bluuebunny/crossref_metadata_2025 huggingface dataset:
Congenital malformations registered in the Federation of Bosnia and Herzegovina 2019-2021
Authors: Cilović-Lagarija Š , Skočibušić S
Published: October 2023

Congenital malformations are defined as structural or functional anomalies that occur in utero or at birth and can be detected at an early age. They are also known as birth defects, disabilities or congenital malformations. Congenital malformations are accompanied by hereditary or developmental disabilities or disease. From the establishment of the registry in early 2019 until the end of 2021, the total number of reported congenital malformations is 449. According to available data from EUROCAT (European network of population-based registries for the epidemiological surveillance of congenital anomalies), the average rate of congenital malformations in the countries of the European Union (EU) is 262/per 10,000 live births, while the registered rate of congenital malformations in the Federation of Bosnia and Herzegovina is 261/per 10,000 live births. In the Federation of Bosnia and Herzegovina, the highest incidence rate was registered in Sarajevo Canton (175 cases with a rate of 416/10,000 live births) and Tuzla Canton (122 cases with a rate of 356/10,000 live births). The most common congenital malformations are heart defects, cleft lip and palate, musculoskeletal deformities and Down syndrome. In the Federation of Bosnia and Herzegovina (FBiH) in 2020, 135 children under the age of 5 died, among which 18 children (13.3%) died from congenital malformations, deformations and chromosomal abnormalities (Q00-Q99). Congenital malformations can lead to chronic diseases and disabilities, death of infants and children up to five years of age. Congenital malformations represent a significant public health problem, given that they lead to disability, incapacity and pressure on the health system, as well as the problem of social integration of patients.

Key messages

• The registered rate of congenital malformations in the Federation of Bosnia and Herzegovina is 261/per 10,000 live births.

• Congenital malformations can lead to chronic diseases and disabilities, death of infants and children up to five years of age.
Vaccination choices among pregnant women: findings from the MAMI-MED cohort
Authors: Magnano San Lio R , Barchitta M , Maugeri A , La Rosa M C , La Mastra C , Favara G , Ferrante G , Galvani F , Ettore G , Agodi A
Published: October 2023

Background

According to the Italian National Immunization Plan 2023-2025, vaccinations against Measles, Mumps, Rubella (MMR), Varicella and Human Papillomavirus (HPV) are indicated for women of childbearing age. During pregnancy, vaccination against Diphtheria, Tetanus, and Pertussis (DTaP), and Seasonal Influenza are recommended. The present analysis aimed to estimate vaccination choice and its main determinants among pregnant women.

Methods

We used data from the “MAMI-MED” cohort, an ongoing prospective study on mother-child dyads established in December 2020. Socio-demographic information (i.e., age, educational level and employment) were assessed at enrollment, during the first trimester visit at the Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima (Catania, Italy). Self-reported maternal vaccination status was collected at delivery.

Results

Among 1004 women with a complete vaccination assessment, 83.5% were vaccinated against MMR, 87.4% against DTaP, 68.3% against Varicella, while only 23.7% and 9.4% against HPV and Seasonal Influenza, respectively. During pregnancy, only 8.7% and 21.1% of women were vaccinated against DTaP and Seasonal Influenza, respectively. The lack of information was the main ground for refusal, accounting for 93.7% for HPV, 82.5% for Influenza, 64.7% for DTaP, 31.8% for MPR, and 18.9% for Varicella. Women vaccinated against HPV and MMR were younger than their unvaccinated counterpart (p < 0.001 and p = 0.023, respectively). The logistic regression showed that the odds of being vaccinated against HPV increased with increasing age, adjusting for education and employment (OR = 1.12; 95% CI = 1.09-1.16; p < 0.001).

Conclusions

The analysis showed modest vaccination coverages, mainly depending on the lack of information about vaccination programs. Moreover, we observed that younger women were more aware of HPV vaccination, which probably reflects improvements in the national vaccination program over the years.

Key messages

• It is necessary to increase knowledge about vaccination among women in the reproductive age.

• Social determinants should be assessed to understand the barriers that might affect vaccination choice.
Factors influencing maternal control in child feeding in Hungary
Authors: Paulik E , Szabó A , Umami A , Molnár R , Erdős C , Maróti-Nagy Á
Published: October 2023

Background

Globally, more than 340 million children and adolescents aged 5-19 were overweight or obese in 2016. Obesity in children and poor dietary habits in adulthood are associated with parental feeding practices. This study aimed to characterize the sociodemographic status, lifestyle, and health related factors of mothers associated with child feeding control practices.

Methods

A questionnaire-based cross-sectional study was carried out in Hungary among 8-13-year-old students and their parents (N = 454). In this analysis only mothers of normal/overweight/obese children were analysed (n = 338). Questions included mothers’ characteristics and their practices in child feeding measured by the Hungarian version of the Child Feeding Questionnaire. It has two main categories: “risk factors and concerns” and “control in child feeding”; we analysed the last one with its three domains (restriction, pressure to eat and monitoring). Factors influencing mothers’ feeding control were analysed by multivariate logistic regression models.

Results

According to our classification 86.9% of mothers were “monitoring”, 20.0% “pressure to eat”, and 26.9% “restrictive”. Neither of the variables was explored in the regression model of “restrictive” mothers. Mothers of overweight children (79%) and of obese children (89%) were less likely to be “pressure to eat” mothers (p = 0.007, p = 0.036). Women with high education were 2.19 times more likely to be “monitoring” mothers (p = 0.047) than lower educated. Mothers who had hopeless feelings were 94% less likely to be “monitoring” (p = 0.016). Overweight children's mothers were 4.12 times likely to be “monitoring” mothers (p = 0.040) than mothers of normal weighted children.

Conclusions

In our analysis predicting factors of child feeding were educational level and mental health of mothers and nutritional status of children. Improved education, self-efficacy and mental status are important public health issues from the point of the promotion of healthy nutrition.

Key messages

• Parents, especially mothers can significantly influence children’s eating experiences, so the evaluation of mothers’ feeding control may be used in the formulation of obesity prevention in children.

• The mothers’ feeding strategy and their ideas about child feeding are determined by many factors which can be modified by the promotion of their education and health way of life.
Process evaluation of The Breastfeeding Trial. What factors impact the intervention delivery?
Authors: Rossau H K , Gadeberg A K , Strandberg-Larsen K , Nilsson IMS , Villadsen S F
Published: October 2023

Background

Breastmilk is the ideal nutrition for infants, and breastfeeding is an important health promoting behaviour. In Denmark, most mothers initiate breastfeeding but many cease within the first months resulting in just 14% reaching the World Health Organization recommendation of six months exclusive breastfeeding. A large-scaled, cluster-randomized intervention study implemented in the Danish health visiting programme aimed to extent the duration of breastfeeding and reduce social inequality. To elucidate how the intervention was implemented, a process evaluation of the intervention was conducted.

Methods

Following the MRC guidelines for process evaluation, we used a mixed methods approach to assess the delivery of the intervention, and facilitators and barriers in the context that affected the implementation. Data from questionnaires distributed to the health visiting managers of 21 Danish municipalities and 242 health visitors employed there, and data from three focus groups with health visitors and eight individual interviews with mothers in the intervention informed the process evaluation.

Results

Preliminary findings from questionnaires imply that the training program slightly enhanced health visitors’ breastfeeding support competencies. However, health visitors explained in the focus groups that they provided support as usual. A contextual factor hindering the implementation was change of personnel. Having had favourable experiences with the intervention acted as facilitator. Findings from interviews with mothers indicated a high fidelity in the distribution of intervention materials and partner involvement.

Conclusions

Preliminary findings of this study show variability in how the intervention was implemented throughout the intervention sites. This evaluation will assist in the interpretation of the results of the effectiveness study and inform policy makers about if and how this intervention could be scaled up.

Key messages

• Health visitors in intervention clusters seemed to have gained competencies in breastfeeding support; however, expressed that they provided support ‘as usual’.

• Change of personnel acted as a barrier, while having had positive experiences with the intervention acted as a facilitator.
Alcohol per capita and prevalence of alcohol exposed pregnancies: systematic review and meta-analysis
Authors: Burton E , Kelly S , Kearney P M , Moffat M , Morris J , Popova S , Rankin J , O'Mahony M
Published: October 2023

Background

Alcohol is a teratogen that crosses the placenta. While studies have estimated the global burden of alcohol use in pregnancy, reliable and valid data on alcohol consumption during pregnancy in many countries is lacking. Alcohol consumption per capita (APC) data are available worldwide. This systematic review, by investigating the association between APC and alcohol consumption in pregnancy by country, aims to evaluate the accuracy of using APC data to predict the prevalence of prenatal alcohol exposure (PAE).

Methods

This study combines studies identified in a systematic review by Popova et al. 2017 and a systematic search of MEDLINE from 2015 through 6th October 2022, to identify additional papers. Papers identified in either search were on the prevalence of PAE or fetal alcohol syndrome (FAS). Two authors independently screened titles, abstracts, full-text articles and performed data extraction and quality assessment. APC data,per country, by year, was obtained from the World Health Organization (WHO) website. A meta-analysis, assuming a random effects model will be performed. Sensitivity analyses, including restricting by population, timing of exposure, time and method of ascertainment of alcohol consumption will be carried out.

Results

Of 24,935 PAE and 12,231 FAS prevalence articles identified, 400 PAE studies and 77 FAS studies met the inclusion criteria. Studies represent data from 1959-2020 from all 6 WHO regions, with APC between 0.012-14.78. Preliminary analysis suggests a statistically significant correlation between prevalence of alcohol consumption during pregnancy and APC.

Conclusions

Preliminary results from this study suggest that publicly available data on APC can be used to predict the population-based prevalence of alcohol use in pregnancy in different countries. Effective policies and interventions are required to reduce APC and thus, alcohol use in pregnancy and associated detrimental child health outcomes around the globe.

Key messages

• Knowing the prevalence of FAS and its main risk factor- prenatal alcohol use, will inform the setting of priorities for public health policy, public health initiatives, and health-care planning.

• By investigating the association between alcohol intake in pregnancy and APC we will assess whether APC can predict alcohol intake in pregnancy.
Association between influenza vaccination and antibiotic prescription in pediatric population
Authors: Arzilli G , De Angelis L , Baglivo F , Forni S , Gambioli A , Gemmi F , Rizzo C
Published: October 2023

Introduction

A major cause of antimicrobial resistance (AMR) is inappropriate antibiotic consumption in humans. The scientific literature is discordant on the impact of the indirect effect that influenza vaccination in the pediatric population in counteracting AMR. This study aims to evaluate the impact of influenza vaccination on antibiotic prescriptions in the pediatric population in Tuscany (Italy) for the 2019-20 influenza season.

Methods

A retrospective cohort study was performed from current data obtained from the Tuscany Regional Health Authority. We recruited all the children between 6 months-6 years old who underwent influenza vaccination between September 2019 and April 2020. Each vaccinated child was matched with an unvaccinated by Propensity Score Matching for sex, age, area of residence, exemptions, previous hospitalization, and deprivation index. The consumption of beta-lactam antibiotics and macrolides (main drugs used for pediatric respiratory infections) between 15 days after vaccination and the end of the study period was measured for each child. The outcome is the number of antibiotic prescriptions per 100 weeks at risk. The association between influenza vaccination and antibiotic consumption was measured by estimating relative risk from a Poisson regression model.

Results

The study population consisted of 23,034 vaccinated children. Antibiotic prescriptions were 2.27 per 100 weeks at risk in the unvaccinated and 3.01 per 100 weeks in the vaccinated. Antibiotic prescribing in vaccinated children was higher than in the unvaccinated, with a relative risk of 1.33 [CI 95% 1.29-1.35; p < 0.00001].

Conclusions

The results show a higher prescription of beta-lactams and macrolides in children vaccinated with influenza vaccine than in unvaccinated children during the study period. This result may depend on factors that cannot be measured with the available data, such as the number of visits to the pediatrician and the medical's propensity to prescribe antibiotics.

Key messages

• The results of this study showed that vaccinated children had a higher rate of antibiotic prescriptions than unvaccinated children.

• Factors not measured, such as the frequency of pediatrician visits and medical prescribing habits, may have influenced the higher rate of antibiotic prescriptions in vaccinated children.
Pandemic experiences and mental health among young people in Ireland: lessons from Teenpath COVID
Authors: Lee S J , Muhammed U , Ahmed Z , Pirghasemi P , Tambe K , Stanistreet D
Published: October 2023

Teenpath COVID is a mixed-methods, participatory study exploring the experiences of young people in Ireland since the COVID-19 pandemic and its impacts on existing health inequalities. As part of an exploratory sequential research design, we conducted a stakeholder analysis, online survey, and participatory arts programme evaluation to identify cross-cutting issues impacting the health and well-being of young people in Dublin and across Ireland. Interviews conducted with stakeholders spanning youth service, public health, and education sectors, and young people aged 16-25 explored individuals’ experiences of the pandemic; adaptations to working and maintaining engagement online; key concerns about young people's health and wellbeing; and priorities for future research and policy. Thematic analysis identified impacts of the pandemic on health inequalities with potential policy implications. This informed a subsequent online survey exploring young people's mental health since the pandemic, and an ethnographic case study of a participatory arts programme exploring key issues important to young people in Dublin. Our findings suggest the pandemic has impacted predominantly on young people's mental health and access to youth mental health services; disruption to work, education and social and peer support networks; and health behaviours. Protective measures, from accessing and maintaining social support networks, to developing coping strategies were important for young people's mental health. However the extent to which these were possible was shaped significantly by individuals’ personal circumstances at the time. These findings show the importance of social participation and support for young people in navigating the uncertainties and difficulties of growing up in a pandemic. Participatory approaches can be a pathway for aligning healthy priorities and policy that contributes unique and rich insights into community health, and places young people at the centre of change.

Key messages

• Young people in Ireland have experienced significant impacts to their mental health since the COVID-19 pandemic began, particularly regarding disruptions to education and social support networks.

• Participatory approaches to research and youth engagement with young people is important for gathering high quality and diverse data on complex topics such as mental health and health inequalities.
Reducing the impact of COVID-19 on physical activity and mental health
Authors: Ambrosio L , Faulkner J , Lambrick D , Morris J , Compton E , Portillo M C
Published: October 2023

Background

During the COVID-19 pandemic the United Kingdom government released regular guidance on limiting the spread of COVID-19. People, including those with long term conditions, were told to use physical distancing, self-isolation and/or shielding during COVID-19 to protect themselves and others. A consequence of these interventions was to exacerbate poor lifestyle behaviours, namely less physical activity.

Objectives

To propose recommendations to support and sustain their physical activity of people with long term conditions during and after COVID-19 or other pandemics.

Methods

A mixed methods project was conducted. An online quantitative survey with 368 people in the United Kingdom was conducted, followed by 26 online semi-structured interviews.

Results

The study demonstrated that online resources are not accessible for all populations. During COVID-19 pandemic, provision of PA information was most commonly available online. Also, COVID-19 lockdowns meant the sudden loss of opportunities to be active along with the social interaction and motivation usually in place to support activity. Finally, physical activity guidelines should be more specific. Local and national government guidelines were identified as unclear for those living with long term conditions and should be more specific regarding what people who were shielding could and could not do.

Conclusions

Based on the findings, more suitable and accessible physical activity guidelines for people with long term conditions is recommended. Also, prioritizing vulnerable groups is recommended to support physical activity to avoid the worsening of emotional wellbeing, and quality of life. Finally, government and public health authorities should consider charities and long term conditions voluntary organizations to design bespoke physical activity recommendations and guidelines for those shielding at home and living with long term conditions.

Key messages

• Government and public health authorities design bespoke PA recommendations for those living with LTCs.

• Simple strategies such as ‘move more and sit less’ or ‘breaking up sitting time’ could be promoted as safe and accessible options for those living with LTCs.
Modelling health effects of air pollution in Ukraine
Authors: Schutte L , Belis C , Van Dingenen R , Turos O I , Petrosian A A
Published: October 2023

Background

Air pollution places a burden on health, climate, national economies and well-being in the European Union (EU) and EU candidate countries. Ukraine was the country with most deaths per 100,000 inhabitants attributable to atmospheric air pollution in 2017 according to the World Health Organisation. Harmonisation of air quality monitoring regulations and control methods with EU standards is important to lower the burden of air pollution in Ukraine.

Methods

This study applies the JRC-Fast Scenario Screening Tool (JRC-FASST) with ground air quality measurement data in order to study how premature mortality in Ukrainian cities is affected by the pollutant PM2.5 pre- and during COVID-19. Furthermore, a scenario analysis at country level is carried out to evaluate past and projected trends of mortality in Ukraine under three different air quality policy scenarios.

Results

The preliminary results show that estimated PM2.5 attributable mortality is significantly lower in the year 2020 compared to 2019 in all studied cities. Both at a country level and at a city level, ischemic heart disease is the main cause of death associated with PM2.5 attributable all-cause mortality.

Conclusions

Increasing the body of research on the health effects and costs of air pollution in Ukraine is important to acquire evidence in support of further alignment of Ukrainian air quality policies with those of the EU.
Multidimensional poverty and depression among with and without Disabilities
Authors: Yeob K E , Kim S Y , Park J H
Published: October 2023

Background

Traditionally, poverty has been measured based on an individual income, however it is now accepted that income gives too narrow a view of an individual's overall living standards and other indicators of living standards are needed. Multidimensional poverty measures are a useful tool for policymakers in order to identify target populations for policies aiming to improve equity and reduce chronic disadvantage.

Methods

We analyzed the Korea Welfare Panel Study, a nationally representative survey. Poverty variables were selected based on monetary and non-monetary categories. The six poverty dimensions were income, education, housing, medical care, social relationships, and employment. Depressive symptoms were measured using the Korean version of CES-D-11.

Results

All dimensions of poverty and depression had higher rates in people with disability than non-disabilities in the order of income (+33.1%p), education (+27.2%p), social relationships (+9.7%p), and medical care (+6.5%p). Depression rate was also higher for people with disability (p < .0001). The factors influencing depression of people with and without disability by multidimensional poverty were somewhat different. The disabled and non-disabilities with poverty of social relationships were equally more likely to have a depression (aOR=7.33, <.0001, aOR=3.85, <.0001), however, the non-disabled with medical care poverty were more likely to have a depression (aOR=6.76, <.0001) than without medical care poverty, and the disabled with employment poverty were about 3 times more depressed (aOR=3.67, <.0001) than with employment poverty.

Conclusions

This study suggest that access to various aspects of life, as well as income support, should be considered in policy making for resolving the poverty problems and mental health among people with disabilities.

Key messages

• There were disparities in the prevalence of multidimensional poverty and depression in the people with disabilities, especially those with severe disabilities.

• The main factors influencing depression of people with disability by multidimensional poverty were social relationships and employment poverty.
Which needs assessment tool to use? Review of the needs assessment tools for service evaluation
Authors: Makivić I , Selak Š , Kragelj A
Published: October 2023

Background

Needs assessment enhance patient-centered care quality and is important within evaluation process, as well as for implementation of new services. Needs assessment tools can help clinicians to plan treatment and also to assess subsequent service impacts. Aim of the present research was to review quantitative tools for mental health needs assessment, that are either self-reported or can be used by professionals or researchers.

Methods

A comprehensive literature search in two bibliographic databases was carried out following the PRISMA protocol. Additional search was performed in specific review papers. Included papers are quantitatively assessing the needs of people with mental health problems and exclude people with dementia or disabilities. Also other inclusion and exclusion criteria were applied.

Results

The majority of all studies were published in English (n = 234). The majority of research papers (n = 163) were conducted in Europe between 2000-2010, while in other countries the trend followed the year 2011. Preliminary results are showing that there are 29 different tools for needs assessment and 17 of them can be used at the system level also as an outcome measure. The most frequently used tool for assessing the needs that can be also used as an outcome measure was Camberwell Assessment of Needs (CAN) also in combination with Health of the Nation Outcome Scales (HoNOS). As well Cardinal needs schedule (CNS) and Resident Assessment Instrument Mental Health (RAI-MH) were used more than once.

Conclusions

When choosing an appropriate assessment tool, it is vital to use the most widely used ones, focusing on validated tools (culturally adapted), tools modified for specific populations (elderly, children, etc.) and also to bear in mind the ultimate goal that the service is aiming. CAN, HoNOS and CNS are assessing psychiatric and social care needs comprehensively. While RAI-MH is also a tool that is supporting seamless approach to person-centered care.

Key messages

• When choosing an appropriate assessment tool, it is vital to use the most widely used ones, focusing on validated tools and tools modified for specific populations.

• When choosing an appropriate assessment tool, it is important to focus on the ultimate goal the service is aiming.
Use and attitudes towards digital technologies in addiction rehabilitation in the SARS-CoV-2 pandemic
Authors: Brünger M , Schall F , Köhn S , Spyra K , Burchardi J
Published: October 2023

Background

Before the start of the pandemic, digital technologies were hardly used in addiction rehabilitation in Germany - also due to the lack of a legal framework. During the SARS-CoV-2 pandemic, the funding agencies enabled their use. The aim of the study is to describe the use of and attitudes towards digital technologies in addiction rehabilitation from the perspective of both clinic management and rehabilitation patients.

Methods

Clinic management of all 1044 outpatient and inpatient addiction rehabilitation clinics in Germany were asked in summer 2022 to complete an online questionnaire on the use of and attitudes towards digital technologies in addiction treatment. 415 clinics provided answers (response rate 40%). In addition, 460 rehabilitation patients from 34 different clinics were questioned in written form (mean age 46.0 years (SD: 13.3), 73% male; 81% alcohol addiction).

Results

According to the clinic management, digitally conducted therapies were carried out in individual therapy (inpatient: 22% vs. outpatient 62%), group therapy (4% vs. 37%), family-oriented interventions (55% vs. 51%), and pre-admission interviews (45% vs. 45%). Among the rehabilitation patients, 10% in inpatient and 37% in outpatient rehabilitation stated that they had used digitally conducted therapies. 87% of the clinic management felt that digital therapy offers were useful during the pandemic, and 84% were in favour of using them beyond the pandemic. Among rehabilitation patients, the approval rate was 85% and 59% respectively.

Conclusions

Digital technologies were used for different therapy services in addiction rehabilitation. The majority of both clinic management and rehabilitation patients were in favour of this, even beyond the pandemic. For further use after the pandemic, the establishment of a legal, financial and organisational framework is required. Non-inferiority studies (comparing digital to face-to-face) could add to the evidence.

Key messages

• Digital technologies were used for therapeutic purposes (e.g. individual therapy, group therapy, family-oriented interventions) by a large proportion of addiction clinics during the pandemic.

• The majority of clinic management and rehabilitation patients are in favour of the use of digital technologies in addiction rehabilitation even beyond the pandemic.
Econometric models derived from meta-analysis to estimate VSL and VOLY associated to air pollution at a global level: preliminary results
Authors: Ciarlantini S , Frontuto V , Verri C , Pezzoli A , Belis C
Published: October 2023

Epidemiological research has shown a strong correlation between air pollution and risk of premature death. Among the damage costs of air pollution, premature mortality is by far the largest contributor, hence accounting for the number of deaths linked to poor air quality has become a key environmental indicator. Monetizing reductions in risks of death through cost-benefit analyses can be useful to create efficient public policies aiming at improving air quality. The benefits of prevented mortalities can be expressed in terms of a Value of a Statistical Life (VSL), an economic parameter representing individuals’ willingness to exchange wealth for mortality risk reduction. In addition, the monetary Value Of a Life Year (VOLY) is also an important parameter to be measured, as it considers the change in life expectancy associated with air pollution. However, determining reliable estimates of VSL and VOLY can be challenging, as the methods employed in different studies can vary widely between, and even within, countries. Furthermore, most countries have insufficient and unreliable VSL and VOLY estimates. Lack of country-specific data and common methodology makes it difficult to assess climate policy at a global scale. To address this gap, a meta-analysis of existing literature is conducted to develop econometric models for estimating VSL and VOLY on a global level. The comprehensive search of articles and databases revisits established quantification methodologies for air pollution related mortality, which results in an extensive database of empirical data on VSL and VOLY estimates. Based on this new and updated database, transfer functions of VSL and VOLY are estimated for specific pollutants and different countries, according to each country's distinctive characteristics.
Adaptation of an existing intervention to improve mental health literacy in educators
Authors: Tullius J M , Geboers BJM , Reijneveld S A , de Winter A F
Published: October 2023

Mental health problems are increasingly prevalent among adolescents. Improving mental health literacy (MHL) within the school context has been identified as a useful prevention strategy. Recently, interventions have been developed aimed to improve the MHL of educators, who have a key role in identifying signals of mental health problems and promoting help-seeking in adolescents. To implement such existing interventions in another context and assess their effectiveness, it is necessary to first adapt them in a systematic way. Therefore, we systematically adapted an existing intervention targeting MHL of secondary school educators in the Netherlands following the Intervention Mapping (IM) Adapt principles. We followed the six-step procedure of IM Adapt in an iterative process. As part of that, we 1) performed a needs assessment with adolescents and educators, 2) identified a suitable existing intervention (i.e., ‘LEARN': a suitable existing English-language intervention that aligned with the formulated goals and determinants (mentalhealthliteracy.org)), 3) consulted mental health and educational experts for adaptation planning, and 4) translated, shortened, and adapted it to fit the needs of the Dutch context. This resulted in a 6-module digital online training that upholds the fidelity of the original intervention. Finally, we made plans for 5) further implementation and 6) (preliminary) evaluation of the intervention to improve Dutch secondary school educators’ MHL. Following the principles of IM Adapt, we systematically adapted an existing comprehensive MHL training for Dutch secondary school educators, which has the potential to promote mental health help-seeking of adolescents in schools and support early identification of mental health problems and illness. Future research is needed to evaluate its feasibility and effectiveness.

Key messages

• For implementation of existing interventions in another context and assess their effectiveness, it is necessary to first adapt them in a systematic way.

• We systematically adapted an existing MHL training for Dutch secondary school educators, which has the potential to promote mental health help-seeking of adolescents in schools.
Relationships between problematic ICT use, anxiety, psychological, and behavioral aspects
Authors: Méndez-López F , Dominguez-Gárcía M , León-Herrera S , Mártinez-Pecharroman M M , Samper-Pardo M , Aguilar-Latorre A
Published: October 2023

Background

Anxiety is a substantial and developing health issue with significant consequences for psychosocial functioning and quality of life. The onset and severity of mental health problems have been linked to a number of biological, psychological, and behavioral factors.

Purpose

The aim of this study is to investigate the relationship between the degree of anxiety, problematic information and communications technology (ICT) use, and certain related personal characteristics and adult health behavior. It also investigates the impact of personal characteristics in the moderating role of the association between problematic ICT use and anxiety.

Patients and Methods

Descriptive, bivariate, multivariate, and moderation analyzes of data from 391 participants of 35-74 years old in primary healthcare centers located in Aragón, in northern Spain were performed between July 2021 and July 2022. The primary outcome was the severity of anxious symptoms as continuous variable (GAD-7).

Results

Low self-esteem (β = −0.120; p= 0.012), low self-efficacy (β = −0.092; p=0.004), and high problematic use of ICT (β = 0.169; p = 0.001), are predictors of having more severe anxious symptoms. Moderation analyzes were significant in the effect of self-efficacy (b = −0.040, p = 0.001) and resilience (b = −0.024, p = 0.033) on the relationship between problematic ICT use and anxiety.

Conclusions

The problematic use of ICT and personal factors are related to anxious symptomatology. Adults with low resilience and self-efficacy have worse severity of anxiety associated with the problematic use of ICTs. These findings allow for a new approach to preventive identification and early care measures among people at risk and their families.

Key messages

• Abuse of information and communication technologies happens at all ages and in a wide range of cultural situations, and it is a growing health issue.

• Knowing the psychological factors that lead to this harmful use of ICTs should be essential for early detection and intervention among those at risk and their families.
Psychosocial work factors and sickness absence among young Danish workers with a disease history
Authors: Sørensen J K , Jensen J , Rugulies R , Madsen IEH
Published: October 2023

Background

Young workers with a disease history may be more sensitive to adverse work environment, which could lead to increased rates of sickness absence (SA). This study investigates the association between psychosocial work factors and SA among young Danish workers with a history of somatic or mental disorders (N = 39,772).

Methods

We included young workers (aged 15-30) with a history of hospital-diagnosed somatic or mental disorders before labor market entry (between 2010 and 2018). SA spells of any length (≥1 day) were measured in registers and psychosocial work factors were estimated on the occupational level using job exposure matrices. We separately estimated adjusted rate ratios (RR) and 95% confidence intervals (95% CI) for women and men using Poisson regressions.

Results

Among women, employment in occupations with high quantitative demands, low decision authority, high job strain, high emotional demands, or high work-related physical violence was associated with higher rates of SA. Employment in occupations with high vs. low emotional demands showed the strongest association with a RR of 1.56 (95% CI: 1.48-1.65). Among men, employment in occupations with low decision authority showed the strongest association (1.40 [1.32-1.48]). In contrast, employment in occupations with high quantitative demands or high job strain was associated with lower rates of SA.

Conclusions

In a large nationwide sample of young workers with a history of somatic or mental disorders, we found several psychosocial work factors associated with SA at the job group level. Associations were overall similar to previously published results on all young workers. The results indicate that young workers with a history of somatic or mental disorders may not be more sensitive to adverse working conditions concerning the risk of SA and that preventive interventions, toward reducing SA, may have a similar impact regardless of disease history.

Key messages

• Several psychosocial working conditions were associated at the job group level with sickness absence in a nationwide sample of young workers with a disease history.

• Associations were similar to previous results indicating that young workers with a disease history may not be more sensitive to adverse working conditions compared to the overall workforce.
Adverse childhood experiences and age-trajectories of depressive symptoms in older adults from China
Authors: Ren X , Hu B , Demakakos P
Published: October 2023

Background

Adverse childhood experiences (ACEs) have profound lifelong consequences. Less is known about their impact on outcomes in late life, such as psychological distress in older adults. Moreover, there is a paucity of evidence on associations of ACEs with age-trajectories in depressive symptoms, especially with distinct patterns of trajectories. We investigated associations between ACEs and trajectories of depressive symptoms at mid-to-older ages in a Chinese population sample.

Methods

We used the longitudinal data from the China Health and Retirement Longitudinal Survey (13846 participants ≥45y). Depressive symptoms were measured by CES-D10 (Centre for Epidemiologic Studies Depression Scale) at four waves (2011-18). A range of ACEs (<17y) were retrospectively reported by participants. Growth Mixture Models were used to identify distinct age-trajectories of depressive symptoms and their associations with ACEs.

Results

We identified two trajectory groups: (1) persistent high (men 14%; women 19.2%) and (2) low/normal levels of depressive symptoms. Several ACE measures were associated with increased risk of having persistent high levels of depressive symptoms (mid-to-older ages) after adjusting for other ACEs, sex, childhood SES (financial status, parental education, occupation), adult SES (education, financial status, urban/rural residence), health behaviors and limitations in daily activities. For example, adjusted OR was 1.35 (95% CI:1.17,1.55) for physical abuse (28.2%), 1.38(1.19,1.59) for domestic violence (24.3%), 1.48(1.23,1.78) for parental drinking, drug or mental health problems (9.4%), 1.59(1.38,1.84) for those had a bedridden parent (18.7%).

Conclusions

ACEs have a long lasting effect on trajectories of depressive symptoms in older adults, independent of childhood SES and adult factors, highlighting the need to act early to reduce the long lasting impact on mental health in later life.

Key messages

• Adverse childhood experiences are associated with persistent high levels of depressive symptoms from mid-to-older ages.

• Associations are independent of childhood SES and adult factors.
Disparities in Quality of Life Among European Cancer Survivors Aged 50 and Over
Authors: Li P , Myrskylä M
Published: October 2023

Background

This study aims to investigate regional disparities of quality of life (QoL) among older cancer survivors across European countries.

Methods

This is a longitudinal study based on the Survey of Health, Ageing and Retirement in Europe (SHARE) project. European-level, regional and national QoL among cancer survivors were investigated using mixed-effect regression models based on demographic and health-related factors.

Findings

The prevalence of low QoL vary from 12.4 (Denmark) to 84.9 (Greece) for women and from 10.4 (Denmark) to 74.6 (Greece) for men. Cancer survivors had higher risks of low QoL (prevalence ratio (PR) = 1.59, 95% confidence interval (CI) = 1.47 - 1.71) than general population. Numbers of mobility limitations has the largest effects on QoL (NL mobility =1: PR = 1.54, 95% CI = 1.45 -1.64; NL mobility ≥ 2: PR = 2.59, 95% CI = 2.47 - 2.73), followed by several other factors (e.g., age, gender, BMI, civil status, employment status, education level and geographical region). Most of the effects kept stable or decreased slightly after subjects survived more than 5 years.

Conclusions

Significant disparities of QoL were observed across Europe. Cancer survivors face a substantially increased risk of decreased QoL comparing to general population. Several factors were identified as risk factors for lower QoL.

Key messages

• QoL in general population show significant disparities across Europe.

• Further steps should focus on improving QoL of cancer survivors simultaneously across European countries.
Factors influencing access to water, sanitation, and hygiene among crisis-affected populations
Authors: Noh J W , Lee L L , Kim K B , Heo M H
Published: October 2023

Background

The Central African Republic is suffering a long and complex humanitarian crisis. Population access to water, sanitation, and hygiene (WASH) services remain a challenge in the context of protracted conflicts. However, research on access to WASH in this population is limited. The purpose of the study was to investigate factors associated with access to WASH among crisis-affected populations in the Central African Republic.

Methods

This study analyzed 11,723 crisis-affected households from the 2020 Central African Republic Multi-Cluster Needs Assessment survey data. This survey was conducted between June to August 2020 by the Racial and Ethnic Approaches to Community Health (REACH) Initiative and geographically covered all sub-prefectures of the country.Sampling weighted multivariable binary logistic regression analysis was performed.

Results

Internally displaced persons (IDPs) were more likely to affect their access to WASH than their host families.Movement restricted due to COVID-19, household members with difficulties in self-care (e.g., washing, dressing), education level, and monthly household income were significantly associated with access to WASH.

Discussion

This study suggests that certain factors place the crisis-affected populations in the Central Africa Republic a thigh risk for access to WASH, especially among IDPs. The findings in this study can inform public health professionals to develop support and education programs and shape health care policies. In addition, the results highlight the importance of access to safely managed WASH services during infectious disease outbreaks, including the current COVID-19 pandemic

Key messages

• The findings in this study can inform public health professionals to develop support and education programs and shape health care policies.

• The results highlight the importance of access to safely managed WASH services during infectious disease outbreaks, including the current COVID-19 pandemic.
“Sweden have changed me”: a qualitative study exploring sexual health needs of young male migrants
Authors: Tewelde McDonald J , Ekström A M , Salazar M
Published: October 2023

Background

With increasingly numbers of migrants arriving in Europe, migration has become a worldwide public health challenge. Although evidence show that poor sexual health is associated with migration and that young migrants often experience sexual and mental health needs, most studies have overwhelmingly focused on women, and have shown gaps of sexual health needs of young migrant men. Thus, the aim of this study was to explore sexual health needs of young Syrian, Afghan and Eritrean men and how the fulfillment (or not) of these needs is related to their mental health. In addition, we also explored the factors that restricted and/or facilitated the fulfillment of their sexual health needs.

Methods

An explorative qualitative study was carried out in Region Stockholm, using 32 in-depth interviews with young migrant men. Analysis of the data was performed by using constructivist grounded theory.

Preliminary results

Our analysis showed that our informants’ sexual health needs and mental health challenges followed a process of individual change as they adapted to the Swedish society. The core category represented this process of change: “On my way, but not there yet”. It contains four sub-categories: “being on the move: the migration journey”, “newly arrived: contrasting old and new values and learning new concepts”, “navigating relationships, love and sex, and “the respectful man. We identified six key factors that influenced their sexual health: Attending school/ receiving sex education, support to adapt, experiencing enjoyable relationships, conservative parents, exposure to stigma/discrimination and negative image/narrative of young male migrants.

Conclusions

This study highlights that sexual health needs and mental health challenges changes over time. The findings also illustrate the importance of understanding the factors influencing this process of change.

Key messages

• Young migrant men’s sexual and mental health needs evolve alongside their individual process of change.

• Factors influencing this process were exposure to sex education in schools, receiving support to adapt to their new environment, family relations and perceived discrimination.
Change over time in migrantś self-assessed unmet health care need in Finland
Authors: Kuusio H , Lija E , Aalto A M , García-Velázquez R
Published: October 2023

Background

Previous studies have shown that people of foreign background (PFB) often experience barriers in accessing and utilizing medical care services. This study examines the potential change in unmet health care need among PFB living in Finland in two time points: 2018 and 2022. Furthermore, we study the potential factors (age, sex, education, treason for migration and country of origin) associated with the unmet health care need.

Methods

We used two nationally representative cross-sectional data sets: the Survey on well-being among foreign-born population (FinMonik, n = 6836; response rate 53.1%) in 2018-2019 and the National survey on health, well-being and service use among foreign-born population (MoniSuomi, n = 7838; response rate 44.1%) in 2022-2023. The analyses were limited to those aged 20-64-years. Our indicator for unmet health care need was based on the question: “Do you feel that you have adequately received primary care services during the past 12 months?''

Results

Unmet health care need among PFB has increased significantly between the years 2018 and 2022 (p = 0.005). The prevalence of unmet health care need among PFB was 24.9% in 2018 and 33.7% in 2022. Preliminary results show that younger age, those who moved to Finland from Middle East and Africa, refugees and Ingrains Finns reported more frequently unmet health care need.

Conclusions

The increase of unmet health care need among PFB is alarming. More studies are needed to investigate the reasons behind the high rates of unmet health care need.

Key messages

• Unmet health care need is an indicator of problems in access to care.

• Actions are needed to improve access to care among the migrant population in Finland.