bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid response platform to manufacture human immunoglobulins
Authors: Van der Hart E , Wall A , Pronyk R , Buhay S , Wiebe P
Published: October 2020

A rapidly deployable drug product for use in the early stages of a disease outbreak could prevent further spread of the pathogen. Emergent BioSolutions is developing a rapid response platform (RRP) to manufacture human immunoglobulins (HIG) for use as a passive immunotherapy during public health emergencies. Passive immunotherapies derived from either convalescent plasma or purified immunoglobulins (Ig) have a long history of success in treating a range of viral, bacterial and toxin diseases, as they provide the immediate benefit of a protective response. Emergent's RRP is being developed to address the need for front-line therapy/prophylaxis with immediate benefit with the potential to overcome the current limitations of convalescent plasma.

Emergent's proposed RRP begins with identification of plasma donors with measurable levels of pathogen-specific antibodies using a field deployable real-time donor screening assay. Plasma collected from eligible donors is treated using the Mirasol® Pathogen Reduction Technology, pooled, purified and concentrated into HIG using Emergent's rapid HIG manufacturing process to produce product formulated for intramuscular administration.

Our rapid HIG process is chromatography based and each 30 L run aims to purify, formulate, and fill ∼65 doses (1 g of total IgG) with testing and release onsite for immediate use. Multiple innovations to streamline operations, including single-use technologies and minimal human interfaces, allow for the manufacture of HIG product in ∼30 hours.

To house the process, Emergent has designed and constructed a working modular manufacturing unit (MMU) prototype. The MMU consists of a modified 53-foot shipping container designed for multiple modes of transport, to meet ISO 8 environment requirements with self-contained utilities, including HVAC, and can run off a diesel generator or local power.

Product from multiple development runs within the MMU have been characterized and validation work is ongoing.

Key messages

A modular manufacturing unit is being developed with the potential to provide a local capability to produce health solutions for endemic diseases. A modular manufacturing unit is being developed with the potential to rapidly manufacture human immunoglobulins during public health emergencies and pandemics.
Multidrug-resistant Klebsiella pneumoniae: risks to food safety and public health
Authors: Cornacchia A , Di Marzio V , Ciarrocchi A , Saletti M A , Marfoglia C , Ancora M , Cammà C , Di Pasquale A , Blasi G , Centorotola G
Published: October 2020

Background

Klebsiella pneumoniae (Kp) is a Gram-negative hospital-acquired pathogen. Kp also poses a potential food safety hazard, since a significant increase of multidrug-resistant (MDR) Kp was observed in foods. The purpose of this study was to characterize MDR Kp strains in order to evaluate the presence of beta-lactams, quinolones and aminoglycosides resistance genes.

Methods

A total of 13 Kp strains, isolated from chicken (n.8), raw milk (n.2), waste water (n.2), human faeces (n.1), and identified as MDR by microdilution test, were selected to evaluate antimicrobial resistance profiles, focusing on beta-lactams, quinolones and aminoglycosides. Next Generation Sequencing (NGS), with NextSeq 500 Illumina platform, was performed to acquire genome sequences. The antimicrobial resistance profiles were obtained using ResFinder (https://cge.cbs.dtu.dk/services/ResFinder/).

Results

From the 13 Kp considered, 6 strains (46.2 %) showed the presence of several beta-lactam genes. The blaSHV gene was carried by 12 Kp (92.3%); of these strains, 5 also carried blaTEM (41.7%) and 3 also blaCTX-M (25.0%) genes. Only 1 Kp strain showed the presence of blaOKP-A gene. All the 13 Kp carried the oqxA and oqxB genes. Of these strains, 4 also highlighted the presence of qnrB or qnrS plasmid-mediated gene for quinolone resistance. Regarding aminoglycoside resistance, 6 Kp strains (46.2%) carried aph, aadA and aaC genes, linked to gentamicin and streptomycin resistance protein.

Conclusions

These preliminary results emphasize the need of further studies on more several samples, to better understand the antimicrobial resistance of Kp strains, the hypothetical transmission of MDR Kp from foods to consumers and the potential risk posed to food safety, environmental and public health.

Key messages

The increasing prevalence of multidrug-resistant Klebsiella pneumoniae requires the need to investigate more foods and environmental samples to ensure consumer safety and public health. Public health safety requires a major knowledge of the hypothetical mechanisms and routes of transmission of multidrug-resistant Klebsiella pneumoniae.
Risk perception, knowledge, prevention, information sources and efficacy beliefs related to Covid-19
Authors: Genovese C , Signorelli C , Pavia M , Icardi G , Mistretta A , Casuccio A , Villari P , Pellissero G , Siliquini R , Squeri R
Published: October 2020

Background

Sars-Cov-2 is one of the latest examples of an emerging infectious disease challenging the world and it is the third case, in just two decades, of “spillover”. In light of the recent outbreak (Italy is in 2nd position), it is important to evaluate people risk perception and to support the Health Authority with effective communicative actions to avoid the spread of “infodemia”/alarmism. The aim of this study is a) to study levels of perceived threat, risk perception, severity and comparative vulnerability b) to compare risk perception with other communicable/not communicable diseases; c) provide information to increase awareness/ knowledge of the disease.

Methods

We performed an Italian multicentre study from 11 February 2020 and it is still in progress. The subjects in study (general population, HCWs and university students) were enrolled through the administration of a standardized questionnaire based on Health Belief Model through CAPI and CAWI methods. The summary and inferential statistical analyses will be carried out using the R software.

Results

We enrolled 2495 people from 11 February until 4 March 2020. All the respondents had heard of COVID19. Only 2% didn't know any symptoms and 3% answered to all the questions correctly (mean knowledge score of 13). 48% thought that he/she could acquired COVID 19 in the next 12 months and 70% stated that their concern of the disease was high(score5). Perceived capability to avoid it was rated as good/very good by 62%. The correct mask use (WHO) was reported by 64% of the sample and 47% stated all preventive actions (2% no one). Only 22% of the sample stated all actions to be taken in case of suspected acquisition of COVID19.

Conclusions

Italy is facing an epidemic that could have the potential to affect the entire national health system. It's so important to implement public health activities and surveillance systems in order to limit the spread of the disease and bad/disinformation.

Key messages

This study is the first to report on public perception of Sars-Cov-2 in all the Italy. The results indicated that the Italian population is aware of the outbreak and it is concerned about their risk. On the other hand, only half of the sample is aware about all preventive actions and not everybody knows all procedures to be taken in case of COVID 19 suspect.
Organizational Commitment Of Afad Istanbul Search And Rescue Unit
Authors: Karakoç M , Erdoğan Ö , Demirbaş E
Published: October 2020

Background

Our study is intended to evaluate the Organizational Commitment of the Istanbul AFAD Search and Rescue Unit (AKB) employees operating at national and international level during disasters and to serve as a model for the other organizations that conduct national and international operations in the area of search and rescue.

Methods

This research was carried out with a total of 75 employees from Istanbul AFAD AKB from 02.11.18 to 01.01.2019. Introductory Information Form and Organizational Commitment Scale were used for data collection. Findings of the study were evaluated via IBM SPSS Statistics 22.

Results

Among 71 persons who participated in the study, it was determined that 91.5% were male, 50.7% were at the age of 40 or older, 81.7% were married, 67.6% had bachelor's degree, 63.4% were search and rescue technicians, and 50.7% were employed by their current organization for 10 years or less. Regarding the employees, it was found that 25.4% had very good organizational commitment while 54.9% faced issues in relation to the organizational commitment. OCS point average of the employees was 3.07±0.20 and the obtained Cronbach Alfa internal consistency coefficient of the scale was 0.678. OCS points of those employed for 12 years or longer in total were determined to be high at statistically significant level. Also, OCS points of those who did not face any issue in relation to the Organizational Commitment were found to be high at a statistically significant level against those who faced issues.

Conclusions

It is important to ensure work satisfaction, provide harmonization, and avert chaos and stress for boosting the organizational commitment. Therefore, the managers should conduct activities intended to boost the employee commitment levels within the organization.

Key messages

Disaster is a significant public health issue and disaster employees are special. The issues faced by the employees that perform search and rescue operations must be considered important and resolved.
Challenges and innovations in the use of active methodologies in undergraduate medical courses
Authors: Hermes E , Montenegro I , Lazorek J , Sarubbi V
Published: October 2020

Background

Conscious perception of oneself and others in their complexity and subjectivity allows the approach of trying to understand the human being to overcome the labeling stigma of the disease. For the educator, it is unique to guide the way that can transform a gap in the undergraduate medical education into a possibility of positive action. It was in this sense that the perception workshop was developed based on the concept of Integrated Gestalt Therapy. Teachers of the Communication, Leadership, and Management Skills discipline invited undergraduate medical students to stimulate the five senses. For sensory experiments, 6 stations were used in the classroom. Season 1 - View: Photos from the 'More Medical Programs' and deductive interpretation were posted on the board for observation. Season 2 - Tact: Blindfolded they handled four types of objects with different textures. Season 3 - Movement: two photos of yoga position (medium and high complexity) for imitation. Station 4 - hearing: auditory processing through binaural stimulation with computer-attached headset. Season 5 - nose and taste memory: through spices, leaves and dried fruits, the nostrils were stimulated for identification and recognition. Station 6 - Speech: Voice Lab through Voice Spectrogram Analysis (Praat).

Results

Faced with activities like this, we can see that students go through a process of breaking paradigms, which significantly influences their way of thinking. This training is part of continuing education through the perspective of the knowledge spiral. With the evolution of the undergraduate years, the student will be able to refine and deepen their reflections in a continuous process.

Conclusions

This work represents a breakthrough in the field of health education. Humanized professionals, aware of their skills and abilities, with actions aimed at the well-being of the population, in a generalist, critical and reflective manner.

Key messages

The impact generated on the assisted population have been observed when this new professional profile is inserted in health services. This workshop represents a breakthrough in the field of training health professionals with actions focused on the welfare of the population in a generalist, critical and reflexive manner.
Formulating a structured description of the levels of qualifications recognized in the health system
Authors: Koikov V , Baigozhina Z , Bekbergenova Z , Umbetzhanova A , Derbissalina G , Mergentai A
Published: October 2020

Issue

Constantly emerging new challenges for national health systems (HS) and new technologies require the creation of conditions for the continuous provision of the HS with the necessary number of health workers (HW) with the appropriate level of qualifications. In this regard, the high relevance acquires the formulation of a structured description of levels of qualifications in the HS, the requirements for the future and existing qualifications, taking into account the priorities of the HS development, as well as mapping of occupations by the qualification level.

Description of the Problem

The main problems in regulating the sectoral qualifications system (SQS) in Kazakhstan is the lack of a sectoral framework of qualifications (SQF) and professional standards governing the requirements for specialists in the HS, and the lack of a clear distinction of competencies by the qualification level. Accordingly, there is a discrepancy between educational programs and practical health care needs, and an imperfection of the HWs certification system.

Changes: We have incorporated into the National Code 'On the health of the people and the HS' points that define the SQS basic principles and regulation. As SQS has been defined set of legal and institutional mechanisms to control demand of HWs from the labor market and the qualifications offer from the health education system. SQS includes SQF; professional standards; state compulsory health education standards; system for assessing the professional preparedness and certification of specialists; system of continuing professional development of HWs. For a structured description of the levels of qualifications recognized in the HS we developed SQF. In SQF all HWs were divided into sub-sectors: medicine, pharmacy, public health and intersubsectoral processes.

Lessons

The presence of an effective SQS will create the conditions for providing the HS with human resources that meet the needs of the state, business and society.

Key messages

We have analyzed the existing system for regulating the qualifications of health professionals and have proposed legislative mechanisms for regulating the SQS in the field of healthcare. This made it possible to ensure conditions for effective legal regulation of the HWs qualification demands from the labor market and the supply of qualifications from the health education system.
Students’ knowledge and attitude towards scientific research at Tbilisi State Medical University
Authors: Gabunia L , Khetsuriani S , Gamkreldze N , Antia N
Published: October 2020

Background

Since 2012, Scientific-Research Skills Center (SRSC) of Tbilisi State Medical University (TSMU) conducts “Basic of scientific research skills” course for the students of TSMU. The activities and functions of the center are derived from the competence of basic medical education in the Bologna Process. The center is continuously developing Research-Skills teaching in both, theoretical and practical terms.

Objectives

We conducted a survey among medical students of TSMU to assess students' knowledge about research and attitudes towards the scientific research prior and after completing “Basics of Scientific Research skills”course; to evaluate the importance of the course and reveal students' possible motivation changes towards becoming future researchers.

Results

To accomplish this aim, we conducted survey in two phases, before and after completion of the module. 177 students of faculty of Medicine completed the self-administered pre- and post-test anonymously. The possible answers to the questions were graded by 1-5 points (5- maximum). According to the results, 58% of students graded the question about “importance of research” by maximum points in post-tests, as opposed to pre-test (42%). Before undertaking the course, 82% of surveyed students considered research as an integral part of medical science. while, this indicator increased till 92% after the course completion. The survey results also showed that the majority of students (60% pre-test; 74% post-test) are willing to participate in scientific research in future.

Conclusions

scientific research skills course has a positive impact on the development and advancing scientific research skills among medical students. The course helps students to understand the importance of scientific research in health care. The course needs further development and more emphasis on practical research skills such as fieldwork, students' involvement in ongoing research projects etc.

Key messages

Our study showed that Tbilisi State Medical University students consider scientific research as an extremely important course in their curricula. Based on our survey findings, SRSC will further improve the course and will strengthen scientific research approaches.
A hub of high quality PhD education across Switzerland: SSPH+ Inter-university Graduate Campus
Authors: Walser A , Bauwens J , Abel T , Nocera S , Flahault A , Crivelli L , Künzli N
Published: October 2020

Background

Due to the lack of critical masses, no Swiss university offers a full PhD education in public health sciences. Separate programs are inefficient and limit students' access to multi-disciplinary exchange. To address these problems, the Swiss School of Public Health (SSPH+) launched the Inter-university Graduate Campus (IGC) as a hub of high quality inter-disciplinary training offered across Switzerland. The SSPH+ Foundation, initiated by six universities (2005), meanwhile assembles 12 Swiss universities to represent the virtual inter-university multi-disciplinary faculty of > 250 public health science professors and their research teams.

Objectives

The IGC provides PhD students state-of-the art training and access to inter-disciplinary research, teaching and networking with SSPH+ scientists throughout the country. The IGC Academic Board with representatives of 12 universities defines study recommendations and the course program. IGC meetings strengthen the inter-university exchange among students and supervisors. The SSPH+ IGC Internship Program widens career tracks in non-academic institutions.

Results

Currently 298 PhD students (190 women, 108 men) enrolled in 7 partner universities and from 74 countries are part of the IGC. IGC includes courses in methods, public health science topics, and soft skills, taught by international experts. The Academic Board and student representatives are working on study recommendations, and a challenging state-of-the-art course program. The IGC coordinator leads the quality assurance which includes standardized evaluation procedures of all courses.

Conclusions

The IGC is a remarkable nationwide collaboration across language regions, universities, and disciplinary borders in a country where single universities lack resources for multi-disciplinary PhD-trainings in public health sciences. Swiss as well as international PhD students enrolled in the IGC and their supervisors benefit from this unique training innovation.

Key messages

The SSPH+ Inter-university Graduate Campus, as a Swiss hub of high quality teaching in public health sciences for PhD students, is an innovative and contemporary approach for small countries. Students benefit from an excellent inter-university and inter-disciplinary public health education, an international network and an easy access to innovative, comprehensive, up-to-date teaching.
Professional education in curricular internships of occupational therapists in Primary Health Care
Authors: Fornereto A P N , Furlan P G , Ferigato S H , Moura A S , Faria C B , Giovannetti G , Cruz M C C
Published: October 2020

This study regards the experience of implementing a professional internship intended to students of Occupational Therapy in Primary Health Care in a Federal University located in São Paulo State, Brazil. Occupational therapist profession in Brazil was inserted in this level of care to offer specialised support to teams, mainly concerning qualification of care to vulnerable and invisible populations (community, family and cultural aspects), health promotion, encouragement of team work, humanisation in health. Such curricular internship occurs since 2017 to students of the 4th and 5th years of undergraduate course, completing 240 hours. How is the practice programme in Primary Health Care organised in the pedagogic project? Which are the strengths and fragilities of this field, as far as education is concerned? Among the practice scenarios, there are Basic Health Unit, Family Health Strategy teams, Family Health Support Centre, Street Clinic and University Basic Health Unit, with tutors who establish the collaboration. The interns follow individual and group cases, take part in team meetings and actions for team qualification and are also supervised weekly by a professor. Among their strengths, we can list a diversified education, based on the most recent public policies for the level of care that represents the stepping stone to the health system. As well as the access to the occupational therapy professional in this first contact, if the team identifies such necessity. Regarding challenges, there is unawareness about professional practice, difficulty to access work instruments and resources, as well as physical space. We hope this experience can help other educational institutions to implement their practice programmes in and for the health system. Egresses report that enables learning to work in a team in different scenarios. Such strategy aims to form a generalist professional, with criticality regarding challenges and potentialities of Brazilian public health.

Key messages

This study reports the experience of a professional internship of Occupational Therapy in Primary Health Care, understanding the health system as a scenario for practice, teaching and learning. Educating occupational therapists to this level of care is necessary, in agreement with the attributes of Primary Care.
Primary health care attributes of family health teams with and without family physician
Authors: Martins A C F , Pereira G A , Gomes W P P , Monteiro C N , Siqueri C A S , Sumida G T , Ramos D V R , Ribeiro R , Borges L M , Mafra A C C N
Published: October 2020

Background

The four essential attributes of primary health care (PHC): access, longitudinality, comprehensiveness and coordination, guide the professional practices of service management and also the professionals of the family health strategy teams. Family medicine residence (FMR) is the speciality that trains medical practitioners capable of acting properly in PHC. It develops a person-centred approach, oriented towards the individual, his family and community, which dialogues with the PHC precepts of comprehensive patient care from a social point of view. Thus, the objective of this study was to verify whether there are differences in the PHC attributes perceived by patients treated by teams with FMR doctors and by the others.

Methods

This was an observed cross-sectional study conducted during 2019, which used the Adult Primary Care Assessment Tool (PCATool) to evaluate preliminarily 28 PHC teams working at the city of São Paulo, Brazil. The teams were compared based on 337 patient answers using domains medians and Mann-Whitney tests. The study was approved by the ethics committee.

Results

Eight teams (28.6%) had doctors trained in FMR. The attributes of longitudinality and access were very similar between the two groups. The teams with FMR doctors showed better evaluations in the components: information systems, median 7.78, versus 6.67 (p = 0.391); services available, median 6.52, versus 6.06 (p = 0.086); and services received, median 4.85, versus 3.85 (p = 0.180) of the coordination and comprehensiveness attributes.

Conclusions

We didn't find statistically significant results indicating better PHC attributes of teams with FMR doctors, based on user perception. A continuous study is recommended to follow the evolution of this speciality in the PHC context.

Key messages

FMR is a fundamental key to PHC and must be evaluated continuously. It is necessary to strengthen their insertion in the Brazilian health system and discuss the ways to do so.
Core competencies for public health medicine: protocol for an Italian inter-society Delphi consensus
Authors: De Nard F , Battaglini A , De Vita E , Barbara A , Corradi A , Quattrone F , Bonaccorsi G , Damiani G , Privitera G
Published: October 2020

Background

Developing core competencies is crucial for the quality of educational curricula in Public Health Medicine (PHM). The postgraduate medical School of Public Health of the University of Pisa developed a core curriculum for PHM specialists (CCV0), adapted from the list of core competencies promoted by the Association of Schools in Public Health of the European Region (ASPHER).

Objectives

We will apply the Garavalia method, a three-round step-wise Delphi consensus, for adapting the CCV0 to the Italian context. Participants will be enrolled through purposive sampling among the members of the Italian Society of Hygiene, Public Health and Preventive Medicine, aiming at the best possible balance between geographical distribution and professional profiles (PHM residents, academics, and Public Health operators). A sample of representatives of other PHM-related Italian Societies will also be included.

Results

We will invite 139 participants through e-mail invitations. During round zero, we will collect additional suggested competencies through an open-ended question. We will analyze data qualitatively and integrate the most relevant suggestions with the CCV0, resulting in the CCV1. A subgroup of 64 experts (among PHM residents, academics, and representatives of the included Societies) will participate in the following rounds. The first round will use Likert scales to measure agreement on the appropriateness of the CCV1 competencies. Consensus and agreement will be computed using the RAND/UCLA criteria. The final round will reach out for consensus repeating the same ratings for competencies classified as uncertain, with the help of quali-quantitave summaries of the answers of the first round. The final document (CC2) will report competencies classified as consensus or uncertain, with the corresponding level of consent.

Conclusions

The CC2 will enable current courses to be assessed and inform the design of future educational programs for Italian PHM residents.

Key messages

The Delphi method ensures anonymity and a balanced involvement of all stakeholders –including medical residents- in the development of a core curriculum for Public Health Medicine specialists. A consensus on core competencies in Public Health Medicine will enable the evaluation of current training curricula and the development of future educational programs.
Midwifery crisis in Africa: the introduction of the human resources information systems
Authors: Palestra F , Ussai S
Published: October 2020

Background

Each year, 2.7 million newborns die during their first day of life: a number that equals the entire population of Namibia. In the “Year of Nursing and Midwives”, this article highlights the importance of skilled birth attendants: researchers estimate a 56% of maternal, fetal and neonatal deaths reduction in case of midwife assisted delivery.

Methods

Authors propose an integrative review involving a mapping exercise of the literature. The search included peer reviewed research and discursive literature on variables to assess the capacity of HRH.

Results

Research shows that steps to recognize and support this working relationship require multipronged approaches to address imminent training, resource and infrastructure deficits, as well as broader health system strengthening. Central Africa Republic, Côte d'Ivoire, Democratic Republic of Congo, Ethiopia, Liberia, Madagascar, Rwanda, Sierra Leone, Uganda and Tanzania all experience a midwife density per 1000 population lower than 1. Improved service provision may be associated with development of supervision systems like the introduction of a human resources information system to help mobilise domestic resources. This review also looks at the level and the relative importance of each revenue.

Conclusions

Given issues such as shortages and poor retention of human resources for maternal and newborn health service delivery in low resources settings, international organizations should focus on strengthening capacity of midwives at community and facility level as a realistic measure to at least halve maternal and perinatal mortality. Information systems may contribute to the development of national and local policies in the country, which address the human resources needs of the health care system to meet regional and national demands.

References

World Health Organization. The World Health Report 2006-working together for health. UNFPA, ICM, WHO. The State of the World-s Midwifery (SoWMy) 2014.

Key messages

Information systems may contribute to the development of national and local policies in the country. international organizations should focus on strengthening capacity of midwives at community and facility level.
Institutional support: a strategy to articulate management and work in the Brazilian public health
Authors: Estefania Dias S , Maris Nicolau S , Stoever Dacal C , Stoever I , Santos Soares R
Published: October 2020

Problem

How to build health work processes that are democratic, respect the socio-cultural characteristics of their territories and promote better health conditions for the population? After 30 years, the National Health System of Brazil faces great challenges to ensure equity, universality and comprehensiveness. For this, the models and organization of management and care must seek to guarantee care and health care in a democratic manner. In São Bernardo do Campo, institutional support was established as an important management tool for the qualification of work and health care processes. As of 2009, incorporated supporters to its team as a strategy for transforming health practices and consolidating the Health Care Network.

Results

The attributions of the institutional supporter are varied, comprehensive, non-standardized and focused on individual and collective care, respecting the autonomy and the ability of users to choose and decide about their lives. They promote debates, carry out case studies and problems of the territory. They act in an interprofessional manner and articulate services from the health network and other sectors in the territories.

Lessons

Institutional support encourages the teams' ability to identify needs and seek instruments to respond to them in specific territories in an interprofessional way, helping professionals and services to work in a network and collaboratively to achieve the prescribed health policies. But this work faces challenges because the supporter circulates in many spaces and is often seen as a homeless professional. The supporter mediates several conflicts, different interests and power relations to which he is also submitted, since he does not have a hierarchical relationship with the teams, he is not a boss, although he takes and brings information from the base to the summit and vice - conversely, he is a professional who is often caught in conflicts of interest between teams, users and management.

Key messages

Increase the teams' resolving capacity, in the face of health needs within particular social contexts and seeking to identify the needs of the population to produce more appropriate responses. Democratization of health care spaces, valuing differences in territories and uniqueness of professionals and the population.
The challenges in training and education of hospital designers and planners
Authors: Capolongo S , Barach P , Brambilla A , Gola M , Signorelli C
Published: October 2020

Background

The designed hospital environment is one of the most complex endeavors of work and there is a growing need of specialization. Scientific, technological and research developments and innovation along with new discoveries within health promotion and prevention strategies are increasingly requiring a multidisciplinary and interdisciplinary approach to the design and management of hospitals. Therefore, it is likely that the current professions will be replaced and flanked by more specialized ones.

Objectives

The scope of the paper is to display an overview of the current educational courses of the emerging Hospital Planner, referring to the worldwide available training courses (BSc, MSc, specialization and PhD courses) related to healthcare design. The focus relates to the fields of Medicine and Nursing sciences, Architecture and Engineering.

Results

A preliminary investigation has been conducted of websites and snowballing technique. The search was limited to active training programs and courses. Currently several institutions offer BSc, MSc courses and PhD programs in Healthcare Design, Environmental and Building Hygiene and Public Health. As well, there are several professional postgraduate courses either in classroom or using hybrid programs including webinars. Clemson University, USA and Ontario College of Art and Design University, Canada, offer a full MSc degree in Architecture and Health. In addition, there are several joint degree programs such as physician-engineer, physician-architect, nurse-architect or engineer.

Conclusions

From the preliminary study emerged a considerable number of international experiences addressing the topic of Hospital Planner training. Further in-depth investigations will examine the topic through questionnaires and interviews of the course organization, students' experiences, outcomes and professional careers, fields of interest and collaborations with other institutions.

Key messages

Hospital environments are the most complex field of work and require many years of specialization and multidisciplinarity and influence the quality of patient outcomes. The academic stream of the built environment is evolving toward proving specific multidisciplinary courses and hands-on experiences to support a degree in hospital planning, design and management.
Leadership in Public Health: an Italian learning experience
Authors: Giovanazzi G , Barbara A , Parente P , Restivo V , Selle V , Siddu A , Silenzi A , Trucchi C , Voglino G , gualano M R
Published: October 2020

Background

The “Public Health Leadership” Working Group of Italian Society of Public Health (S.It.I.) organized a two-days Workshop in Verona in January 2020. Leadership is linked to capacity of inspiring people to craft and achieve vision and goals, to provide mentoring, coaching and recognition and to encouragement empowerment, allowing other leaders to emerge and high quality of care. As in others country, in Italy investing in new generations is fundamental and far-sighted to create Leadership culture in tomorrow's professionals.

Objectives

The Workshop aim was to immerse Public Health residents into Health Leadership. Two types of practical/interactive experiences (Design thinking and Barometer strategy) and three speakers' interventions aroused curiosity, suggesting innovative ways to manage emerging local and global healthcare problems. Are residents interested in Leadership? Do they think Leadership could influence, motivate and enable to contribute to organization effectiveness?

Results

100 residents (Male 52, Female 48), from 72% of Public Health Schools (26), attended Workshop: 46 of 1st, 23 of 2nd, 18 of 3rd and 13 of residency program last year. Satisfaction questionnaire was completed by 58 residents (7 points Likert scale from 1 [dissatisfied/not useful] to 7 [satisfied/useful]). 5.91 pts result in interventions satisfaction, increasing from 1st (5.84) to last year (6.00); interventions topics deepening results in 5.38 pts, decreasing from 1st (5.52) to last year (5.00). Overall satisfaction on practical/interactive activities was 5.89 and 5.83 pts results in these methodologies usefulness.

Conclusions

Health Leadership is a hot topic for residents; during residency program Leadership in not a main theme and residents want to improve non-technical skills to realise organization high quality of care. The practical/interactive activities were a winning choice to capture attention and cultivate mutual trust. This experience could be adapted in other countries.

Key messages

Teaching Leadership in Public Health is a main topic that needs to be strengthened in Public Health agenda. Italian Public Health residents are very interested in Health Leadership improvement during their trainings.
Next generation sequencing applied to food safety. A new professional profile
Authors: Recchioni M , Pompei F , Cammà C , Castello V , Cito F , Del Vecchio S , Di Pasquale A , Garofolo G , D'Albenzio S , Pomilio F
Published: October 2020

The advent of “omics” is transforming Biological Sciences. Next Generation Sequencing (NGS) in Food Safety represents a challenge for Clinical Microbiology and Public Health. A new professional profile which combines different domains represents a strategic lever to increase competitiveness in this field. The Erasmus+ project Learning Genomics for Food Safety(LEGO) is aimed at defining an innovative profile, the Food Microbial Bioinformatician (FMB), a professional able to use NGS technologies applied to the analysis of food-borne pathogens. FMB bridges diverse professional areas within processes integrating Genomics, Computer Science, Statistics and Microbiology. It mixes hard/technical and soft skills and competencies to be applied in different sectors. LEGO is carried out by a European consortium (UH, UTP,UNIVAQ, AINIA, UdAnet), led by IZSAM.Desk and in-field research activities have been conducted at European level to define the FMB profile, leveraging on: national/international professional classification; the 4C model, clustering the profile in 4 areas of hard and soft skills(primary - cognitive, individual, social; organisational interpersonal behaviours). The new profile development process is made of three key phaces. First of all, a questionnaire has been delivered to almost 50 experts within the Consortium to set the draft scheme concerning FMB roles, activities and competences. Secondly, a broad range of relevant stakeholders have beeninvolved for deepening relevance, frequency and complexity of each professional dimension. Finally, the collected information guided the Consortium through the validation of the new profile at the European level. The definition of a comprehensive, standard FMB profileallows to: analyse existing curricula and training gaps; ground customised modular training programmes to fill in the gaps; increase Food Safety, promoting continuous training in a sector strongly influenced by the evolution of technology.

Key messages

Professional excellence bridging different areas (both scientific and technical).Health System innovation for wellbeing and professional development of carrier pathways and mobility.
The emerging extensively drug resistant bacteria in a university hospital in Tunisia in 2019
Authors: Tilouche L , Haddad N , Boujaafar S , Elaissi R , Kahloun S , Ketata S , Bouallegue O , Boujaafar N
Published: October 2020

Background

The discovery of antibiotics revolutionized medicine in the 20th century, however the emergence of extensively drug-resistant bacteria constitute a growing problem in our hospitals in Tunisia and across the world. This study aims to evaluate a screening program for Carbapenemase Producing Enterobacteriaceae (CPE) and vancomycin-resistant enterococci (VRE) undertaken by the Microbiology Laboratory of Sahloul University Hospital.

Methods

A descrptive and retrospective study was carried out between 01st April 2018 and 31th December 2019 in the university hospital Sahloul, in East Coast of Tunisia. The screening was based on rectal swabs; it concerned Medical Intensive Care Units, the postoperative unit, the paediatric and the nephrology departments. The rectal swabs were seeded on the chromID CARBASMART and chromID VRE agars(biomerieux, France)in search of CPE and VRE respectively. The identification and the antibiotic susceptibilities testing were performed using the Vitek2 System (biomerieux,France)

Results

In total, 191 patients were screened. Among them, 56% were admitted in Intensive Care Units, 9.95% in postoperative unit, 30.9% in paediatric department and 3.14% in the nephrology department. A total of 38 extensively drug-resistant bacteria were isolated: 20 CPE and 18 VRE. Among isolated CPE, 17 were identified as Klebsiella pneumonia: The ConfirmationKPC/MBLkit (RoscoDiagnostica, Denmark) supplemented with a disc of Temocillin showed that 7 strains produced metallo-carbapenemase and 10 strains produced OXA 48 carbapenemase. The other isoloted CPE were OXA-48 producers. All VRE were identified as Enterococcus faecium, Their Vancomycin and Teicoplanine MICs were greater than 32 mg/L.

Conclusions

Mastering the spread of extensively drug-resistant bacteria involves a multidisciplinary preventive strategy. It must include strict application of hygiene measures, early detection and isolation of carriers and rationalization of antibiotic use.

Key messages

the emergence of extensively drug-resistant bacteria constitute a growing problem that`s why Carbapenemase Producing Enterobacteriaceae and vancomycin-resistant enterococci screening is crucial. Anti microbial agents use must be rationalized.
Attitudes, behaviors and consequences of sexting in Mexican gay and bisexual adolescents
Authors: Rodríguez Otero L
Published: October 2020

Sexting refers to the reception, sending and/or forwarding of photographs, videos and / or text messages of erotic-sexual content through the telephone and/or virtual media. To identify the attitudes, behaviors and consequences of sexting in homosexual and bisexual students (LGB) of Secondary School of Nuevo León (Mexico), a quantitative investigation was carried out. Through a simple random sampling consisting of 1,186 adolescents (76 homosexuals and 82 bisexuals), The sample was analyzed using a a self-administered anonymous questionnaire composed of sociodemographic issues, the Likert scale of behaviors on sexting by Chacón, Romero, Aragón, and Caurcel (2016), the Likert scale of attitudes towards sexting by Weisskirch and Delevi (2011) and the questionnaire about the consequences of Alonso's sexting practices (2017).

The results reveal that 78.73% perform passive sexting and 34.81% active sexting; on the other hand, it is evident that the frequency of the actual participation in sexting (M = 0.46; DT = 1.37) is average; and the active disposition towards sexting (M = 0.67; DT = 1.09) and Emotional expression in sexting (M = 0.64; DT = 1.52) are low. It is also identified that the perception of risk (M = 2.57; SD = 1.81) is high, the relational expectations (M = 0.84; SD = 1.78) are low; and considered as fun and / or carefree (M = 1.29; DT = 1.56) average. Likewise, it is evident that 15.82% of the sample declare to have receive coercion, 10.75% blackmail, and 8.86% teasing after having sexted.

Based on these results, it is considered necessary to propose preventive measures from the educational and community level through a biographical-professional Sexual Education model.

Key messages

Diagnosis of the problem in Nuevo León. Basis for proposing measures.
Cardiovascular disease risk factors of ultra-Orthodox Jewish women in Israel: a comparison study
Authors: Leiter E , Greenberg K L , Donchin M , Keidar O , Siemiatycki S , Zwas D R
Published: October 2020

Background

Women from low socio-economic, culturally insular populations are at increased risk for cardiovascular disease (CVD). The ultra-Orthodox Jewish (UOJ) community in Israel is a difficult to access, rapidly growing low socio-economic, insular minority with numerous obstacles to health. The current study investigates CVD-related risk factors (RF) in a sample of OUJ women, comparing sample characteristics with the general population. Addressing the questions, 'Are UOJ women at increased risk for CVD?', 'Which RFs should be addressed beyond the general population's?', this study can inform public health initiatives (PHI) for this and similar populations.

Methods

Self-administered questionnaires completed by a cluster randomized sample of 239 women from a UOJ community included demographics, fruit, vegetables, and sweetened drink consumption, secondhand smoke exposure, physical activity (PA) engagement, and BMI. Population statistics utilized for comparison of demographic and cardiovascular risk factors were obtained from government-sponsored national surveys.

Results

Compared with the general population, UOJ women were less likely to consume 5 fruits and vegetables a day (12.7% vs. 24.3%, p<.001) and more likely to consume > 5 cups of sweetened beverages a day (18.6% vs. 12.6%, p=.019). UOJ women also reported less secondhand smoke exposure (7.2% vs. 51.4%, p<.001) and higher rates of PA recommendation adherence (60.1% vs. 25.6%, p<.0001) than the general population. Obesity was higher in UOJ women (24.3% vs. 16.1%, p<.0001).

Conclusions

This study suggests that PHIs in this population target healthy weight maintenance, nutrition, and PA. As a consequence of this study, the first CVD prevention intervention has been implemented in this population, targeting the identified RFs. Utilizing a mixed methods and community-based participatory approach, this innovative 3-year intervention reached over 2,000 individuals.

Key messages

This study identified nutrition risk behaviors and high levels of obesity in a difficult to access, minority population. This study informed the planning and implementation of a community-based PHI.
Transsexuality in the streets of Campinas: borderline resistance movements towards a humanistic care
Authors: Komoda D S , Justino J , Danny B , Suzy S , Carvalho S R , Botteon L M , Oliveira C F
Published: October 2020

According to WHO, transgender people are more likely to suffer from a broad range of health

Issues

high HIV prevalence, low access to health, discrimination, violence, rejection, unemployement, poverty, housing insecurity, and marginalisation. Structural macho-sexism is one of the main causes not only of violence, but also of lack of protective legislation and policy to this population. Developing research regarding transgender people's life experience in the streets and their pathways to healthcare is of major importance to achieve a more equitable society and public health system.

This qualitative research is a chapter of the book “Experiências do Cuidado na Rua” (”Living Care in the Streets”). From the experience of offering care in downtown Campinas to people living in the streets, 2 case reports were selected. The narratives were collected in a field journal. Both participants were female transgenders living in the context of Brazil's Universal Health System. National policy and legislation were confronted with narrative analysis of the participants, to show the barriers to receiving proper and humanistic care.

Some narratives show the clear violence suffered from law enforcement personnel: “We used to be beaten by the Police because we were prostituting ourselves”. Others show a transphobic moralistic context: “Last week a transexual had her heart torn here in Campinas, and a Saint image was put in her chest! I'm afraid to walk alone in the streets at night. “Yet others show a clear transphobic and problematic position from the now president Bolsonaro which reflects in transphobic sympathizers in hate speeches: “Nowadays [after presidential election] we hear in the streets 'let's send them to Bolsonaro!'”, as sending someone to the guillotine.

The narratives show a clear need of global and local actions towards a more accepting society, and actions must be taken in a broad range of fields, such as human rights legislation, policy and surveillance.

Key messages

This research show the neglect for the transgender population and the lack of protective measures, which reflects in access to the health care system and actual care. A growth of discrimination and hate speeches directly related to the election of an extremist-right national administration has been observed.