bluuebunny/crossref_metadata_2025_split huggingface dataset:
Challenges Related to Recruitment and Involvement of Frail Older People in Service Development
Authors: Langergaard S , Overgaard C , Petersen K S , Andreasen J 
Published: October 2023

Abstract

Background
Involving relevant stakeholders in development or improvement of community health services is rapidly increasing and found to be of pivotal importance for the success of the service. Involvement can help identify priorities, understand the problem, and find solutions. However, frail older people are often hard to reach, and can be an underrepresented group in terms of involvement in community health services. If community health services targeted frail older people, are expected to benefit their health and well-being, the voices of this group need to be heard and taken into consideration.
The objective was to involve frail older people in the development of a health service offered in municipal senior centers, aiming to improve frail older peoples’ possibilities of accessing the social communities of senior center and thereby improve their health and well-being.

Methods
The involvement was carried out as continuous panel meetings throughout the development process with a panel consisting of five senior center users, recruited through a senior center staff member functioning as gatekeeper. One researcher facilitated the panel meetings.

Results
The involvement brought forth important knowledge about the need of frail older people, when wanting to become part of a social community. Nevertheless, two main challenges emerged during the involvement period: 1) Recruiting frail older people proved difficult albeit a gatekeeper being used and 2) Facilitation of, and the methods used for, the panel meetings should be appropriate for involvement of the specific target group, in this case frail older people, to allow for all participants to be heard.

Conclusions
Considerations about the involvement concepts, methods and facilitation are crucial in order for challenges linked to involvement to be minimized, making it possible for the needs of frail older people to be heard and met in the development or improvement of community health services.
The Added Value and Unintended Negative Consequences of Involvement Processes
Authors: Petersen K S , Pedersen J F , Egilstrød B , Overgaard C 
Published: October 2023

Abstract

Background
Public involvement is widely considered a way to improve health and quality of health services. The research literature reveals ambiguities concerning the added value and the unintended negative consequences of public involvement processes. The aim of this study was to identify, synthesize and present an overview of added value and unintended negative consequences of public involvement processes in the planning, development, and implementation of community health services.

Methods
36 peer-reviewed articles retrieved from a systematic search (published in a review article) in the CINAHL, Cochrane Library, Embase, PsycINFO, PubMed, ProQuest, and Scopus databases in 2021 were coded and extracted according to the aim of the study. A thematic synthesis was conducted involving (1) line-by-line text coding, (2) developing descriptive themes and (3) generating analytical themes.

Results
Two main themes with corresponding subthemes were identified providing an overview of the added value of public involvement processes (theme 1) at individual, service, and political levels. Unintended negative consequences (theme 2) show how individual resources is required, and uncertainty about the effect of involvement on services and power differences among providers and the public revealed.

Conclusions
The added value of public involvement processes is primarily reported on an individual and service level and often accompanied by unintended negative consequences. Professional facilitators and recruitment of a wider group of participants representing vulnerable groups is important to promote equality in public involvement.
International Comparison of Professional Competency Frameworks for Advanced Practice Nurses
Authors: Wit R F , Noorland S A , de Veer AJE , Batenburg R S , Francke A L 
Published: October 2023

Abstract

Background
Advanced Practice Nurses (APNs) have become established professionals in many healthcare systems. APNs combine nursing with medical expertise, bridging the boundaries of traditional professions in nursing and medicine. This study focuses on the content of professional competency frameworks for APNs in different countries to determine (1) how these frameworks define the competencies of APNs and (2) address the division of tasks between APNs and physicians.

Methods
An inductive content analysis is conducted of the competency frameworks for APNs in Belgium, Canada, the Netherlands, the United Kingdom, and the United States.

Results
In Belgium, the Netherlands and the US, the framework is based on an existing model, while in Canada and UK, frameworks do not refer to a model. The analysis revealed twelve generic competency domains for APNs: 1. Clinical Care in Practice, 2. Independent Practitioner, 3. Professional Attitude, 4. Scientific Research & Evidence-Based Practice Care, 5. Leadership, 6. Health Promotion and Public Healthcare, 7. Communication and Collaboration, 8. Organisation of Care and Policy, 9. Support of Self-Management and Patient Empowerment, 10. Quality and Safety of Care, 11. Teaching and (continuing) Education, 12. Technology and E-Health. There are some differences in explicitly to which high-risk procedures are described per country. The frameworks provide limited descriptions of task division and delegation from physicians to APNs, except for the frameworks from Belgium and the Netherlands.

Conclusions
Despite variations in the basis of professional competency frameworks per country and country-specific influences, twelve generic competency domains with similar competencies were identified. It is recommended to stimulate the development of a global standardised competency framework for APNs, including clear descriptions of task division and delegation, to optimise their role in delivering high-quality healthcare services.

Key messages
• Similar APN competency expectations suggest the need for an international competency framework, including roles and tasks for APNs, to function as a basis for individual country frameworks.
• Nursing associations can use this study to learn from other countries and enhance their development of country-specific competency frameworks for advanced practice nurses.
Assessing examination equipment accessibility for the disabled using non-fidelity of checkup items
Authors: Park B , Park J , Kim S 
Published: October 2023

Abstract

Background
Even after arriving at the hospital for a health checkup, access to equipment of the disabled is often limited. However, there is a lack of investigation on accessibility of health examination equipment due to difficulty in appropriate evaluation.

Methods
The Korean national health information database was analyzed to assess the non-fidelity of health checkup screening items for the disabled and non-disabled. Health checkup items included height, weight, BMI, visual acuity, audiometry, blood pressure, urinary protein, hemoglobin and chest X-ray. To analyze the non-fidelity of health checkup items according to the characteristics of the disabled, a chi-square analysis was conducted. Logistic regression analysis was performed to non-fidelity the influencing factors for non-fidelity of each health checkup item for the disabled and non-disabled.

Results
Among all health checkup participants, women's non-fidelity rate of checkup items was twice higher than men's (OR 2.20, 95% CI 2.18-2.21). The disabled were more twice times higher non-fidelity rate than the non-disabled(OR 2.49, 95% CI 2.47-2.52). It was evident in the case of women disabled, severely disabled or elderly disabled(&lt;.001).

Conclusions
The non-fidelity rate of the disabled was high, especially for women disabled, severly disabled or elderly disabled. Even if the disabled visit a hospital for health checkup, access to the equipment may be limited. To increase accessibility to diagnostic equipment and improve access to essential health services, it is important to monitor and support the non-fidelity of each checkup item.

Key messages
• The disabled are more than twice as likely to have higher non-fidelity rates of health checkup items than the non-disabled.
• Especially it was high among women disabled, severely disabled or elderly disabled.
The impact of compliance with health literacy principles in Facebook posts on user engagement
Authors: Wei M , Chen C 
Published: October 2023

Abstract

Background
Addressing health literacy in designing health messages can improve understanding and application of health information by the audience. However, the impact of health literacy-compliant social media posts on user engagement remains unclear. The aim of this study was to investigate the relationship between compliance with health literacy principles in Facebook posts and user engagement by governmental and non-governmental health organizations in Taiwan.

Methods
A total of 3,305 Facebook posts were collected from two governmental and four non-governmental health organizations. Using a proportional sampling method, 600 posts were selected for analysis. A quantitative content analysis was conducted. Compliance with health literacy principles was assessed using a Chinese tool adapted from the US CDC Clear Communication Index, which provided health literacy scores for the text and visual components of each post. User engagement was measured by the number of likes, shares, and comments. Non-parametric statistical methods were used for analysis.

Results
The use of pictures had a positive impact on the number of likes (z = 4.77, p &lt; .001) and shares (z = 2.45, p = .014) received. Posts with higher health literacy scores in their text and visual components received more likes (Spearman's r = .21, p &lt; .001 for text; r = .25, p &lt; .001 for visual), shares (r = .24, p &lt; .001; r = .24, p &lt; .001), and comments (r = .12, p = .002; r = .13, p = .002). Posts with text components that fully corresponded to health literacy indicators received more likes (z = 3.78, p &lt; .001), shares (z = 4.05, p &lt; .001) and comments (z = 2.21, p = .027) than those that only partially corresponded to. The same trend was found in visual components (z = 4.95, p &lt; .001 for likes; z = 4.92, p &lt; .001 for shares; z = 2.73, p = .006 for comments).

Conclusions
Compliance with health literacy principles and/or using pictures in Facebook posts positively affects user engagement for health organizations.

Key messages
• Health organizations should consider health literacy principles when creating social media posts to improve user engagement.
• Applying visual aids on Facebook posts enhances user engagement for health organizations.
Physical activity in leisure time and motivation among citizens with chronic disease in in Denmark
Authors: Toxvaerd C , Aadahl M , Groenkjaer M , Eliasen M , Andreasen A , Elsborg P 
Published: October 2023

Abstract

Background
Physical activity (PA) has a preventive effect on chronic disease, but PA also promotes health among citizens with chronic disease. However, the presence of chronic disease may be a barrier for PA engagement. The aim of this study was to examine the difference between citizens with various chronic diseases and all citizens in The Capital Region of Denmark in terms of the proportion who reports low PA levels in their leisure time, wants to be more physically active, and has been advised to exercise by their doctor.

Methods
Information from national registers on hospital diagnoses and medical treatment was used to identify citizens with chronic diseases. Data from “The Danish Capital Region Health Survey” among citizens (≥16 years) in The Capital Region in 2021 (N = 56,245, response rate=54.9%) were used to obtain information about citizens’ movement behaviour in leisure time, their motivation to become more physically active and whether they have been advised by their doctor to exercise. Results for several diseases will be presented but heart disease is used as example in this abstract.

Results
Preliminary results show that the proportion in 2021 who has reported low PA levels in their leisure time is almost twice as high among citizens with heart disease (35%) compared with all citizens in The Capital Region (18%). Less citizens with heart disease (62%) are motivated to become more physically active compared with all citizens in The Capital Region (73%). The proportion who has been advised to exercise by their doctor is not significantly different among citizens with heart disease (31%) and all citizens in The Capital Region (28%).

Conclusions
Among citizens with heart disease low PA levels in leisure time are more prevalent, they are less motivated to become more physically active and, despite their chronic illness, they receive advice from their doctor to the same extent. For citizens with chronic disease, it is important to engage in PA.

Key messages
• Among citizens with chronic diseases low PA levels in leisure time are more prevalent and they are less motivated to become physically active compared with all citizens in The Capital region in DK.
• Despite their illness, they receive advice from their doctor about exercising to the same extent as all citizens in The Capital Region of Denmark.
Assessing and projecting the burden of diabetes mellitus in the European Union by 2030
Authors: Mahrouseh N , Kovacs N , Andrade C , Varga O 
Published: October 2023

Abstract

Background
Although the upward trend in diabetes mellitus (DM) is known in many countries, there are considerable uncertainties in the forecasts. This study provides valuable insights into the potential development of DM in the European Union (EU) member states through past trends and future projections.

Methods
European Health Interview Survey (EHIS) 2015 and 2019 microdata from 27 EU countries were used. Finite mix model (fmm) was applied to identify subgroups within the population and obtain probability of risk factors within each group. Time indicator as interaction was added to obtain the developing trend of heterogeneous effects with socioeconomic and lifestyle risk factors that were included in the model. Forecasting was used to project probability of risk factors within each group up to 2030.

Results
Data included 500,840 participants (274,016 from 2015 and 226,824 from 2019). Fmm and forecasting results showed DM prevalence was 7.4% in 2015 and 8.4% in 2019 and expected to increase to 11.15% in 2030. High- and low-risk subgroups were identified. Most risk factors and lifestyle categories increased in the high-risk group in comparison to the low-risk group between 2015 and 2019. However, within the high risk group, the probability of living rural areas has decreased 2.7% 2015 vs. 2019 and is expected to further decrease by 10.2% up to 2030. Additionally, within the high-risk group, the likelihood of living in towns and suburbs, having a tertiary education and eating fruit and vegetables 1-6 times a week have increased by (3%, 5%, 1.7%, 4.4%) compared to other categories for each risk factor and are expected to be higher in 2030 by (11.6%, 18.6%, 5%, 16.3%).

Conclusions
According to EHIS data, from 2015 to 2030, the number of people with diabetes in the EU will change and increase by 3.8 %. This increase will vary by subgroup.More data on risk factors are needed to obtain more accurate estimates.

Key messages
• The future health and economic burden of diabetes on society, health systems and the national economy is expected to increase in the EU.
• Implementing effective prevention strategies on a large scale can reduce the future burden of diabetes.
Mini-ethnography for medical students. Inquiry-based learning to foster transcultural competences
Authors: Ziegler S , Bozorgmehr K 
Published: October 2023

Abstract

Background
Transcultural competences are important for health professionals in plural societies. But if ‘culture’ is addressed in medical curricula, the underlying concepts are often not up to date with constructivist approaches of social sciences. Instead of teaching multiple definitions and complex theory, medical students can be familiarized with the perspective of these sciences through a methodologically structured exposure.

Objectives
An ethnographic field exercise was included in a clinical elective on refugee health care for medical students at a German university between 2016 and 2023. An anthropologist introduced the scientific perspective as well as participant-observation as qualitative method. Evaluations after introducing the task were analysed and a qualitative content analysis after completion was done to discern if learning goals were reached.

Results
130 students participated in the ethnographic exercise. Perceived relevancy for medical education varied (4-p; M = 2,6; SD = 0,7; n = 81); 47% of students regarded written reflection as enhancing competencies (5-p; M = 3,3; SD = 1,2; n = 107). Many considered the exercise as demanding, but interesting. The field protocols show it sharpened perception, ‘culture’ became one of many factors impacting on interactions. Learning to separate description from interpretation, students were able to reflect on own thoughts, evaluations, stereotypes and emotions. Awareness of context-dependency and structural embeddedness of medical encounters, critical assessment of power-dynamics, political issues, service quality and professional ethics in a resource constrained setting were fostered.

Conclusions
An anthropological approach and self-experience as participant observer can provide medical students with the opportunity to cultivate situational awareness and a holistic, multi-layered, structurally sensitive perception that may be more helpful in dealing with the challenges of diversity than presumed knowledge about ‘cultures'.

Key messages
• Ethnographic exercises linked with exposure to refugee settings help to foster transcultural and structural competences of medical students without the need for an extensive study of culture theory.
• Essentialist culture concepts within medical education can be countered by short theoretical updates and inquiry-based learning within contexts characterised by diversity and exclusion.
Access and utilization of health services improved by trained posyandu cadres in rural Indonesia
Authors: Yani F , Shah M , Retno W , Luqman P 
Published: October 2023

Abstract

Posyandu stands for ‘Pos Pelayanan Terpadu’ in Bahasa, meaning ‘Integrated Service Post,’ a community-based health center to provide a range of services for mothers and under five children in Indonesia. Each Posyandu center s served by five posyandu cadres who are community-based health workers and responsible to deliver essential health services and counseling to their communities. In Central Lombok district, Indonesia, we facilitated building capacity and skill of posyandu cadres for counseling and health education and to encourage the community to attend Posyandu center as well as to seek care from nearby Puskesmas and Polindes (other community based static health facilities). During January - August 2022, we trained 1100 posyandu cadres and equipped them with pictorial cards with health education and counseling messages. We retrieved monthly attendance and care seeking data from Puskesmas, Polindes and Posyandu centers through routine health management information system for January 2022 to February 2023 and we compared pre-training (January-August 2022) and post-training (September 2022-February 2023) data. Monthly average number of pregnant women and sick children who were brought to nearby Puskesmas and Polindes for care during pre-training period was 1553 which was significantly increased to 1844 during post-training period (p &lt; 0.001). We also observed statistically significant ((p &lt; 0.001) increase in average monthly attendance of mothers and children at Posyandu centres (from 12,751 in pre-training period to 14,677 in post-training period). This incremental attendance at Posyandu centers and increased care seeking from Puskesmas and Polindes can potentially be attributable to counseling-education session by trained and skilled posyandu cadres and it reconfirms the worthiness of additional investment for capacity and skill building of posyandu cadres to improve community health in rural Indonesia.

Key messages
• Posyandu cadres have potential strength to make significant improvement in community health care service delivery by educating and counseling communities in rural Indonesia.
• Investment on capacity building and training of posyandu cadres can pay off by improving access and utilization of health care services by pregnant women and children.
Rapidly increasing multimorbidity results in increase of health care costs
Authors: Wikström K , Linna M , Reissell E , Laatikainen T 
Published: October 2023

Abstract

Background
Ageing of the population increases the prevalence and co-existence of many chronic diseases, i.e. multimorbidity. In Finland, information on the significance of multimorbidity and its relation to healthcare capacity is scarce. We aimed to study the prevalence of multimorbidity, the transitions between patient groups with and without multiple diseases and associated healthcare cost in 2017-2019.

Methods
The study cohort includes all adults (≥18 yrs) who used Finnish primary or specialized healthcare services in 2017. Multimorbidity status (non-multimorbid, multimorbid or multimorbid at risk) at baseline was determined based on the recordings of a diagnosis of interest using Finnish Care Register data from the year's 2015-2017. The costs were calculated using the care related patient grouping and national standard prices. Transition plots were drawn to observe the transition of patients and costs between different multimorbidity categories during two-year follow-up.

Results
Of 3,201,276 patients, 59% were non-multimorbid, 25% multimorbid and 16% multimorbid at risk in 2017. During the follow-up, we found a considerable number of patients moving from non-multimorbid group both to multimorbid and multimorbid at risk -groups. In 2019, 38% of patients were non-multimorbid, 31% were multimorbid, and 28% were multimorbid at risk of poor outcomes, and 3% had died. The proportion of multimorbid patients at risk increased the most in two years. The healthcare cost depended on the severity of multimorbidity. The total healthcare costs were the lowest among non-multimorbid patients and the highest among multimorbid patients at risk, costing 5660 million euros and accounting for 66,8% of total healthcare cost of this patient cohort in 2019.

Discussion
Multimorbidity, especially multimorbid patients at risk, is causing a heavy burden and costs for Finnish healthcare. The estimates on its effect on health care usage and costs should be used to guide healthcare planning.

Key messages
• The number of multimorbid patients, especially those at risk, is increasing fast.
• Interventions for improving the prevention and care of multimorbidity are urgently needed.