bluuebunny/crossref_metadata_2025_split huggingface dataset:
Living Lab: Design a digital health intervention for healthy diet of ethnic minority adolescents
Authors: Lee J , Lee H , Lee H , Konlan K , Seo J 
Published: October 2022

Abstract

Eating habits cultivated during adolescence continue through adulthood, and can widen the health gap in adulthood for vulnerable ethnic minority adolescents (EMA). Living Lab is a methodological approach through which stakeholders co-create innovations as citizen scientists in real-life settings. This study aimed to design a digital health intervention (DHI) for enhancing the heathy diet of EMA using the Living Lab approach. The DHI’s content and strategies were derived through literature reviews and focus group interviews. The Living Lab was structured by using 5 principles: real-life setting, user engagement, multi-stakeholder participation, multi-method, and co-creation. It has four activity phases of discovering problems, exploring solutions, solving problems, and disseminating solutions putting more emphasis on the use of digital device and multiple stakeholders such as peers and teachers in co-ideation. DHI participants were grouped into equal proportions of EMA and Korean-ethnic peers. The DHI operates for 2 hours once a week for 4 weeks, with orientation and wrap-up sessions before and after the DHI. Each activity of the co-working process is designed by applying behavior change techniques such as prompts/cues, framing/reframing, and credible sources in a digital educational environment: creating content using Google Jamboard and Padlet, and working on the metaverse platform ZEP. The responses and feedback from the participants are received through an online reflection diary weekly. Usability and acceptability of digital technology are assessed by an online survey on completion of the DHI. The efficacy of DHI is assessed through the change in dietary behavior and food literacy. This study was designed to enable EMA recognize the harmful effects of an unhealthy diet and co-create solutions through dynamic activities in a digital environment. Further, it may serve to change the cultural sensitivity of native peers that influence the health choices of EMA.

Key messages
• Digital-based intervention would be an effective way for vulnerable ethnic minority adolescents to engage in healthy diet.
• The Living Lab approach was used as an essential strategy to develop a digital health intervention to improve the healthy diet of ethnic minority adolescents.
A unified qualitative-quantitative method to evaluate the impact of being a near-peer health educator
Authors: Arva D , Cseh A , Mészáros Á , Major D , Jeney A , Dunai D , Zörgő S 
Published: October 2022

Abstract

Grasping the complexity of public health interventions is of increasing interest. Program evaluation may involve previously known and unknown variables; the former are best explored with quantitative, the latter with qualitative methods. As part of the impact evaluation of the Balassagyarmat Health Education Program (BEP), a near-peer education intervention targeting adolescents from a disadvantaged region of Hungary, we aimed to understand the complex effects of being an educator on medical students’ knowledge about the biopsychosocial model of health. Thus, we developed a unified method that enables us to conduct an exploratory study on the effects of our intervention, then quantify and model that qualitative data. We started the method design with literature review and consultations with methodological and public health experts. We then refined the research questions based on a focus-group discussion held with 6 peer educators. After a set of pilot-interviews, we chose simulation interviewing as our knowledge elicitation procedure, then finalized the protocol with the help of additional piloting. In this unified method, simulation interviews are administered to peer educators and aligned controls, and cognitive task analysis is performed with the help of visual stimuli. Codes are developed inductively and, along with segmentation procedures, applied deductively to the entire dataset via the Reproducible Open Coding Kit. Resulting quantified narratives are further processed with Epistemic Network Analysis. The relative frequency of code co-occurrence in each segment is modelled with networks enabling the qualitative and statistical comparison of data between subsamples. Building on the benefits of qualitative and quantitative approaches, this method offers a complex evaluation of the impact of health education interventions. By strengthening the methods of program evaluation we aim to facilitate the development of more effective interventions.

Key messages
• Qualitative and quantitative methods can be unified in program evaluation to promote a deeper understanding of the complexity in public health interventions.
• Cognitive task analysis as a knowledge elicitation procedure can be used for the impact evaluation of health education programs.
Improving the quality of medical records
Authors: Guarducci G , Sanguineti I , Cuccaro C , Randisi R , Messina G , Nante N 
Published: October 2022

Abstract

Background
Medical record is an essential tool both in patients’ diagnostic and therapeutic pathways and communication between different care providers. It also has an economic-administrative, medical-legal and epidemiological function. From an economic-administrative point of view, a medical record allows an evaluation and review of services to better manage the corporate health budget. In addition, it allows traceability and complete transparency of the health activities carried out. The study evaluates the formal quality of medical records compiled in an Italian private clinic before and after a training intervention.

Methods
In June 2019, a retrospective study was carried out to assess a private clinic’s quality of medical records. One month later, healthcare providers were trained on the appropriate compilation of medical records, whose pre-printed format was structurally improved. In March 2020, we verified the quality of medical records produced after that training intervention. Statistical analysis (Wilcoxon test) was carried out through Stata.

Results
A total of 149 medical records were reviewed. Statistically significant improvements (p &lt; 0,05), between before and after training intervention, were for overall readability (33.3% vs 74.7%), completeness of admission and discharge dates (33.3% vs 74.40%), for completeness of anamnesis (13.6% vs 63.9%), for completeness of therapeutic card (53% vs 85.5%), in the reduction of non-compliance corrections (22.7% vs 4.8%), signature presence of physical examination (34.9% vs 71.1%) and for signature presence in the hospital discharge card (86.4% vs 96.4%).

Conclusions
The results show that simple measures, such as staff training and restructuring of the format, are effective in improving the quality of medical records.

Key messages
• Healthcare providers should perceive the proper completion of medical records as a common goal.
• Well-completed medical records contribute to better health care.
Trends in emigration of Polish health professionals. Where are we heading?
Authors: Domagała A , Kautsch M , Kulbat A , Parzonka K 
Published: October 2022

Abstract

Background
Migration of health professionals is one of the key challenges for many healthcare systems. In Poland this phenomenon is still under-researched. The aim of our study was to explore the estimated trends and directions of emigration among Polish health professionals.

Methods
The research was based on the data analysis of specifying the number of people who applied for the certification of their professional qualifications (the right to practice a profession) at five national registers maintained by chambers of health professionals: 1) doctors and dentists, 2) nurses and midwives, 3) physiotherapists; 4) pharmacists and 5) laboratory diagnosticians. The gathered data reported information which allows for an approximate determination of how many professionals are considering a decision to migrate from Poland. Additionally exploration of data from the European Commission Regulated Profession Database in the EU Single Market was performed.

Results
About 7-9% of Polish doctors and nurses have applied for certificates, which confirm their right to practice their profession in other European countries. The number of such certificates applied for by physiotherapists is also worrying. Emigration among pharmacists and laboratory diagnosticians is rather marginal. The biggest number of certificates, was issued to health professionals in the years 2004-2007, right after Poland joined the EU. In the period 2008-2015 the trend was not constant and it was related to the healthcare reform and changes in health professionals’ remuneration. Since 2016 the number of health workers applying for the certificates is by to a certain extent falling. The main destination of Polish emigrants were and are: United Kingdom, Germany, Sweden, Spain, Ireland, and EFTA countries (Norway, Switzerland).

Conclusions
Implementation of a mechanism for monitoring emigration is necessary, but systemic improvement of working conditions in Polish healthcare system is also needed.

Key messages
• The emigration, especially of young generations of medical staff, causes significant problems for the Polish healthcare system.
• More in-depth research on migration of health professionals is necessary.
Factors associated with Finnish home care workers job satisfaction
Authors: Ruotsalainen S , Väisänen V , Corneliusson L , Noro A , Sinervo T 
Published: October 2022

Abstract

Background
In Finland, home care is seen as a primary form of care for older people. However, rising numbers of clients with increasingly complex conditions have led to deteriorated working conditions and poor job satisfaction among home care staff. In this study, we examined if greater amount of direct care time, higher team autonomy, number of unique clients, and client’s need for care are associated with job satisfaction.

Methods
Data for the study was collected in October 2021. The amount of direct care and number of unique clients were obtained from a staff time measurement in home care units. The level of team autonomy was obtained from a survey sent to managers of participating organizations. Demographic information and a score for job satisfaction were retrieved from a survey for workers in the participating organizations. Client’s need for care was based on Resident Assessment Instrument (RAI). Data was analyzed using multiple linear regression.

Results
The number of respondents was 387, of which the majority were practical nurses 307 (79%). Higher team autonomy was associated with better job satisfaction, whereas higher number of unique clients and higher amount of direct care time were associated with poorer job satisfaction. The models were adjusted with clients’ care needs, but these effects will be further examined.

Conclusions
The results demonstrated that the workers are more satisfied if there is enough time to perform the work, they have adequate number of clients, and teams have autonomy over their work. This seems to be the case despite the level of clients’ need for care, however this needs further analysis. By increasing job satisfaction, better retention of care workers and attraction of care work might be achieved.

Key messages
• Higher team autonomy is associated with care worker’s job satisfaction.
• Enhancing care continuity is important, therefore, when planning home care workers’ workday, it is important to consider that the workers could work with clients they know.
Time trends in Surgical Site Infection rates in a Tunisian university hospital
Authors: Ghali H , Bhiri S , Ben Cheikh A , Bannour R , Khefacha S , Ben Rejeb M , Said Latiri H 
Published: October 2022

Abstract

Background
Surgical site infections (SSIs) are the most common hospital-acquired infections (HAIs) in low- and middle-income countries. Many reports have shown that surveillance and management of factors associated with SSI decreased rates and improved overall outcomes.This study aimed to appraise the prevalence trend and risk factirs of SSIs during 10-year period (2012 - 2021) in a Tunisian university hospital.

Methods
The SSI surveillance module is based on the National Healthcare Safety Network (NHSN), Centers for Disease Control and Prevention (CDC). For the current study, data collected over ten years through point prevalence surveys were analyzed. Univariate and multivariate logistic analysis were used to identify SSI risk factors.

Results
Overall, 2957 patients were observed; the mean age was 48.4 ± 23.5 years and 57.2% were male. We identified 289 infected patients (9.8%) and 319 HAIs (10.8%). SSIs were found in 21.6% of cases.The prevalence of SSI decreased from 27.9% in 2012 to 21.6% in 2021. However, this decrease was not statistically significant. The majority of the positive cultures were Staphylococcus aureus (14.3%) followed by Escherichia Coli (11.1%) and Klebsiella pneumoniae (9.5%). Antimicrobial resistance was found in 17.5% of cases. Univariable analysis found that lenght of stay (p &lt; 10-3), obesity (p = 0.047), the use of antibiotic treatment in 6 months (p = 0.002), and the use of central line (p &lt; 10-3) were associated with SSI. Independent risk factors significantly associated with SSIs were length of stay (aOR=8.6), the use of central line (aOR=3), and the use of antibiotic treatment in 6 months (aOR=2.2).

Conclusions
With continuous surveillance, the prevalence of SSIs decreased. In Sahloul university hospital, there has been a strengthening of the application of hygiene standard precautions during the two last years, and more particularly the respect of hand hygiene, combined with continued inpatient antimicrobial stewardship programs.

Key messages
• Active surveillance and management of factors associated with surgical site infection (SSI) decreased the incidence and improved overall outcomes.
• With continuous surveillance, the prevalence of SSIs decreased over the 10-year study period.
Linear pathway analysis of European botulism poisoning response guidelines
Authors: Learoyd T 
Published: October 2022

Abstract

Background
Botulism is a rare illness caused by Clostridium botulinum toxin with a naïve case fatality ratio of 40-50%. There is no coordinated collective worldwide reporting on cases and comparatively few recommendations on case management. This study examined 14 European botulism treatment guidelines.

Methods
A ten-language search was conducted to examine European botulism guidelines. The guidelines were classified by differential diagnosis advice; expert advice access; mention of causalities; contract tracing; biological sampling method; and treatment access rapidity. The guidelines were linearly represented on a probability pathway. Quantified probabilities were entered into the algorithm. Probabilities for algorithmic delay or deviance were estimated or mathematically modeled against Hamiltonian, Ford- Fulkerson and Kruskal pathways. Case recognition was deemed proportional to the availability of information at point of care and produced a hazard function related to a Bayes’ probability model.

Results
Two guidelines did not display all diagnostic information in one place, and six European nations had incomplete descriptions of the chain of causality linking botulism cases: factorially reducing the Borel algorithmic likelihood of diagnosis through contact tracing and decreasing the affectable survival chance. Another limitation was specialist advice and treatment availability in a 48-hour window. Survival probability models to the quoted naïve minimum constraint of a 60% survival factor were depicted, with pharmacokinetic tendential to an exponential decay model. This highlighted the importance of well-constructed case management and logistical stockpiling methods.

Conclusions
In botulism poisoning the 48-hour window is cited as crucial to patient survival chances, to this extent, the availability of clear diagnostic criteria including causation considerations, expert advice access and logistically considered therapeutic stockpiles could improve survival probability.

Key messages
• An international standard for botulism guidance may further improve botulism case identification and survival rates.
• National botulism guidelines with direct contact method to an expert and with strategic positioning of therapeutic stockpiles may reduce time to treatment and improve survival chances.
Trust and its relations to vaccine beliefs: a latent class analysis on 140,000 individuals worldwide
Authors: Sanmarchi F , Gibertoni D , Golinelli D , Gori D , Scheier LM 
Published: October 2022

Abstract

Background
Research shows that vaccine-related beliefs (i.e., about efficacy, safety, purpose) may reflect a host of within-person and contextual factors yielding homogeneous subgroups of individuals. This study aims to characterize distinct subgroups of people and identify ideal targets for tailored public health interventions to increase vaccine adherence.

Methods
Latent class analysis was used to derive subgroups based on unique response profiles using the 2019 Gallup survey of 140 countries (&gt;140,000 individuals). We modeled a composite of vaccine beliefs as a distal outcome examining differences for the obtained classes, with and without covariates in the model.

Results
A 5-class model fit best with classes distinguished primarily on whether individuals possessed or sought personal knowledge about science, medicine, and health, whether they trusted science, scientists and have confidence in the healthcare system. The lowest levels of vaccine beliefs were reported by a class not endorsing any of these indicators and the highest levels by a class endorsing all the indicators (p &lt; 0.001). Age class showed a U-shaped relation with vaccine beliefs, while higher educational level (p = 0.025), higher subjective income (p = 0.006) and employment (p &lt; 0.001) were related to higher vaccine beliefs. Country-level income was moderately related to class membership and vaccine beliefs were higher in lower-income countries (p &lt; 0.001).

Conclusions
Our findings suggest that more work is needed to improve trust in science and medical providers. Tailored interventions grounded in a community-based and empowering approach with the collaboration of multiple stakeholders seems to be needed to improve vaccination rates. This can only be achieved when individuals trust science, scientists and healthcare providers and accrue the necessary wisdom to make good healthcare decisions that affect not only themselves but their fellow citizens.

Key messages
• Efforts to alter vaccine beliefs should touch on where people access information on science and health, the processes that build trust, and their belief whether science improves well-being.
• Public health interventions should focus on reassuring individuals that science and health workers are benevolent. An essential first step in the health worker-patient relations is building trust.
Flu shot in the era of COVID-19 vaccination: findings from a research hospital of Rome
Authors: Pascucci D , Nurchis MC , Sapienza M , Lontano A , Marziali E , Castrini F , Ricciardi W , Damiani G , Laurenti P 
Published: October 2022

Abstract

Influenza represents a major burden for public health. Healthcare workers (HCWs) are a priority target group for flu vaccination. During the COVID-19 pandemic, when SARS-CoV-2 vaccines were not yet available, susceptibility to influenza vaccination especially by HCWs increased. The aim of this study is to analyze the flu vaccination coverage among HCWs and to study which factors affected their adherence given the concomitant COVID-19 vaccination. The retrospective study was conducted in an Italian research hospital from October 2021 to January 2022. A total of 7,048 individuals was included. Age class, gender and job category variables were analyzed. Statistically significant differences among groups were tested through χ2 test. Univariate and multivariate analyses (p &lt; 0,005) were performed to assess differences towards vaccination attitude. The flu vaccination coverage rate was 24.6%. Among the selected job categories, 29.8% of physicians, 19.9% of nurses and 19.7% of other HCWs were vaccinated with a statistically significant decrease (p &lt; 0.001) across all categories respect with the last campaign. The findings of the logistic regression depicted that the 40-59 years old age class, compared with the youngest age class (OR 1.30, 95% CI 1.12-1.43) as well as being physician (OR 2.79, 95% CI 1.87-3.41) with the respect to being nurses, had a higher adherence to vaccination. Interestingly, being male, is associated with a statistically significant reduction (OR 0.71, 95% CI 0.59-0.87) in vaccination uptake. Study findings showed a several decline in the flu vaccination coverage comparing with previous campaigns, probably due to the concomitant administration of the booster dose against SARS-CoV-2. This alarm should not be underestimated and requires timely and innovative organizational approaches (i.e., combined vaccine). Further studies are needed to analyze the reasons for this poor adhesion and the strategies to be adopted to increase the awareness of the HCWs.

Key messages
• Reaching high coverage rates and restore a positive trend for the future campaign for flu vaccination it is essential strategy to protect HCWs themselves, their patients and the hospital community.
• Decision-makers should implement consistent communication strategies to lessen vaccine hesitancy among HCWs.
Knowledge about HPV vaccination among Croatian university students
Authors: Miskulin I , Simic I , Pavic Z , Miskulin M , Bilic-Kirin V , Kovacevic J 
Published: October 2022

Abstract

Background
Studies have shown the low uptake of the human papillomavirus (HPV) vaccine among university students. Knowledge about the HPV virus and the vaccine can be a factor that may sway an individual’s decision to receive the vaccine. This study aimed to investigate HPV vaccine uptake and knowledge about HPV vaccination among Croatian university students.

Methods
This cross-sectional questionnaire study was conducted from February to May 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, data about HPV vaccine uptake, and data regarding knowledge about the HPV virus and the vaccination was self-administered to a cross-faculty representative student sample of the University of Osijek in Eastern Croatia.

Results
The study sample included 840 subjects with, median age of 20 years (interquartile range 20-21), 45.8% males, and 54.2% females. The prevalence of vaccination uptake in the studied population was 20.8%. The study revealed that there were 25.6% of students with a low level of knowledge and 74.4% of students with satisfactory levels of knowledge about the HPV virus and the vaccination. The excellent knowledge about the HPV virus and the vaccination was more frequently shown by students who studied in biomedicine and health area of science (p &lt; 0.001) and students with an excellent average grade of study (p &lt; 0.001). HPV vaccination uptake was higher among females (p &lt; 0.001), students who studied within biomedicine and health area of science (p &lt; 0.001), students with an excellent average grade of study (p &lt; 0.001), and students who showed excellent knowledge about the HPV virus and the vaccination (p &lt; 0.001).

Conclusions
The majority of Croatian university students had a satisfactory level of knowledge about the HPV virus and the vaccination but the vaccination uptake is still very modest. Additional efforts are needed to organize more appropriate education and promotion of vaccine uptake in the studied population.

Key messages
• The HPV vaccination uptake among Croatian university students is very modest although the majority of students have a satisfactory level of knowledge about the HPV virus and the vaccination.
• Continuous examination of HPV knowledge gaps and identification of factors influencing vaccine uptake is key to increasing vaccination rates in the Croatian university student population.