bluuebunny/crossref_metadata_2025_split huggingface dataset:
(Pharmaco)economic evaluations for mental health related services: the PECUNIA project
Authors: Simon J , Konnopka A , Brodszky V , Evers S , Hakkaart-van Roijen L , Serrano-Pérez P , vador-Carulla L S a l , Park A L , Hollingworth W 
Published: October 2020

Abstract

Background
Mental health disorders affect large proportions of the general public resulting in serious cost consequences even beyond the health care sector. The PECUNIA project (EU H2020 grant agreement No 779292) aims to establish standardised costing and outcome assessment measures for optimised healthcare provision in the EU for multi-sectoral, multi-national and multi-person (pharmaco)economic evaluations using selected mental health disorders as illustrative examples.

Methods
Harmonised Identification, Definition, Measurement and Valuation of service costs in multiple sectors (health care, social care, criminal justice, education, productivity, patient, family). Reviews and surveys of mental health related services and other resource use in six European countries (AT, DE, ES, HU, NL, UK) to develop a new harmonised costing concept and related tools.

Results
We identified many taxonomical and conceptual discrepancies which currently hinder harmonized costing efforts and comparability of economic evaluations/HTAs across countries and sectors. The 'PECUNIA care atom', a new multi-sectoral costing concept forms the basis of resource item classification and international coding of mental health related services using the DESDE-PECUNIA system. Linked, harmonized tools such as the PECUNIA-European Resource Use Measurement instrument and the PECUNIA-European Reference Unit Costing Templates have been developed and are currently deployed in six countries to establish a PECUNIA-European Unit Cost Compendium alongside pan-European outcome evaluation methods.

Conclusions
The PECUNIA tools will lead to better understanding of the variations in costs and outcomes of mental health services/interventions within and across countries, and improve the feasibility, quality, comparability and transferability of (pharmaco)economic evaluations and HTAs in Europe. They also allow the harmonized measurement of broader economic and societal impacts of mental health services.

Key messages
The PECUNIA project developed compatible European multi-sectoral, multi-national and multi-person costing and outcome assessment tools. Methods & tools allow the harmonised measurement of broader economic & societal impacts of mental health related services, and improve the transferability & comparability of economic evaluations/HTAs.
Patients’ experiences of remote communication after pacemaker implant
Authors: Lopez-Villegas A , Catalan-Matamoros D , Lappegard K T , Peiro S , Lopez-Liria R 
Published: October 2020

Abstract

Background
the concept of 'patient experience' has become central to how to improve healthcare. Remote communication with patients is today a frequent practice in healthcare services, showing similar outcomes to conventional monitoring at the hospital (CM) while enabling cost reduction in both formal and informal care. The purpose of this study was to analyse the experiences of people with remote monitoring (RM) of pacemakers.

Methods
Patients were randomly allocated to either the RM or CM. Using the 'Generic Short Patient Experiences Questionnaire' (GS-PEQ), as well as an ad-hoc survey from the 'telehealth patient satisfaction survey' and 'costs survey', patients' experiences were measured six months after the pacemaker implant in a cohort of 50 consecutive patients. The mean age was 74.8 (±11.75) years and 26 (52%) patients were male of which 1 was lost in follow-up. Differences in baseline characteristics between groups were not found.

Results
Findings showed overall positive and similar experiences in patients in both groups. Significant differences were found in GS-PEQ concerning how RM patients received less information about their diagnosis/ afflictions (p = 0.046). We did not find significant differences in other items such as 'confidence in the clinicians' professional skills', 'treatment perception adapted to their situation', 'involvement in decisions regarding the treatment', 'perception of hospital organisation', waiting before admission', 'satisfaction of help and treatment received', 'benefit received', and 'incorrect treatment'.

Conclusions
The remote communication of pacemakers was met with positive levels of patients' experiences similarly to patients in the CM group. However, patients included in RM group received less information. Thus, improving the quality and timing of information is required in RM group in the planning and organisation of future remote communication healthcare services for people living with a pacemaker implant.

Key messages
Patients included in both groups of follow-up showed similar levels in their experiences with the use of the pacemakers. It is necessary improving the quality and timing of information required in remote monitoring of users in the planning of future remote communication healthcare services for people with pacemaker.
Disaster preparedness level of university hospitals of Sousse -Tunisia
Authors: Lamine H , Tlili M A , Aouicha W , Taghouti E , Chebili N , Zedini C 
Published: October 2020

Abstract

Background
Disasters, whether natural or man-made, are unpredictable. The health care systems, represented by hospitals, are on the front lines of the emergency and disaster response. Tunisian health structures, must be able to cope with a case of mass influx of victims following any disasters. Therefore, we conducted this study to describe the level of disaster preparedness of University Hospitals of Sousse - Tunisia.

Methods
A simple descriptive quote is the basis of a data collection, conducted between September and October 2019 and performed in both University Hospitals of Sousse - Tunisia (Farhat Hached and Sahloul). The measuring instrument used in this study is the 'Hospital Safety Index' designed by the World Health Organization in 2008.
Data was analyzed using the 'Module and safety index calculator' which calculates a specific score for each module (structural safety, nonstructural safety and emergency and disaster management) and an overall score for hospital safety, and assigns an appropriate classification which can be “c/C” corresponds to a score from 0 to 0.35, “b/B” from 0.36 to 0.65, or “a/A” from 0.66 to 1.

Results
The overall safety index class of both hospitals was 'B'. Sahloul University Hospital was classified as 'a' in both structural and nonstructural safety modules and classified as 'c' in the emergency and disaster management module, in the other hand Farhat Hached University Hospital was classified as 'c' in structural safety module and classified as 'b' in both nonstructural safety and emergency and disaster management modules.

Conclusions
The hospitals' current levels of emergency and disaster management needs to be improved. Actually, both patients and staff safety as well as the hospital's ability to function during and after emergencies and disasters are potentially at risk. In both hospitals, intervention measures are needed in the short term.

Key messages
Appropriate disaster management should be based on a clear plan, preparedness and collaborative and effective efforts on the part of the community and the different organizations involved. A safe hospital needs to assure that its services remain accessible and functioning at maximum capacity, before, during and immediately after the impact of emergencies and disasters.
COVID-19 and young Italians: results of a cross-sectional study
Authors: Lia L , Dorelli B , Marte M , Chiappetta M , Faticoni A , Lucaccini Paoli L , Grassucci D , Gelardini M , Ardizzone C , La Torre G 
Published: October 2020

Abstract

Background
At the end of 2019, a novel pneumonia-causing Coronavirus called Sars-CoV-2 was first identified in Wuhan, Hubei Province, China. It subsequently spread throughout China and elsewhere, becoming a global health emergency. In February 2020, WHO designated the disease COVID-19, which stands for Coronavirus disease 2019. The aim of this study was to evaluate the impact of the COVID-19 epidemic on the perception of young Italians and to assess their knowledge and attitudes about the disease.

Methods
An online survey was conducted on 3rd-4th-5th February 2020 with the collaboration of “Skuola.net”, an important Italian Website for students. Young people had the opportunity to participate in the survey by answering an ad hoc questionnaire created to investigate knowledge and attitudes about the new Coronavirus, using a link published on the homepage.

Results
5234 responses were received of which 3262 were females and 1972 were males, aged from 11 to 30. 82,4% were students (50,4% high school students) while 17,6% did not attend school or university. Regarding knowledge, 80% of the participants knew that the infection occurs through droplets from infected people; 63% knew that symptoms can appear up to 14 days after exposure; 80% knew that a vaccine has not yet been discovered. Regarding attitudes, 36% admitted that their attitude towards Chinese tourists has significantly worsened; 26% did not buy from Chinese run stores and 24% avoided Chinese restaurants.

Conclusions
Although most of the participants seem correctly informed about COVID-19, young Italians are at risk of assuming irrational behavior due to psychosis.

Key messages
The global emergency of COVID-19 needs adequate information to avoid the spread of dangerous psychoses. Young people, usual users of social networks as a means of information, are more at risk of being influenced by fake news and adopting wrong behaviors.
Readiness of the nurses employed by Bezmi-alem Vakif University hospital for disasters
Authors: Karakoç M , Erdoğan Ö , Zeren H 
Published: October 2020

Abstract

Background
This study is intended to increase disaster awareness of the nurses so as to increase the survival rate during disasters.

Methods
The research was done via a total of 430 nurses, consisting of 360 nurses employed by Bezmialem Vakıf University (BVU) Medical Faculty Hospital and 70 nurses employed by the BVU Dragos Hospital from 01.11.2018 to 01.02.2019. Data was collected by using the Introductory Information Form and the Scale for Basic Qualifications for Readiness of the Nurses for Disasters. IBM SPSS Statistics V23 program was used for evaluation of the data.

Results
For the nurses, it was determined that the average age was 26.06±6.05 and the average working hours was 6.24±5.86. It was found out that 60.6% of the nurses did not have any training in relation to the disasters. It was found that the average point for perception of readiness for the disasters by the nurses was 5.03±2.38 (0-10) while the average point for perception of disaster plan information at hospital was 4.27±2.53 (0-10). It was established that the nurses consider the disaster management course as the course required most for disaster preparation with a rate of 47.9%. It was found that the average point achieved via the Scale for Basic Qualifications for Readiness of Nurses for Disasters was 141.46±32.48, and the lowest average sub-dimension point was 11.49±3.42 as critical thinking abilities while the highest average sub-dimension point was 48.23±12.21 as technical abilities. A positive weakly significant relationship was found between critical thinking abilities and evaluation of readiness for disasters.

Conclusions
Nurses have technical knowledge and abilities on topics related to their field, but they need to participate in educational activities for increasing the level of knowledge in terms of disasters.

Key messages
The role of nurses in emergency health services during disasters is great. Thus, disaster awareness of all the nurses worldwide must be increased so that they are ready for the disasters.
Social integration of migrant physicians in inpatient rehabilitation
Authors: Jansen E , Haenel P 
Published: October 2020

Abstract

Purpose
In Germany, numerous inpatient rehabilitation facilities employ migrant physicians. Yet the remote location of many such institutions makes it difficult for migrant physicians to establish social relationships and networks near their place of employment. This lack of social resources has implications for employee retention, quality of life, and quality of care. In this light, our study examines the following questions: what social relationships do migrant doctors have access to? What challenges and opportunities do these relationships represent? Our aim is to provide concrete recommendations for stakeholders to improve the social integration of migrant physicians.

Methodology
Semi-structured interviews with 58 migrant physicians and their colleagues. Braun & Clarke thematic analysis.

Results
Migrant physicians' social relationships fall into four broad categories: friends and acquaintances in general, family, community of origin, and working team. Migrant physicians in our sample face difficulties in each of these four categories.

Implications
Establishing social relationships in rural and semi-urban areas is more difficult for migrants in general, and migrant physicians in particular. We propose a number of recommendations to overcome these challenges on several levels: individual, work team, institution, regional, and trans-regional.

Key messages
The integration of migrant physicians in inpatient rehabilitation facilities is challenging. Specific measures can help the retention of migrant physicians.
Workload pressure of nurses at an emergency satellite hospital in Peshawar Pakistan
Authors: Khan H M 
Published: October 2020

Abstract

Introduction
Health managers face challenges to respond to the demands of the population with limited resources. Balancing the health workforce is of high concern as the health workers are indispensable resource in a health system. The objective of this study was to determine the workload pressure of nurses working at an Emergency Satellite Hospital for efficient planning and management.

Methods
The Workload Indicators of Staffing Need (WISN) method was used for this study which is a human resource management tool which determines the number of health workers required to cope with the workload and asses the workload pressure by using the available service statistics. It calculates the level of staff shortage or surplus in a facility and the ratio of actual to the required number of staff determines the workload pressure with which the staff is coping.

Results
According to the findings of the study there were 1966 available working hours for the nurses in a year. Out of this time 33.33% was taken by support activities of all nurses, 18.75% by additional activities of some of the nurses and 47.92% by health services activities of all the nurses. At the time of the study there were 4 nurses working in the in the hospital but according to the calculations based on WISN 3 nurses were required to carry out the activities identified by the experts working group. The study shows that there was no workload pressure on the nursing staff as the WISN ratio was 1.33 and one nurse was surplus.

Conclusions
The study found that there was no workload pressure on the nursing staff and one nurse was surplus who can be adjusted in any other unit where there is more need of nursing staff. This can increase the overall productivity and the demands of the population for health services can be responded to in an efficient way.

Key messages
Balancing the health workforce in any institution is of high concern as the health workers are the most costly, least readily available and indispensable resource in a health system. Efficient planning and management of health workforce is essential for better productivity.
Motivations for choosing a specialty among the residents in the Congo
Authors: Mbou Essie D 
Published: October 2020

Abstract

Background
Congo is experiencing a greater shortage of doctors for certain specialties, in order to help reduce this disparity, we have studied the motivations for choosing specialties.

Materials and Methods
A descriptive, prospective crosscutting survey. All interns in a calendar year were interviewed between July and August 2019. Gender and age, specialization choice and motivation were studied. Specialties were: surgical, medical, pediatrics, gynecology obstetrics, ORL, ophthalmology, imaging, psychiatry, public health, occupational and legal medicine, medical biology and general medicine. Age mean, frequencies were calculated and compared by Odds ratio and Fisher Khi2 at p &lt; 0.05; on Epi info 7.2.

Results
Out of 137 interns, 62.77% were men, middleaged 25 years, all want to specialize. The choice of specialties was: Medical (38.6%), surgical (20.5%), gynecology-obstetrics (9.4%) and pediatrics (7.9%). Psychiatry (1.46%) and medical biology (no choice) were the last. The majority of women chose the gynecology-pediatric block (OR = 9.37, IC 95% = [3.767-23.326], p &lt; 0.0001), surgery attracted more men without significant difference (OR = 1.6384, IC 95% = [0.54 79 - 4.8994], p = 0.3771). The main motivations were: the passion for the organ or specialty theme (53.52%), vocation inspired by the masters (37.32%), social prestige (28.1%), career opportunity (21.83%).

Conclusions
Specialties for which there are more masters were the most popular. The main motivations for choice could be related to teaching and teachers. Student preferences were not in line with national health priorities. Incentives are needed to fill medical deserts in some areas.

Key messages
The motivations of speciality choice is mostly linked to teaching approaches. Actions must be implemented to match specialities choice with public health issues.
Perception and attitude of medical students in UNEC towards Community Medicine as a career choice
Authors: Ugwunna N C , Okeke A J , Okeke C P , Okafor C P , Ezeoke U , Chinawa J , Anusiem C , Ibiok C N , Umeobili A k , Ugwunna O C 
Published: October 2020

Abstract
Community Medicine tends to study health and disease in a population of a defined community and it provides comprehensive health services ranging from preventive, promotive, curative to rehabilitative services. Understanding the perceptions and attitude of medical students towards Community Medicine will be a great tool in planning a sound medical labour force for a better healthcare delivery

Objective
This study was carried out to ascertain the perception of medical students towards Community Medicine as a specialty.
The study was carried out in UNEC with a total of 204 respondents who were in their fifth and final year classes. Data collection was by means of self-administered close ended questionnaire. Two hundred and four medical students returned their questionnaires and they displayed good knowledge of the discipline and its role in the society; majority 195(95.6%) perceived Community Medicine as vital part of medicine. While 150(73.5%), disagreed with living and working in rural area. However, only 90(44.1%) would choose Community Medicine as a specialty. Among the 114 who would not specialize in Community Medicine, 101(49.5%) were of the opinion that 'it was not interesting'.
Medical students in UNEC showed good knowledge of Community Medicine but majority would not specialize in the discipline mainly because they did not find it interesting. Continuous education of stakeholders, students, parents and general populace as to what really constitutes Community Medicine might be useful. Also curriculum should be redesigned to lay emphasis on the peculiarly interesting rural community-based postings.

Key messages
Continuous education of stakeholders, students, parents and general populace as to what really constitutes Community Medicine might be useful. Curriculum should be redesigned to lay emphasis on the peculiarly interesting rural community-based postings.
How do managers and physicians reconcile between financial and clinical considerations in hospitals?
Authors: Waitzberg R , Quentin W , Gottlieb N , Busse R , Greenberg D 
Published: October 2020

Abstract

Background
Hospital managers and physicians may face dilemmas due to their role as dual agents, committed both to their hospitals and their patients. We aim to pinpoint situations where economic and clinical considerations are aligned or conflicting; and to explore how managers and physicians reconcile different considerations in their decision-making in Germany and Israel.

Methods
Qualitative, thematic analysis based on 47 in-depth interviews with managers, ward directors and physicians in five hospitals in Germany and five in Israel.

Results
Economic and clinical considerations are aligned when gaps between hospital payments and costs are small, and economic incentives do not distort clinical considerations or when good medicine avoids complications while saving costs. Dilemmas arise when procedures are underpriced, resulting in financial losses to the hospital, and represent barriers for adoption of new, costly, medical equipment. In many instances, managers and ward directors choose one of the principals (hospital or patient), yet sometimes they develop reconciliation strategies that include: (1) improving coding of activities and diagnoses to assure higher payments; (2) reducing costs per case by choosing cheaper supplies with the same quality, bulk purchasing or reducing unnecessary lengths-of-stay; (3) providing clear treatment guidelines that support decision-making. Hospitals in Germany increase efficiency through specialization, and try to find alternative, less costly, care settings such as rehabilitation facilities. In Israel, hospitals balance the amount of unprofitable cases with many other profitable cases.

Conclusions
While sometimes one principal prevails, agents reconcile economic and clinical considerations. In Germany, a high-expenditure hospital market, there is some flexibility to change the character of hospitals activity, while in Israel, a middle-expenditure market, agents balance activities within the existing framework.

Key messages
Dilemmas exist regardless of the amount of hospitals’ funds. In Germany there is flexibility to change hospitals’ activity, while in Israel agents balance activities within the existing framework.