bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving communication with hard of hearing and D/deaf patients: a capacity-building intervention
Authors: Bodenmann P , Singy P , Graells M , Schmutz E , Sebaï T , Favre V , Richème-Roos J , Cantero O , Morisod K , Grazioli VS 
Published: October 2022

Abstract

Background
D/deaf and hard of hearing (D&HoH) populations are disproportionally affected by physical and mental health problems while facing barriers to accessing health services. These barriers stem from communication challenges with healthcare providers, who are often unprepared to meet their specific needs. This study aimed to develop and evaluate an intervention to improve healthcare providers’ skills to communicate with these patients.

Methods
This study featured a participative action research design. Consistently, the intervention was developed through iterative phases together with the target populations and key stakeholders. The finale version was tested in healthcare workers in Canton of Vaud in Switzerland. Participants completed a questionnaire before (T0) and 6 months after (T1) the intervention, assessing perceived knowledge of deafness and hard of hearing and tools to improve communication, self-efficacy on how to communicate with D&HoH patients and institutional benefits (application frequency of communication rules and tools).

Results
The final intervention aimed to increase participants’ 1) awareness of D&HoH experience and communication needs, 2) knowledge of the tools and basic rules to improve communication. Two D&HoH trainers led one half-day intervention among 28 healthcare providers (e.g., nurses, pharmacists; mean age=43.6). Paired-sample t-tests revealed significant increases in knowledge between T0 and T1, t (23) = -7.81, p &lt; .001 and in self-efficacy, t (24) = -10.23, p &lt; .001, whereas there was no significant difference between institutional benefits at T0 and T1.

Conclusions
Although findings suggest the intervention is a promising means to increase perceived knowledge and self-efficacy on how communicating with D&HoH patients, complementary approaches, such as a resource person within the institutions providing day-to-day support to the teams besides the intervention, may be necessary to induce institutional changes.

Key messages
• Future research should implement the intervention more broadly within inpatient and outpatient settings in Switzerland to increase knowledge on how communicating with D&HoH patients.
• Intervention implementation should be complemented by an additional structural approach to induce sustainable changes in practice and evaluated over 12 months to ensure sustainability.
Hospital nurse understaffing and short work experience: associations with mortality among patients
Authors: Peutere L , Pentti J , Ropponen A , Kivimäki M , Härmä M , Krutova O , Ervasti J , Koskinen A , Virtanen M 
Published: October 2022

Abstract

Background
Determining and maintaining optimal staffing level in hospitals is crucial, as understaffing may have serious consequences and even increase mortality risk among patients. There is no consensus, however, on the optimal way to determine staffing requirements in hospitals as patients’ care needs vary between wards and days. Nurse work experience may also affect quality of care and ultimately patients’ survival but research on this topic is scarce.

Methods
Administrative register data on patients (N = 254,308) and employees of 40 hospital units was used in one hospital district in Finland from years 2013-2019. Both nurse understaffing and nurse work experience were measured with two different indicators in each unit-day. Mixed-effects survival models were used to analyse the associations of these exposures with mortality at patient-level, when adjusted for patients’ characteristics, such as age, sex and comorbidities.

Results
Preliminary results showed that every one percent increase in the cumulative proportion of understaffed days - measured as low nursing hours relative to planned - was associated with 1.002-fold mortality risk among patients (95% CI, 1.000-1.004, p-value=0.044). Short work experience was not associated with increased risk of death.

Conclusions
This study supports previous findings on the associations between nurse understaffing and increased mortality risk among patients in Finland although no association with mortality was found for the other three staffing characteristics. However, the average daily shares of actualized nursing hours relative to planned hours were quite high in hospital units. An indicator based on actualized relative to planned working hours in routine administrative data could be useful in evaluating understaffing in hospitals.

Key messages
• Adequate level of nursing professional in hospitals is related to patient survival.
• It is also crucial of develop efficient ways to evaluate understaffing in hospitals.
Health System Barriers for HPV-vaccine uptake in females with a Turkish or Moroccan Migration background in the Netherlands
Authors: De Zeeuw J , De Zeeuw J , Vervoort JPM , Jansen DEMC 
Published: October 2022

Abstract

Background
HPV vaccine uptake in female adolescents with a Turkish or Moroccan migration background in the Netherlands is lower as compared to the national average. This study aimed to study health system barriers for HPV vaccine uptake in these groups.

Methods
Semi-structured interviews with Turkish/Moroccan (2nd and 3rd degree migrants) female adolescents (12-18 years old), their parents and grandparents were conducted. In addition a focus group discussion with healthcare providers with particular experience with HPV immunization and the target groups was organized. Data was collected between November 2021-April 2022.

Results
22 interviews were conducted among twenty-three individual participants. Sixteen participants with a Turkish migration background were recruited and seven participants were having a Moroccan migration background. In thirteen cases young women in the families did not receive an HPV vaccination. Health system barriers identified were: language barriers in the information provided, focus on HPV being a sexually transmitted disease in information campaigns, lack of knowledge and awareness on HPV among participants and healthcare providers and inability to reach the target groups with tailored immunization programs. Similar health system barriers were mentioned by the healthcare providers, but also included a lack of trust in the government and healthcare institutions, insufficient coordination and collaboration between different healthcare providers. National immunization programs with mass campaign vaccination is mentioned as a barrier to reach families with a Turkish/Moroccan migration background.

Conclusions
Various health system barriers were addressed to be related to HPV vaccine uptake in females with a Turkish/Moroccan migration background in the Netherlands. Despite similarities concerning health system barriers among community members and healthcare providers, different health system barriers were also mentioned.
Health system barriers to HPV vaccination in marginalized Roma communities in Slovakia
Authors: Filakovska Bobakova D , Dankulincova Veselska Z , Halanova M , Jarcuska P 
Published: October 2022

Abstract

Background
People from marginalized Roma communities often experience poverty, limited access to education, employment, housing, and health care (HC). The aim of the study was to explore the perceptions of people from marginalized Roma communities and health professionals regarding health system (HS) barriers to HPV vaccination.

Methods
A qualitative study was conducted in the Kosice region as a part of the RIVER-EU project. Semi-structured interviews with marginalized Roma parents (N = 18), children (N = 15), and health professionals (N = 18) were audio-recorded and thematic analysis of the transcripts was performed in MAXQDA.

Findings
Four main themes were identified regarding HS barriers: 1. Lack of information (lack of culturally and linguistically appropriate information, lack of information provision from HC providers, unreliable and conflicting information on the internet), 2. Restricted access to HC providers (lack of capacities, work overload, long wait in the waiting room, distance, traffic connection), 3. Financial and organizational barriers (limited coverage of vaccination expenses from health insurance, picking up prescribed vaccines in a pharmacy by parents, parental consent), 4. Attitudes and behaviours of HC providers (neglect of care, double standard, inappropriate behaviour and communication, prejudices, racism).

Conclusions
The reasoning and perception of several barriers to HPV vaccination differ among groups of respondents. Nevertheless, HPV is not viewed as a priority by both - marginalized Roma and health professionals. HS fails to reach marginalized Roma with appropriate information about HPV and HPV vaccination. Moreover, the lack of capacities and motivation of HC providers to address these topics lead to a lack of awareness. Organization and health insurance coverage of vaccination pose additional barriers to HPV vaccination.
Exclusive breastfeeding during the COVID-19 pandemic in 17 WHO European Region countries
Authors: Chertok I , Artzi-Medvedik R , Arendt M , Sacks E , Otelea M , Rodrigues C , Costa R , Linden K , Zaigham M , Mariani I 
Published: October 2022

Abstract

Background
Maternal experience of labour and delivery is multidimensional and is influenced by a variety of factors.

Aim
to report maternal childbirth experience as described by the women themselves during the COVID-19 pandemic in Sweden using a WHO Standards-based tool adapted for an online survey (Quality of maternal and newborn care-QMNC).

Methods
Women ≥ 18 years of age who gave birth from March 1, 2020 to June 30, 2021 were asked to give voluntary consent to participate in an online survey. The survey included 40 questions on four key domains: provision of care, experience of care, availability of human and physical resources and organisational changes due to COVID-19.

Results
5003 women were included in the analysis. Among those who underwent labour (n = 4528), 46.7% perceived a reduction in QMNC due to the COVID-19 pandemic, 50.7% were not allowed a companion of choice, 62.5% reported that health workers were not always using protective personal equipment and 36.5% rated the number of health workers as “insufficient”. Fundal pressure was applied in 22.2% of instrumental vaginal births and 36.8% received inadequate breastfeeding support. In addition, 18.4% of women did not feel treated with dignity and 6.9% reported some form of abuse. In general, findings were significantly worse among women who did not undergo labour (n = 475).

Conclusions
Swedish mothers’ satisfaction of care provided during childbirth was strongly influenced by many variables. Actions to promote high-quality, evidence-based, patient-centered respectful care for all mothers and newborns are urgently needed.
Structural stigma and sexual minority men’s depression and suicidality: A multi-level examination of mechanisms and mobility across 48 countries
Authors: Pachankis J , Hatzenbuehler ML , Bränström R , Schmidt AJ , Berg RC , Jonas K , Pitoňák M , Baros S , Weatherburn P 
Published: October 2022

Abstract

Background
Sexual minority men are at greater risk of depression and suicidality than heterosexuals. Stigma, the most frequently hypothesized risk factor for this disparity, operates across socioecological levels-structural (e.g., laws), interpersonal (e.g., discrimination), and individual (e.g., self-stigma). However, there is limited data on whether changes in structural stigma, such as when a stigmatized person moves to a lower stigma context, affect mental health, and on the mechanisms underlying this association

Methods
The current study uses data from the 2017/18 European Men-who-have-sex-with-men Internet Survey (n = 123,428), which assessed mental health and psychosocial mediators. We linked these data to an objective indicator of structural stigma related to sexual orientation in respondents’ countries of origin (N = 178) and receiving (N = 48) countries

Results
Among respondents who moved from higher-to-lower structural stigma countries (n = 11,831), longer exposure to the lower structural stigma environments of their receiving countries was associated with a significantly: 1) lower risk of depression and suicidality; 2) lower odds of concealment, internalized homonegativity, and social isolation; and 3) smaller indirect effect of structural stigma on mental health through these mediators.

Conclusions
This study provides evidence that structural stigma is associated with the mental health of sexual minority men, both through proximal experiences and as a function of length of exposure to structurally diverse contexts, at least for those who move higher-to-lower structural stigma contexts. Findings suggest the importance of routinely assessing life-course structural influences on mental health and deploying interventions to address those influences.
The future of health digitalization: The case of Primary Health Care in Portugal
Authors: Peyroteo dos Santos M , Lapao L 
Published: October 2022

Abstract

Background
The sustainability of Healthcare Services will depend on the proper implementation of the digital transformation of Primary Health Care (PHC) Services. COVID-19 Pandemic have shown precisely this, where there was pressure from health Professionals and managers for the integration of teleconsultations within the health work processes. This study aims at developing scenarios for the digitalization of PHC in the Portuguese Health System.

Methods
This study follows the methodology of scenario development, similar to the future of community pharmacy services scenario study. A conceptual model of PHC services was developed, based on the literature and a set of interviews. The target group was the primary healthcare professionals: family doctors, nurses, and operational assistants. The time horizon was 2032 and, by selecting actors from different regions of Portugal, it was possible to achieve broad representativeness.

Results
Three focus groups were conducted. The first enabled to identify the two driving forces that may influence the digitalization of PHCs in the next 10 years: 1) service innovation and 2) Governance and Regulations. These two driving forces enabled to design three plausible scenarios: a) Innovate or Fade-away; b) Isolated PHC and c) Digital PHC. These scenarios were developed, and their impacts were reflected upon. It was found that the role of human Resources is critical.

Conclusions
The process of reflection and discussion for the identification of the different driving forces made the different actors discuss the different points of view and find a meeting point to reach a conclusion. Furthermore, this study allowed the different stakeholders to understand the measures and actions to be taken for PHC digitization to be implemented in the most effective way, allowing the sustainability of the National Health Service in Portugal, which until this point were only ideas discussed at the institutional and individual level.
Potential gains by effective early detection of diseases: proposal to approach informing public health policy in the Czech Republic
Authors: Majek O , Ngo O , Hejduk K 
Published: October 2022

Abstract

Background
Significant amount of disease burden could be averted by early detection and treatment of diseases. In the Czech Republic, National Screening Centre (NSC) of the Institute of Health Information and Statistics is responsible for informing public health policy in the field of early disease detection. The objective of the proposed early detection public health foresight study (PHFS) is to gather evidence, use available computational tools, utilise knowledge and opinions of stakeholders, and summarize it in a systematic manner to inform public health policies. The presentation outlines the approach undertaken within the proposed early detection PHFS.

Methods
The key source of data for monitoring of population health status and healthcare system in the Czech Republic is the National Health Information System (NHIS). The study will also utilise external sources of data, namely demographic projections and data on global burden of disease, as well as qualitative data from stakeholders. The study will also utilise analytical tools and outputs developed by NSC (situational analyses, decision modelling, etc.). The conceptual model of the study will cover important underlying aspects like public policies, driving forces, population health and healthcare system, and health impact variables.

Results
The proposal for early detection PHFS has been developed within the PHFS capacity building course, utilising the experience and insights of tutors and fellow participants. The development of study methodology was accompanied by gathering of evidence and consultations with relevant stakeholders.

Conclusions
PHFS is a very useful approach to assess possible future developments of public health system, achieve participation of stakeholders, and to inform public health strategies. Following finalisation of the early detection PHFS protocol, governing board of the NSC will decide on the degree of implementation of the study.
Foresight methodologies to unravel the indirect health economic impact of the COVID-19 pandemic on cancer care and management in Belgium studied in the HELICON project
Authors: Khan Y 
Published: October 2022

Abstract

Background
The COVID-19 pandemic had indirect effects on segments of the population affected with non-COVID-19 diseases e.g. through delayed care and management of cancer patients. Early diagnosis and appropriate treatment are key to improving patient outcomes and reducing societal and health care costs. Tio support policymakers to anticipate these trends a public health foresight study (PHFS) was done.

Methods
The PHFS follows a structured approach provided through a compact guide and is supervised by PHIRI team members. Its evolution is measured through a template gathering data on the study's contextual information, objective, main target groups, conceptual model, indicators, driving forces, time horizon, spatial unit, identifying uncertainties, scenario logics, scenario type, stakeholders, data, tools and instruments, projection methods, communication strategy/products, and the uptake of results and evaluation.

Results
Several foresight elements were identified. Contextual information on the resources and governance structure were elucidated. The objective was made clear by identifying the topic, general issue, and sub-issues of the initial study. A conceptual model was developed to analyse the interaction of the topic with other aspects that could influence it. The main driving forces, which are factors that influence the studied topic, were then determined through the DESTEP method. Stakeholders were identified and classified through the power-interest matrix.

Conclusions
Establishing a foresight study on the indirect impact of the COVID-19 pandemic on the care and management of cancer patients allows exploring potential and unsuspected issues that may affect society, health care systems, and patients. Those groups should not be considered individually but as an ecosystem continuously interacting, where a decision may affect everyone. This type of information may be of high relevance to policy- and decision-makers in their public health interventions.
Applying Essential Public Health Functions in building health systems’ resilience globally
Authors: Zhang Y , Mustafa S , McDarby G , Seifieldin R , Saikat S , Schmets G 
Published: October 2022

Abstract

Background
The COVID-19 pandemic has exposed Public Health system weaknesses due to chronic underinvestment in Public Health. In this context, Essential Public Health Functions (EPHFs) have been revitalized as an integrated, cost effective and sustainable approach to operationalising Public Health. The World Health Organization's recent position paper on building health systems resilience towards universal health coverage and health security recommended investing in EPHFs as a key mean for countries’ health systems recovery and transformation during COVID-19 and beyond. There is a need for conceptual and operational clarity of EPHFs to support countries to build back better, fairer and more resilient health systems.

Methods
A rapid review of peer-reviewed and grey literature regarding the EPHFs was conducted to identify different actors’ understandings of EPHFs and key lessons of applying the EPHFs at the global, regional and national levels, in order to identify the added value and key enablers to operationalising EPHFs. A crosswalk analysis of different authoritative lists of EPHFs was conducted to develop a common list of EPHFs as a reference for countries in response to Public Health challenges.

Results
A consolidated list of 12 EPHFs derived from the crosswalk analysis of different authoritative lists is presented, underpinning the consideration of health systems components and pressing health challenges. Six key enablers are identified from evidence and experience. These enablers are fundamental for countries to build holistic and strong Public Health capacities.

Conclusions
The EPHFs provide a clear and integrated framing to operationalise Public Health in countries that can be adapted to country contexts to build resilience. Health authorities and other Public Health stakeholders must seize the opportunity brought by COVID-19 recovery to continue advocating for and strengthening Public Health as a priority in health systems’ reconstruction and reform.
Health services during Covid-19: What do we know of the degree of service disruption and size of the backlogs?
Authors: Tille F , Zapata T 
Published: October 2022

Abstract
Since the onset of the COVID-19 pandemic, there have been concerns that shifting health system capacities towards acute COVID-19 cases can affect the provision of non-COVID-19 essential health services, causing severe disruptions and lack of care. Examples of this have been seen during other epidemic outbreaks, such as the 2014-2016 Ebola outbreak in West Africa. To capture the degree of service disruption across the European and Central Asian region, we analysed data from the World Health Organization's Pulse Survey on the Continuity of Essential Health Services, conducted in three rounds in 2020 and 2021. The key findings include:
– Health service provision has been heavily disrupted in virtually all countries. 91% of countries reported service disruptions in late 2021, indicating that health services continue to be disrupted at large scale.
– Service discontinuation has been substantial across all levels of care and in most service areas, often resulting in delays and cancellations of elective and emergency procedures, routine visits, prescription renewals, and referrals to specialty care. This has led to growing backlogs and record waiting times for services.
– Countries have been affected to varying degrees and report different levels of service disruption, size of the backlog, recovery of services aiming for pre-pandemic levels, and interventions to manage waiting lists.
The findings indicate that even as health systems are better learning to care for acute COVID-19 patients, the pandemic's impact on essential health services is massive and likely to affect the care for people's health and well-being post the acute phase of the public health emergency. Measuring the size of backlogs and implementing innovative care solutions are urgent and paramount.