bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaccines in support of globalisation: the current status of coronavirus and future implementation challenges
Authors: Pavlakis G 
Published: October 2020

Abstract
The key aspects to be discussed by this panelist are the role of vaccines in the support of globalization and the life style of global village, and the current status of coronavirus vaccines and future challenges of implementation.
The present pandemic made obvious to the general public the central role of vaccines in the support of modern lifestyle. It also revealed the possibility (or near certainty) of totally new pandemics, for which the world had ample warnings, with AIDS, Ebola, Zika, Lassa, Hendra, SARS, MERS, and many other emerging viruses threatening the world order. We entered a new era of pandemics as the last areas of the planet become members of the global village and due to climate change. Therefore, the world will go through a period of new threats that become more intense due several factors. These include the climate change, the dense co-habitation of large number of humans and their food, the rapid, cheap and universal travel, and the public health rules and traditions. Vaccines and immunotherapies are among the best and most cost-effective ways to address new and established epidemic threats.
Work on a safe and effective coronavirus vaccines progresses with unprecedented speed and substantial resources. Vaccines may be available in a year, and this time could be shortened if emergency approval of a safe but not fully tested vaccine is allowed. Production ability is expected to address the challenge of high demand, but the worrisome signals are that, even under the conditions of a spreading epidemic, a sector of the population is not convinced about the remedies, whether they are public health measures, or preventive vaccines. Addressing the reasons for the denial of scientific method and conclusions is a major priority for everybody involved in the fight of this and other epidemics. Scientific progress and implementation of the results is the only way forward.
Design epistemology as innovation in public health research
Authors: Estany A 
Published: October 2020

Abstract
The idea of design has reached our theories of epistemology: a field that, at first glance, seems to be quite far removed from the analysis of practical situations. However, we should bear in mind that epistemology has shifted from an a priori perspective to a naturalized one, in the sense that we cannot engage in epistemology without taking into account the empirical results of science when it comes to configuring methodological models. The objective is to explore just how far design epistemology (DE) can be adopted as a methodological framework for research in biomedical sciences and in some of their applications as public health. To this end, we will analyze different approaches to DE and related terms and expressions such as “design thinking”, “design theory” and “designedly ways of knowing”. One of the issues that we need to address is precisely the polysemy that exists in the field of design, related to many different concepts. Thus, it seems impossible not to engage in a certain amount of conceptual analysis before we can embark on the study of the role of DE in public health research. Another of the questions that we will consider here is where to place biomedical sciences within the field of academic knowledge and research. The disciplines involved in this field of research range from biology to medicine and also to the applications of these knowledges, as in the case of public health. We will examine some of the definitions provided by international organizations and we will locate public health within the framework of healthcare services and their organization. Finally, we will see how DE can offer proposals and solutions to the challenges that a phenomenon as complex as public health currently faces. That is, we will measure up DE proposals against public health research needs.
Knowledge of stroke and attitude to activate emergency medical services: a cross-sectional study
Authors: Carrossa E , Favaretto A , De Luca C , Boscaro G , Gregori D , Martinato M 
Published: October 2020

Abstract

Introduction
Acute brain stroke is one of the leading causes of death in the world. Translating knowledge of stroke warning signs into appropriate actions is critical to decrease prehospital delay, meaning that the population has a key role in reducing the hospitalization time of affected people.

Objectives
The aim is to understand in which percentage adults (318, without healthcare formation) would react properly by calling emergency medical services (EMS) when presented with hypothetical stroke-related scenarios and how the knowledge of warning signs is related to different factors.

Methods
a population-based online survey was carried out in a random sample of Italian adults in June-July 2019. The STAT (Stroke Action Test) questionnaire included 21 close-ended questions focused on stroke symptoms. The prevalence and distribution of stroke knowledge was examined.

Results
445 subjects were enrolled; the mean age was 36 years. The average score was 10,9/21, and only 21% had an optimal performance. Higher scores are associated with female gender and older age (p &lt; 0,01). When a situation described a single stroke sign, only the 15% recognized the importance to call EMS. The sign/symptom mainly recognized (57%) was “trouble speaking”.

Conclusions
this study provides data describing stroke knowledge among Italian adults; despite its limitations, the study shows that people hesitate to call EMS when stroke signs and symptoms are presented. The knowledge of stroke signs/symptoms remains lower than the heart attack ones. As expected, it would be 'useful to give proper information and training on stroke signs/symptoms' but also it is fundamental to emphasize that stroke is a medical emergency and needs a fast hospital admission.

Key messages
There is a lack of knowledge in stroke emergency shall raise community awareness about the need of education campaigns. It is important to improve stroke's signs and symptoms in order to have better prognosis.
The economic consequences of decriminalizing sex work in Washington, DC
Authors: Srsic A , Dubas-Jakóbczyk K , Kocot E 
Published: October 2020

Abstract

Background
Under repressive policies, sex workers are at disproportionate risk for violence, HIV, and sexually transmitted infections. The decriminalization of sex work between consenting adults provides increased social and health benefits to both sex workers and society at large. Proponents of decriminalization advocate for these added human rights; this is the first research that complements these arguments with a quantifiable economic impact of such a law and a model for future calculations. This research assesses the potential economic consequences of decriminalizing sex work in the District of Columbia (DC) in three areas: (1) income tax revenue, (2) criminal justice system savings, and (3) health sector savings (violence, HIV, gonorrhea, and herpes).

Methods
An economic model is developed and utilized based on a literature review and records from local and federal agencies.

Results
The decriminalization of sex work in DC will generate $5,191.61 per sex worker and $2.49 per client annually, plus an additional $20,118.17 in total criminal justice system savings a year. Per sex worker, $4,906.39 will be gained from income tax revenue, and $285.46 will be generated through health sector savings. Per client, decriminalization will generate $0.05, $2.28, and $0.16 from HIV, gonorrhea, and herpes respectively, or $8,311.67 annually after considering the total number of clients. Estimates are reported in 2019 US dollars.

Conclusions
The potential economic impact of decriminalizing sex work is widespread. In DC, this legislation should be implemented to not only promote the city's human rights but also economic growth. The presented model, in conjunction with a rights-based foundation, should urgently be used by advocates, sex workers, decision-makers, and other researchers.

Key messages
An economic analysis of a policy to decriminalize sex work in DC demonstrates its widespread economic impact across sectors. The economic model generated in this research should be utilized in other regions to strengthen human rights-based arguments in support of these policies.
Can the timing of hospitalization influence the outcomes of childbirth?
Authors: Kundisova L , Nante N , Bardelli S , Lorenzini C , Alaimo L 
Published: October 2020

Abstract

Background
The timing of hospitalization of pregnant females could influence the outcomes of both mother and the baby. The aim of this study was to analyze impact of coming to hospital too early on outcomes of childbirth.

Methods
A cross-sectional study was conducted in the birth center of Siena University hospital (Italy), all women that gave birth between 2017 and 2019 were included. Examined variables were: age, parity, gestational age: GA(weeks), Bishop score at admission: BS (0-13; &gt;9 high possibility of spontaneous delivery), time to delivery:TTD (min), labor duration:LD (min), n°of interventions (induction, amniorhexis, augmentation):NI, type of birth (vaginal/caesarean section: CS/operational birth: OB), laceration, episiotomy, hematic loss: HL (ml), skin to skin:StS and initiation of breastfeeding: BR (yes/no). The females that came too early were identified if TTD &gt;75° percentile. Analysis was performed with Stata 12.

Results
A total of 758 females were analyzed (32.0±5.2years), 55.5% multiparous, average GA was 39.6±1weeks, average BS was 7.2±2.5; 63% had BS &lt;9. Average TTD was 376.7±318.5min; 23% came too early (TTD 865.6±244), more likely primiparous (OR 3.9) and those with higher GA (OR 1.2). A negative correlation between BS and TTD was observed (Rho=-0.6), females with BS &lt;9 had higher probability to have prolonged TTD (OR10.8). Ninety-three% had vaginal birth, 6%CS, 1%OB Average LD was 169.1±145 min, average NI was 0.64±0.93, 78% had lacerations, 7.2% episiotomy. Average HL was 299.3±282.7ml. Females with prolonged TTD had higher NI (1.2 ±1 vs 0.4±0.6), higher probability of CS (OR 3), OB (OR4.5) and episiotomy (OR3.6), lower probability of StS and BR (OR 0.9), prolonged LD (299±184 vs. 120±102) and major HL (347.2±301.8 vs 284.9±275.4).

Conclusions
Our study showed an association between too early arrival to hospital and adverse maternal and fetal outcomes in terms of higher use of medical interventions that can interfere with physiological processes.

Key messages
The risk of arriving too early in hospital for labor was higher in primiparous and in those with higher gestational age. The too early arrival in hospital for labor was associated within increased use of medical interventions, interfering with physiological processes.
Monitoring knowledge translation and the impact of HI in European countries
Authors: Delnord M , Abboud L A , Van Oyen H 
Published: October 2020

Abstract

Background
National health information systems (NHIS) report on the health of populations, the determinants of health and service use within countries. Thus far, the evaluation of HIS has largely focused on data production, and less on their impact in policy and practice. This entails that there is no standardized framework for monitoring the uptake of Health Information (HI) in the healthcare system.

Methods
An international Delphi with public health professionals and policy makers allowed reaching agreement on criteria for monitoring the impact of NHIS, based on four domains: (a) Health information Evidence Quality, (b) HIS Responsiveness, (c) Stakeholder Engagement, and (d) Knowledge Integration. Next, we pretested the Index among participating countries in the European Joint Action on Health Information.

Results
Over 130 public health professionals and policy-makers from 38 countries participated in the Delphi. The panel reached agreement on 30 criteria to monitor the impact of HIS in policy and practice; these constitute the HI-Impact Index. Eight countries participated in pretesting the HI-Impact Index. InfAct country representative found the HIS evaluation tool user friendly and the time needed to fill the evaluation acceptable. They noted however the need to refine the auditing guidelines further as to who shall be responsible for conducting the evaluation (i.e. multistakeholder evaluation vs. single governing body), and which type of population health data sources should be included as part of the evaluation.

Conclusions
Knowledge translation facilitates the implementation of practices that will benefit population health and well-being. The HI-Impact Index addresses a growing demand for more transparency and accountability in the use of HI and scientific evidence within countries. Next steps consist in further piloting the HI-Impact Index for use in specific health areas (i.e. maternal and child health, cancer, antimicrobial resistance).
“Falling off the radar” – uninsured Chinese patients in Austria
Authors: Seidler Y , Novak-Zezula S , Trummer U 
Published: October 2020

Abstract

Background
Even in European welfare states with close to universal health coverage, undocumented migrants often fail to gain access to essential health services, falling “off the radar” of public health policies. Our study aimed to explore the characteristics, health problems and health care needs of undocumented Chinese migrants in Vienna, Austria.

Methods
We analysed anonymized medical records of 74 Chinese migrants utilizing the services of a non-governmental organization (NGO) providing primary care to uninsured people in Vienna during a three-month period. The medical data was then coded using the International Classification of Primary Care, 2nd version.

Results
At present, NGOs in Austria fill major gaps in access to health services that exist in the public system. The most frequently diagnosed health problems in the study sample were cardiovascular and metabolic-related diseases (hypertension and diabetes) and there was a high burden of multiple chronic non-communicable diseases.

Conclusions
NGOs can play a vital role in providing health services to underserved groups, and they can also contribute to public health surveillance and the collection of high-quality data.
The specialised health workforce matters: how to adapt the WHO National Health Workforce Accounts
Authors: Kuhlmann E , Ernst D , Jablonka A 
Published: October 2020

Abstract

Background
The importance of a sustainable health workforce is increasingly recognised. However, the specialised heath workforce remains marginal in health workforce planning, policy and research. This paper aims to improve the integration of small specialised professional groups in health workforce governance and to critically assess existing tools, using Germany and rheumatology physicians as a case study.

Methods
A qualitative explorative approach was applied, which draws on a scoping review of the literature, public statistics and expert information. The National Health Workforce Accounts (NHWA) and the WHO 'AAAQ' framework served as guidance to assess workforce development in rheumatology in Germany.

Results
On average physician density is high in Germany, yet access to specialised care may be seriously delayed and services may not be accessible to all patients; e.g. currently only half of the patients with spondyloarthritis are treated by a rheumatologist which impacts quality of care. An estimated 850 to 1000 additional rheumatologists are needed to ensure early diagnoses and treatment and prevent long-term health damage. However, shortage will even reinforce in future: annual inflow of newly registered rheumatologists over recent years did not exceed 30 to 50 physicians and young rheumatologists more often prefer part-time work.

Conclusions
Specialised health professions with small numbers and long duration of training face specific challenges to create a sustainable workforce. This calls for (1) greater investment in education and training, (2) greater attention to qualitative indicators, such as assess and prevention measurements like early diagnosis, and (3) a dynamic health workforce approach to respond to both new technologies/ treatments and changing preferences of the health professionals, like part-time work.

Key messages
Integrating the specialised health workforce in health workforce governance is important to improve prevention, quality and access to care. NHWA may be aligned to qualitative indicators and prevention policies to respond more effectively to future population needs.
Cervical cancer screening information flow in Northern regional administrative service in Portugal
Authors: Portela D , Cruz V , Monteiro H , Tavares F 
Published: October 2020

Abstract
Management of a population-based screening program circuit depends on characteristics and technical barriers of its application and implementation. The aim is to clarify the information flow, to understand and build a vision of cervical screening information flows in Northern Regional Health Administration Portuguese Public System and to identify the constraints among them. A total of 5 cluster meetings were presented and two expert interviews were conducted allowing to present an informational flow and its constraints. Aims addressed in each interview where based on the expertise of the interviewed. Cervical cancer screening program depends on the use of SiiMA application. This is an information system for the management of population-based screening program which involves mainly 3 entities and allows a longitudinal data collection and study. Three main constraints were reported. The time for updating data for the list of eligible women was bigger than accorded reaching up to 3 months delay. A duplicate of records and discharges in hospital care since the discharge was done both in the hospital system and the SiiMA platform manually in order to the woman re-enter the screening program. Pendencies were seen due to other screening programs running in parallel which had to be sorted out manually in the regional level or by the entity involved. The existence of a screening application is vital for the implementation purposes of a screening program. The lack of integration of the systems increases bureaucratic work, costs and causes time delay. To improve the efficiency of digital transformation ensuring the quality of the process it is necessary to adapt the design of the health informatic systems to the daily practice and its wants and needs. The strategies of forcing an ever-increasing number of frameworks have demonstrated not to be so effective. Therefore, it is a cornerstone to understand these flows in order to improve its structure, intervention and optimization.

Key messages
The existence of a screening digital application is vital but its expanding use arises constraints. Due to the complexity of such programs, a digital strategy is crucial for management and monitoring of the screening at this scale.
Underreporting of chronic kidney disease according to laboratory criteria of Brazilian adults
Authors: Carvalho Malta D , Kellen Alenkar L , Martins Dias de Andrade F , Santos de Magalhães Cardoso L , Malta dos Santos F , Gomes da Silva A , Junio Sady Prates E , Thalita Almeida Alves F , Eloha Machado I , Landman Szwarcwald C 
Published: October 2020

Abstract

Background
This is the first study in Brazil that evaluates the prevalence of low renal function in the Brazilian population and associated factors, using biochemical measures.

Methods
This is a cross-sectional household-based epidemiological survey, the National Health Survey (PNS), conducted in 2014 and 2015. The explanatory variables were: sociodemographic characteristics, lifestyles, chronic diseases, anthropometry. The prevalence of kidney filtration rate (KFR) &lt;60 ml / min / 1.73m2 was estimated, using Poisson regression to calculate the Prevalence Ratio Adjusted (RPaj) by age and gender.

Results
The prevalence of low renal function was 6.48% (95% CI 5.88-7.09). After adjusting remained associated: female (RPaj 1.4 CI (95% 1.16-1.68), age 45-59 years was RPaj = 7.3 (95% CI 3.8-14.1), 60 years or older RPaj = 33.6 (95% CI 17.8- 63.4), obesity RP 1.32 (95% CI 1.1-1.7), diabetes PR = 1.4 (95% CI 1.2-1.8), poor / very poor self-rated health PR = 1.5 (95% CI 1.2-1.9).

Conclusions
Renal function &lt;60 ml / min / 1.73m2 was higher in females, increased with age, was associated with obesity, diabetes and poorer health assessment. CKD through biochemical tests and risk and protection factors are essential to support public health policies.

Key messages
The prevalence with laboratory data was 4 times higher than self-reported studies, showing the underreporting of low renal function in Brazil population. The primary care team should request simple biochemical tests, such as creatinine, routinely in the target population, especially the elderly, for prevention and early management of kidney diseases.
Workplace violence in the health sector: An assessment of prevalence and pattern
Authors: Ogboghodo E O , Okojie O H 
Published: October 2020

Abstract

Background
Workplace violence has gained significant attention over the last few decades. Violence against health care workers is a complex and persistent occupational hazard facing the health profession and constitutes almost a quarter of all violence at work. This study was conducted to assess the prevalence and pattern of workplace violence among Healthcare workers in Tertiary Health facilities in Benin - City, Nigeria with a view to making recommendations that will enhance the safety of the healthcare workers and improve patient care.

Methods
A descriptive cross-sectional study was carried out among healthcare workers in tertiary healthcare facilities in Benin City. Benin City is the capital of Edo State, Nigeria. Edo State is in the South-South geo-political zone of Nigeria and is the country's central gateway to the North, East, and West. Respondents were selected using the stratified sampling technique. Data was collected using a pre-tested structured questionnaire adapted from the International Labour Organization/World Health Organization joint programme on workplace violence in the health sector confidential survey. Data analysis was carried out using IBM SPSS version 22.0 software. A p-value &lt;0.05 was considered statistically significant.

Results
A total of 386 healthcare workers, with a mean age (SD) of 33.9 ± 6.0 years and male: female ratio of 1:1.7 participated in the study. Physical, verbal, sexual and emotional violence were suffered by 285 (73.8%), 267 (69.2%), 133 (34.5%) and 104 (26.9%) respectively in the workplace. Overall, majority, 323 (83.7%) of respondents had experienced workplace violence. Being female, single and nursing profession were significantly associated with workplace violence (p &lt; 0.001).

Conclusions
The prevalence of workplace violence was high among the studied group. Interventions focusing on the fundamental role of prevention in effectively combating violence at work is recommended.

Key messages
Violence against health care workers is an occupational hazard facing the health profession and constitutes almost a quarter of all violence at work. Prevalence of workplace violence was high among the studied group. The most common pattern of workplace violence was physical violence.