bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multimodal Surveillance of HAI in an Intensive Care Unit of a Large Teaching Hospital
Authors: Migliara G , Di Paolo C , Barbato D , Baccolini V , Salerno C , Nardi A , Cottarelli A , Marzuillo C , De Giusti M , Villari P 
Published: November 2019

Abstract

Background
Healthcare associated Infections (HAIs) represent a significant burden in terms of mortality, morbidity, length of stay and costs for patients in intensive care units (ICU). Surveillance systems are recommended to gather data in order to elaborate and evaluate intervention to reduce HAIs risk. Here we describe results of the multimodal surveillance system implemented in the ICU of a large teaching hospital in Rome from April 2016 to October 2018.

Methods
The surveillance system integrated four different approaches: i) active surveillance focused on inpatients; ii) environmental microbiological surveillance; iii) surveillance focused on isolated microorganisms; iv) behavioral surveillance of the healthcare personnel. The system included the molecular genotyping of bacterial isolates through the pulsed field gel electrophoresis (PFGE). Moreover, an intervention to improve personnel adherence to hand hygiene (HH) guidelines was conducted.

Results
Overall, 773 patients were included in the surveillance. The global incidence rate of the device related HAIs was 14.1 (95%CI: 12.2-16.3) per 1000 patient day. Monthly device related HAIs incidence rate showed a decreasing, from 26.9 per 1000 patient day in October 2016, to 4.9 in September 2018. The most common bacterial isolate was K. pneumoniae (20.7%), the 94.0% of which were multidrug-resistant. A total of 305 environmental bacterial isolates were retrieved and the most frequent was A. baumannii (27.2%), that was always multidrug-resistant. Genotyping showed a limited number of major PFGE patters in clinical and environmental isolates. Behavioral compliance to HH guidelines improved after the educational intervention.

Conclusions
The data showed an overall slight decrease over time of the adjusted risk HAIs rates. Through the integration of information gathered from the four approaches, the application of this model returns a precise and detailed view of the infectious risk and of the microbial ecology of the ICU.

Key messages
Multimodal surveillance systems are effective to monitor HAI incidence and to determine the infectious risk. Genotyping techniques allows to characterize and link the clinical and environmental isolates.
Effect of family psychoeducation and access to information on illness negative perceptions: a study on French families of persons experiencing schizophrenia
Authors: Villani M 
Published: November 2019

Abstract

Background
A better understanding of schizophrenia, a chronic disease often leading to heavy negative consequences both on users and families, has been shown to reduce those difficulties. Studies recommend family psychoeducation, as this structured educative intervention reduces parents’ depressive symptoms, enhances family mood, and decreases risks of relapse for users. Our objective is to assess whether family psychoeducation and access to information has an effect on close relatives’ illness negative perceptions.

Methods
Our sample consists in 27 close relatives of persons with schizophrenia. We used a semi-structured interview assessing access to psycho-education and information about illness and diagnosis. We also used the Brief Illness Perception Questionnaire, which explores various illness negative perceptions, as well as probable causes of the illness.

Results
A better access to diagnosis for families is associated with a shorter perceived probable illness duration (p=.044). Family psychoeducation programs, followed by 38,5% of close relatives, reduces their perception of the frequency of user’s present symptoms (p=.029). This could be caused by a better understanding of real symptoms, or by an enhancement of family mood. Also, family psychoeducation has an effect on causal attributions: 50% of close relatives with access to family psychoeducation believed in a substance abuse causality, opposed to 12,5% of the others (p=.036).

Conclusions
Family psychoeducation could help allowing a shift in causal attributions and more generally enhancing family reaction to the disease, which, in turn, can have an impact on the user’s recovery process. Thus, this intervention deserves more attention and should be more systematically proposed to French families, alongside with an easier access to information.
Neighborhood walkability related to knee and low back pain for older people: A multilevel analysis
Authors: Okabe D , Tsuji T , Hanazato M , Asada N , Kondo K 
Published: November 2019

Abstract

Background
Previous research has linked built environments to physical activity. However, the association between built environments and musculoskeletal pain is unknown. This study aimed to investigate the effects of neighborhood walkability as a built environment on the knee and low back pain for older people.

Methods
Data were from the Japan Gerontological Evaluation Study (JAGES) 2013, a population-based study of independent people from aged 65 and older. A cross-sectional multilevel analysis was performed on 22,892 subjects in 792 neighborhoods. We used neighborhood walkability as regional level residents’ perception of access to parks and sidewalks and fresh food stores and difficulty in walking due to slopes and stairs and population density. Knee and low back pain which restrict daily life within the past year were our objective variables.

Results
The prevalence of knee pain was 26.2 %, and that of low back pain was 29.3 %. Neighborhood walkability was positively associated with knee and low back pain after adjusting for individual confounders and mediators such as physical activity, a quarter increased perception of access to parks and sidewalks decreased the prevalence of knee pain (PR: 0.85, 95% CI: 0.77-0.94), a quarter increased perception of access to fresh food store decreased the prevalence of knee and low back pain (PR: 0.90, 95% CI: 0.84-0.96, PR: 0.92, 95% CI: 0.86-0.98), a quarter increased population density decreased the prevalence of knee and low back pain (PR: 0.95; 95% CI: 0.93-0.98, PR: 0.96; 95% CI: 0.94-0.98). This trend remains after adjusting the population density, and higher difficulty in walking due to slopes and stairs is newly significant to knee pain (PR: 1.09; 95% CI: 1.01-1.18).

Conclusions
Some of the neighborhood walkability has a protective relation to the knee and low back pain for older people. Longitudinal and intervention studies of the built environment for musculoskeletal pain are required.

Key messages
To our knowledge, this is the first study to discover that neighborhood walkability has a protective relation to knee and low back pain considering various adjustments in a large-scale survey. Improvement of built environments could potentially reduce musculoskeletal pain. In the future, not only individual factors but also environmental determinants of pain should be studied.
The European FOOD programme (Fighting Obesity through Offer and Demand)
Authors: Leaute R , Bertrand N 
Published: November 2019

Abstract

Designated by the WHO as one of the greatest public health challenge of our century, obesity in 2018 is still responsible for 1 in 5 deaths in different parts of Europe. A balanced diet is therefore essential for European citizens’ health. Moreover, as employees spend a significant amount of their waking hours at work, it is a designated place to convey health promotion messages and improve the workers’ eating behavior. The FOOD programme contributes to this objective by promoting healthy eating habits during the working day towards two complementary target groups: workers and restaurants, making the healthy choice more obvious and more accessible.
The FOOD programme is a public-private consortium gathering representatives of Public Health Authorities, Nutritionists and Universities around the lead partner and coordinator Edenred in Austria, Belgium, Czech Republic, France, Spain, Italy, Portugal, Romania, and Slovakia. To meet its objectives, the Consortium followed a five-step methodology with a strong evaluation, enabling a qualitative and adapted set of actions. After a phase of analysis of the needs, communication tools were created to provide practical advice and recommendations to encourage healthy eating habits among the workers and restaurants.
Since 2009, 380 communication tools have reached 6,9 million employees and 521,000 restaurants. In addition, as part of the annual evaluation, barometers are being conducted towards employees and restaurants in order to collect their habits and perception of healthy eating during the working day. Since 2012, 82,600 workers and 7,700 restaurants answered the questionnaires. Return from the target groups confirms a change of perception in the last years as almost half of employees choose a restaurant based on healthy options. On their side, restaurants state a regular increase in the demand for healthy meals and reckon that they could learn more about healthy eating.

Key messages
Creating healthier eating patterns during the working day. Making the healthy choice the easy choice.
Could chips and nuts be vector of food-borne outbreaks during happy hour?
Authors: Gori F , Cuccaro C , Santamaria M , Cardaci R , Burgassi S , Battaglia M A , Messina G 
Published: November 2019

Abstract

Background
A Greater tendency to eat meals outside the home has led to an increase in the attendance of restaurants, cafes, and fast food. That is one of the reasons why the global interest in handling food has risen over the years. The aim of this study is to understand the level of microbial contamination in the food that is served along happy hour in cafe.

Methods
This cross sectional pilot study was performed from April to May 2018 in the city of Siena, central Italy (&lt;60000 citizens). Ten cafes were randomly selected. Samples of peanuts and potatoes were obtained in three different moments, at the beginning (T0), in the middle (T1), at the end (T2) of happy hours events. Collection of the samples was obtained using sterile kit and laboratory analysis was conducted in the University lab. The samples were located on selective medium and the growth of microbial pathogens were checked at 24 and 48 hours. The tested microorganisms were Enterococci, Staphylococci, Coliforms bacteria, Molds, and Yeasts. The statistical analyses were conducted using the Wilcoxon test using Stata 12.

Results
A significant Yeasts contamination appeared only on chips at T0, while within T0 and T1 we found a significant increase of Enterococci, Staphylococci, and Yeasts (p &lt; 0.05) both in peanuts and chips. Comparing T1 and T2 only Yeasts showed significant growth in potatoes (p = 0.04). Between T0 and T2 we also found the growth of Coliforms bacteria in peanuts (p = 0.03).

Conclusions
We showed an increase in the microbial load associated with food handling, mostly of Enterococci. Long exposure time increased the likelihood of contamination and the possibility to exceed the dose for the occurrence of good outbreak. It is likely that offering small portions of handling food would reduce the manipulation by participants and the risk of food-borne outbreaks.

Key messages
Define the most frequent microrganisms could be associated with backed food and evaluate which one of these can exceed the dose for the occurrence of disease in long time. Reflect on the likelihood that the risk of food-borne outbreak caused by manipulation of happy hour participants, may result in an increase in hospital admissions.
4.N. Workshop: Health workforce coordination and agency across sectors, organisations and professions
Authors:   Organised by: EUPHA (HWR), EUPHA (HSR) Chair persons: Ellen Kuhlmann - EUPHA (HWR), Viola Burau - Denmark
Published: November 2019

Abstract

Background
An increase in chronic illness and multimorbidity together with ‘ageing societies’ and demand for long-term care have created growing need for integrated care and improved coordination of services. However, health systems largely failed to respond to changing needs. Education and training of health professionals are still organised ‘in silos’; connections between health and social care and other groups providing relevant services are usually absent; and fragmentation of care according to specialisation remains the dominant organising principle of healthcare services. In this situation there is an urgent need for change to build skills and competencies, use health human resources more effectively and rearrange care according to population needs and preventative approaches.

Objectives
This workshop brings together research from different national and European research projects positioned at the interface of healthcare services and workforce development. The major aim is to foster the building of bridges across professions, organisations and sectors. The workshop seeks to explore the benefits and novel insights gained from comprehensive efforts to strengthen coordination and integrated models of care and how this may foster agency of the health professions as well as the implementation of new models of care that strengthen health promotion. The findings illustrate that capacity for innovating health systems can be improved through coordination and the crucial role of health professions in these transformations. Health professionals may act as facilitators of integrated work and care arrangements. Strengthening professional agency and coordination across sectors, organisations and professional groups embodies new opportunities for innovating health service provision and health workforce development. These transformations, in turn, may foster people-centred healthcare services.

Key messages
Building bridges between sectors, organisations and professions is a key to people-centred care. Coordination improves health workforce agency and service capacity to respond to population needs.
Intersectoral coordination and diabetes prevention: building capacity through professional agency
Authors: Burau V , Hillersdal L , Timm A , Maindal H T 
Published: November 2019

Abstract

Background
Intersectoral coordination of disease prevention is highly complex. The case of women who develop diabetes during pregnancy (GDM) is a case in point: intersectoral coordination mainly concerns diabetes prevention and thus stretches over the life course of women and their families. Our study aims to analyse how health professions through their day-to-day practice contribute to the creation, maintenance and transformation of intersectoral coordination of diabetes prevention over the life course; and how contexts at systems/organisational influences such processes.

Methods
The study draws on organisational studies of professions and focuses on the mechanisms underlying the making of intersectoral coordination. As part of a pilot study, we conducted a review of the international literature on intersectoral coordination of public health, a review of national policy documents, and a secondary analysis of interviews conducted as part of the development of the Face-it intervention.

Results
The organisation of GDM diabetes prevention in Denmark emerges as fragmented. Care pathways are divided between different phases, types of services, sectors and health professions. There are additional variations among municipalities. Formal (intersectoral) coordination is also limited to vulnerable women and their families. GDM diabetes prevention involves a broad range of professions; professional agency in GDM diabetes prevention is dispersed. Clinical specialists in hospitals show the strongest interest, rooted in healthcare knowledge on prevention. General practitioners have a similar knowledge base, but consider prevention less central. The same applies to health visitors and midwives, whose knowledge base also includes social care.

Conclusions
Individual professions have a strong capacity for intersectoral agency. Strengthening this capacity requires alignment across professions and adaptation to specific contexts.
Interprofessional collaboration in health promotion: changing tasks as leverage for innovation
Authors: Ledderer L , Christensen M , Burau V 
Published: November 2019

Abstract

Background
Increasing demand for interprofessional collaboration calls for change in organisational practice and interactions of professionals. Health promotion is a particularly interesting area for observing these changes, because it involves professionals with different disciplinary backgrounds usually also working in different sectors. In Denmark new health promotion strategies in organisations were introduced to engage professionals in new tasks and establish interprofessional ways of working. Our research aimed to explore how these strategies impact in professional practices, using a cookery project for children as a case study, which involved care assistants and school teachers.

Methods
A qualitative case study was conducted to investigate how care assistants from a nursing home and school teachers implemented a cookery project in a Danish school; the focus was on joint care and teaching situations among the two professions and their users. Our data consisted of documents, participatory observations, and interviews with professionals; a sociological institutional framework was applied to analyse the data.

Results
Institutional changes and the demand for joint care and teaching activities in the cooking project fostered new interprofessional collaboration. Three themes of new professional activities emerged: 1) ‘interplay’ related to making different generations collaborate on the tasks involved in the cookery session, 2) ‘care’ concerned with caregiving activities, and 3) ‘learning” focused on schooling on healthy food and cooking. The activities were related to traditional and new roles in professional practices of both groups.

Conclusions
Changes in professional practices evolved in an informal manner from new tasks and ‘lived’ experiences in the cookery project. The specific practical tasks of health promotion offer an important leverage for future interprofessional collaborations.
Building bridges: Sustainable Urban Health in Hamburg, 2018
Authors: Fehr R , Trojan A , Hornberg C 
Published: November 2019

Abstract

Issue
With most humans, globally, now living in cities, “Urban Health” receives increasing attention. For sustainably securing and promoting human health in the urban setting, a multitude of urban systems, fierce dynamics, and systemic interactions need to be considered. The goal is to provide an integrative view of Sustainable Urban Health (SUH), i.e. capturing the “forest” instead of merely the “trees”. How is this possible, and what insights can be derived? A theory-based SUH approach, starting out from the Human ecology perspective, provides a framework which is compatible with WHO’s Healthy Cities approach.

Methods
Methods used include literature searches and managed cooperation, proceeding from a model exercise (published paper) to a full-scale book publication, thus building bridges across disciplines and societal sectors.

Results
As for results, there is a comprehensive account of Hamburg SUH, including history, health status, governance, health care, rehabilitation, prevention and health promotion, “health in all policies” (e.g. economics, housing, mobility), and current integrative community projects. 100 authors delivered c.70 contributions. Activities around “health” are shown to constitute a remarkable element of urban culture, with room for improvement, e.g. concerning quality assurance on a systems level; more focus on sustainability (incl. environmental impact and overall future-proofing); and safeguarding relevant sources as a “collective memory”. To take the issue forward in civic society, one venerable Hamburg NGO (founded in 1765) now established a SUH working group.

Conclusions
The intensity and diversity as well as certain catch-up needs of SUH in a European metropolis are demonstrated. This “no regrets” approach meets with interest also in civic society. Once it is applied in multiple cities, innovative concepts and efforts can be compared easily, and get locally adjusted, for further strengthening SUH.

Key messages
Sustainable Urban Health (SUH), based on Human ecology, is an integrative “no regrets” approach and can cooperatively be applied anywhere, informing and guiding professionals and civic society. Even where activities around “health” constitute a remarkable element of urban culture, there is room for improvement, e.g. quality assurance on systems level, and more focus on sustainability.
Differences in attitudes of medical and dental students about e-professionalism on social media
Authors: Vukusic Rukavina T , Relic D , Marelic M , Machala Poplasen L , Viskic J , Jokic D , Sedak K 
Published: November 2019

Abstract

Background
Since the use of social media (SM) has increased among health professionals, it is necessary to explore students’ use of SM. Aim of this study was to recognize the patterns of SM use and difference in attitudes about e-professionalism on SM among medical and dental students.

Methods
A cross-sectional study was carried out in the School of Medicine University of Zagreb and the School of Dental Medicine University of Zagreb in academic year 2018/2019. Data were collected using online questionnaires. Data were analysed by descriptive statistics.

Results
A total of 698 responses were received, 411 from second and fifth year medical students (RR 69%), and 287 from first to sixth year dental students (RR 68%). Facebook was the most commonly used SM platform (99%), followed by Instagram (81%) and YouTube (72%). Dental students significantly more accepted friend requests from patients (28% vs 6%, P &lt; 0.001), sent friend requests to patients (5% vs 1%, P = 0.002) and significantly more plan to use SM in interaction with patients (39% vs 16%, P &lt; 0.001). Attitudes regarding what should be considered as unprofessional online behaviour significantly differed regarding posting patient photographs (90% medical vs 61% dental students, P &lt; 0.001), posting interactions with unidentifiable patients (42% medical vs 23% dental students, P &lt; 0.001) and inappropriate language use (72% medical vs 83% dental students, P &lt; 0.001). Students would find useful existence of guidelines about e-professionalism (84% medical vs 90% dental students, P = 0.016).

Conclusions
Results showed that dental students are more open to communicating with patients using SM. Results showed difference in attitudes among medical and dental students what constitutes unprofessional behaviour on SM. Results indicate the need to develop guidelines for students regarding e-professionalism.

Key messages
The difference exists in attitudes among medical and dental students what constitutes unprofessional behaviour on SM. There is a need to develop guidelines for students regarding e-professionalism.