Introduction and purpose
National cancer control plans cf. programmes (NCCPs) are policy instruments to structure, map and organise comprehensive cancer policies in a country or its region. One of ...their important objectives is improvement of quality in cancer care and control.
Methods
We explored several methodological papers on NCCPs and analyses on their implementation in the European Union as well as recommendations and guidelines concerning prostate cancer screening and management.
Results and discussion
Quality is still not a very common feature of NCCPs as an independent, self-standing issue. Only a handful of countries structured and implemented specific activities to monitor quality of cancer care in their policy documents. In others, quantitative approaches focusing on epidemiology and provision of care are dominant, not focusing on indicators, especially those of process and outcome. In view of that and exploring its position in a broader sense, prostate cancer is poorly represented and insufficiently addressed, in particular with respect to screening, but also in after-care and survivorship challenges.
Conclusions
Given that methodological tools on NCCPs envisage quality as a separate chapter and an overarching topic in NCCPs, the current situation shows that we are still a long way away from the goals set. Absence of structured approaches for a cancer, such as prostate cancer, in NCCPs demonstrates the lack of consistency on all phases of comprehensive control on a frequent cancer, where practices and outcomes show unacceptable variations.
Full text
Available for:
EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Measuring the safety culture in Healthcare is an important step in improving patient safety. One of the most commonly used instruments to measure the safety climate is the Safety Attitudes ...Questionnaire (SAQ). The aim of the current study was to establish the validity and reliability of the Slovenian version of the SAQ for the operating room SAQ-OR.
The SAQ, consisting of six dimensions, was translated and adapted to the Slovenian context and applied in operating rooms from seven out of ten Slovenian regional hospitals. Cronbach's alpha and confirmatory factor analysis (CFA) was used to evaluate the reliability and validity of the instrument.
The sample consisted of 243 health care professionals who hold positions in the OR, divided into 4 distinct professional classes, namely, 76 surgeons (31%), 15 anesthesiologists (6%), 140 nurses (58%) and 12 auxiliary persons (5%). It was observed a very good Cronbach's alpha (0.77 to 0.88). The CFA and its goodness-of-fit indices (CFI 0.912, TLI 0.900, RMSE 0.056, SRMR 0.056) showed an acceptable model fit. There are 28 items in the final model.
The Slovenian version of the SAQ-OR revealed good psychometric properties for studying the organisational safety culture.
Full text
Available for:
CEKLJ, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background and Objectives: Glaucoma is a major cause of irreversible visual impairment and blindness, so its timely detection is crucial. Retinal images from diabetic retinopathy screening programmes ...(DRSP) provide an opportunity to detect undiagnosed glaucoma. Our aim was to find out which retinal image indicators are most suitable for referring DRSP patients for glaucoma assessment and to determine the glaucoma detection potential of Slovenian DRSP. Materials and Methods: We reviewed retinal images of patients from the DRSP at the University Medical Centre Ljubljana (November 2019–January 2020, May–August 2020). Patients with at least one indicator and some randomly selected patients without indicators were invited for an eye examination. Suspect glaucoma and glaucoma patients were considered accurately referred. Logistic regression (LOGIT) with patients as statistical units and generalised estimating equation with logistic regression (GEE) with eyes as statistical units were used to determine the referral accuracy of indicators. Results: Of the 2230 patients reviewed, 209 patients (10.1%) had at least one indicator on a retinal image of either one eye or both eyes. A total of 149 (129 with at least one indicator and 20 without) attended the eye exam. Seventy-nine (53.0%) were glaucoma negative, 54 (36.2%) suspect glaucoma, and 16 (10.7%) glaucoma positive. Seven glaucoma patients were newly detected. Neuroretinal rim notch predicted glaucoma in all cases. The cup-to-disc ratio was the most important indicator for accurate referral (odds ratio 7.59 (95% CI 3.98–14.47; p < 0.001) and remained statistically significant multivariably. Family history of glaucoma also showed an impact (odds ratio 3.06 (95% CI 1.02–9.19; p = 0.046) but remained statistically significant only in the LOGIT multivariable model. Other indicators and confounders were not statistically significant in the multivariable models. Conclusions: Our results suggest that the neuroretinal rim notch and cup-to-disc ratio are the most important for accurate glaucoma referral from retinal images in DRSP. Approximately half of the glaucoma cases in DRSPs may be undiagnosed.
Introduction
National Cancer Control Programmes (NCCPs) provide a country’s policy framework for the development of cancer control, focussing on the reduction of cancer morbidity and mortality and ...improving quality of life of cancer patients.
Objective
Exploring and analysing to which extent some of the key elements of the European Guide for Quality National Cancer Control Programmes (Guide) are implemented in NCCPs in the EU.
Methods
Survey carried out through 30 countries, EU members, Iceland, Montenegro, Norway and Turkey, focussing on stakeholders’ participation, inclusion of all the envisaged chapters from the Guide as well as implementation and dissemination.
Results
The results of the policy survey on European NCCPs carried out within Cancer Control Joint Action (CANCON JA) are presented. The response was 30 out of 35 countries. In total, 28 out of 30 countries, which completed the survey, had an NCCP or another cancer document. Cancer documents were mostly single documents, managed and supervised by the respective Ministries of Health and communicated to the public via websites and press. Nine documents were defined as programmes, eight as plans and six as strategies; in five countries, terminology was mixed. Regarding the content, recommended by the Guide from 2015, comprising ten chapter areas in three parts. Only 10 countries included in their NCCPs all elements suggested in the Guide.
Conclusion
Based on our results, we can see that a more comprehensive approach in the process of NCCPs is needed. Policy should focus on the development of instruments for efficient cancer management, which would encompass the entire trajectory of the cancer care from diagnosis to survivorship and supportive care.
National cancer plans (NCPs) saw a strong push with the recommendation of the European Commission from 2009, which called upon Member States to adopt NCPs or national cancer strategies. This process ...resulted in rapid adoption of NCPs. Joint Action EPAAC developed the European Guide for Quality National Cancer Control Programmes in support of their preparation. Europe's Beating Cancer Plan poses a new task and challenge in the need to transpose its recommendations into the national cancer documents.
Full text
Available for:
NUK, OILJ, UL, UM, UPUK, VSZLJ
In the second half of 2021, Slovenia will assume the Presidency of the Council of the European Union. As part of a trio, Slovenia will join Germany, which held the presidency in the second half of ...2020, and Portugal in the first half of 2021. The EU Presidency aims to contribute to an open, fair and sustainable Europe in the world, which is a call to action for us all. Faced with a public health crisis, it is important to join hands to increase public support for a European Union that puts global solidarity, the Agenda 2030 for Sustainable Development, development cooperation, human rights, and the inclusive participation of civil society at the centre of its work. The presentation will reflect on the future Parthership in the context of the Presidency, with a particular focus on the operational level of establishing linkages between a Partnership and exsisting public health initatives, closely related to current recovery and reconstruction plans.
Full text
Available for:
NUK, OILJ, UL, UM, UPUK, VSZLJ
The COVID-19 pandemic deepened challenges and opened new fronts where old and unresolved problems met with new problems triggered by the pandemic itself. There are several issues, problems, and ...challenges related to the post-COVID world we are in. This paper discusses some of them from different perspectives and elaborates on the future challenges and their solutions, which need to be tackled. Apart from the pre-existing problems, we are now also facing new military conflicts, interrupted supply chains, even in medicines supplies, as well as the worsening of climate change, further complicated by the military conflicts and a potential new global economic crisis. The COVID-19 pandemic left the world with many uncertainties about the future as there seem to be few answers ready to tackle the combination of the fallout of the COVID-19 pandemic coupled with the pre-existing problems and challenges. Inequalities in terms of socio-economic differences and inequalities in health are driving disease burden, which will again be marked by the population aging and non-communicable diseases (NCDs). Global collaboration and the joint search for solutions to global challenges have become inevitable. Research into behavioral determinants of health and health promotion are essential in understanding the sources of controversy regarding and resistance to proven public health interventions.
Background: Opioid over-prescription after cesarean delivery (CD) delays postoperative recovery, interferes with breastfeeding and may prompt persistent opioid use after hospital discharge. We ...evaluated the effects of implementing a multimodal stepwise analgesic regimen on opioid consumption and pain scores after CD. Methods: This was a retrospective before-after study. Opioid intake (expressed as morphine milligram equivalents (MME)) and pain scores (using the 11-point numerical rating score) within 24-hours following planned cesarean delivery under spinal anesthesia without intrathecal morphine were compared before vs. after change in post-cesarean analgesia regimen. This included intensified non-opioid analgesia with quadratus lumborum block and shifting from scheduled to as-needed opioids. Mann-Whitney U test was used for statistical comparison (p < 0.05 was considered statistically significant). Results: We included 116 women: 58 in pre-intervention and 58 in post-intervention group. There was an 86% reduction in MME (median 14 (interquarile range (IQR) 14–18) mg pre-intervention vs. 2 (IQR 2–4) mg post-intervention; p < 0.001). Pain scores were statistically higher at 2 and 4 hours post-CD in the post-intervention group (1 (IQR 1–2) vs. 2 (IQR 1–3); p = 0.001, and 2 (IQR 1–3) vs. 2 (IQR 2–3); p = 0.03, respectively) but lower at 6 hours post-CD (3 (IQR 2–4) vs. 2 (IQR 2–3); p = 0.02). No statistically significant difference in pain scores at 1, 12 and 24 hours post-CD were observed. Conclusion: Multimodal stepwise analgesic regimen allowed shifting from scheduled to as-needed opioids for post-CD pain management without increase in pain scores. This resulted in significant reduction in opioid consumption after CD.
PDF
