bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards a more integrated approach of housing and care for persons with a disability in Flanders
Authors: Van Acker Nina 
Published: January 2024

Aiming to offer persons with disabilities more opportunities to live independently and more inclusive, the Flemish government radically revised its subsidies for care and care infrastructure for persons with disabilities. Since 2016, subsidies for care are no longer allocated to care providers, but directly to the person with disabilities. In 2018, brick-and-mortar subsidies for care infrastructure were replaced with subject-specific investment subsidies. In this oral paper, we present the results of a study carried out in 2019 aiming to evaluate the impact of this more demand-driven subsidisation on the housing situation of persons with a disability.
The evaluation was carried out by academic researchers, but set up in co-design with the Housing Agency Flanders, the Flemish Department responsible for care, care organisations, social housing providers, municipalities and organisations supporting persons with a disability. Persons with a disability receiving a care budget were invited to respond to a survey about their living conditions and how these changed after receiving the care budget. Another survey was send to care organisations and social housing providers and contained questions on the impact of the policy change on their investment decisions. After analysing the data, discussions with stakeholders were held to deepen the understanding of the results.
Persons with disabilities reported in their answers to the survey changes in housing choices, housing quality and housing costs and linked these to the policy changes. Housing and care providers reported how their investment strategies were affected. The results of the study reveal how even after a few years the effects of a more demand driven subsidization are visible. Moreover, the study provides an example of how policy outcomes in one policy field (housing) can be affected by policy initiatives in another policy field (care). As such, the study stresses the need for more transversal research in studying housing policy outcomes and the need for an integrated policy approach.
The presentation of the study will be followed by a presentation of one of the initiatives of the Housing Agency Flanders aiming at a better integration of these two distinct policy fields. The Agency is currently the driver of diverse incentives and experimental innovations for a more sustainable housing policy and initiatives. The Agency launched a call in 2017 for the development of experimental and innovative housing forms, focusing on building ‘common housing’ or ‘leasehold’ models. For a period of 6 years, 28 initiatives can develop an innovative practice exempt from housing regulation. In several initiatives, the aspect of care is intrinsically related to the experiment and innovation. We will present initiatives that provide an inclusive co-housing solution for people who need intensive and long-term care. Goal is to develop new housing initiatives, detect difficulties and gaps in legislation and explore possibilities to enroll these practices in Flanders.
Physical, psychological and social frailty among community-dwelling older adults in five European countries: a longitudinal study to support the development of personalized care.
Authors: Ye Lizhen , Van Grieken Amy , Zhou Shuang , Alhambra Borrás Tamara , Markaki Athina , Clough Gary , Bilajac Lovorka , Raat Hein 
Published: January 2024

Background: Frailty is defined as a state with increased vulnerability in functioning across multiple physiological systems when facing stressors. Often three domains of frailty are considered: physical, psychological, and social. These three domains of frailty may relate to each other and develop over time. This study aimed to gain insight into the associations between physical, psychological and social frailty in order to support personalized prevention and care for older adults.
Methods: Participants were 1781 older adults in the population-based Urban Health Centres Europe (UHCE) project. Repeated assessments of physical, psychological, and social frailty and covariates were collected at baseline and one-year follow-up. Linear regression analyses were conducted to examine the unidirectional associations. Cross-lagged panel modelling was used to assess bi-directional associations.
Results: The mean age of participants in this study was 79.57 years (SD=5.54). More than half were female (61.0%) and completed secondary education (64.0%). A bi-directional association existed between physical and psychological frailty (effect of physical frailty at baseline on psychological frailty at follow-up: β=0.14, 95%CI:0.09, 0.19; reversed path: β=0.05, 95%CI:0.01, 0.09). A stronger effect from physical to psychological frailty was observed (Wald test for comparing lagged effects: P<0.05). A unidirectional association indicated that a higher level of physical frailty was associated with a higher level of social frailty over one-year (β=0.05, 95%CI:0.01, 0.68). No associations were found between social and psychological frailty.
Conclusion: This longitudinal study suggests that among community-dwelling older adults, a reciprocal relationship may exist between physical and psychological frailty, with a stronger effect from physical to psychological frailty. Also, a higher level of physical frailty was associated with a higher level of social frailty. Further research is needed to validate our findings and explore the underlying pathways. Meanwhile, public health professionals should be aware of the associations between physical, psychological and social frailty in order to provide personalized prevention and care.
A role of nurse e-prescription in GPs’ time reorganization
Authors: Owczarczyk Anna , Bogdan Magdalena , Zuk Pawel , Guzek Marika , Sarnowski Andrzej 
Published: January 2024

The digitization of Polish health care began before 2000, but recent years, especially the period of the COVID pandemic, accelerated it. The basis of the digital ecosystem of medical services is the e-health system P1. P1 consists of digital services: e-prescription, e-referral, DMR, and applications: Internet Patient Account, MojeIKP, office.gov.pl, as well as solutions improving the processes of planning and implementing health care services.
One of the most popular e-tools used in medical services is the e-prescription. It was first issued in 2018, and since 2020 it has been a permanent element of e-services. Its advantages are, for example:
-accelerating and facilitating the process of issuing prescriptions,
-ensuring the correctness of issuing an e-prescription,
-this prescription cannot be lost, because it is ""in the patient's phone"" and on his electronic account
-the doctor has an access to all e-prescriptions filled by the patient
-it enables the National Health Fund to keep accurate statistics on issued and dispensed prescriptions
Since January 2016, nurses and midwives in Poland have had the right, with some restrictions, to prescribe basic medicines (on their own) and to continue prescription medicines ordered by a doctor, with the exception of narcotics and psychotropic drugs. That has given an easier access to certain health services for Polish patients.
Currently, both e-prescriptions and the nurse prescribing, as a systemic solution, allow Polish doctors for saving their time and spending it more effectively on the complex needs of their patients.
The aim of this study is to present the data of nursing prescribing as well as to show how nurse e-prescription influences the time saving by doctors.
The study is based on the statistical data and the initial simulation was carried in Medical and Diagnostic Center LTD. An in-depth analysis may deliver crucial knowledge not only for single doctors, but also health managers and politicians.

The study covers the years 2016-2022 and answers the following research questions:
1.How many e-prescriptions have been issued since the implementation of the e-prescription by doctors and nurses/midwives?
2.How has nursing prescription evolved due to digitalization – comparative study of statistical data
3.How many nurses do regularly issue e-prescriptions (at least once a month)?
4.What is the possibility of saving time by the doctors when prescription visits are carried out by nurses?
5.What challenges do e-prescriptions face as a tool that serves the medical personnel, patients and the whole health system?
Identifying risk factors for becoming obese: a record linkage longitudinal study in metropolitan Sydney using the 45 and Up Study
Authors: Vuong Kylie , Alamgir Kabir A Y M , Conway Damian , Williamson Margaret , Harris Mark , Barr Margo 
Published: January 2024

Background: Obesity is the fourth leading cause of mortality globally. Australia has one of the world’s highest rates of adult obesity, with 31% being obese in 2017/2018, and increasing. If this trend continues, the Australian Bureau of Statistics predicts 18 million Australians will be obese or overweight by 2030. We aimed to identify risk factors for becoming obese among people aged 45 years and older.
Methods: A record linkage longitudinal study of people from metropolitan Sydney was undertaken using data from the: 45 and Up Study at baseline (2005-2009) and first follow-up (2012-2015); Medicare Benefits Schedule; Pharmaceutical Benefits Scheme; and deaths registry. We examined risk factors for becoming obese (Body Mass Index [BMI]:30-40) at follow up (5-7 years after baseline), separately for people within the: healthy weight range (BMI:18.5- < 25), and overweight range (BMI: 25- <30) at baseline. We considered demographics, modifiable behaviours, health status, primary care usage, and medication use as covariates. Crude and adjusted relative risks (RR) were measured using Poisson regression model.
Results: At follow up, in the healthy weight range cohort, 1.1%(180 of 16,205) people became obese, and in the overweight range cohort, 12.7%(1,939 of 15,266) people became obese. In both cohorts, the following were associated with an increased risk of becoming obese: current smokers, physical functioning limitations, allied health services use through team care planning and use of psychiatric medications, while alcohol consumption and adequate physical activity were found to be protective. In the healthy weight cohort, high psychological distress was associated with an increased risk of becoming obese. In the overweight cohort, being female and full-time work were associated with increased risk, while older age was found to be protective.
Conclusions: These findings should assist primary care clinicians to identify patients with characteristics that place them at risk of becoming obese for intervention.
Pilot Randomized Controlled Trial of Multi-Disciplinary Community-Based Biofeedback Vs Health Promotion Programs on Mental Health And Drug Use Among People Experiencing Homelessness
Authors: Nyamathi Adey 
Published: January 2024

Background: PEH are most vulnerable to COVID-19 due to high levels of chronic disease and social isolation. However, in Skid Row Los Angeles, there are limited resources for mental health and drug treatment services. Biofeedback (BF) has been found to decrease depression and substance use among drug users; however, no studies have assessed the impact of BF on PEH during the COVID-19 pandemic.
Aim: Our multi-disciplinary team designed and pilot tested an 8-week Heart Rate Variability-Biofeedback (HRV-BF) intervention, utilizing a nurse-led, Community Health Worker model of care with 50 people experiencing homelessness (PEH) as compared with a Health Promotion (HP) program. Our goal was to establish feasibility of the program, and to assess effects HRV-BF on measures of HRV, mental health and drug use as compared to HP.
Methods: Utilizing Community Based Participatory Research (CBPR) principles, a community advisory board was established to refine the HRV-BF intervention and assess acceptability and feasibility. We enrolled 40 PEH and randomized into HRV-BF vs HP program and assessed a) impact on anxiety and depression; b) HRV and cortisol indices; and c) drug and alcohol use among all participants.
Results: In total, 40 PEH were enrolled with 36 completing the intervention; 17 HRV-BF and 19 HP. Majority were male (80%) and were equally Black (37.5%) or Hispanic (35%). The mean age of PEH was 49 (SD 16.7), median age 53. The HRV measure RMSSD (root mean square of successive differences between normal heart beats, a time-based variable reflecting vagally mediated HRV), assessed during the resting 5-minute period, showed significant increases in 71% of participants (75% among HRV-BF and 68% among HP), using paired t-tests with natural log transformed variables, p=0.004, and by non-parametric tests, p= 0.006 (p values one-sided). Across the sample, PHQ-9 (depressive symptoms) showed marginally significant improvement (p= 0.09). Anxiety and Mental Health Inventory scores showed improvement, though not significant. Between-group analysis showed the HRV-BF group had better GAD-7 and MHI scores at 8 weeks (post-intervention), though not statistically significant. Chronic disease was found to be high in both groups (67% among HRV-BF and 82% among HP). No significant differences were found in terms of substance use.
Conclusions: As the first known study to date examining the role of a biofeedback self-regulation training on biomarkers of stress/mental health measures among PEH, our study shows feasibility and acceptability among the study population and positive initial results for both arms of the study. We plan to extend the follow-up period beyond the intervention period of 8 weeks to establish the sustainability of the intervention.
Funding: Susan Samueli Integrative Health Institute Pilot Studies Award
Bibliotherapy in practice: shared reading as integrated care
Authors: Pieters Jürgen , Ghyselinck Zoë , Kerre Tessa 
Published: January 2024

This workshop aims to present the outlines of a research project situated in the interdisciplinary research domain of bibliotherapy: the use of literature in healthcare contexts. With this project we want to demonstrate that different syndromes and pain experiences require a diversification of the (prescribed or non-prescribed) texts and the associated reading practice. On the one hand, the project aims to refine the international discourse of bibliotherapy on this central point. On the other hand, through concrete reading and co-reading sessions with participants from different medical backgrounds (cancer patients, the elderly, patients in rehabilitation, renal dialysis patients), we aim to gain a sharper insight into various bibliotherapeutic needs associated with specific syndromes. The project brings together a team of literary scholars and medical experts who, with their joint efforts, want to make a significant contribution to the interdisciplinary domain of health humanities and narrative medicine.
In the project we want to find out how literary texts have a therapeutic effect in specific care contexts and we want to increase that effect through a better understanding of the functioning of that text. We assume that the therapeutic effect of literary texts is determined by an interplay between the text itself (with its specific characteristics), the way and circumstances of reading and the mental and physical state of the patient-reader.
In the workshop we want to present the outline of the project and together with participants simulate a shared reading session.
Tools to start a multidisciplinary collaboration.
Authors: Akin Alev 
Published: January 2024

In general: Huis voor Gezondheid was one of the first organizations to start developing an instrument in 2013 to support general practitioners and pharmacists in organizing medical-pharmaceutical meetings at a local level. The instrument was developed in close collaboration with Brusano (supporting professionals in primary care) and Pharmacy Brussels (Pharmacy Association of Brussels). A few years after the development (in 2015) of this tool, the NIHDI (National Institute for Health and Disability Insurance) also recognized the importance of an medical-pharmaceutical meeting. They made subsidies available to develop medical-pharmaceutical packages and to encourage GPs and pharmacists to organize meetings at a local level. The packages are bilingual (Dutch and French) and recognized by the NIHDI .
Following on from this concept, we have recently developed a support package to improve the collaboration between general practitioners and physiotherapists . And this in close collaboration with Domus Medica (professional association for general practitioners) and AXXON (professional association for physiotherapists). Currently, the support package is only available in Dutch. In the short term, we also want a French version and we hope to receive recognition from the NIHDI.
These tools are a start to multidisciplinary collaboration. To be able to offer patients high-quality care, we need to look beyond our own field of expertise. Different healthcare professionals can complement each other so that a goal can be achieved together that a healthcare provider is not capable of alone.
The purpose of these methodologies: These tools aim to encourage and improve collaboration between certain professional groups. The package(s) consist of various themes that are ready for use and can be used immediately to help organize and structure the desired multidisciplinary meeting.
Results: During such local meetings, the various professional groups get to know each other better and exchange experiences. In addition, they make clear agreements about how they will work together in the future. And all this in function of offering quality care to the patient.
Next steps: Following on from these methods, Huis voor Gezondheid has now also started developing a local medical-psychological meeting for general practitioners and psychologists. And this in close collaboration with VVKP (Flemish Association of Clinical Psychologists), Domus Medica (professional association for general practitioners), the Brussels GP circle and the Brussels networks for mental health.
Aiming for equity in care provision
Authors: Andreassen Hege 
Published: January 2024

Since the introduction of the triple aim for health quality improvement around 2008 the suggested multi-layered approach to quality improvement has gained ground. The idea is that when working for quality improvement in the health and care sector one needs to have several aims in sight at the same time. Originally the three aims singled out were: enhancing patient experience, improving population health, and reducing costs. These were then expanded to include an additional goal of improving the work life of health care providers (the quadruple aim). Now, the last addition to the idea is a new layer; namely equity (the quintuple aim).
This presentation addresses the discussion on how to work towards the newly added aim on equity. In Scandinavia and elsewhere in Europe we are moving towards more integrated care, but also more complex care economies consisting of an increasing number of private and public providers that in various ways depend also on domestic agents. Indeed, the ongoing transformations of care work holds in it several potential routes for change when it comes to equity, and it is of vital importance we keep our gaze on these issues to ensure a desired outcome.
From gender research it has been pointed out that research addressing inequality and equity in (care) work, often remain on an individual micro level, when instead we need to lift our gaze to culture and social structure to get the whole picture. To meet this challenge the concept of gender regimes can be helpful; it points to the variation in the political and organizational contexts in which care work institutions are founded and embedded. The presentation will explore weather this approach, in combination with a look towards care economy as a societal field going across domestic, public and private spheres, can allow for a conceptual discussion on how we can succeed in increasing awareness of equity and inclusion in health care improvement work.
We Are: Giving citizens control over their data.
Authors: Lambrechts Nathalie , Goesaert Elfi , Buelens Bart , Laes Erik , Raeymaekers Peter , Rijne Wil , Neyens Koen , Van Meerbeeck Anne , Tambuyzer Else , Wouters Annet 
Published: January 2024

Summary: The We Are platform gives citizens control of their own health data and actively involves them in decisions about the platform that manages the data, thereby guaranteeing them that they can manage and share their data in a safe way as a leverage for personal wellbeing and the common good.
Challenge: Data about citizens, consumers and patients is collected by the government in order to make policies, by companies to develop new products and for marketing and sales, or by hospitals, universities and knowledge institutions for research and innovation. Smart use of data is leading to new insights, valuable innovative processes and even better medicines and health care. Big data will allow us to have a better understanding of who is at risk from specific diseases and who benefits from particular treatments.
This can only happen if the data does not continue to be gathered and stored in separate silos. Bringing together data from a wide variety of sources creates inconceivable opportunities for research and development, but it will also require the data to be handled with extreme care.
Engaging citizens and technology to do something about it: To this end, a Flemish consortium is building a platform providing a personal digital data safe, based for each Flemish citizen. The SOLID technology, a new way of managing data on the web, provides citizens with their own data safe in which they can store their personal data. Citizens manage this safe themselves. They only must enter their data once and can then immediately reuse it for the applications they prefer.
All safes are maintained together by a legal entity like a cooperative society. The cooperative governance structure is socially engaged and, on behalf of citizens, ensures utilisation of personal data for innovations aimed at a sustainable health system.
What are the next steps, what is the impact: Hence, the combination of personal health data types of all citizens, ranging from lifestyle to wellbeing, curated by themselves, is an unprecedented resource for sustainable innovation & growth, provided the access is arranged, by design, in an ethical way and compliant with legislation. It provides a way to enrich personal health data in a natural way and to collect citizen generated data which is currently often lost or scattered.
The realisation of this system innovation requires various activities in which all possible stakeholders (government, companies, research community, civil society and citizens, cf. the quadruple helix) have an important role to play. Doing so, we believe citizen-centered data management will contribute to the empowerment of the patient as a pilot in integrated care