Palliative care coverage across European National Health Systems: proposal of a synthetic indicator

Background: The coverage of palliative care (PC) may be understood as a country’s capacity to offer prevention and relief from serious health-related suffering in relation to an existing need. The aim of this study is to estimate European countries´ coverage capacities. Method: Secondary analysis of three indicators, including the number of specialized services (SSPC), integration capacity scores (ICS) and the PC needs. By means of a K-medians clustering supervised algorithm, three coverage profiles were obtained: (1) Advanced: countries with high ICS and SSPC, and low PC needs; (2) Limited: countries with low ICS and SSPC, and low PC needs; and (3) Low: countries with low ICS and SSPC and high PC needs. Results: On average, the ratio of specialized services per population was 0.79 per 100,000 inhabitants, the average ICS was 19.62 and the average number of deceased patients with SHS per 100,000 inhabitants was 5.69. Twenty countries (41%) reached an advanced coverage profile. Nine countries (18%) demonstrated a limited coverage profile; and 20 countries (41%) fell under a low-coverage capacity. Conclusion: The level of palliative care coverage across Europe shows that 59% of European countries have either limited or very low availability of PC resources as regards their palliative care needs

Palliative care in the Eastern Mediterranean: comparative analysis using specific indicators

Background Monitoring the development of palliative care (PC) illustrates the capacity of health systems to respond to the needs of people experiencing serious health-related suffering. Aim To analyse comparatively the situation of PC in the countries of the Easter Mediterranean region using context-specific indicators. Method An online questionnaire with 15 context-specific PC indicators investigating service provision, use of medicines, policy, education, and vitality was designed. Authors Institution 1 nominated in-country experts to complete the survey. Data were analysed using a comparative description of indicators per domain and a multivariate analysis. Results In-country experts were identified in 17/22 countries. 12/17 contributed to the survey. In total, 117 specialized PC services were identified. Specialized services per population ranges from 0.09 per 100,000 inhabitants in Lebanon and Saudi Arabia, Qatar and Kuwait; to zero services in the Occupied Palestinian Territories. On average, opioid consumption was 2.40 mg/capita/year. National PC strategies were reported in nine countries. In six countries, PC is officially accredited either as a specialty or sub-specialty, and PC mandatory courses are implemented in 36% of medical schools and 46% of nursing schools. National PC associations were documented in six countries. A higher pattern of development was identified in Jordan, Kuwait, Saudi Arabia, Oman, Lebanon, Qatar. Conclusions Despite a higher development in the Arabian Peninsula, the region is characterised by a very low provision of specialized PC services and opioid consumption. Policy improvements represent an opportunity to improve access to PC

Not everything helps the same for everyone: relevance of extracurricular activities for academic achievement

Participation in organized Extracurricular Activities has contributed to improve academic achievement. However, this does not happen in the same way; it depends on sex, age, or parental educational level. Our objective is to know the importance of these factor interactions¿ in the explanation of academic achievement. The sample consisted of 1148 adolescents, aged between 12 and 18 years, 52% of whom were female. Participants completed the Extracurricular Activities questionnaire, and academic and sociodemographic data were collected. The results show that differences in academic achievement depend on the adolescent stage. In early adolescence, girls improve in academic achievement, as well as with better parental education, reading of books and activity duration. On the contrary, in the middle and late adolescence, academic achievement improves with not participating in collective sports and reduced activity breadth, although parental educational level follows the same trend as in the early adolescence. These results reinforce the evolutionary hypothesis of specialization in the choice of activities throughout adolescence. In this sense, some proposals for schools that advocate for greater integration of curricular and non-curricular elements are discussed

Structural empirical model of personal positive youth development, parenting, and school climate

This study tested an empirical model of the relationship between Personal Positive Youth Development (PPYD) and two contextual factors: Positive Parenting (PP), and Perception of the Climate and Functioning of the School (PcfS). The hypothesis tested was that a positive relationship with parents and a positive perception of the school will contribute to the prediction of PPYD. The sample was composed of 1507 adolescents recruited in 10 Spanish schools who were aged between 12 and 18 years and 52% were female. PPYD was evaluated through Dispositional optimism, Self‐competence, and Sense of coherence. PP was evaluated through Affect and communication, Autonomy granting, Humor, and Self‐disclosure. PcfS was evaluated through School climate, School bonds, Clarity of rules and values, and Empowerment. Previous reliability and validity analyses of the constructs were carried out, and correlational analyses and structural predictions were made. The results show that both PP and PcfS were associated with better scores in PPYD. Also, a positive correlation between those two contextual factors was found. Implications for applied research are discussed. Highlights: Positive Parenting has a positive association with Perception of climate and functioning of the School.Positive Parenting and better Perception of climate and functioning of the School both predict Personal Positive Youth Development.Positive Parenting is the most relevant predictor of Personal Positive Youth Developmen

Structural empirical model of personal positive youth development, parenting, and school climate

This study tested an empirical model of the relationship between Personal Positive Youth Development (PPYD) and two contextual factors: Positive Parenting (PP), and Perception of the Climate and Functioning of the School (PcfS). The hypothesis tested was that a positive relationship with parents and a positive perception of the school will contribute to the prediction of PPYD. The sample was composed of 1507 adolescents recruited in 10 Spanish schools who were aged between 12 and 18 years and 52% were female. PPYD was evaluated through Dispositional optimism, Self‐competence, and Sense of coherence. PP was evaluated through Affect and communication, Autonomy granting, Humor, and Self‐disclosure. PcfS was evaluated through School climate, School bonds, Clarity of rules and values, and Empowerment. Previous reliability and validity analyses of the constructs were carried out, and correlational analyses and structural predictions were made. The results show that both PP and PcfS were associated with better scores in PPYD. Also, a positive correlation between those two contextual factors was found. Implications for applied research are discussed. Highlights: Positive Parenting has a positive association with Perception of climate and functioning of the School.Positive Parenting and better Perception of climate and functioning of the School both predict Personal Positive Youth Development.Positive Parenting is the most relevant predictor of Personal Positive Youth Developmen

Palliative care coverage across European National Health Systems: proposal of a synthetic indicator

Background: The coverage of palliative care (PC) may be understood as a country’s capacity to offer prevention and relief from serious health-related suffering in relation to an existing need. The aim of this study is to estimate European countries´ coverage capacities. Method: Secondary analysis of three indicators, including the number of specialized services (SSPC), integration capacity scores (ICS) and the PC needs. By means of a K-medians clustering supervised algorithm, three coverage profiles were obtained: (1) Advanced: countries with high ICS and SSPC, and low PC needs; (2) Limited: countries with low ICS and SSPC, and low PC needs; and (3) Low: countries with low ICS and SSPC and high PC needs. Results: On average, the ratio of specialized services per population was 0.79 per 100,000 inhabitants, the average ICS was 19.62 and the average number of deceased patients with SHS per 100,000 inhabitants was 5.69. Twenty countries (41%) reached an advanced coverage profile. Nine countries (18%) demonstrated a limited coverage profile; and 20 countries (41%) fell under a low-coverage capacity. Conclusion: The level of palliative care coverage across Europe shows that 59% of European countries have either limited or very low availability of PC resources as regards their palliative care needs

Palliative care integration indicators: an European regional analysis

Objective To estimate the capacity of European countries to integrate palliative care (PC) into their health systems through PC service provision for patients of all ages, with different care needs and diseases, in various settings and by a range of providers. Methods Secondary analysis of survey data from 51 countries with 22 indicators explored the integration of available PC resources for children, for patients of all ages, at the primary care level, for oncology and cardiac patients, and in long-term care facilities. We also measured volunteer participation. Results were quantified, converted into weighted subscores by area and combined into a single ‘Integration Capacity Score (ICS)’ for each country. Results Thirty-eight countries reported 543 specialised paediatric PC services. One-third of all surveyed countries reported 20% or more of patients with PC needs at the primary care level. Twenty-four countries have a total of 155 designated centres that integrate oncology and PC. Eight countries were pioneering cardiology services that integrate PC. Eight reported a volunteer workforce of over 1000 and 12 had policies regulating PC provision and interventions in long-term care facilities. Across all indicators, 39 countries (76%) score from low to very low integration capacity, 8 (16%) score at an intermediate level, and 4 (8%; the Netherlands, UK, Germany and Switzerland) report a high-level integration of PC into their health systems. Conclusion Variable progress according to these indicators shows that most European countries are still in the process of integrating PC into their health systems

Palliative care integration indicators: an European regional analysis

Objective To estimate the capacity of European countries to integrate palliative care (PC) into their health systems through PC service provision for patients of all ages, with different care needs and diseases, in various settings and by a range of providers. Methods Secondary analysis of survey data from 51 countries with 22 indicators explored the integration of available PC resources for children, for patients of all ages, at the primary care level, for oncology and cardiac patients, and in long-term care facilities. We also measured volunteer participation. Results were quantified, converted into weighted subscores by area and combined into a single ‘Integration Capacity Score (ICS)’ for each country. Results Thirty-eight countries reported 543 specialised paediatric PC services. One-third of all surveyed countries reported 20% or more of patients with PC needs at the primary care level. Twenty-four countries have a total of 155 designated centres that integrate oncology and PC. Eight countries were pioneering cardiology services that integrate PC. Eight reported a volunteer workforce of over 1000 and 12 had policies regulating PC provision and interventions in long-term care facilities. Across all indicators, 39 countries (76%) score from low to very low integration capacity, 8 (16%) score at an intermediate level, and 4 (8%; the Netherlands, UK, Germany and Switzerland) report a high-level integration of PC into their health systems. Conclusion Variable progress according to these indicators shows that most European countries are still in the process of integrating PC into their health systems

Palliative care in the Eastern Mediterranean: comparative analysis using specific indicators

Background Monitoring the development of palliative care (PC) illustrates the capacity of health systems to respond to the needs of people experiencing serious health-related suffering. Aim To analyse comparatively the situation of PC in the countries of the Easter Mediterranean region using context-specific indicators. Method An online questionnaire with 15 context-specific PC indicators investigating service provision, use of medicines, policy, education, and vitality was designed. Authors Institution 1 nominated in-country experts to complete the survey. Data were analysed using a comparative description of indicators per domain and a multivariate analysis. Results In-country experts were identified in 17/22 countries. 12/17 contributed to the survey. In total, 117 specialized PC services were identified. Specialized services per population ranges from 0.09 per 100,000 inhabitants in Lebanon and Saudi Arabia, Qatar and Kuwait; to zero services in the Occupied Palestinian Territories. On average, opioid consumption was 2.40 mg/capita/year. National PC strategies were reported in nine countries. In six countries, PC is officially accredited either as a specialty or sub-specialty, and PC mandatory courses are implemented in 36% of medical schools and 46% of nursing schools. National PC associations were documented in six countries. A higher pattern of development was identified in Jordan, Kuwait, Saudi Arabia, Oman, Lebanon, Qatar. Conclusions Despite a higher development in the Arabian Peninsula, the region is characterised by a very low provision of specialized PC services and opioid consumption. Policy improvements represent an opportunity to improve access to PC