32 results on '"Sfetcu R"'
Search Results
2. Discharge planning, self-management, and community support: Strategies to avoid psychiatric rehospitalisation from a service user perspective
- Author
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Ådnanes, M., Cresswell-Smith, J., Melby, L., Westerlund, H., Šprah, L., Sfetcu, R., Straßmayr, C., and Donisi, V.
- Published
- 2020
- Full Text
- View/download PDF
3. Resource use during systematic review production varies widely: a scoping review: authors’ reply
- Author
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Nussbaumer-Streit, B, primary, Ziganshina, LE, additional, Mahmić-Kaknjo, M, additional, Gartlehner, G, additional, Sfetcu, R, additional, and Lund, H, additional
- Published
- 2022
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- View/download PDF
4. Warum die Erstellung von systematischen Reviews ressourcenintensiv ist – Gründe, Einflussfaktoren und potentieller Effizienzgewinn: eine qualitative Studie
- Author
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Affengruber, L, Ellen, M, Ziganshina, LE, Nussbaumer-Streit, B, and Sfetcu, R
- Subjects
ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Hintergrund/Fragestellung: Systematische Reviews sind arbeits- und zeitintensiv. In den letzten Jahren wurden Methoden untersucht, um die Erstellung systematischer Reviews effizienter zu machen. Welche Schritte eines systematischen Reviews jedoch als besonders ressourcenintensiv wahrgenommen werden[zum vollständigen Text gelangen Sie über die oben angegebene URL], Who cares? – EbM und Transformation im Gesundheitswesen; 22. Jahrestagung des Deutschen Netzwerks Evidenzbasierte Medizin
- Published
- 2021
- Full Text
- View/download PDF
5. The balance of mental health care in Europe: a comparative analysis of core health care versus the provision of other types of care for adults with mental health problems in eight study areas
- Author
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Cetrano, Gaia, Salvador-Carulla, L., Tedeschi, F., Rabbi, L., Gutiérrez-Colosía, M. R., Gonzalez-Caballero, J. L., Park, A. L., McDaid, D., Sfetcu, R., Kalseth, J., Kalseth, B., Hope, Ø., Brunn, M., Chevreul, K., Straßmayr, C., Hagmair, G., Wahlbeck, K., and Amaddeo, F.
- Abstract
Aims\ud Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. ‘Core health care’ refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. ‘Other care’ is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, ‘other care’ does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify ‘core health’ and ‘other care’ services provided to adults with mental health problems; and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services.\ud \ud Methods\ud The study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or ‘Main Types of Care’ (MTC) as the standard for international comparison, following the DESDE-LTC system.\ud \ud Results\ud In these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as ‘other care’, significant variation was found in the typology and characteristics of these services across the eight study areas.\ud \ud Conclusions\ud The functional distinction between core health and other care overcomes the traditional division between ‘health’ and ‘social’ sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.
- Published
- 2020
6. Interventions to reduce stress, anxiety and depression symptoms in teenagers – a systematic review
- Author
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Florescu, S, primary, Mihaescu Pintia, C, primary, Ciutan, M, primary, Sasu, C, primary, Sfetcu, R, primary, Scintee, S G, primary, and Vladescu, C, primary
- Published
- 2019
- Full Text
- View/download PDF
7. Appropriate approaches for improving health promotion literacy in adolescents – a systematic review
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Florescu, S, primary, Mihaescu Pintia, C, primary, Sasu, C, primary, Ciutan, M, primary, Scintee, S G, primary, Sfetcu, R, primary, and Vladescu, C, primary
- Published
- 2019
- Full Text
- View/download PDF
8. Mental health service users’ experiences of psychiatric re-hospitalisation - an explorative focus group study in six European countries
- Author
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Ådnanes, M., primary, Melby, L., additional, Cresswell-Smith, J., additional, Westerlund, H., additional, Rabbi, L., additional, Dernovšek, M. Z., additional, Šprah, L., additional, Sfetcu, R., additional, Straßmayr, C., additional, and Donisi, V., additional
- Published
- 2018
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- View/download PDF
9. Overview of post-discharge predictors for psychiatric re-hospitalisations: a systematic review of the literature
- Author
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Sfetcu, R., primary, Musat, S., additional, Haaramo, P., additional, Ciutan, M., additional, Scintee, G., additional, Vladescu, C., additional, Wahlbeck, K., additional, and Katschnig, H., additional
- Published
- 2017
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10. KÖTHE-BOCHNER SPACES THAT ARE BANACH ALGEBRAS WITH UNIT.
- Author
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CHIŢESCU, I., SFETCU, R.-C., and COJOCARU, O.
- Subjects
BANACH spaces ,MATHEMATICS theorems ,MATHEMATICAL analysis ,MATHEMATICAL functions ,BANACH algebras - Abstract
In a previous paper of the first author, it was proved that the only Köthe (scalar) spaces which are also Banach algebras with unit are the L
∞ (µ) spaces. Using this result, in the present paper it is shown that the only KötheBochner (vector) spaces which are also Banach algebras with unit are the L∞ (X, µ) spaces. [ABSTRACT FROM AUTHOR]- Published
- 2018
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11. Burden of rehospitalisation of psychiatric patients for health systems
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Scintee, G, primary, Ciutan, M, additional, Sfetcu, R, additional, and Vladescu, C, additional
- Published
- 2016
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12. What does Circular Migration Cost for the Sending Country? Evidence of Mental Health Costs after Return to Romania
- Author
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Junjan, Veronica, Popescu, C.A., Sfetcu, R., Miclutia, I., and Ciumageanu, M.
- Subjects
METIS-275131 - Published
- 2011
13. How prepared is the mental health care system to answer the increasing mental health needs of the elderly? A nursing perspective
- Author
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Sfetcu, R., primary, Mazilu, C., additional, and Gagiu, C., additional
- Published
- 2014
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14. EPA-1268 – Mental health disorders in emergency departments of general hospital in east european countries
- Author
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Mihai, A., primary, Duric, P., additional, Pirlog, M.C., additional, Stoica, M., additional, Sfetcu, R., additional, Chihai, J., additional, Boderscova, L., additional, Skendi, V., additional, and Hranvov, G.L., additional
- Published
- 2014
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15. How do the Romanian nurses perceive their level of professionalism and professional status in relation to competence/knowledge and professional identity?
- Author
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Sfetcu, R, primary and Mazilu, C V, additional
- Published
- 2012
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16. Comparing financing mechanisms of psychiatric hospital care in Austria, Germany and Romania
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Denk, P, primary, Weibold, B, additional, Scheffel, S, additional, Sfetcu, R, additional, and Katschnig, H, additional
- Published
- 2011
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17. The balance of adult mental health care: provision of core health versus other types of care in eight European countries
- Author
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Cetrano, G., Salvador-Carulla, L., Tedeschi, F., Rabbi, L., Gutiérrez-Colosía, M. R., Gonzalez-Caballero, J. L., Park, A. L., McDaid, D., Sfetcu, R., Kalseth, J., Kalseth, B., Hope, Brunn, M., Chevreul, K., Straßmayr, C., Hagmair, G., Wahlbeck, K., Amaddeo, F., Cetrano, G., Salvador-Carulla, L., Tedeschi, F., Rabbi, L., Gutiérrez-Colosía, M. R., Gonzalez-Caballero, J. L., Park, A. L., McDaid, D., Sfetcu, R., Kalseth, J., Kalseth, B., Hope, Brunn, M., Chevreul, K., Straßmayr, C., Hagmair, G., Wahlbeck, K., and Amaddeo, F.
- Abstract
Aims. Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. 'Core health care' refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. 'Other care' is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, 'other care' does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify 'core health' and 'other care' services provided to adults with mental health problems; and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services.MethodsThe study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or 'Main Types of Care' (MTC) as the standard for international comparison, following the DESDE-LTC system.ResultsIn these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as 'other care', significant variation was found in the typology and characteristics of these services across the eight study areas.ConclusionsThe functional distinction between core health and other care overcomes the traditional div
18. Research for food and health in Europe: themes, needs and proposals
- Author
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McKenna Brian, Lobstein Tim, Hirani Vasant, Frewer Lynn, Bánáti Diána, Aitsi-Selmi Amina, McCarthy Mark, Mulla Zenab, Rabozzi Giulia, Sfetcu Raluca, and Newton Rachel
- Subjects
Public aspects of medicine ,RA1-1270 - Abstract
Abstract Background Diet, in addition to tobacco, alcohol and physical exercise, is a major factor contributing to chronic diseases in Europe. There is a pressing need for multidisciplinary research to promote healthier food choices and better diets. Food and Health Research in Europe (FAHRE) is a collaborative project commissioned by the European Union. Among its tasks is the description of national research systems for food and health and, in work reported here, the identification of strengths and gaps in the European research base. Methods A typology of nine research themes was developed, spanning food, society, health and research structures. Experts were selected through the FAHRE partners, with balance for individual characteristics, and reported using a standardised template. Results Countries usually commission research on food, and on health, separately: few countries have combined research strategies or programmes. Food and health are also strongly independent fields within the European Commission's research programmes. Research programmes have supported food and bio-technology, food safety, epidemiological research, and nutritional surveillance; but there has been less research into personal behaviour and very little on environmental influences on food choices - in the retail and marketing industries, policy, and regulation. The research is mainly sited within universities and research institutes: there is relatively little published research contribution from industry. Discussion National food policies, based on epidemiological evidence and endorsed by the World Health Organisation, recommend major changes in food intake to meet the challenge of chronic diseases. Biomedical and biotechnology research, in areas such as 'nutrio-genomics', 'individualised' diets, 'functional' foods and 'nutri-pharmaceuticals' appear likely to yield less health benefit, and less return on public investment, than research on population-level interventions to influence dietary patterns: for example policies to reduce population consumption of trans fats, saturated fats, salt and energy density. Research should now address how macro-diets, rather than micro-nutritional content, can be improved for beneficial impacts on health, and should evaluate the impact of market changes and policy interventions, including regulation, to improve public health. Conclusions European and national research on food and health should have social as well as commercial benefits. Strategies and policies should be developed between ministries of health and national research funding agencies. Collaboration between member states in the European Union can yield better innovation and greater competitive advantage.
- Published
- 2011
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19. An exploration of available methods and tools to improve the efficiency of systematic review production: a scoping review.
- Author
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Affengruber L, van der Maten MM, Spiero I, Nussbaumer-Streit B, Mahmić-Kaknjo M, Ellen ME, Goossen K, Kantorova L, Hooft L, Riva N, Poulentzas G, Lalagkas PN, Silva AG, Sassano M, Sfetcu R, Marqués ME, Friessova T, Baladia E, Pezzullo AM, Martinez P, Gartlehner G, and Spijker R
- Subjects
- Humans, Research Design, Systematic Reviews as Topic methods
- Abstract
Background: Systematic reviews (SRs) are time-consuming and labor-intensive to perform. With the growing number of scientific publications, the SR development process becomes even more laborious. This is problematic because timely SR evidence is essential for decision-making in evidence-based healthcare and policymaking. Numerous methods and tools that accelerate SR development have recently emerged. To date, no scoping review has been conducted to provide a comprehensive summary of methods and ready-to-use tools to improve efficiency in SR production., Objective: To present an overview of primary studies that evaluated the use of ready-to-use applications of tools or review methods to improve efficiency in the review process., Methods: We conducted a scoping review. An information specialist performed a systematic literature search in four databases, supplemented with citation-based and grey literature searching. We included studies reporting the performance of methods and ready-to-use tools for improving efficiency when producing or updating a SR in the health field. We performed dual, independent title and abstract screening, full-text selection, and data extraction. The results were analyzed descriptively and presented narratively., Results: We included 103 studies: 51 studies reported on methods, 54 studies on tools, and 2 studies reported on both methods and tools to make SR production more efficient. A total of 72 studies evaluated the validity (n = 69) or usability (n = 3) of one method (n = 33) or tool (n = 39), and 31 studies performed comparative analyses of different methods (n = 15) or tools (n = 16). 20 studies conducted prospective evaluations in real-time workflows. Most studies evaluated methods or tools that aimed at screening titles and abstracts (n = 42) and literature searching (n = 24), while for other steps of the SR process, only a few studies were found. Regarding the outcomes included, most studies reported on validity outcomes (n = 84), while outcomes such as impact on results (n = 23), time-saving (n = 24), usability (n = 13), and cost-saving (n = 3) were less often evaluated., Conclusion: For title and abstract screening and literature searching, various evaluated methods and tools are available that aim at improving the efficiency of SR production. However, only few studies have addressed the influence of these methods and tools in real-world workflows. Few studies exist that evaluate methods or tools supporting the remaining tasks. Additionally, while validity outcomes are frequently reported, there is a lack of evaluation regarding other outcomes., (© 2024. The Author(s).)
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- 2024
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20. Delphi survey on the most promising areas and methods to improve systematic reviews' production and updating.
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Mahmić-Kaknjo M, Tomić V, Ellen ME, Nussbaumer-Streit B, Sfetcu R, Baladia E, Riva N, Kassianos AP, and Marušić A
- Subjects
- Humans, Surveys and Questionnaires, Research Design, Records
- Abstract
Background: Systematic reviews (SRs) are invaluable evidence syntheses, widely used in biomedicine and other scientific areas. Tremendous resources are being spent on the production and updating of SRs. There is a continuous need to automatize the process and use the workforce and resources to make it faster and more efficient., Methods: Information gathered by previous EVBRES research was used to construct a questionnaire for round 1 which was partly quantitative, partly qualitative. Fifty five experienced SR authors were invited to participate in a Delphi study (DS) designed to identify the most promising areas and methods to improve the efficient production and updating of SRs. Topic questions focused on which areas of SRs are most time/effort/resource intensive and should be prioritized in further research. Data were analysed using NVivo 12 plus, Microsoft Excel 2013 and SPSS. Thematic analysis findings were used on the topics on which agreement was not reached in round 1 in order to prepare the questionnaire for round 2., Results: Sixty percent (33/55) of the invited participants completed round 1; 44% (24/55) completed round 2. Participants reported average of 13.3 years of experience in conducting SRs (SD 6.8). More than two thirds of the respondents agreed/strongly agreed the following topics should be prioritized: extracting data, literature searching, screening abstracts, obtaining and screening full texts, updating SRs, finding previous SRs, translating non-English studies, synthesizing data, project management, writing the protocol, constructing the search strategy and critically appraising. Participants have not considered following areas as priority: snowballing, GRADE-ing, writing SR, deduplication, formulating SR question, performing meta-analysis., Conclusions: Data extraction was prioritized by the majority of participants as an area that needs more research/methods development. Quality of available language translating tools has dramatically increased over the years (Google translate, DeepL). The promising new tool for snowballing emerged (Citation Chaser). Automation cannot substitute human judgement where complex decisions are needed (GRADE-ing)., Trial Registration: Study protocol was registered at https://osf.io/bp2hu/ ., (© 2023. The Author(s).)
- Published
- 2023
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21. An Evidence and Consensus-Based Definition of Second Victim: A Strategic Topic in Healthcare Quality, Patient Safety, Person-Centeredness and Human Resource Management.
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Vanhaecht K, Seys D, Russotto S, Strametz R, Mira J, Sigurgeirsdóttir S, Wu AW, Põlluste K, Popovici DG, Sfetcu R, Kurt S, and Panella M
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- Humans, Consensus, Quality of Health Care, Workforce, Patient Safety, Health Personnel
- Abstract
The concept of second victims (SV) was introduced 20 years ago to draw attention to healthcare professionals involved in patient safety incidents. The objective of this paper is to advance the theoretical conceptualization and to develop a common definition. A literature search was performed in Medline, EMBASE and CINAHL (October 2010 to November 2020). The description of SV was extracted regarding three concepts: (1) involved persons, (2) content of action and (3) impact. Based on these concepts, a definition was proposed and discussed within the ERNST-COST consortium in 2021 and 2022. An international group of experts finalized the definition. In total, 83 publications were reviewed. Based on expert consensus, a second victim was defined as: "Any health care worker, directly or indirectly involved in an unanticipated adverse patient event, unintentional healthcare error, or patient injury and who becomes victimized in the sense that they are also negatively impacted". The proposed definition can be used to help to reduce the impact of incidents on both healthcare professionals and organizations, thereby indirectly improve healthcare quality, patient safety, person-centeredness and human resource management.
- Published
- 2022
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22. JBI series paper 3: The importance of people, process, evidence, and technology in pragmatic, healthcare provider-led evidence implementation.
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Lockwood C, Munn Z, Jordan Z, Pilla B, Püschel VAA, Dos Santos KB, Albornos-Muñoz L, Kent B, Mu PF, Khalil H, McArthur A, Porritt K, Cooper A, Sfetcu R, and Lizarondo L
- Subjects
- Humans, Evidence-Based Practice, Technology, Communication, Health Personnel, Delivery of Health Care
- Abstract
In this paper, we describe and discuss evidence implementation as a venture in global human collaboration within the framework of "people, process, evidence, and technology" as a roadmap for navigating implementation. At its core implementation is not a technological, or theoretical process, it is a human process. That health professionals central to implementation activities may not have had formal training in implementation, highlights the need for processes and programs that can be integrated within healthcare organization structures. Audit with feedback is an accessible implementation approach that includes the capacity to embed theory, frameworks, and bottom-up change processes to improve the quality of care. In this third paper in the JBI series, we discuss how four overarching principals necessary for sustainability (Culture, Capacity, Communication, and Collaboration) are combined with evidence, technology, and resources for evidence-based practice change. This approach has been successfully used across hundreds of evidence implementation projects around the globe for over 15 years. We present healthcare practitioner-led evidence-based practice improvement as sustainable and achievable in collaborative environments such as the global JBI network as a primary interest of the practicing professions and provide an overview of the JBI approach to evidence implementation., (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Published
- 2022
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23. Teams for sustainability of evidence implementation.
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Sfetcu R and Lockwood C
- Subjects
- Qualitative Research, Program Evaluation
- Published
- 2021
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24. Romanian GPs Involvement in Caring for the Mental Health Problems of the Elderly Population: A Cross-Sectional Study.
- Author
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Sfetcu R, Toma D, Tudose C, and Vladescu C
- Abstract
The mental health of the elderly is a matter of increased concern in the context of an aging population since currently only a small fraction of this population is receiving adequate care. The provision of treatment in primary care by the General Practitioners (GPs) has been proposed for over a decade as a potential solution, as services offered by GPs are more accessible, less susceptible to stigma, and have a more comprehensive view of the other health care problems that the elderly might suffer from. In this study, we explored the perception of Romanian GPs regarding their practice and roles in caring for the mental health of the elderly as well as the willingness to increase their future involvement in the management of dementia and other mental health problems. Data was collected via an online questionnaire structured on four dimensions: (1) GPs' sociodemographic profile and practice characteristics, (2) GPs assessment of the services available for elderly with mental health problems, (3) GPs current involvement in mental health care for different categories of problems, and (4) factors that might influence the future involvement of GPs in providing care for elderly with mental health problems. The survey was sent via the member mailing lists of the National Society for Family Medicine. Results show that GPs are currently limited by prescribing possibilities, available resources and knowledge in the area, but they are willing to expand their role in the areas of early recognition and prevention of mental health problems as well as providing disease management and collaborative care. An improved communication with mental health care professionals, a better access to resources and having more financial incentives are the three most important categories for GPs to increase their involvement. In conclusion, increasing the access to personal and professional resources and setting up functional communication channels with specialized mental health care could motivate GPs to provide timely mental health support to elderly patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Sfetcu, Toma, Tudose and Vladescu.)
- Published
- 2021
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25. 'If we would change things outside we wouldn't even need to go in…' supporting recovery via community-based actions: A focus group study on psychiatric rehospitalization.
- Author
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Cresswell-Smith J, Donisi V, Rabbi L, Sfetcu R, Šprah L, Straßmayr C, Wahlbeck K, and Ådnanes M
- Subjects
- Focus Groups, Humans, Mental Health, Qualitative Research, Social Stigma, Mental Disorders therapy, Mental Health Services
- Abstract
Background: Psychiatric rehospitalization is a complex phenomenon in need of more person-centred approaches. The current paper aimed to explore how community-based actions and daily life influence mental health and rehospitalization., Design, Setting and Participants: The qualitative study included focus group data from six European countries including 59 participants. Data were thematically analysed following an inductive approach deriving themes and subthemes in relation to facilitators and barriers to mental health., Results: Barriers consisted of subthemes (financial difficulty, challenging family circumstances and stigma), and facilitators consisted of three subthemes (complementing services, signposting and recovery). The recovery subtheme consisted of a further five categories (family and friends, work and recreation, hope, using mental health experience and meaning)., Discussion: Barriers to mental health largely related to social determinants of mental health, which may also have implications for psychiatric rehospitalization. Facilitators included community-based actions and aspects of daily life with ties to personal recovery. By articulating the value of these facilitators, we highlight benefits of a person-centred and recovery-focused approach also within the context of psychiatric rehospitalization., Conclusions: This paper portrays how person-centred approaches and day-to-day community actions may impact psychiatric rehospitalization via barriers and facilitators, acknowledging the social determinants of mental health and personal recovery., Patient or Public Contribution: The current study included participants with experience of psychiatric rehospitalization from six different European countries. Furthermore, transcripts were read by several of the focus group participants, and a service user representative participated in the entire research process in the original study., (© 2020 The Authors. Health Expectations published by John Wiley & Sons Ltd.)
- Published
- 2021
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26. Ethics in quality improvement: Reimagining the clinician role.
- Author
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Lockwood C and Sfetcu R
- Subjects
- Clinical Nursing Research, Humans, Leadership, Organizational Innovation, Quality Improvement ethics
- Published
- 2020
- Full Text
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27. Using national electronic health care registries for comparing the risk of psychiatric re-hospitalisation in six European countries: Opportunities and limitations.
- Author
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Katschnig H, Straßmayr C, Endel F, Berger M, Zauner G, Kalseth J, Sfetcu R, Wahlbeck K, Tedeschi F, and Šprah L
- Subjects
- Adult, Age Factors, Europe epidemiology, Female, Hospitalization, Humans, Incidence, Male, Middle Aged, Databases, Factual supply & distribution, Health Information Interoperability, Mental Disorders epidemiology, Patient Readmission statistics & numerical data, Registries
- Abstract
Psychiatric re-hospitalisation rates have been of longstanding interest as health care quality metric for planners and policy makers, but are criticized for not being comparable across hospitals and countries due to measurement unclarities. The objectives of the present study were to explore the interoperability of national electronic routine health care registries of six European countries (Austria, Finland, Italy, Norway, Romania, Slovenia) and, by using variables found to be comparable, to calculate and compare re-hospitalisation rates and the associated risk factors. A "Methods Toolkit" was developed for exploring the interoperability of registry data and protocol led pilot studies were carried out. Problems encountered in this process are described. Using restricted but comparable data sets, up to twofold differences in psychiatric re-hospitalisation rates were found between countries for both a 30- and 365-day follow-up period. Cumulative incidence curves revealed noteworthy additional differences. Health system characteristics are discussed as potential causes for the differences. Multi-level logistic regression analyses showed that younger age and a diagnosis of schizophrenia/mania/bipolar disorder consistently increased the probability of psychiatric re-hospitalisation across countries. It is concluded that the advantage of having large unselected study populations of national electronic health care registries needs to be balanced against the considerable efforts to examine the interoperability of databases in cross-country comparisons., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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28. The balance of adult mental health care: provision of core health versus other types of care in eight European countries.
- Author
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Cetrano G, Salvador-Carulla L, Tedeschi F, Rabbi L, Gutiérrez-Colosía MR, Gonzalez-Caballero JL, Park AL, McDaid D, Sfetcu R, Kalseth J, Kalseth B, Hope Ø, Brunn M, Chevreul K, Straßmayr C, Hagmair G, Wahlbeck K, and Amaddeo F
- Subjects
- Adult, Europe, Health Services Research, Humans, Mental Disorders psychology, Mental Health, Urban Population, Community Mental Health Services statistics & numerical data, Mental Disorders therapy
- Abstract
Aims: Although many mental health care systems provide care interventions that are not related to direct health care, little is known about the interfaces between the latter and core health care. 'Core health care' refers to services whose explicit aim is direct clinical treatment which is usually provided by health professionals, i.e., physicians, nurses, psychologists. 'Other care' is typically provided by other staff and includes accommodation, training, promotion of independence, employment support and social skills. In such a definition, 'other care' does not necessarily mean being funded or governed differently. The aims of the study were: (1) using a standard classification system (Description and Evaluation of Services and Directories in Europe for Long Term Care, DESDE-LTC) to identify 'core health' and 'other care' services provided to adults with mental health problems; and (2) to investigate the balance of care by analysing the types and characteristics of core health and other care services., Methods: The study was conducted in eight selected local areas in eight European countries with different mental health systems. All publicly funded mental health services, regardless of the funding agency, for people over 18 years old were identified and coded. The availability, capacity and the workforce of the local mental health services were described using their functional main activity or 'Main Types of Care' (MTC) as the standard for international comparison, following the DESDE-LTC system., Results: In these European study areas, 822 MTCs were identified as providing core health care and 448 provided other types of care. Even though one-third of mental health services in the selected study areas provided interventions that were coded as 'other care', significant variation was found in the typology and characteristics of these services across the eight study areas., Conclusions: The functional distinction between core health and other care overcomes the traditional division between 'health' and 'social' sectors based on governance and funding. The overall balance between core health and other care services varied significantly across the European sites. Mental health systems cannot be understood or planned without taking into account the availability and capacity of all services specifically available for this target population, including those outside the health sector.
- Published
- 2018
- Full Text
- View/download PDF
29. Effectiveness of pain management educational interventions on nurses' knowledge and attitudes regarding postoperative pain management: a systematic review protocol.
- Author
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Mazilu DC, Zazu M, Nedelcu V, and Sfetcu R
- Subjects
- Attitude of Health Personnel, Humans, Research Design, Systematic Reviews as Topic, Education, Nursing methods, Health Knowledge, Attitudes, Practice, Nurses psychology, Pain Management psychology, Pain, Postoperative nursing
- Abstract
Review Question/objective: The objective of this review is to identify the effectiveness of pain management education programs (PMEPs) in improving the level of knowledge and the attitudes of nurses working in adult surgical departments and intensive care units on postoperative pain management.
- Published
- 2018
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30. Developing a tool for mapping adult mental health care provision in Europe: the REMAST research protocol and its contribution to better integrated care.
- Author
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Salvador-Carulla L, Amaddeo F, Gutiérrez-Colosía MR, Salazzari D, Gonzalez-Caballero JL, Montagni I, Tedeschi F, Cetrano G, Chevreul K, Kalseth J, Hagmair G, Straßmayr C, Park AL, Sfetcu R, Wahlbeck K, and Garcia-Alonso C
- Abstract
Introduction: Mental health care is a critical area to better understand integrated care and to pilot the different components of the integrated care model. However, there is an urgent need for better tools to compare and understand the context of integrated mental health care in Europe., Method: The REMAST tool (REFINEMENT MApping Services Tool) combines a series of standardised health service research instruments and geographical information systems (GIS) to develop local atlases of mental health care from the perspective of horizontal and vertical integrated care. It contains five main sections: (a) Population Data; (b) the Verona Socio-economic Status (SES) Index; (c) the Mental Health System Checklist; (d) the Mental Health Services Inventory using the DESDE-LTC instrument; and (e) Geographical Data., Expected Results: The REMAST tool facilitates context analysis in mental health by providing the comparative rates of mental health service provision according to the availability of main types of care; care placement capacity; workforce capacity; and geographical accessibility to services in the local areas in eight study areas in Austria, England, Finland, France, Italy, Norway, Romania and Spain., Discussion: The outcomes of this project will facilitate cooperative work and knowledge transfer on mental health care to the different agencies involved in mental health planning and provision. This project would improve the information to users and society on the available resources for mental health care and system thinking at the local level by the different stakeholders. The techniques used in this project and the knowledge generated could eventually be transferred to the mapping of other fields of integrated care.
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- 2015
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31. Conducting systematic reviews of association (etiology): The Joanna Briggs Institute's approach.
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Moola S, Munn Z, Sears K, Sfetcu R, Currie M, Lisy K, Tufanaru C, Qureshi R, Mattis P, and Mu P
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- Bias, Empirical Research, Evidence-Based Medicine standards, Guidelines as Topic standards, Humans, Causality, Evidence-Based Medicine organization & administration, Research Design standards, Review Literature as Topic
- Abstract
The systematic review of evidence is the research method which underpins the traditional approach to evidence-based healthcare. There is currently no uniform methodology for conducting a systematic review of association (etiology). This study outlines and describes the Joanna Briggs Institute's approach and guidance for synthesizing evidence related to association with a predominant focus on etiology and contributes to the emerging field of systematic review methodologies. It should be noted that questions of association typically address etiological or prognostic issues.The systematic review of studies to answer questions of etiology follows the same basic principles of systematic review of other types of data. An a priori protocol must inform the conduct of the systematic review, comprehensive searching must be performed and critical appraisal of retrieved studies must be carried out.The overarching objective of systematic reviews of etiology is to identify and synthesize the best available evidence on the factors of interest that are associated with a particular disease or outcome. The traditional PICO (population, interventions, comparators and outcomes) format for systematic reviews of effects does not align with questions relating to etiology. A systematic review of etiology should include the following aspects: population, exposure of interest (independent variable) and outcome (dependent variable).Studies of etiology are predominantly explanatory or predictive. The objective of reviews of explanatory or predictive studies is to contribute to, and improve our understanding of, the relationship of health-related events or outcomes by examining the association between variables. When interpreting possible associations between variables based on observational study data, caution must be exercised due to the likely presence of confounding variables or moderators that may impact on the results.As with all systematic reviews, there are various approaches to present the results, including a narrative, graphical or tabular summary, or meta-analysis. When meta-analysis is not possible, a set of alternative methods for synthesizing research is available. On the basis of the research question and objectives, narrative, tabular and/or visual approaches can be used for data synthesis. There are some special considerations when conducting meta-analysis for questions related to risk and correlation. These include, but are not limited to, causal inference.Systematic review and meta-analysis of studies related to etiology is an emerging methodology in the field of evidence synthesis. These reviews can provide useful information for healthcare professionals and policymakers on the burden of disease. The standardized Joanna Briggs Institute approach offers a rigorous and transparent method to conduct reviews of etiology.
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- 2015
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32. Research for food and health in Europe: themes, needs and proposals.
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McCarthy M, Aitsi-Selmi A, Bánáti D, Frewer L, Hirani V, Lobstein T, McKenna B, Mulla Z, Rabozzi G, Sfetcu R, and Newton R
- Abstract
Background: Diet, in addition to tobacco, alcohol and physical exercise, is a major factor contributing to chronic diseases in Europe. There is a pressing need for multidisciplinary research to promote healthier food choices and better diets. Food and Health Research in Europe (FAHRE) is a collaborative project commissioned by the European Union. Among its tasks is the description of national research systems for food and health and, in work reported here, the identification of strengths and gaps in the European research base., Methods: A typology of nine research themes was developed, spanning food, society, health and research structures. Experts were selected through the FAHRE partners, with balance for individual characteristics, and reported using a standardised template., Results: Countries usually commission research on food, and on health, separately: few countries have combined research strategies or programmes. Food and health are also strongly independent fields within the European Commission's research programmes. Research programmes have supported food and bio-technology, food safety, epidemiological research, and nutritional surveillance; but there has been less research into personal behaviour and very little on environmental influences on food choices - in the retail and marketing industries, policy, and regulation. The research is mainly sited within universities and research institutes: there is relatively little published research contribution from industry., Discussion: National food policies, based on epidemiological evidence and endorsed by the World Health Organisation, recommend major changes in food intake to meet the challenge of chronic diseases. Biomedical and biotechnology research, in areas such as 'nutrio-genomics', 'individualised' diets, 'functional' foods and 'nutri-pharmaceuticals' appear likely to yield less health benefit, and less return on public investment, than research on population-level interventions to influence dietary patterns: for example policies to reduce population consumption of trans fats, saturated fats, salt and energy density. Research should now address how macro-diets, rather than micro-nutritional content, can be improved for beneficial impacts on health, and should evaluate the impact of market changes and policy interventions, including regulation, to improve public health., Conclusions: European and national research on food and health should have social as well as commercial benefits. Strategies and policies should be developed between ministries of health and national research funding agencies. Collaboration between member states in the European Union can yield better innovation and greater competitive advantage.
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- 2011
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