program's website and analyzed in NVivo 12. Course descriptions were independently categorized by two researchers into one or more of the seven categories of the core competencies outlined by PHAC.

Results
We identified 18 universities with MPH programs with 267 courses across Canada. Thematic analysis revealed that 100% of programs had coursework that addressed the “Public Health Sciences” and “Assessment and Analysis” categories; 93% addressed “Policy and Program Planning, Implementation, and Evaluation”; 67% addressed each of “Communication,” “Leadership,” and “Partnerships, Collaboration, and Advocacy”; and only 56% had course descriptions addressing “Diversity and Inclusiveness.”

Conclusions
We find that Canadian MPH programs may lack course offerings addressing core competency categories relating to diversity and inclusiveness, communication, and leadership. Our findings were limited in scope as we relied on program Web sites; thus, further research should explore course content in more depth than this course description analysis allowed and identify ways to close the MPH curricular gaps we identified.

Key messages
Further research should be conducted to determine if the current model of competency education in Canada is successfully guiding MPH programs in meeting local and international workforce demands. Continued discussion is needed to raise the importance of MPH competency-based education in Canada.
Reform design, institutional and workforce factors affecting the pace of change
Authors: Krczal E , Franczukowska A , Braun A 
Published: October 2020

Abstract

Background
When implementing health care reforms the pace of change is often lacking behind the expectations of policy makers. This research is exploring in-depth the experiences of a primary care initiative from the perspective of general practitioners. The physicians' perspectives on design features, supporting environment and acceptance of the pilot are being explored. Enabling and constraining factors that may influence the pace of change of health care reforms are identified. Implications can be drawn for the strategic planning and smooth implementation of the change process.

Methods
14 problem-focused interviews with general practitioners working in pilot projects and 2 focus group discussions with 4-6 general practitioners working in single practices have been conducted. In addition, document analysis of secondary qualitative data and relevant policy documents has been conducted.

Results
Analysis revealed 9 codes: (1) Status of the general practitioner; (2) Institutional and legal framework; (3) Between cooperation and competition; (4) Hesitation from the young generation; (5) Reluctance from sole practitioners; (6) Personal drivers for starting a pilot (7) Challenges during set-up phase; (8) Challenges during growth phase; (9) Working conditions in primary care pilot projects. Enabling factors were a strong desire to be pioneering primary care provision and improved working conditions. The main constraining factors were low status of the general practitioner, uncertainty about future directions, lack of information and advice, high perceived financial risk, fear of losing autonomy and uncertainty about functioning teamwork.

Conclusions
For a smooth implementation of the primary care reform, system changes should improve education and training, compensation schemes and competence profiles of the professional groups involved. Further, initiatives should provide information and advice for practitioners striving for participating in a pilot project.

Key messages
The success of health care reforms also depends on institutional and workforce factors that may affect the pace of change. Health care reforms need strategic planning for a smooth implementation.
Work overloading, rate of health and sick leave in connection with quality of management
Authors: Ratkajec T 
Published: October 2020

Abstract

Description of the Problem
In some companies, production increases and workers are feeling overloaded. Managers have role in an organisation of work and in a handling various situations. The aim of study was to analyse if a quality of management of working situations is in connection with overloading, health rate and sick leave.

Methods
575 workers filled out a questionnaires in the period May to September 2017. We used Karasek-Theorell questionnaire, work ability index and seven questions about work organisation. We chose a three questions from all and asked workers: Are you generally overloaded with work in past year? Answers were: yes, frequently; yes, seldom; no, rarely and no. Does your superior organize, plans work and solves disputes well? Four possible answers were: no, no fully; yes, fully and yes, very good. How would you rate your health in the last year 1-5? Have you been absent from work in the last year more than 9 days? In statistics we used the h-square and the t- test.

Results
156 workers or 27.1% declared overloading, 111 or 19.3% rarely or not at all feld overloaded. The overloaded workers reported statistically poorer management (answers no and no fully), hi-square = 7.84, p = 0.01 and had lower health rating t-test = 7.22, p = 0.01 in comparison with non overloaded workers (2, 7 points vs. 3.4). The overloaded were not more absent from work than non overloaded workers (t-test=0,005).

Lessons
Work planning and a solving dispute impact on health status and work overloading in workers in glass factory. Overloaded workers did not have higher sick leave and that indicates a presentism in this group.

Key messages
The study showed that a managers could be have important role on the health of workers. Overloaded workers did not have higher sick leave than non overloaded which indicates a presentism in this group.
Fit for purpose and for practice? The self-perception of Serbian nurses
Authors: Šantrić Milićević M , Vasić V , Gačević M 
Published: October 2020

Abstract

Background
Nursing competencies are paramount to the quality of care outcomes and patient satisfaction. Serbia is lagging behind developed countries in the number of highly educated nurses. The study objective was to examine how well hospital nurses' competency fit for purpose (fit the needs of patients) and fit for practice (fit the needs of job requirements).

Methods
In the 2016 survey, 356 nurses in a general hospital have self-assessed how well their competencies fit for purpose and how well they fit for practice. In total 29 competencies that were classified as a health care professional competencies and managerial competencies were analyzed. Similar to the literature, we used educational standards and curriculum to construct a survey instrument - a two-dimensional questionnaire with two sub-scales. The paired-samples t-test and repeated measure general linear model were used to calculate the effect size of parameter estimates. The bivariate correlation analysis was also used, namely Pearson's and Spearman's rho correlation coefficient, and the effect size of the estimated correlation coefficients was calculated as well as their 95% confidence interval based on 1000 simulated samples via the bootstrap procedure.

Results
The survey instrument had Cronbach alpha 0.889 and 0.908 for health care and management competencies, respectively. Competency compliance rate was 69% (competency ratio 20 for purpose v 29 for practice). More fit for purpose were collaborating with external professionals and motivating patients for a healthy lifestyle, while prevention of intrahospital infections and the use of information technology better fit for practice. Low-income nurses have better-complied competencies. The nurses value teaching method the most.

Conclusions
In Serbia, nurses' competencies are moderately fitted for purpose and for practice. Managerial competencies are insufficiently acknowledged in nursing practice.

Key messages
Hospital nurses in Serbia have more competencies that are fit for purpose than is required for their current position. The development of higher education for nurses and the revision of job descriptions should be strategically oriented towards meeting the needs of patients.
The European campaign to fight musculoskeletal disorders - the need for eHealth
Authors: Hristova L , Tzacheva N , Kundurzhiev T , Stoycheva M 
Published: October 2020

Abstract
The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018.

Background
The focus of the European Health and Safety Agency's 2020-2022 campaign is on the prevention of work-related musculoskeletal disorders (MSD). In the employment of medical professionals, they are common. The introduction of eHealth in Bulgaria supports the processes of information, monitoring and prevention.

Methods
An adapted Neck Injury Index (NII) questionnaire was developed by: Vernon, H. & Mior, S. (1991) to determine specific injuries in the cervical spine, administered to 251 healthcare professionals from a large medical establishment.

Results
A study of the relationship between gender and the answers given in the ten sections of the questionnaire revealed a statistically significant difference in the answers for 'headache', 'driving' and 'sleeping' with p = 0.005, p &lt; 0.001 and p = 0.020 respectively. 74.6% of men and 63.7% of women gave negative answers for headache, no driving pain, with men leading by 92.3% and a lower proportion of women than 56.1%, and without any sleep disturbances. 94.9% of men and 68.9% of women surveyed. The relationship between the profession and the medical profession indicating symptoms of neck damage, statistical significance was confirmed except in the above sections and also in 'lifting weights' (p = 0.009) and 'reading' with p = 0.002. As 65.3% of physicians, 51.9% of healthcare professionals and 56.5% of paramedics have no complaints of additional neck pain when lifting weights. A significant correlation was also found between mild injury rate (10 to 28%) and work experience over 10 years in 53.5% of those working in the hospital (p = 0.031).

Conclusions
The multifactorial influence of gender, position, and special length of service in the surveyed health care professionals did not cause symptoms indicating specific changes in the neck.

Key messages
It is important to establish a database through the introduction of eHealth with an information system. Identification changes in health and the presence of MSD in working nurses.
Improving the system continuous professional development of the health workers
Authors: Koikov V , Baigozhina Z , Abdrakhmanova A , Kabdullina G , Mergentai A , Derbissalina G 
Published: October 2020

Abstract

Issue
In modern conditions of the labor market, there is a need to implement an effective system of continuous professional development (CPD) of health workers (HWs) in accordance with existing and emerging health care needs. The system of CPD of HWs should be aimed at maintaining and improving the competencies (knowledge, skills, abilities) of each individual specialist, important to meet the changing needs of patients and the health system.

Description of the Problem
The lack of effectiveness of the CPD system of HWs in the Kazakhstan is due to the lack of accounting for many types of training activities in the system for confirming the qualifications of HWs (with certification of HWs every 5 years). So at present, when confirming a certificate, only formal additional education courses are taken into account, however, they do not correspond to the qualification level of a HW. Such types of activities in the CPD are not taken into account: non-formal education (fellowships, master classes, online trainings, etc.), activities that are aimed at developing and maintaining professional competencies such as mentoring young specialists, publication articles, participation in conferences, etc.
Changes: We have developed a new system for the CPD of HWs, harmonized with the procedure for regularly confirming the certificate of a HW (physician, nurse, pharmaceutical worker, specialist of the sanitary and epidemiological service), which gives access to professional work. The new CPD system is based on the credit accumulation mechanism in which Professional Development Units are assigned for each type of activity of formal and non-formal additional education and other types of activity aimed at professional development (mentoring, articles, conferences, expert activities, etc.).

Lessons
The introduction of a new CPD system allows for the effective maintenance and improvement of the qualifications of health workers.

Key messages
The lack of effectiveness of the CPD system of HWs is a serious barrier to maintaining the HWs qualifications at a sufficient level. The introduction of credit accumulation mechanisms for recording achievements in non-formal and non-formal additional education has enabled the formation of an effective system for the CPD of HWs.
Evaluation of training effects in the person-centered clinical method through active methodologies
Authors: Barros M 
Published: October 2020

Abstract
The Patient-Centered Clinical Method (PCCM) recognizes the particularities of each person who falls ill and values the therapeutic role of the doctor; promotes a holistic approach to the patient and / or the disease in its context; highlights the reasoning and decision-making process leading to the diagnosis taking into account the patient's expectations, feelings and fears. The proportion of patients who remain without a specific diagnosis is high because the clinical conditions present with nonspecific symptoms and the patient's understanding is the key to understanding. The challenge that is faced is training professionals with these skills and competences. The PCCM is an approach that respects the patient's preferences and in which communication has an effect on health outcomes, through self-confidence and motivation for change that can contribute to adherence and self-care. This work aims to present an experience of training new professionals at PCCM based on active methodology and mentoring in which the student himself is a source of reflection and study. The course was taught within the Residency Program in Family and Community Medicine in the Municipality of Vitória da Conquista, Bahia, Brazil, developed in 9 meetings of 4 hours each with themes such as, family, life cycle, genogram, ecomap, sexuality, death, diagnostic disclosure, ICU experience, psychosomatics. Many group dynamics and participatory techniques were used to enable involvement, at the end of the course they were asked to evaluate it, the writings were analyzed qualitatively through discourse analysis. The students showed a great willingness to bring their own experience of illness and style of illness, producing a greater empathy with the patient's condition. Trained professionals change from the authority paradigm to that of partnership, solidarity, empathy and collaboration. Training at the PCCM is a differential in the quality of care of any health professional.

Key messages
Allows to get closer to the user, facilitates understanding his problems and propose the developing joint strategies or plans - based on your expectations, limitations, feelings. PCCM tools contributed to the structuring of the clinical consultation in Primary Health Care (PHC), valuing the listening and the use of open questions.
Portugal's primary health care human resources assessment
Authors: Oliveira Miranda J , Santos Luis P , Sarmento M 
Published: October 2020

Abstract

Background
Primary health care services are the cornerstone of all health systems. Having clear data on allocated human resources is essential for planning. This work intended to map and compare the primary health care human resources of the five administrative regions (ARS) of the Portuguese public health system, so that better human resources management can be implemented.

Methods
The chosen design was a descriptive cross sectional study. Each of the five ARS were divided into primary health care clusters, which included several primary health care units. All of these units periodically sign a “commitment letter”, where they stand their service commitments to the covered population. This includes allocated health professionals (doctors, nurses), and the information is publicly accessible at www.bicsp.min-saude.pt. Data was collected for 2017, the year for which more commitment letters were available. Several ratios were calculated: patients/health professional; patients/doctor (family medicine specialists and residents); patients/nurse and patients/family medicine specialist. Mean, standard deviation, minimum and maximum values were calculated.

Results
National patients/health professional ratio was 702 with the mean of the 5 ARS calculated at 674+-7.15% (min 619, max 734) whilst the national patients/doctor ratio was 1247 with the mean of the 5 ARS calculated at 1217+-7.17% (min 1074, max 1290). National patients/nurse ratio was 1607 with the mean of the 5 ARS calculated at 1529+-13.08% (min 1199, max 1701). Finally, national patients/family medicine specialist ratio was 1711 with the mean of the 5 ARS calculated at 1650+-6,36% (min 1551, max 1795).

Conclusions
Human resources were differently spread across Portugal, with variations between the five ARS in all ratios. The largest differences occur between nursing staff, and may translate into inequities of access, with impact on health results. A more homogeneous human resources allocation should be implemented.

Key messages
Human resources in the Portuguese primary health care services are not homogeneously allocated. A better and more homogeneous allocation of human resources should be implemented to reduce access health inequities.
Tensions in the workplace: reflections on gender violence in contemporary Brazil
Authors: Santa Rosa G , Turatti B 
Published: October 2020

Abstract

Background
Women's control over their own bodies was highlighted by the expansion of their participation in the professional market, as well as by the greater liberalization of customs, thus provoking the transformation of previously male domains, especially in the workplace. However, this insertion and permanence occurred in an unstable way, impregnated with stereotypes, which sometimes result in different remunerations and harassing attitudes, especially in the gestational period.

Objective
The general objective of this work was to understand the process of becoming a pregnant woman in the working world in contemporary Brazil.

Methods
We sought to highlight the excerpts according to the chosen theoretical framework, namely the female performativity as pregnant, as a door to violence in the working world, in the light of Judith Butler's theoretical framework. This was an exploratory, descriptive, qualitative study that used the Internet to search and draw the national profile of women cases in the gestational period that had their labor lawsuits judged by the Regional Labor Courts of Brazil. After reading and selection of the speeches, three main groups of categories were identified: labor issues, exclusion of women's bodies in the working world and consequences for the the mother-child binomial`s health.

Results
From the moment women have had the option to control motherhood, they have made significant advances towards emancipation. Controlling motherhood does not mean not desiring it but rather having the right to choose it. Moreover, when a woman chooses to become pregnant and remain in the labour market, the challenge deepens, as she begins to be viewed as a failed piece in the oppressive machinery of labour.

Conclusions
The highly prejudiced scenario portrayed here, translates the fundamental brand of culture that is known: patriarchy. It means that women are forced to perform as men to conquer things and spaces in the masculine universe of work.

Key messages
The discrimination and barriers impeding women's professional and personal development are not present only in the professional environment but are also a reflection of the society. Violence against women is shaped by the naturalisation of gender inequality, which is based on hierarchical and historically constructed categories.
Bottled water consumption habits in Estonian residents and their opinions of possible health hazards
Authors: Vahur K , Ploomipuu I , Pastak E 
Published: October 2020

Abstract
Human needs about 28-15 mL/kg body weight of water daily (National Institute for Health Development). The sources of drinking water are either tap water, private wells or bottled water. According to the Health Board of Estonia, 89.13% of Estonian population used tap water in 2016 and 88.87% in 2017. Of all the consumers, 99.2% used water, for which the microbiological, chemical and indicator parameters did not exceed any normative (except for radiological parameters) (Joogivee..., 2017). However, more and more people are consuming bottled water and this trend is global (Kodumaine..., 2016). For example, in Estonia 72% of consumers used bottled water in 2007 (Noop & Riivits-Arkonsuo, 2007).
Different authors bring out that convenience, purity, better taste, better odour and quality were the main reasons for consuming the bottled water (Foote, 2011; Akpinar & Gul 2014). Some studies have shown that socio-demographic factors influence bottled water consumptions (Rothwell, 2006; Dupont et al, 2010).
The aim of this research was to determine the bottled water consumption habits of Estonian residents and their subjective assessment of the potential health impact of bottled water. The sample of this research were Estonian residents (n = 869) who agreed to take the online questionnaire through 21.11.2016-20.01.2017. For statistical analysis, X2 - test was used.
The conclusions of the research were: 1. Most of the respondents use bottled water and the main reasons are convenience and good taste or odour. 2. Factors as gender, income, education or having children do not affect the consumption of bottled water, but age and marital status do as younger and single or married/in relationship respondents buy bottled water more frequently. 3. About half of the respondents could not tell if the consumption of bottled water can affect health or not. Those respondents who thought that it could, mentioned carcinogenicity, digestive problems, toxicity and bad influence on teeth.

Key messages
Most of the respondents use bottled water, even if the tap water is of good quality, safe and cheaper, and the main reasons are convenience and good taste or odour. About half of the respondents could not tell if the consumption of bottled water can affect health or not.