The ballad of financial dependency: sponsoring in public health professional societies

The European Public Health Association (EUPHA) has become one of the leading voices of public health in Europe. Its annual European Public Health Conference (EPH), jointly organized with the Association of Schools of Public Health in Europe (ASPHER), is now the main platform for direct exchange between scientists and public health practitioners. This is good. And yet there remains a constant irritant, repeatedly discussed in EUPHA boards, covered by a detailed ‘Code of Conduct’,1 and still not resolved to everybody’s satisfaction: the issue of industry sponsoring, in particular by the pharmaceutical sector. ASPHER, the World Federation of Public Health Associations (WFPHA)2 and many national public health professional societies face similar challenges

Rethinking the 'global' in global health. A dialectic approach

Bozorgmehr K. Rethinking the 'global' in global health. A dialectic approach. Globalization and Health. 2010;6(1): 19

Effect of cultivar, processing, and storage on the quality characteristics of sweet potato chips

This study was undertaken to compare sweet potato chips utilizing different sweet potato cultivars, and to evaluate the effect of processing and storage on the quality characteristics of the chips. Chips contained an average of 1.7% moisture, 4.6% crude protein, 52% crude fat, 1.9% ash, 4.5% total dietary fiber, and 36% carbohydrate, with an average 2411 kj/100g (155 kcal/oz.). Proximate composition of the cultivars showed no significant differences, however, total dietary fiber of the Southern Delite (SD) chips was significantly higher than either W-221 (W2) or Red Jewel (RJ) chips. Moisture decreased with storage time and reached a plateau after three weeks. Beta-carotene content of chips averaged 2671 R.E. There was a significant difference among the cultivars in beta-carotene content with SD chips having the highest amount (3978 R.E.). Beta-carotene decreased with the presence of salt or air over storage time. Chips required an average force of 357g to break as measured with the Instron Universal Testing Machine. W2 required the highest force (379g) to break. Chip color was analyzed with the Hunter Colorimeter. L and a values significantly differed among the cultivars. The a value decreased due to atmosphere and time of storage. W2 chips were lighter than the other two cultivars and were more yellow than red with an a : b ratio of 0.6 compared to 0.7 for SO and RJ. An experienced panel found a slightly detectable off-flavor after 9 weeks of storage with no difference due to processing or storage time. They rated chips very crispy with slightly pale-orange yellow to moderately dark-orange yellow in color

Effects of introducing a walk-in clinic on ambulatory care sensitive hospitalisations among asylum seekers in Germany: a single-centre pre-post intervention study using medical records

Objective Measuring the effect of introducing a walk-in clinic on ambulatory care sensitive (ACS) hospitalisations among asylum seekers in a large state reception- and registration centre. Design and setting Pre-post intervention study using anonymous account data from a university hospital functioning as referral facility for a state reception- and registration centre in the third largest German federal state. Participants We included all asylum seekers residing in the reception centre and admitted to the referral hospital between 2015 to 2017. Interventions Establishment of an interdisciplinary walk-in clinic in the reception centre (02/2016). Main outcome measures International lists for ACS conditions for both adults and children were adapted and used to calculate the prevalence of ACS conditions among the population (primary outcome measure). The impact of the intervention on the outcome was analysed using a segmented Poisson regression to calculate incidence-rate ratios with respective 95% CIs, adjusted for age, sex and admission. Results The prevalence of ACS hospitalisations changed over time, as did the effect of age, sex and quarter of admission. Introducing the walk-in clinic reduced the prevalence of ACS hospitalisations among asylum seekers compared with the period before establishment of the clinic (incidence-rate ratios (IRR)=0.80 (0.65 to 1.00), p=0.054), but the effect was attenuated after adjustment for time trends. The average difference in prevalence of ACS hospitalisations compared with the period before establishment of the clinic, corrected for pre-existing time trends, age and sex of asylum seekers was IRR=1.03 ((0.69 to 1.55), p=0.876). Conclusions A walk-in clinic in reception centres may be effective to reduce ACS hospitalisations, but our study could not prove evidence for a measurable effect after full adjustment for time trends. Further research, ideally with parallel control groups, is required to establish evidence for the effectiveness of walk-in clinics in reception centres on reducing ACS hospitalisations

Effects of introducing a walk-in clinic on ambulatory care sensitive hospitalisations among asylum seekers in Germany: a single-centre pre–post intervention study using medical records

Lichtl C, Bozorgmehr K. Effects of introducing a walk-in clinic on ambulatory care sensitive hospitalisations among asylum seekers in Germany: a single-centre pre–post intervention study using medical records. BMJ Open. 2019;9(12): e027945.ObjectiveMeasuring the effect of introducing a walk-in clinic on ambulatory care sensitive (ACS) hospitalisations among asylum seekers in a large state reception- and registration centre.Design and settingPre–post intervention study using anonymous account data from a university hospital functioning as referral facility for a state reception- and registration centre in the third largest German federal state.ParticipantsWe included all asylum seekers residing in the reception centre and admitted to the referral hospital between 2015 to 2017.InterventionsEstablishment of an interdisciplinary walk-in clinic in the reception centre (02/2016).Main outcome measuresInternational lists for ACS conditions for both adults and children were adapted and used to calculate the prevalence of ACS conditions among the population (primary outcome measure). The impact of the intervention on the outcome was analysed using a segmented Poisson regression to calculate incidence-rate ratios with respective 95% CIs, adjusted for age, sex and admission.ResultsThe prevalence of ACS hospitalisations changed over time, as did the effect of age, sex and quarter of admission. Introducing the walk-in clinic reduced the prevalence of ACS hospitalisations among asylum seekers compared with the period before establishment of the clinic (incidence-rate ratios (IRR)=0.80 (0.65 to 1.00), p=0.054), but the effect was attenuated after adjustment for time trends. The average difference in prevalence of ACS hospitalisations compared with the period before establishment of the clinic, corrected for pre-existing time trends, age and sex of asylum seekers was IRR=1.03 ((0.69 to 1.55), p=0.876).ConclusionsA walk-in clinic in reception centres may be effective to reduce ACS hospitalisations, but our study could not prove evidence for a measurable effect after full adjustment for time trends. Further research, ideally with parallel control groups, is required to establish evidence for the effectiveness of walk-in clinics in reception centres on reducing ACS hospitalisations.</jats:sec

A Contracting Fractal Group, Schreier Graphs and The Spectra

This paper explores a previously uncharted automaton group generated by a 5-state automaton $(\Pi, A)$ acts by self-similarity on the regular rooted tree $A^{*}$ over a 2-letter alphabet set $A$. Group $G$ has been subjected to several observations that reveal the self-similar $G$-action possesses several notable characteristics: it is a weak branch, contracting, fractal group, and satisfies the open set condition with an exponential growth rate in activity. The corresponding Schreier graphs $\Gamma$ of the group action on the binary rooted tree, for $n\leq 12$, are presented. Furthermore, we delve into a numerical approximation of the spectrum of the discrete Laplacian operator, which is defined on the limit Schreier graph $\hat{\Gamma}=\lim_{n\rightarrow\infty} \Gamma_{n}$

Cost-utility of screening for depression among asylum seekers: a modelling study in Germany

Background: Asylum seekers have a high burden of mental illness owing to traumatic experiences before, during and after flight. Screening has been suggested to identify asylum seekers with psychosocial needs. However, little is known about the costs of screening relative to expected gains. We assessed the cost-effectiveness of population-based screening for depression in German asylum reception centres compared to case-finding by self-referral. Methods: Explorative modelling study using a decision tree over 15 months to estimate the incremental cost per Quality-Adjusted Life-Year gained. Data points were taken from the published literature. Deterministic and probabilistic sensitivity analyses were used to address uncertainty around parameter estimates. Value of information analyses were performed to indicate the value of future research. Results: The model demonstrates a high probability (p = 83%) of the screening intervention being cost-effective at a Є 50,000/QALY threshold. Cost-utility depends on the process of care following screening: when acceptability and adherence parameters were decreased by 40%, the resulting ICER increased by 27-131%. Eliminating uncertainty was most valuable for the screening process and cost parameters, at Є 3·0 and Є 4·4 million respectively. Conclusions: Screening asylum seekers for depression may be a cost-effective strategy to identify those in need of care. However, there is considerable value in conducting further research in this area, especially regarding resource requirements and the process of care following screening

Characteristics and determinants of knowledge transfer policies at universities and public institutions in medical research — protocol for a systematic review of the qualitative research literature

Background: Universities, public institutions, and the transfer of knowledge to the private sector play a major role in the development of medical technologies. The decisions of universities and public institutions regarding the transfer of knowledge impact the accessibility of the final product, making it easier or more difficult for consumers to access these products. In the case of medical research, these products are pharmaceuticals, diagnostics, or medical procedures. The ethical dimension of access to these potentially lifesaving products is apparent and distinguishes the transfer of medical knowledge from the transfer of knowledge in other areas. While the general field of technology transfer from academic and public to private actors is attracting an increasing amount of scholarly attention, the specifications of knowledge transfer in the medical field are not as well explored. This review seeks to provide a systematic overview and analysis of the qualitative literature on the characteristics and determinants of knowledge transfer in medical research and development. Methods: The review systematically searches the literature for qualitative studies that focus on knowledge transfer characteristics and determinants at medical academic and public research institutions. It aims at identifying and analyzing the literature on the content and context of knowledge transfer policies, decision-making processes, and actors at academic and public institutions. The search strategy includes the databases PubMed, Web of Science, ProQuest, and DiVa. These databases will be searched based on pre-specified search terms. The studies selected for inclusion in the review will be critically assessed for their quality utilizing the Qualitative Research Checklist developed by the Clinical Appraisal Skills Programme. Data extraction and synthesis will be based on the meta-ethnographic approach. Discussion: This review seeks to further the understanding of the kinds of transfer pathways that exist in medical knowledge transfer as well as what factors lead to the adoption of one pathway over another. The aim is to provide evidence for political and academic actors designing policies for the translation of medical knowledge and public-private cooperation. Systematic review registration: PROSPERO CRD4201501424

Ventilator-Associated Pneumonia and Its Responsible Germs; an Epidemiological Study

Introduction: Ventilator-associated pneumonia (VAP) is one of the most common hospital infections and a side effect of lengthy stay in intensive care unit (ICU). Considering the ever-changing pattern of common pathogens in infectious diseases and the raise in prevalence of hospital infections, the present study was designed aiming to determine the prevalence of VAP and its bacterial causes. Methods: In this cross-sectional study, the medical profiles of all the patients under mechanical ventilation, who had no symptoms of pneumonia at the time of intubation and developed new infiltration in chest radiography after 48 hours under mechanical ventilation along with at least 2 of the symptoms including fever, hypothermia, leukocytosis, leukopenia, or purulent discharge from the lungs, were evaluated. Demographic data, clinical and laboratory findings, and final outcome of the patients were extracted from the patient’s clinical profile and reported using SPSS version 20 and descriptive statistics.Results: 518 patients with the mean age of 62.3 ± 20.8 years were evaluated (50.9% female). Mean time interval between intubation and showing symptoms was 10.89 ± 12.27 days. Purulent discharges (100%), leukocytosis (71.9%), fever (49.1%), hypothermia (12.3%), and leukopenia (8.8%) were the most common clinical and laboratory symptoms and acinetobacter baumannii (31.58%) and klebsiella pneumoniae (29.82%) were the most common germs growing in sputum cultures. 19 (33.3%) cases of pan drug resistance (PDR) and 10 (17.5%) cases of extensive drug resistance (XDR) were seen. Mortality due to VAP was 78.9% and there was no significant correlation between age (p = 0.841), sex (p = 0.473), ICU admission (p = 0.777), duration of hospitalization (p = 0.254), leukocytosis (p = 0.790), leukopenia (p = 0.952), fever (p = 0.171), hypothermia (p = 0.639), type of culture (p = 0.282), and type of antibiotic resistance (p = 0.066) with mortality. Conclusion: Prevalence of VAP and its associated mortality were 11% and 78.9%, respectively. The most common symptoms and signs were purulent discharge, leukocytosis, and fever. Acinetobacter baumannii and klebsiella pneumoniae were the most common germs in sputum cultures with 50% resistance to commonly used antibiotics

Suicide from the Perspective of Islam and Psychology with an Emphasize on the Models Explaining the Relationship between Impulsivity and Suicidal Behaviors

Suicide is the act of taking one's own life which is made within the framework of a voluntarily action by an informed individual. Impulsivity is one of the most reasons for the emergence of suicidal behaviors. Impulsivity takes place without considering the possible consequences of the action and for a fast access to a reward.The purpose of the present study is to study suicide in the perspective of Islam and psychology with an emphasize on the models explaining the relationship between impulsivity, suicidal behaviors and to discuss each model as well. Due to the multilayer nature of suicide, the research methodology is in documentation-based, analytical and meta-analytical forms.In order to study the models explaining the relationship between impulsivity and suicidal behaviors, different data bases and with key words such as: impulsivity, impulsive behaviors, suicidal behaviors and as likes were broadly reviewed and upon completion of data collection, the related studies were closely examined.The research findings indicate that in the perspective of Islam, suicide is in connection with components such as: the weakness of ideological and ethical bases, the lack of positive perception and disappointment with God, the lack of thinking on the belongings, magnifying the hardships and shortages, and considering the life as something meaningless. In psychology, based on the personality model, the impulsive individuals have a greater inclination towards experiencing the provocative and painful incidents. From the viewpoint of idea to practice framework, the forecasting factors of suicide are classified based on the rate of risk of suicidal ideations and also the rate of action risk for suicide.  In the integrated conceptual model, the evaluation of the suicide risk is made integrally and during the treatment process. The model of addiction to suicide, considers the suicidal behaviors as a kind of addiction. The three-step theory states that in the event that the sense of pain is associated with disappointment, and the lack of dependence on life and companions, the individual will make suicidal behaviors. The result is that in the perspective of Islam, the growth of awareness and increase of intellectual skills aiming at gaining knowledge and improving the relationship between human and God, reinforcing the basic beliefs and monotheistic doctrine are the most basic and effective steps to deter the suicidal behaviors. In psychology, opposite to the prevailing beliefs, it seems that impulsivity is not considered as a trustable forecaster for suicidal actions and the personality feature of impulsivity does not have a strong and noticeable relationship with suicidal actions