bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effectiveness of leadership: meta-analysis of trial, cross-sectional, and before after studies
Authors: Restivo V , Gaeta M , Odone A , Trucchi C , Battaglini A , Carli A , Capraro M , Minutolo G , Casuccio A , Favaretti C 
Published: October 2020

Abstract

Background
The clinical and surgical procedures are often based on scientifical evidence but 30-40% of patients do not receive treatment according to evidence based medicine. The main aim of this review and meta-analysis is to assess the effectiveness of leadership in healthcare setting.

Methods
It was conducted a literature research on MEDLINE, Pubmed and Scopus with publication year between 2015 and 2019. The inclusion criteria were studies involving healthcare workers that evaluated effectiveness of opinion leaders in improving behaviour of healthcare workers, according to clinical or patient related outcomes. The quality of studies were assesed with the NHLBI for before after studies and the NOS for other study designs. The effect of leadership was assessed as risk difference for all studies with the exception of cross sectional studies. For the last it was evaluated correlation between leadership level and outcome measurment.

Results
A total of 3,155 articles were screened and 284 were fully assessed including 22 of them in the final database: 1 randomized trial, 9 cross sectional and 12 before after studies. For the cross-sectional studies there was a correlation of 0.22 (95% CI 0.15-0.28) between leadership level and outcome measurment. In the metaregression analysis the only factor that increased the correlation was private setting (meta regression coefficent =0.52, p = 0.022). The pooled efficacy was 24% (95% CI 10%-17%) for before after studies. Furthermore, a higher effectiveness was revealed in studies conducted on multi professional (24%) than single professional (9%) healthcare workers.

Conclusions
According to results, the guidelines adherence and task performance increased in a setting with leadership implementation. The leadership effectiveness appears comparable to other strategies as audit and feedback used to implement evidence-based practice in worldwide healthcare.

Key messages
The translation of evidence into clinical practice is often difficult but this study suggests that leaderhip can had higher effectiveness in multiprofessional healthcare workers and private setting. The effectiveness of leadership in this review suggests that it can be of help in order to make aware healthcare professionals about effectiveness of comply with evidence-based practice.
Global PhD Programme in Public Health Sciences boosts international collaborative doctoral training
Authors: Bauwens J , Schulze M , Nocera S , Flahault A , Crivelli L , Walser A , Künzli N 
Published: October 2020

Abstract

Background
The Swiss School of Public Health's (SSPH+) Global PhD Programme in Public Health Sciences (GlobalP3HS) is a doctoral programme, promoting transnational education and mobility co-funded by the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 801076. Students from abroad absolve a PhD training at one of the 12 SSPH+ partner universities in Switzerland.

Objectives and Methods
GlobalP3HS aims to train the next generation of public health leaders in both the academic and non-academic sector. Specific attention was given to PhD studies under the “sandwich model” (SM) which fosters research of students from low/middle income countries (LMIC) conducting LMIC-relevant PhD studies in collaboration with an LMIC-based academic institution. The SM targets at increasing chances for LMIC-based postdoctoral careers. The five year programme (October 2018 to September 2023) provides 42-months fellowships to profit from PhD programmes at a Swiss university. Top-scoring candidates were selected in a transparent, merit-based procedure by an international jury, considering students' background and motivation; innovation; methodological quality; public health relevance; and feasibility of the proposed research.

Results
Out of 342 valid applications, the jury scored 147 as eligible (score 8-10). In total, 53 students (31 women) were successful in matching up with co-funding supervisors. PhD-students from 31 countries representing all global regions, including 21 PhD under the SM, are enrolled at seven Swiss SSPH+ partner universities.

Conclusions
GlobalP3HS is an innovative solution to strengthen global research collaborations. The SM abates “brain drain” as it clears the path for successful careers in LMICs, where graduates become change makers capitalising on solid academic collaborations with the SSPH+ network.

Key messages
GlobalP3HS trains PhD fellows in public health sciences to become change-making leaders in academic institutions and public health organisations. GlobalP3HS is an initiative from the Swiss School of Public Health strengthening equitable, fair, balanced, and innovative inter-university and global partnerships.
The communication between physicians and patients
Authors: Kucuk Bicer B 
Published: October 2020

Abstract

Background
The first appointment between the physician and the patient is unknown. The aim of the study was to evaluate the communicative skills of the physician with the patient through the eye of the latter.

Methods
This descriptive study has been conducted in the clinics of a university hospital in Ankara. After physical examination a questionnaire, including socio-demographic properties and relations between the physician and patient, was applied under observation to 200 participants.

Results
Of the participants 56.5% were female, 47.5% were under 30 and 45.5% were high school, 16.0% were university graduates. 60% stayed in the examination room for 10 and 32.5% 5 minutes. 62% stated the conditions in the examination room were totally satisfied, 10% were partially and 28% were unsatisfied. “My doctor accepted me with a smiling face” has received the highest positive answer during initial communication with 78%, while “My doctor had a conversation with me” has got the lowest positive answer with 44%. “My doctor paid special attention to my privacy” has been to one to receive the highest positive answer during examination(90.5%), the lowest positive answer was “My doctor took notice of my social and cultural values”(45%). After examination, “My doctor was very kind and friendly” has received the highest positive answer(89%). “He listened to my opinions for the treatment” has been given lowest positive point 55%. “I recommend my doctor to other people” was accepted by 95.2%. Ages over 30 had more positive answers than younger participants in every item whereas two were significant (p &lt; 0,05). Male had given more positive answers in every item and 8 items were significant (p &lt; 0,05). “He listened to my opinions for the treatment” item received positive answer from 80% of those with a secondary education degree and 48% for the high school or university graduates (p = 0.023).

Conclusions
The manner that was used for communication in clinic was acceptable by the patients.

Key messages
The regulations/awareness of patient-physician rights the communication between the physician and patient has been favourably affected by the increasing satisfaction of patients from health services. Patients still have problems related to communication while their checkups in hospitals. Communication skills must be taught in internships also.
Self-evaluation of the success of the main core skills taught in six years of medical education
Authors: Kucuk Bicer B , İlhan S 
Published: October 2020

Abstract

Background
The aim of medical education before graduation is to train qualified physicians who have the knowledge, skills and attitudes that can provide qualified services, who can improve themselves continuously, acquire problem-solving skills and have clinical competence. We would like to determine how the interns feel about their practice and knowledge and just before the field.

Methods
A questionnaire was developed by the medical education specialist according to the curriculum. Every skill was majored from 1(insufficient)-10(sufficient) points. The questionnaire was tested with 10 students. The forms made of 25 questions were sent by Google forms and 172 (51%) interns replied. Ethical approval was taken from the university committee.

Results
Of the participants 62.3% was female and 61.1% was born in 1995. 18.1% of the students repeated the class. 29.2% of interns gave a score of 5 and below to the question of gaining the ability to make the diagnosis of the patient. 40.3% didn't gain the ability to make decisions on both the therapy and the tests; %93 didn't gain the implementation of intrauterine device skill, 20.9% didn't gain the ability to suture, %15.3 didn't gain the ability of CPR. 40.3% thought that they're not clinically sufficient.

Conclusions
The medical education and the curriculum might be revised and the theoric burden on students can be reduced. Moreover pratical skills can be thought on more simulators and simulated patients.

Key messages
The curriculum used in medical faculties should evolve more to practical based patient services. Medical students can evaluate themselves and can make the need assessment for thrown training.
Caring for refugees: Training the health workforce towards structural competence and responsibility
Authors: Ziegler S , Kratochwill S , Jahn R , Bozorgmehr K , Rast E 
Published: October 2020

Abstract

Background
Providing high-quality health care to superdiverse populations of newly arrived refugees poses specific structural, organisational, communicative, ethical and medical challenges that medical students in Europe are often not systematically prepared for. We created a clinical elective, to enable future doctors to identify and address the needs of refugee-patients and deliver high quality care to this population.

Objectives
We provided medical, structural, administrative, communicative and socio-cultural knowledge and skills training through seminars (24 h) and field placements (2 days) in a reception centre clinic for refugees. The training aimed at stimulating a systematic professional, personal, scientific, and political reflection, to foster social accountability, and raise awareness for the special situation of vulnerable groups. The didactic concept built on multidisciplinary lectures, student centred teaching, and research-oriented learning. Mainly qualitative summative and formative evaluations were applied to improve the course and examine training outcomes.

Results
A total of 112 students completed the elective over four terms, 50 evaluated it, of which 80% considered it worthwhile. Self-reported competencies in caring for refugee patients were low at the beginning and increased after course completion. The most important learning outcomes were knowledge of the asylum-law, gaining a multi-perspective view through multiple disciplinary lenses as well as professional, ethical, interpersonal and political insights during practical experience and reflection.

Conclusions
A multidisciplinary course that combines theory, practice and reflection, can prepare students for the complex challenges medical professionals face in caring for refugees. This could help strengthen their professional role as advocates of health equity. Our innovative didactical approach, course and evaluation concept can inspire the creation and implementation of similar courses elsewhere.

Key messages
The health workforce needs training to identify, address and help compensate respective barriers to health care and foster equal opportunities to health for refugees. A multidisciplinary teaching concept, tailored to specific target groups can help make future doctors and nurses in Europe fit for their responsibility and work in plural and ever changing societies.
Management model of primary health services and interprofessional practice in Brazil
Authors: Silva J A M , Souza G C , Mininel V A , Agreli H F , Peduzzi M , Ogata M N , Machado M L T , Feliciano A B , Sampaio S F , Pedro W J A 
Published: October 2020

Abstract

Background
Brazilian primary health care is organized by decentralized Family Health Strategy composed with interprofessional teams. This study focused on finding out how are the relationship between the management model of primary health services and interprofessional practice.

Methods
Qualitative study, part of a mixed-methods sequential explanatory design. Thirteen semi-structured interviews were conducted with health managers from six Brazilian municipalities. Data were collected between October and December 2018 and applied content analysis.

Results
The results allow three major content categories, 1) “Characteristics of management models to support interprofessional practice”: continuous communication among managers, health care professional and patients is the principal attribute of management. The interviewed mentioned the need to communicate with teams using regular meetings and technological resources. They recognize the availability of interprofessional practice in favour of dialogue, shared decision and physical space. In order to patient engagement, they adopted open communication with patients focused on spontaneous demands. 2)”Management actions for comprehensive care”: the interviewed recognized the lack of services integration and interprofessional teams. They mentioned participatory management strategies as team meetings in health services and engagement in public health council to shared health planning. 3)”Challenges for management interprofessional practice”: Challenges considered the lack of permanent policies focused on patient needs, frequent changes of the municipal managers and health care professionals, the lack of planning actions, and the need to meet spontaneous management demands.

Conclusions
Management practices can support interprofessional practice and comprehensive care however challenges are related to non-permanent policies, unplanning actions and spontaneous management demands.

Key messages
Communication is the principal attribute of the management model of primary health services to reinforce interprofessional practice. Compreehensive care depends on patient and interprofessional teamwork engagement for share decision making.
Education through Health Work: the knowledge and practice of health professionals in Brazil
Authors: Barreto L , Dal Poz M 
Published: October 2020

Abstract

Background
The Study discusses education through health work in Brazil through socio-historical and political-economic analysis to face the movement for reorienting professional training in health. Workforce planning, successful experiences and alternatives in inter-ministerial programs show a policy of professional training in health with an international influence on the health paradigm for tackling social inequalities (WHO, 2006). Importance of the research lies in the analysis of the health needs of the population with no answers. Guiding question inserts the dissociated character between the professional training model of higher education schools in health and the work redefined by the Unified Health System (SUS).

Methods
Integrative Bibliographic Review of documents related to the model of training through health work in the database of the Virtual Health Library (VHL), Mapping of Interministerial Programs to design the model for reorienting the National Policy for Permanent Education in Health (PNEPS) and National Curricular Guidelines (DCN's). The selected information sources with inclusion criteria used studies in the form of articles, ministerial documents and professional training.

Results
Brazil portrays the replacement of the health care model by SUS and by the political ordering of professional health education curricula, however, higher education institutions, still remain resistant.

Conclusions
The curricular reorientation is identified in successful experiences of higher education courses and practices, creation of the Secretariat for Management through Health Work (SGTES), insertion of inter-ministerial education programs through health work that promote change through alternative curricula within health schools.

Key messages
Education through health work. Professional training in health. Interministerial education / health programs.
Prevalence of intestinal parasites and associated risk factors in primary school children, Lahore
Authors: Abdul Latif A , Butt A , Mansha M , Fatima S , Farooq A 
Published: October 2020

Abstract
Intestinal parasites are the major reasons for deaths all over the world especially in the third world. Poverty, poor sanitation, unclean drinking water, moist environment are the conditions for these parasitic ailments. Poor personal hygiene among children is considered an effective cause of parasitic invasion. In present study the prevalence of intestinal parasites and their associated risk factors were determined among the school children of Lahore. A total of 150 faecal samples were collected from the children of 3-15 years of age belonging to Private and Government Schools. Different techniques like Direct smear method, Formalin ether concentration, Sedimentation and McMaster were used to identify different stages of intestinal parasites. The parasites found were Giardia lamblia (4.66%), Entamoeba histolytica (3.3%), Ascaris lumbricoides (4.66%), Taenia saginata (4%), Hymenolepis nana (2%), Trichuris trichura (2.66%) and Enterobius vermicularis (4%). A. lumbricoides was found to the most frequent of all parasites. The prevalence was higher among the children, with poor hygiene, having lack of education especially of mothers because they play a big role in child's upbringing and maintaining his good health. Educating cleanness alertness on parasitic diseases and application of helpful strategies for parents to raise socioeconomic circumstances may decrease the load of infection.

Key messages
Educating cleanness alertness on parasitic diseases and application of helpful strategies for parents to raise socioeconomic circumstances may decrease the load of infection. Health is Wealth.
The role of water distribution system in HCAIs
Authors: Mazzitelli F , Genovese C , D'Amato S , La Fauci V , Maisano D , Costa G B , Ceccio C , Squeri R 
Published: October 2020

Abstract

Introduction
The water distribution system in hospitals may constitute a source of healthcare-associated infections. Understanding the means of acquisition, sources and reservoirs of nosocomial pathogens is crucial for developing methods to reduce the incidence of nosocomial infections. The aim of our study was to evaluate the microbiological contamination by Pseudomonas aeruginosa in the water system of the University Hospital “G. Martino” in Messina over a period of nine years, in order to a) clarify possible relationship between the presence of aerators and contamination, b) to highlight the presence of a yearly variation and c) to verify the statistical difference between microbiological contamination of taps with and without filters.
Materials and

Methods
We carried out a retrospective study for nine year through the collection of water samples that were analysed for total bacteria count and Pseudomonas aeruginosa. The differences between the results recorded over the nine-year study period were evaluated using variance analysis. P values of &lt; 0.05 were considered statistically significant. Software R was used for statistical assessment.

Results
We analysed a total of 6168 samples with a positive rate of 9.31% and a decreasing trend over the nine years to a value of 2.44% (p &lt; 0.001), due to the elimination of the aerators of taps without filters and also to the introduction of filters in taps of high-risk wards and surgical rooms. We found statistical difference between taps with or without filter (p &lt; 0.001) and a higher positive rate during the summer season compared to the other months. Also, an increase of the positivity rate was detected in some year due to the lack of monthly replacement of the filter.

Conclusions
These results reveal a high level of contamination of taps by opportunistic bacteria with severe implications especially for high-risk settings and therefore, the need to improve the management of these devices.

Key messages
Particular attention must be reserved to the water distribution systems in hospitals in order to prevent the spread of healthcare associated infections. The continued application and strengthening of guidelines and procedures is essential to limit the spread of multidrug resistant pathogens.
Legionella and agar cultures in healthcare facilities waters: a monitoring study in North-East Italy
Authors: Chirico L , Righini M , Bravo G , Mellace F , Cocconi R 
Published: October 2020

Abstract

Background
Water healthiness is fundamental in medical facilities. Monitoring Legionella spp. and agar cultures concentration is therefore very important. This study looks into these parameters to examine possible criticalities that could need interventions.

Methods
We collected 399 Legionella and 82 agar cultures withdrawals between November 2019 and February 2020 from 157 detection points (like taps and showers) in 31 structures of four health districts. Withdrawals referred to the 4 quarters of year 2019 (t1, t2, t3, t4). Legionella values were expressed in colony forming units (CFU)/l; agar cultures in CFU/ml. We performed a non-parametric analysis to compare mean values between districts. We used the statistical software package SAS version 9.4 for Windows, setting the significance level at α = 0.05.

Results
45% of structures presented at least one positive withdrawal for Legionella (in six we found positivity in more than 1 quarter). Concerning Legionella concentration, we found significant difference between districts in t2 (p = 0.012) and between wards of one district in t3 (p &lt; 0.05). We observed agar positive values in 11 structures (in four cases in more than 1 quarter). In t4 we found a very significant difference (p &lt; 0.0001) between agar values in the four districts, while in t3 we observed a non significant association (p = 0.067). In t3 we found a significant difference for agar values between wards of one district (p = 0.025). We finally considered the simultaneous presence or absence of Legionella and agar positivities: without considering quarters division, we observed accordance (both present or both absent) in 60 detection points, while in 34 points we didn't find it.

Conclusions
Data provided by this study show that Legionella is rather present in our districts, revealing an association with concentration of CFU in agar. Disinfecting operations should be implemented considering the differences between districts to provide a safe water in every ward.

Key messages
Water quality monitoring in healthcare facilities is fundamental to provide a safe and healthy environment. Legionella spp. and agar cultures concentrations depend by quarter and spot considered; focused operations should be taken into account to improve disinfection quality.