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Bienvenu AL, Cour M, Pavese P, Guichon C, Leray V, Chapuis C, Dureault A, Mohkam K, Gallet S, Bourget S, Kahale E, Chaabane W, Subtil F, Maucort-Boulch D, Talbot F, Dode X, Richard JC, Leboucher G. Correlation between antifungal clinical practices and a new clinical decision support system ANTIFON-CLIC® for the treatment of invasive candidiasis: a retrospective multicentre study. J Antimicrob Chemother 2024; 79:1407-1412. [PMID: 38656566 DOI: 10.1093/jac/dkae118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/03/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Invasive candidiasis is still recognized as a major cause of morbidity and mortality. To support clinicians in the optimal use of antifungals for the treatment of invasive candidiasis, a computerized decision support system (CDSS) was developed based on institutional guidelines. OBJECTIVES To evaluate the correlation of this newly developed CDSS with clinical practices, we set-up a retrospective multicentre cohort study with the aim of providing the concordance rate between the CDSS recommendation and the medical prescription (NCT05656157). PATIENTS AND METHODS Adult patients who received caspofungin or fluconazole for the treatment of an invasive candidiasis were included. The analysis of factors associated with concordance was performed using mixed logistic regression models with department as a random effect. RESULTS From March to November 2022, 190 patients were included from three centres and eight departments: 70 patients from centre A, 84 from centre B and 36 from centre C. Overall, 100 patients received caspofungin and 90 received fluconazole, mostly (59%; 112/190) for empirical/pre-emptive treatment. The overall percentage of concordance between the CDSS and medical prescriptions was 91% (173/190) (confidence interval 95%: 82%-96%). No significant difference in concordance was observed considering the centres (P > 0.99), the department of inclusion (P = 0.968), the antifungal treatment (P = 0.656) or the indication of treatment (P = 0.997). In most cases of discordance (n = 13/17, 76%), the CDSS recommended fluconazole whereas caspofungin was prescribed. The clinical usability evaluated by five clinicians was satisfactory. CONCLUSIONS Our results demonstrated the high correlation between current antifungal clinical practice and this user-friendly and institutional guidelines-based CDSS.
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Affiliation(s)
- Anne-Lise Bienvenu
- Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
- Univ Lyon, Malaria Research Unit, SMITh, ICBMS UMR 5246, Lyon, France
| | - Martin Cour
- Service de Médecine Intensive-Réanimation, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | - Patricia Pavese
- Service des Maladies Infectieuses, CHU de Grenoble, Grenoble, France
| | - Céline Guichon
- Service d'Anesthésie-Réanimation, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Véronique Leray
- Service d'Anesthésie-Réanimation, Groupement Hospitalier Centre, Hospices Civils de Lyon, Lyon, France
| | | | - Amélie Dureault
- Service des Maladies Infectieuses, CH de Valence, Valence, France
| | - Kayvan Mohkam
- Service d'Hépato-Gastro-Entérologie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Salomé Gallet
- Service des Maladies Infectieuses, CHU de Grenoble, Grenoble, France
| | | | - Elham Kahale
- Direction de l'Innovation, Hospices Civils de Lyon, Lyon, France
| | - Wajih Chaabane
- Direction des Services Numériques, Hospices Civils de Lyon, Lyon, France
| | - Fabien Subtil
- Service de Biostatistique-Bioinformatique, Hospices Civils de Lyon, Lyon, France
| | | | - François Talbot
- Direction des Services Numériques, Hospices Civils de Lyon, Lyon, France
| | - Xavier Dode
- Service Pharmacie, Groupement Hospitalier Est, Hospices Civils de Lyon, Lyon, France
| | - Jean-Christophe Richard
- Service de Médecine Intensive-Réanimation, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
| | - Gilles Leboucher
- Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, Lyon, France
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Heide MP, Prodan S, Lazaroiu G, Kreis-Engelhardt B, Ghigiu AM. Communication as a Key Performance Indicator in Employer Branding in the Context of the Social Economy-A Quantitative Study. Behav Sci (Basel) 2024; 14:303. [PMID: 38667099 PMCID: PMC11047342 DOI: 10.3390/bs14040303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 04/03/2024] [Accepted: 04/05/2024] [Indexed: 04/29/2024] Open
Abstract
Performance measurement refers to the systematic evaluation and analysis of the performance and results of business processes, initiatives, or strategies. This study discusses the crucial role of communication using signaling theory in employer branding in the context of the social economy organization (SEO). The aim is to measure employee satisfaction in concrete terms and to determine the status quo of the communication culture of the organization under investigation in order to develop an employer branding strategy based on the results. The authors use an employee survey as a quantitative research method and limit the data collection to the EU member state of Germany considering the research background. The results provide insights into the specific communication policy in relation to employer branding. The focus here is on (digital) communication. Organizations need to understand how communication strategies directly influence the perception of the employer brand in the social economy. Furthermore, practical implications are derived in order to increase employer attractiveness. Concrete recommendations of action for SEOs should help them be successful in the competition for qualified specialists and talent.
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Affiliation(s)
- Michael P. Heide
- Department of Marketing, Faculty of Economics and Business Administration, Babeş-Bolyai University, 400591 Cluj-Napoca, Romania;
- Faculty of Business and Law (FWR), Nürtingen-Geislingen University of Applied Sciences (HfWU), 72622 Nürtingen, Germany;
| | - Silvana Prodan
- Department of Marketing, Faculty of Economics and Business Administration, Babeş-Bolyai University, 400591 Cluj-Napoca, Romania;
- Department of Languages and Communication, Inter-Languages Center: Text, Image, Language (TIL) (EA4182), University of Burgundy, 21000 Dijon, France
| | - George Lazaroiu
- Faculty of Science and Engineering, Curtin University, Bentley, WA 6102, Australia;
- The Intelligent Communications and Computing Lab, Toronto Metropolitan University, Toronto, ON M5B 1G3, Canada
- Department of Economic Sciences, Spiru Haret University, 030045 Bucharest, Romania
| | - Barbara Kreis-Engelhardt
- Faculty of Business and Law (FWR), Nürtingen-Geislingen University of Applied Sciences (HfWU), 72622 Nürtingen, Germany;
| | - Alexandru-Mihai Ghigiu
- Department of International Relations and European Integration, National University of Political Studies and Public Administration, 012244 Bucharest, Romania;
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Blondino CT, Knoepflmacher A, Johnson I, Fox C, Friedman L. The use and potential impact of digital health tools at the community level: results from a multi-country survey of community health workers. BMC Public Health 2024; 24:650. [PMID: 38429773 PMCID: PMC10905785 DOI: 10.1186/s12889-024-18062-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/10/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Community health workers (CHWs) are increasingly viewed as a critical workforce to address health system strengthening and sustainable development goals. Optimizing and widening the capacity of this workforce through digital technology is currently underway, though there is skepticism regarding CHWs' willingness and optimism to engage in digital health. We sought to understand CHWs' perceptions on the use of digital health tools in their work. METHODS We obtained survey data from 1,141 CHWs from 28 countries with complete study information. We conducted regression analyses to explore the relationship between CHWs' training and perceived barriers to digital health access with current use of digital devices/tools and belief in digital impact while adjusting for demographic factors. RESULTS Most of the CHWs worked in Kenya (n = 502, 44%) followed by the Philippines (n = 308, 27%), Ghana (n = 107, 9.4%), and the United States (n = 70, 6.1%). There were significant, positive associations between digital tools training and digital device/tool use (Adjusted Odds Ratio (AOR) = 2.92, 95% CI = 2.09-4.13) and belief in digital impact (AORhigh impact = 3.03, 95% CI = 2.04-4.49). CHWs were significantly less likely to use digital devices for their work if they identified cost as a perceived barrier (AORmobile service cost = 0.68, 95% CI = 0.49-0.95; AORphone/device cost = 0.66, 95% CI = 0.47-0.92). CHWs who were optimistic about digital health, were early adopters of technology in their personal lives, and found great value in their work believed digital health helped them to have greater impact. Older age and greater tenure were associated with digital device/tool use and belief in digital impact, respectively. CONCLUSIONS CHWs are not an obstacle to digital health adoption or use. CHWs believe that digital tools can help them have more impact in their communities regardless of perceived barriers. However, cost is a barrier to digital device/tool use; potential solutions to cost constraints of technological access will benefit from further exploration of reimbursement models. Digital health tools have the potential to increase CHW capacity and shape the future of community health work.
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Affiliation(s)
- Courtney T Blondino
- Department of Health Studies, School of Arts and Sciences, University of Richmond, Richmond, VA, 23173, USA.
- Mercer, New York, NY, 10036, USA.
| | | | | | - Cameron Fox
- Platform for Shaping the Future of Health & Healthcare, World Economic Forum, New York, NY, 10017, USA
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Khanal V, Shaw T, Wills E, Wakerman J, Russell DJ. Co-design of digital health technologies in Australian First Nations communities. Lancet Digit Health 2024; 6:e90. [PMID: 38278618 DOI: 10.1016/s2589-7500(23)00251-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/25/2023] [Accepted: 12/01/2023] [Indexed: 01/28/2024]
Affiliation(s)
- Vishnu Khanal
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT 0871, Australia.
| | - Timothy Shaw
- Charles Perkins Centre, School of Medical Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Elaine Wills
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT 0871, Australia
| | - John Wakerman
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT 0871, Australia
| | - Deborah J Russell
- Menzies School of Health Research, Charles Darwin University, Alice Springs, NT 0871, Australia
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Jin G, Shi H, Du J, Guo H, Yuan G, Yang H, Zhu Z, Zhang J, Zhang K, Zhang X, Lu X, Xu W, Wang S, Hao J, Sun Y, Su P, Zhang Z. Pre-Exposure Prophylaxis Care Continuum for HIV Risk Populations: An Umbrella Review of Systematic Reviews and Meta-Analyses. AIDS Patient Care STDS 2023; 37:583-615. [PMID: 38011347 DOI: 10.1089/apc.2023.0158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023] Open
Abstract
Pre-exposure prophylaxis (PrEP) is an effective biomedical strategy for HIV prevention. This umbrella review is aimed at providing a comprehensive summary of the current status of each stage of the PrEP care cascade. A systematic literature search was conducted in PubMed, Embase, and Cochrane. Additionally, a Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) tool and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) checklist were used to evaluate their methodological and reporting quality, respectively. A total of 30 systematic reviews met the inclusion criteria. According to the results of methodological quality assessment, 3 reviews were rated as low, while 27 as critically low. Furthermore, the results of the reporting quality evaluation revealed a mean score of 23.03 for the included reviews. Across all the reviews, awareness of PrEP was generally moderate in all populations, and the acceptability was even higher compared with awareness. Unfortunately, the PrEP uptake among different groups was even less optimal, although the adherence was almost above moderate, and several barriers that hindered the utilization of PrEP were identified, and the most common are as follows: cost, stigma, lack of knowledge, mistrust, low risk perception, and more. Although PrEP has proven to be an effective prevention method to date, the promotion of PrEP failed to achieve the anticipated outcome. To reinforce the generalization of and use of PrEP, and effectively control HIV transmission, it is urgent to identify the underlying causes of low uptake rates so that efficient interventions can be implemented.
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Affiliation(s)
- Guifang Jin
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Haiyan Shi
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Jun Du
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Haiyun Guo
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Guojing Yuan
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Huayu Yang
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Zhihui Zhu
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Jianghui Zhang
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Kexin Zhang
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Xueqing Zhang
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Xiaoyan Lu
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Wenzhuo Xu
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Sainan Wang
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Jiahu Hao
- Department of Maternal, Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Ying Sun
- Department of Maternal, Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Puyu Su
- Department of Maternal, Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Zhihua Zhang
- Department of Epidemiology and Biostatistics and Child, & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
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Borges do Nascimento IJ, Abdulazeem H, Vasanthan LT, Martinez EZ, Zucoloto ML, Østengaard L, Azzopardi-Muscat N, Zapata T, Novillo-Ortiz D. Barriers and facilitators to utilizing digital health technologies by healthcare professionals. NPJ Digit Med 2023; 6:161. [PMID: 37723240 PMCID: PMC10507089 DOI: 10.1038/s41746-023-00899-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 08/01/2023] [Indexed: 09/20/2023] Open
Abstract
Digital technologies change the healthcare environment, with several studies suggesting barriers and facilitators to using digital interventions by healthcare professionals (HPs). We consolidated the evidence from existing systematic reviews mentioning barriers and facilitators for the use of digital health technologies by HP. Electronic searches were performed in five databases (Cochrane Database of Systematic Reviews, Embase®, Epistemonikos, MEDLINE®, and Scopus) from inception to March 2023. We included reviews that reported barriers or facilitators factors to use technology solutions among HP. We performed data abstraction, methodological assessment, and certainty of the evidence appraisal by at least two authors. Overall, we included 108 reviews involving physicians, pharmacists, and nurses were included. High-quality evidence suggested that infrastructure and technical barriers (Relative Frequency Occurrence [RFO] 6.4% [95% CI 2.9-14.1]), psychological and personal issues (RFO 5.3% [95% CI 2.2-12.7]), and concerns of increasing working hours or workload (RFO 3.9% [95% CI 1.5-10.1]) were common concerns reported by HPs. Likewise, high-quality evidence supports that training/educational programs, multisector incentives, and the perception of technology effectiveness facilitate the adoption of digital technologies by HPs (RFO 3.8% [95% CI 1.8-7.9]). Our findings showed that infrastructure and technical issues, psychological barriers, and workload-related concerns are relevant barriers to comprehensively and holistically adopting digital health technologies by HPs. Conversely, deploying training, evaluating HP's perception of usefulness and willingness to use, and multi-stakeholders incentives are vital enablers to enhance the HP adoption of digital interventions.
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Affiliation(s)
- Israel Júnior Borges do Nascimento
- Division of Country Health Policies and Systems (CPS), World Health Organization Regional Office for Europe, Copenhagen, 2100, Denmark
- Pathology and Laboratory Medicine, Medical College of Wisconsin, Milwaukee, WI, 53226-3522, USA
| | - Hebatullah Abdulazeem
- Department of Sport and Health Science, Techanische Universität München, Munich, 80333, Germany
| | - Lenny Thinagaran Vasanthan
- Physical Medicine and Rehabilitation Department, Christian Medical College, Vellore, Tamil Nadu, 632004, India
| | - Edson Zangiacomi Martinez
- Department of Social Medicine and Biostatistics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Miriane Lucindo Zucoloto
- Department of Social Medicine and Biostatistics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, 14049-900, Brazil
| | - Lasse Østengaard
- Centre for Evidence-Based Medicine Odense (CEBMO) and Cochrane Denmark, Department of Clinical Research, University Library of Southern Denmark, Odense, 5230, Denmark
| | - Natasha Azzopardi-Muscat
- Division of Country Health Policies and Systems (CPS), World Health Organization Regional Office for Europe, Copenhagen, 2100, Denmark
| | - Tomas Zapata
- Division of Country Health Policies and Systems (CPS), World Health Organization Regional Office for Europe, Copenhagen, 2100, Denmark
| | - David Novillo-Ortiz
- Division of Country Health Policies and Systems (CPS), World Health Organization Regional Office for Europe, Copenhagen, 2100, Denmark.
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