bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sustainability of organisational models implementation in primary care: the CIRCE-JA approach
Authors: Borghini A , Scotellaro M , Baldini L , Cosi R , Carriazo A M , Walch Elarre V , Nieto Guerrero V , Carini E , Mantoan D 
Published: October 2023

Abstract

Fostering healthcare is the aim of EU4Health 2021-2027 agenda. To promote it the EU commission has launched calls for projects, in particular, a call for best practices (BPs) in primary healthcare (PHC). The Joint Action (JA) CIRCE-JA that was funded aims to transfer and implement PHC BPs among Member States, raising their capacity in implementing innovative care models and addressing health system transformation. To be fully effective and maintained over time a BP should be sustainable; part of the efforts of CIRCE-JA are dedicated to study and assure sustainability of the project. Sustainability is a key issue to make an intervention, although already proved of good quality, useful for the population through time. To identify factors of a sustainable implementation, a search of the literature has been done to outline a questionnaire that will be validated through DELPHI methodology and submitted to organisations already managing the BPs and the affiliated entities that will introduce the BPs in their organisations. CIRCE JA will lead to the implementation of 6 PHC BPs in 44 implementation sites located in 14 European countries. This variability calls for a solid transferring methodology to sustain the implementation. The theme of sustainability is not new and the literature search is going to provide enough material for the implementation of the questionnaire. The questionnaire will be compiled by BPs owners which have created the organisational model and the implementing sites; this will be done in order to understand the problems faced and assay the perceived issues. PHC is a priority for EU bodies. Sharing experiences and organisational models on PHC and the diffusion of BPs can be useful to improve quality and access of healthcare, also promoting the so-called European Health Union. Furthermore, a proper study of the sustainability of the interventions leads to a better and longer implementation, not causing a waste of effort, money and time.

Key messages
• To effectively transfer and implement an organisational model, a solid study on sustainability should be conducted.
• An efficient PHC organisation and provision is crucial to improve quality and access to healthcare.
Patient Autonomy in Practice - A Privilege or a Burden?
Authors: Connelly Y , Kaplan G , ZiV A , Karni T , Rubin C , Tal O 
Published: October 2023

Abstract

Background
Patient-centered approach contributes to overall quality of healthcare, can reduce healthcare utilization by targeted treatments, and may increase patient-provider trust. Beyond attention to patient's needs and characteristics, granting them with autonomy in the decisions-making process is required. However, it is important to recognize not all patients are capable nor desire to translate autonomy into action.

Methods
A survey among a representative sample of 462 adults in Israel (50% response rate), examined the ability and willingness of individuals to be involved in decisions related to their own care. The questionnaire included items concerning trust in providers, perceived ability, and degree of desired autonomy (decisional and executive).

Results
While 341 (74%) estimated their abilities as medium or high, only 171 participants (37%) express they will to make the decisions (following doctor's opinion, or even against recommendations). A mediation process model demonstrated that high capabilities indirectly effects trust in providers through two mediators - decisional and executive autonomy [F(8,402) = 2.82, R2 = .06, p=.0047]. High perceived capabilities associate participants with higher desired autonomy to take the decision by themselves, and the latter associates with higher tendency to execute willingness to actions (e.g., non-adhere to treatment recommendations). Finally, higher tendency to perform executive autonomy results in lower trust in providers. The indirect effect is significant (-.006, .003, [-.0118-0010]).

Conclusions
we present an innovative model correlating autonomy, trust and willing to act by patients facing health decisions. Providers should be aware that the desire to be autonomous does not always merge with the ability or willing to take actions. Personalized approach based on the autonomous profile of each patient could lead to more efficient utilization of medical resources.

Key messages
• Autonomy may not align with desires and abilities of some patients.
• Autonomy preferences affect adherence, trust and potentially also healthcare utilization, emphasizing the need for personalized care.
Quality of life and Job satisfaction in medical specialists
Authors: Ordaz Lopez K , Quevedo Flores J M , Trujillo Peña G J , Viveros Sosa O , Villegas Dominguez J S 
Published: October 2023

Abstract

Background
Following the COVID-19 pandemic, the outlook for many physicians changed unexpectedly. There is evidence indicating that clinical performance decreases in stressed physicians, or with job dissatisfaction, factors that influence your quality of life.

Objective
To determine the correlation between quality of life and job satisfaction in medical specialists in Veracruz, Mexico.

Methods
A cross-sectional, observational, prospective and analytical study was carried out between November and April 2023. Medical specialists from Veracruz were included; retired physicians and physicians with motor and neoplastic disabilities were excluded. Data collection was carried out using Google Forms, applying the S21/26 job satisfaction (SL) test (A.Cronbach 0.9) and the WHOQOL-BREF quality of life test (A.Cronbach 0.8). The SPSS v22 program was used, X2 test, Pearson correlation, Odds Ratio (OR) and confidence interval (CI95%).

Results
237 medical specialists were included. social characteristics, the points of general quality of life, job satisfaction and its components showed R values between 0.3 and -0.3; Low quality of life was associated (OR/CI95%) with low SL (2.2/1.1-4.1), high SL (0.3/0.2-.7), being a woman (2.7/1.5-4.9), wanting another specialty (3.4/1.3-8.9), hours greater than 12 noon on weekends (0.4/0.1-0.8); High job satisfaction 1.88 (1.06-3.33), Male sex 2.45 (1.34-4.47), Not having children 1.78 (1.01-3.14), Married in 2nd, 3rd, 4th marriage 4.36 (1.6-11.7), Having a salary that satisfies 5.37 (1.59-18.17) are associated with high quality of life (p &lt; 0.05).

Conclusions
Job satisfaction, practicing a desired specialty, favorable working conditions and health directly influence the quality of life of doctors. It is important to point out that some of these factors are modifiable, so we must work so that doctors carry out their work activities in the specialty they want, with fair shifts to favor their quality of life, which would favor better medical care.

Key messages
• There are modifiable factors from the work environment to favor the quality of life of specialist doctors, so investing in them should be considered to increase the quality of care for patients.
• Medical students should know that the quality of life of a specialist doctor must be considered from the moment of choosing our specialty, in order to develop in a satisfactory work environment.
Intersectoral care for children with autism spectrum disorder in Kazakhstan: Parents perspective
Authors: Kozhageldiyeva L , Sabyrdylda Z , Akhtayeva N , Samambayeva A 
Published: October 2023

Abstract

Background
The prevalence of autism spectrum disorder (ASD) is steadily increasing worldwide, including in Kazakhstan. Recognizing the significance of early detection and providing intersectoral assistance encompassing social, medical, and educational support, it is essential for promoting children's socialization in their daily lives. The purpose was to analyze the provision of comprehensive assistance to parents of ASD children. We conducted a descriptive qualitative study that involved semi-structured face-to-face interviews with parents of ASD children. 60 respondents (51,7% under 34 years old, 45,0% - 35-44 years and 3,3% up to 45 years) participated in our study. Framework Analysis used to interpret results.

Results
The average age of ASD children was 6.3. 26.0% of families were single-parent households, 30.0% residents in rural areas, 66.6% had one working parent, and 58.3% had obtained higher education. 52 parents note partial support from the government, mainly the expenses of parents are associated with the purchase of books, receiving other supporting services as sports activities. Due to long waiting list from the government parents noted the other services related to out-of-pocket payments as ABA therapy, a visit to a neurologist, correctional trainings. All parents noted that they want to receive information through organizing seminars, including psychological support.

Conclusions
Intersectoral collaboration plays a crucial role in facilitating comprehensive assistance for ASD children and meeting their needs through government support. Improving access to transportation, resource books, organizing seminars, and implementing programs to reduce waiting lists for medical and pedagogical specialists are necessary steps.

Funding
The Ministry of Science and Higher education of Kazakhstan (BR18574199 «Integrating children with autism spectrum disorder into the social and educational environment based on comprehensive support: challenges and benefits).

Key messages
• To achieve the SDG the decision makers of all three sectors in Kazakhstan need to improve care program for ASD children.
• It is necessary to expand and revise the provision of services to ensure access to educational, medical services.
Seeking mental health services before and during COVID-19 Pandemic in the Acre region of Israel
Authors: Kalyva D , Bakola M , Kitsou K S , Alon S , Ginat K , Plotas P , Charalambous G , Jelastopulu E 
Published: October 2023

Abstract

Background
The Covid-19 pandemic and the measures (social and physical distancing, school closure, etc.) taken to prevent the spread had remarkable psychological and social effects on the population. These measures have been linked to post-traumatic stress disorders, anxiety, depression, and other stress symptoms that negatively impact the psychological well-being. Our aim was to compare the determinants of use of psychiatric services before and during the pandemic.

Methods
We conducted a record-based retrospective study from two periods, before and during the Covid-19 pandemic, utilizing the electronic system Prometheus at the Mazor Mental Health Medical Center (MMHMC) located in the Acre region of Northern Israel.

Results
Our sample consisted of 528 newly admitted patients, 96.6% came voluntarily, 55.9% were male, with a mean age of 41.1 years (SD ± 16) and living approximately 7.1 km (SD ± 8.5) from MMHMC away. 53% were Jewish, 21.8% lived alone, and 79.9% were unemployed. The main diagnoses were psychotic disorders (16.3%), adjustment and posttraumatic stress disorders (both 13.6%), followed by depression (9.3%), anxiety (7.8%), personality disorders (4.7%), and all other diagnoses. Most patients were referred to MMHMC by their primary care physician (58.1%) or psychiatrist (41.5%), and 21.4% had a family psychiatric history. Comparing the two periods, no statistically significant differences were observed in all examined variables and clinical characteristics except for the underlying risk factors for seeking mental health services. In the pre-pandemic period, the rate of suicide attempts is 26.9%, of violence 38.8%, and of other risk factors 34.3%, while the corresponding percentages during the pandemic are 49.1%, 39.6%, and 24.2%, respectively.

Conclusions
Our study revealed approximately the same characteristics of people seeking mental health services during the Covid-19 pandemic. However, a significant increase in suicide attempts was observed during this period.
Situational context of home-based sexual education in urban slums of Ibadan, Nigeria
Authors: Aliyu T 
Published: October 2023

Abstract

Background
Little is known about how events in slum settings interfere with informal sexual education in Nigeria. This study explores the influence of situational context on parent-adolescent communication about sexual and reproductive health (SRH) issues in the urban slums of Ibadan, Nigeria.

Methods
A qualitative exploratory study was conducted in the Southeast and Northeast local government areas of Ibadan. Eight (8) vignette-based focus group discussions (FGDs) with parents and adolescents of both sexes were conducted in addition to four (4) key informant interviews (KIIs) with community and women's leaders. Interviews were audio-recorded, transcribed, and translated into English. Descriptive and interpretative analyses were conducted with the aid of ATLAS Ti 9 software.

Results
Findings portray SRH meanings and experiences, intergenerational cultural norms, and expectations for SRH, gender double standards in SRH discussion, streetwise SRH knowledge, and social media exposure to SRH as contexts that interfere with parent-adolescent communication on SRH issues. The findings show that although parents and teenagers understood SRH issues and their consequences, there was no effective communication about them. Also, the conversation between parents and adolescents promotes gender inequalities as different SRH information is passed to adolescent girls and boys. Streetwise SRH knowledge was identified to impede effective parent-adolescent conversation on SRH issues. Social media exposure had a significant impact on where teenagers got their unfiltered SRH knowledge, interfering with and distorting SRH discussion between parents and adolescents.

Conclusions
Interventions that enable parents to give and allow their children early access to appropriate SRH knowledge, considering their context, are urgently needed.

Key messages
• The study emphasizes the need for tailored sexual education programs that are culturally sensitive, age-appropriate, and accessible to parents and children in urban slums.
• The study highlights the absence of formal sexual education in schools and communities in urban slums of Ibadan, Nigeria.
Process evaluation of an intersectoral intervention for health equity in Munich, Germany
Authors: Voss S , Hummel J , Jung-Sievers C , Rehfuess E A , Coenen M 
Published: October 2023

Abstract

Background
Intersectoral partnerships can help building sustainable urban environments for children and adolescents that decrease the impact of socioeconomic inequities regarding health and development. However, facilitators for implementing these kinds of public health interventions have hardly been researched. This study conducted a process evaluation of the intersectoral network Präventionskette Freiham that was implemented in a new residential development area in the city of Munich, Germany.

Methods
We collected data in four different sub-studies following a mixed methods design: (1) qualitative interviews and ego-centered network maps with the network coordinators; (2) qualitative interviews with local professionals from institutions engaged with or relevant for the intervention; (3) a focus group with representatives of the three municipal departments guiding the intervention; (4) an online survey with local network members.

Results
The intervention was able to integrate stakeholders from different sectors quickly at the start of the implementation process. However, the early development status of the area and the ongoing COVID-19 pandemic were a challenge for working processes within the network. Sufficient funding and resources, support from local politics and administration, transparent communication and perceived benefits for the individual members of the network were considered as facilitators for a successful implementation.

Conclusions
The early development status of the area was a challenge for building an intersectoral network. Availability of resources is a key factor for implementing a sustainable support infrastructure promoting health equity for children and adolescents.

Key messages
• This study increases the knowledge on implementing public health interventions in new residential development areas and helps to build better chances for disadvantaged children.
• Implementing sustainable intersectoral partnerships for health equity in communities requires a long-term engagement by local stakeholders, especially in settings without established infrastructure.
Determinants of vaccine uptake in the elderly. Results from a mobile health clinic survey in Italy
Authors: Fonzo M , Miccolis L , Serpentino M , Penzo N , Tognon F , Russo F , Putoto G , Bertoncello C 
Published: October 2023

Abstract

Background
Vaccination is one of the most effective public health tools for improving the quality of life of adults and reducing healthcare utilisation. Despite numerous vaccination campaigns targeting this population, vaccine uptake is generally low. The aim of this study was to investigate the main determinants of vaccine uptake in people aged 65 years and over.

Methods
A mobile health clinic initiative for health promotion has been set up in a railway wagon in the Veneto Region, Italy, in October 2022. Access was free and voluntary. Information was collected on age, gender, nationality, education level, BMI, as well as on smoking, physical activity, vegetable consumption and presence of hypertension, hypercholesterolemia and diabetes. Uptake of flu, zoster, pneumococcal and tetanus vaccines was reported by participants, as was any recommendation by healthcare professional. The effect of the variables on uptake was assessed using a multivariable logistic regression.

Results
A total of 638 participants were included, of whom 50.9% female. Mean age 72.6±6.1. Uptake of flu vaccine was 61.8%, while zoster 17.1%, pneumococcal 21.6% and tetanus 10.0%. The main factor for uptake was having received a recommendation from a healthcare professional (flu: AOR=4.29 95%CI 2.77-6.63; zoster: AOR=3.12, 95%CI 1.52-6.40; pneumococcal: AOR=5.11, 95%CI 2.50-10.44; tetanus: AOR=14.23, 95%CI 4.20-48,35). Flu vaccine uptake was associated with hypertension (AOR=1.77, 95%CI 1.03-3.06) and smoking (AOR=1.84, 95%CI 1.04-3.25). No association was found with other comorbidities, lifestyle or SES.

Conclusions
Population growth and increasing average life expectancy in Europe make vaccine uptake by older adults an integral part of a healthy lifestyle. Among factors involved in the decision whether or not to vaccinate, the recommendation from a healthcare provider remains the most important determinant, and this is more evident in the absence of specific campaigns, as in the case of tetanus.

Key messages
• Among possible determinants, recommendation from a healthcare provider is associated with a significantly higher uptake for flu, zoster, pneumococcal and tetanus vaccine in the 65+ population.
• The magnitude of this effect is even greater in the absence of specific campaigns, as in the case of tetanus, when it increases uptake 14-fold.
Applying health behavior theories that explain elderly’ deprescribing behavior: a systematic review
Authors: Alves Jorge S , Van den Broucke S 
Published: October 2023

Abstract

Deprescribing is a strategy to optimize medication use. Despite the fact that behavioral theories have shown to be useful in explaining health behaviors, the literature on deprescribing relies almost exclusively on attitudes as an explanatory factor for this behavior. This systematic review aimed to assess the capacity of health behavior theories and concepts to explain patient's and caregivers’ deprescribe behavior. Two independent reviewers performed a search on Medline, Embase, Scopus, Psycinfo, Cochrane, and the grey literature, using the key words: older adults, informal caregivers, deprescribing, behavioral models, health belief model, theory of planned behavior, social cognitive theory, nudge, and health literacy, Interventional and non-interventional studies that applied at least one health behavior theory or at least one concept from these theories to older adults’ or their caregivers’ intention or deprescribing behavior were included. Quality screening of the identified records was done using the JBI critical appraisal tool. Ten non-interventional studies and twelve interventional studies were identified. Social Cognitive Theory was most often used to explain deprescribing intention, whereas self-efficacy was used most often to explain deprescribing behavior. Higher health literacy also predicted deprescribing intention, whereas internal locus of control was a barrier to deprescribing behavior. One study applied nudging to deprescribing but showed no significant effect. The only study involving informal caregivers revealed that the belief that relatives experienced side effects was a reason to support deprescribing. It is concluded that health behavior theories and concepts involved in these theories explain deprescribing intentions and behaviors more effectively than only relying on attitudes toward deprescribing.

Key messages
• Deprescribing behavior requires complexes changes to established patters of behaviors.
• Health behavior theories and concepts from these theories can explain deprescribing intentions and behaviors more effectively than relying only on widely studied attitudes toward deprescribing.
Health activation of patients in the face of a novel and unknown syndrome, Long COVID
Authors: León-Herrera S , Oliván Blázquez B , Méndez-López F , Samper-Pardo M , Magallón-Botaya R , Aguilar-Latorre A 
Published: October 2023

Abstract

Background
Long COVID can still be considered as a novel disease. Although several clinical guidelines on the management of this disease have already been published, treatment options are still limited. This has left these patients frustrated in seeking treatment, and they express a willingness to try anything to manage their symptoms. The objective of this study is to analyze the level of activation of these patients in their own health.

Methods
A cross-sectional study was performed. The sample consisted of 134 patients with Long COVID in Spain. The main variable was the activation of the patient in his own health. It was collected using the Patient Activation Measure (PAM). This tool evaluates the skills, knowledge and confidence perceived by the patient when carrying out health self-management activities. It consists of 13 items that are evaluated on a scale from 1 (totally disagree) to 4 (totally agree). The resulting score ranges from 13 to 52, and is stratified into 4 activation levels (level 1, poor activation - level 4, adequate activation). A descriptive statistical analysis was performed using the SPSS v.25 program. Frequencies and percentages were calculated for each of the ranges.

Results
Although there was a large percentage of participants with low levels of activation in health (28% within level 1, and 17% within level 2 activation), more than half of the study participants showed an adequate level of activation in the management and care of their own health (30% within level 3, and 23% within level 4 of activation).

Conclusions
Patients with Long COVID present an adequate activation in managing their own health, which can support the actions of the professionals involved in interdisciplinary treatments for this disease. However, excessive activation and the search for any resource for symptoms management (over-the-counter medications, dietary changes, supplements) without professional control could be harmful and worsen their symptoms.

Key messages
• Patients with Long COVID present an adequate degree of activation in managing their own health.
• People with Long COVID express a willingness to try anything in order to control and manage their symptoms.