bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical illnesses associated with childhood homelessness - a literature review
Authors: Strashun S , D'Sa S , Foley D , Hannon J , Murphy A M , O'Gorman C S
Published: October 2020

Background and aims

Childhood homelessness is a growing concern in Ireland creating a Pediatric subpopulation at increased risk of physical illnesses, many with life-long consequences. Our aim was to identify and categorize the physical morbidities prevalent in homeless children.

Methods

A review of the English-language literature on physical morbidities affecting homeless children (defined as < 18 years of age), published from 1999-2019 was conducted. A total of 1194 articles were identified, 33 articles of which met our inclusion criteria.

Results

Respiratory issues were the most commonly cited illnesses affecting homeless children; including asthma, upper respiratory tract infections, and chronic cough. Homeless children were described as being at increased risk of contracting infectious diseases, many studies placing emphasis on STI and HIV/AIDS transmission. Dermatologic concerns comprised of scabies and head lice infestation, dermatitis, and abrasions. Malnutrition manifested as a range of physical morbidities; including childhood obesity, iron deficiency anemia, and stunted growth. Studies found a higher prevalence of poor dental and ocular health in this population as well. Many articles also commented on the risk factors predisposing homeless children to these physical health concerns, which can broadly be categorized as limited access to health care, poor living conditions, and lack of education.

Conclusions

This literature review summarized the physical illnesses prevalent among homeless children and the contributing factors leading to them. Gaps in the literature were also identified, and included a dearth of studies focusing on younger children compared to adolescents. We believe that the current issue of child homelessness is socially and medically unacceptable and that homelessness occurring today will be one of the scandals of the next generation. Further research into prevention and intervention programs for this vulnerable population is urgently needed.

Key messages

This literature review shows that homeless children are at an increased risk of several physical morbidities and identified the common themes among them. Based on this literature review, it is recommended that more research be done into developing appropriate intervention and prevention strategies to help this vulnerable population.
Own migration experience is not a risk factor for incident cardiovascular disease – a cohort study
Authors: Krist L , Dornquast C , Reinhold T , Solak S , Durak M , Icke K , Danquah I , Becher H , Willich S N , Keil T
Published: October 2020

Background

Studies have shown differences regarding prevalence and incidence of chronic diseases among first (own migration experience) compared to second (born in host country) generation migrants. The aim of this study was therefore to investigate the incidence of cardiovascular diseases (CVD) among persons of Turkish descent with and without migration experience living in Berlin, Germany.

Methods

In 2012-2013, Berliners with a Turkish migration background were recruited, examined, and contacted again 5 years later via postal mail. Incidence of diagnosed CVD (myocardial infarction, stroke, coronary heart disease, heart failure, cardiac arrhythmia, intermittent claudicatio or transient ischaemic attack) was assessed via self-report. Incidence of any CVD is presented as number and percentages. Associations between the incidence of any CVD and having an own migration experience were investigated with uni- and multivariable regression analyses. Results are presented as odds ratios with a 95%-confidence interval (OR, 95%-CI).

Results

Data of 234 persons of Turkish descent (62.8% women) with a mean age±standard deviation of 44±12.4 years were included in the analyses. Out of these, 79.9% were first generation migrants. First compared to second generation participants differed regarding CVD incidence (any CVD 16.6% vs. 4.3%, respectively; p = 0.03), socio-demographic, and lifestyle factors. After adjusting for these factors, multivariable analysis showed that only BMI (OR 1.12 per BMI point, 95%CI [1.02;1.24], and having a diagnosis of dyslipidemia (OR 4.0, 95%CI [1.45;12.05]), were independently associated with CVD incidence.

Conclusions

In a cohort study with Berliners of Turkish descent, CVD incidence was associated with increasing BMI and dyslipidemia, but not with own migration experience. Future migration-related public health research needs to focus on the prevention of harmful health behaviours to avoid the progression of overweight/obesity and dyslipidemia.

Key messages

CVD incidence is higher in persons with migration experience compared to those without. Migration experience is not associated with CVD incidence after adjusting for confounders (e.g. age, BMI).
Loss to follow up among men who have sex with men and heterosexual men living with HIV in Haiti
Authors: Dunbar W , Sohler N , Coppieters Y
Published: October 2020

Background

Despite the benefits of adherence in HIV medication, health systems are struggling to keep all categories of patients in care due to loss to follow up (LTFU). Men who have sex with men (MSM) are at higher risk of HIV infection and also face several barriers to reach treatment, it is hypothesized that they may also have higher incidence of dropping-off. This study aims to determine whether MSM living with HIV have a greater risk of LTFU compared with heterosexual men and to identify the risk factors for the two groups.

Methods

A retrospective matched cohort study of electronic medical record data from 554 patients living with HIV and enrolled in care between 2015 and 2018 at a Port-au-Prince-based HIV clinic was performed. The 125 MSM and 429 heterosexual patients were matched on gender age and enrolment date. The primary outcome was LTFU defined as not refilling an ART prescription for a period of 90 days. MSM and heterosexual men was compared using t-tests and chi-square tests. The Kaplan-Meier technique was used to estimate time to LTFU after initiation of ART and the Cox Proportional Hazards regression model was used to determine predictors of LTFU.

Results

The sample had a mean age of 31.1 years (SD 8.0) for MSM and 32.4 years (SD 7.7) for heterosexual men. LTFU was significantly more common among the MSM group than the heterosexual group (MSM 48.8%, heterosexual men 34.7%; p = 0.012). Factors associated with LTFU were greater amongst younger patients, with lower educational and economic level. The median time to LTFU for MSM was 679 days and 1110 days for heterosexual men. The log rank test showed that this is statistically significant at p = 0.001.

Conclusions

This study showed that the risk of LTFU is significantly higher and the time to LTFU is significantly shorter for MSM relative to heterosexual men. Identifying predictors to LTFU in HIV clinical settings and providing appropriate services and supports are important steps in addressing this issue.

Key messages

Men who have sex with men continue to face barriers to effective HIV treatment in Haiti. Adapted interventions are needed to improve HIV care for Men who have sex with Men in Haiti.
Ending female genital mutilation – a city’s coordinated effort
Authors: Paixão M , Carmona A , Capelão H , Calé E , Silva A
Published: October 2020

Female genital mutilation (FGM) has short and long-term impacts on the health of girls/women. In Portugal, an estimated 5246 women were subjected to it, with 568 of them residing in the city of Amadora, in the metropolitan area of the capital Lisbon. As such, Amadora was considered a priority area for developing strategies to prevent female genital mutilation, under the coordination of the local public health unit.

Our aim was to capacitate professionals to recognise and act on risk/danger and on minimising potential health impacts of FGM on the local institutions these girls/women might come into contact with.

We created a task force that held meetings with different local actors: hospital, teams at the primary healthcare facility, city hall of Amadora, child protection services, a school, social inclusion projects, representatives of the justice system and a non-governmental organisation. We designed different scenarios for the different needs and entry points of these girls/women in the system and created appropriate procedures for all these actors. Within the primary healthcare facility, we created guidelines specifying criteria for referral to other specialties. This led to the development of a county protocol targeting FGM during the summer of 2019.

We trained 160 healthcare professionals. In addition, we created a booklet for schools and held sessions in school groups targeting teachers, psychologists and operational assistants with a focus on risk and danger indicators and on how to proceed. Overall, 360 school professionals received training. During these sessions, we also presented resources on how to integrate FGM in discussions with students regarding gender violence and human rights.

This intervention will be evaluated after one year (summer of 2020) through mixed-methods to understand the impact on the practice of the professionals in Amadora. We will conduct interviews and apply questionnaires to capture the implementation of this city-wide protocol.

Key messages

Given the complexity of FGM a wide societal and multidisciplinary approach should be used with a public health team coordinating the intervention. In Portugal there is a need for an organised and systematic response by professionals regarding FGM; our county-specific protocol aimed to create that response.
Language barriers in HRQOL assessment: development of a picture-based questionnaire (PictoQOL)
Authors: Erdsiek F , Aksakal T , Dyck M , Padberg D , Yilmaz-Aslan Y , Brzoska P
Published: October 2020

Background

Translations and adaptations of standardized HRQOL questionnaires (e.g., SF-8) are available for many large population groups. For smaller groups, like certain migrant communities, whose language use can differ from the respective population in their countries of origin, often no adequate adaptations are available. Nonverbal, picture-based questionnaires could address these challenges. The present study provides insights into the development of such a measure (PictoQOL) for HRQOL assessment.

Methods

We used a qualitative design. We conducted 6 focus group discussions with a total of 18 adults from different cultural backgrounds to identify suitable visual cues based on the the dimensions of the SF-8 and WHOQOL-BREF and to create drafts of visual representations for different items. Subsequently, we developed a draft of the questionnaire and further revised it according to findings from 45 cognitive interviews, based on a think aloud and verbal probing approach.

Results

Preferred visual representations and understanding of pictorial elements differed between participants from different cultural backgrounds. Simpler concepts were considered easier to understand than compounded concepts. Preferences in element style and composition were similar between the groups. In addition, using a recurring character was considered helpful for identification.

Conclusions

In the development of the PictoQOL, decisions concerning style and composition of pictorial elements were culture-independent. In contrast, preferences of visual representations of abstract concepts were strongly dependent on cultural aspects, confirming the need of a participatory approach to develop the measure. The PictoQOL is likely to be comprehensible cross-culturally without further need of adaptation.

Key messages

To ensure cross-cultural comprehensibility development of a picture-based questionnaire, a participatory approach to development is necessary. The PictoQOL is suitable to measure health-related quality of life in understudied, culturally diverse populations.
Achieving real equality in health and social care: IENE9 project, a work in progress for LGBT+ people
Authors: Lopez-Villegas A , Lopez-Liria R , Rocamora-Perez P , Pezzella A , Dudau V , Kouta C , Nielsen D , Baiocco R , Kuckert-Wöstheinrich A , Papadopoulos R
Published: October 2020

Background

Issues with professional conduct and discrimination against Lesbian, Gay, Bisexual, Transgender (LGBT+) people in health and social care, continue to exist in most EU countries and worldwide.

Objectives

The project IENE9 titled: “Developing a culturally competent and compassionate LGBT+ curriculum in health and social care education” aims to enable teacher/trainers of theory and practice to enhance their skills regarding LGBT+ issues and develop teaching tools to support the inclusion of LGBT+ issues within health and social care curricula. The newly culturally competent and compassionate LGBT+ curriculum will be delivered though a Massive Open Online Course (MOOC) which is aimed at health and social care workers, professionals and learners across Europe and worldwide.

Results

We have identified educational policies and guidelines at institutions teaching in health and social care, taken into account for developing the learning/teaching resources. The MOOC will be an innovative training model based on the Papadopoulos (2014) model for “Culturally Competent Compassion”. The module provides a logical and easy to follow structure based on its four constructs 'Culturally Aware and Compassionate Learning', 'Culturally Knowledgeable and Compassionate Learning', 'Culturally Sensitive and Compassionate Learning', 'Culturally Competent and Compassionate Learning'.

Conclusions

Specific training may result in better knowledge and skills of the health and social care workforce, which helps to reduce inequalities and communication with LGBT+ people, as well as diminishing the feelings of stigma or discrimination experienced.

Key messages

More information about the IENE 9 project at http://iene-lgbt.com. The partners organization will support local partners, education and training providers, LGBT+ care organizations to do learning using our platform and our created MOOC, to set up new training.
Healthy Pacific Islands Grandparents: ‘Putting your best foot forward’
Authors: Tautolo E
Published: October 2020

Background

People of Pacific ethnicity are characterised as at 'high risk' of poor lower limb health by podiatric care professionals, likely due to a high rate of diabetes within the NZ Pacific community. Foot care maintenance is identified as an ongoing health challenge by Pacific elders with seemingly simple tasks, such as regular trimming of toenails, often found to be difficult due to reduced physical flexibility, and a lack of knowledge of appropriate foot health maintenance. A research collaboration between a cohort of older Pacific people and a research team was developed to design and implement a programme to address podiatric health for this vulnerable population group.

Methods

This research project was based in Auckland, NZ, where 70% of the total NZ Pacific population is resident. The team adopted a Participatory Action Research (PAR) process, placing participants in a leadership role where they are co-researchers involved in the research design and implementation of recommendations. Talanoa - a Pacific-designed qualitative interview method, was used to raise, discuss and identify strategies for healthy ageing among Pacific older people in NZ.

Results

A total of 78 Pacific Islands elders had their foot health assessed, and participated in footcare information sessions. Overall, lower limb health was good, 21 required follow-ups primarily for thickened toenails and minor issues such as dry skin. 2 participants were referred to their general practitioner for treatment of suspected melanoma underneath their nails.

Conclusions

The PAR process empowers older Pacific co-researchers to identify their own priority health issues, and determine how they could be more effectively addressed. In view of this, the provision of healthcare assessments in ethnic-specific community settings is a more effective approach for addressing podiatric health and preventing further serious complications.

Key messages

Utilising appropriate Indigenous research approaches is necessary to ensure more effective and sustainable outcomes for these minority communities. Participatory Action Research is an effective way for facilitating collaboration and innovative strategies to address the health needs of older minority groups.
Mental health status of refugee children
Authors: Lemonjava N , Antia K , Lobjanidze M , Lobjanidze T
Published: October 2020

Background

A number of refugees and asylum seekers have increased dramatically in recent years. More than 250 million people worldwide are considered as refugees (United Nations High Commission for Refugees, 2018), among whom more than 50% are children. General health and especially psychological health of the refugee and asylum seeking children are an emerging, however, not well explored issues. In this study, we aimed to review the literature on the psychological health of refugee children.

Methods

We performed a literature search and descriptive analysis of studies published until July 2019, through MEDLINE and Science Direct databases. We identified literature on psychological health state of refugee and asylum seeking children. We analysed results of 16 studies.

Results

The study found that refugee children are facing severe psychological health issues, such as Post-traumatic stress disorder (PTSD), depression, anxiety, sleep disorders, behavioural problems. We identified 3 phases of psychological trauma and stress among refugee children: stress due to conflict in their home countries, stress during migration, and upon the arrival to host country. Our analysis reviled integration difficulties such as racism and bulling as important stress factors for the refugee children. Studies found that prevalence of PTSD is more than 54% among refugee children residing in Norway, significantly higher than in reference population. The studies identified the need of regular mental health assessment and preventive care, psychological counselling services for the refugee children. All included studies showed significantly higher stress among refugee children when compared to local children in host countries.

Conclusions

Rehabilitation services and follow-up supportive programs should be implemented to improve the mental health status of refugee children; these interventions will also contribute to their better integration.

Key messages

Screening and regular monitoring provided by host countries healthcare system is crucial to identify high risk children. More research is needed to better investigate the psychological health state and needs of refugee children.
Pathways to healthcare for migrants and vulnerable people inclusion: the experience of Genti di Pace
Authors: Mancinelli S , Buonomo E , Mosaico F , Biondi G , Zampa A , Marchegiani M P , Gnolfo F
Published: October 2020

Issue

Chronic and acute diseases affects migrants and vulnerable people who often face barriers in accessing health care services. Here is the description of an innovative health center (HC) developed for identifying barriers and facilitating access to health care services of hard-to-reach (HTR) people in Rome.

Description of the Problem

The Community of Sant'Egidio together with the “Migrant Health Unit” of ASL Roma 1 has established an innovative HC program aimed to improve health outcomes in HTR urban population. One of the main Public Health challenge is to reduce inequalities among migrants and vulnerable people through improving access to health services. Data here analysed were collected during 2019.

Results

897 migrants and vulnerable people received heath care assistance. 52.4% were females, mean age 40.7±21.4 ds, 16.3% aged under 18 years and 69.6% were between 18-64 years. Countries of provenance: 56.8% Eastern Europe (Bosnia and Romania), 16.8% South America and 15.2% North Africa. 3.2% were refugees. Among 1986 health interventions 56.3% were general medical visits, 35.4% prescriptions and free drugs distribution, 4.1% children growth controls and baby milk supplies, 3.6% specialist visits and only 0.3% were sending to the Emergency Room.

Lessons

Improving the access to health care services of migrants is both a public health and an economic goal. The increase in chronic-degenerative diseases underlines the need to facilitate access to health services, also through collaboration networks between public and private social. This allows continuity in treatment, which has great meaning of secondary prevention, as well as rationalization of resources, reducing an improper use of the Emergency Room, which provides occasional intervention, but does not integrate into an efficient/effective therapeutic path.

Key messages

Promoting health care services like this can reduce barriers, improve health outcomes in migrants and increase sustainability of the NHS. Improving access to public and private social health services is important especially in presence of chronic-diseases which require continuous therapies and examinations.
Subjective employment perspective among older workers with and without migrant background in Germany
Authors: Schröder C C , Breckenkamp J , du Prel J-B , Hasselhorn H M
Published: October 2020

Background

In the coming years, large groups of workers with migrant background will reach pensionable age in Germany. However, this group has been virtually ignored by worldwide retirement research so far. The aim of this study was to investigate the subjective employment perspective in higher working age for employees with migrant background (EMB) and without (non-EMB). By subjective employment perspective, we mean willing, being able to and planning to work until the individual state pension age (iSPA).

Methods

A representative sample of socially insured employees, born in 1959 or 1965, was surveyed in 2011, 2014 and 2018 with computer assisted personal interviews for the lidA-study. The current cross-sectional analysis is based on data from the third study wave (n = 3286) of the lidA cohort study. EMB were differentiated via generation (first-generation, G1, vs. second-generation, G2), or nationality (German vs. foreign). Applying bivariate statistics with tests of independence and block-wise logistic regressions, group differences were investigated. Sex, age, educational level, net household income, health and work factors were considered as covariates.

Results

When comparing subgroups of EMB, significant differences appeared in bivariate analyses for willing and planning to work. G1 were to a higher degree planning to work longer than G2 and those EMB with foreign nationality were more willing and planning than those EMB with German nationality. Multivariate analyses revealed significant differences of G1 and non-EMB for planning, being significant in the fully adjusted model, but not for willing.

Conclusions

Our study has found persistent differences between first-generation migrants and non-migrant workers in the subjective employment perspective with regard to planning. These findings underline the need for further retirement research in migrant groups as well as the need for differentiation of migrant groups in social and public health research.

Key messages

Socio-epidemiological research identifies employees born abroad or with foreign nationality as risk-groups in times of extending working lives. Public health and social policy shall focus on them. Public health research should differentiate migrant subgroups, as people with migrant background are not homogenous and very diverse in various aspects.
From Barbara to Bia: Art, policy and science dialoguing with rights and health of lesbians in Brazil
Authors: Lima M G , Sandroni C , Medina L P B
Published: October 2020

Issue

Discrimination and homophobia are latent and can affect health. Chico Buarque composed at least three songs about lesbian love: Barbara (with Ruy Guerra - 1972), Sea and Moon (1980) and Blues for Bia (2017).

Problem

Beginning with the view that art can manifest itself as narrative, this paper analyzes the alignment of the content of the three songs mentioned above with Brazilian policies ensuring LGBT rights and the trend of studies on lesbian health in Brazil from 1970 to 2019. The results can assist the promotion of discussions in other places. We performed 1) a search of governmental policies aimed at protecting the rights of the LGBT population; 2) a systematic search for studies on lesbian health in PUBMED; 3) a musical analysis of the songs.

Results

The 1970s was marked by a military government when the love addressed in the song 'Barbara' was closeted and sad. The song (composed in a minor tone) uses half-step intervals, generating melancholy feelings. In the 1980s, still under a dictatorial government, several social movements initiated a militant stance for the LGBT movement and the song “Sea and Moon” addressed the suicide of a lesbian couple. We found no government actions in this period or studies conducted in Brazil in the PUBMED database up to 1998. Government policies emerged in the 2000s, especially through the program entitled 'Brazil without Homophobia' in 2004. Other policies followed and intensified in the 2010s. The number of studies increased from seven up to the year 2009 to 105 from 2010 onward. “Blues for Bia” addresses sexual freedom with lightheartedness.

Lessons

The increase in policies for the rights of the LGBT population was aligned with a trend in studies on lesbian health and with the three songs analyzed. Songs began with sad, negative tones until finally arriving at issues of autonomy and freedom, suggesting the importance of the maintenance of these actions that can alleviate problems related to LGBT rights and health.

Key messages

Policies for LGBT rights and studies on lesbian health have increased in Brazil since 2000s, especially after 2010. The tone of the songs studied changed from pain to lightness, in line with increase of the research and policies, emphasizing the importance of such actions.
Nutrition and physical activity among foreign students of the University of Georgia
Authors: Gelashvili M , Lobjanidze M , Antia K , Lobjanidze T
Published: October 2020

Background

Nowadays millions of students are moving to another country to advance their education. They must adapt to the changing conditions for education. Students who leave their own country face many challenges. The purpose of the study was to investigate and evaluate the nutrition and physical activity of foreign students of the University of Georgia (UG) after entering the university.

Methods

Cross-sectional study was conducted among international students. We used self-administrated validated questionnaire with closed and open questions. Behaviors regarding the physical activity, diet of foreign and Georgian students were identified. Local students of the UG were used as a comparison group. Study participants were selected randomly among all international and Georgian students of UG.

Results

The results of the study showed that stress factors, the environment and various cultures influence students' nutrition and physical activity. A noticeable change in the deterioration of physical activity was observed among Georgian and foreign students (8% of international students physical activity has deteriorated sharply). The students showed a significant changes of body mass index (BMI). Meanwhile, most international students are overweight. 10 % of international students are facing obesity. Weight of Georgian students increased by 32 % after entering the University, while international students it increased by 30 %. The results showed that the nutritional ratio worsened after entering at the university almost equally with both Georgian and foreign students. However, the study identified that 56% of Georgian, and 86% of international students are willing to improve their physical activity in the future.

Conclusions

The study identified that international students of the UG face nutrition and healthy lifestyle problems, such as overweight, physical inactivity. Further promotion of a healthy lifestyle of international students is recommended.

Key messages

More attention on health promotion and monitoring should be given to international students who are coming to advance their education in Georgia. More research is recommended to better promote healthy lifestyle among international students in Georgia.
Stress and sleeping disorders among international students of the University of Georgia
Authors: Shonia T , Lobjanidze M , Antia K , Lobjanidze T
Published: October 2020

Background

Psycho-physiological factors play a major role in the well-being of students. Available studies have shown that students' sleep habits and stress levels are changing dramatically, especially international students are affected negatively. Increased stress level is associated with decreased cognitive functioning, which negatively affects their academic performance. The main aim of this study was to evaluate sleep disturbance and stress level among international students of the University of Georgia (UG).

Methods

We conducted a cross-sectional survey of 100 randomly selected foreign and local students of UG. Self-administrated questionnaire was used to evaluate students' stress level and sleeping habits. Local students of UG were selected as a control group.

Results

The study found high prevalence of stress (47%) and sleep deprivation (64%) among international students. The students are facing severe psychological health issues, such as: stress, depression, anxiety, sleep disorders and behavioral problems. The results of the survey also revealed that 43% of all respondents had stress and sleep disorders, stress factors were similar for both groups. The study identified two common stress and sleep disorders among international and local students: stress and sleep problems due to changing lifestyle and due to new education system. However, several stress factors such as: different language, homesickness and cultural differences also contributed to the increased stress.

Conclusions

Our study identified that international students of the University of Georgia face stress and sleep deprivation. Stress related to their academic performance contributed significantly to sleep disorders.

Key messages

More research is recommended to better examine psychological health state of international students of the University of Georgia. More interventional programs are needed to support international students’ better integration and academic performance.
Nursing work process in Street Clinic to combat vulnerability of the Homeless Persons
Authors: Bombonatti G R , Santos D S
Published: October 2020

Background

The Street Clinic was created to expand access to health for Homeless Persons. Within the service, the role of the nursing team is very important in accessing and establishing care, welcoming, bond building, promoting a save environment, health prevention and education, interdisciplinary communication, patient management and articulation with other services. The research aimed to analyze the objects, instruments, purposes and products in the nursing work process, considering the principle of equity of Brazilian National Health System and the serious vulnerability of the population in question. In this way, it is necessary to understand the valorization of nursing.

Methods

Study of qualitative approach with participant observation, field diary, application of three semi-structured interviews and use of thematic content analysis method. The study scenario was the nursing team of the Street Clinic in a city in the interior of São Paulo.

Results

The following elements of the nursing work process were analyzed: dwelling place, health demands and intersectionality of this population (objects); team organization, materials, harm reduction, communication with the intersectoral network, assistance, health guidance, opportunities for action, administration, management and personal and professional transformation (instruments); comprehensive and equitable care, building bonds and trust (purposes and products). Nursing, in this process and within a biomedical logic in the service, faces overload, pressure and devaluation.

Conclusions

Nursing is configured as a strategic category in the performance of the Street Clinic and in the equity of care. There are facilities and difficulties to act independently with the multiprofissional team, especially with the biomedical model present in the service. It is necessary to build recognition of the performance of nursing and the empowerment of professionals in this category.

Key messages

Nursing still needs professional empowerment and recognition of the importance of their work process as essential in addressing vulnerabilities and equity in care. Bonding, trust and harm reduction are essential elements in the nursing work process in addressing the vulnerability of the Homeless Persons.
Health in prison: characterization and perception of inmates
Authors: Machado F H B , Silva L S , Costa P A D , Rodrigues A S , Miranda M L
Published: October 2020

The health actions directed to the population deprived of freedom in the Brazilian prison system make invisible important aspects of prison conditions and thus, corroborate the permanence of iniquities in prison units. The prison scenarios have several particularities that require the search for new ways of planning and executing health actions in these spaces. The objective was to characterize the prison environment and to know the perception of inmates about the health care available to them. That's a mixed, descriptive-exploratory study conducted in a prison in the state of Bahia. Secondary data were collected from the local nursing team and a survey on the structure of the services, as well as semi-structured interviews with fourteen interns. The testimonies were transcribed, analyzed through Content Analysis, originating thematic categories, discussed in the light of pertinent literature. The study was approved by the Research Ethics Committee, under the opinion 2,168,846. The data point to the existence of cell overcrowding, insalubrity, poor hygiene, unsatisfactory food and the physical structure of the prison unit. The inmates' reports reinforce that such elements contribute to the aggravation of already existing illnesses and to emergence of others disease. In addition, these conditions favour fragmented health care, which intensifies the vulnerability of inmates and delegitimizes their constitutional rights. The study made it possible to deepen the knowledge about the conditions of confinement of the prison population in the state of Bahia and instigates the development of new research on the subject. Furthermore, the results offer subsidies for the development of health actions within prisons.

Key messages

The study opened up spaces of voice for people in situations of incarceration and problematized the offer of health actions and services in prison, inviting professionals to rethink their practices. The study made it possible to deepen the knowledge about the conditions of confinement of the prison population in the state of Bahia and instigates the development of new research on the subject.
Exploring the experience of intimate partner violence in the LGBT community
Authors: Papadakaki M , Zioti F , Karadimitriou Z N , Papadopoulou M
Published: October 2020

Background

The study aimed at measuring the prevalence and identifying the risk factors of intimate partner violence in individuals from the LGBT community.

Methods

A total of 180 individuals participated in the study, both male and female, aged 18-60 years, living in the broader area of Athens, Greece. Snowball sampling was applied to identify eligible individuals and social media were employed to recruit them. The questionnaire explored the violence victimization and perpetration in their relationships, the preferred reaction to various forms of violence and the role of childhood victimization in adulthood experiences of violence.

Results

72.8% were homosexual, 26.7% bisexual, 81.7 % were women with a mean age of 25.2 years (6.0 standard deviation). A total of 67.2% were subjected to verbal abuse before the age of 16, 49.4% to physical violence, 6.7% to sexual violence and 46.7% were neglected. The prevalence of violence victimization was higher than the prevalence of violence perpetration (mean 9.81 and 5.92 respectively). Psychological violence was the most common among other forms of violence, both in victimization (psychological 7.34, physical 1.66, sexual 0.81) and perpetration (psychological 4.48, physical 1.26, sexual 0.18). In hypothetical scenarios of psychological violence, the majority of participants preferred separation and discussion about boundaries as strategies to deal with the situation (56.1 and 45.0 respectively), in scenarios of physical violence they primarily preferred separation and secondarily asking a professional advice (73.3 and 20.6, respectively) and in sexual violence they primarily preferred a discussion about boundaries and secondarily separation (69.4% and 31.7% respectively). Experiences of childhood victimization (p=.006), and female gender (p=.002), were found to be associated at a statistically significant level with violent victimization in adulthood.

Conclusions

Further research is necessary to identify groups at risk of victimization.

Key messages

Preventive efforts need to take into account individual sociodemographic and attitudinal characteristics that increase the risk of victimization. Experiences of victimization during childhood are highly associated with victimization in adulthood.
Street Medical Consultation: health access of the Homeless People and intersectoral articulation
Authors: Santos D , Bombonati G R , Marques D , Vilela M F G , Silva E M
Published: October 2020

Background

The Homeless People is marked by serious social vulnerability, related to the absence of human dignity. Requirements of personal and residential documents, reception and inadequate approaches are barriers to access these people. The creation of Street Medical Consultation (CnaR), based on the logic of harm reduction in association with the other services, is a strategy that seeks to expand access to the services of the Public Healthcare System (SUS) in Brazil. The research aimed to analyze the characteristics and vulnerabilities of this population, the performance of CnaR and its articulation with services from the health care and the social assistance care network.

Methods

Study of a qualitative approach using 8 semi-structured interviews and the Thematic Content Analysis method. The study scenario was the CnaR multiprofissional team in a city in the interior of São Paulo.

Results

Three categories were found: (1) Population in Street Situation - complexity of those who live on the street: prejudices, violence and barriers in society and health institutions constitute a process of invisibility. (2) CnaR's work in the perspective of harm reduction: it is organized to meet the clinical and alcohol and other drugs demands through fixed fields, mobile fields and team meeting. (3) Beyond CnaR - network relationships: bringing dynamics to relationships, being strengthened or weakened. Ignorance of the service and their performance also generates CnaR invisibility process. The strategies developed include coping, dialogue, building partnerships and the process of visibility and fighting for the rights of the Homeless Persons.

Conclusions

CnaR finds itself as an insufficient service to meet all the demands of this vulnerable population in isolation, needing the network to expand access to health and other goods. It is necessary to combat prejudice against this population among health professionals and develop more efficient intersectoral articulation.

Key messages

The Homeless People have serious vulnerability and need humanization, guaranteeing equity in assistance in all sectors of society, especially the health care and the social assistance. The Street Medical Consultation faces performance difficulties to guarantee access to the Homeless People within the intersectoral network, often being the sole responsible for this population.
Migration and infectious disease risk: knowledge and perception among European students
Authors: Marconi D , Casigliani V , Mazzilli S , Lopalco P L
Published: October 2020

Background

In the past years migration has increasingly affected the European continent. The concerns of the local population about infection spread by migrants may increase unjustified stigma. Literature has shown that stigma is a determinant of health. The aim of our study was to assess the knowledge and risk perception of infectious disease introduced by migration.

Methods

Between January and February 2020 we conducted an online survey in Italian and Spanish University students. We collected data on demographics, perception and knowledge of transmission of infectious diseases introduced by migration. We performed a descriptive and a risk factors analysis to assess correlation between our variables.

Results

We collected 1397 answers: 1022(73.16%) from Italian students (F:668/1022, M:341/1022, others:13/1022) and 375(26.84%) from Spanish students(F:253/375,M:119/375, others:3/375) The median age was 24 for Italy and 22 for Spain. In Italy and Spain, respectively, 353/1022(34,54%), 145/375(38,67%) students were from the healthcare area, 316/1022(30,92%), 74/375(19,73%) the scientific area, 349/1022(34,15%), 108/375(28,80%) the non-scientific area and 4/1022(0,39%), 48/375(12,80%) from others area. We found a statistically significant correlation between the knowledge of infectious diseases and the perception of the infectious risk associated with migration. This correlation was not confirmed for the area of study. Healthcare students had the best levels of knowledge and perception of the migratory phenomenon, but the higher perception of infectious risk.

Exposure to the news was associated with the worst perception of the migratory phenomenon and the infectious risk (p < 0.001).

Conclusions

Our study showed that students in the health area had the highest risk perception of infectious diseases. Therefore, the introduction of the course on migration medicine and the increase of practical training could help to reduce the altered risk perception of infectious diseases.

Key messages

The introduction of the course on migration medicine and the increase of practical training could help to reduce the altered risk perception of infectious diseases in healthcare students. Exposure to the news has a negative effect on the perception of the migratory phenomenon and the ìnfectious disease.
Correlates of HIV, STI and TB among sub-Saharan African migrants in Lisbon: a biobehavioral study
Authors: Dias S , Gama A , Simões D , Carreiras E , Mora C , Ferreira A P
Published: October 2020

Sub-Saharan African migrants (SAMs) have been disproportionately affected by infectious diseases such as HIV, other sexually transmitted infections (STIs) and Tuberculosis infection (TB). Research on infectious diseases and related factors among migrant populations is critical to further understand these populations' health needs and inform prevention strategies. However, migrants are often underrepresented in national statistics and research. This study aimed to examine correlates of HIV, past STI and past TB among SAMs.

A venue-based sample of 790 SSAMs completed a cross-sectional biobehavioral survey on sexual practices, HIV testing and self-reported infectious diseases; an HIV rapid test was offered. Uni- and multivariable logistic regression analyses were performed to examine factors associated with HIV, past STI and past TB.

Overall, 5.4% of participants were HIV-positive and 16.7% reported a past STI. Odds of being HIV positive increased by age (OR 1.07, 95%CI 1.03-1.11) and were higher among those who experienced violence from a partner (OR 2.77, 95%CI 1.08-7.10). Increased odds of having a past STI were found among migrants with low income (OR 2.86, 95%CI 1.48-5.56), long-term migrants (>25 years residing in Portugal: OR 2.16, 95%CI 1.06-4.38) and those who reported sexual risk behaviors (≥3 sexual partners: OR 2.06, 95%CI 1.14-3.70; inconsistent condom use: OR 2.61, 95%CI 1.32-5.17). In total, 4.1% of participants had TB in the past; these were more likely male (OR 3.42, 95%CI 1.29-9.06) and HIV positive (OR 11.48, 95%CI 4.55-28.94). Half of the participants had never been tested for HIV before, including over a third of those who had STI or TB in the past.

Efforts are needed to reduce missed opportunities for HIV/STIs prevention and uptake of HIV testing among SSAMs through more integrated care, while addressing social determinants of infectious diseases.

Key messages

High levels of HIV, STI and TB infection among SAMs were found to be strongly associated with socioeconomic disadvantage and poor living conditions in the host country. Social inequalities are persistently a major factor affecting risk for HIV, STIs and TB, and thus addressing social determinants of infectious diseases must remain a public health priority.
Knowledge of risks of malaria in pregnancy on use of ITNs among pregnant women in northern Ghana
Authors: Dun-Dery F , Beiersmann C , Kuunibe N , Müller O
Published: October 2020

Background

Every year malaria in pregnancy causes 10,000 maternal mortalities worldwide, 20% of stillbirths, 11% of all new-born deaths and 900,000 low-birth-weight babies in sub-Saharan Africa. Maternal knowledge of malaria risks in pregnancy plays a significant role in malaria prevention. However, it is unknown if this preventable loss of lives and morbidities are caused by lack of knowledge, lack of prevention tools or both. We measured the pregnancy-related risks of malaria knowledge and bed net availability and use among pregnant women in Ghana.

Methods

We interviewed 770 pregnant women who attended antenatal care in 37 primary care clinics in Ghana from January through May 2019. We integrated this data in a sequential explanatory design with qualitative insights from 6 focus groups with 8 pregnant women each.

Results

697/770 questionnaires were analyzed. 67% have general knowledge on malaria prevention but only 19% knew the specific risks on pregnancy outcomes. ITNs were owned by 89%, but only 75% reported to regularly use them. There was a statistically significant correlation between specific risks of malaria knowledge and ITN use (P<.001, OR = 2.0, CI:1.3-3.0). Other factors associated with ITN use were higher income, owning an ITN, higher parity, formal education, religion, and age. Reasons for non-adherence to ITN use include inappropriate hanging infrastructure, discomfort with using an ITN, and use of other prevention alternatives.

Conclusions

The study demonstrates that maternal knowledge on the risks of malaria in pregnancy significantly influenced their adherence to the use of insecticide-treated bed nets.

Key messages

The use of ITNs as a prevention method for malaria correlates to the knowledge of mothers about risks of malaria in pregnancy. Antenatal care malaria prevention efforts should focus more on teaching the specific risks of malaria in pregnancy.