bluuebunny/crossref_metadata_2025 huggingface dataset:
New generation of medical students: what they are looking for?
Authors: Dobretsova E , Arshukova I , Dugina T
Published: October 2020

Background

Changes in technologies and standards of life leads to the fact that each generation is very different from the previous one. Modification of generations affects the quality and the development of medicine. Current medical students are our future doctors. And changes in health care will be made by them soon. So, their views will influence the development of health care system in the future. Therefore, it is important for us to understand how today's graduates see their future work and what is important for them.

Methods

The opinions of 720 final year medical students were investigated using an anonymous questionnaire in Krasnoyarsk, Russia. Data were analyzed using SPSS 22 program by the following methods (p < 0.05): descriptive statistics, decision trees analysis, χ2-test.

Results

Medicine have to change rapidly in accordance with the demands of new generations. Only in such case, current graduates of medical schools would like to work in practice medicine in the future. In this work, factors that are important for the work of modern students were investigated. Such posers were examined: the opportunities to work in rural areas and the basis for such decisions, the choice of future doctors' specialty, the young doctors' self-confidence and how much time they need experienced doctors' support as mentors. To avoid further staff shortages, we have to take into account the needs and priorities of today's graduates.

Conclusions

Practically all of the graduates are not ready to work alone immediately after medical school graduation - 97.0% of them report that they need a mentor. In addition, the majority of them prefer to work with mentor for a year or more (80.5%). Practically half of the students are ready to work in rural areas (49.5%); the most important factors that influence their decision are salary, free housing and clinic's equipment (important for 53.4%, 35.9% and 26.5% of the graduates, respectively).

Key messages

The majority of the graduates are not ready to work alone immediately after medical school graduation and need a mentor for a year or more. Increased salary, free housing and good clinic’s equipment may attract the medical graduates to work in rural areas.
Global health challenges: Are future physicians prepared? The results of a 4 years training experience
Authors: Sisti L G , Frisicale E M , Corsaro A , Parente P , Riccardi M T , Villani L , Barbara A , Di Pietro M L , Ricciardi W , Bruno S
Published: October 2020

Background

Current health challenges are highlighting as Global Health (GH) is a discipline of growing importance for future physicians. Although its training is globally recommended, it has not universally entered the curricula of degree courses in Medicine and Surgery. A cycle of 6 seminars in global health has been promoted by researchers and public health residents of the Center for Research and Studies in GH of the Università Cattolica del Sacro Cuore (UCSC) in Rome, and offered for 4 consecutive years to medical students attending the UCSC.

Objectives and Methods

Main goal was increasing students knowledge and awareness in global health issues exploring their needs and perceptions about the impact of the topic on their future career. Two-hours frontal lessons held by experts and practical sessions (PBL) facilitated by promoters were planned on topics as determinants and inequalities in health, UHC, fragile and vulnerable population as migrants and victims of violence, SDGs, AIDS and emerging infectious diseases,international cooperation, maternal-child health. A pre-course, single event and post-course questionnaire was administered to participants.

Results

A mean of 48 students (± 15.7SD), 66.7% females, attending mainly the second(40.4%) and the third year (39%), joined each event. The analysis of the pre-course questionnaire has highlighted students' interest in healthcare inequalities, pandemics, migration, health in developing countries, healthcare systems. At the end, 92% of participants has considered the course interesting, 87% stated that the topic should be part of the degree course and 78% that it will influence their career. The methodology was considered adequate in 94% of cases underlining its strong incentive to work in team.

Conclusions

The strong interest of medical students in acquiring skills in global health seems to firmly encourage its inclusion and strengthening in study plans to prepare them properly to face the future challenges in health.

Key messages

Medical students consider the global health training relevant for their career encouraging its inclusion in the Medicine and Surgery curriculum. Practical sessions and team work could be useful tools to adequately train the future health workforce.
Using technology to access health information: greater WASH knowledge/behaviors in Indonesian mothers
Authors: Beckstead E , Niedfeldt H , Chahalis E , Jensen M , Reher B , Torres S , Jusril H , Rachmi C N , West J , Hall C
Published: October 2020

Background

Despite attention, childhood stunting in Indonesia persists. Proper WASH (Water, Sanitation, and Hygiene) practices help lower childhood stunting. As internet access in Indonesia grows, seeking health information online is increasing. However, research on using technology to increase WASH knowledge and behaviors in Indonesia is limited. The purpose of this study is to assess whether Indonesian women using technology to access health information have higher WASH knowledge and behaviors.

Methods

1,740 mothers with children under the age of two were randomly selected with three-stage cluster sampling. They were surveyed and interviewed about handwashing and sanitary defecation benefits, steps, and practices. Adjusted and unadjusted logistic and linear regression models were used to compare WASH outcomes between those who used technology to access health information and the control group. The models controlled for mother's age, mother's education, and total household income.

Results

Participants who used technology to access health information were more likely to know the benefits (OR = 2.603; CI = 1.666-4.067) and five critical times (OR = 1.217; CI=.969-1.528) of proper handwashing. Mothers were more likely to know the risks of open defecation (OR = 1.627; CI = 1.170-2.264) and understand disease transmission from stool (OR = 1.894; CI = 1.438-2.495). Those using technology to access health information were more likely to report using a gooseneck, squat toilet, septic tank, or closed ground to discard feces than the control group (OR = 3.858; CI = 2.628-5.665).

Conclusions

Using technology to access health information was associated with increased handwashing and defecation knowledge and safe elimination of feces. It was not associated with an increase in handwashing with soap. Technology can be used to increase WASH knowledge and behavior, but further research is needed to effectively use technology to increase optimal handwashing behaviors.

Key messages

Increasing technology access may encourage good water, sanitation and hygiene behavior change. Using technology to access health information yielded safer defecation practices but not better handwashing practices. Further research is needed.
Meta-analysis of the efficacy of ertapenem in preventing SSIs after elective colorectal surgery
Authors: Vicentini C , Corradi A , Corcione S , De Rosa F G , Zotti C M
Published: October 2020

Background

The efficacy of standard surgical antimicrobial prophylaxis (SAP) regimens in preventing surgical site infections (SSIs) after colorectal surgery is declining, along with rising rates of intestinal colonization with antimicrobial resistant (AMR) Enterobacteriaceae and Bacteroides spp. Ertapenem has been approved by the FDA and EMA for SAP in this context, however it has not been used extensively for this indication out of concern for increasing carbapenem-resistance rates. A limited number of studies have investigated the efficacy of ertapenem in preventing SSIs after colorectal surgery, comparing ertapenem with different agents or combinations of agents.

Methods

A systematic review was conducted following the PRISMA checklist. PubMed, Embase and Cochrane databases were searched for studies measuring the efficacy of ertapenem in preventing SSIs following elective colorectal procedures. Studies were considered eligible if they reported extractable data on the proportion of SSIs and/or on the proportion of AMR pathogens isolated from SSIs. Data from all ertapenem study arms were extracted. A random effects meta-analysis was performed to estimate the overall proportion of SSI.

Results

Of 1109 identified studies, 5 met the inclusion criteria and were included in the meta-analysis, totalling 3176 participants. The pooled proportion of SSI was 0.10 (95% CI 0.05-0.18; I2=96%; τ2=0.6323; p ≤ 0.01). Only one study reported data on carbapenem resistance: out of 124 isolates from 30 patients, 1 gram negative carbapenem-resistant isolate was identified.

Conclusions

The pooled proportion of SSI using ertapenem as SAP found in this study is in line with the proportion of SSI using standard SAP found by a recent meta-analysis (Gandra, 2019). According to this analysis, the benefit of ertapenem does not outweigh the risk of further promoting AMR, although results should be interpreted with caution due to the high heterogeneity among included studies.

Key messages

According to this study, the efficacy of ertapenem in preventing surgical site infections after elective colorectal surgery is comparable to the efficacy of standard surgical antibiotic prophylaxis. The emergence of carbapenem resistance after surgical prophylaxis with ertapenem should be further investigated through longer term studies before widespread use for this indication.
Financial impact of including dentists in UCIs for reducing cases of Nosocomial Pneumonia
Authors: Simoes A , Greche N , Merchan L , Raimundo A , Cezario L , Cavalcante D , Meneghin M , Pereira A
Published: October 2020

It is a study of Financial Impact Analysis, where the financial consequences arising from the possibility of inclusion of the dentist in the Intensive Care Units (ICU), within the reality of the Unified Health System (SUS), were evaluated in Brazil. It was based on a quick review of the literature and economic evaluation with reference to the year 2018. Information on costs and hospitalizations were collected from the official databases of the Ministry of Health, the Federal Council of Medicine and the Union of Dentists of the State of São Paulo. Only the direct medical costs related to the hospitalizations were calculated. Scenarios were simulated for a time horizon of 1 year (2018) and a sensitivity analysis was made for a more optimistic scenario (values 20% lower) and another less optimistic (values 20% higher). On average, the presence of a dentist in the ICU reduces the development of pneumonia cases by 56% and 8.18 days, which represents a savings of 34.92% in hospitalization costs in the evaluated scenario. In Brazil, when hiring dentists in all ICUs, each avoided case would contribute to savings of R$ 7,949.45 (1US$ = R$ 4,02 in 30/10/2019), ranging from R$ 6,359.56 to R$ 9,539.35 in the optimistic and pessimistic scenarios, respectively, where each case avoided is higher than the dentist's monthly salary. It would be necessary to spend R$ 142,060,140.00 on hiring the dentist to cover the ICUs, making the final savings more than 865 million reais. It is concluded that the inclusion of the Dental Surgeon (DS) in ICU teams would have a positive economic impact, with savings in hospitalization costs from the perspective of SUS. The COVID-19 pandemic in Brazil, depending on the State's action in containment strategies, could require 2.17 times more in the bests of scenarios where the action of total suppression would be used. Such a situation requires emergency measures, and the role of the dentist is a strategy that can support the health system.

Key messages

Dental care in the ICU is an important and cost-effectiveness strategy for the control of microorganisms that act in the evolution of the pneumonia nosocomial. Such a situation requires emergency measures, and the role of the dentist is a strategy that can support the health system.
Vaccinations and the movement of antivaccers
Authors: Rosiello F , D'Oca E
Published: October 2020

Background

Recently, also thanks to some political parties that defend no-vax theories, vaccination coverage is decreasing, increasing the costs of health care spending and the resistance of pathogens to antibiotics. Some studies begin to show that vaccines, reducing the spread of pathogens (also by means of the so-called flock effect), reduce, in addition to mortality, morbidity and cost of health care, also the antibiotic-resistance, which it is increasingly a big problem in industrialized countries.

Methods

analysis of available literature and other valid government sources. The research was carried out by inserting on Pubmed: “vaccines”, “antimicrobial resistence”, “vaccines AND antimicrobial resistence”, “cost vaccination”, “cost antimicrobial resistence”. Later we added “AND Italy” to the previous queries.

Results

mistrust in the vaccines is spread in a variable way within and outside the borders of the European Union[1]: 41% in France, 21% in Italy, 13% in the USA and 10% in Germany; last, the UK with only 9%, compared to a world average of 12%. Regarding costs, the proportion of infections on total acute hospitalizations under ordinary conditions is constantly increasing and in 2014 reached 36.5 per thousand. The infections lengthen the average stay of 3 days (DS: 0.4-10) and giving the value of 700€, on average, to the additional days of hospitalization attributable to infections, we understand how the annual expenditure varies between 369 and 492 millions of euros. As for the total direct and indirect costs of influenza, which for Italy are estimated at 2.86 billion€, vaccinating the whole adult population would fall to 1.56 billion (-€1.3 billion). All this leads to an increase In healthcare spending (in 2015 the National Health System spent €317.9 million on vaccine purchases, Or only 1.4% of total pharmaceutical expenditures), both in terms of resources diagnosis, treatment and treatment, both in terms of working days lost due to illness and post-infectious period.

Key messages

The political fight against antivaccinist movements is as important as the promotion of vaccines in the reduction of AMR. The cost to reduce antivacciners movements are an investment to reduce cost of AMR.
Epidemiology and impact of hospital-acquired sepsis in Rajavithi Hospital, Bangkok, Thailand
Authors: Kamnon K , Supmontri S
Published: October 2020

Background

Sepsis is considered a major health burden, with high mortality and associated costs. Health indicators are essential to define strategies to improve the treatment of diseases and the epidemiology information of sepsis.

Methods

This study was a retrospective descriptive study. The purposes to determine distribution and impacts of hospital-acquired sepsis among patients, who were admitted in Rajavithi hospital. The Data was obtained from medical records of 6,673 sepsis from 2015 to 2019 (1st January 2015 - 31st December 2019), using hospital-acquired sepsis and impacts of hospital-acquired sepsis form developed by researcher. Data analysis was performed by using descriptive statistics.

Results

The major results of this study revealed that 51.1% of sepsis patients were women. The age range of sepsis patient was between 14-100 years old (mean 45.3±6.7 years). There were altogether 6,663 sepsis occurring among these patients. Forty-four point six percent of sepsis was urinary tract infections followed by pneumonia and bloodstream infections (31.2% and 13.7%). The causation of sepsis were related to gram negative bacteria (56.5%), gram positive bacteria (27.2%) and fungus (16.3%). Based on patient department, 57.3% of sepsis occurred in medical department. The length of hospital stay for patients with hospital-acquired sepsis ranged from 6 to 104 days. The average length of stay was 37.6 days. Overall mortality rate of hospital-acquired sepsis was 54.2%. The cost of treatment for hospital-associated sepsis was 9,376.94 USD per case. Sixty-five percent point eight percent of the cost was for antibiotic treatment, 19.6% for equipment, 9.4% for laboratory tests and 5.2% for other procedures.

Conclusions

Hospital-acquired sepsis among patients can have serious impacts on the patients and increase the economic burden of hospital. Hospital have to determine effective and sustainable hospital-acquired sepsis preventions.

Key messages

Sepsis is a serious condition that affects the patient. Sepsis are global public health problems. The factors related to mortality are delayed diagnosis, non-intensive care setting admission, delayed antibiotic and multi-organ failure.
Trend of healthcare-associated infections in a teaching hospital in Tunisia, 2014-2019
Authors: Ghali H , Ben Cheikh A , Bhiri S , Khefacha Aissa S , Dhidah L , Ben Rejeb M , Said Latiri H
Published: October 2020

Background

National surveys on the prevalence of HAIs on a given day have regularly taken place in health facilities. During this period, actions to improve HAI prevention were implemented, including strengthened isolation measures; hand hygiene promotion using the World Health Organization multimodal strategy; and promotion of appropriate antimicrobial use. We aimed to examine trends in HAI in Sahloul Hospital over six years.

Methods

Annual prevalence surveys of healthcare-associated infections (HAIs) between 2014 and 2019 were conducted in the university hospital in Tunisia. It is a cross-sectional study of one-day prevalence with a single pathway. All departments were included in the survey, except emergency and hemodialysis services due to their very short length of stay. Data collection was carried out using NosoTun plug (national HAI prevalence survey).

Results

Over six years, prevalence of HAI ranged from 11.4% in 2014 to 9.5% in 2019. The prevalence of HAIs did not show a significant change across the six surveys. However, there were significant (P = 0.008) reductions in the prevalence of total HAIs in intensive care units, which had the highest frequencies of HAIs over those six years. In 2014, bacteriological analysis was performed in 55.8% of HAI cases. In 66.6% of cases (n = 16), isolated bacteria were gram negative bacilli, the most frequent were Pseudomonas aeroginosa. In 2019, 27 germs were identified, the most frequent were Gram Negative Bacilli (74%), mostly Escherichia coli.

Conclusions

This HAI prevention strategy was influential in decreasing infections among hospitalized patients in intensive care units. Challenges for the future are to minimize infection with gram-negative bacilli while limiting the emergence of antibiotic resistant organisms.

Key messages

Using prevalence surveys, we were able to have an insight into the most common isolates identified throughout the last six years. Repeated prevalence surveys are an effective tool for monitoring HAI frequency and contributing to the establishment of effective infection control.
Prevalence of bacterial urinary tract infections in elderly living in retirement homes in Brazil
Authors: Tietz Marques S , Pitz da Silva B , Silva Mota A , Marinho de Quadros R , de Lima M R
Published: October 2020

Background

Urinary tract infections are common in humans. Urinalysis is the most widely used test for the diagnosis of urinary tract infection in Brazil. This study aimed to identify bacteria that cause urinary tract infection (UTI) in elderly patients permanently living in three retirement homes in the city of Lages, state of Santa Catarina, Brazil.

Methods

The study was approved by the Human Research Ethics Committee of University (protocol number 2.922.891). The participants were 93 elderly people, aged between 51 and 94 years. Urine samples were subjected to physical-chemical tests and to direct analysis of cell and bacterial micromorphology. Gram staining was performed on urine sediment. Positive samples were submitted to urine culture using cystine-lactose-electrolyte-deficient agar and MacConkey culture media. Bacterial colonies were identified by Gram-positive bacteria, biochemical tests and for Gram-negative bacteria, biochemical tests of oxidase and Rugai with Lysine (NewProv®). The χ2 test with the FREQ procedure of the SAS 9.2 statistical package was used, adopting p ≤ 0.05 as the level of significance, with a 95% confidence interval (CI).

Results

The prevalence of bacterial infection was 36.55% with rates of 46.93% in women and 25% in men. There was no positive correlation between urinary tract infections in relation to sex, age group, pH and diaper use (p > 0.05). E. coli appeared in the urine of 20.43% of the elderly, S. aureus in 8,16%; S. saprophyticus in 9,09%, 5,37% with Proteus mirabilis and Klebsiella pneumoniae.

Conclusions

Collaborative and integrated actions are needed to facilitate the recognition and clinical management of UTI in elderly patients, which are responsibility of Federal Government social programs in partnership with states and municipalities.

Key messages

Elderly patients need regular monitoring. Elderly people in nursing homes need to be served by government programs.
Migrant studies using the community-based participatory research partnership approach
Authors: Zlotnick C
Published: October 2020

Background

This integrative review examined the academic-community partnerships in quantitative health care studies using the community-based participatory research (CBPR) approach and targeting migrants.

Methods

The keywords were 'community based participatory or CBPR' AND 'immigrants or migrants.' All studies were written in English and published between January 2010 and December 2018.

Results

In the final sample (n = 26), studies used a variety of community partners including consumers and staff recruited from a variety of sites. The ethnicity between community partners and the target population was concordant in all studies reviewed. Yet, only a single study reported concordance between community partners and the migrant group (a group in which some hold a more privileged status than others) of the target population.

Conclusions

Official status such as citizenship is among the social parameters of intersectionality; yet the majority of CBPR studies examining migrant populations combined disparate migrant groups and used terms such as migrants, refugees and immigrants interchangeably. The CBPR approach is a valuable approach for health care studies as it strives to be culturally-informed so that study results on vulnerable populations are internally and externally validity. When concordance is not possible, researchers must describe the efforts that the partnership undertook to obtain and apply culturally-informed efforts.

Key messages

Optimally CBPR studies seek community partners who are concordant with the target population. When impossible, descriptions of culturally-informed efforts are needed. Migrants are a heterogeneous population. Migrants with less vulnerability may be ineffective representatives of the most vulnerable migrant groups.
Perceptions of Indigenous Australians towards cardiovascular primary prevention programs
Authors: Lord H , Fernandez R , MacPhail C
Published: October 2020

Background

Indigenous Australians have disproportionately poorer health outcomes than their non-Indigenous counterparts. Preventable chronic diseases, such as cardiovascular disease, are primary factors that contribute to their lower life expectancy. Health risk behaviors such as smoking, physical inactivity, poor nutrition and obesity largely contribute to the enduring health divide. Therefore, the aim of this qualitative review was to synthesize the best available evidence on the perceptions of Indigenous Australians towards cardiovascular primary prevention programs.

Methods

A search using MEDLINE, CINAHL, EMBASE, Google Scholar, MedNar, ProQuest and Index to Theses for published and unpublished studies was conducted in January 2020. The methodological quality of the included studies was assessed by two reviewers using the Joanna Briggs Institute (JBI) critical appraisal tool. Meta-aggregation was conducted in accordance with JBI methodology.

Results

Eleven studies involving 249 participants were included. Three synthesized findings were developed 1) External factors can affect participants' experiences of prevention programs. Support from family motivates participation and behavioral change. Support from health professionals that is free from judgment facilitates participation; 2) The complexities of an individual's life influence Indigenous Australian's experiences and participation in prevention programs and health risk behavioral change; 3) A personal desire to change behaviors and participate in prevention programs requires development of knowledge on healthy lifestyles, creation of new social norms and overcoming internal struggles.

Conclusions

Indigenous Australians participation in primary prevention for cardiovascular risk factors and adoption of a healthy lifestyle are influenced by social support, social determinants and personal desire. Future programs need to tackle structural drivers and create a supportive environment to assist in behavior change.

Key messages

Social determinants affect Indigenous Australians experiences and participation in prevention programs for behaviour change. Prevention programs must create a supportive environment with the inclusion of family.
Implementation and maintenance of a community intervention for refugee youth with symptoms of PTSD
Authors: Lampa E , Sarkadi A , Gupta Löfving S , Perez Aronsson A , Torp L , Warner G
Published: October 2020

Background

Transferring effective health and wellbeing interventions into community-based settings is challenging, with many only ever implemented in the academic settings in which they were developed. Over the last few years, Teaching Recovery Techniques (TRT), a community-based intervention for refugee youth reporting symptoms of post-traumatic stress, has been scaled up across Sweden using the model of a distribution network pathway. This means the lead organisation works with a distribution organisation using the latter's existing network of implementing organisations. Often the distribution partner is a national organisation with many local member agencies. The model offers possibility for quick spread, but only allows for a low level of control at the local site level. Therefore, it is important to understand the factors and agents that have facilitated the implementation and maintenance of TRT from successful sites, in order to inform ongoing efforts to scale up the intervention.

Methods

Semi-structured interviews were conducted with personnel from 'successful' TRT sites, defined as having conducted at least two TRT groups and maintaining full delivery of the programme. Interview data were analysed using content analysis.

Results

Our results indicated that active networking and collaboration were key to successful maintenance of TRT delivery. Active recruitment strategies, resource availability and management, and careful integration of the interpreter were also raised as important factors.

Conclusions

Although the interviewed professionals represented successful sites, they remained dependent on informal networks and collaboration for programme delivery. The possibility of integrating TRT into a local stepped-care model for post-traumatic stress in refugee children and adolescents will be presented.

Key messages

Transferring effective health and wellbeing interventions into community-based settings is challenging, with many only ever implemented in the academic settings in which they were developed. Active networking and collaboration are key to successful maintenance of community interventions.
Validity of UK electronic health records to study migrant health: a population-based cohort study
Authors: Pathak N , Patel P , Mathur R , Burns R , Gonzalez-Izquierdo A , Denaxas S , Sonnenberg P , Hayward A , Aldridge R
Published: October 2020

Background

An estimated 14.3% (9.4 million people) of people living in the UK in 2019 were international migrants. Despite this, little is known about how migrants access and use healthcare services. To use electronic healthcare records (EHRs) to study migration health, a valid migration phenotype is necessary: a transparent reproducible algorithm using clinical terminology codes to determine migration status. We have previously described the validity of a migration phenotype in CALIBER data using the Clinical Practice Research Datalink (CPRD), the largest UK primary care EHR. This study further evaluates the phenotype by examining certainty of migration status.

Methods

This is a population-based cohort study of individuals in CPRD Gold (1997-2018) with a Read term indicating migration to the UK. We describe completeness of recording of migration over time: percentage of individuals recorded as migrants. We also describe cohort size based on certainty of migration status: “definite” (country of birth or visa status terms), “probable” (non-English first/main language terms), and “possible” (non-UK origin terms).

Results

Overall, 2.5% (403,768/16,071,111) of CPRD had ≥1 of 434 terms indicating migration to the UK. The percentage of recorded migrants per year increased from 0.2% (4,417/2,210,551) in 1997 to 3.64% (100,626/2,761,397) in 2018, following a similar trend to national migration data. 44.27% (178,749/403,768) were “definite” migrants and 53.68% (216,731/403,768) were “probable” migrants. Only 2.05%(8,288/16,071,111) were “possible” migrants.

Conclusions

We have created a large cohort of international migrants in the UK and certainty of migration status is high. This cohort can be used to study migration health in UK primary care EHR. The large contribution of language terms make this phenotype particularly suitable for understanding healthcare access and use by non-English speaking migrants who may face additional barriers to care.

Key messages

We have developed a way to study migration health in UK primary care electronic health records. Our method is particularly useful to study healthcare for non-English speaking migrants who may face additional barriers to care.
Risky alcohol consumption, dependency symptoms and minority stress in sexual minority young people
Authors: Demant D , Saliba B
Published: October 2020

Background

Sexual Minority Young People (SMYP) use alcohol, tobacco and other drugs at disproportionate levels when compared to their heterosexual counterparts. Limited research has been conducted on dependency symptoms in this population as well as correlations between risky use of alcohol and minority stress including potential differences between identity subgroups.

Methods

A cross-sectional online survey was completed by 1,556 SMYPs (mean age: 22.6 years) from Australia. Variables include demographics, alcohol use, dependency symptoms and different dimensions of minority stress. Descriptive and correlational analyses, and binary logistic regressions were conducted.

Results

Most participants surveyed identified as gay or lesbian (59%) and as men (55%). Regular binge drinking (43%), as well as general high-risk alcohol use (52%), was prevalent in the sample. Dependency symptoms were also common in the sample including health, social, legal or financial problems as a result of alcohol consumption (17%). Meaningful differences in consumption and symptoms between subgroups were identified. Minority stress, including negative family reactions and homophobic harassment were significantly correlated with higher alcohol use and dependency symptoms.

Conclusions

High-risk alcohol consumption including binge drinking as well as dependency symptoms are highly prevalent in Australian SMYP but are not distributed equally across subgroups. Public health initiatives should consider targeting SMYP subgroups and concentrate on the role of alcohol as a potential maladaptive coping mechanism for minority stress.

Key messages

Risky alcohol consumption and dependency symptoms common in sexual minority young people but not equally distributed in subgroups. Minority stress likely to be linked to risky alcohol consumption and dependency symptoms.
Care for women in a situation of violence: an institutionalist look
Authors: Barbosa J , Ferreira B , Santos D , Magalhães F , Martins G , Riquieri M , Cordeiro M , Silva M , Lima R , Andrade M
Published: October 2020

Objective

To know the dynamic processes that involve the production of care for women in situations of violence.

Methods

Study of qualitative approach and cartographic inspiration based on the theoretical reference of Institutionalism that had as scenario a reference center for women in domestic violence located in Espírito Santo, Brazil. Six professionals who worked directly in the care of women participated in the research. Interventions were carried out, through seven workshops, using storytelling. The material production tools were narratives, the researcher's field diary and the collective field diary, which was built from the record and observation of all the participants in the study. The workshops were held at the center according to the availability of participants and lasted an average of 60 minutes. The meetings were recorded and later transcribed together with the notes of the field diaries, seeking, through a cartography, to give meaning to the experiences lived by the participants. Through the analysis of implication, it was possible to give visibility to the various relationships that constitute a certain reality, in which the researcher is involved.

Results

The study pointed out that violence crosses all women influencing the production of care offered by professionals at the reference center. The narratives multiplied senses contributing to the problematization of the care offered, providing the qualification of other ways of thinking/acting in health.

Conclusions

From an ethical-aesthetic-political paradigm it is possible to produce reflections that broaden the view of care for women in violent situations beyond biological issues, contributing with desirable productive processes in the prevention of violence and the promotion of health.

Key messages

It gives visibility to micropolitical processes and contributes to the construction of policies for women's health capable of welcoming differences and singularities. It shows innovation for the field of qualitative health research, broadening the view on the care of women in situations of violence beyond biological issues.
E-health and health literacy of young adult Ukrainian female immigrants and Polish counterparts
Authors: Krasko Y , Marianowska J , Duplaga M
Published: October 2020

Background

According to recent projections, even 10% of Polish gross domestic product is contributed by Ukrainian immigrants. There is also a considerable number of Ukrainians continuing university education in Poland. The level of health literacy in Ukrainian society has not been studied so far. The aim of the study was the comparison of health literacy (HL) and e-health literacy (eHL) of young adult Ukrainian (UA) women with their Polish (PL) counterparts

Methods

A snowball technique was used to recruit a sample of UA women working or studying in Poland to the Internet-based survey. The questionnaire used in the study consisted of the 16-item European HL Survey questionnaire (HLS-EU-16), eHealth Literacy Scale (eHEALS), the set of the questions asking about health behaviours (HB), self-assessment of health status (HS) and items exploring sociodemographic variables. For comparison, the data of an age-matched sample of 100 respondents was extracted from the online survey performed in a representative sample of PL women.

Results

The mean age (standard deviation, SD) of 57 UA respondents was 20.23 (1.78) years and in Polish sample 20.25 (1.79). HL did not differ between both groups (11.06 (4.22) vs 11.44 (4.34), respectively, p = 0.53), but eHL was significantly lower in UA group (25.91 (5.36) vs 28.17 (5.37), U Mann-Whitney test, p = 0.01). Only 58.5% of UA respondents vs 80.5% of PL ones assessed their HS as at least good (Fisher exact test, p < 0.001). The rates of active smoking (34.6% vs. 35.0%, p = 0.55), using e-cigarettes (35.3% vs 34.0%, p = 0.99), frequent alcohol consumption (26.9% vs. 20%, p = 0.41), and intensive physical activity (49.0% vs. 38.0%, p = 0.22) did not differ between study groups.

Conclusions

Young UA women show lower eHL than PL counterparts. Although HL and HB in both groups did not differ significantly, UA respondents have assessed their HS much lower than PL participants.

Key messages

E-health literacy and self-assessed health status were significantly lower among young Ukrainian than among Polish women. Both groups did not differ for health literacy and health behaviours.
Neglected assets in migrants’ health literacy promotion: Translanguaging and second language teacher
Authors: Harsch S , Bittlingmayer U
Published: October 2020

Background

Providing health care to migrants and refugees can be difficult due to language discordance, divergent cultural preferences and low levels of health literacy (HL). To improve it, experts suggest promoting newcomers' HL in second language courses (SLC). Yet, little empirical evidence exists on the promotion HL in SLC exist, and the HL debate ignored the plurilingual and pluricultural competencies defined in the Common European Framework of Reference for Languages. In the project SCURA, funded by the German Federal Ministry of Education and Research, we explored the role of HL in SLC and developed interventions to promote it. This study's purpose was to understand how HL is addressed in SLC, what teachers contribute and how first language and culture are used to promote HL.

Methods

In our multi-method study, we conducted a realist review of SLC (N = 13 interventions), document analyses of SLC teaching materials worldwide (N = 22) and of German textbook-series (N = 8*3), participant observation in two language courses (N = 100 hours), interviews (N = 15) and focus group discussion (N = 14) with German SLC teachers and an online survey (N = 25) among SLC teacher and triangulated our results.

Results

Four topics emerged: SLC material include various units on health stimulating HL development. Newcomers possess many assets (experiences, language and cultural skills) and show various strategies for using these assets to acquire new HL skills such as translanguaging, digital devices, social support. Teachers play a crucial role in promoting HL in informal conversations, by modelling and in developing interactive, asset-valuing HL-promoting activities.

Conclusions

HL interventions in SLC can draw from a wealth of assets and can be more promising by strengthening translanguaging and transculturing skills and providing discussion stimulating materials.

Key messages

Migrants’ health literacy practices are characterized by a unique use of translanguaging and transculturing. Second language teachers can promote migrants’ health literacy especially by facilitating learning opportunities that encourage them to use their assets.
Health policies and organization of services for the LGBT population: Literature review
Authors: Freitas C A M , Carvalho V N , Jesus N N , Bezerra M V R , Kochergin K N , Santos A M , Prado N M B L
Published: October 2020

Background

Historically, the fight for the right to health was one of the paths taken by many LGBT collectives, seeking recognition of their citizenship. However, the policy guidelines have been aligned with the Social determinants in health. In this article, we identify the scope of public health policies for the LGBT population in countries of the European continent, North America and Oceania in order to identify differences and similarities about the content and organization of care services and programs.

Methods

Literature review in scientific databases Science Direct, Web of Science e BVS. 24 articles constituted the corpus. This review followed the recommendations of PRISMA. The instrument proposed by the CASP was used to assess the methodological quality of the selected studies.

Results

Health systems in the countries analyzed, with the exception of the USA, although they have ideological and structural distinctions, were inspired by the Welfare State, broad social protection systems with which they reorganized societies into more egalitarian arrangements in correspondence to the social structure and dynamics of each country. The results reveal different scopes of health policies that influence the process of organizing actions and services in the US, Canada, Australia and the UK. The productions analyzed focused on the provision of specific health services such as population care in cases of HIV, cases of cancer, transgender health care during the transition process, mental health care, health promotion focusing on body weight, smoking cessation program and LGBT population aging Project.

Conclusions

Greater integration between research is proposed, with evaluations going beyond structural aspects, encompassing the comparison of care models and problematizing the qualification of care provided to the LGBT population, to promote services that are more inclusive and equally accessible to all.

Key messages

Contributing to the updating of knowledge, with information that can be implemented in the health care practice of the LGBT population. Give visibility to advances and vulnerabilities in different societal contexts, and contribute to policies and programs and the integration of human rights into public health programming.
The impact of forced displacement on the wellbeing of Syrian refugee children living in Jordan
Authors: Obaje H , Mackinnon S , Sichali J , Sijenyi S , McNatt Z
Published: October 2020

Introduction

The Syrian Civil War is one of the most significant humanitarian crises in modern times. Since 2011, over 5 million Syrians have fled the country in search of safety. Around 650,000 Syrian refugees are registered in Jordan, 48% of whom are children. The impact of forced displacement on children's wellbeing is poorly understood and requires further investigation.

Methods

This is a secondary analysis of a cross-sectional qualitative study consisting of 85 semi-structured interviews, conducted with Syrian refugees living in Jordan in 2017, to understand the impact of forced displacement on child refugees' wellbeing. A four-member research team developed a new Code Structure and analyzed the data thematically.

Results

Education, social integration, behavioral change and mental health, the effect of father's absence, and child marriage, were key areas of consideration. Children not being in school was found to play a big role in child wellbeing because many families had to choose between subsistence and education, with children required to work to earn money for their families. Many parents were afraid to let children out of the house other than for school, resulting in minimal social integration outside the school setting. Children's behavioral changes correlate with the father's absence, and girls were at higher risk of child marriage due to the living conditions of the families.

Conclusions

Education was a major priority for families, but some children were unable to attend school. A novel finding from this research is that many children faced limited social integration outside of school, significantly affecting wellbeing. Thus, providing school buses, prior English classes, as well as the provision of safe spaces where children can socially interact outside of school, needs to be prioritized. Financial difficulty also needs to be addressed so that children are not pushed into child marriage or made to work for their families' survival.

Key messages

Safe spaces that parents trust should be provided where children can socially interact outside the school setting. Financial difficulty needs to be addressed so that children are not forced to work for their families’ survival.
The 'Sick immigrant' and 'Healthy immigrant' phenomenon among Jews migrating from the USSR to Israel
Authors: Pinchas-Mizrachi R , Naparstek Y , Nirel R , Kukia E
Published: October 2020

The “healthy immigrant” phenomenon attributes health benefits to immigrants. We examined this phenomenon using the relationship between immigration and mortality, by income level, among Soviet immigrants to Israel in the 1990s, in comparison to veteran immigrants with similar genetic makeup.

A retrospective cohort study of mortality during 1996-2016 was conducted among 99,037 immigrants born during 1940-1955 in the USSR or Eastern Europe who immigrated during 1990-1995, compared to a control group of 119,150 Jews born during 1940-1955 who and/or whose parents were born in those same countries and immigrated by 1960.

After adjusting for gender, age, income and marital status, we found higher mortality rates among immigrants compared to non-immigrants for the total study population (adjusted hazard ratio (AHR) = 1.297, 99% confidence intervals (CI) = 1.248, 1.348) and among 27,563 men (AHR = 2.941, 99%CI = 2.704, 3.199) and 32,220 women (AHR = 1.756, 99%CI = 1.614, 1.909) with low incomes. The opposite relationship was found for 45,863 men (AHR = 0.714 ,99%CI = 0.635, 0.804) and for 24,852 women (AHR = 0.738 ,99%CI = 0.596, 0.913) with high incomes.

For the total study population, we found support for the “sick immigrant” phenomenon. However, both genders in the high-income subgroup, and women in the middle-income subgroup, demonstrated the “healthy immigrant” phenomenon. Decision makers in Israel should devote particular attention to immigrants from a low socioeconomic level. Our results emphasize the need for social stratification when examining the relationships between immigration and health outcomes.

Key messages

For the total study population, we found support for the “sick immigrant” phenomenon. However, both genders in the high-income subgroup, and women in the middle-income subgroup, demonstrated the “healthy immigrant” phenomenon.