bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tuning a UV-C device to challenge new threats in the sanitization setting of healthcare facilities
Authors: Amodeo D , Pallecchi L , Nagaia C , Spataro G , Cardaci R , Messina G 
Published: October 2020

Abstract

Background
Environmental hospital hygiene plays a role in healthcare-associated infections emergency caused by resistant multi-drug organisms. The implementation of new and effective disinfection procedures is now more than ever important to prevent the cross-transmission of pathogens in the hospital facilities. In combination with common chemicals biocides, UV technology is a realistic option for environmental disinfection. In this study, we evaluate a UV device for its effectiveness on an emerging pathogen.

Methods
A laboratory cross section experiment was performed between August and October 2019. Two different strains of Candida auris (CBS 10913 and CBS 12372) were tested on 20 cm2 stainless steel carriers inoculated with 10 µl of bacterial culture at a concentration of 1x105 CFU/mL. The inoculum was spread until dry in aseptic condition. Carriers were placed parallel to the UV device, having 4 UV-C lamps that emit 325 W, at a fixed distance of 2.44 m. Biocidal tests were carried out in triple at three different light exposure times (5, 10 and 20 minutes). After treatment, laboratories procedures were used to detach and transfer the remaining microorganisms from the carriers to plates and compared them to controls after incubation at 37 °C for 48 h.

Results
A significant inactivation of C. auris already occurred at 5 minutes, reaching 3-4 log10 reduction at 20 minutes of UV-C exposure. No substantial differences were identified by analyzing the results between the two strains.

Conclusions
The chosen distance of 2.44 m from the target allows to ideally sanitize an entire hospital room. However, to avoid the limit of shaded areas due to the presence of non-movable objects, a couple of positions are recommended, so that shorter distances can reduce the exposure time or increase the average irradiance level of exposed surfaces.

Key messages
In sanitation of hospital environments, the use of viable alternatives as UV-C can contribute to the reduction of infections caused by multidrug-resistant microorganisms. Accurate testing of different space-time irradiation configurations allows to achieve important results related to the biocidal effects of UV devices.
A new dedicated clinic for HCWs’ counseling and vaccination: experience of an academic hospital
Authors: Malacarne F , Brunelli L , Miceli S , Gallo T , Petrin G , Rosa I , Gubian F , Cocconi R , Brusaferro S 
Published: October 2020

Abstract

Issue
Despite low healthcare workers (HCWs) vaccination coverage being a risk for hospital outbreaks, vaccine hesitancy is not unusual among HCWs. In Italy vaccinations are strongly recommended for HCWs, but there are few occasions for a dedicated counseling. Aim of the study is to evaluate the effectiveness of a new vaccination service in the academic hospital of Udine (northern Italy) in tackling vaccine hesitancy among HCWs.

Description of the problem
Available data on HCWs specific antibody titers revealed that in high-risk units, 25% of HCWs were certainly unprotected for at least 1/6 of the vaccine preventable diseases (VPDs): measles, rubella, mumps, varicella, pertussis, hepatitis B; only varicella coverage reached the herd immunity target. Periodic occupational health visit was the only moment to screen for VPDs protection and suggest vaccination, but the following inconvenient procedure of HCWs contacting the vaccination office outside the hospital, often lead to delays or loss. In order to improve vaccination adherence, since June 2019 a dedicated clinic has been set up inside the hospital, making vaccination counseling and administration available every two weeks, with appointments directly given by the occupational doctor.

Results
From June 2019 to February 2020, a total of 362 appointments were booked for the dedicated vaccination clinic, 69.7% of which actually took place as 252 HCWs actually accessed the service. Hours dedicated to the service activity were 76 hours, distributed over 19 days. Administered vaccination were 322, including 107 MMR (measles, rubella, mumps), 4 MMRV (MMR+varicella), 20 varicella, 64 hepatitis B, 127 DTPa (diphtheria, tetanus, pertussis).

Lessons
Making the access to vaccination more convenient in term of service location within the hospital and giving the appointment when performing the occupational health visit seems to be helpful in filling the VPDs protection among HCWs gap.

Key messages
Monitoring immunological status of HCWs and promoting vaccination at occupational health visit would sustain herd immunity protection for susceptible individuals in healthcare settings. The dedicated hospital vaccination clinic and the effective procedure of giving the appointment during the occupational health visit could be helpful in improving HCWs vaccine adherence.
Stakeholder analysis in a policy game process in Tunisia
Authors: Oltean O , Coman M A , Sandu P , Essafi Kallel K , Ben Rejeb M , Ghorbel F , Eklund Karlsson L , Chereches R M , Zrig A , Plančíková D 
Published: October 2020

Abstract
This paper discusses the policy game methodology and design that will be used in a simulation that aims to assess and understand the public health policy making in Tunisia. The policy game aims to analyzes the interactions, alliances and networks formed by the institutions and stakeholders during a policy game intervention that will be organized in Tunis, in which policy makers, civil servants, researchers and practitioners will simulate the use of evidence in real life policy making. The simulation has been realized within the Erasmus+ CONFIDE project focused on enhancing transnational partnerships and building capacity to inform evidence-based policies in Tunisia. This capacity building project and policy game is built on the collaboration of four Tunisian universities, from Tunis, Sfax, Sousse and Monastir, and three universities from the European Union, from Romania, Denmark and Slovakia. The policy game will focus on the drafting and implementation of a national strategy for fighting the increase of drug consumption among the Tunisian youth, a phenomenon which is rather new in Tunisia and spreading rapidly. The policy game will be followed by an analysis aiming to explore the impact of the intervention in enhancing cross-sector collaboration and the use of local stakeholder network regarding drug policy making. The preliminary results showed that the stakeholders approached this problem in a collaborative way and were willing to up-take evidence-based measures in the creation of a national strategy to fight drug consumption. This exercise has also shown that the policy game can be an effective tool in enhancing the use of scientific arguments in policy making and encourage stakeholders to approach policy making in a cross-sector way.

Key messages
Policy game can be an effective tool in enhancing the use of scientific arguments in policy making and encourage stakeholders to approach policy making in an interdisciplinary way. Stakeholders approached this problem in a collaborative way and were willing to up-take evidence-based measures in the creation of a national strategy to fight drug consumption.
The NCCMT’s dynamic model for evidence-informed public health
Authors: Clark E , Neil-Sztramko S , Dobbins M 
Published: October 2020

Abstract

Issue
It is well accepted that public health decision makers should use the best available research evidence in their decision-making process. However, research evidence alone is insufficient to inform public health decision making.

Description of the problem
As new challenges to public health emerge, there can be a paucity of high quality research evidence to inform decisions on new topics. Public health decision makers must combine various sources of evidence with their public health expertise to make evidence-informed decisions. The National Collaborating Centre for Methods and Tools (NCCMT) has developed a model which combines research evidence with other critical sources of evidence that can help guide decision makers in evidence-informed decision making.

Results
The NCCMT's model for evidence-informed public health combines findings from research evidence with local data and context, community and political preferences and actions and evidence on available resources. The model has been widely used across Canada and worldwide, and has been integrated into many public health organizations' decision-making processes. The model is also used for teaching an evidence-informed public health approach in Masters of Public Health programs around the globe. The model provides a structured approach to integrating evidence from several critical sources into public health decision making. Use of the model helps ensure that important research, contextual and preference information is sought and incorporated.

Lessons
Next steps for the model include development of a tool to facilitate synthesis of evidence across all four domains. Although Indigenous knowledges are relevant for public health decision making and should be considered as part of a complete assessment the current model does not capture Indigenous knowledges.

Key messages
Decision making in public health requires integrating the best available evidence, including research findings, local data and context, community and political preferences and available resources. The NCCMT’s model for evidence-informed public health provides a structured approach to integrating evidence from several critical sources into public health decision making.
A training program to qualify people with intellectual disabilities for inclusive research
Authors: Grebe C , Voß M , Heitland L , Nadolny S , Latteck ÄD 
Published: October 2020

Abstract

Background
Inclusive research aims to involve people with intellectual disabilities (ID) with their views and values in all steps of the research process. But there is a lack of published training programs that address the qualification of people with ID for their roles as co-researchers.

Objectives
The aim was to develop a training program, based on constructivist didactics, in order to empower people with ID to act as initiators of health-related research, interviewers, data analysts and authors. In addition, the program aims to promote social self-organization and health literacy. The program consists of four steps: 1) Recruiting, relationship and team building; 2) Analysis of communication skills; 3) Choice of topic and formulation of a research question relevant to the lifeworld of the co- researchers 4) Exercises, carried out with an open, flexible approach, taking into account the individual biographies, knowledge, skills and interests of the team. Professional researchers moderate this process and promote the activation of knowledge and experiences. The whole process comprised weekly team meetings over a period of 7 months.

Results
The co-researchers were successfully empowered to deal with new kinds of demands and tasks. As of March 2020, the co- researchers selected pain as their topic and successfully formulated research questions, developed a guideline for semi-structured interviews and acquired essential interviewing skills. Data collection and analysis are still pending.

Conclusions
The implemented inclusive research approach pursued here, offers opportunities for generating research findings that are more relevant for the target group and their lifeworld. Consequently, professionals can better address the needs of their clients and develop tailored interventions. For the involved co-researchers with ID the training program seems to be successful in empowering them in decision-making and in reflecting on their own and other's health-related needs.

Key messages
People with intellectual disabilities can successfully be qualified as co-researchers with a 7-months weekly training program. The training program helps the co-researchers in reflecting on their own and other’s health-related needs.
Social network characteristics are associated with depressive symptoms: The Maastricht Study
Authors: Gianfredi V , Schaper N C , Eussen S J P M , Odone A , Signorelli C , Dukers N , Koster A , Stehouwer C D A , Wasselius A , Schram M T 
Published: October 2020

Abstract

Background
Previous studies suggested that social network characteristics are associated with depression. However, most of the previous studies investigated social network characteristics in isolation. We assessed the association of both structural and functional social network characteristics with prevalent and incident depressive symptoms over 5 years of follow-up.

Methods
We used data from 2,465 participants (49.1% women, mean age 59.8± 8.1 years) of The Maastricht Study, a population-based prospective cohort study. Social network characteristics were assessed through a name generator questionnaire. Depressive symptoms (9-item Patient Health Questionnaire score ≥10) were assessed at baseline and annually over 5 years. We used multivariate logistic regression and Cox regression analyses adjusted for socio-demographic characteristics, lifestyle and cardiovascular risk factors.

Results
Less emotional (odds ratio (OR) (95% confidence interval (CI)):1.19; 1.01-1.40) and informational support (OR (95%CI): 1.20 (1.04-1.39), and every fewer 10% of family members (OR(95%CI) 1.11 (1.01-1.23) were associated with prevalent clinically relevant depressive symptoms. Less emotional support (hazard ratio: 1.13; 95%CI: 1.03-1.25) was associated with incident clinically relevant depressive symptoms.

Conclusions
This study observed associations between poor social network characteristics with higher odds of depressive symptoms. In particular, less emotional support was associated with both prevalent and incident depressive symptoms.

Key messages
Poor social network characteristics were associated prevalent depressive symptoms. Less social support was associated with a higher risk of depressive symptoms.
Developing the health examination protocol for asylum seekers in Finland: project results
Authors: Skogberg N , Garoff F , Ahmed Haji Omar A , Koponen P , Klemettilä K-L , Castaneda A E 
Published: October 2020

Abstract

Issue
Initial health assessment is crucial for identification of healthcare needs and screening of acute health problems among new asylum seekers. As in other countries, practices across reception centres in Finland varied and health data was inconsistently recorded, making systematic monitoring through the electronic health record system (EHR) challenging.

Description of the issue
The main objectives of the national Developing the health examination protocol for asylum seekers in Finland project (TERTTU, 2017-2019) were to unify practices across reception centres through development of health assessment content and the quality of EHR recordings. The project consisted of three phases: 1) baseline evaluation; 2) conduct of a population-based health examination survey among asylum seeking adults and children; 3) development work guided by findings of stages 1 and 2, supplemented with thematic qualitative interviews with end-users (reception centre nurses, asylum seekers and authorities supervising services).

Results
The project exceeded expectations. Altogether 1087 adults and children participated in the survey (participation rate 76 %). Survey findings were published in a national report, providing the main evidence-base for development work. This was complemented by thematic interviews with 15 reception centre nurses, 19 asylum seekers and 3 authority representatives. Health assessment protocol was piloted and further developed based on feedback from end-users and transferred into the reception centres EHR. A handbook for the health assessment was published, supported with educational short videos.

Lessons
Successful implementation required close collaboration with authorities responsible for providing services for asylum seekers and involvement of end users at all stages. Results of this project benefit all other countries receiving asylum seekers. The study protocol is available in English, Somali, Kurdish (Sorani), Dari, Arabic, Russian, French and Finnish.

Key messages
The initial health assessment protocol for asylum seekers and supporting materials developed in the TERTTU project benefits all receiving countries. Systematic recording of health data was also developed, which will be used for planning health system response according to the health care needs of new asylum seekers.
Strengthening Child-centred Health Systems response: what happens with migrant children?
Authors: Gil-Salmerón A , Garcés-Ferrer J 
Published: October 2020

Abstract
Migrant children are especially vulnerable to the challenges experienced during the migratory process and its integration in the host country, even more, if they are unaccompanied. Child-centred Health Systems responses are needed, for that reason, the Erasmsus+ project EUVETCARE aims to strengthen the capacity of the professionals and systems to meet the specific needs of this population.
A qualitative study allowed a needs assessment of the health and social care professionals in 5 EU countries (Cyprus, Germany, Greece, Italy and Spain). A total of 15 focus groups were carried out (99 participants). Focus groups discussions were transcribed verbatim in local languages and transcripts were analyzed using thematic analysis. Moreover, a literature review informed about the current learning opportunities for professionals in the European context regarding migrant children.
Focus groups discussions highlighted some general needs for all professionals such as communicative skills with migrant children and their families as well as cultural competence to deal with these cases. Moreover, participants stressed the need to deal with this population with low levels of health literacy too. Finally, strategies to provide integrated care and meet the major needs of these children were needed. Unaccompanied minors were highlighted as a vulnerable group by participants. In addition, the literature review revealed some gaps in the learning guidelines offer across Europe.
Future training for professionals should stress the specific gaps in order to don't replicate existing materials. Furthermore, professionals' voices should be taken into account in the design of these new training to directly answer to their professional needs. Additionally, the needs of migrant children have to be differentiated and appropriated culturally-competent care delivered in order to minimize health inequalities for this group.

Key messages
Training of healthcare professionals should target culturally-competent case management strategies for minor migrants. The delivery of health care for minor migrants requires major intensity from the health care services.
Contextual housing environment and mental health of asylum seekers – a multi-level analysis
Authors: Mohsenpour A , Biddle L , Bozorgmehr K 
Published: October 2020

Abstract

Background
Housing is an important determinant of health among asylum seekers and refugees (ASR). Little is known about the effects of contextual housing environment. We used state-wide reliable and valid data to examine these effects on ASR mental health.

Methods
We drew a balanced random sample of 58 shared refugee accommodation centers (SRA) from 1938 centres with 70,634 ASR in Germany's 3rd largest federal state. We measured depression (PHQ2) and anxiety (GAD2) using established instruments in nine languages. We assessed physical housing environment with a validated multi-dimensional Small-area Housing Environment Deterioration index (SHED). Linking survey- and SHED-data to GIS- and secondary data sources on accommodation size and remoteness, district urbanity and deprivation, we used multi-level logistic regression to calculate exposure effects and 95 % confidence intervals (CI), while adjusting for age, sex, relocations and chronic illness.

Results
Of 412 ASR living in 58 SRA, 45.0% of inhabitants and 35.7% of SRA were rated as having a high/very high degree of deterioration. The odds for reporting symptoms of generalized anxiety increased for the highest degree of deterioration (1.30; 0.37-4.55), large accommodation size (1.01; 1.00-1.03), remoteness (1.63; 0.61 - 4.36), district urbanity (1.67; 0.66-4.20) and deprivation (1.33; 0.60-2.92). The odds of depression symptoms increased in SRA with highest deterioration (1.98; 0.74-5.33) and accommodation remoteness (1.10; 0.48-2.52), decreased in SRA with district urbanity (0.63; 0.31-1.28) and district deprivation (0.66; 0.36-1.23) but not large accommodation size (1.00; 0.99-1.02).

Conclusions
Almost half of ASR are living in SRA with high/very high degree of deterioration. There is a general tendency of higher odds for mental illness symptoms conditional on housing environment. Future analyses with sample size calculations are needed to better understand these health associations for shared refugee accommodation.

Key messages
We described contextual housing environment, i.e. degree of deterioration, accommodation size, remoteness, urbanity and deprivation, of a balanced random sample of 58 shared refugee accommodations. In multi-level logistic regression, contextual housing environment tends to be associated with higher odds for reporting symptoms of mental illness.
Enhancing partnerships and collaboration in times of change
Authors: Clark E , Neil-Sztramko S , Dobbins M 
Published: October 2020

Abstract

Issue
In 2019, the government of the Canadian province of Ontario announced major changes to the structure, governance and funding of public health services. Throughout these changes, publicly funded local and regional public health organizations are still expected to provide effective, evidence-informed programming to their communities. The National Collaborating Centre for Methods and Tools (NCCMT) has facilitated collaborations to support Ontario public health through this transition.

Description of the problem
In order to support evidence-informed public health in Ontario during this transition, the NCCMT reached out to current and potential partners, within and beyond the public health sector for a multidisciplinary approach. We conducted a needs assessment for an evidence review repository, which would allow public health practitioners to share and build upon each other's work. Finally, demonstrating the value of public health to policymakers can be inherently challenging as the return on investment in public health is often very long term. We partnered with health units in varying capacities to find and synthesize evidence to advocate for continued investment in public health.

Results
This initiative has provided important lessons in developing and maintaining strong partnerships. Looking beyond the public health sector can establish mutually beneficial partners and allies in other disciplines. A key finding was the need to establish infrastructure to support collaboration and resource sharing. Finally, we learned that big picture questions like demonstrating the value of public health require many different perspectives, inputs and areas of expertise.

Lessons
Through this initiative, we have developed a multidisciplinary, collaborative approach to supporting evidence-informed public health through times of major restructuring. This approach can be applied to future changes to public health on smaller or larger scales, or within other geographic regions.

Key messages
Multidisciplinary approaches can support collaboration, unity and advocacy in times of change. Establishing infrastructure to support collaboration and sharing of resources is valuable.