Alumni Evaluation of a Community-Oriented Master of Public Health Program

Health workforce development is a public health priority for the World Health Organization. Public Health training programs need to be relevant in a public health perspective and efficient in and educational perspective. This implies evaluating the programs: in this regard student's perception might be interesting, or the opinion of external experts, or the experience of alumni. To study the perception of alumni of a master's program in public health in order to reevaluate the goals and objectives of the program, a cross-sectional survey through a self-administered questionnaire among former students that graduated from the Geneva University Master in Public Health program was done. This self-administered questionnaire included closed questions on a Likert five-point scale for regarding the use at work of tools acquired during the course, as well as open questions. Overall the alumni gave a positive evaluation of the course. As strong points were mentioned: networking opportunities, student-centered approach and multi-professional background of the student body. More critically judged were: tutorship, time constraints and costs. As most useful tools in their professional settings alumni mentioned: communication skills, project evaluation competencies and literature search strategies and again networking which in this case seemed to be quite active. Evaluation surveys among alumni allow reevaluation of the program's goals and objectives in the light of their professional need

Spinal pain due to metastasis of unknown origin

A 58-year-old woman presented with non-radicular pain in the upper thorax. Due to the prolonged duration of symptoms, a bone scintigraphy was made, which showed pathological enhancement in the upper thoracic spine. An MRI demonstrated lesions of the third and fourth thoracic vertebrae. A biopsy showed a metastasis of poorly differentiated carcinoma. A whole-body 18-F-FDG PET scan failed to identify a primary tumour. The patient was given radiotherapy, chemotherapy and analgesic treatment. She died within 3years. In the late stage, the tumour marker CA 19-9 was positive; however, an MRI of the abdomen failed to identify a pancreatic tumour. Metastasis from an unknown primary site can present as cervical spinal disease very similar to degenerative diseas

Barriers to COVID-19 Health Products in Low-and Middle-Income Countries During the COVID-19 Pandemic: A Rapid Systematic Review and Evidence Synthesis

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has intensified the urgency in addressing pressing global health access challenges and has also laid bare the pervasive structural and systemic inequities that make certain segments of society more vulnerable to the tragic consequences of the disease. This rapid systematic review analyses the barriers to COVID-19 health products in low-and middle-income countries (LMICs). It does so from the canon of global health equity and access to medicines by proposing an access to health products in low-and middle-income countries framework and typology adapted to underscore the complex interactive and multiplicative nature and effects of barriers to health products and their root cause as they coexist across different levels of society in LMICs.MethodsModified versions of the Joanna Briggs Institute (JBI) reviewers' manual for evidence synthesis of systematic reviews and the PRISMA-ScR framework were used to guide the search strategy, identification, and screening of biomedical, social science, and gray literature published in English between 1 January 2020 and 30 April 2021.ResultsThe initial search resulted in 5,956 articles, with 72 articles included in this review after screening protocol and inclusion criteria were applied. Thirty one percent of the articles focused on Africa. The review revealed that barriers to COVID-19 health products were commonly caused by market forces (64%), the unavailability (53%), inaccessibility (42%), and unaffordability (35%), of the products, incongruent donors' agenda and funding (33%) and unreliable health and supply systems (28%). They commonly existed at the international and regional (79%), health sectoral (46%), and national cross-sectoral [public policy] (19%) levels. The historical heritage of colonialism in LMICs was a commonly attributed root cause of the barriers to COVID-19 health products in developing countries.ConclusionThis review has outlined and elaborated on the various barriers to health products that must be comprehensively addressed to mount a successful global, regional, national and subnational response to present and future epidemics and pandemics in LMICs

Macroinvertebrate assemblages in 25 high alpine ponds of the Swiss National Park (Cirque of Macun) and relation to environmental variables

High-altitude freshwater ecosystems and their biocoenosis are ideal sentinel systems to detect global change. In particular, pond communities are likely to be highly responsive to climate warming. For this reason, the Swiss National Park has included ponds as part of a long-term monitoring programme of the high-alpine Macun cirque. This cirque covers 3.6km2, has a mean altitude of 2,660m a.s.l., and includes a hydrographic system composed of a stream network and more than 35 temporary and permanent ponds. The first two steps in the programme were to (i) make an inventory of the macroinvertebrates of the waterbodies in the Macun cirque, and (ii) relate the assemblages to local or regional environmental variables. Sampling was conducted in 25ponds between 2002 and 2004. The number of taxa characterising the region (Macun cirque) was low, represented by 47 lentic taxa. None of them was endemic to the Alps, although several species were cold stenothermal. Average pond richness was low (11.3 taxa). Assemblages were dominated by Chironomidae (Diptera), and Coleoptera and Oligochaeta were also relatively well represented. Other groups, which are frequent in lowland ponds, had particularly poor species richness (Trichoptera, Heteroptera) or were absent (Gastropoda, Odonata, Ephemeroptera). Macroinvertebrate assemblages (composition, richness) were only weakly influenced by local environmental variables. The main structuring processes were those operating at regional level and, namely, the connectivity between ponds, i.e. the presence of a physical connection (tributary) and/or small geographical distance between ponds. The results suggest that during the long-term monitoring of the Macun ponds (started in 2005), two kinds of change will affect macroinvertebrate assemblages. The first change is related to the natural dynamics, with high local-scale turnover, involving the metapopulations characterising the Macun cirque. The second change is related to global warming, leading to higher local and regional richness through an increase in the number of colonisation events resulting from the upward shift of geographical ranges of species. At the same time the cold stenothermal species from Macun will be subject to extinctio

Umsetzung der Tallinn-Prinzipien beim Kanton Zürich

Der Handlungsdruck im Bereich der digitalen Transformation ist für die öffentlichen Verwal-tungen der Schweiz und anderswo gross. Einen Orientierungsrahmen bildet die Tallinner Erklärung der EU- und EFTA-Staaten über elektronische Behördendienste. Ergänzt wird sie seitens der EU durch die Berliner Erklärung zur Digitalen Gesellschaft und wertebasierten digitalen Verwaltung sowie durch die europäische Datenstrategie. Diese Grundlagendoku-mente zeichnen eine öffentliche Verwaltung der Zukunft, die vernetzt und kollaborativ ist. Auch der Kanton Zürich berücksichtigt viele Aspekte und Prinzipien der Tallinn-Deklaration in seinen strategischen Grundlagen. Um eine Gesamtsicht herzustellen und eine Diskussions-grundlage für die weitere Gestaltung der digitalen Transformation zu erhalten, hat die Abtei-lung Digitale Verwaltung und E-Government (DVE) des Kantons Zürich die beiden Fach-hochschulen BFH und ZHAW im Herbst 2021 damit beauftragt, den aktuellen Entwicklungs-stand der Digitalisierung beim Kanton Zürich vor dem Hintergrund der Tallinn-Prinzipien einzuordnen und Anregungen für die weitere Umsetzung der digitalen Transformation in der kantonalen Verwaltung zu geben. Zu diesem Zweck wurde der strategische Rahmen des Kantons Zürich mit den Vorgaben der Tallinn-Prinzipien verglichen, mit dem aktuellen Umsetzungsstand der Prinzipien in den öffentlichen Verwaltungen der Schweiz und Europas in Beziehung gesetzt und mit der aktuellen Situation in zwei Beispielämtern abgeglichen. Die Dokumentenanalyse wie auch die Interviews mit Vertretern von Ämtern, die als Vorreiter der digitalen Verwaltung gelten, haben insgesamt ein Bild einer fortschrittlichen Verwaltung ergeben. Die vor kurzem verabschiedeten Leitsätze adressieren die Aspekte, welche weiterverfolgt oder verstärkt berücksichtigt werden sollen. Sie stärken die Ambition und schärfen das Zielbild für die digitale Verwaltung. Als Ergebnis der Studie wurden im Hinblick auf eine zielgerichtete Weiterentwicklung der digitalen Verwaltung beim Kanton Zürich fünf Thesen formuliert; diese sind als Diskussions-grundlage im Hinblick auf die weitere Umsetzung der digitalen Verwaltung beim Kanton zu verstehen: These 1: Die Führungsverantwortung zur Förderung von Kooperation und Kollabo-ration ist stärker wahrzunehmen und einzufordern. These 2: Es braucht stärkere Verbindlichkeiten und Anreize für nachhaltiges bereichs- und stufenübergreifendes Arbeiten. These 3: Bei den Mitarbeitenden ist ein besseres Verständnis für die Dringlichkeit digitaler Arbeitsweisen zu schaffen; eine Stärkung der Kompetenzen führt zu besserer Akzeptanz. These 4: Bei den rechtlichen Grundlagen braucht es mehr Klarheit und klar definierte Freiheitsgrade. These 5: Es sollten vermehrt Ansätze verfolgt werden, welche zum Experimentieren und Innovieren über Organisationsgrenzen hinweg einladen

Perinatal mental disorders and suicidal risk among adolescent mothers living in urban areas of Cameroon

BackgroundIn sub-Saharan Africa the birth rate among teenage mothers is the highest in the world. In 2021, there would be 6,114,000 births for 15–19-year-olds in this part of the world. In Cameroon, the fertility rate among adolescents aged 15–19 is 24%. However, there is a significant lack of data on the mental health of teenage mothers. Given the biopsychosocial conditions of the perinatal period and adolescence, we hypothesise that the prevalence of mental disorders and the risk of suicide is very high in Cameroon. The aim is therefore to determine the prevalence of perinatal mental disorders and suicide risk among adolescent mothers in urban areas of Cameroon.MethodsFollowing ethical approval of the submitted protocol, we recruited adolescent mothers and data were collected using diagnostic interviews based on the DSM-5, PDM-2 and MINI guidelines. The types of sampling used were typical and incidental. Data were tabulated with Epidata 3.1 and processed with SPSS 25.Results66.4% of adolescent mothers were diagnosed with a mental disorder and 27.4% with suicidal risk. It was found that there was a link between mental disorders and suicidal risk (p<0.001), with mothers at suicidal risk having an 8.4 times greater risk of having a mental disorder (OR=8.423). Linear regression confirmed the statistically significant relationship between perinatal mental disorders and suicidal risk. 31.1% of the total variance in suicidal risk was explained by mental disorders. The regression coefficients for mental disorders with a p<0.05 value is: perinatal depression (-0.279), post-partum psychosis (-0.133), trauma disorder (-0.034), generalised anxiety disorder (-0.008) and conduct disorder (-0.020).ConclusionsOur hypothesis is confirmed, because the prevalence of 66.4% of mental disorders and 27.4% of suicidal risk are significantly high in Cameroon. In some way, the disorders predict suicidal risk, because the less an adolescent mother has one of these pathologies during the perinatal period, the less she will be at risk of suicide. More research of this kind is needed to contribute in providing more data, including solutions to address the morbidity and mortality problems associated with the mental health of teenage mothers

Initial characterisation of commercially available ELISA tests and the immune response of the clinically correlated SARS-CoV-2 biobank "SERO-BL-COVID-19" collected during the pandemic onset in Switzerland

Background To accurately measure seroprevalance in the population, both the expected immune response as well as the assay performances have to be well characterised. Here, we describe the collection and initial characterisation of a blood and saliva biobank obtained after the initial peak of the SARS-CoV-2 pandemic in Switzerland.Methods Two laboratory ELISAs measuring IgA & IgG (Euroimmun), and IgM & IgG (Epitope Diagnostics) were used to characterise the biobank collected from 349 re- and convalescent patients from the canton of Basel-Landschaft.Findings The antibody response in terms of recognized epitopes is diverse, especially in oligosymptomatic patients, while the average strength of the antibody response of the population does correlate with the severity of the disease at each time point.Interpretation The diverse immune response presents a challenge when conducting epidemiological studies as the used assays only detect ∼90% of the oligosymptomatic cases. This problem cannot be rectified by using more sensitive assay setting as they concomitantly reduce specificity.Funding Funding was obtained from the "Amt für Gesundheit" of the canton Basel-Landschaft, Switzerland.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThis study was sponsored by Jurg Sommer, head of the Amt fur Gesundheit, and the logistics of the sample collection were provided by the crisis staff and the civil protection service of the canton Basel-Landschaft.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:This study is part of the project COVID-19 in Baselland Investigation and Validation of Serological Diagnostic Assays and Epidemiological Study of Sars-CoV-2 specific Antibody Responses (SERO-BL-COVID-19) approved by the ethics board Ethikkommission Nordwest- und Zentralschweiz (EKNZ), Hebelstrasse 53, 4056 Basel representative of Swissethics under the number (2020-00816).All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesData are available upon reques

Women and healthcare providers' perceptions of a midwife-led unit in a Swiss university hospital: a qualitative study.

BACKGROUND: The development of medical-led care in obstetrics over the past decades has contributed to improving outcomes for both mother and child. Although efficiency has improved in complex situations, unnecessary interventions are still practiced in low-risk pregnancies, contrary to international recommendations. A shift to a less interventionist model of care has encouraged many countries to review their policies on maternal health care and develop models such as the "midwife-led unit" (MLU) where the midwife plays a predominant role with a minimum of routine intervention. Existing research has provided convincing evidence that MLUs lead to better maternal and neonatal outcomes when compared to traditional models. They not only improve the level of satisfaction amongst women, but are also associated with reduced healthcare costs. This study aimed to explore the perceptions of women and healthcare providers regarding the creation of an MLU in a Swiss university hospital. METHODS: A descriptive research study using qualitative methods was conducted among pregnant women and new mothers in a Swiss maternity unit, including also midwives and medical staff. Data collection was carried out through one-to-one interviews, focus groups, and telephone interviews (n = 63). After transcription, thematic analysis was performed. RESULTS: The triangulation of perceptions of women and healthcare providers indicated support for the implementation of an MLU to promote physiological delivery. Most women welcomed the idea of an MLU, in particular how it could help in offering continuity of care. Healthcare providers were optimistic about the implementation of an MLU and recognised the need for some women to have access to a less interventionist approach. From the women's perspective, barriers concerned the lack of awareness of midwives' full scope of practice, while barriers for midwives and obstetricians were related to the challenge to develop a good interprofessional collaboration. CONCLUSION: Alternative models to provide maternity care for low-risk women have been developed and evaluated widely in several countries outside Switzerland. This study showed that women and healthcare providers were favourable towards the development of a new care model, while taking into account the specific expectations and barriers raised by participants