bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health impacts of pregnant working women victims of discrimination and moral harassment In Brazil
Authors: Turatti B , Rosa G , Moretti-Pires R 
Published: October 2020

Abstract

Background
Brazilian women are still a recurring target of discrimination in the workplace, facing violence related to gender relations and moral harassment, especially when they are pregnant. When the worker perceives discriminatory acts and attitudes or any violation of the rights guaranteed by law, she may appeal to the Labor Court to initiate legal action. The rights of pregnant women to temporary stability, free time for medical examinations, change of duties and maternity leave contrast with the usurpation of the administration's workforce. Considering pregnancy as a specific moment of change in a woman's life, one issue becomes all the more important: is it possible to be a pregnant in the working world?

Objective
Reflect on the consequence of moral harassment at work for the health of the mother-child binomial.

Methods
This was an exploratory, descriptive, qualitative study that used the Internet to search and draw the national profile of women cases in the gestational period that had their labor lawsuits judged by the Regional Labor Courts of Brazil. After reading and selection of the speeches, three main groups of categories were identified: labor issues, exclusion of women's bodies in the working world and consequences for the the mother-child binomial`s health.

Results
After analyzing 5,238 labor lawsuits, four main groups were identified considering the motivating fator. We sought to highlight the excerpts according to the chosen theoretical framework, namely the increased female performativity during the pregnant, abortion cases, postpartum depression and preterm births.

Conclusions
This research argues that social relations in the workplace imply the exclusion of female bodies in favour of masculine ones and seeks to understand the process of becoming a woman and becoming pregnant in the workplace in contemporary Brazil.

Key messages
This inclusion and permanence of women in the workplace is unstable and steeped in stereotypes, particularly when these women are pregnant, often resulting in violent and discriminatory attitudes. Motherhood must be understood and defended when it is desired as a social function that contributes to building a society based on respect for community. Defending this is part of reproductive rights.
The Burden of Antimicrobial Resistant Infections in Wales: a population-level modelling analysis
Authors: Wang H , Thomas P P M 
Published: October 2020

Abstract

Background
Antimicrobial Resistance (AMR) threatens the sustainability of an effective, global public health response to infectious disease. This study uses routine surveillance data to estimate the public health burden (PHB) of AMR infections in Wales for the period 2017-19, with further stratification by Age, Sex, local Health Board (HB) area and relative deprivation, to guide public health action.

Methods
Welsh AMR Surveillance data, collected as part of the European AMR Surveillance Network (EARS-Net), was collated for the period 2017-19. Adapting the methodology of the European Centres for Disease Control Burden of Communicable Diseases in Europe (BCoDE), we modelled the PHB of five types of antibiotic-resistant infection (invasive and non-invasive), and 7 pathogens which associated with AMR, using the Burden of Healthcare-Acquire Infection (BHAI) R package. Postcodes were used to assign patients' resident health board, as well as their relative socio-economic deprivation, using the Welsh Index of Multiple Deprivation (WIMD).

Results
Preliminary results (median estimation with 95% confidence interval (CI)) were calculated for: number of infections with AMRnumber of deaths attributable to AMRnumber of DALYs attributable to AMR
Estimates were stratified by age; sex; HB; relative deprivation; and pathogen and infection type.

Conclusions
This is the first study of its kind to study the relationship between AMR incidence and relative deprivation. It offers a clear picture of the epidemiology of AMR within Wales to support public health action.

Key messages
Infections from AMR bacteria represent a major PHB in Wales, and the modelling PHB of AMR by socioeconomic group and local area can inform effective public health action. The results of this study are valuable for guiding public health action to address AMR at the national and international level.
Exploring equity, gender and social determinants aspects of antimicrobial resistance: Scoping review
Authors: Saint V , Mohsenpour A , Mühling C , Bozorgmehr K 
Published: October 2020

Abstract

Background
Antimicrobial resistance (AMR) is a considerable threat to modern medicine and global health. Inequity, gender and social determinants of health (SDH) have a significant impact on health and health services, including in relation to AMR. Despite this, there is a lack of systematic focus on these dimensions in AMR research, policy and practice. We aimed to scope and review the existing evidence related to the equity, gender and SDH considerations for AMR globally through a systematic, iterative approach.

Methods
We conducted a scoping review by searching PubMed, Web of Science and CINAHL for empirical research on AMR in humans, with consideration of equity, gender or SDH, published in English between January 2000 and September 2019. In a two-stage process, we analysed full texts to extract information about explicit and then implicit references to equity, gender or SDH.

Results
The search yielded 4628 articles after removing 578 duplicates. 737 articles were analysed with explicit reference to equity, gender or SDH in title or abstract. Preliminary results show that 93.2% of these studies mentioned gender but mostly meaning biological sex (90.8%) rather than its social construct. Articles on equity (6.0%) and SDH (1.1%) reported on associations between AMR rates and income and non-income dimensions of inequality, health system issues and disadvantaged subpopulations within countries. Other articles in this category explored public and policy discourse or approaches for AMR (0.8%) and equity issues for AMR-related R&D (0.7%). These results combined with the PROGRESS-Plus acronym informed the subsequent analysis of the 4628 articles for implicit considerations of equity, gender and SDH.

Conclusions
Despite casting a wide net, we found relatively little research explicitly considering equity, gender and SDH aspects of AMR especially at a systematic or structural level. This reflects an important gap in the current understanding of and efforts to tackle AMR.

Key messages
We conducted a scoping review on equity, gender and social determinants considerations of AMR that indicates limited research on these important aspects of the social and structural drivers of AMR. Further research on these aspects is essential to inform the design of effective policy and practice interventions that target vulnerable groups and address structural inequities.
Carbapenem-resistant enterobacteriaceae: don’t trust your neighbour
Authors: Cuccaro C , Tarroni M , Tinturini A , Cresti S , Basagni C , Nante N , Messina G , De Marco F M 
Published: October 2020

Abstract

Background
The spread of carbapenem-resistant enterobacteriaceae (CRE) outbreaks consists not only of germs producing KPC and OXA-48, endemic already, but also metallo-beta-lactamase such as NDM or VIM. In Tuscany, Italy, a multidisciplinary regional task force has extended, since NDM alert spread out, from 1st Oct 2019 the CRE screening programme, via molecular testing, to newly admitted patients in high risk settings (medical, intensive care, oncology, transplant, infectious diseases, cardiac surgery units) to fight cross-contamination. The aim of the study is to assess levels and types of CRE in an italian teaching hospital (615 beds) after the programme became effective.

Methods
The surveillance team began recording daily all the CRE positive cases, defined as laboratory confirmed colonizations/infections with CRE. Our retrospective, descriptive study covers the time span between 30th Sep - 16th Dec 2019. Cases were classified by infected apparatus and by resistance phenotype, and we calculated descriptive statistics.

Results
In total we identified 97 cases (male 60.82%, mean (+/-SD) age 71.58+/-17.34 years, 74.23% in medical wards); 5 patients had two body districts infected and 9 carried two different phenotypes. Out of 102 positive samples, 92.16% were bowel colonization, 1.96% BSI, 3.92% urinary and 1.96% respiratory. Among these, 21 were NDM (19.81%), 29 KPC (27.36%), 4 OXA-48 (3.77%), 52 VIM (49.06%). The most detected germ was Klebsiella pneumoniae (30.19%), followed by Escherichia coli (2.83%), Enterobacter cloacae (2.83%), Citrobacter freundii and braakii (2.83%), Klebsiella oxytoca (1.89%). 61 agents were unspecified (57.55%). Among the 21 NDM, 76.19% were K. pneumoniae, only one was a BSI.

Conclusions
CREs continue to be present despite constant surveillance. Although high levels of KPC-producing agents persist, the new spread of VIM phenotype is significant, highlighting, however, that the pathogen wasn't detected in over 50% of the samples.

Key messages
Despite increased surveillance, there is still a consistent portion of patients colonized with unidentified CRE. A surveillance mainly focused on NDM-producing CREs had incidentally highlighted an unexpected spread of VIM phenotype.
Evolution of antimicrobial resistance in departments with high risk of cross infections in Tunisia
Authors: Haddad N , Azouzi F , Ben Chaikh A , Kahloun S , Rania A , Ketta S , Boujaafar N , Said Laatiri H , Bouallegue O 
Published: October 2020

Abstract

Background
Antimicrobial resistance is actually a real and ever-changing public health problem. The microbiology laboratory plays a key role to achieve collaboration with clinical services and the prevention and control of infection team.

Objective
Describe the bacterial ecology of departments with high risk of Health care associated infections and analyze the evolution of antimicrobial resistance.

Methods
A descriptive and retrospective study was carried out in the university hospital Sahloul. It concerned all strains isolated in departments with high risk of Health care associated infections. The study period was spread over 7 years from January 1st, 2010 to December 31th, 2016.

Results
A total of 6108 non-redundant bacterial strains were isolated. Isolated pathogens were mainly from the urology departement (n-2651, 43.4%).The most frequent isolated pathogens were Escherichia coli (n = 1329, 21,8%), K. pneumoniae (n = 992, 16,2%), and Acinetobacter baumannii (n = 763, 12,5%). Concerning these main isolated species, significant statistical differences were noticed in bacterial resistance evolution over the years. With E. coli, the evolution was essentially represented by an increase of amoxicillin, amoxicillin clavulanic, cefotaxime, gentamicin, and fluoroquinolones resistance. With K. pneumoniae, cefotaxime resistance was stable, however resistance to imipenem and gentamicin was increasing. There was also a significant increase in fluoroquinolone and aminoside resistance. With S. Aureus, an increase in methicillin resistance was detected from 11.1% in 2010 to 20% in 2016.

Conclusions
Antibacterial Drug Resistance is a dynamic and rapidly evolving phenomenon in our hospital. The most common MDR bacteria studied were enterobacteriaceae producing carbapenemase. The emergence of glycopeptid resistance in enterococci must be controlled in order to prevent its spread to the community and the transfer of staphylococcus resistance genes.

Key messages
Antibacterial Drug Resistance is a dynamic and rapidly evolving phenomenon in our hospital. The most common multi drug resistant bacteria studied were enterobacteriaceae producing carbapenemase.
Implementing Indigenous cultures and Indigenous knowledges: A public policy dilemma
Authors: Parter C D R , Skinner J C 
Published: October 2020

Abstract
In Australia, governments are committed to integrating the cultures of Indigenous peoples into the decisions and actions of governments - known as public policies. The National Aboriginal and Torres Strait Islander Health Plan 2013-2023 has culture central to its policy framework making it permissible for Indigenous peoples to practice their cultures and knowledges.
While there is a readiness to implement Indigenous cultures, regrettably there still remains deep-seated resistance due to institutional and systemic racism, and racist attitudes. These factors along with unconscious biases prevent the realisation of Indigenous people's cultures and their knowledges.
A system-wide translational model of practice (the model) has been developed that aims to support the implementation of Indigenous cultures and knowledges. The model adopts a system thinking approach that considers complex social phenomenon's involving paradigms, structures and actors within and across systems and sub-systems. Similarly, the model targets system leverage points aimed to embed Indigenous cultures and knowledges into policy practice.
Indigenous people's cultures and knowledges could be the answer to the global challenges facing the public health community. However, as is the case in Australia, Indigenous people's cultures and knowledges are devalued and often dismissed as irrelevant. The model of practice offers a framework to enable, embed and enact the cultures and, in deed the knowledges held by Indigenous peoples. The model could be beneficial for other countries who are searching for solutions to address complex problems like global warming.
Critically, a key requirement of the model is to listen and learn from Indigenous peoples along with acknowledgement that Indigenous cultures is innately related to the knowledges held by Indigenous people. Finally, using leverage points in systems to embed Indigenous people's cultures and knowledges into global solutions is a necessity.

Key messages
Indigenous cultures is their knowledges and their knowledges count. Have an open heart and an open mind to listen and learn.
If the dolphin come to help: Education and Health without Boundaries for transversal competences
Authors: Rubba F , Scamardo M S , Di Mauro F , Egidio R , Avati P , Passione A , Giulierini P , Continisio I G , Iervolino A , Triassi M 
Published: October 2020

Abstract

Aims
Italy is a veritable bridge to the Mediterranean that peoples, civilizations and cultures pass through. The exchange, confrontation and interaction are key element that could lead to greater well-being of the communities. The project called: “If the dolphin come to help: Education and Health drive the orientation path for transversal competences toward reception and integration with the aim to promote the educational development and cultural growth of students and, at the same time, to provide schools with the opportunity to enhance their educational offerings.

Methods
The geographical position leads our country to a particularly heavy task: to provide in a timely and appropriate way for the reception and livelihood of a very large number of people. Question assessed were.” Who are the migrants and what happens when they land in Italy? Where are they detained and for how long? What are the reception services that take care of migrants? The first step was to clarify the subject starting from the difference between asylum seekers, refugee, beneficiary of humanitarian protection / applicants for international protection, illegal immigrant, going through the process of entry in Italy at one of the four hotspots. The students worked in 3 groups creating one short story. The second step it was to encourage students, through the role playing tool, to reflect on what it feels like to be a migrant and what feelings you feel in front of a migrant. The third step was to ask to the student to describe with only one word the feelings.

Results
The stories were synthesized in a word cloud, through a string analysis algorithm in which the semantic fields of integration, acceptance and empathy prevailed. Immigration is perceived not as a problem but as a resource

Conclusions
Educational and health projects shared with high schools may be a useful tool to promote integration, acceptance and social cohesion beyond the limits of fear.

Key messages
Immigration today in our country is a very complex subject that is difficult to address in a few lines. Italy is on the route of the migratory flows of Africa and the Middle East. The project may be a trigger to create a place where everyone is equal and can access education, health and knowledge, not being denied because of the origin.
A qualitative study on mental health and wellbeing of Syrian refugees in the UK
Authors: Tattan M , Paudyal P , Cooper M 
Published: October 2020

Abstract

Background
The Syrian conflict has resulted in an estimated 5.3 million registered Syrian refugees in various parts of the world. Evidence suggests that these individuals are at considerable risk of developing common mental disorders. This study aimed to explore the mental wellbeing of Syrian refugees, identify their coping mechanisms and pathways towards integration into new communities, and formulate recommendations for better access to mental healthcare services.

Methods
We conducted a qualitative study using in-depth semi-structured interviews with adult refugees (&gt;18 years old) who are currently residing in Southeast of England. Interviews were conducted in Arabic, recorded, transcribed and translated verbatim. Translated transcripts were analysed using thematic analysis. Ethical Approval was obtained from the Brighton and Sussex Medical School Research Governance Ethics Committee (ER/BSMS9DAP/1).

Results
Twelve participants (3 females and 9 males) took part in the study; all were born in Syria and the majority (n = 9) were over 45 years of age. Participants described symptoms of reduced psychological wellbeing. Preliminary findings shows that almost all participants talked about psychological distress resulting from previous trauma, loss of and separation from family members and challenges adjusting to their host country. Barriers to accessing the healthcare system in the UK included fear of stigma, being misunderstood by healthcare staff and language issues. Communicating with loved ones, connecting with nature, practising faith and pursuing hobbies were reported as coping strategies.

Conclusions
For Syrian refugees in the UK, mental wellbeing embraces living with past traumatic experiences, achieving social integration and facing challenges accessing healthcare. Understanding differences between refugee and host communities is key to appropriately cater to the specific needs of each community and achieve equity in healthcare access.

Key messages
Syrian refugees in UK described symptoms of reduced psychological wellbeing. Understanding the needs of refugee communities is necessary to achieve equity in healthcare access.
Management of chronic diseases and healthcare use among the elderly in Turkey and Turkish migrants
Authors: Erdsiek F , Aksakal T , Padberg D , Özcebe H , Üner S , Gershuni O , Westerling R , Daryani A , Brzoska P 
Published: October 2020

Abstract

Background
Turkish migrants are one of the largest groups of migrants in Germany, the Netherlands and Sweden. Particularly older migrants face different barriers in the health system that may limit their access to and quality of health care. The aim of this study was to examine how elderly people in Turkey and Turkish migrants in Germany, the Netherlands and Sweden manage chronic conditions, including how they utilize the respective healthcare systems.

Methods
A qualitative study design was used. A total of 20 in-depth interviews with individuals in Turkey and 10 semi-structured in-depth interviews each with Turkish migrants in Germany, the Netherlands and Sweden were conducted during 07/2018 and 05/2019. The interviews were based on a topic guide and were analyzed using qualitative content analysis.

Results
Participants from all groups experienced barriers in accessing health services and described difficulties in managing chronic conditions in their daily life. Pathways to care and patterns of utilization strongly depended on the structure of the respective health systems and differed between all groups. Circular migrants to Turkey relied on health professionals from their respective host countries to treat their chronic diseases, consulting professionals in Turkey mostly for emergencies or acute illness.

Conclusions
Turkish migrants and elderly adults in Turkey experience similar barriers and challenges in managing chronic diseases. How they access and utilize health services is dependent on the respective health system structures. Circular migrants use the Turkish health system differently than health systems in their host countries and elderly adults from Turkey. These results can contribute to the development of diversity-sensitive health care strategies.

Key messages
Turkish migrants and adults in Turkey experience similar challenges in managing chronic diseases. How Turkish migrants and adults in Turkey access healthcare depends on the respective systems.
Polypharmacy and drug misuse in elderly migrants: care practice and interprofessional collaboration
Authors: Tezcan-Güntekin H , Bird R , Özer-Erdogdu I 
Published: October 2020

Abstract

Background
Polypharmacy is associated with an increased risk of falls and adverse events in the elderly. Factors such as inappropriate infrastructure for resolving language barriers can make people with migration backgrounds more vulnerable to polypharmacy. This study aimed to assess barriers in the drug therapy of elderly migrants and to obtain input for an e-health application supporting medication management and interprofessional communication.

Methods
10 expert interviews were conducted with health professionals working with chronically ill patients of Turkish descent. The sample included physicians, pharmacists, social workers and nursing professionals. The interviews were analyzed using structuring content analysis.

Results
Respondents perceived language barriers and discontinuities in medication prescription as key problems in the drug therapy of elderly migrants. Changes in the brand of medication prescribed were highlighted as particularly damaging to patient-provider relationships. Interprofessional communication was deemed important, with physicians and pharmacists expressing dissatisfaction in this area. Some respondents saw potential in the e-health application, while others cited concerns about data protection or the digital capabilities of elderly migrants.

Conclusions
Healthcare professionals may require support in providing information in a variety of languages. Additionally, more interprofessional collaboration is desired but it is necessary to first establish better channels of communication. An e-health application could help achieve clearer communication between stakeholders. However, it is necessary to work in close cooperation with professionals when designing the application to ensure that it can be implemented in practice.

Key messages
Language barriers and inconsistent prescription practices harm patient-provider relationships. Better channels of communication are needed to provide less fragmented care to elderly migrants.