bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enabling self-direction in return to work of workers with high and low levels of education
Authors: Hoefsmit N , Pennings B , Houkes I 
Published: October 2020

Abstract

Background
Dutch legislation stimulates active participation of employees in their return-to-work (RTW) process. Earlier research showed that employees, particularly with low levels of education, are not always able to self-direct RTW. Empowering leadership may support this process. This study answers two research questions: (1) What differences and similarities do employers of employees with low versus high levels of education show in their management of RTW? (2) To what degree do the roles of employers in both types of organizations resemble empowering leadership?

Methods
We performed semi-structured, in-depth interviews with 10 HR professionals and supervisors working at a Dutch university. We also analysed transcripts from a study in which 13 HR professionals and supervisors from multiple Dutch industries (employing workers with low levels of education) were interviewed. We used purposive sampling to recruit participants. For question 1, the transcripts were analysed thematically. For question 2, pattern matching was applied.

Results
Preliminary results indicate that supervisors of both types of employees, show several similarities in managing RTW, such as the focus on possibilities instead of impossibilities, asking the advice of the occupational physician, and seeking support to increase employability. We also found that supervisors of employees with low levels of education have a stronger tendency to control and steer RTW and feel that possibilities for RTW are limited, while supervisors of high-educated employees tend to engage in dialogue more often and search for possibilities for work adjustments. Empowering leadership seems to be less common among supervisors of employees with low levels of education.

Conclusions
This study will benefit employers (of workers with both low and high levels of education) who aim to enable employees' self-direction in RTW, and help supervisors to develop more empowering leadership styles. This may lead to more sustainable RTW.

Key messages
Supervisors of employees with lower levels of education have a strong tendency to control and steer their employees’ return-to-work. Enabling employees’ self-direction in return-to-work requires empowering leadership.
Factors associated with psychoactive substance use among truck drivers
Authors: Abreu A , Costa R , Portela I , Jomar Rafael , Sousa A I , Souza M H 
Published: October 2020

Abstract

Introduction
The World Health Organization's report shows a growing concern about drug use and road safety worlwide.

Objectives
To identify sociodemographic, health and occupational characteristics associated with use of psychoactive substances among truck drivers.

Methods
This is a cross-sectional study conducted with 354 drivers from January to June, 2016. Data collection was based on a multidimensional questionnaire that included the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST-WHO) and the Self Reporting Questionnaire (SRQ-20) instruments. The hierarchical approach was adopted for odds ratio (OR) adjustment. The variables that showed statistical significance with p ≤ 0.10 in the bivariate analyzes were selected for the multiple logistic regression analysis performed in the IBM SPSS software (v.19.0).

Results
The use of psychoactive substances in the last three months was associated to low family per capita income (OR, 2.59; 95%CI, 1.23-5.47) and poor self-reported health (1.96; 1.16-3.32), self-reported insomnia (2.9; 1.73-4.87), Common Mental Disorders (3.05; 1.62-5.75) and illness-related absenteeism (1,70; 1.02-2.85). Regarding work characteristics, the use of psychoactive substances in the last three months was observed among those with less than 15 years of work (1.78; 1.07-2.94), daily work journey longer than 6h/day (2.83; 1.69-4.74) and with less than 6 hours of daily rest (1.88; 1.12-3.14).

Conclusions
The results showed worrying vulnerability factors associated with the use of psychoactive substances among truck drivers in Brazil.

Key messages
The survey of 354 truck drivers described the vulnerability and risk factors, which are exposed, as inadequate work conditions associated with the use of psychoactive substances. It showed a greater chance of at least the use of one of the substances (alcohol, cocaine, amphetamine), among truck drivers and the importance in the development of public policies for this worker.
Home and Leisure Accidents in children and young people from 0 to 19 years old in Portugal 2018
Authors: Alves T , Rodrigues E , Mexia R , Neto M , Matias-Dias C 
Published: October 2020

Abstract

Background
Injuries and accidents are a challenge for public health considering their impact on victims and their families, especially in the younger, and also the potential for prevention and predictability. Due to specific characteristics of children and young persons related to the need of exploration and curiosity injuries namely those occur in domestic and leisure time, including the school setting are a topic of particular interest and study. This study aimed to characterize the occurrence of Home and Leisure Accidents (HLA) using hospital Emergency Department (ED) registered in EVITA system, in victims between 0 and 19 years old considering the injury mechanism, place of occurrence and products involved in the accident, in 2018, in Portugal.

Methods
Were analysed data from the EVITA system, fed by the HLA registry at the ED of the Hospitals National Health that participate in this system. The frequency and distribution of HLA were analysed according to the injury mechanism, place of occurrence and products involved.

Results and Discussion
In 2018, there were 38 528 ED attendances due to HLA 35,0% of the victims were between 10-14 years old; 23,7% had 5-9 years; 22,8% between 15 and 19 years old and 18,5% had under 4 years old. The results show more frequently HLA in males (59,0%) than in females (41,0%). In children under 4 years old 67,8% of the HLA occurred at home, due to fall (68,6%), having as products most involved the bed (10,2%) and chair or bench (7,5%). Between 5 and 9 years old, most HLA occurred at school (44,5%) due to fall (62,9%), involving ball (15,1%) and scooter/tricycle/bike (6,8%). In young people between 10 and 19 years old 47,7% of HLA occurred at school, due to fall (54,6%), having as main agents involved ball (28,7%) and scooter/tricycle/bike (20,3%). This information reinforces the importance of this problem but it is necessary future lines of research in order to point out the determinants of this mechanisms of injury.

Key messages
The National Injury Surveillance System provides information that allows to know the characteristics and underlying causes of HLA that occur in children and young people. These data provide useful information for public health professionals working in the field of injury prevention among this vulnerable group of young people.
Occupational exposure in acute-care hospitals, can we ensure equity in treatment?
Authors: Antinolfi F , Brunelli L , Malacarne F , Cocconi R , Brusaferro S 
Published: October 2020

Abstract

Background
Healthcare workers (HCWs) occupational exposure to vaccine-preventable diseases (VPDs) is a great challenge, especially for the risk of disease transmission to patients and general population. Our aim was to explore HCWs occupational exposure management within Friuli Venezia-Giulia (FVG) Region (Italy) in order to identify the most appropriate and equal strategies.

Methods
In December 2019 we collected data from the 7 acute-care hospitals of FVG. Total number of employees, methods to investigate on potential exposure to VPDs, immunity assumptions and management of occupational exposure were investigated.

Results
We obtained data from all FVG hospitals, for a total of 14,002 employees (average 2,000; range 551-4,336), including 12,557 HCWs (average 1,794; range 467-3,922). Four hospitals also include students, being academic centers (2) or research institutions (2). All hospitals conduct potential exposure investigation among HCWs, including patients, caregivers, visitors, non-HCW employees, but students are considered in 6/7 hospitals. Immunity of exposed subjects is assumed based on vaccination evidence or serological positivity. Exclusion from work is prescribed to exposed susceptible HCWs in 5/7 hospitals, while workers re-allocation to lower risk wards is required in 4 hospitals; in 2 cases HWCs are asked to wear a mask during their shift. When appropriate, 2 hospitals administer immunoglobulin, whereas a specific procedure for susceptible HCWs exposure was not always available. In 6 cases the exposure of non-HCWs subjects is notified to the occupational doctor or worker manager, and in 1 case serological positivity is directly tested.

Conclusions
There is heterogeneity in the management of VPDs occupational exposure within FVG, in particular regarding the surveyed categories and the actions required to the exposed subjects. The evaluation of potential adverse outcomes on patients would contribute in designing a more effective preventive strategy.

Key messages
The adoption of different strategies in the HCWs occupational exposure management could result in potential treatment inequality. Exploring occupational exposure management strategies adopted in hospitals is fundamental to standardize practices.
Directive 2019/904/EU. The need to raise awareness on plastic misuse and consequences on health
Authors: Aristei L , Villani L , Ricciardi W 
Published: October 2020

Abstract
The EU Directive 5 June 2019, n. 904, aims to promote sustainable reusable products and systems in a circular perspective, reducing the production of disposable products and waste.
Abandoned plastics take decades to disintegrate, never disappearing completely from the environment, with serious consequences for human health. A study conducted by the European Food Safety Authority (EFSA) has found that pollutants such as polychlorinated biphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs) or bisphenol A (BPA) can accumulate in microplastics, which are swallowed by humans as well as inhaled or ingested reaching lungs. For instance, it has been estimated that every week we ingest the same amount of microplastics as a credit card. Furthermore, plastic kills and damages biodiversity. Aquatic animals are the most affected, as they are either trapped in man-made plastic waste or they swallow plastics with serious damage to their and the humans' health that eat them. Dangerous are also nanoplastics that can penetrate cell walls and are chemically more reactive.
However, Directive 2019/904/EU does not eliminate the use of plastic, setting the percentages of recycled plastics to be used in the manufacture of disposable plastic products. For instance, beverage PET bottles must contain at least 25% of recycled plastic from 2025 and 30% from 2030.
Despite the Directive has provided elements for states to legislate in favour of a society that makes less use of plastics, today no zero- plastic society has been created. In order to achieve this 'zero' it is necessary to start from the citizens, raising their awareness through awareness-raising campaigns and the distribution of leaflets and posters on the consequences of the mismanagement of plastic waste (and microplastics) on their health and on the environment.

Key messages
Raise citizens awareness on the consequences of the mismanagement of plastic waste (and microplastics) on their health and on the environment is fundamental. The importance of the creation of a zero plastic society thanks to the application of Directive 2019/904/EU at international level.
The Tunisian societal dialogue for health reform (a qualitative study)
Authors: Ben Mesmia H , Chtioui R , Ben Rejeb M 
Published: October 2020

Abstract

Background
Tunisia is currently through its second phase of the Societal Dialogue for Health System Reform to develop a National Health Policy 2030. By contributing to the documentation of this process this work will allow the different partners to have an overview of its place in health planning as well as the success factors and the challenges of the model in relation to international norms and experiences.

Methods
This work was based on a qualitative analysis of semi-structured interviews with citizen juries and experts that took place from May 2018 to September 2018. The qualitative analysis was done according to a cross-matrix between the themes of the interview of the two groups of interviewees. The analysis of the data was mixed: a coding of the data collected was done beforehand. However this frame has been adjusted according to the transcriptions.

Results
The qualitative analysis of the data highlighted four axes: the context of initiation of the societal dialogue and the passage from the claim to the political instrumentalization, the citizen participation and the role of the various actors, the mixed perception of the societal dialogue and the crisis of trust, the methodology of the social dialogue process, especially the 'Citizen Jury' method. The main factors of success of the societal dialogue are the commitment of the actors, the political will, the inclusivity and the multidisciplinarity of the process and finally the communication around the process. The main challenges are the non-ownership of the process by the policies and the different stakeholders as well as the doubt about the achievement of these results.

Conclusions
It is important to introduce regular citizen and societal consultation so that it can credibly feed into policy review processes and inform policy makers on a regular basis. It would be important to think of a model for the sustainability of this approach. This involves finding the necessary financial and operational means.

Key messages
The promotion of citizen's participation in health is crucial in the new Tunisian democratic experience. A legal framework is needed to ensure the sustainability of the new approach of citizen's participation in health.
A single-payer health care system in Croatia: problem or solution?
Authors: Kujundžić Tiljak M , Orešković S , Tiljak H 
Published: October 2020

Abstract

Background
Andrija Štampar implemented innovative healthcare solutions in Croatia at the beginning of the 20th century, advocating principles of comprehensiveness, continuity, and availability. These principles are globally challenged at ideological, social and policy levels, reflecting discussions in the USA and EU on whether a single-payer, mandatory health insurance (MHI) system and universal health coverage (UHC) are optimal solutions for the sustainable health system of the 21st century?

Methods
Analyzing the impact of the Croatian Health Insurance Fund (CHIF) as a single-payer on the performance of Croatia's health care system through the analysis of the financial and health outcomes for the 2000-2020 period to assess allocative efficiency, organizational effectiveness, and economic sustainability.

Results
The CHIF is the single purchaser of all publicly financed individual health services, delivered through both public and private providers. Although the broad scope of the MHI scheme, patients must pay towards the costs of many goods and services, and the right to free health care services has been systematically reduced in the last twenty years. The financial sustainability of the system is decreasing mainly caused by the model focusing on the tertiary care and payment scheme based on monthly hospital limits. However, the incidence of catastrophic and impoverishing payments is lower in Croatia than in many other EU13 countries.

Conclusions
The solution might be in the development of integrated health services, implementation of health promotion, education, and awareness, diseases prevention, and focus on the outcomes. The funding should follow the population needs in accordance with public health priorities and not only the structural demand of the existing system. The alternative is to face additional financial burden and impoverishment of the population in need of healthcare services.

Key messages
Modern universal health coverage strives to integrate health care and focuses on the outcomes. Single-payer system is not an obstacle for integration or source of fragmentation.
Vaccination attitude assessment among attendees the birthing preparation course: a pre-post study
Authors: Di Pilla A , Bruno S , Carini E , Beccia V , Quaranta G , La Milia D , Masini L , Carducci B , Lanzone A , Laurenti P 
Published: October 2020

Abstract

Background
Vaccinations are among the most effective and safe ways to prevent the spreading and the complications of infectious diseases. In order to reduce risks and to protect children from the early beginning of their life, most vaccinations are recommended within the 15th month of life. In Italy, the law provides 10 compulsory vaccinations to the 0-16 age group. A training program was carried on by a Public Health specialist during the birthing preparation course, aimed at increasing the attitude to vaccination in maternal-child age.

Methods
A training session in the birthing preparation course was specifically carried out to raise awareness about vaccination during both pregnancy and puerperium and in early childhood; a questionnaire on vaccination awareness was administered before and after the training session.

Results
Out of 119 pregnant women attended the birthing preparation course from October 2019 to January 2020. As a result of the interventions, the percentage of the participants who consider the preparatory course a useful tool to obtain information about vaccines increases significantly from 30.34% pre-intervention to 64.56% post-intervention (p &lt; 0.001). There is a significant increase in the mean number of vaccinations that the participants want their children to get, out of the 12 vaccinations proposed in the questionnaire: 9.68/12 pre-intervention versus 10.57/12 post-intervention (p = 0.021). Participants supporting the mandatory vaccinations are 96.04% pre-intervention and rise to 98.73% post-intervention.

Conclusions
Attitude and knowledge related to vaccination are crucial values for maternal-child health: they significantly increased after a training session dedicated to vaccination as a part of the pregnant pre-birth course, whose aim can be therefore extended to the management of the health of the child, well beyond the period of pregnancy, labor and childbirth, according the life-course approach to health, from the Public Health perspective.

Key messages
The childbirth preparation courses for pregnant should be valuable as a precious opportunity to raise parents’ awareness and their attitude to vaccinations, if dedicated sessions are included in them. The mandatory nature of vaccines is very well received by pregnant women.
Prevalence of second-hand smoke exposure in houses in Turkey: a meta-analysis study
Authors: Kılınç A , Çam C , Önsüz M F , Metintaş S 
Published: October 2020

Abstract

Background
Second hand smoke(SHS) exposure means breathing the air polluted by someone else's cigarette smoke. The aim of the study was to perform a meta-analysis of studies about the in-house second hand smoke exposure prevalence in Turkey.

Methods
PubMed, Web of Science, Turkey Citation Index, TR Index and the Cochrane library databases in the screening of articles published in Turkish and English languages “second hand smoke”, “prevalence” and “Turkey” keywords were used. Studies who were original, were cross-sectional, had the number of participants and the number of people exposed to in-house SHS, used age groups and were conducted in Turkey were in accordance with our inclusion criteria thus included in the study. Global tobacco surveys and studies using data from them were also included. OpenMeta[Analyst] program was used to calculate the prevalence rate of the study groups. Since the articles were p &lt; 0.001 in the heterogeneity test, prevalence rate and 95% confidence intervals were calculated from the number of cases using the random effects model in group analysis.

Results
As a result of the scan, 59 articles were reached. Duplications were eliminated and summaries of the remaining articles were read as double-blind. Suitable for inclusion criteria and quality evaluation 11 studies were included in the meta analysis. Among them, 7 studies were conducted on people who are younger than 15 years. The meta analysis showed that the SHS exposure for those aged 15 and above was 12 097/30 138 (39.3%; 95% CI: 25.9-52.8) and for those younger than 15 was 57 028/112 547 (55.9%; 95% CI: 42.4-69.4).

Conclusions
As a result of the comprehensive literature research, it was found that the SHS exposure in houses is a huge problem for Turkey especially for the young people.

Key messages
The exposure to second-hand smoking in houses puts both youth and adult population’s health at risk in Turkey. Intervention programs should be commenced to tackle high exposure rates and in-house smoking.
2019-20 influenza coverage among healthcare workers: how a Northern-Italian Region tackles hesitancy
Authors: Antinolfi F , Brunelli L , Malacarne F , Bucci F G , Varadi G , Gallo T , Cocconi R , Brusaferro S 
Published: October 2020

Abstract

Introduction
WHO stresses the need to implement multi-component interventions to raise coverage among healthcare workers (HCWs). We investigated different HCWs influenza immunization programs within Friuli Venezia Giulia (FVG) Region hospitals (Italy) during 2019-20 flu season with the aim of identifying the most effective strategies to tackle hesitancy.

Methods
In December 2019 we collected from FVG hospitals: number of employed HCWs, vaccination strategies against flu and refusers management during 2019-20 flu season. We obtained data about HCWs flu vaccination coverage from the regional database; Chi-square test was used to find correlation between strategies and coverage.

Results
We collected data from 7/7 hospitals for a total of employed HCWs of 12,557 (average 1,794; range 467-3,922); 2 hospitals being academic centers and 2 research institutions. All hospitals promoted flu vaccination using emails, notice on hospital website and posters display; 3/7 organized training courses. Vaccination was always provided within the hospital in a dedicated easy and free access room; most hospitals (5/7) also offered ward on-site sessions, some allowing ward self-administration (3/7) or organizing on demand extra-sessions (2/7). No countermeasures were taken in case of refusal. Regional HCWs flu vaccination coverage resulted to be 24.9% (range 17-33.3). Multi-component intervention including passive and active offer, communication and education activities was confirmed to be significantly associated with higher HCWs flu coverage (OR 1.7; CI 1.6-1.9; p &lt; 0.01), as well as being the hospital an academic center or a research institution (OR 1.3; CI 1.2-1.5; p &lt; 0.01).

Conclusions
Different strategies to foster HCWs vaccination were adopted in FVG Region during 2019-20 flu season. The multi-component approach producing the best results should be further analyzed in order to identify the most effective recipe to be shared both nationally and internationally.

Key messages
Investigating the relation between HCWs flu immunization strategies and their effect is crucial to identify best practices. A multi-component approach including passive and active offer, communication and education activities seems the most effective way to tackle influenza vaccine hesitancy among HCWs.