bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 pandemic providing a window of opportunity for higher education: Case study of a three-country teaching-learning experience
Authors: Poirier Mathieu JP , Hard Julie , Holst Jens 
Published: May 2023

Aim: Since March 2020, the COVID-19 pandemic has been causing unprecedented challenges to higher education by disrupting traditional face-to-face teaching as well as international mobility of students, faculty and staff. The factual knock-out of established modes of teaching and learning and the restriction of international travel called for rapid action and a shift towards remote learning and teaching.
Methods: Within the framework of a pragmatic approach, global health faculty from Fulda University of Applied Sciences in Germany and York University in Canada, including a small group of public health students from Cluj in Romania, established a globally networked learning environment. Between November and December 2020, a total of 147 students participated in joint virtual lectures and international collaborative group projects. To capture the acceptance and effectiveness of the innovative didactic experience, a semi-structured student survey was conducted directly after the last session.
Results: The overall rating of internet-based cross-university teaching-learning was positive: Students reported benefits of an enriched learning experience through the sharing of different perspectives, approaches and debates with international professors and peers. Success and overcoming challenges for collaboration among students depended strongly on the level of coordination relating to time differences and expectations.
Conclusion: The COVID-19 pandemic has revealed that transnational inter-university teaching-learning is feasible, provides a beneficial pedagogic option and points promising ways to the future.
Conflict of interest: None declared.
Acknowledgements: We gratefully acknowledge the contributions of Prof. Dr. Kai Michelsen and Prof. Dr. Marius I. Ungureanu to the development of the three-country teaching-learning experience.
Infection prevention and control in healthcare facilities in Albania
Authors: Qirjako Gentiana , Qosja Alketa , Draçini Xheladin , Çomo Najada , Hyska Jolanda , Fico Albana , Bukli Mariana , Burazeri Genc 
Published: May 2023

Aim: The objective of this study was to assess the current status regarding Infection Prevention and Control (IPC) in selected healthcare facilities in Albania in light of the ongoing COVID-19 pandemic which continues unabated.

Methods: A cross-sectional study was conducted in April 2021 including a nationwide representative sample of 505 health professionals working mostly in primary health care centres in Albania (84 men and 421 women; response rate: 95%). A structured questionnaire developed by the World Health Organization was administered online to all participants inquiring about a wide range of measures and practices employed at health facility level for an effective IPC approach. Fisher’s exact test was used to assess potential urban-rural differences in the distribution of characteristics regarding IPC aspects reported by survey participants.

Results: About 47% of health facilities did not have a designated focal point for IPC issues; the lack of one patient per bed standard was evident in more than one-third of health facilities (37%); and the lack of an adequate distance between patient beds was reported in a quarter of health facilities (which was twice as high among health facilities in urban areas compared to rural areas). Furthermore, water services were always available only in about two-thirds of health facilities (63%), whereas an adequate number of toilets (at least two) was evident in slightly more than half of the health facilities surveyed (53%). Also, one out of four of the health facilities did not have functional hand hygiene stations and/or sufficient energy/power supply. A completely adequate ventilation was evidenced in slightly more than half of the health facilities (51%). Four out of five health facilities had always available materials for cleaning and about half (49%) had always available personal protective equipment. Functional waste collection containers were available in nine out of ten health facilities, of which, four out of five were correctly labelled.

Conclusion: This study informs about the existing structures, capacities and available resources regarding IPC situation in different health facilities in Albania. Policymakers and decision-makers in Albania and in other countries should prioritize investments regarding IPC aspects in order to meet the basic requirements and adequate standards in health facilities at all levels of care.
Feasibility and clinical utility of Bates-Jensen wound assessment tool among nurses caring of patients having pressure ulcers
Authors: Younis Wejdan Y. , Abdalrahim Maysoon S. , Zeilani Ruqayya S. , Albusoul Randa , Alosaimi Dalyal , Hamdan-Mansour Ayman M. 
Published: May 2023

Aims: One of the vital roles of nurses is to perform pressure ulcer risk assessment that enables them to appropriately assess and track healing progress of wound and pressure ulcers among patients. Our aim was to assess the feasibility and clinical utility of the Bates-Jensen Wound Assessment Tool (BWAT) among nurses caring of patients with pressure ulcer.
Methods: A descriptive cross-sectional design used to collect data from 177 registered nurses caring of patients who developed or have a risk of developing pressure ulcers working in three hospitals in Jordan.
Results: The mean feasibility score of the BWAT was 28.3 out of 36 (SD=3.4) with a median score of 29. Most of nurses reported that the BWAT was easy to use on a scale of 1-4 (best) (M=3.40/4, SD=0.62) and can successfully assess wound characteristics (M=3.40/4, SD=0.59). The mean utility score of the BWAT was 21.3 out of 28 (SD=2.7) with a median of 21. Nurses had a perception that using the BWAT enhances care of patients with wounds (M=3.36/4, SD=0.61) and makes communication easier between nurses and physicians.
Conclusion: This study provided evidence that support the use of the Bates-Jensen Wound Assessment Tool for patients with pressure ulcer. Nurses perceived BWAT as easy to use, understandable, and relevant for assessing patients with pressure ulcers.
Funding statement: This work was supported by supported and funded by The Deanship of Scientific Research at The University of Jordan, Amman, Jordan [number1953/2017/19].
Learning from the pandemic, building increased international cooperation
Authors: Lopes Henrique , Middleton John 
Published: May 2023

The COVID-19 pandemic highlighted a fragile preparation by countries and regions for epidemic events, exposing exacerbated nationalisms in pandemic mitigation and control actions. Both conditions decisively compromise the effectiveness and efficiency of pandemic control capacity. It is important to develop frameworks that help overcome frailties in response to epidemics.
Based on a thematic literature review and discussions with multiple national and international entities an attempt was made to build a tool for responding to future epidemics, the Pandemic Preparation Framework (2PF).
The proposed 2PF tool is aligned with the Sendai Framework for Disaster Risk Reduction and with international bodies, such as the European Health Emergency Preparedness and Response Authority (HERA). It aims to be a framework for operationalizing these agreements.
The response to pandemics must be based essentially on international action and closer collaboration between countries and regions.
Improving the health status of sex workers in Europe: a policy brief with recommendations
Authors: Ravenswaaij Hilde van , Rojas Daniela , Sharjeel Muhammed , Slaats Puck , Andelic Petra , Paric Martina 
Published: May 2023

Context: Although the United Nations and the European Union are set to improve life on earth through the Sustainable Development Goals (SDG) Framework, sex workers have not been included in this Framework, thereby further increasing various issues, which affect this group, such as discrimination, stigma, and poor mental- and physical health. The COVID-19 pandemic has exacerbated the already existing disadvantages of sex workers, highlighting the need for a systematic change to sustainably improve the empowerment and health status of sex workers throughout the European Union.
Policy Options: The aim of this policy brief is to propose recommendations, which can contribute to the sustainable improvement of the health status and empowerment of sex workers throughout the EU. Policy options include a bottom-up approach with use of community-based organizations and public-private partnerships, targeting inclusion of sex workers, the organization of workshops, and the distribution of toolkits.
Recommendations:

Inclusion of sex workers in the SDG Framework;
Organization of community-based workshops by and for sex workers;
Distribution of culture-personalized toolkits by and to sex workers.
Increasing influenza vaccination rates among healthcare workers by focusing on workplace and patient safety
Authors: Bruin Jeanine de , Machado Matilde , Marie Nabbe , Saccà Riccardo , Verhoeven Jeske , Clemens Timo 
Published: May 2023

Context: In 2014, the influenza vaccine uptake in Europe was below 35% among healthcare workers (HCWs). Due to a lack of confidence in vaccination as a result of safety concerns, HCWs increasingly do not take the influenza vaccine. Consequently, there is a rising influenza burden which results in increasing mortality of vulnerable patients and absenteeism in hospitals. This policy brief aims to increase the awareness of HCWs regarding the importance of influenza vaccination uptake, which may result in improved patient and workplace safety.
Policy Options: To increase vaccination coverage and reduce vaccine hesitancy among HCWs, a change in attitude towards and knowledge about the influenza vaccine is needed. Two potential approaches are presented in this paper. Firstly, a mandatory vaccination policy is discussed. Practical and ethical challenges of implementing a mandatory vaccination policy are considered. Secondly, information campaigns are described, consisting of three pillars: safety, information, and knowledge.
Recommendations: It is recommended to initiate information campaigns focussing on patient safety. Furthermore, a structural approach to increase access to vaccination at the workplace must be taken. Higher vaccination rates of HCWs lead to an improved workplace safety. The recommended information campaign can also be used for other vaccine preventable diseases or in other situations, such as HCWs vaccine hesitancy regarding COVID-19 vaccines. Lessons from the COVID-19 pandemic regarding acceptance of vaccines should be considered for the improvement of future influenza vaccine uptake.
Acknowledgments: We would like to thank Kasia Czabanowska for the opportunity to develop this policy brief and Timo Clemens for his guidance and extensive feedback during the writing process
How are excellence and trust for using artificial intelligence ensured? Evaluation of its current use in EU healthcare
Authors: Bimczok Simon Paul , Godynyuk Elizabeth Alexandra , Pierey Joris , Roppel Malin Siv , Scholz Mirjam Lisa 
Published: May 2023

Context: Artificial intelligence (AI) could be a key driver in different healthcare dossiers, ranging from preventive to diagnostic and treatment purposes. The establishment of the Artificial Intelligence High-Level Expert Group in the European Commission, as well as their White Paper, show first attempts of creating policies in the domain of artificial intelligence in the EU. Despite these policy approaches, there is a need for a coherent regulatory framework that enables the efficient use of AI in the field of health. The aim of this policy brief is to evaluate current legislative gaps in terms of the introduction of AI in healthcare, focusing on the domains of Data Protection, Liability & Transparency, as well as Robustness & Accuracy.
Policy Options: This policy brief identified a high degree of eHealth infrastructure fragmentation on member state level and limited action towards a structured and coherent framework for AI in healthcare, under the domains of Data Protection, Liability & Transparency, and Robustness & Accuracy.
Recommendations: A unified approach at EU-level, based on proposed recommendations and merged into the form of a Directive, is advised. The development of the Health-AI-Directive will bring progress and improvement to legal certainty in the European AI-landscape. The introduction of the Health-AI-Directive is recommended to ensure trust and excellence in the use of AI in healthcare.
Incorporating sustainability into food-based dietary guidelines by “Traffic Light Ecolabelling”
Authors: Asselt Evelien van , Elamin Abdullah , Sánchez Clara González , Kalesi Anastasia , Majoor Elodie 
Published: May 2023

Context: Food-Based Dietary Guidelines (FBDGs) are science-based recommendations in the form of guidelines for healthy eating. They provide information and advice on foods and dietary patterns to consumers to promote the overall health and prevent chronic disease. As of now, these FBDGs lack information about the sustainability of food products. Consumer food choices have a large impact on human and planetary health and wellbeing, as the production and processing of diets make up between 20% and 30% of the total greenhouse gas emission of consumable goods in the European Union (EU). A plethora of different ecolabels exist to aid consumers in making sustainable choices when purchasing items, both food and non-food products. These ecolabels make it easier for consumers to choose eco-friendly product alternatives, with the aim of lowering the environmental impact of the products a consumer buys. While the growth of ecolabels may be interpreted as a sign of success, label overload and gaps in the understanding might result in confusion for consumers, resulting in the limit of use of these already existing ecolabels. Therefore, this policy brief proposes the development of a universal, understandable ecolabel for food products, to enable consumers to make better informed decisions.
Policy Options: Three policy options are examined. Firstly, a hypothetical ‘do nothing’ scenario is considered, in which food ecolabels are not used. As a second alternative, the use of carbon footprint labelling is examined. Lastly, the implementation of a “traffic light” colour pattern label that uses the colours green, orange and red to demonstrate low, medium and high environmental impact, respectively, is examined.
Recommendations: In order to determine the best policy option, the three proposed policy options are compared using five evaluation criteria (time of implementation, cost of implementation, ease of implementation, consumer friendliness and positive environmental impact). The traffic light ecolabel had the highest overall score, and it is thus recommended that this food ecolabel should be used. Lastly, it is recommended that the ecolabel is incorporated into the already existing EU ecolabel, in an effort to increase consumer knowledge and understanding of this novel ecolabel.
Health of the Slovenian population: Where do we stand?
Authors: Zaletel-Kragelj Lijana , Batista Kaja , Bertoncelj Marusa , Brlek Aljaz , Carli Tanja , Grasek Manja , Horvat Martina , Kebler Ines , Mavric Ana , Mozetic Matija , Opresnik Denis , Rozic Mirjam , Strmsek Anja , Sivec Nastja , Smarcan Vesna , Vurzer Blaz , Zadravec Kristina , Zaletel Rok , Kukec Andreja , Erzen Ivan 
Published: May 2023

Aim: Aiming at assessing the state of the Slovenian population health according to the latest available data, and comparing it with health in selected countries, the objective was to analyse the burden of disease (BoD) data available in a selected database.
Methods: The Institute for Health Metrics and Evaluation Global Burden of Disease Study (IHME-GBD) database was used. Causes of all three big IHME-GBD groups: A) communicable, maternal/neonatal conditions, and nutritional deficiencies, B) non-communicable diseases, and C) injuries, in total 18 groups of causes, were observed. Overall mortality, Disability Adjusted Life Years (DALYs), Years of Life Lost (YLLs) and Years Lived with Disability (YLDs) (all per 100.000 population), were used as indicators. Percentage of BoD generated by selected cause, and the ratios of rates in 2019 versus rates in 2014 (reference year) in Slovenia, and the ratios of rates in Slovenia versus rates in Western Europe Region countries (WERC) were analysed. Ratios >1.20 or ˂0.83 were considered as important.
Results: When considering mortality, the greatest burden was generated by cardiovascular diseases and neoplasms. In maternal/neonatal conditions, an important decrease in overall (0.68) and premature (0.68) mortality, while in nutritional deficiencies an increase in overall mortality (1.27) were observed. An increase in overall mortality was noticed also in neurological disorders (1.21), diabetes (1.21) and skin diseases (1.24). Mortality rates were higher in Slovenia than in WERC in digestive diseases, substance use, unintentional injuries and self-harm. When considering disability, the greatest burden was generated by musculoskeletal and mental disorders, and unintentional injuries. Disability rates were higher in Slovenia than in WERC in maternal/neonatal conditions, and unintentional and transport injuries.
Conclusion: In the observed five-year time span, cardiovascular diseases and neoplasms remained at the forefront. However, their burden didn’t change. Causes with burden expressed by disability, musculoskeletal and mental disorders, and unintentional injuries, which has been neglected in the past due to lack of indicators, proved to be an important problem as well. MPHPs in which a lot has to be done to reach rates in WERC, digestive diseases, substance use, and injuries, were identified.
Learning needs assessment among professional workers in community mental health centres in Slovenia: Study protocol
Authors: Kragelj Anja , Pahor Majda , Zaletel-Kragelj Lijana , Makivic Irena 
Published: May 2023

Aim: This article aims to present a study protocol that represents a tool developed for a learning needs assessment. With a pilot study, based on the presented concept of a model study, we will be able to assess what mental health learning content is not yet part of formal higher education for professionals working in community mental health centres, but has been identified as necessary for inclusion. The presented tool is transferable with appropriate modifications. The goal is to conduct multiple research with the same basic tool at all levels of the educational system and in continuing professional education for all professionals who work with people.
Methods: The learning needs assessment study protocol presented uses both quantitative and qualitative research approaches. It is expected that the research will be conducted in several interrelated phases that holistically cover the needs assessment process.
Results: The pilot study will provide insight into the advantages and disadvantages of the prepared learning needs assessment tool. Through the research study, the learning needs of professionals working in community mental health centres, will be identified.
Conclusion: Professional mental health care workers must be equipped with the necessary knowledge, skills, attitudes, and values to perform their work with quality. By implementing appropriate mental health learning content in educational processes from pre-school education to higher education and further to continuing professional education, we can impact the mental health of the entire population. Since this can lead to acquiring the competencies necessary to care of one’s own mental health and that of others, it can be considered an important public health intervention.
Overview of the main incremental health care reforms introduced between 2014 and 2020 in Romania
Authors: Scintee Silvia Gabriela , Vladescu Cristian 
Published: May 2023

Aim: On 2014 the Government of Romania has committed to improving health and health system through the implementation of the 2014–2020 National Health Strategy: Health for Prosperity. An official evaluation of the strategy implementation is not publicly available yet. This paper aims to provide an overview of the main incremental reforms taken during this period in Romania and to analyse the results from the perspective of the main Strategy goals.
Methods: Information was collected from legislative documents, statistical and scientific publications. The main implemented or initiated incremental reforms, during the assessed period, were assigned to five main clusters: ”governance”, “resources for health”, “coverage and access”, “organization of health care”, “quality of care” and were analysed in accordance with the aim, the type, the implementation stage and the corresponding objectives of the Strategy.
Results: The 2014–2020 National Health Strategy has definitely not reached all its objectives, but one sign of prosperity, is that based on 2019 per capita income (of $12,630) World Bank classified Romania, for the first time, as a high-income country. The health status of the population has increased in many aspects, yet Romanians’ health has still remained among the poorest in the European Union (EU).
Conclusion: Incremental reforms might be successful, but the small steps should be taken in a holistic approach, and should be tailored to specific needs. Previous strengthening health systems resilience and plans for overcoming possible risks and obstacles might ensure successful implementation. Assessments of the reforms might draw lessons that help policymakers in shaping further health policies and designing of next strategies.
Burnout and optimism among health workers during the period of COVID-19
Authors: Theofilou Paraskevi , Platis Charalampos , Madia Konstantina , Kotsiopoulos Ioannis 
Published: May 2023

Aim: The investigation of the level of burnout and optimism as well as the effect of socio-demographic and other factors on the above two variables among health workers during the period of covid-19.
Methods: The following two psychometric tools were used to collect the research data: the Maslach Burnout Inventory to assess burnout and the Revised Life Orientation Test (LOT-R) to assess the level of optimism.
Results: In the present study 10 men (24.4%) and 31 women (75.6%) participated. The majority of them were between 36-45 years (36.6%), married and unmarried (48.8% and 48.8% respectively), holding bachelor degree (61.0%) and with 11-25 years of work experience (53.7%). Very high levels of exhaustion and especially emotional exhaustion and depersonalization were observed with also a high degree of personal achievement. The levels of optimism were high. There were statistically significant differences between the two genders in terms of burnout (only the dimension of emotional exhaustion) with women showing higher rates. Employees aged 25-35 years and those who had 1-10 years of work seemed to have higher levels of emotional exhaustion (all differences were considered statistically significant for p<0.05). Finally, a statistically significant correlation took place between burnout and optimism (p<0.05).
Conclusions: The level of burnout among health workers seems to be high during the period of covid-19. In addition, various socio-demographic and occupational factors appear to influence burnout.