bluuebunny/crossref_metadata_2025_split huggingface dataset:
The emerging extensively drug resistant bacteria in a university hospital in Tunisia in 2019
Authors: Tilouche L , Haddad N , Boujaafar S , Elaissi R , Kahloun S , Ketata S , Bouallegue O , Boujaafar N 
Published: October 2020

Abstract

Background
The discovery of antibiotics revolutionized medicine in the 20th century, however the emergence of extensively drug-resistant bacteria constitute a growing problem in our hospitals in Tunisia and across the world. This study aims to evaluate a screening program for Carbapenemase Producing Enterobacteriaceae (CPE) and vancomycin-resistant enterococci (VRE) undertaken by the Microbiology Laboratory of Sahloul University Hospital.

Methods
A descrptive and retrospective study was carried out between 01st April 2018 and 31th December 2019 in the university hospital Sahloul, in East Coast of Tunisia. The screening was based on rectal swabs; it concerned Medical Intensive Care Units, the postoperative unit, the paediatric and the nephrology departments. The rectal swabs were seeded on the chromID CARBASMART and chromID VRE agars(biomerieux, France)in search of CPE and VRE respectively. The identification and the antibiotic susceptibilities testing were performed using the Vitek2 System (biomerieux,France)

Results
In total, 191 patients were screened. Among them, 56% were admitted in Intensive Care Units, 9.95% in postoperative unit, 30.9% in paediatric department and 3.14% in the nephrology department. A total of 38 extensively drug-resistant bacteria were isolated: 20 CPE and 18 VRE. Among isolated CPE, 17 were identified as Klebsiella pneumonia: The ConfirmationKPC/MBLkit (RoscoDiagnostica, Denmark) supplemented with a disc of Temocillin showed that 7 strains produced metallo-carbapenemase and 10 strains produced OXA 48 carbapenemase. The other isoloted CPE were OXA-48 producers. All VRE were identified as Enterococcus faecium, Their Vancomycin and Teicoplanine MICs were greater than 32 mg/L.

Conclusions
Mastering the spread of extensively drug-resistant bacteria involves a multidisciplinary preventive strategy. It must include strict application of hygiene measures, early detection and isolation of carriers and rationalization of antibiotic use.

Key messages
the emergence of extensively drug-resistant bacteria constitute a growing problem that`s why Carbapenemase Producing Enterobacteriaceae and vancomycin-resistant enterococci screening is crucial. Anti microbial agents use must be rationalized.
Attitudes, behaviors and consequences of sexting in Mexican gay and bisexual adolescents
Authors: Rodríguez Otero L 
Published: October 2020

Abstract
Sexting refers to the reception, sending and/or forwarding of photographs, videos and / or text messages of erotic-sexual content through the telephone and/or virtual media. To identify the attitudes, behaviors and consequences of sexting in homosexual and bisexual students (LGB) of Secondary School of Nuevo León (Mexico), a quantitative investigation was carried out. Through a simple random sampling consisting of 1,186 adolescents (76 homosexuals and 82 bisexuals), The sample was analyzed using a a self-administered anonymous questionnaire composed of sociodemographic issues, the Likert scale of behaviors on sexting by Chacón, Romero, Aragón, and Caurcel (2016), the Likert scale of attitudes towards sexting by Weisskirch and Delevi (2011) and the questionnaire about the consequences of Alonso's sexting practices (2017).
The results reveal that 78.73% perform passive sexting and 34.81% active sexting; on the other hand, it is evident that the frequency of the actual participation in sexting (M = 0.46; DT = 1.37) is average; and the active disposition towards sexting (M = 0.67; DT = 1.09) and Emotional expression in sexting (M = 0.64; DT = 1.52) are low. It is also identified that the perception of risk (M = 2.57; SD = 1.81) is high, the relational expectations (M = 0.84; SD = 1.78) are low; and considered as fun and / or carefree (M = 1.29; DT = 1.56) average. Likewise, it is evident that 15.82% of the sample declare to have receive coercion, 10.75% blackmail, and 8.86% teasing after having sexted.
Based on these results, it is considered necessary to propose preventive measures from the educational and community level through a biographical-professional Sexual Education model.

Key messages
Diagnosis of the problem in Nuevo León. Basis for proposing measures.
Cardiovascular disease risk factors of ultra-Orthodox Jewish women in Israel: a comparison study
Authors: Leiter E , Greenberg K L , Donchin M , Keidar O , Siemiatycki S , Zwas D R 
Published: October 2020

Abstract

Background
Women from low socio-economic, culturally insular populations are at increased risk for cardiovascular disease (CVD). The ultra-Orthodox Jewish (UOJ) community in Israel is a difficult to access, rapidly growing low socio-economic, insular minority with numerous obstacles to health. The current study investigates CVD-related risk factors (RF) in a sample of OUJ women, comparing sample characteristics with the general population. Addressing the questions, 'Are UOJ women at increased risk for CVD?', 'Which RFs should be addressed beyond the general population's?', this study can inform public health initiatives (PHI) for this and similar populations.

Methods
Self-administered questionnaires completed by a cluster randomized sample of 239 women from a UOJ community included demographics, fruit, vegetables, and sweetened drink consumption, secondhand smoke exposure, physical activity (PA) engagement, and BMI. Population statistics utilized for comparison of demographic and cardiovascular risk factors were obtained from government-sponsored national surveys.

Results
Compared with the general population, UOJ women were less likely to consume 5 fruits and vegetables a day (12.7% vs. 24.3%, p&lt;.001) and more likely to consume &gt; 5 cups of sweetened beverages a day (18.6% vs. 12.6%, p=.019). UOJ women also reported less secondhand smoke exposure (7.2% vs. 51.4%, p&lt;.001) and higher rates of PA recommendation adherence (60.1% vs. 25.6%, p&lt;.0001) than the general population. Obesity was higher in UOJ women (24.3% vs. 16.1%, p&lt;.0001).

Conclusions
This study suggests that PHIs in this population target healthy weight maintenance, nutrition, and PA. As a consequence of this study, the first CVD prevention intervention has been implemented in this population, targeting the identified RFs. Utilizing a mixed methods and community-based participatory approach, this innovative 3-year intervention reached over 2,000 individuals.

Key messages
This study identified nutrition risk behaviors and high levels of obesity in a difficult to access, minority population. This study informed the planning and implementation of a community-based PHI.
Transsexuality in the streets of Campinas: borderline resistance movements towards a humanistic care
Authors: Komoda D S , Justino J , Danny B , Suzy S , Carvalho S R , Botteon L M , Oliveira C F 
Published: October 2020

Abstract
According to WHO, transgender people are more likely to suffer from a broad range of health

Issues
high HIV prevalence, low access to health, discrimination, violence, rejection, unemployement, poverty, housing insecurity, and marginalisation. Structural macho-sexism is one of the main causes not only of violence, but also of lack of protective legislation and policy to this population. Developing research regarding transgender people's life experience in the streets and their pathways to healthcare is of major importance to achieve a more equitable society and public health system.
This qualitative research is a chapter of the book “Experiências do Cuidado na Rua” (”Living Care in the Streets”). From the experience of offering care in downtown Campinas to people living in the streets, 2 case reports were selected. The narratives were collected in a field journal. Both participants were female transgenders living in the context of Brazil's Universal Health System. National policy and legislation were confronted with narrative analysis of the participants, to show the barriers to receiving proper and humanistic care.
Some narratives show the clear violence suffered from law enforcement personnel: “We used to be beaten by the Police because we were prostituting ourselves”. Others show a transphobic moralistic context: “Last week a transexual had her heart torn here in Campinas, and a Saint image was put in her chest! I'm afraid to walk alone in the streets at night. “Yet others show a clear transphobic and problematic position from the now president Bolsonaro which reflects in transphobic sympathizers in hate speeches: “Nowadays [after presidential election] we hear in the streets 'let's send them to Bolsonaro!'”, as sending someone to the guillotine.
The narratives show a clear need of global and local actions towards a more accepting society, and actions must be taken in a broad range of fields, such as human rights legislation, policy and surveillance.

Key messages
This research show the neglect for the transgender population and the lack of protective measures, which reflects in access to the health care system and actual care. A growth of discrimination and hate speeches directly related to the election of an extremist-right national administration has been observed.
Can innovative digital collaborations help overcome barriers to intersectoral collaboration?
Authors: Nordström C , Kumar B 
Published: October 2020

Abstract

Issue
Health in all policies is desirable, but moving from the silos approach is a challenge for health care systems. New health policies require more cooperation and broader collaboration between governmental, private and volunteer sector, as well as across professions. Though it is key to implementation of national policies and long-term public health work at the local level, intersectoral collaboration remains elusive. Professionals working with public health and migrant health across Norway often work independently of each other and other sectors.

Description of the Problem
Evaluation of the Norwegian network for migrant friendly hospitals showed that with the opportunity to meet and share experiences, participants used the new knowledge and network in developing their practice and organisation of services. They experienced greater support to challenge status quo in their institutions. However, fear of making the network “too big to handle” is a barrier to creating intersectoral network. In a recent survey (2017), health personnel ask for digital solutions for finding resources and support in their practice to give better health care to immigrant patients.

Results
The newly (2020) knowledge HUB part of JAHEE actions brings stakeholders together at the local, regional and national level, ensuring access to the same knowledge, increase evidence based decisions among stakeholders when choosing interventions on the local, regional and national level, including sharing of good practices and promising initiatives at a national level so that they can be replicated.

Lessons
Professional networks that are coordinated and collaborative are important for development of services and implementation of measures for migrant health. However, expanding them across sectors and fields may create challenges. Combining sectoral networks with a common digital platform may overcome some of these challenges.

Key messages
Exploiting the potential of collaborative digital solutions may help overcome some barriers to intersectoral approach to migrant health. Coordinated collaborative professional networks can support the participants in developing their practice and organisation of services for migrants.
Self-care experiences of Indonesian adults with chronic disease living in Montreal
Authors: Lukman N A , Leibing A , Merry L 
Published: October 2020

Abstract

Background
Self-care (i.e., the actions towards monitoring and managing chronic illness and maintaining health) is an essential aspect of chronic disease management. These experiences are shaped by culture and values, health literacy, support from others and access to care. We conducted a study to explore the chronic illness self-care experiences and various influencing factors among a minority immigrant group, Indonesians, living in Montreal, Canada.

Methods
We used a qualitative descriptive approach. Eight adult men and women living with various chronic illnesses were recruited. Data were collected via semi-structured interviews and thematically analyzed.

Results
Three broad themes were identified: What's helpful, Challenges and responses, and Expectations. What's helpful captured different sources of supports of that helped the participants manage and monitor their illness and feel well and healthy. Challenges and responses highlighted the key challenges that participants have faced while living with a chronic illness, and how they have adapted (or not) and responded to these. Expectations include participants' disappointments towards their own self-care and/or support from family, the community and healthcare professionals, and describes what participants wished was different about their situation. The multiple views and nuances of their experiences as well as the various influencing factors of pre- and post-migration were interwoven within the description of each theme.

Conclusions
The self-care experiences of Indonesians living in Montreal shaped by different sources that helpful, challenges they faced and their responses as well as their disappointments and wishes for their own self-care.

Key messages
The self-care experiences of Indonesians living in Montreal are vary and shaped by different factors and sources. Healthcare professionals should engage more and consider the helpful sources for them, their challenges and the responses, their disappointments and hopes shaping their self-care experiences.
Access to health care and Informal Patient Payments for health care in Serbia
Authors: Buch Mejsner S , Lavasani Kjær S , Eklund Karlsson L 
Published: October 2020

Abstract

Background
Evidence often shows that migrants in the European region have poor access to quality health care. Having a large number of migrants seeking towards Europe, crossing through i.e. Serbia, it is crucial to improve migrants' access to health care and ensure equality in service provision

Aim
To investigate what are the barriers and facilitators of access to health care in Serbia, perceived by migrants, policy makers, health care providers, civil servants and experts working with migrants.

Methods
six migrants in an asylum center and eight civil servants in the field of migration were conducted. A complementary questionnaire to key civil servants working with migrants (N = 19) is being distributed to complement the data. The qualitative and quantitative data will be analysed through Grounded Theory and Logistic Regression respectively.

Results
According to preliminary findings, migrants reported that they were able to access the health care services quite easily. Migrants were mostly fully aware of their rights to access these health care services. However, the interviewed civil servants experienced that, despite the majority of migrants in camps were treated fairly, some migrants were treated inappropriately by health care professionals (being addressed inappropriately, poor or lacking treatment). The civil servants believed that local Serbs, from their own experiences, were treated poorer than migrants (I.e. paying Informal Patient Payments, poor quality of and access to health care services). The interviewed migrants were trusting towards the health system, because they felt protected by the official system that guaranteed them services. The final results will be presented at the conference.

Conclusions
There was a difference in quality of and access to health care services of local Serbs and migrants in the region. Migrants may be protected by the official health care system and thus have access to and do not pay additional fees for health care services.

Key messages
Despite comprehensive evidence on Informal Patient Payments (IPP) in Serbia, further research is needed to highlight how health system governance and prevailing policies affect IPP in migrants. There may be clear differences in quality of and access to health care services between the local population and migrants in Serbia.
Similarities and intersections – A comprehensive view in three studies
Authors: Stern A 
Published: October 2020

Abstract

Background
Various groups face difficulties in access to, and usage of health care. Research on marginalization in health care, and programs aiming to reduce inequalities usually focus on one single group at a time. Regarding the heterogeneity of groups defined by a few social characteristics, our aim was to question the specificity of barriers, and similarities between different groups.

Methods
The results of a mixed methods study focusing on elderly people with Turkish migration background were compared to the interim results of a qualitative study focusing on transgender persons, and the interim results of a qualitative study focusing persons with trauma related psychiatric diagnoses.

Results
1) While relevant barriers in access to, and usage of health care seem to be group-specific at the first view, their underlying mechanisms of emergence are analogous. 2) Beside more obvious similarities, 3) further barriers arise by the combination of more than the mainly addressed characteristics of the different groups.

Conclusions
Barriers analogous or similar among different groups lead to underlying structural or professionality-related issues. If different dimensions of marginalization intersect, they may be disguised by a concentration on single characteristics. To target health inequalities on the long term, a closer look on similarities between groups facing health inequalities could improve the development of programs for a broader range of persons.

Key messages
The comparison of different marginalized groups is useful to identify and target systematic inequalities in health care. Researchers and stakeholders should consider mechanisms of multiple marginalization.
Sense of belonging and years lived in Finland: associations among foreign-born population
Authors: Seppänen A , Lilja E , Kuusio H 
Published: October 2020

Abstract

Background
Belonging to different groups is associated with migrants' health. In this study, we examined the associations between sense of belonging (SoB) and years lived in Finland.

Methods
The data from the cross-sectional Survey on Well-Being among Foreign-Born Population (FinMonik, n = 6 836), conducted in Finland in 2018-19, was used. SoB was assessed by the question “Which of the following areas or groups you feel you belong to?” with options: local municipality; Finns; Europeans, country of origin; world citizens; religious or spiritual community; professional group or colleagues; political or ideological group. The data of years lived in Finland were linked from the National Population register and classified into three categories: less than five years; five to 10 years; over 10 years. Those who had lived less than one year in Finland were not included in the survey. Logistic regression was used to test the association between SoB and years lived in Finland, with age, sex and country of origin as confounding variables. In the analyses, weights were used to reduce non-response bias.

Results
Those who had lived in Finland over 10 years had higher odds for SoB towards Finns (OR = 1.74, p = &lt;0.001), local municipality (OR = 2.41, p = &lt;0.001) and Europeans (OR = 1.54, p = 0.001) and lower odds for SoB towards country of origin (OR = 0.68, p = 0.003) and religious or spiritual community (0.73, p = 0.043) when compared to those who had lived in Finland less than five years. No significant differences in SoB were found between less than five years in Finland and five to ten years in Finland.

Conclusions
SoB varied considerably when comparing those who had lived less than five years in Finland and those who had lived more than 10 years in Finland. Belonging to local people is more likely when one has lived in Finland more than ten years. Belonging to country of origin and religious or spiritual community is less likely when lived more than ten years in Finland.

Key messages
Sense of belonging seems to change over the course of stay in the new home country, but first after 10 years of stay. Identifying with local people and even with Europeans becomes more prominent after 10 or more years in Finland.
Health system response to large scale migration: the case of Emilia-Romagna region
Authors: Quargnolo M , Mammana L , Gherardi G , Bodini C , Damosto D , Florescu C , Fantini M P 
Published: October 2020

Abstract

Background
In Italy, recent changes in migration flows posed complex public health challenges. The Emilia-Romagna region (ERR) was one of the first regions to adopt specific policies addressing the health of newly arrived asylum seekers. In our study, we analysed the regional health system response comparing it to the regional and national guidelines, in order to assess its strengths and its critical areas.

Methods
In 2019, we conducted a survey among the referents of the regional clinics that provide healthcare to asylum seekers, in order to learn about local policies, challenges and best practices. A questionnaire with 35 closed and 11 open questions was administered and analysed through descriptive statistical analysis and text analysis.

Results
Regional policies showed good responsiveness and Local Health Authorities (LHAs) adhered to the guidelines. A special permit was introduced to grant asylum seekers access to healthcare, which also allowed integration of health data into the regional health information system. However, data integration was done in only 2 clinics out of 14. Instances of discretion in issuing the special permit were reported, due to ambiguity in the rules and inadequate training of office workers. Policies and LHAs protocols focused greatly on the arrival phase and on Communicable Diseases (CDs) surveillance. Other areas - such as protection of vulnerable groups, health promotion, NCDs - were prioritized in the national guidelines, but unevenly considered throughout the region, also due to lack of resources. Some clinics responded autonomously to these gaps with local resources.

Conclusions
The ERR health response to the influx of asylum seekers was rapid but incomplete. Interventions focused more on CDs surveillance than on responding to asylum seekers' health needs in terms of quality, access and equity. Areas to be strengthened include protection of vulnerable groups, health promotion and NCDs, together with coordination and long-term planning.

Key messages
The Emilia-Romagna region health response to the influx of asylum seekers reflects an emergency approach focused on communicable diseases, while NCDs and health promotion are relatively neglected. The health system in Emilia-Romagna needs to be strengthened in its capacity to respond to asylum seekers’ health needs. Health policies and practices should be planned to ensure equity and quality.