bluuebunny/crossref_metadata_2025_split huggingface dataset:
Building back better after COVID-19: public health competencies for health workforce preparedness
Authors: Czabanowska K , Kuhlmann E 
Published: October 2021

Abstract

Background
The COVID-19 pandemic is raising new questions on public health competences and leadership and on health workforce preparedness for global public health emergencies of this magnitude. This study aims to explore the new demand and opportunities for innovation in public health competencies, which were caused by the COVID-19 crisis.

Methods
We draw on secondary sources and critically review the public health competency framework recently launched by WHO and ASPHER through the lens of COVID-19.

Results
The WHO-ASPHER Competency Framework for Public Health Workforce illustrates an interdisciplinary, inter-professional and lifelong learning approach to public health. Five critical competency areas can be identified in relation to global public health emergencies: (1) flexibility, adaptation, motivation, communication, (2) research, analytical sensitivity, ethics, diversity, (3) epidemiology, (4) preparedness and (5) employability. However, this may not be enough. New models of public health leadership and changes in the health workforce are needed, which transform the silos of professions and policy. Such transformations would include learning, working, leading and governing differently and must stretch far beyond the public health workforce. Innovating public health competences stretches far beyond individual competence development. Moreover, it is about resilience and preparedness and calls for learning, working, leading and governing differently. Critical public health competences are not limited to the public heath workforce, but must become relevant for all healthcare professions.

Conclusions
To achieve transformative capacity, critical public health competences must be considered for all healthcare workers on all levels of policymaking, thus becoming the ‘heart' of health workforce resilience and pandemic preparedness.

Key messages
Innovating public health competencies calls for learning, working, leading and governing differently. Public health competences must be considered for all healthcare workers and transform professional silos.
Students as drivers for global health and pandemic preparedness in medical education in Germany
Authors: Kreitlow A , Steffens S , Jablonka A , Kuhlmann E 
Published: October 2021

Abstract

Background
The COVID-19 pandemics has reinforced Germany's role as global health player, but the education system is lagging behind and does not adequately prepare health professionals for the new challenges. This study aims to strengthen global health in undergraduate medical education in Germany. Major objectives include: to review the current situation, explore changing demand for global health and introduce innovative teaching models and the role of student as drivers for change.

Methods
Mixed methods and an explorative approach were applied, comprising a scoping review, online surveys carried out at Hannover Medical School, March/April 2020, and finally a new multi-professional teaching courses initiated by students and developed collaboratively. Target groups of the survey were undergraduate medical students (n = 384) and additionally lecturers (n = 172).

Results
The results reveal that new health policies and Germany's new global political responsibility do not adequately translate into innovation in the education system. At the same time, demand for global health education has increased markedly and students have taken action bottom-up and introduced new courses. However, the transformative power on the level of institutions is limited. There is a need for appropriate funding and comprehensive governance innovation to align health and education institutions, research and education, policy and practice, and students and lecturers.

Conclusions
Implementation of global health programmes illustrates how students can become change agents and enhance institutional innovation bottom-up. However, in order to achieve wider transformative potential, these efforts must be flanked by macro-level policy changes and integrated in future pandemic preparedness strategies.

Key messages
Strengthening global health education is driven by students’ demand and novel teaching models. Innovation driven by students needs institutional support to achieve transformative powers.
Highlights of oncology care training in the Nurse specialty in Medical University – Pleven, Bulgaria
Authors: Gergova P , Georgieva S 
Published: October 2021

Abstract

Background
Training of nurse students at Faculty of Health Care - Pleven should be carried out in accordance with the Faculty mission for building highly qualified health professionals. For ‘Nurse' specialty there is an approved educational documentation in accordance with the latest changes in the national and European regulations for higher education. The aim of the study is to analyze methods of training in oncology care for student nurses and to give recommendations for their updating.

Material and methods
A direct group self-administered questionnaire was conducted amongst 124 students in II, III and IV year of their nursing education. In addition, document analysis of the curriculum and methods of teaching and training have done. Data processing was performed by SPSS v.24.

Results
Almost all (96,78%) respondents consider that oncology care requires special competencies and 85,45% say they need additional training to perform their duties. Students assess as insufficient their skills in: performing emergency actions in extravasation of cytostatic, application of algorithms for behavior in case of hypersensitivity, application of diet in patients undergoing cytotoxic therapy. It was found that the oftenest teaching methods for the acquisition of knowledge are lectures. Ranking of methods for acquiring skills according to the respondents are as follow: lectures (66,13%), practical (63.71%), work in small groups (14,53%) and role games (7,34%). The least represented is the simulation as a training method (6,41%). Four of five students didn't participate in projects with oncological focus during the training period.

Conclusions
Mastering practical skills in the field of oncology care during the basic training of nurses is an important but neglected part of education. The role of interactive methods should be increased because practical training of students in Nurse is theorized. Involving students in practical activities will stimulate their creative activity.

Key messages
Students in Nurse specialty assess their practical skills in the field of oncology care as insufficient, and emphasizes on the necessity of their enhancement. One of the main problems of training nurses in oncological care is a prioritization of theory than practice. Skills acquiring is not effective without application of interactive methods of training.
Dual-duty caregivers: formal and informal care roles and their implications among nursing workers
Authors: Gur A , Halperin D , Mashiach-Eizenberg M 
Published: October 2021

Abstract

Background
A nursing worker who is also a caregiver of an elderly family member, plays a dual-duty role, which is challenging and requires knowledge, skills and professional experience. The interaction between family and work entails a spillover between the two, and affects employees and healthcare organizations. The current exploration study examined differences between nursing employees who hold a dual role and those who do not, while identifying implications of the dual-duty role and the correlations between them at the individual level that might negatively affect the organization.

Methods
A cross-sectional quantitative study was conducted, including 158 staff members from nursing homes in Israel: 41.8% were also informal caregivers for elderly family members, 62.5% were women, and 79.2% were Arabs. A self-administered questionnaire was used to measure workload, family-work conflict, absenteeism, tardiness, and intentions to leave the organization. Participants with a dual role tended to be older, had more children, had worked for longer period, and held part-time positions compared to those who do not.

Results
Preliminary results showed no significant differences between the two groups. Pearson correlations revealed that workload and family-work conflict were positively associated with leaving intentions (dual-role caregivers: r=.30, p&lt;.05, r=.45, p&lt;.01; others: r=.61, p&lt;.01, r=.34, p&lt;.05). Among the dual-role group, workload was related to absenteeism (r=.27, p&lt;.05), and family-work conflict was related to absenteeism and tardiness (r=.24, r=.29, p&lt;.05). Among the other group, only family-work conflict was associated with tardiness (r=.33, p&lt; .01).

Conclusions
As negative consequences were indicated for workers with a dual-duty role, additional research in the healthcare sector should be conducted, leading to intervention programs for helping employees and organizations deal with the dual role and serving as the basis of policies and procedures.

Key messages
Nursing workers often suffer from workload and family-work conflict. Workload and family-work conflict among dual-duty caregivers might result in withdrawal behaviors (tardiness and absenteeism).
Measures for co-medicals in postwar Okinawa: scarcity of the personnel for allocating vaccinations
Authors: Ogawa S , Otani J , Cavaliere P , Dini L 
Published: October 2021

Abstract

Background
The shortage of doctors in postwar Okinawa has led to the creation of co-medicals. They were called medical service personnel and authorized to handle certain medical treatments. This included tasks such as providing injections and vaccinations under the supervision of the doctor in the health center.

Issue/problem
The system of co-medicals only applied in Okinawa and not in Japan. As such, when Okinawa was reverted back to Japan in 1972, it was proposed to abolish the system. In the current emergency of the new coronavirus pandemic, we are facing a similar situation in terms of the shortage of medical personnel.

Description of the problem
In Japan, like many countries, there is a shortage of health resources due to the COVID-19 pandemic. The focus will be on healthcare personnel, those who have taken on the role of COVID-19 vaccinators in Japan, and a comparison of the situation in other countries.

Results
In Japan, vaccinations are legally limited to being administered by doctors and nurses. However, pharmacists have taken on the role of administering vaccinations in the UK, US, Ireland, Canada, and Italy, thus COVID-19 vaccinations could be easily integrated into these routine procedures.Even vaccinations by medical students have been carried out. In addition, non-healthcare volunteers have been trained as vaccinators in UK and Italy. The coverage has reached 50% in the UK, 42% in the US, and 30% in Canada, whereas 1.8% in Japan in April (Our World in Data, 2021).

Lessons
Although the COVID-19 situation is substantially different from the case of postwar Okinawa, it will be necessary to take resilient measures to solve the medical personnel shortage. Additionally, the strict measures of limiting vaccinations by medical doctors may need to be reconsidered in Japan. Establishing a system of allowing co-medicals to have a shared role could offer innumerable benefits for all.

Key messages
Expanding the task of vaccinations to co-medicals has had beneficial results in several countries. Dividing roles of medical doctor need to be considered.
Awareness of knowledge related to administering medication for children by mothers among pharmacists
Authors: Yanagi N , Satoh H , Sawada Y 
Published: October 2021

Abstract

Background
Inappropriate medication use for children by caregivers such as mothers and nursery staff has been reported in Japan. The pharmacists have the responsibility to support adequate medication administration and should consult effectively. However, it is not clear how much pharmacists are aware of the knowledge of medication use by caregivers. This study aimed to examine the knowledge related to administering medication for children among mothers and nursery staff and to evaluate the awareness of that understanding among pharmacists.

Methods
Three online surveys involving 600 mothers living with nursery school children, 558 nursery staff at nursery schools, and 584 pharmacists in Japan were conducted separately (Cross-sectional data, in 2019/2021). Ten statements about the knowledge related to administering medication for children such as “You could give the medicine that has been prescribed before if similar symptoms are shown”, “You should give children the medicine using favorite beverages such as milk and juice, regardless of the kind of medicine” were shown and measured using a 5-point Likert scale. The answer: “disagree”, was considered as correct understanding. The pharmacists were asked how much they think mothers/nursery staff answered correctly using a 5-point Likert scale.

Results
The proportion of correct answers for ten statements by mothers and nursery staff were 35.8%-76.0% and 43.0%-69.9%, respectively. Most answers from pharmacists were in the category range of 40%-59%. Only 11.5%-33.0% of pharmacists chose the correct category in each of ten items with mothers' answers and 24.0%-83.4% of them had lower awareness.

Conclusions
Overall, the pharmacists were less likely to be aware of the mothers'/nursery staff members' knowledge related to administering medication. The pharmacists need to instruct mothers to administer medication after confirming their understanding at the pharmacy.

Key messages
The awareness of knowledge related to administering medication for children by mothers and nursery staff among pharmacists was lower than the answers. The pharmacists need to instruct mothers to administer medication at the pharmacy after confirming their understanding of medication use.
Occupational standards as a tool to bridge the gap between health care practice and education
Authors: Koikov VV , Akanov AB , Baigozhina ZA , Abduazhitova AM , Derbissalina GA , Abdrakchmanova AO 
Published: October 2021

Abstract

Issue/problem
The intensive development of the labor market in the healthcare system (HS) and the active introduction of new technologies, noted in recent years, require the creation of conditions for the continuous provision of the HS with the necessary number of specialists with the appropriate level of qualifications and scope of competencies. To do this, it is necessary to ensure that medical educational programs (EP) correspond to the competencies that are actually necessary for health professionals and meet the requirements of the authorized body (Ministry of health), the expectations of employers, the needs of employees and patients.

Description of the problem
One of the significant problems of the medical education system in the Republic of Kazakhstan (RK) is that the EP of medical universities and colleges do not fully reflect the needs of the HS, and graduates of universities and colleges do not fully meet the needs of the HS. This situation is due to the fact that until recently there were no occupational standards (OPs) that determine the requirements for the competencies of specialists working in the HS.

Results
To solve this problem, the new Code of the RK ‘On the health of the people and the health care system', adopted in 2020, defines the norms that regulate the fact that: medical educational organizations develop EPs in accordance with the requirements for the level of qualifications established in OPs; assessment of the professional preparedness of graduates of EPs is based on OPs; continuous professional development and certification of healthcare workers is based on OPs. In 2020-2021, the development of OPs and their introduction into the medical education system began, which made it possible to bring EPs in line with the needs of practical healthcare.

Lessons
The introduction of OPs into the medical system makes it possible to ensure that the competencies of healthcare workers meet the needs of practical healthcare.

Key messages
The introduction of occupational standards helps to bridge the gap between practical health care and medical education system. Orientation of educational programs to occupational standards allows to ensure healthcare system by specialists corresponding to the needs of practical health care.
Evaluating the effectiveness of pneumococcal conjugate vaccine in Taoyuan city on adult population
Authors: Yen A , Chen L , Jeng Y 
Published: October 2021

Abstract

Pneumococcus is one of the major threat for senior citizens health worldwide. Pneumococcal Conjugate Vaccines (PCV7, PCV10, and PCV13) were gradually commenced in the national pediatric immunization programme in Taiwan since 2005 and polysaccharide pneumococcal vaccine (PPV23) was granted adult indication since 2015. However, in a most-recent nationwide long-term surveillance, the PCV13 serotypes have shifted to being dominated types in that of &gt; = 65 years-old seniors. This study aims to evaluate the PCV13-introduction effectiveness based on a selected test city. Data of the national health insurance research database (NHIRD) between 2013 and 2018 were retrieved to collect data on yearly medical use of citizen aged 65-66 years and were linked to the death registry database for death-ascertainment. Compared to females, males had more hospitalization due to IPD (RR = 1.37, 95% CI: 1.04-1.79) and due to pneumonia (1.69, 1.34-2.14). The introduction of PCV13 free-vaccination was associated with significant reductions of hospitalization by 40% for IPD (0.6, 0.51-0.71) and 36% for pneumonia (0.64, 0.58-0.7) in females. However, the effects were not significant in both sex combined and in males. As far as mortality is concerned, the introduction of the PCV13 free-vaccination had 33% lower risk of all cause death with IPD claimed within one month of death (0.67, 0.49-0.91) and for pneumonia (0.77, 0.60-0.99). This was also observed in both sex combined (0.82, 0.68-0.98) for IPD, but not for pneumonia, or for both events in males. In conclusion, the policy of PCV13 vaccination for seniors aged 65 years was associated with all-cause mortality with IPD or pneumonia claims one month before death. The evidence was stronger in females than in males. The effectiveness for the associated reduced hospitalization has been demonstrated in females. Further analysis with individual vaccination history and extended years is needed. Funding: The current study was funded by Pfizer Limited (Taiwan).

Key messages
The pneumococcal serotype shift has been found in elderly from PPV-23 vaccine-type to PCV vaccine-type and hence the preparedness of PCV13-introduction for elderly immunization programme is necessary. The findings of this pilot study included the effectiveness of PCV13-introduction in seniors aged 65 years and some implications to subgroup analyses needed for preparing a nationwide implementation.
Parents’ perception of overweight-obese children Quality of Life in different settings
Authors: Esposito F , Sanmarchi F , Marini S , Masini A , Gori D , Scrimaglia S , Reno C , Serra L , Vandini S , Dallolio L 
Published: October 2021

Abstract

Background
Children's Health-Related Quality of Life (HRQoL) has been frequently investigated, in particular among individuals affected by chronic diseases. It is reported that agreement between child and parent ratings regarding the child's HRQoL is strongly influenced by the latter's health status. To our knowledge, there is no evidence of how this agreement is related to different healthcare settings. Thus, our study aims to examine the relationship between child's and parent-proxy reported HRQoL of similar overweight/obese children according to the recruitment setting.

Methods
A cross-sectional study was conducted among 68 overweight/obese children, aged 6-10, recruited in a primary school (Group1, G1) and in a hospital outpatient clinic (Group2, G2) of Imola (Italy) in 2019. HRQoL was assessed using Italian version 4.0 of the Pediatric Quality of Life (PedsQL) questionnaire. For each child, we obtained self-reported children's and parents' perceived children's HRQoL total score (5 questions investigating Physical Health domain and 10 questions investigating Psychosocial Health domain divided in Emotional, Social and School Functioning).

Results
In G1 there were n = 42 overweight/obese children and in G2 n = 26. The correlation between children's reported and parents' perceived HRQoL scores is lower in G1 (Physical Health: r=-0,17; Psychosocial Health: r = 0.38) compared to G2 (Physical Health: r = 0.80; Psychosocial Health: r = 0.66). Notably, in G1, parents tend to overestimate their children's HRQoL, specifically in the Physical Health domain.

Conclusions
Correlation between children's and parents' HRQoL scores is higher in the clinical setting compared to the school setting. Implementing this questionnaire on a large scale would allow us to identify settings which need awareness-raising initiatives to improve parents' knowledge about their children's health.

Key messages
Parents’ overestimate children’s HRQoL in the school setting, particularly in the Physical Health domain. Children’s HRQoL misinterpretation might determine less targeted actions to improve their wellbeing and highlights the need for raising parents’ awareness about obesity and its effects on children.
Do families have moderating or mediating effects on early health inequalities? A scoping review
Authors: Hoffmann S , Sander L , Blume M , Schneider S , Herke M , Fialho PM , Pischke CR , Schüttig W , Lampert T , Spallek J 
Published: October 2021

Abstract

Background
During early childhood, families have a crucial impact on children's health behaviour, health, and development (bhd). However, a family's socioeconomic position (SEP) determines both the parental behaviour, living conditions, and child health. To understand how family characteristics may influence the development of health inequalities, this scoping review synthesised research on their mediating and moderating effects.

Methods
The review followed the guidelines of the PRISMA Extension for Scoping Reviews. The search included German and English peer-reviewed articles published between January 1st, 2000 and December 19th, 2019. The search in PubMed, PsycINFO, and Scopus used both free text terms in the title/abstract and index terms within linked keyword blocks: (1) family characteristics, (2) inequalities, (3) income, education, occupation, (4) bhd, (5) newborn, infant, toddler, preschooler. Two researchers independently examined eligibility for inclusion in two rounds (title/abstract; full-text).

Results
Of 7,089 articles identified, ten sources were included that studied family characteristics and health inequalities among 0-6 years olds. Parental rules, stress, and screentime, and TV in bedroom showed mediating effects on inequalities in behaviour problems or children's screentime. Families' negativity, single parenthood, and the number of children in the household moderated differences in impairment, health, behaviour problems, development or breastfeeding initiation.

Conclusions
The effect of family characteristics on early health inequalities has been sparsely investigated. The evidence supported models of family stress and investment. Further research is needed to comprehensively understand this association.

Key messages
Family characteristics contribute to health inequalities. Taking families’ stress and investment into account could improve targeted prevention efforts aimed at reducing health inequalities.