bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mapping refugees and migrants’ access to health care in Tunisia
Authors: Arfa C 
Published: October 2020

Abstract
Objectives of the study carried out under the request of the Office of Family Planning and population are collecting data on refugees and migrants, assessing their social and health needs, mapping health care providers and formulating recommendations to ensure equitable and affordable access to quality health services. The methodology has combined qualitative and quantitative research and focus group discussion scattered over the country, NGOs, ministries, and desk review.
Results shown several gaps in relation to access to health care by refugees and migrants including: NGOs provide 55% of servicesVulnerability is increased by lack of official documents for residency and work permitLack of response of public and private providersCultural and linguistic barriersXenophobic and racist attitudes of both population and health care providers
Based on gap analysis and inputs from several focus groups several recommendations were made to improve access of refugees and migrants to quality health care including the need: to fill the legal vacuum on refuge and migrationto establish an independent public authority on migrationto establish with support from civil society organizations a space for dialogue and communication with refugees and migrantsto improve health system responsiveness to refugees and migrants.
As the issue of migrant's access to quality health care is multi-dimensional there is a need to establish inter sectoral task force involving concerned line ministries (i.e health, interior, migration, social affairs, etc..) national and international civil society organizations and concerned United Nations agencies.
The objectives of the paper are to: Map the social, economic and health conditions of refugees and migrants in TunisiaTo assess gaps of health services access of refugees and migrantsTo advocate a right base approach to health of refugees and migrants in Tunisia.
Implementing Health Literacy Intelligence during COVI-19 outbreak
Authors: Leiras G , Arriaga M , Gaspar R , Raposo B , Domingos S 
Published: October 2020

Abstract

Background
During events that involve health risks, people may feel the need personal and social resources to cope with the demands posed by event. Depending on their individual characteristics, people may perceive their resources as sufficient or as insufficient to face the situation. Risk perception analysis was conducted in Portugal during the COVID-19 outbreak, to develop communication strategies, customized to the changing needs, helping people make informed decisions.

Methods
Citizens messages on social networks of 3 official information sources, and 8 media sources were analyzed between 26th January and 5th March 2020. A sample of comments to publications related to COVID-19 were analyzed in 4-days periods and categorized. A qualitative theory-driven thematic analysis was carried out based on two global categories: Demands and Resources. From this analysis, the threat level ratio (Demands/Resources) was calculated.

Results
A total of 8,251 comments were analysed in 10 periods of 4 days of data collection, from 26th January to 5th March. The threat level ratio increased during the first 15 days of analysis, having its maximum (6.80) in the period between the 7th and 14th of February, mostly associated with the perceived danger associated with the lack of airports arrivals control from China. After the announcement of the first confirmed case of COVID-19 in a Portuguese citizen outside Portugal, on 23rd February, the risk perception increased 1,4% compared to the previous period of analysis. On the contrary, after announcing the first confirmed case in Portugal, on the 1st March, the risk perception decreased 1,6%, which is inferred to be associated with a shift in the media discourse and to the use of humour.

Conclusions
Awareness of risks is a necessary condition for people to adhere to the necessary recommendations to mitigate the crisis. During an epidemic, an effective communication strategy can become an opportunity to promote health literacy.

Key messages
Risk perception is essential to define effective communication strategies to promote health literacy and best practices among targeted populations. effective communication strategies customized to people’s needs and priorities help people making informed decisions during a public health emergency.
Organisational barriers to accessing vaccination services: a literature overview focusing on underserved populations in Europe
Authors: Jansen D 
Published: October 2020

Abstract

Background
Immunization and equitable access to immunization are core components of the right to health (WHO). Although more and more children in the WHO European Region are being vaccinated against measles than ever before, coverage gaps even persist within countries. As a result, specific, underserved populations are left unprotected, resulting in a record number of these populations affected by the virus in 2018. Aim of this presentation is 1) to explore barriers that underserved populations might encounter and 2) share good examples of organisation of vaccination services for underserved populations.

Methods
Literature searches have been conducted in a variety of databases, using different search terms. Published studies in English that explores 1) barriers in the organization of care; 2) successful interventions related to the organization of care, in (expected) low vaccination uptake populations will be included. The databases will extend beyond the medical literature to include social science literature. The literature search included peer reviewed international academic literature and government reports dating from 2010 to 2019.

Results
In this presentation the results of the literature review will be presented: what barriers in the organization of care are experienced by populations that have low vaccination uptake? And what evidence does the literature present concerning the organisation of care that lead to a sufficient to high uptake of vaccination in populations where you would not expect this?

Conclusions
the results of the literature review will provide a useful and valuable overview of barriers and facilitators of accessing vaccination services of (expected) low uptake populations in Europe. Since access, as a key dimension of organisation of care, is still the main factor hindering vaccine uptake it is important to learn lessons not only from poor practices but also from good practices.
Narrative medicine in the cancer care: implementation and impact
Authors: Scardoni A , Cenci C , Sancini S , Moro M , Signorelli C , Odone A 
Published: October 2020

Abstract

Issue
National and international health authorities have described Narrative-based medicine (NBM) in clinical practice as a fundamental tool for acquiring, understanding and integrating the different points of view of those involved in the disease and its treatment, promoting more effective and appropriate care.

Description of the problem
The use of NBM is part of the strategic project to improve patient-engagement in San Raffaele Hospital in Milan. Its implementation started, using the 'DNM-Digital Narrative Medicine' web-based platform, with the pilot prostate cancer path in March 2019.

Results
A 10-item questionnaire was sent to all 47 patients and 45 doctors involved, to evaluate: benefits perceived by the care team in terms of communication support, personalization of therapy, observation of cognitive elements not otherwise evident; benefits perceived by the patient (support, communication, self-management, identification of emotional, relational, social elements of daily life); patient and medical staff opinions in terms of compliance, accessibility, ease of use. The overall rating was 4.3/5 for doctors and 4.2/5 for patients. Patients valued the most the platform supporting them in the decision on what treatment to undergo (4.8/5), for the doctor the platform has been important in considering unknown aspects of the patient and understanding the patient's point of view (4.4/5). Patients, more than doctors, perceived platform usability positively. 43% of the patients who decided not to participate reported to prefer a direct approach with the doctor.

Lessons
The oncologic field represents an optimal setting for the implementation of methods aimed at strengthening communication and relationship of care. NBM offers the possibility of exploring elements as adherence to treatment, perception of illness, socio-psychological impact, sometimes missed during the visit, enhancing the conversation between patient and care team and stimulating the co-construction of care.

Key messages
NBM has proven to be a useful tool and a good communication channel in the oncologic setting. The NBM platform demonstrated good acceptability and ease of use by doctors and patients.
Evaluating quantitative methods for intercategorical-intersectionality research: a simulation study
Authors: Mahendran M , Bauer G , Lizotte D , Zhu Y 
Published: October 2020

Abstract

Introduction
This study evaluated seven quantitative methods for their predictive accuracy for intersectionally defined subgroups, via a simulation study. The methods were single-level regression with interaction terms, cross-classification, multilevel analysis of individual heterogeneity and discriminatory accuracy (MAIHDA), and four decision tree

Methods
classification and regression trees (CART), conditional inference trees, chi-square automatic interaction detector, and random forest. Also evaluated was how well methods identified variables relevant to the outcome. An example analysis will be presented using data from the U.S. National Health and Nutritional Examination Survey.

Methods
The simulated datasets varied by outcome variable type (binary and continuous), input variable types, sample size, and size and direction of the effects. Accuracy was evaluated using mean squared error or mean absolute percentage error. The secondary outcome was evaluated via significance and confidence interval coverage of regression terms and variable selection of the machine learning methods.

Results
Predictive accuracy improved with increasing sample size for all methods except CART. At small sample sizes random forest and MAIHDA generally created the most precise predictions. Variable selection consistently faced a high type 1 error for CTree and CHAID. While performing well for prediction, variable selection by random forest and confidence interval coverage and power of MAIHDA main effects coefficients were suboptimal.

Discussion
From this study emerge recommendations for applying methods in quantitative intersectionality. Different methodologies are optimal for different purposes, for example while random forest and MAIHDA performed well for prediction, they were less reliable for variable identification. In our discussion, we will work through how to select, apply, and interpret methodologies to achieve analytic goals that align with intersectionality theory.
Prevalence of suicidal behaviour and violence among young people
Authors: Jakubauskiene M , Lindert J 
Published: October 2020

Abstract

Background
Violence and suicidal behaviour among young people is an enormous public mental health issue in Europe and worldwide leading to poor mental health outcomes, increased use of healthcare services and loss of life. Specifically, vulnerable are young people especially in societies were prevalence of violence and suicide rates are considerably high.
Public mental health of young people in Lithuania is of a great concern due high prevalence of various determinants resulting in poor public mental health outcomes and high suicide rates. This study aimed to identify the prevalence of violence and suicidal behaviour as well as use of health care services among 15-29 years of age young population in Lithuania.

Methods
A cross sectional survey involving 1007 respondents aged 15-29 years in Lithuania was conducted in 2016. Descriptive statistics and logistic regression were applied.

Results
39.7% (95% CI: 34.3-45.2) of young people in Lithuania referred to have suicidal behaviour during the last 12 months, 39.5% (95% CI: 34.1-44.9) of respondents had suicidal ideations, 13.4% (95% CI: 9.7-17.1) - made plans for suicide and 2.1% (95% CI: 0.6-3.7) attempted to commit suicide during the last 12 months. Prevalence of suicide risk was very similar in both gender groups. 27.5% of young people reported experience of psychological violence, 7.26% - physical violence and 4.3% - sexual harassment within the last year. Experienced violence increases risk of suicidal behaviour from 1.85 times in case of psychological violence to 3.79 time in case of physical violence. Young adults who had suicidal behaviour and experienced violence tend to call emergency medical services and were hospitalized more often.

Conclusions
Experienced physical, psychological and sexual violence is related to higher risk of suicidal behaviour. Suicide prevention strategies should consider violence prevention and vigilance of health care system to address suicidal behaviour.
Canada’s health system: struggling to modernize a half-century old system
Authors: Allin S , Marchildon G , Merkur S 
Published: October 2020

Abstract
Canada receives worldwide attention for its single-payer and single-tier universal health coverage system, with hospital, diagnostic and primary care services free of user fees. The level of health spending and overall population health outcomes are comparable to other high-income countries such as France and Australia, but compared to the US Canada spends half as much on health care and achieves significantly better health outcomes. Nevertheless, it faces several challenges. One is providing financial access to other services. Pharmaceutical coverage is uneven and less generous than in comparable countries globally. Access to dental care, not covered for the general population, is challenging for the roughly one-third of the population lacking supplemental coverage, which nearly always is obtained through the workplace. The 2016 Commonwealth Fund international population surveys of 11 countries found that 41% of Canadians said they skipped dental care/check-ups in the past year due to costs - second highest among after the US. A second challenge is waiting for services. Canada shows the longest waits for specialist and surgical services. The third is stasis regarding adapting to changes in medicine and service delivery to improve quality and address major gaps in health across sub-populations such as Indigenous peoples. Innovations such as managed care and pay-for-performance lag behind most countries. Reform efforts aim to address fragmented care across providers, increase coverage, and reduce pharmaceutical costs. There are efforts to strengthen primary care, better coordinate across sectors, and reduce costly specialized care. There has also been increasing momentum to address financial barriers to accessing prescription drugs and containing pharmaceutical costs through a national “pharmacare” plan.
Public preferences for involvement in the governance of health data
Authors: De Freitas C , Amorim M , Leão Teles E , Maia T , Machado H , Silva S 
Published: October 2020

Abstract

Background
Public involvement in the governance of epidemiological and public health studies can foster needs-driven research, enhance participants' recruitment, reduce attrition and improve the quality of and ethics in research and surveillance. However, it can also reinforce health inequalities if it fails to ensure public representation across socioeconomic gradients. This study aimed to assess patients' and carers' preferences for involvement in collective health data governance, and its associated factors, to strengthen the evidence base for policy development.

Methods
Between June 2019 and January 2020, 644 people (157 patients and 487 carers; participation rate=89.3%) followed at two reference centres for rare diseases in a university hospital from Northern Portugal were enrolled in an observational cross-sectional study. Data about willingness to participate in data governance was collected through four intersecting options: periodic or sporadic meetings, by either giving opinions (consultation) or participating in decision-making (deliberation). Data were analysed using descriptive and inferential statistics.

Results
From a total of 629 respondents, 39% are willing to get involved through at least one of the four participatory options and 16% do not want to participate. Patients and carers do not differ in their preferences for involvement. Sex and education are associated with willingness to participate, after adjustment for participant type (patient/carer), occupation and trust in national and international institutions (OR:1.60; 95%CI 1.05-2.45 for men vs. women and OR:1.65; 95%CI 1.07-2.56 for &gt;12 vs. ≤12 educational years). Participants' preferred option for participation is consultative sporadic meetings (29.5%).

Conclusions
Anticipating which social groups are likely to become under-represented in participatory exercises is crucial to inform policy aimed at promoting inclusive involvement in health data governance.

Key messages
Men and higher educated participants are more willing to participate. Forecasting potential for subgroup under-representation is crucial to develop policy for inclusive participatory data governance.
Research Fairness Initiative opens a new era for equitable and impactful research collaborations
Authors: Al-Khaldi M 
Published: October 2020

Abstract
The global collaborations and partnerships in research and science are evidently growing as an inevitable reality to tackle the mounting common global challenges. To overcome all of these challenges and create a balance between countries, institutions, stakeholders, and fields and to strengthen the research and science fair collaborations and boost institutional research capacities and potential, the Council on Health Research for Development (COHRED), developed an evidence-based tool, the Research Fairness Initiative (RFI). This paper investigates the RFI experience and application among the Middle East partners to propose better ways for better research and science collaborations. The COHRED team used two scientific methods to understand the region's stakeholders on research collaboration. 7 telecom. meetings were carried out with 7 academic institutions in the region and a literature review was implemented. Partners in the region were largely interested when the RFI was introduced to 7 academic institutions from five countries: Palestine, Egypt, Lebanon, Jordan, and Saudi Arabia. 3 have launched the work of the RFI and they will be potential RFI reporting institutions by submitting RFI report. Efforts seeking to build and strengthen research and scientific collaborations receive real attention and also evidently proves the lack of collaboration and partnership platforms and frameworks is a reality. The RFI was seen as a useful institutional instrument to develop the institution's capacity. The major reason behind this is that the institutions are lacking structural, technical, logistical, ethical, resource capacities to establish and develop regional and international research and scientific collaborations. Research collaboration is a global, regional, and national priority and RFI is evidently recognized as a realistic and forward-thinking tool in building collaborations based on fairness, integrity, impact, and transparency.

Key messages
RFI is one of the best institutional reporting tools that ensure equitable and fair research collaborations. Research collaboration is a global, regional, and national priority for the slow-developing countries (Middle East region).
The importance and challenge of carcinogenic air pollutants for health risk and impact assessment
Authors: Mudu P , Pérez Velasco R , Zastenskaya I , Jarosinska D 
Published: October 2020

Abstract
Along the years, the International Agency for Research on Cancer (IARC) has classified many air pollutants components as carcinogens, including solvents, diesel engine exhaust, metals, such as chromium, nickel, arsenic, and cadmium. The IARC list of Group 1 carcinogens includes benzene, diesel exhaust, benzo[a]pyrene (B[a]P, a polycyclic aromatic hydrocarbon [PAH]), indoor emissions from coal combustion, and 1,3-buta-diene. Sources, mainly combustion-related, that emit airborne carcinogens can be both in indoor and outdoor. In 2013, the IARC has classified outdoor air pollution and one of its major components, particulate matter (PM), as carcinogenic. In its evaluation, the IARC suggested sufficient evidence showing that exposure to outdoor air pollution and PM causes lung cancer and it noted that a positive association between such pollution and an increased risk of bladder cancer. The association between exposure to air pollutant and cancer risk has been investigated in cohort studies and the results are generally consistent, indicating that long-term exposure to air pollution can cause lung cancer and increase risks of cancer in other locations. The use of the information on carcinogenicity is fundamental to produce estimates to quantify risks and impacts on exposed population. WHO in several recent activities has addressed this issue. For example, it is also under consideration by various experts in the framework of the Task Force for Health (TFH) of the UNECE Convention on Long-range Transboundary Air Pollution. The discussion of this session will focus on the implications and the challenges to integrate toxicological and epidemiological evidence of identified air carcinogens in health in risk and impact assessment.
Re-imagining anti-racism in the health sector in Aotearoa New Zealand
Authors: Came H , Kidd J , McCreanor T , Baker M , Rodgers B 
Published: October 2020

Abstract

Background
Racism and dishonouring of te Tiriti o Waitangi are significant contributors to ethnic health inequities in Aotearoa. It is unclear how health professionals can contribute to the disruption of racism.

Methods
This multi-disciplinary study draws on systems change tools, evidence from the health kaupapa Waitangi Tribunal claim (WAI 2575), a review of professional competencies documents, and focus groups with Māori and non-Māori health practitioners to identify how to strengthen anti-racism praxis in health services. The preliminary data collected in 2019 has undergone a thematic analysis and is being synthesised collaboratively with stakeholders to generate a complex continuum of anti-racism praxis. This will be applied via two site-specific action research projects.

Results
The pilot study has been completed but data collection is still underway on the main study. The initial cut of a continuum of practice grouped behaviours into i) problematic, ii) variable to iii) proactive. Problematic behaviors included examples of cultural and institutional racism, Variable behavior included engagement with Te Reo me ona tikanga (Māori language and protocols), and professional development and compliance. The proactive grouping included Māori leadership and workforce, responding to Māori realities, reflective practice and critical consciousness.

Conclusions
Initial findings suggest anti-racism continuum of practice may be useful to strengthen competency documents, curricula, policy and discipline-specific professional development planning.

Key messages
With the persistence of institutional racism in colonial settings like Aotearoa we need to imagine new ways to pursue anti-racism. Mapping anti-racism praxis is a useful way to identify variations in practice with a view to strengthening curriculum, competencies and ultimately practice.