bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic versus opportunistic risk assessment for the primary prevention of cardiovascular disease: Cochrane systematic review protocol
Authors: Dyakova Mariana , Drew Christian , Wright Nicola , Clarke Aileen , Rees Karen 
Published: May 2023

A large number of people, considered at increased risk of vascular disease, remainunidentified, untreated and not reached by lifestyle advice or intervention, despite publichealth and clinical efforts. This has prompted the initiation of national screening/systematic risk assessment programmes for vascular disease in healthy populations. These exist in addition to the more ad hoc opportunistic risk assessment initiatives undertaken worldwide. There is currently not enough indisputable evidence either showing clear clinical or economic benefits of systematic screening-like programmes over opportunistic risk assessment of cardiovascular disease (CVD) in primary care. We present the rationale and methodology of a Cochrane systematic review, assessing the effectiveness, costs and adverse effects of systematic risk assessment compared to opportunistic risk assessment for the primary prevention of CVD.
Committed collaboration to address homelessness in the Netherlands
Authors: Argyrou Flora , Hirschler Josefine , Karan Filip , Kugel Raika , Romancenca Elena , Neicun Jessica 
Published: May 2023

Context: In the Netherlands, the number of homeless people increased from 17.800 in 2009 to 39.300 in 2018. Due to the COVID-19 pandemic and its socioeconomic consequences, the needs of marginalized people have increased worldwide in terms of access to services and relevant information. In the Netherlands, along with the Red Cross, other humanitarian organizations such as the Salvation Army, the Rainbow Foundation, and the Foundation for the Homeless are already providing people in need with primary needs such as food and housing, but also with healthcare and legal support. Cooperation between services for the homeless is also gaining attention. However, collaboration between relevant stakeholders is still insufficient and urges to be expanded. Moreover, centralized monitoring is challenging as different services are provided (shelters, assisted housing) by different stakeholders and there is no central data collection system or pre-defined indicators. Recent, comprehensive data on homelessness figures are needed to understand the needs and how these may have changed, given the exacerbated consequences of COVID-19 pandemic on those in socioeconomic vulnerability, in order safeguard the health, safety and dignity of homeless people.
Management of Medical Record Unit Services for Covid-19 Patients in Type C Hospitals: A Study of Legal Aspects.
Authors: Setijaningsih Retno Astuti , Suyoko Suyoko , Sukamto Mellinia , Wijayanti Arinimar Shaffa , Vaninda Brissa Gustaviar , Rochmah Eva Nur , Wahyuni Ngesti , Nufus Sabrina Hayatun , Isworo Slamet 
Published: May 2023

Background: The impact of the pandemic on medical record health service procedures has induced significant changes. The duplication of Covid-19 patient numbers in the patient medical record unit is an important concern. This study aims to analyze the legal aspects of managing medical record services during the Covid-19 pandemic in hospitals.
Methods: This type of research is descriptive and quantitative with a cross-sectional approach. The key informants are 15 registration and medical record unit officers, using online interview techniques, employed in three hospitals in Semarang with a focus on group discussions. The object of research includes the management of medical records and service standards for Covid-19 patients as regulations in the medical record unit of the Semarang city general hospital.
Results: Policies and standards for medical record services for Covid-19 patients, have not been adjusted to the provisions based on Circular Letter Number HM.01.01/001/III/2020 concerning procedures for work in situations of the Covid-19 outbreak. The medical record service for Covid-19 patients still applies paper-based or semi-electronic medical records so that errors can occur. This can cause legal problems for hospitals; therefore, medical record service standards must meet legal aspects as legal evidence that can protect the interests of various parties.
Conclusions: It is necessary to manage a medical resume form design that is better, complete, electronical, and in accordance with legal aspects.
Fetal outcome of adolescent pregnancy in a tertiary care center in western Nepal: A case control study
Authors: Mahato Sweta , Younjan Sanjeev , Mahato Anamika 
Published: May 2023

Background: The incidence of adolescent pregnancy is decreasing in developed countries, whereas developing countries like Nepal still report a high incidence.
Aims: To compare the fetal outcomes of adolescent pregnancies with those of the optimal reproductive age group in a country that accounts for 95% of teenage pregnancies, in contrast to 11% worldwide.
Method: A hospital-based case-control study was conducted with 150 pregnant women with singleton gestation admitted to Kathmandu University Hospital. An adolescent pregnancy (<19 yrs.) was considered a case, and pregnant women of the optimal age group (20-35 yrs.) were considered the control. The data were collected from Jan 5, 2018, to Jan 5, 2019. The control group was selected by matching the parity of the cases in the study groups during the same study period. Respondents were interviewed and examined with a pre-structured tool. Odds Ratio (OR) and 95% Confidence Interval (CI) were calculated using conditional logistic regression (P<0.05 considered significant).
Results: The mean age of adolescent mothers was 17 years, the majority being primigravida. This study identified that fetal complications were higher in adolescent pregnancies (61% vs. 40%). The fetal complications like low birth weight (OR 2.42, 95%CI :1.044-5.43, P=0.03), NICU admission (OR 3.27, 95%CI:1.48-7.25, P=0.003), low APGAR score (OR 2.32, 95%CI:1.05-5.11, P=0.034) and Neonatal Death (OR 3.72, 95%CI:1.15-12.01, P=0.04) were associated with the adolescent pregnancies respectively.
Conclusion: Adolescent pregnancies are at increased risk of fetal complications compared to pregnancies in the optimal reproductive group. Adolescent pregnancies were at increased risk of low birth weight, neonatal death, low APGAR score, and higher admission in NICU. Therefore, an adequate antenatal visiting program for early detection and timely management likely will reduce the fetal complications during adolescent pregnancy.
Health behavior, stress and obesity among working age women in Myanmar
Authors: Htut Win Mya Mya , Sornlom Kittipong , Loahasiriwong Wongsa 
Published: May 2023

Aim: This study aimed to determine the prevalence of overweight and obesity and to investigate the association between socioeconomic factors, health behaviors, health literacy, knowledge, attitude, physical and mental health status, and overweight and obesity among working age women in Myanmar.
Methods: A cross-sectional study was conducted among 1,094 women aged 18 to 59 years old who were recruited by using multistage random sampling from 12 townships out of 6 districts among three states/regions. A structured questionnaire was developed and applied to assess the prevalence of overweight and obesity. Generalized Linear Mixed Model (GLMM) was performed to determine the association between dependent and independent variables after controlling the effects of covariates presenting adjusted OR and 95% confidence interval.
Results: More than half of the respondents were with overweight and obesity (51.28%; 95%CI: 48.31-54.23). The multivariable analysis indicated that factors significantly associated with overweight and obesity included; aged 31-59 years (Adjusted Odds Ratio (AOR) = 1.72, 95%CI:1.22-2.40), living without family (AOR= 2.07, 95%CI:1.20-3.57), average monthly income ≥200,000MMK (AOR= 1.38, 95%CI:1.05-1.82), parity≥1 (AOR= 1.61, 95%CI: 1.17- 2.23), high fat & protein consumption ≥5-days per week (AOR= 2.90, 95%CI:1.91-4.39), alcohol consumption (AOR= 2.53, 95%CI:1.91-3.36) and moderate-severe stress (AOR= 1.47, 95%CI:1.11-1.94).
Conclusion: More than half of working age women were with overweight and obesity. Socioeconomic status, health behavior and stress are the factors behind over nutrition. The findings provide relevant evidence to develop the appropriate policies and public health interventions in order to minimize the burden of overweight and obesity. Likewise, it is anticipated that this outcome would support the prevention of cardiovascular and other chronic diseases.
Policy Brief on Revising the TB Action Plan for the WHO European Region 2016-2020: What amendments are needed to reach the UN SDG3 to eliminate TB epidemics by 2030?
Authors: Serling Willa , Lotushko Volodymyr , Bocken Nick , Gietz Lisa , Paric Martina 
Published: May 2023

Context: The World Health Organization (WHO) European Region’s political attention shifted to the COVID-19 pandemic from the start of 2020 onwards. A consequence of this shift has been decreased political attention towards combating tuberculosis (TB) in the WHO European Region. As a result, decreasing TB data reporting, rising death rates, and increasing antimicrobial resistance (AMR) have prevented the WHO European Region from remaining on track to reach the United Nations Sustainable Development Goal 3 (SDG3) to eliminate TB epidemics by 2030. Furthermore, the WHO tuberculosis action plan for the WHO European Region 2016-2020 has missed opportunities to mitigate TB in this region, thus exacerbating the issue and preventing the achievement of SDG3.
Policy Options: The WHO’s Roadmap to implement the tuberculosis action plan for the WHO European Region 2016-2020 provided guidance for TB management in the member states (MS), but did not sufficiently address AMR, lacking promotion of new TB vaccine rollout, nor describe national TB implementation strategies. The WHO 2016-2020 TB action plan is now overdue and WHO policymakers should consider the following recommendations when creating the new TB action plan.
Recommendations: This policy brief addresses the urgent need for a new WHO TB action plan to integrate a national level implementation commitment, AMR programming, and WHO support in creating a vaccine strategy with aims for the WHO European Region to achieve SDG3 and eliminate TB epidemics by 2030.
Autism and Inclusive Education: Recommendations for improvement during and after COVID-19
Authors: Reijnders Anne Petronella Maria , Eijnde Sanne Quérine van den , Janssen Ruben Renerus Martin , Kesse Robin van 
Published: May 2023

Context: COVID-19 has disproportionately affected the autism community yet also provided an opportunity to improve education delivery. There are several policies to ensure education for autistic children, but there are still gaps that need to be filled.
Policy Options: This policy brief analyses several interventions designed to create a more inclusive education environment for autistic children. The four policy options described and analyzed are: Teacher assistants focussing on children with special education needs, Peer Mentoring Interventions (PMI), Digitalization of Education, and Gamification.
Recommendations: The analysis concludes that PMI and Gamification would be the most feasible to implement. PMI can improve the dynamic between autistic children and their neurotypical peers. Gamification enables personalization to educational needs and fluid transition to at-home education. Subsequently, the European Union already invests in gamification, making the step smaller to invest in gamification for inclusive education.
Technical efficiency of Kosovo public hospitals
Authors: KarmaPhD Emiljan , Gashi Dr. Silvana 
Published: May 2023

Aim: The goal of this paper is to evaluate the technical efficiency of Kosovo public hospitals and to propose ways to improve the situation.
Methods: An input-oriented Data Envelopment Analysis model with a constant return to scale was applied for a 3-year period from 2018 to 2020. Input variables of number of beds, number of specialists and how they are used to produce outputs of inpatient discharges and surgical operations, are examined.
Results: The analysis highlights the marked hospital technical inefficiencies. This study clearly points out the greater attention of public healthcare institutions toward production efficiency. Results illustrate that at least half of Kosovo Public Hospitals operate inefficiently compared to their counterparts. Inefficient, compared to efficient hospitals, on average utilize at least (depending on scenarios analysed) 30% more beds and specialists.
Conclusions: The resources available for public health services in Kosovo are the lowest in Europe and the challenge remains to secure financial resources and use them effectively. The study illustrates that most of Kosovo Public Hospitals run inefficiently. Productivity is low, efficiency needs to be improved, especially in terms of introducing modern treatment methods such as daycare. Based on this research, it seems advisable to decrease the number of beds while rationalizing the number of specialized physicians with respect to the special requirements of therapeutic and diagnostic processes in the individual hospitals.
Nonoperative management for major blunt hepatic trauma in a 3-year-old child
Authors: Cela Dritan , Abilaliaj Valmira , Shpuza Aldo 
Published: May 2023

Introduction: Based on hemodynamic stability, non-operative management of low- and high-grade liver injury is the first treatment choice over surgical treatment. Small clinics are still preferring primary operative approach instead of nonoperative one.
Presentation of the case: We are presenting a case (3-year-old male child) of nonoperative treatment of a grade IV blunt liver trauma (lacero-contusive injury of V, VI and VII segments) with massive hemoperitoneum. The patient was put into a conservative treatment with antibiotics, fluids and ½ unit of blood. The results of Computed Tomography showed significant amounts of perihepatic and periileal fluid between the bowels and in the Douglas pouch, which persisted for five days. Laboratory alterations ​​of Serum Glutamic Pyruvic Transaminase, Serum Glutamic-Oxaloacetic Transaminase, and Total Bilirubin reached their maximum values on third day, persisting in decline until fifth day and returned to normal after tenth day. The hospital stay was 11 days, the length of time necessary for the complete conservatory treatment and full recovery of the trauma.
Discussion: More than 80%-90% of liver injuries are managed with nonoperative intervention. Early and late complication can be managed by interventional radiology procedures when it is possible. Success rate of conservative treatment is over 80%.
Conclusion: If no other abdominal injuries are evident and patient is hemodynamically stable nonoperative management for major blunt hepatic trauma in children is the best choice of treatment
Predicting the intention to use social media among medical students in the United Arab Emirates: A machine learning approach
Authors: Alomari Khaled Mohammad 
Published: May 2023

Aim: The volume of research being conducted on the acceptance of social media platforms is rising. But the factors influencing the acceptance for academic reasons are still not properly identified. This study's goal is two-fold. Initially, by including Technology Acceptance Model (TAM) and external variables, analyze the students' intention to use social media networks. Secondly, to employ Machine Learning (ML) algorithms and Partial Least Squares-Structural Equation Modeling (PLS-SEM) to verify the proposed theoretical model.
Methods: The focus of this research is to create a conceptual model by supplementing TAM with a subjective norm to assess students' adoption of social media in the classroom. Students currently at one private university in the United Arab Emirates (UAE) provided a sum of 627 acceptable questionnaire surveys out of 700 distributed corresponding to 89.6%. The collected data were evaluated using ML and PLS-SEM.
Results: According to the research findings, students' intention to utilize social media networks for learning is significantly predicted by “subjective norms, perceived usefulness, and perceived ease of use”. These findings illustrated how crucial it is for students to feel capable and secure using social networks in their academic work. For validation using machine learning classifiers, the results showed that J48 (a decision tree) typically outperformed other classifiers.
Conclusion: According to the empirical findings, "subjective norm," "perceived usefulness and ease of use" all significantly increase students' intention to use social networks for learning. These results were in line with earlier research on social network acceptability. Lawmakers and managers of social media platforms in education must therefore concentrate on those factors that are crucial to promoting education and enhancing students' capacity for developing and implementing successful social media applications.
Efficacy of an IgM preparation in the treatment of patients with sepsis: a double-blind randomized clinical trial in a pediatric intensive care unit
Authors: Kola Ermira , Çelaj Ermela , Bakalli Iliriana , Lluka Robert , Kuli-Lito Gjeorgjina , Sallabanda Sashenka 
Published: May 2023

Aim: Additional treatments for sepsis to be administered alongside the standard therapy recommended by the Surviving Sepsis Campaign have recently undergone evaluation. Due to its anti-bacterial, anti-inflammatory and immunomodulatory properties, intravenous polyvalent immunoglobulin M (IgM)–enriched immunoglobulins (IgM preparation) has been investigated as one of these potentially valid adjunctive therapies. The aim of this trial was to assess the efficacy of an IgM preparation as adjuvant therapy in the treatment of pediatric patients with sepsis.
Methods: In our study, 78 septic patients admitted to a pediatric intensive care unit (PICU) at the University Hospital Center “Mother Teresa” in Tirana, Albania, were randomized into two groups (intervention and control). All patients were treated according to standard PICU sepsis guidelines. Additionally, patients in the intervention group received the IgM preparation Pentaglobin® while patients in the control group received standard sepsis therapy, but no immunoglobulin administration.
Results: The survival rate was higher in the intervention group (87%, N=34) than in the control group (64%, N=25), and this difference was statistically significant (P=0.03). Length of stay (LOS) was also significantly shorter in the intervention group.
Conclusion: In this study conducted in Albania, use of an IgM preparation, in addition to standard sepsis therapy, led to a significant increase in the survival rate as well as a significant reduction in LOS compared with placebo, when administered in PICU patients with sepsis.
Public Health Teaching Books (Open Access)
Authors: Laaser Ulrich 
Published: May 2023

European Stability Pact for South Eastern Europe
Funded by Germany 2001-2010
PUBLIC HEALTH TEACHING BOOKS (1st edition) PUBLISHED OPEN ACCESS
Health Systems and Their Evidence Based Development (578 pages)
Management in Health Care Practice (672 pages)
Health Promotion and Disease Prevention (806 pages)
Health Determinants in the Scope of New Public Health (633 pages)
Public Health Strategies: A Tool for Regional Development (647 pages)
Methods and Tools in Public Health (1014 pages)
Sexual health knowledge, attitude and risk perception among in-school and out-of-school female adolescents in Onitsha, Anambra State, Nigeria
Authors: Adogu Prosper , Udigwe Ifeoma , Nwabueze Achunam , Adinma Echendu , Udigwe Gerald , Onwasigwe Chika 
Published: May 2023

Aim: Young people need protective information and skills in order to reduce the riskassociated with unsafe sex. This study assessed and compared the sexual health knowledge, attitude and risk perception of in-school and out-of-school female unmarried adolescents in Onitsha North Local Government Area, Anambra State, Nigeria.
Methods: A comparative cross-sectional design was used in which 391 in-school female adolescents (mean age: 15.9±1.4 years ) were selected from 25 private and 17 public schools in Onitsha North Local Government Area, Anambra State, Nigeria using multistage sampling method. A comparison group of 392 out-of school female adolescents (mean age: 15.5±2.5 years) was also selected from a major market in the same Local Government Area using cluster sampling technique. Data was collected from the respondents with pre-tested, interviewer-administered questionnaires on reproductive and sexual health knowledge, risk perception and attitude, sexual behaviour, contraceptive knowledge and sources of sexual health information.
Results: In-school girls demonstrated better knowledge of sexual and reproductive health compared to their out-of-school counterparts. The awareness of fertile period, contraception methods, STI and HIV transmission and prevention were all significantly better among the in-school adolescents compared to their out-of-school counterparts (P<0.05). They also had markedly higher risk perception of getting pregnant (P<0.05) or acquiring HIV infection (P<0.05) compared to their out-of-school counterparts.
Conclusion: About 21% of adolescents in this study area were involved in risky sexualbehaviour and this was higher among the out-of-school adolescents than their in-school counterparts. All stakeholders in the state and the Local Government Area should come together and develop interventions that would improve the sexual health knowledge and sexual risk perception of the adolescents.
Self-perceived level of competencies of family physicians in transitional Kosovo
Authors: Skeraj Fitim , Czabanowska Katarzyna , Bojaj Gazmend , Burazeri Genc 
Published: May 2023

Aim: Family physicians and general practitioners are currently facing increasing demands to meet patients’ expectations and rapid technological and scientific developments. The aim of this study was to determine the self-perceived level of competencies of primary health care physicians in Kosovo, a post-war country in the Western Balkans.
Methods: A cross-sectional study was conducted in Kosovo in 2013 including arepresentative sample of 597 primary health care physicians (295 men and 302 women; mean age: 46.0±9.4 years; response rate: 90%). A structured self-administered questionnaire was used in order to determine physicians’ competencies regarding different domains of the quality of health care. The questionnaire included 37 items organized into six subscales/domains. Answers for each item of the tool ranged from 1 (“novice” physicians) to 5 (“expert” physicians). An overall summary score (range: 37-185) and a subscale summary score for each domain were calculated for each participant. General linear model was used to assess the association of physicians’ self-perceived level of competencies with covariates.
Results: The internal consistency of the whole scale (37 items) was Cronbach’s alpha=0.98. Mean summary score of the 37-item instrument and subscale summary scores were all higher in men than in women. In multivariable-adjusted models, mean level of self-perceived competencies was higher among older physicians, in men, those with >10 years of working experience, physicians serving >2500 people, specialized physicians and those involved in training activities.
Conclusion: Our study provides useful evidence on the self-assessed level of competencies of primary health care physicians in post-war Kosovo. Future studies in Kosovo and other transitional settings should identify the main determinants of possible gaps in self-perceived levels of physicians’ competencies vis-à-vis the level of physicians’ competencies from patients’ perspective.