bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applying “Acting Within Contexts” to intervention evaluation and equitable intervention design
Authors: Adam C 
Published: October 2020

Abstract
With the rise of chronic illness in the last century, notably diabetes, cardiovascular disease, and obesity, public health has worked to identify the causes of these diseases in order to develop effective interventions and improve population health. Research has shown that these chronic diseases are strongly linked to lifestyle-related risk factors such as smoking, poor eating habits, and physical inactivity. Based on this knowledge, public health interventions have focused on health information and education programs that target these lifestyle-related risk factors. However, these programs have been found to be ineffective because these lifestyle-related strategies do not take into account the contexts that influence behaviour change. This has been found to be particularly true for vulnerable populations who tend to live in contexts of poverty. We therefore asked: how do contexts of vulnerability influence the way people act in their daily lives? To address this question, findings from a qualitative project led to the development of the “Acting Within Contexts” framework. It is a system of five interrelated components (i.e. agency, resources, capacities, threats, and opportunities), which offers an analytical lens to better understand the influence of vulnerable contexts on how people carry out their daily actions.
This presentation will first propose an explanation of the limits of public health interventions that aim to change behaviours. Secondly, based on the two previous presentations, it will present how “Acting Within Contexts” can be used: 1) to develop a better understanding of contexts in which vulnerable populations live, based on how the five components interact in people's lives to either hinder or facilitate their access to health; and 2) to design interventions that will shift the focus away from lifestyle-related risk factors, and rather, towards targeting the five components that make up people's everyday contexts.
Immunization programs for hospital healthcare workers in Northern-Italy, can we do more?
Authors: Antinolfi F , Brunelli L , Malacarne F , Cocconi R , Brusaferro S 
Published: October 2020

Abstract

Background
Coverage for vaccine-preventable diseases (VPDs) among healthcare workers (HCWs) in Italy remains low, and WHO strongly recommends to tailor immunization programs to tackle hesitancy. Aim of the study was to investigate HCW-specific immunization programs within Friuli Venezia Giulia (FVG) Region in order to plan new common strategies.

Methods
In December 2019 we collected information about FVG hospitals and HCWs immunization programs conducted within each of them, including: number of HCWs employed, monitored VPDs, immunization assumption, vaccination strategies and refusers management.

Results
We obtained data from 7/7 hospitals, for a total of 12,557 employed HCWs (average 1,794; range 467-3,922); 2 hospitals are academic centers, while 2 are research institutions. All hospitals have immunization programs for measles, mumps, rubella; the majority for hepatitis B (6/7); 5 for diphtheria, tetanus, pertussis, chicken pox. Presumptive evidence of immunity is established when written vaccination documentation is available or in presence of laboratory evidence. HCWs immunization programs are responsibility of the occupational doctor in most hospitals (6/7). Vaccination promotion strategies include: mail or email personal invitation, training courses, video and notice display on hospital website, reminders. Most hospitals set up a dedicated vaccination service located in a hospital common area (4) or outside the hospital (2); one hospital also offered ward on-site vaccination. For airborne or droplets transmission diseases, refusers are asked to wear a mask during shift in 2 hospitals.

Conclusions
HCWs immunization programs in FVG Region are heterogeneous, and their specific effectiveness has to be studied yet. This study represents the first step in the process of FVG hospitals engagement in sharing effective actions in order to plan a new regional strategy for HWCs immunization.

Key messages
The investigation of effective strategies conducted in different FVG hospitals is essential for their scaling-up evaluation. A common regional plan for healthcare workers immunization is needed to tackle hesitancy and reduce infectious risk within hospitals.
“A room of our own”. Social media use amongst youth with immigrant background in Norway
Authors: Spjeldnæs I O , Agdal R 
Published: October 2020

Abstract

Background
Social media includes webpages, apps and digital games, where content can be created and shared, and participation in social networks is possible. It is known that social media impacts the lives of youth in a complex way. So far, little is known about how immigrant youth use social media and how that impacts their lives. The immigrant population is heterogeneous and complex, but overall, experiences a heavier burden of disease. In this study, we explored how immigrant youth use social media, and particularly how social media could contribute to health promotion.

Methods
We collaborated with non-governmental organisations to establish six focus group interviews that lasted for two hours each. The interviews were transcribed and analyzed by thematic content analysis.

Results
Immigrant youth met both barriers and benefits related to their background through their participation on social media. Barriers related to lack of knowledge about relevant social codes and to limited access due to negative social control. Benefits were the social interaction with people of similar identity. The youth navigated and carved rooms on social media to discuss topics like identity, social control, and to escape attributed identities and social control. They used several platforms established by immigrant youth and their organisations that contributed positively.

Conclusions
Social media represents arenas that serve as resources for immigrant youth. We found examples of use and platforms established by immigrant youth that can be incorporated into public health strategies. Yet, social media consists of social codes and structures, and unequal accessibility, like other social arenas. Such barriers can be addressed by providing more equal access to these social arenas.

Key messages
To youth with immigrant background in Norway, social media represents valuable arenas for health promotion. Social media signifies fruitful opportunities to navigate identities and social control.
Systematic review on multidisciplinarity and management of multimorbid chronic patients in hospital
Authors: Di Serafino F , Pascucci D , Sassano M , Di Pilla A , Carini E , Specchia M L , Ricciardi W , Damiani G 
Published: October 2020

Abstract
Multimorbidity requires that many physicians shift the focus of the care they provide towards the management of multiple chronic conditions such as heart diseases, diabetes, chronic obstructive pulmonary disease and mental illness. The aim of this systematic review is to summarize the scientific evidence on the effects of Multidisciplinary Teams (MDT) on chronic patients' management in hospital settings, evaluating outcomes, costs and workload.
Medline, Scopus and Ovid were queried for relevant articles using the Population-Intervention-Context-Outcome (PICO) model. Selected articles were assessed for quality and risk of bias using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Data were analyzed using descriptive statistics, and comparison among comorbid patients with at least one mental illness versus those without was performed using Chi-square test (p &lt; 0,05).
Out of 7332 records, 7 studies met the inclusion criteria and 85 indicators were identified: 52% improved significantly, 46% did not show any variation and 2% (nausea and delirium) worsened. In particular, in-hospital mortality was significantly reduced in 65% of the studies describing such indicator. The presence of a mental illness showed a statistically significant increase of length of stay (p &lt; 0,05), hence related to a lower bed-day saving, while no statistically significant effect was observed on 30-day readmissions (p = 0,13). In addition, few studies highlighted that a higher workload leads to greater burn-out rates.
MDT meetings represent a fundamental step in a complex path care. They are useful to discuss clinical cases to define their diagnosis and to formulate shared treatment plans in order to deliver personalized treatment options and appropriate follow-up. These findings should stimulate decision makers to invest in the development of MDT and further research should be conducted to evaluate team efficacy.

Key messages
Successful management of chronic diseases can be enhanced by Multidisciplinary Teams. Caregivers can be involved in this relational process to ensure a better path care.
A participatory and systemic training approach for IPC improvement in Nigerian health facilities
Authors: Zocher U , Okwor T J , Dan-Nwafor C , Yahya D , Ita Ita O , Saleh M , Ogunniyi A , Ihekweazu C , Poggensee G 
Published: October 2020

Abstract

Background
Health care-associated infections (HAI) are one of the most common adverse events in care delivery and a major public health problem. A large percentage of HAI in hospitals are preventable through effective infection prevention and control (IPC) measures. IPC trainings for health care personnel based only on technical content do not lead to sustainable improvement of IPC standard precautions. To address this problem, the Nigeria Centre for Disease Control (NCDC) in collaboration with the Robert Koch Institute (RKI) developed a multimodal training approach to facilitate the transfer of IPC competences into working routine in Nigerian health facilities.

Objectives
The training should foster the ability of health care workers to act and communicate participatory, analyze IPC problems systemically and to develop and perform tailored IPC activities in their health facilities. It should empower health care workers to initiate and promote sustainable IPC improvement locally.

Results
We developed a participatory training approach which focusses on the relational and organizational dimension of IPC. It addresses the human and infrastructural factors for IPC compliance in daily working routine. A variety of training methods offers practice tools in communication, systemic thinking and team work, and allows experiencing a participatory attitude. The training program consists of two face to face workshops and an interjacent field project. 28 Health care workers of 14 health facilities in Lagos State participated the first implementation of the training program in 2018. The training evaluation showed the high relevance of the training to the HCW. The field projects showed that the participants could apply the participatory approach for IPC improvement.

Conclusions
A participatory and systemic approach for IPC trainings enables health care workers to take action for IPC improvement locally.

Key messages
We developed and implemented a participatory training approach that addresses the relational and organizational dimension of IPC. Health care workers took tailored actions for IPC improvement locally.
Organization and activities of school health services among EU countries
Authors: Michaud Pierre-André , Vervoort Johanna P M , Visser Annemieke , Baltag Valentina , Reijneveld Sijmen A , Kocken Paul L , Jansen Danielle 
Published: October 2020

Abstract

Background
School health services (SHS) can be defined as health services provided to enrol pupils by health professionals and/or allied professions. The aim of this study was to explore the current state of the governance, organization and workforce of SHS and their provision of preventive activities in European countries.

Methods
Observational study. Data were collected as part of the Horizon 2020-funded project ‘Models of Child Health Appraised’. Only 1 expert from each of the 30 included European countries answered a closed-items questionnaire during the years 2017 and 2018.

Results
All countries (except Spain and the Czech Republic, which do not have formal SHS) provided school-based individual screening and health-enhancing measures. The majority performed height, weight, vision and hearing checks; some integrated other assessments of limited evidence-based effectiveness. Most countries also delivered health education and promotion activities in areas, such as sexual health, substance use and healthy nutrition. Almost all countries seemed to suffer from a shortage of school health professionals; moreover, many of these professionals had no specific training in the area of school health and prevention.

Conclusions
Many EU countries need better administrative and legal support. They should promote evidence-based screening procedures and should hire and train more school health professionals. Overall, they need to adapt to the evolving health priorities of pupils, adopt a more holistic paradigm and extend their activities beyond traditional screening or vaccination procedures.
Composition of soil bacterial and fungal communities in relation to vegetation composition and soil characteristics along an altitudinal gradient
Authors: Bayranvand Mohammad , Akbarinia Moslem , Salehi Jouzani Gholamreza , Gharechahi Javad , Kooch Yahya , Baldrian Petr 
Published: October 2020

ABSTRACT
The objective of the present study was to evaluate how altitudinal gradients shape the composition of soil bacterial and fungal communities, humus forms and soil properties across six altitude levels in Hyrcanian forests. Soil microbiomes were characterized by sequencing amplicons of selected molecular markers. Soil chemistry and plant mycorrhizal type were the two dominant factors explaining variations in bacterial and fungal diversity, respectively. The lowest altitude level had more favorable conditions for the formation of mull humus and exhibited higher N and Ca contents. These conditions were also associated with a higher proportion of Betaproteobacteria, Acidimicrobia, Acidobacteria and Nitrospirae. Low soil and forest floor quality as well as lower bacterial and fungal diversity characterized higher altitude levels, along with a high proportion of shared bacterial (Thermoleophilia, Actinobacteria and Bacilli) and fungal (Eurotiomycetes and Mortierellomycota) taxa. Beech-dominated sites showed moderate soil quality and high bacterial (Alphaproteobacteria, Acidobacteria, Planctomycetes and Bacteroidetes) and fungal (Basidiomycota) diversity. Particularly, the Basidiomycota were well represented in pure beech forests at an altitude of 1500 m. In fertile and nitrogen rich soils with neutral pH, soil quality decreased along the altitudinal gradient, indicating that microbial diversity and forest floor decomposition were likely constrained by climatic conditions.
The influence of small states: how Bhutan succeeds in influencing global sustainability governance
Authors: Theys Sarina , Rietig Katharina 
Published: October 2020

Abstract
How do small states succeed in influencing global policies? Traditional International Relations theories highlight the vulnerability and limited capacity of small states and suggest that the scope for these states to influence global policies is limited. However, recent literature on small states in global governance has challenged this view. Studies have found that in the context of international organizations, participation in coalitions and favourable decision-making structures, among others, contribute to explaining the influence of small states in global governance. While these factors are indeed relevant, they only partly explain how small states are able to influence global policies. Drawing on in-depth qualitative research exploring the influence of small states, this article advances understandings of how small states can influence global governance and international negotiations. Focusing on one small state, the article analyses how Bhutan, through policy entrepreneur Jigme Y. Thinley, challenged fundamental ideas about what constitutes development by placing happiness on the global agenda. We contribute unique data on the influence of Bhutan and an analytical framework on the influence of small states, outlining a process of how small states can influence global policy despite their structural weaknesses. The framework consists of an attribute in the form of policy entrepreneur(s) who speak and act on behalf of the state, four strategies comprising the marketing of the state, venue shopping, facilitating learning and coalition networks, and two framework conditions, including windows of opportunity and a conducive decision-making process.
Multinational security coalitions and the limits of middle power activism in the Middle East: the Saudi case
Authors: Miller Rory , Cardaun Sarah 
Published: October 2020

Abstract
This article examines Saudi Arabia's decision in recent years to use novel and hitherto unexplored informal alliance formats, which we term multinational security coalitions (MSCs). This development was initiated by the new Saudi political leadership under King Salman and Crown Prince Mohammad bin Salman, who have a much greater inclination to pursue proactive foreign and security policies than their predecessors. However, it will be highlighted that beyond the priorities of individual personalities, this shift in Saudi Arabia's behaviour occurred against the backdrop of significant changes in the existing security environment, including the perceived withdrawal of the United States from the security affairs of the region during the presidency of Barack Obama, and crucially also Saudi Arabia's frustration over the failure of the Gulf Cooperation Council (GCC) to develop into a viable security mechanism. The article begins with the introduction of the key ideas relating to institutional design, the conceptual framework for this study. Section two outlines the most important reasons for Saudi Arabia's choice of the MSC format. The third section examines the strengths of the MSC format—especially informality, the resulting low entry-thresholds and the low risk of entrapment—that provided Saudi Arabia with partial and temporary success in recruiting coalition partners and thus bolstering its leadership role. The final section demonstrates, however, that ultimately MSCs are not a panacea. The informality of MSCs that makes it easy for the pivotal state to assemble a coalition also makes it hard for it to forge, and enforce, a common vision.
Three lumps of coal: doing fisheries research in Lowestoft in the 1940s
Authors: Holt Sidney J 
Published: October 2020

Abstract
Following graduation from the University of Reading in 1946, I was offered a job as a “Naturalist” at the Lowestoft Fisheries Laboratory. I learned to appreciate Michael Graham, the director, and was incredibly lucky to have such a man as my first boss and mentor. During my few months working alone before Ray Beverton returned from Cambridge, I put together the simple yield equation in the form in which it was eventually published, and produced most of the theorems that you may see in Parts I and II of Beverton and Holt (On the Dynamics of Exploited Fish Populations. Her Majesty’s Stationery Office, UK. 533 pp.). When Ray returned, we began to work seriously together in 1947–1950 to complete the substantive work on the book. The three lumps of coal was the fuel brought daily into our office in an annex to the main laboratory to keep us warm while working. Before leaving Lowestoft in 1950 for the Nature Conservancy, considerable time was devoted to publishing papers and “diversions” such as attending/speaking at conferences and international negotiations, as well as research on possible effects on fish of low-level radioactive wastes from a nuclear power plant. In late 1953, I resigned from the Nature Conservancy and accepted a position with the UN’s Food and Agriculture Organization in Rome.
Combinatorics of Orbit Configuration Spaces
Authors: Bibby Christin , Gadish Nir 
Published: October 2020

Abstract
From a group action on a space, define a variant of the configuration space by insisting that no two points inhabit the same orbit. When the action is almost free, this “orbit configuration space” is the complement of an arrangement of subvarieties inside the Cartesian product, and we use this structure to study its topology. We give an abstract combinatorial description of its poset of layers (connected components of intersections from the arrangement), which turns out to be of much independent interest as a generalization of partition and Dowling lattices. The close relationship to these classical posets is then exploited to give explicit cohomological calculations.
Immunization Against Poliomyelitis and the Challenges to Worldwide Poliomyelitis Eradication
Authors: Modlin John F , Bandyopadhyay Ananda S , Sutter Roland 
Published: October 2020

Abstract
Both inactivated poliovirus vaccine (IPV) and oral poliovirus vaccine (OPV) have contributed to the rapid disappearance of paralytic poliomyelitis from developed countries despite possessing different vaccine properties. Due to cost, ease of use, and other properties, the Expanded Programme on Immunization added OPV to the routine infant immunization schedule for low-income countries in 1974, but variable vaccine uptake and impaired immune responses due to poor sanitation limited the impact. Following launch of the Global Polio Eradication Initiative in 1988, poliomyelitis incidence has been reduced by &gt;99% and types 2 and 3 wild polioviruses are now eradicated, but progress against type 1 polioviruses which are now confined to Afghanistan and Pakistan has slowed due to insecurity, poor access, and other problems. A strategic, globally coordinated replacement of trivalent OPV with bivalent 1, 3 OPV in 2016 reduced the incidence of vaccine-associated paralytic poliomyelitis (VAPP) but allowed the escape of type 2 vaccine–derived polioviruses (VDPV2) in areas with low immunization rates and use of monovalent OPV2 in response seeded new VDPV2 outbreaks and reestablishment of type 2 endemicity. A novel, more genetically stable type 2 OPV vaccine is undergoing clinical evaluation and may soon be deployed prevent or reduce VDPV2 emergences.
P2X receptor agonist enhances tumor-specific CTL responses through CD70+ DC-mediated Th17 induction
Authors: Yamamoto Shinya , Matsuo Kazuhiko , Sakai Sho , Mishima Itsuki , Hara Yuta , Oiso Naoki , Kawada Akira , Yoshie Osamu , Nakayama Takashi 
Published: October 2020

Abstract
Extracellular ATP is known to promote Th17 cell differentiation in the intestinal lamina propria by stimulating CD70+CD11clow dendritic cells (DCs) via P2X receptors (P2XRs). Recent studies have also shown that Th17 cells enhance antitumor immunity by directly promoting proliferation of cytotoxic T lymphocytes (CTLs). These finding led us to test a P2XR agonist, αβ-methylene ATP (αβ-ATP), as a mucosal vaccine adjuvant to promote CTL responses through Th17 induction. We demonstrated that (i) CD70+CD11clow DCs were present in the nasal lamina propria and expressed P2X1R, P2X2R and P2X4R; (ii) CD70+CD11clow DCs isolated from the nasal lamina propria enhanced Th17 cell differentiation of cocultured splenic CD4+ T cells upon stimulation with αβ-ATP; (iii) mice intranasally immunized with ovalbumin (OVA) and αβ-ATP had increased OVA-specific Th17 cells and CTLs in the nasal lamina propria and regional lymph nodes; (iv) mice intranasally immunized with OVA and αβ-ATP also had elevated resistance to E.G7-OVA tumor growth compared with those intranasally immunized with OVA alone; (v) suramin, a broad-range inhibitor of P2 receptors, suppressed the increases of OVA-specific Th17 cells and CTLs in mice intranasally immunized with OVA and αβ-ATP; and (vi) suramin also abrogated the enhanced antitumor immunity of mice intranasally immunized with OVA and αβ-ATP against E.G7-OVA. Collectively, αβ-ATP may be a promising mucosal adjuvant that promotes antigen-specific CTL responses via CD70+CD11clow DC-mediated Th17 induction.