1.10-P19Adoption of guidelines concerning medical examinations on arrival for asylum seekers and refugees: systematic review of the literature and proposals for an implementation plan in Italy
Bibliographic record
Abstract
A joint programme of the National Institute for Health, Migration and Poverty (INMP), the Istituto Superiore di Sanità (ISS) and the Italian Society for Migration Medicine (SIMM) recently produced the guidelines “Medical examinations on arrival and protection pathways for migrants hosted at reception centres”. The Guidelines are intended to provide evidence-based recommendations to decision-makers and health care providers about appropriate health care pathways for asylum seekers on arrival in Italy and during the phases of hospitality. In order for the guidelines to be translated into current practice, local health care systems should adopt the recommendations through a proper implementation plan. The objective of the present work is to build a set of knowledge-based interventions to be implemented at the regional and local level. For this purpose, the PRISMA guidelines were followed to produce a systematic review of existing implementation models for recommendations concerning health care procedures in asylum seekers and refugees. We searched PubMed and Cochrane databases. Grey literature and documents provided by key opinion leaders were also examined. Though several guidelines focusing on asylum seekers are available, the systematic review found few thorough models for implementation. The programme developed by the Canadian Collaboration for Immigrant and Refugee Health is worth noting as a comprehensive line of action. Based on available suggestions, we designed a preliminary set of educational interventions to facilitate the dissemination phase among general practitioners and medical students. Educational programmes will be extended to all professionals involved along the health care pathway. Furthermore, we outlined a plan to monitor formal acts released at the regional and hospital level. According to the results from the systematic review, we can conclude that there is a need for knowledge-based models aimed at facilitating the effective adoption of recommended procedures for asylum seekers and refugees.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.048 | 0.122 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.008 | 0.010 |
| Bibliometrics | 0.020 | 0.016 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.006 | 0.006 |
| Open science | 0.004 | 0.004 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.017 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".