bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient-GP-Pharmacist cooperation towards individualized tapering schemes for long term benzodiazepine users
Authors: Saevels Jan , Storme Michael , Straetmans Koen , De Rocker Hendrik 
Published: January 2024

Long-term use of benzodiazepines and Z-drugs is associated with multiple side effects, such as increased sedation, fall risk, and an elevated risk of dependency and abuse. Avoiding initiation of treatment, or stopping treatment after a few weeks, is definitely the best-case scenario. But for patients that are already using benzodiazepines for more than 3 months (up to 20 years or more), a deprescribing methodology should be deployed. Abrupt withdrawal, particularly if the individual has been taking the drug in high doses, can result in severe symptoms, including psychotic reactions. The recommendation is for slow withdrawal, tapering the dosage gradually over a period of several months.
Pharmacy compounding of capsules has been a possibility for many years, and allows to prepare and dispense individualized dosages to patients. Medical practitioners such as GP’s have always had the possibility to prescribe dose reduction schemes for patients motivated to taper off. Unfortunately, as benzodiazepines are not reimbursed in Belgium, this came at a high cost for patients.
In 2022, pharmacy associations together with health insurance funds and the National Institute for Health and Disability Insurance (NIHDI) worked on a reimbursement scheme that allowed tapering off benzodiazepines. The patient-GP-pharmacist triangle is at the core of the scheme:
-Pharmacists raise awareness when dispensing prescribed benzodiazepines, and prepare and dispense individualized doses
-GP’s motivate patients to consider tapering and prescribe the programme
-Patients engage in a tapering path and are intensively followed by the GP and the pharmacist
Apart from the roles and responsibilities of the 3 parties, there are some rules set out to increase the change of successful tapering whilst keeping expenditure under control. For instance, a maximum daily consumption of 3 DDD set out, there is choice between 3 tapering schemes (5, 7 or 10 steps), and the total duration of the programme should not exceed 360 days.
Critical success factors of these programs are: intrinsic motivation of the patient, therapeutic contract with 3 parties concerned, absence of financial penalty for patients, and smooth communication between prescriber and preparer/dispenser.
How collaboration between (occupational) physicians and work actors foster successful reintegration to work after or during health problems.
Authors: Bassele Nikolaj , Germeys Lynn , De Roeck An , Vanacker Hilde 
Published: January 2024

Incapacity to work has a high price tag. The longer someone is incapacitated for work, the more difficult it is to return to work. It is therefore of the utmost importance to give employees the opportunity to return to work at an early stage. Fortunately, in most cases employees with health problems return to work, whether or not through a (in)formal reintegration process. However, sometimes employees need more specialized support or guidance to return to work, either to their own employer in the same or an adjusted function, or to a new employer.
Two Belgian external services of prevention and protection at work (Idewe and Mensura) collaborated with the Flemish public employment service (VDAB). They aimed to foster and speed up the reintegration of incapacitated employees who could not return to their own employer. The pilot study ran from September 1, 2021 till December 31, 2022. The study included more than 300 incapacitated employees who were definitively unfit for their agreed work according to the assessment of the occupational physician.
During the pilot study the incapacitated employees were informed individually about the range of services VDAB and its partners have to offer to support the reintegration into the labor market. In addition, the study examined the outcomes of a fast and privacy-proof manner of voluntary registration from the occupational physician to VDAB. Moreover, the study examined the communication between the actors involved in the reintegration process, such as when and which information is needed.
During the presentation we will be able to present the final conclusion of the pilot study (e.g., which services were provided to support reintegration, how many incapacitated employees returned to work).
First steps towards a shared care model for spinal cord injury in rural Switzerland
Authors: Tomaschek Rebecca , Touhami Dima , Essig Stefan , Gemperli Armin 
Published: January 2024

Background: Persons with spinal cord injury regularly consult primary and secondary care physicians for their holistic needs. However, in remote areas of Switzerland general practitioners (GPs) compensate for a potential undersupply of specialized services. Building collaboration and distributing roles between GPs and specialists is needed to improve the continuity of care for persons with spinal cord injury living in rural Switzerland. This intervention study aims to develop, implement and evaluate an integrated care model as a case in point.
Intervention: As part of the study, physicians from specialized spinal cord injury centers, specialized mobile nurses and GPs collaborate to improve patients' outcomes and providers’ experience with delivery of care. Measures to enhance collaboration include joint continuous medical education, training in the primary care practices and support for complex patients. Medical education topics cover the most prevalent secondary health conditions, as well as physicians’ priorities and interests for shared care. During the design of the intervention, persons with spinal cord injury and their families were engaged in a sounding board, where they expressed their wishes and concerns.
First results: Seven primary care practices were successfully recruited to expand competences in spinal cord injury care. Persons with spinal cord injury, living in the practices’ catchment area were invited to the practice. Mixed methods evaluate patient and health provider outcomes at specific time points. Baseline results on the collaboration between GPs and specialists, show high physician satisfaction ratings. Challenges in collaboration seem to be related to unclear roles and responsibilities due to different expectations among physicians. Between baseline and 1-year follow-up, significant differences were found in the average number of patients’ GP visits.
Next steps: As a second study phase, more primary care practices will be recruited. Healthcare professionals will discuss and negotiate their roles and responsibilities in round tables. To support a common understanding, a toolkit for primary care will be developed. Lastly, more components that enhance shared care should be introduced such as joint patient consultations or information exchange platforms.
Youth Wellness Hubs Ontario: A Youth Mental Health and Substance Use Learning Health System
Authors: Henderson Jo , Papadimitriou Maria , Darnay Karleigh 
Published: January 2024

Problem and Context. The need for youth-friendly early intervention services to meet the mental health, substance use, primary care, and other social needs of adolescents and young adults is well-documented. Clinicians and researchers in child and youth mental health have been calling for better integration of child, youth, and family-facing systems (e.g., health, mental health, child welfare, youth justice, education), as well as increased attention to holistic services that reflect the developmental, cultural, social, and health realities of children, youth and families. Integrated youth services are designed to address the gaps in youth mental health by providing youth-friendly, comprehensive services for youth ages 12 to 25, in a one-stop shop model of service delivery.
Who is it for? Service providers, researchers, clinicians, youth and families.
Who did you involve and engage with? A fundamental contribution of YWHO is the inclusion of meaningful youth and family engagement processes in service design, delivery, and evaluation. YWHO has youth and family advisory councils both at the provincial and local levels who contribute to planning and operations, including service planning, governance, training, evaluation, communications, and funding-related decision-making. A decade of research has supported the development of integrated youth services for youth mental health.
What did you do? This presentation will describe Youth Wellness Hubs Ontario, a province-wide initiative in Ontario, Canada to build and implement a one-stop-shop model of integrated youth services. The presentation will also describe the model’s values, core components, and services.
What results did you get? What impact did you have? The demonstration phase of Youth Wellness Hubs Ontario was initiated in 2017-2018 with the implementation of 10 sites. In 2022, 22 IYS networks have been established. Youth Wellness Hubs Ontario is co-created with youth for youth aged 12 to 25 years old across diverse community contexts. Youth Wellness Hubs Ontario centres engagement and equity, and offers developmentally-appropriate services in an integrated, community-based walk-in format. As an initiative committed to continuous learning and quality improvement, Youth Wellness Hubs Ontario offers evidence-based and evidence-generating services, and measurement-based care. Youth Wellness Hubs Ontario is supported by backbone resources with expertise in implementation science, health equity, Indigenous practices, youth and family engagement, evaluation, and knowledge translation.

What is the learning for the international audience? Youth Wellness Hubs Ontario demonstrates the feasibility of integrated mental health and substance use early intervention services, offered in the context of a broad range of health and social services.
What are the next steps? Future directions include continuous learning and evaluation of the YWHO model in communities.
A plea for a meaningful life ... on the road with your own network
Authors: Hugens Skrolan 
Published: January 2024

If someone becomes seriously ill, has a child with a disability, has a serious accident… a lot of organization is needed to arrange all medical care and necessary support for that person (and often for the family as well).
People testify; you are overwhelmed by your illness, you do what needs to be done, you go into survival mode… This survival mode is a major force in making sure people can arrange everything that needs to be arranged, but it also results in disregarding important questions such as 'what do I really want now?', 'how do I feel good in this situation?', 'how do I survive in the long term?'.
Fortunately, in such moments there are often other people like family and friends, who think of the “small bearers of luck in life”: which music can be played in their room, which friend can join them at a treatment, which cake is to be taken to the rehabilitation centre, how can the parents recharge their own batteries so they can keep on going? ...
Important human gestures, close ones and relatives who stay involved, fight for what's important, don't let go, are as important as good medical care and support.
People who call on Lus feel the need for a strong(er) "back-up group" or "loop (lus)" of family and friends, because they want to build a good and happy life, not just survive...
Lus-groups meet this requirement. Volunteers ensure that a Lus-meeting is guided so that subjects/themes that really matter are discussed. Concerns are talked about and plans are made to engage, also in fun things. All participants assess in what way(s) the central person’s talents/interests/wishes stay at the center of the gatherings. They discuss problems, celebrate/share successes and express gratitude. Great and small, genuine concerns are shared so that people can lead a meaningful life again. Having conversations that really matter, making choices based on this knowledge, those are the strengths of our groups.
Over time we see that people in Lus-groups slowly regain control of their own lives again and reciprocity grows back: the central person takes on the hosting, he helps an other, ....
People have been meeting in Lus-groups in Flanders for 20 years. At this time there are 120 active groups. This way, 700 people are involved in the lives of others and we form a web of caring Flemish citizens.
As a result of the expertise we built in our Lus-groups, we designed a model that highlights the 4 key elements of every lus-group. In the workshop we want to discuss those 4 themes. Through small excercises and testimonials we want to let the participants feel the Lus-vibe!
Awareness, Knowledge and Attitudes of the Brussels and Flemish-Brabant Population towards Paternal Perinatal Depression in Belgium
Authors: D'haenens Florence , Akalin Ayse , Demedts Dennis , Fobelets Maaike , Tricas-Sauras Sandra 
Published: January 2024

Introduction: Paternal perinatal depression (PPND) occurs in 10% of fathers, which implies an important burden for families and public health services. A better understanding of the population awareness on the topic is essential to adequately identify and adequately support these cases.
Objective: This study aims to investigate the awareness, knowledge, and attitudes of the Brussels and Flemish-Brabant population in Belgium towards PPND, using the validated Depression in Dads (DDads) questionnaire.
Methods: A two-strands descriptive study was conducted in the Brussels’ Capital Region and in the province of Flemish Brabant, Belgium between March-May 2020 and March-May 2021. The sample included 314 adults, aged 18-65 years, Flemish speaking, and living in the previously cited provinces. The DDads Questionnaire was administered online via LimeSurvey© (an encrypted and secured online data collection service) due to the COVID-19 social distancing measures. Data were analysed using IBM SPSS 28.0 SPSS© Statistics for Windows©. Ethical approval was obtained from the Brussels’ University Hospital and the Vrije Universiteit Brussel (VUB) committees.
Results: In the case of respondents, anxiousness was the most frequently cited mental health problem as experienced by men during their partners’ pregnancy (82.4%) and during the postnatal period (68.4%). Although well recognized as mental health issue, and as a general health concern, paternal depression had low recognition by respondents, and it was considered by 37.3% of them as being “normal” during the process of fatherhood. New personality traits such as (withdrawal, avoidance, isolation, indecision, or irritability, amongst others) were regarded as a common symptom of PPND by 64.6% of respondents. When asked about best ways of coping -in the case of paternal depression- non-pharmacological approaches were mostly preferred. In the case of experiencing PPND, the main advice was to ask for support from informal networks (family or friends) whilst professional support from the mental health services was suggested only as a secondary option. Over 70% of respondents believed that paternal depression requires from a specialized treatment though. Only 39.2% of the respondents agreed that all men should be screened for depression symptoms during pregnancy, and 43.0% of participants agreed that those symptoms should also be checked after delivery.
Conclusion: Attitudes towards PPND appeared to be diverse. PPND and perinatal mental health terms seem to be poorly understood. A clear need to increase awareness concerning men’s mental health during pregnancy (of their partners) and PPND is patent. Better awareness may help fathers in difficulty to be identified earlier, for them to be better attended during this process, and to decrease PPND rates and ultimately improve perinatal mental health.
Unlocking the muse - Developing arts-based approaches for people with Parkinson’s disease
Authors: Stap Thieme , Koksma Jur , Crone Julia , Pelowski Matthew , Bloem Bas , Spee Blanca 
Published: January 2024

Interventions considering the arts are increasingly gaining acceptance in the clinical-methodological repertoire, and in supporting people with diseases. However, current approaches are often limited considering the variety of offered creative activities and are neglecting the influence of the artistic context. Furthermore, there is often a focus on momentary well-being primarily and not on the impact on quality of life, missing centralization around the transferability of creative engagement and art-based interventions into daily life issues. The goal of our study is the implementation of a person-centered, art-based program.
We offer people with Parkinson’s a program wherein they participate in orientation sessions (playgrounds) to find preferred activities, and in specialization sessions (artist studio’s) to develop deep engagement/flow in the preferred activities. Self-direction by participants and a psychological safe environment, are the cornerstones of this program. The first group of participants (n=5) took part in a pilot study. A second pilot and full trial will take place early 2023.
The activities can address both instrumental (practical utilization) and non-instrumental (existential) creativity, with the upper goal to increase the individuum’s quality of life as the main outcome variable. Besides these three quantitative measures (pre/post), individual open interviews (pre/peri/post) are held and analyzed using thematic and grounded methodologies. We aim to distil the active ingredients to transform a person’s mindset and skill-set to learn that engaging with creativity is a tool for enhancing individual quality of life in a self-empowered manner. We will present the first outcomes of our study in this poster.
Integrated Care and Social Protection for Senior Citizens In West Africa: A Scoping Review
Authors: Banaru Abubakar Ibrahim , Banaru Abubakar Hafsat 
Published: January 2024

Background: West Africa's population is aging at a rapid rate, and the prevalence of older adults with multiple chronic conditions is rising. However, there is little information available about healthcare policies for this age group in this region ten years after the Madrid International Plan of Action on Ageing (MIPAA). To manage the physical and psychosocial needs of senior citizens, a greater integration of healthcare services is required.
Methods: A scoping review was conducted adhering to the Joana Briggs Institute’s systematic scoping review protocol guidelines. A simple search strategy was developed to collate relevant articles from PubMed, Google Scholar, and AJOL, as well as policy databases, between 2002 and 2022. Articles were included if published in English and related to primary care, social care, and multi-morbidity among older persons in West Africa.
Results: The findings yielded three thematic issues. First, most West African countries have policies on healthy aging; however, only a few have coherent policies on access to healthcare for older people and the availability of social safety nets, highlighting the need for policymakers to provide coherence and avenues for integration. Secondly, while integration of non-communicable disease services focuses on individual-level services rather than multi-sectoral integration, there is also a poor focus on mental health and sexual and reproductive health integration. Finally the inherent capacity development needs and technical up-skilling requirements require a whole-system approach with contextual nuances.
Conclusion: The literature is increasingly recognizing an aging population and the prevalence of multi-morbidity in West Africa. Countries in West Africa, in response to the MIPAA, have formulated policies with regards to older persons' healthcare needs; however, improvements in clinical care at the individual setting level may not be sufficient. A deliberate whole-system approach that fosters multi-sectoral collaboration for integrated healthcare might go a long way toward better outcomes for senior citizens and a step forward toward universal health coverage.
Neighbourhood care meetings by BruZEL
Authors: Moortgat Dorrit 
Published: January 2024

What is it about? The main task of the BruZEL primary care zone is to connect first-line care actors to ensure that people in need of care or assistance get the help and care they need in their own neighbourhood.
Who is it for? Finding the help and care they need is a difficulty for many citizens, especially in the Brussels Capital Region where the health care landscape is complex and fragmented. A first step in facilitating access to care is creating a local network of care providers to get to know each other and coordinate with one another. This ensures a multiple aim, e.g.:
* all citizens receive the help and care they need
* qualitative integrated care is provided in an effective way
* care providers are more satisfied
Who is involved? A staff member of BruZEL initiates, stimulates, inspires and leads the local network.
This network involves all actors listed within the integrated care model: it is open to all health care providers and welfare workers, local authorities, citizens, teachers, shop owners...
What do we do? The neighbourhood care meeting assembles all actors mentioned above about 4 or 5 times a year either physically or online:
* to get to know each other (and each other’s work) better
* to exchange information
* to find local solutions for complex cases
Furthermore, they all exchange contact details in order to be able to address whenever necessary to everyone and to provide the answers ASAP. Prerequisite is that they do not share sensitive information (GDPR compliant).
What are the results and the impact?
* (Health)care professionals know each other more and know what role they can play in the (health)care process. This knowing leads to better understanding which eventually results in a better collaboration

* Defining (health)care-related information and/or referral points with a broad view and therefore a key role
* People in need of care get adequate (local) help through their (health)care provider
* Creation of a local health and care map (work-in-progress)
* Possibility to detect recurring problems
What is the learning?
* It is a simple concept but it works!
* The connection in the bilingual Brussels Capital Region is not a problem as everyone can speak their own language
What are the next steps?
* This concept has so far been developed in 1 community (Jette). The idea is to extend it to others.
* Explore what is possible with the central role of the (health)care-related information and/or referral points
* Achieve sustainability by handing over the meeting to local actors who can strengthen and formalize these steps towards integrated care
Shifting to person-centred service delivery with coordinated health and social outcomes
Authors: Upegui Héctor 
Published: January 2024

CHSO is a person-centric service delivery model where health and social services are provided in a coordinated way to improve outcomes. It does not require merging agencies or governmental bodies, but it’s an approach that involves all stakeholders, including the person receiving the service. It’s a model to enhance the flow of service, so that the person doesn’t navigate alone through all this complexity, but that the system adequately rotates around the person. It goes beyond just aligning health and social care services, or just organising them as check lists for execution. It is about understanding the needs of the person, the service delivery process, the rationale behind it and the best route in reaching outcomes.
To provide person-centric care, health and social services need to improve their coordination of services. This paper presents and reflects on six elements identified through worldwide observations of ongoing care transformations.