bluuebunny/crossref_metadata_2025_split huggingface dataset:
Activation of 574 new Alzheimer’s special care unit beds in the Metropolitan City of Milan
Authors: Castelli B , Centurione E , Marino A F , Garau L , Cofano R , Ferrara A , Pannese C , Raimondi A , Gandolfi C E , Da Re N R 
Published: October 2020

Abstract

Issue
Dementia is among the main causes of disability and dependency in the elderly. It was defined a public health priority by the WHO. The health and social-care system of the Lombardy region (SSR) plays a key role in implementing assistance and care pathways specifically designed for fragile populations, including those affected by dementia and Alzheimer's disease, its most common form.

Description of the Problem
The SSR provides residential care options especially conceived for dementia patients, known as Alzheimer's special care units (ASCU). However, waiting lists are concerning, and distribution of these facilities is inconsistent throughout the region. In 2018 there were 981 accredited and SSR-covered ASCU beds in the Metropolitan City of Milan (MCM), translating in 1.26 beds/1000 people aged ≥ 65. With regional legislation (DGR 1046/2018), the SSR proposed activation of new ASCU beds in all territories with less than 2 beds/1000 people aged ≥ 65. The MCM Agency for Health Protection (ATS) thus analyzed the distribution of ASCU beds in afferent districts, defining specific needs for each district. The aim was to fund and activate 574 new ASCU beds homogenously among previously accredited and SSR-covered residential care facilities, reaching the targeted 2 ASCU beds/1000 people aged ≥ 65. Applicant facilities had to respond to specific personnel, technological, therapeutic and structural requirements.

Results
Preliminary results indicate 29 residential care facilities applied for evaluation in 2019. The ATS received and evaluated all applications. Following site-inspection, 8 facilities were deemed inappropriate.

Lessons
In 2019, 21 residential care facilities were approved for funding and activation of 558 new ASCU beds. Residual beds will be funded in 2020. Main messages: Activation of new ASCU beds in 2019 and 2020 increased specialized long-term care beds for dementia patients by almost 60%, allowing a more homogenous distribution among MCM districts.

Key messages
The health and social-care system of the Lombardy region proposed activation of new Alzheimer’s special care units beds in all territories with less than 2 beds/1000 people aged ≥ 65. Activation of 574 new Alzheimer’s special care units beds increased by almost 60%, allowing a more homogenous distribution among Metropolitan City of Milan districts.
Health promotion interventions involved medical students: a semi-experimental design assessment
Authors: Ladner J , Demaegdt C , Villard S , Vérin E , Vittecoq O 
Published: October 2020

Abstract

Background
In France, a new approach of health promotion re-enforcement was developed in 2919. The purpose is to train health students in health promotion interventions in different communities during two weeks and on a specific thematic, and associating interdisciplinarity partnership between curricula. This national policy is called “national health service” (NHS). The objective was to assess the NHS among medical students

Methods
A semi-experimental design “before-after” was used. Two anonymous self-questionnaires was completed by medical students (3rd year, preclinical course). A first questionnaire “before” the NHS, the second “after” in April 2019. For comparisons, identical information were collected 'before' and 'after'. Specific information to the two stages were also collected. An additional qualitative study based on same design (”before-after”) with interviews was also conducted.

Results
A total of 221 students in the “before” stage (exhaustivity: 92.9%) and 206 in the “after” (86.8%) were included. Schools represented more than half of community sites. Before the NHS, 49.5% of the students considered themselves insufficiently trained. Comparisons between the two stages showed, respectively: satisfaction with the health promotion intervention thematic (33.7% vs 53.2%; p = 0.0001), a major interest in the PS approach in the curriculum (21.3% vs 33.6%; p = 0.001), a major desire to integrate PS into future professional practice (33.6% vs 42.4%; p = 0.02), an interest major in the PS approach in interdisciplinarity (45.2% vs 59.8%; p = 0.0001).

Conclusions
The first edition of the NHS shows promising results, the training ground and the action carried out in cross-professionalism, declared interest in prevention actions and integration of health promotion in professional practice. This health promotion policy includes in the initial training of health students could be a innovative approach for a reinforcement of the French preventive health system.

Key messages
Innovative health portion intervention: first edition of the French NHS. Longitudinal approaches are needed to measure and assess the potential impact of the NHS.
Tobacco industry data on illicit tobacco trade: a systematic review of existing assessments
Authors: Gallagher A , Evans-Reeves K A , Hatchard J L , Gilmore A B 
Published: October 2020

Abstract

Background
The tobacco industry portrays itself as key to solving Illicit Tobacco Trade (ITT) and presents its funding of research on ITT as its attempt to address the problem. In recent years, transnational tobacco companies (TTCs) have been a major funding source of data on ITT which is heavily publicised, especially when a tobacco control policy is being debated.

Methods
Papers and reports assessing tobacco industry-funded data on ITT were obtained via systematic searching of academic and grey literature through databases and Google/website searches respectively. Characteristics of assessed industry funded data and criticisms/praise of them as detailed in the assessments were coded using a framework based on existing literature on methods for measuring ITT and for assessing the quality of estimates on tobacco tax avoidance and evasion.

Results
Of the 35 assessments reviewed, 31 argued that tobacco industry estimates were higher than independent estimates. Criticisms identified problems with data collection (29), analytical methods (22) and presentation of results (21), which resulted in inflated ITT estimates or data on ITT that were presented in a misleading manner. Lack of transparency from data collection right through to presentation of findings was a key issue with insufficient information to allow replication of the findings frequently cited.

Conclusions
Our findings demonstrate that the contribution of tobacco industry-funded data on ITT thus far in aiding understanding of ITT is extremely limited, if not counterproductive, as tobacco industry funded data on ITT is unreliable and primarily serves as a platform for the industry to lobby against tobacco control policies, including tax increases.

Key messages
TTC-funded data routinely exaggerate/overestimate levels of illicit when compared with independent sources and fail to meet the standards of peer-reviewed publications. A potential means for providing high-quality and transparent ITT research would be a tax on tobacco companies, with funds going towards independent development of established methodologies.
Hazardous workers and risk for third parties
Authors: Magnavita N , Ciprani F , De Lorenzo G , Garbarino S , Sacco A 
Published: October 2020

Abstract
Impaired workers, unable to practice their activities with effective skills and adequate safety protection because of physical or mental illness, alcohol and drug addiction, inappropriate behaviour as a consequence of fatigue, sleepiness, or distress, may be hazardous for colleagues and customers.
To properly manage these workers, public health must resolve the ethical dilemma arising from the legitimate interests of all stakeholders. The sick worker's interests include career expectations, role in organization, right to privacy, and right to freedom from discrimination. The customer's interests include protection from harm, right to autonomy, and right to informed choice. The society's interests include maintaining effective and affordable public services, as well as the benefits and burdens of any policies. Traditional ethics, oriented toward the individual relationship, failed to find an uncontroversial solution to these complex issues. Our research pointed to the organisation level.
The La.R.A. Study group on Hazardous Workers was set up in 1999 in Italy, to study how to protect the health and safety of impaired workers and that of third parties, without prejudice to the civil rights of workers. The group includes many subject matter experts like: doctors from different specialties, jurists, bioethicists, employees' and employers' representatives. It is independent and not financed.
The ethical, legal and operational aspects of each specific problem are discussed from different points of view and at the end a consensus document containing the practical indications for the prevention operators is produced. Over the years, Lara has produced 10 consensus documents on specific problems and has stimulated companies to develop policies for hazardous workers, preferably according to a bottom-up participatory model.
The collective definition of methods and solutions allows management of hazardous workers.

Key messages
Disability management is preferable to exclusion from work. A shared company policy is the basic principle of management of hazardous workers.
Making equal rights to health an election issue in NZ local body elections
Authors: Stone P , Leyland D e b 
Published: October 2020

Abstract
In New Zealand there are 20 district health boards (DHBs) with local elections every 3 years. There is low voter turnout for these, we suspect because the public has low cognizance of the role DHBs have in governing their health and disability system. Good governance ensures everyone whatever ethnicity, gender or sexual proclivity, from birth to old age, able or disabled, mentally well or unwell, drugfree or addicted, has equal rights of dignified access to healthcare. Without public engagement in DHB elections, the community risks having candidates elected that also don't understand their role through a preventative public health framework or human rights lens. The United Community Action Network (UCAN) developed a human rights framework and Health Charter for people driven into poverty by the costs of staying well in NZ. The framework outlines 6 social determinants of health needing protection through policy, to ensure all enjoy their rights to health. UCAN and the Public Health Association of New Zealand (PHA) partnered to raise public and the candidates' awareness during 2019 elections, of these social determinants causing inequity in health outcomes. A series of short explainer-videos were created for sharing through social media during the election build-up period, helping to promote PHA Branches' public Meet the Candidates events. Post-election, a longer film was produced to send to the elected DHB members. Our theory of change centred on spotlighting health inequity for voters, so that they would elect DHB members who had the greatest understanding and commitment to addressing this issue. With shareable videos we aimed to attract audience, raise awareness and debate the policy solutions to health inequity with candidates, enabling more informed choice amongst the voting public. Post-election, we maintain supportive relationships with the elected DHB members that promised their commitment to our Health Charter during their campaigns.

Key messages
Using videos and social media, local body elections provide an opportunity to promote everyone’s right to affordable healthcare, supporting and informing voter decision-making. UCAN's Health Charter is an advocacy resource for raising awareness of the social determinants of health inequity and poverty for people with mental illness, addiction and disability.
Swedish politicians’ reflection of health effects for newly arrived migrants in decision-making
Authors: Svanholm S , Carlerby H , Viitasara E 
Published: October 2020

Abstract

Background
The political context of health promotion is important, however politicians' role has been sparsely researched. The aim was to explore whether politicians reflect on health effects of newly arrived migrants during political decision-making.

Methods
In total 667 politicians from municipalities and regional councils in the north of Sweden answered a web-based survey in 2019. The variable self-reported reflection of health effects during decision making in the last three months, focused on newly arrived migrants and the general population in the area, was used for analysis. Differences between political groups were analysed through Chi-squared test and differences in focus between the general population and newly arrived migrants were analysed by Wilcoxon Signed Rank Test.

Results
Preliminary results indicate that out of the participants 29,0% reported reflection on health effects for newly arrived migrants in large parts of their decisions, 50,5% having done so a few times, while 20,5% did not reflect. The politicians from the regions reported to a higher degree, compared to the municipality politicians, to have reflected on health effects (p = 0,003, Cramer's V = 0,136). Politicians more often considered the health effects of the general population in their decisions than for newly arrived migrants (z=-0,006, p &lt; 0,001, r = 0,249). This difference remained when testing the municipality politicians (z=-7,417, p &lt; 0,001, r = 0,228) and regional politicians (z=-5,138, p &lt; 0,001, r = 0,346) separately.

Conclusions
Not all politicians reflect on the health effect of their decisions, especially not for newly arrived migrants' health. Politicians in the municipalities, responsible for many of the social determinants of health, did so to a lesser degree than the politicians in the regions, responsible for the healthcare system. The potential for politicians to promote health is thus not realized and political decisions can unintentionally affect health.

Key messages
Only a relatively small part of politicians considers health effects for newly arrived migrants in large parts of their decision-making. Municipality politicians, whose political decisions affect many determinants of health, consider health effects in a lesser degree than regional politicians do.
Are we going to do something about the calamity of prostitution? A Public Health perspective study
Authors: Sanchez-Rodriguez D , Arana-Aragon B , Rueda-Nieto S , Monteagudo-Perez J F 
Published: October 2020

Abstract

Background
Regulatory attempts throughout history have not concluded in an improvement of living and health conditions of sex workers. The main purpose of this work is to defend the abolition of prostitution with a reflection from the historical and current evidence provided by Public Health workers.

Methods
We perform a systematic strategy for literature searching in both primary and secondary sources of biomedical information, obtaining original articles, systematic reviews, case reports, thesis and legal texts. We included those studies focused on prostitutes placed in Spain and Europe within nineteenth and twentieth century. Encounters with local associations are being arranged in order to achieve information about sex workers' situation in Region of Murcia.

Results
In 2011, the average age of prostituters was 28,01 years old. The origin of the sex workers was Spanish in 11.3% of the cases, declaring 61% of them being single at the current moment. The use of drugs and the inconstant use of protection during sex are other factors that coexist with this activity. These results are provisional since local data are not available yet.

Conclusions
Nowadays prostitution is still an uncomfortable problem in most democratic countries. Governments have shown unable to approach the phenomenon with equity and gender perspective. Poverty is widely recognised as the main cause that push not only women to prostitution, but also cis males and transsexuals. However, there is a cornerstone question regarding gender determinants in health and patriarchal structure of our society. Those are topics that cannot be eluded by Public Health policies.

Key messages
Management of health problems derived from sex work is mandatory for Public Health workers. Future solutions must include equity and gender perspective in order to achieve the abolition of prostitution.
Health workers on the move: the need for global policy
Authors: Hinlopen C , Ligterink L , Bemelmans M , Koutsoumpa M , Kramer K 
Published: October 2020

Abstract

Issue
WHO's Global Code of Practice on the International Recruitment of Health Personnel was adopted in 2010 by WHO Member States to 1: monitor and address unethical international recruitment practices; 2: to strengthen national health workforces. Unethical recruitment and lack of investments in resilient health workforces was leading to increased health inequalities worldwide. The WHO Code provided non-binding behavioral principles to address these.

Description
The WHO Code came with a monitoring and review mechanism. Member States were to report on Code implementation every three years and every five years the Code's relevance and effectiveness is reviewed. In the 2018/19 reporting round, non-state actors, too, submitted reports to WHO. Wemos carried out a qualitative analysis of these (14) reports and presented the findings to the Expert Advisory Group (EAG) tasked to review the Code in 2019/20.

Results
Non-state actor reports provide important additional information to Member States' reports on Code implementation. The 14 submissions included cases of unfair treatment of migrant health workers and indicated some improvement in health workforce planning and forecasting. Moreover, they pointed to a lack of efforts (or results thereof) by governments to invest in more resilient health workforces, fueling health worker mobility globally.

Lessons
These findings are consistent with observations from civil society, trade unions, health professional associations and employers' organizations, as evidenced during the roundtable discussions with the EAG in June 2019. They noted that increased global mobility, not just by health workers, is a given and actually further accelerated by a growing number of inter-country migration agreements, undermining equitable access to a health worker across the globe. They urged for supra-national policies and practices in order to achieve Universal Health Coverage for all by 2030.

Key messages
With increased global mobility of individuals, an equitable distribution of health workers worldwide surpasses the policy scope of national governments and requires supra-national measures. The involvement of civil society in the monitoring of mobility trends and equity effects of health workforce policies is essential for shared prosperity as envisioned in the SDG Agenda.
Alcohol purchases from a large Finnish retail chain before and after a change in alcohol legislation
Authors: Uusitalo L , Nevalainen J , Rahkonen O , Erkkola M , Saarijärvi H , Fogelholm M , Lintonen T 
Published: October 2020

Abstract

Background
In January 2018, the legal limit for alcoholic beverages in grocery stores changed from 4.7 to 5.5 % alcohol. The increased availability of stronger beer, cider and ready-to-drink beverages was expected to increase the total amount of 100% alcohol bought. The study aimed to examine how the change in alcohol legislation affected the purchasing of 100% alcohol from grocery stores by comparing the years 2017 and 2018.

Methods
The study data consisted of 47,066 loyalty card holders of Finland's largest retail chain, who gave their consent and provided background information by an online questionnaire. The data contained the type, volume and alcoholic content of the purchases, from which we calculated the amount of 100% alcohol bought. The mean individual alcohol purchases in the years 2017 and 2018 were compared by age, gender, level of education and household income using repeated measurements ANOVA models.

Results
There was only a small, non-significant change in the total amount of 100% alcohol between 2017 and 2018 (mean 1.9 l and 2.0 l, respectively, p = 0.220). Lower income was associated with a decrease in total 100% alcohol purchased, whereas higher income groups showed an increase. Increase in 100% alcohol bought as ready-to-drink beverages was seen in all population groups.

Conclusions
The availability of stronger alcoholic beverages in grocery stores did not result in a notable overall increase in total purchases of 100% alcohol. The increased purchases of alcohol as ready-to-drink beverages were, on the average, compensated for by decreased purchases of alcohol as other beverages. The association of income with total alcohol purchases may indicate the effect of price in consumer behavior.

Key messages
The raise in the legal limit of alcohol content raised did not result in a significant increase in the total amount of 100% alcohol bought from grocery stores. Alcohol purchased as ready-to-drink beverages increased in all population groups.
The precarious public policies related to asbestos in Brazil
Authors: Ribeiro E A , Paiva C H A 
Published: October 2020

Abstract
In this decade, Brazil was the world's third largest producer of asbestos, and the fourth largest consumer, with an estimated 500,000 Brazilian workers being exposed to asbestos during the working day, and millions of users to several asbestos materials. In Brazil, the precarious public policies related to asbestos production and commercialization contributes to the invisibility of the problems related to its exposure. Thus, an immersion in the discussion of public policies related to asbestos was necessary. A qualitative investigation of an exploratory type was conducted, based on documentation research of requirements of commissions, ordinances, bills, and public hearings published in the period from 1970 to 2019, related to asbestos, by the Brazilian National Congress. We found 624 occurrences/documents, which were analyzed and discussed in this study. The complexity of the interrelations between actors and the State in the formulation and implementation of public policies is demonstrated, asbestos being the subject on the decision-making agenda several times, however, the creation of a national public policy occurred only on a few occasions. International scientific cooperation is one of the ways to cope with asbestos-related diseases, as it allows the transfer of know-how of best practices. When discussing the Brazilian reality, it is possible to disseminate the attitudes that were important in the process of policy construction in Brazil, thus preventing the waste of time and practices in procedures that have already proved wrong.

Key messages
Precarious public policies contributes to the invisibility of the asbestos problems. International scientific cooperation is one of the ways to cope with asbestos related diseases.