bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards collaborative action: A project on interprofessional stroke care in the Covid-19 pandemic
Authors: Schloemer T , Schüller A 
Published: October 2022

Abstract

Background
Stroke is one of the leading causes of disability in adulthood. Cooperatively organised stroke care requires a high degree of interprofessional competence of junior professionals.

Objectives
The project aim was to develop interprofessional competences for stroke care, to identify gaps in care as well as approaches to innovation during the pandemic through joint research. The focus was on person-centred care, communication and collaboration, roles and responsibilities, including stroke-navigators. German Bachelor students of occupational therapy, physiotherapy and speech therapy of the 7th semester (n = 22) were accompanied online in 60 teaching units in 2020/2021. The seminars consisted of (a) theoretical introduction to interprofessional stroke care (b) case-based collaboration with problem-based learning (c) applied health services research. The evaluation was based on a central questionnaire and written reflections from all students.

Results
The following themes were identified and investigated in 5 interprofessional groups: (1) Impact of the Covid-19 pandemic on the acute care and rehabilitation of stroke patients, (2) International comparison of interprofessional stroke care based on guidelines to improve current practice, (3) Interprofessional diagnostics in stroke care, (4) Interprofessional patient-centered goal setting in outpatient stroke care, (5) Agreements of actors involved in stroke treatment to best serve the needs of the patient. The response rate to the centralised evaluation was low (14%). The project was rated good to very good in terms of planning and presentation, relevance, and interaction with students.

Conclusions
The students reported central aspects for interprofessional learning: The reflections predominantly described growth in professional competences, in skills for cooperation and problem solving, which can be transferred to professional life. The main point of criticism was the necessity of digital teaching in the pandemic.

Key messages
• Empowering interprofessional cooperation through a joint project of different Bachelor programmes helps to strengthen the students’ professional identity and shared responsibility for stroke care.
• Online teaching can be a valuable facilitator of learning, but should not completely replace face-to-face teaching for stroke care.
Control of Acinetobacter baumannii outbreak in intensive care units in Tunisia, 2022
Authors: Mziou E , Ghali H , Bhiri S , Ben Cheikh A , Bannour R , Ghribi M , Trabelsi S , Khefacha S , Ben Rejeb M , Said Latiri H 
Published: October 2022

Abstract

Introduction
Acinetobacter baumannii is an emerging pathogen that is increasingly resistant to antibiotics and is mainly responsible for pneumopathy in fragile patients. This germ is frequently responsible for epidemics in hospitals. We aimed to describe the steps of the investigation of an outbreak of Acinetobacter baumannii affected our hospital, the measures implemented and the follow-up of the actions.

Methods
Following alerts issued by the microbiology department concerning 5 swabs detecting Acinetobacter of the same strain and the same antibiotic resistance profile in 3 different departments of intensive-care units (ICU), a team of the prevention and healthcare security department went onsite for an investigation in the hospital.

Results
We identified five cases with identical strains of multi-resistant Acinétobacter. The field visit allowed to identify some deficiencies in professional practices. All the patients were hospitalized in ICU (medical and surgical). The synoptic table showed that there was an overlap of hospitalization periods.A crisis cell was set up to validate, coordinate and implement control measures in accordance with CTINILS recommendations. Indeed, we proceeded to a technical isolation of the cases in their hospitalization sector, reinforced the basic hygiene and bio-cleaning measures and sensitized the medical and paramedical. Given that the three ICU departments shared the same medical staff during night shifts, the assumption that the germ was carried by the caregivers was the most likely hypothesis. We proceeded with a swab of the elements of the environment in the services concerned. Results showed that Acinetobacter was found on the nursing cart (visibly clean). A training about bio-cleaning and hygiene standard precautions is programmed.

Conclusions
Continuous surveillance, continuous hygiene trainings, combined with a rapid reaction capacity in case of identification of a new case, is essential to control the spread of nosocomial germs.

Key messages
• Multidrug-resistant Acinetobacter baumannii (MRAB) is an emerging cause of intensive care unit (ICU) outbreaks.
• Enhanced infection control measures limited the outbreak.
Design of a care pathway for Hepatitis C: a pilot study with three University Hospitals from Tuscany
Authors: Corazza I , Ceccarelli L , Moretti G , Tavoschi L , Vainieri M 
Published: October 2022

Abstract

Monitoring and evaluation activities are recognised as key to quality improvement in healthcare performance. The present study is intended to design a performance evaluation system for care pathway for patients with chronic Hepatitis C virus (HCV) infection, to follow them along the continuum of care throughout regional healthcare services, from diagnosis to treatment course completion. Four phases of the care pathway, namely diagnosis, linkage to care, treatment, and outcome were identified. Each phase of the care pathway was populated by a set of observation and evaluation indicators. Data sources were: administrative health data from the Tuscany Regional Healthcare System; patient-reported experience and outcome measures collected by means of questionnaires administered by the health professionals during patients’ consultation in the three University Hospitals of the Tuscany Region. The availability of data, collected from the administrative flows and thanks to the active involvement of health professionals, showed the feasibility of designing a care pathway for HCV. More particularly, using administrative data, three performance indicators were calculated for the prevention phase, two for the linkage to care phase and two more for the treatment and outcome phases, respectively. Moreover, two indicators related to linkage to care and outcome phases were designed, but data require further investigation. On the other hand, using patient-reported experience data, four indicators can be calculated for the linkage to care phase, while regarding patient-reported outcomes, the feasibility of calculation depends on the number of patients that will be involved in follow-up visits. The care pathway designed may be useful to: identify shortcomings of the healthcare services for chronic HCV patients; foster quality improvement actions; inform allocation of resources to accelerate HCV elimination in Tuscany.

Key messages
• The authors propose a care pathway for Hepatitis C, consisting of four distinct phases, populated respectively with diagnosis, linkage to care, treatment, and outcome indicators.
• The care pathway can be used as a management tool for the identification of possible quality improvement actions to be undertaken with respect to the healthcare services provided to HCV patients.
International Health Regulations core capacities monitoring in 2020-2021 at Italian Points of Entry
Authors: Frisicale E , Zichichi S , Di Virginio A , Falvo R , Angeloni U , Rezza G 
Published: October 2022

Abstract

Under the International Health Regulations (IHR) 2005 States Parties (SP) are required to develop and maintain core public health capacities and report related progress to World Health Organization (WHO) annually,including those related to Points of Entry (PoEs).Using an appropriate tool,provided by WHO, Italian PoEs assessments in 2020 and 2021 were conducted to have the status quo,describe any differences among years and promote corrective actions if required. The tool was designed in 2009 to support SP in ascertaining prior capacities in PoEs and monitoring their progress in order to designate PoEs under IHR.The tool was translated in Italian.Coordination and communication among authorities involved in each PoE (C1),core capacity at all times (C2) and at PHEIC (Public Health Emergency of International Concern) (C3) were assessed by cross border health Authorities for 2020 and 2021.For each of these sections the maximum score is 100%. For each year,a descriptive analysis was conducted and any differences in scores between the two years were noted.The presence of a contingency and vectors’ control plans was also investigated.The assessment was completed respectively for 2020 and 2021 by 24 and 25 airports, 53 and 52 ports. C1 in 2020 resulted on average 89% for airports and 95% for ports, in 2021 respectively 90% and 95%; C2 in 2020 resulted on average 64% for airports and 63% for ports, in 2021 respectively 63% and 64%; C3 in 2020 resulted on average 68% for airports and 61% for ports,in 2021 respectively 63% and 58%.Few differences in scores between 2020 and 2021 were noted in some PoEs. 4 PoEs declared the presence of a contingency plan only in 2021.Few PoEs stated to not have a vectors’ control plan in both years.The assessment pointed out a good level of coordination and communication among all the stakeholders involved, including the Italian Red Cross,but it revealed lower scores for the other IHR core capacities. Improvement actions have to be pursued surely.

Key messages
• The specified tool helps cross border and national Authorities to understand strengths and weaknesses in each PoE and leads to develop a specific plan of action to overcome potential gaps.
• Maintaining a good level of core capacities at points of entry is fundamental to protect national public health.
Not just anti covid vaccine in hub! Local Health Authority Rome 4, Lazio, Italy experience
Authors: Fusillo C , Di Carluccio C , Scognamiglio D , Belfiori G , Sinopoli M , Ursino S , Matera C , Matranga C 
Published: October 2022

Abstract

Issue
At the end of December 2020 in Italy was started anti-covid vaccination campaign. For this purpose in the territory of Local Health Authority Rome 4, vaccination Hubs have been set up, one per each of four territory districts. The Hubs were large, never available previously, with routes suitable for welcoming and vaccinating a large number of people. Vaccination Service (SV) has organized anti-covid vaccinations with every day open Hubs, for 12 hours a day and more, without stopping, reaching very high vaccination coverage, but adherence to vaccinations into the calendar for 0-16 years further decreased during the pandemic period, particularly in adolescence.

Description of the problem
At the end of January covid vaccination requests decreased and SV realized a vaccination line dedicated to other vaccinations in each Hub so SV decided to invite the cohort of those born in 2010 that defaulted with the vaccination against human papilloma virus (HPV) and other mandatory/recommended vaccines.

Results
There were 2629 non-compliant adolescents (83% of resident population in 28 company territory municipalities). 2,353 phone calls were made and 232 smart-sms were sent (very recent method). They booked 598 children, who were vaccinated in just 3 days from 8.30 to 12.30 between February and March 2022. Total vaccines performed were 678: HPV9 389; meningococcal (ACWY and B) 278; 11 other. About 38 teenagers vaccinated every hour

Lessons
The way we used to contact resident population was innovative, easy and quick, necessary features to complete the intervention in a short time. This confirmed the importance in recruiting and adhering to vaccinations and leds to a driving effect also in the following days. Hubs as capacious and familiar places for the population, have allowed an excellent organization with a fast vaccination course, facilitated reception, resources optimization of health personnel.

Key messages
• To achieve vaccine prevention goals it is important to take advantage of available opportunities.
• It is very important to apply the experience gained with the Covid vaccination to non covid vaccinations as well.
Falls among elderly: evidence from hospital settings in Georgia
Authors: Pitskhelauri N , Dochviri T , Akhobadze K , Chkhaberidze N , Chikhladze N , Kereselidze M , Peek-Asa C , Adina Coman M 
Published: October 2022

Abstract

Introduction
Falls are one of the major public health problems and a leading cause of injury-related morbidity and mortality globally. Around of 80% of fall deaths occur in low- and middle- income countries. Falls are the most common cause of hospitalization among the population aged 65 years and older. According the data from Global Burden of Disease (GBD) Study in Georgia, DALYs from falls exceed the average in LMICs. The aim of this observational study was to explore epidemiological characteristics of fall-related injury among hospitalized elderly patients in Georgia in 2020.

Methods
This study was designed in the framework of the project iCREATE: Increasing Capacity for Research in Eastern Europe’ funded by the NIH (2D43TW007261). All patients aged 65 and older admitted to hospital settings due fall-related injury in 2020 were identified from the Hospital Registry (included a total of 152 hospitals in the country) of the National Center for Disease Control and Public Health of Georgia.

Results
A total of 7159 injured patients age 65 and above were admitted to hospitals in Georgia, and among them 4213 were hospitalized due to the falls (60%). Males comprised 30,7% of cases and females - 69,3%. The most common source of hospital arrival was ambulance 2791 (65,0%), followed by private/public transport 1432 (33,3%). The highest number of injuries (43,5%) occurred in Tbilisi (capital of Georgia). The leading cause in fall-related hospitalization was fall on same level. Pelvis and the head were the most common body regions injured accounting for 48,0% and 22,9% of cases, respectively. The highest LOS was 2014 (SD 6,161). 111 patients died due to falls related injury during the study period.

Conclusions
This study indicates that fall- related injury prevention among elderly population should become a key priority area in Georgia. There is a need for elaborating relevant preventive interventions of falls injuries in population aged 65 years and older.

Key messages
• Falls are the leading cause of hospitalization of patients 65 years of age and older.
• Fall risk awareness campaigns should be the first step to fall prevention among elderly.
Supply-side contribution to the lack of PBF impact on unmet need for family planning in Burkina Faso
Authors: Hertler C , Lohmann J , Koulidiati JL , Robyn PJ , Somda SMA , De Allegri M , Brenner S 
Published: October 2022

Abstract

Background
In 2020, about one in four women in Burkina Faso faced an unmet need for family planning (FP). Between 2013 and 2017, Burkina Faso implemented a performance-based financing (PBF) program to improve primary health care service provision (including FP) at rural health centers. Our prior work revealed that PBF did not lead to a reduction in unmet need for FP, in spite of FP being an explicitly targeted service. Our current study assesses supply-side factors that have likely contributed towards this lack of effect at population level, by examining changes in facility-based indicators relevant to the provision of FP induced by PBF.

Methods
We used facility-based survey data from 406 PBF and 117 control facilities collected before and after the PBF implementation. To compare changes in FP service provision, we examined changes in a number of relevant indicators including: a. the types of FP methods offered by facilities; b. trainings received by different FP providers; and c. available stocks of modern contraceptives. We relied on a difference-in-differences (DID) regression model to estimate the impact of PBF on these indicators.

Results
We observed a significant positive impact on the number of staff qualified to provide injectables, implants and IUDs (effect size 0.47, p 0.003) as well as the number of facilities offering IUDs (effect size 0.28, p 0.016) and a significant reduction in the number of facilities experiencing stock-outs of female condoms (effect size -0.09, p 0.007) and implants (effect size -0.03, p 0.042).

Conclusions
Given the significant positive impacts on the number of qualified staff, facilities providing IUDs and a reduction in stock-outs of female condoms and implants attributable to the PBF intervention without showing signs of negative effects on the indicators measured supply-side factors might not have been the main reason for the lack of effect of the PBF program on unmet need for FP.

Key messages
• Supply-side factors might not have been the main reason for the lack of effect of the PBF program on unmet need for FP.
• Further research is needed to explore other potential underlying reasons.
Co-creating an intervention promoting healthy weight development during infancy
Authors: Kierkegaard L , Rothkegel Carlsson R , Ayoe Sparvath Brautsch L , Thørring Bonnesen C 
Published: October 2022

Abstract

Background
Childhood obesity is a major public health challenge, and it is recommended to promote healthy weight development already during infancy. It is important to co-create interventions to maximize the feasibility and thus improve the chances of successful implementation. This paper describes the co-creation process of the Danish Bloom Trial - an early intervention to promote healthy weight development among children of first-time parents.

Methods
Development of the trial is inspired by co-creation frameworks and the Intervention Mapping protocol. The co-creation process comprises three stages: 1) Evidence review, qualitative research with community health nurses (CHNs) and parents, and stakeholder consultations; 2) co-creation of the intervention content including workshops and group meetings with CHNs and other stakeholders and focus group discussions with parents; and 3) prototyping, feasibility- and pilot-testing. Currently, we are in stage 2 and have conducted four workshops with CHNs and one parent group discussion.

Results
During stage 1, we identified the intervention setting; the unique system of CHNs in Danish municipalities. Furthermore, we identified the need for developing intervention content focusing on nutrition, physical activity, sleep, screen time and sense of security to promote healthy child weight development. The main intervention components are a course for CHNs and guidelines on how to talk to parents about behavioral risk factors. The main components for parents are eight home visits and six telephone consultations from CHNs during pregnancy and until the child is 2½ years old and a video library.

Conclusions
The description of the development of the Bloom Trial provides an example of how to co-create an intervention balancing evidence, the practical work of the implementers and the needs of the families. Co-creation with relevant stakeholders increases the chances of producing a relevant, successful, and sustainable intervention.

Key messages
• The co-creation process resulted in development of intervention content focusing on nutrition, physical activity, sleep, screen time and sense of security from pregnancy to child age 2½ years.
• Involving parents and stakeholders in the development of an intervention increases the chances of producing a relevant, successful, and sustainable intervention.
Inflammatory bowel disease at a young age – implications for achieving upper secondary education
Authors: Rasmussen J , Nørgård BM , Nielsen RG , Bøggild H , Qvist N , Brund RBK , Bruun NH , Fonager K 
Published: October 2022

Abstract

Background
The incidence of inflammatory bowel disease (IBD) among children and adolescence is increasing worldwide. Having a chronic condition at a young age may affect educational achievement and later employment and self-support. The study aims to examine the impact of being diagnosed with IBD before 18 years of age on achieving an upper secondary education before 25 years of age.

Methods
Using the Danish National Patient Register (1980-2018) all patients (born 1970-1994) diagnosed with IBD at a young age (&lt;18 years) were identified. The IBD-patients were matched on age and sex with 10 references without IBD at the index date (date of diagnosis of IBD). The outcome was achieving an upper secondary education using data from Danish Education Registers. The association between IBD diagnosis and achieving an upper secondary education was analyzed using Cox regression with robust variance estimation adjusting for parents’ highest educational level. Furthermore, stratified analyses were performed on parental socioeconomic status (education and income).

Results
We identified 3,178 patients with IBD: Crohn’s disease (CD) n = 1,344, Ulcerative colitis (UC) n = 1,834. Reference n = 28,220. The median age at diagnosis was 15.3 years (IQR: [13.0;16.9]). At the age of 25 74.0% (CI: 71.6-76.4) for CD, 75.8% (CI: 73.8-77.8) for UC, and 69.7% (CI: 69.2-70.3) for references had achieved an upper secondary education. The adjusted Hazard ratio (HR) of achieving an upper secondary education was 1.05 (CI: 1.00 -1.11) for CD and 1.09 (CI: 1.04 -1.15) for UC. When stratifying the IBD-patient with the lowest socioeconomic status performed better than their peers.

Conclusions
Being diagnosed with IBD before 18 years of age did not reduce the chance of achieving an upper secondary education. Patients with low socioeconomic status performed better than their peers, however the study gives no explanation of this.

Key messages
• Children diagnosed with IBD before 18 years of age had at least the same chance of achieving an upper secondary education compared to references.
• IBD patients with low social economic status performed better than their peers.