bluuebunny/crossref_metadata_2025 huggingface dataset:
Youth voices: A participatory approach to promoting mental health literacy through digital means
Authors: Wright M , Reitegger F , Gasteiger-Klicpera B , Vidmar M , Veldin M , Borzucka-Sitkiewicz K
Published: October 2024

A concerning number of young people worldwide experience mental health challenges, often compounded by limited mental health literacy, such as a lack of knowledge about how to recognize mental disorders and strategies for seeking help (Cairns & Rossetto, 2019). Therefore, it is crucial to promote mental health literacy among youth. Due to the scarcity and often high cost of readily available mental health services, as well as concerns about anonymity, digital programs have become an alternative means of reaching youth. To this end, a digital prevention program was developed. The pivotal question now is how to effectively promote young people’s mental health literacy through digital means, more specifically: How to develop (1) evidence-based and (2) target group-specific content? To investigate these questions, two systematic reviews were conducted that analyzed a total of 65 digital evidence-based mental health programs. Since the active use of programs also depends on how suitable and appealing the content is for the target group, a participatory approach was chosen to actively involve the target group in the process of developing the program’s design and content. Therefore, four participatory workshops were conducted in Slovenia, Poland, and Austria, with 12-15-year-old students (N = 182). Selected results from the systematic reviews and cross-national results from the workshops will be presented. It was found that psychoeducation is an important and effective method for promoting mental health literacy among youth and that young people prefer this content to be delivered as briefly and concisely as possible, and in a multimodal format. The discussion will highlight key takeaways regarding the benefits and challenges of this approach, emphasizing the necessity of including student voices in the creation of psychoeducational content for a digital mental health program in order to highlight and recognize young people’s right to participate.

Key messages

• The value of youth participation - Involving young people in the development of content for a digital mental health literacy program is a means to increase its relevance and appeal to them.

• The intricacies of youth participation - Involving young people in the development of a digital mental health literacy program presents challenges that require careful consideration.
Efficacy of digital interventions for smoking prevention among children: a systematic review
Authors: Gianfredi V , Traverso L , Sgueglia A C , Barbati C , Bertuccio P , Odone A
Published: October 2024

Background

Smoking remains a leading preventable cause of morbidity and mortality globally, with initiation often occurring in childhood. Early smoking onset is linked to increased difficulty in quitting and higher risk of long-term health complications. Traditional prevention strategies have not fully succeeded in curbing youth smoking rates, highlighting the need for innovative approaches. Digital interventions (DI), such as gamified education, social media campaigns, and virtual reality, offer a novel avenue for engagement and education. This systematic review aims to assess the efficacy of DI in preventing smoking, and improving knowledge and awareness about smoking damages, among children. This review is part of the PRIN project, whose goal is to evaluate the effectiveness of a DI aimed at school-aged children, intended to increase knowledge about the negative effects of smoking and prevent its use.

Methods

On the 18th of March 2024, PubMed, Scopus, and PsycINFO were surfed for trials and observational studies evaluating DI for smoking prevention among children aged 6-12 years. Study quality will be evaluated using the Cochrane Risk of Bias Tool and New Castle-Ottawa scale. The protocol has been registered in PROSPERO.

Results

From 3,081 initially identified articles, 328 papers were removed because duplicate. The screening process is ongoing.

Conclusions

DI are a promising tool for engaging young populations through platforms they are familiar with and receptive to. By leveraging the high penetration of digital technology in the daily lives of children, these interventions have the potential to deliver smoking prevention messages in a compelling and interactive manner. Understanding the effectiveness of DI in smoking prevention can significantly contribute to public health by providing viable alternatives to traditional methods and potentially reducing future smoking-related health burdens.

Key messages

• Evaluating digital strategies for smoking prevention among children could offer vital alternatives to traditional methods, potentially reducing long-term health risks.

• Digital interventions (DI) offer promising new ways to engage young audiences on smoking prevention using familiar platforms, potentially reshaping public health approaches.
Educational and communication strategies to promote HPV vaccination: A Systematic Review
Authors: D’Ambrosio F , Sezzatini R , Nisticò A , Maida A , Bucciardini R , Calabrò G E
Published: October 2024

Background

Despite the evidence supporting the value of vaccination, Cervical Cancer (CC) and HPV-related diseases still represents a public health challenge, requiring international efforts to address all barriers that can reduce vaccine acceptance and equitable uptake. In this context, implementing interventions aimed at enhancing knowledge levels within target populations emerges as a crucial approach to improve vaccination coverage. Thus, this study conducted within the PERCH project (PartnERship to Contrast HPV), aimed to explore all educational interventions/communication strategies adopted at the international level to improve HPV vaccine uptake.

Methods

A systematic literature review was conducted by querying three databases from July 1, 2006 (the time of the first HPV vaccine licensure) to January 30, 2024. It included studies focused on educational interventions/communication strategies adopted by healthcare providers (HCPs) targeting the World Health Organization (WHO)-recommended population for HPV vaccination, as well as parents, caregivers, teachers, and other influential individuals involved in vaccination decision-making.

Results

Overall, 16 studies were considered, with 68.7% (11/16) focusing on educational initiatives and 50% (8/16) on communication strategies. Regarding the target population, 19% (3/16) involved parents/caregivers, 25% (4/16) included both parents and adolescents, and the remaining 56% (9/16) targeted adolescents/young adults. Videos were the most commonly used channel for both types of interventions (54%), followed by informative materials (31%), person-to-person solicitation (17%), social media (15%) and slide presentations (23%).

Conclusions

Understanding the strengths and weaknesses in HPV knowledge and communication is crucial for developing effective, tailored strategies to disseminate reliable information and promote evidence-based knowledge, thereby implementing high-value healthcare.

Key messages

• Effective communication of vaccination’s value to stakeholders is essential for informing health policies, guiding best practices, and countering misinformation.

• Further research is needed to develop interventions that effectively increase HPV vaccine acceptance, aligning with the WHO’s goals to eliminate CC and HPV-related diseases.
Asking to thrive: structures supporting young men’s behavioural health in Belfast, Northern Ireland
Authors: Morse A , Higgins K
Published: October 2024

Background

Men in Northern Ireland are three times more likely to die by suicide and psychiatric morbidity is significantly higher than for the United Kingdom overall, in part due to the Troubles, a 30-year conflict during which there were 34,000 shootings, 14,000 bombings, and 3,500 deaths. Prior studies suggest strong friendships and high collective efficacy in communities are protective against suicide and self-harm in adolescents and that inquiring about supportive people and structures directly-rather than through parental intermediaries-yields more accurate responses.

Methods

Semi-structured interviews were conducted with 30 adolescent males aged 16-19 from working-class communities across Belfast. Participants were recruited via trusted community partners and often had experiences with sectarianism and restorative justice. A deductive thematic analysis was conducted of interview transcripts, supplemented by responses to the Self-Harm Inventory and a modified Collective Efficacy Scale. Analyses were completed in NVivo and RStudio.

Results

In addition to male peer friendships in which they could share confidences, participants strongly endorsed the value of youth work organisations as keystones in supporting not only their own behavioural health through positive modelling but also the reduction of antisocial and sectarian behaviours in their communities. Participants named specific aspects of these structures they found most useful, including demonstrating “masculine success” though community engagement and family life, providing a safe venue for socialising, and delivering restorative justice programming.

Conclusions

Findings from this study suggest that youth work programming is an important component of both adolescent behavioural health promotion and community safety through the reduction of sectarian and other antisocial behaviours. Participants expressed dismay at the reduction of these services and endorsed both their personal and wider community importance.

Key messages

• Youth workers may provide valuable positive modelling and behavioural health support to the young men.

• Youth work programmes may function both for behavioural health promotion and community violence reduction in Belfast, Northern Ireland.
Improving health workers’ well-being in Cittadella Hospital (Province of Padua)
Authors: Tikvina S , Zilli E , Bonaldo D , Varotto M , Bevilacqua S , Calzavara A , Madia A , Ruffatto A
Published: October 2024

Issue

A healthy workplace increases productivity, creativity and decreases absenteeism and turn-over. It also contributes to creating a more secure work environment with fewer risks of violence. In the past 3 years, the healthcare system has suffered the psychological, economic and social consequences of the COVID-19 pandemic. On the other hand, the healthcare staff reductions determine high levels of work related stress that are often unsustainable.

Description

In an effort to improve staff well-being, in the Hospital of Cittadella, which counts nearly 1,250 employees, a wide range of activities have been initiated. A questionnaire was submitted to the hospital’s staff and the results showed that nearly 10% of workers had experienced physical symptomatology related to work. The most commonly experienced symptoms included: anxiety, nervousness, headache, stomach ache, excessive fatigue and insomnia. Participants also indicated feeling excessive mental fatigue and emotional overload at the end of their work shift.

Results

Psychomotor practice, held according to the Aucouturier method, is one of the projects intended especially for the staff operating in Intensive Care, Emergency and Pneumology Units. This method brings focus to controlled breathing, posture, muscle work and movement that help manage stress and fatigue. A Qigong course, which is an ancient Chinese practice designed to optimize the energy within the body reducing the stress levels and increasing general wellbeing, was held every two weeks for 5 months. And finally, Tibetan singing crystal bowls sessions consisted of monthly guided meditation sessions using the sounds of the crystal bowls.

Lessons

In conclusion, well-being and organizational performance are closely related to each other. It is crucial for any organization to encourage and maintain better physical and mental health of the healthcare staff as it directly affects productivity and consequently user’s satisfaction of the services provided.

Key messages

• Stress management is important amongst healthcare professionals as they are continuously exposed to different job stressors.

• Promoting self awareness and self care can help create a healthier work environment.
Evidence of association between gender and physical fitness in physically active people in Colombia
Authors: Morales Eraso N S , Caviativa Castro Y P , Murcia Doncel M P , Rubiano Espinosa O F , Jaramillo Guzmán V
Published: October 2024

Background

Physical Condition (PC) is an important health marker (Colley, 2019), as a predictor of morbidity and mortality from cardiovascular diseases, among other causes (Cruz, 2018).

Aim

To perform association tests between gender (G) and CP in physically active people in Colombia. This study is observational cross-sectional, 1,503 people participated, 1,019 Women (W) (68.6%) and 485 Men (M) (31.4%) in Colombia, mean age 52±16.2 in W and 42±17.8 in M. Data were analyzed with Rstudio v2022.12.0. The statistical protocol was: 1- Empirical distribution. 2- Normality tests with Kolmogorov-Smirnov. 3- Tests of independence with Chi-square (χ²). The mean (X¯), percentage (%) and standard deviation (±) were taken into account. PC was measured in body composition variables; Body Mass Index (BMI), Body Adiposity Index (BAI) and Abdominal Circumference (AC), Grip Strength (GS) and Maximal Oxygen Consumption (Vo2max).

Results

In W, 38.3% (27.2±1.37) were overweight (Ow) and 19.1% (33.0±2.83) obese (Ob), 69.6% (90.9±8.14) cardiovascular risk (CVR) for AC and 50.4% (32±4.73) risk for BAI. Regarding GS 43.4% (15.8±6.38) is weak and 54.6% (27.7±4.98) Vo2max is low. In M 35.6% (26.9±1.48) presented Ow and 10.6% (32.7±2.39) in Ob, 39.7% (98.4±6.8) with Rcv by AC and 24.3% (29.7±3.45) at risk by BAI. As for GS 41.5% (27.1±6.39) are weak and 32.3% (33.3±6.33) under Vo2max. According to independence tests with χ² there is association between the G and BMI (χ²=1452.1, df = 1427, p-value=0. 315), G and AC (χ²=394.9, df = 382, p-value=0. 313), G and Vo2max (χ²=155.5, df = 6, p-value<2. 2e-16), G and BAI (χ²=2970.3, df = 1502, p-value<2.2e-16), G and GS (χ²=6015.5, df = 1502, p-value<2.2e-16). This project has been approved by the bioethics committee.

Conclusions

Test of independence with (χ²), being a non-homogeneous sample, there is a strong association between G and PC with BMI, BAI, AC, GS and Vo2max, each variable depending on the others, evidencing higher Rcv in women with respect to men.

Key messages

• Several studies consider Physical Condition (PC) is an important health marker (Colley, 2019), as a predictor of morbidity and mortality of cardiovascular disease, among other causes (Cruz, 2018).

• There is a strong association between G and the levels of BMI, BAI, AC, SG and Vo2max variables, each variable depending on the others, showing a higher Rcv in women compared to men.
Strengthening data management skills amongst public health professionals during the war in Ukraine
Authors: Kostetska O , Boyko V , Caillaud M , Matthys B , Koch D , Delvento G , Dumcheva A , Vernyhor Y , Bugaienko N , Karkishchenko O
Published: October 2024

Background

The current war in Ukraine has led to disturbances in public health surveillance and epidemiological data flow, which impacts timely decision-making at regional and national levels. The five-year USAID project “Public Health System Recovery and Resilience Activity” (PHS R&R) aims to strengthen the Public Health system of Ukraine, including through the training of specialists in data management and disease surveillance.

Objectives

An innovative mixed-method, multi-module course was piloted in January 2023 to provide epidemiologists and other public health professionals with up-to-date knowledge and practical skills in disease surveillance and data management. The course was designed based on a needs assessment study carried out across the regional Centres for Disease Control (CDCs) in 2022. Modules were delivered both in person and online to reach a wider audience.

Results

1,540 public health specialists attended the first module on Excel skills, online. A further 26 completed a second module, covering disease surveillance methods, data management, and data flow across regions, in person. Over 85% of participants in the second module reported that it was highly relevant to their day-to-day work, especially practical sessions on data analysis and reporting. The second module is currently under revision based on participants’ feedback before being scaled up. A more advanced module on data management is being developed and aimed to launch at the end of 2024.

Conclusions

The course was timely and relevant for Ukrainian public health specialists in need of enhanced surveillance and data management skills to detect and respond to public health threats. Its innovative format allowed it to train a large cohort of specialists across a variety of essential public health functions despite the full-scale war. This experience would be relevant for any country aiming to strengthen its preparedness for potential public health emergencies, especially in fragile settings.

Key messages

• The comprehensive training course on epidemiological surveillance and data management will equip Ukrainian public health specialists with data-driven decision-making skills in the war context.

• The described training approach would be relevant for the countries which seek sustainable workforce development solutions to strengthen public health systems in fragile settings.
How much digital public health is taught in German public health programs? A qualitative analysis
Authors: Maass L , Albrecht J , Tokgöz P , Hrynyschyn R , Wrona K J , Stark A L , Dunsche C , Fischer F , Schmidt A , Dockweiler C
Published: October 2024

Background

Digital public health (DiPH) professionals are crucial for a successful digital transformation in social and health care. However, the extent to which academic professionals are taught DiPH-related content in their public health studies in Germany remains unclear.

Methods

We used a systematic module handbook analysis to assess accredited full-time public health-oriented degree programs at German Universities for DiPH-related modules. Programs were identified through the Hochschulkompass platform and among the German Public Health Association member programs. We used MAXQDA for the content analysis of the included module handbooks.

Results

We identified 79 public health programs. Of these, 10 Bachelor’s and 6 Master’s offered at least one DiPH module, all being highly heterogeneous in their overall addressed public health subfields. Regarding DiPH, 6 programs lectured on the ethics of digitalizing health and data protection, 5 programs each offered modules on DiPH in health policy, on data science in healthcare and software used for eHealth, or on the digital determinants of health. 4 programs each included modules on digital health promotion and alternative evaluation methods. 3 programs each addressed digital science communication and health technology assessment. Finally, 2 programs had modules on digital epidemiology. We found differences between the common understanding of DiPH in academia and the content in the module handbooks. The content identified in the analysis focused mainly on technical areas. Social and health science content was only marginally present.

Conclusions

The diverse DiPH study programs allow academic public health specialists in Germany to develop specific profiles. There is a need for further development of modules with relevance to the respective degree program to achieve comprehensive competencies in DiPH. We encourage the uptake of our analysis to develop a core curriculum in DiPH among European public health programs.

Key messages

• Digitalization affects all areas of life, including healthcare systems and public health. Preparing the future workforce already during their training is crucial to enable them to lead the change.

• German public health programs are not fit to prepare students for their professions. Developing DiPH curricula with pre-defined and updated competencies will strengthen programs in Germany and beyond.
Assessment of healthy worker survivor bias among middle-aged manufacturing employees in Korea
Authors: Yun B , Oh J , Sim J , Park H , Lee J , Yoon J-H
Published: October 2024

Background

Healthy Worker Survivor Bias (HWSB) describes a selection bias where those continuously employed tend to exhibit superior health outcomes compared to their unemployed counterparts. This bias challenges for adjustments due to its time-dependent nature. This study aims to evaluate the extent of HWSB related to changes in employment status among middle-aged manufacturing workers using comprehensive national data from Korea.

Methods

The study analyzed data from the National Health Insurance Service, targeting individuals aged 40-49 who maintained consistent insurance coverage-either as manufacturing employees or non-employees (self-employed or unemployed)-from 2008 to 2010. The observation period spanned from January 2011 to December 2022, with all-cause mortality as the primary outcome. We employed landmark analysis to quantify HWSB related to employment status by comparing age-standardized mortality ratios between employees and the general population from the initial assessment to the last landmark period (up to 7 years), calculating 95% confidence intervals (CI) using Poisson distribution.

Results

The cohort included 4,621,983 participants (726,616 manufacturing employees and 3,895,367 (84.3%) non-employees). Throughout an average follow-up of 10.9 years (43.1% male; median age of 44), there were 116,418 deaths (11,530 (1.6%) among manufacturing employees and 104,888 (2.7%) among non-employees). Analysis revealed a consistent linear increase in HWSB over time. Notably, the bias was more pronounced among females (7-year HWSB-ES [95% CI]: 0.27 [0.17-0.37]) compared to males (7-year HWSB-ES [95% CI]: 0.18 [0.14-0.22]).

Conclusions

This study quantifies the extent of HWSB among middle-aged manufacturing workers in Korea, highlighting its significant impact, notably in females. These findings are vital for occupational health research, emphasizing the necessity to consider HWSB to prevent the underestimation of health risks associated with hazardous exposures.

Key messages

• Findings suggest HWSB is more pronounced in female manufacturing workers, indicating the need for targeted occupational health interventions.

• The study underscores the importance of accounting for HWSB in occupational health studies to avoid underestimating health risks associated with workplace exposures.
General Practitioner Availability and Accessibility in Serbia Before and During the Pandemic
Authors: Šantrić Milićević M , Stevanović A
Published: October 2024

Background

During the COVID-19 pandemic in Serbia, state-owned primary health centres’ general practitioners (GPs) served as the first point of care for adults (the population aged 19 years and older) and gatekeepers of the health system. The study highlights changes in the overall availability, accessibility, and workload of GPs during the pandemic.

Methods

We used routine health facility data at the national level to describe the changes in GPs over the past three years, before the pandemic (2017-2019) and during the pandemic (2020-2022). Specifically, we looked at the total number of GPs, the percentage of specialists, the average number of citizens per GP, the services used per capita, the average number of visits per GP, and the leading causes of morbidity.

Results

The study found a decrease in the total number of GPs in both periods (before: -10%, during: -9%) and in the number of specialists (before: -2%, during: -3%). During the pandemic, the average number of citizens per GP varied. In 2022, the average number of visits per GP decreased noticeably to 3557 GPs, of which 37% were specialists. In the same year, each GP received 6661 annual visits and served 1509 citizens on average. However, these figures exhibit considerable regional and geographical differences. Circulatory and respiratory diseases were the most common reasons for visiting a GP (about 14% and 13% of all visits, respectively). Up to 10% of all visits resulted in either a diagnosis of external factors that influence health status or in ill-defined symptoms, clinical and laboratory findings.

Conclusions

This study’s findings underscore the critical reductions in availability, accessibility, and workload of general practitioners in the Serbian public sector and emphasize the importance of strengthening the primary healthcare system to better respond to future challenges.

Key messages

• Public health officials should prioritize the development of effective strategies and policies that focus on improving the quality and accessibility of primary health care services in Serbia.

• A greater investment in general practice is necessary to ensure it can effectively meet the population’s needs during health emergencies.
Global insights of AMR education within One Health
Authors: Nowbuth A A , Charani E , Jere S , Makashinyi M , Mwanza M M , Tazinkeng N , Asombang A W , Parmar V S
Published: October 2024

Introduction

Amidst rising concerns over antimicrobial resistance (AMR), traditional educational models fall short in addressing the complexities of AMR which spans environmental, animal, and human health. Education plays a key role in equipping students with skills to combat AMR effectively. We analyzed the difference in knowledge, attitude, and practices (KAP) regarding AMR across medical, dental, and veterinary students, in relation to the quality of AMR education they receive.

Methods

Pubmed, Scopus, Web of Science and Google Scholar were searched for articles related to KAP and education until 3 August 2023. The inclusion criterion was the presence of KAP data related to AMR, and details on the AMR education curriculum. Meta-analysis is currently being performed.

Results

We retrieved 1301 articles, and 90 articles met inclusion criteria for final analysis. Articles spanned 42 countries, first to final year, sample sizes ranging from <100 to > 3000 participants. Across medicine and dentistry, 79% of studies were done, compared to 17% in the veterinary sector and 5% that adopted a One Health approach. HICs prioritize improving current educational frameworks with practical skills and innovative teaching methods. LMICs deal with challenges like raising awareness about AMR and addressing educational deficiencies at a basic level. Findings indicate a wide variance in AMR knowledge levels, with some studies reporting as low as 32.4% of participants having “good knowledge” on AMR. Attitudes towards antibiotic use and resistance were casual, with a significant number of students expressing the need for more education. Practices varied widely, from high rates of self-medication to better-informed antibiotic use in regions with more comprehensive AMR curricula.

Conclusions

Enhancing the quality of AMR education across medical, dental, veterinary, and environmental health is imperative to equip future health professionals with the knowledge and attitudes necessary to combat AMR.

Key messages

• Traditional educational models are insufficient for addressing the complexities of AMR which crosses multiple health sectors.

• Improving AMR education quality is crucial to equip future health professionals to effectively combat AMR.
Health workers’ perceptions on refugees’ access to healthcare and right to health in Turkiye
Authors: Mardin F D , Ozgulnar N , Karabey S
Published: October 2024

In Turkey, over the past decade, the influx of refugees has significantly influenced migration policy and consequently, health policy for refugees, shaping the perspectives of healthcare workers towards refugees. To gauge healthcare workers’ perceptions regarding refugees’ access to healthcare and their right to health, a survey was conducted across three hospitals in two cities (n = 547). The drop-collect methodology was used, obtaining consent in advance. Healthcare workers (HCWs) were classified into four groups: doctors (n: 139), nurses and midwives (n: 201), other healthcare professionals (n: 58) and non-healthcare professional (n: 137). Additionally, twelve people who did not want to disclose their profession were excluded from the statistics when comparing responses by profession. According to HCWs’ experiences, the most common obstacles faced by refugees included language barriers due to not knowing Turkish, the absence of interpreters in hospitals, cultural disparities, and financial constraints. Among HCWs, 89.8% (n = 491) believe that health constitutes a fundamental human right, yet only 55.8% (n = 305) advocate for free emergency services for all. Furthermore, 43.1% express concerns that providing healthcare to refugees might attract more refugees, and 38% suggest that only individuals deemed healthy through health screening upon entry should be permitted into the country. Responses to inquiries about the prevalent issues varied across cities and occupational groups. Despite the majority of HCWs adopting a right-based approach to health, it is evident that some lean towards a deservingness perspective regarding refugees’ access to healthcare. Consequently, there is a pressing need for collaboration among various sectors to furnish adequate information and training for HCWs on migrants’ rights and prejudice. This should be a part of migration policy, leading to a more migrant-friendly health system.

Key messages

• Collaboration among diverse sectors is urgently needed to provide healthcare workers with thorough information and training on the rights of migrants and addressing prejudice.

• Implementing training programs for healthcare workers as a component of migration policy is essential for building a migrant-friendly healthcare system.
Seroepidemiological study of Epstein-Barr virus infection in reproductive age women in Bulgaria
Authors: Petkova T , Pachkova S , Georgieva S
Published: October 2024

Background

At the present stage, studies on the involvement of Epstein-Barr virus (EBV) in neonatal pathology are rare. Establishing seroprevalence among women of reproductive age has important epidemiological significance in order to determine the risk of infection during pregnancy and intrauterine infection of the fetus. The aim of the study is to determine the seroepidemiological status of EBV in reproductive age women.

Methods

We conducted a prospective seroepidemiological study in which 96 healthy women of reproductive age (18 to 49 years) were tested during the period December 2023 - January 2024 in Medical Center “Clinical Institute for Reproductive Medicine”- Pleven, Bulgaria. Participants were surveyed on a voluntary basis. The exclusion criteria were: presence of autoimmune disorder, immunosuppressive states, malignancy and populations at risk such as persons under 18 years of age and pregnant women. The presence of specific antibodies were detected using a standardized Anti-EBV VCA IgM, Anti-EBV VCA IgG and Anti-EBV EBNA-1 IgG ELISA kits. The demographic and anamnestic data were collected for each participant in Case Report Form.

Results

The average age of the women was 34.41±5.44 years. Dominating were women with higher education (76.04%) living in urban areas (91.67%). The results of the seroepidemiological study of markers for EBV show that 98.96% of women of reproductive age are seropositive. There was no significant correlation between the presence of antibodies and socio-demographic indicators (living area, education and number of family members).

Conclusions

The results of this study imply that only 1.04% of the reproductive age women in Pleven region are susceptible to infection with EBV. Although interpretation of the serological status indicates a low risk of primary infection, active monitoring of high-risk groups pregnant women is necessary because of the possibility of EBV reactivation.

Key messages

• On-going monitoring of the seroepidemiological EBV status in reproductive age women is necessary to determining the possibility of EBV reactivation and to reduce the teratogenic risk of the infection.

• Seroepidemiological surveillance of markers for EBV infection in reproductive age women is part of effective preventive measures at the public health level.
Adult Immunization Board: A platform to provide guidelines for implementation of adult immunization
Authors: Pattyn J , Del Riccio M , Hendrickx G , Boccalini S , Bechini A , Van Damme P , Bonanni P
Published: October 2024

Background

Several organizations, including governments, (inter)national public health organizations and vaccine manufactures are currently considering how adult immunization can be further improved to increase health impact and promote a lifelong approach to vaccination. Despite many organizations thinking about ways to improve adult immunization, there is currently no multidisciplinary discussion platform focusing on this topic at the European level. Therefore, a group of experts in the field of adult immunization established the Adult Immunization Board (AIB).

Methods

AIB is established with the aim of contributing to the reduction of the impact of vaccine-preventable infections and diseases in European adults. AIB works by organizing 2 meetings per year: 1) a technical meeting to discuss specific technical aspects on adult immunization with subject-matter experts, and 2) a country meeting to discuss country specific aspects of adult immunization together with local experts.

Results

In April 2023 and 2024 the AIB organized its first technical meetings on “Assessing the health burden of vaccine-preventable infections in European Adults (2023)” and “Strategies for introducing and implementing vaccines for adults into National Immunization Programs in Europe (2024)”. In December 2023, the AIB organized its first country meeting in Italy with local experts to learn out best practices in adult immunization and address aspects to improve.

Conclusions

AIB is a platform that brings together the different key European stakeholders in adult immunization to effectively contribute towards the implementation and optimization of adult immunization programs in Europe.

Key messages

• Continued efforts to promote research, implementation, awareness, accessibility, and vaccine uptake are crucial to mitigate the burden of (future) infectious diseases in the adult population.

• The AIB represents a significant step towards bolstering adult immunization efforts in the EU.
Administrating first aid in road traffic accidents in Bulgaria: a cross-sectional study
Authors: Radeva N , Rohova M , Bakhova A , Romanova H
Published: October 2024

Background

Bulgaria had the highest road mortality rate among European Union members in 2023, having previously ranked second after Romania. Research has consistently demonstrated that prompt pre-hospital care can significantly reduce the adverse effects of road traffic accidents. Thus, we conducted a cross-sectional study to explore the involvement of trained road traffic casualties and bystanders in administering first aid.

Methods

The study, carried out between April and December 2021, collected data via an online survey administered to members of the Scientific and Academic Cooperation Council by the State Agency Road Safety. The survey encompassed a range of topics, including first aid training, involvement in traffic accidents, behaviour of bystanders, administration of first aid, and sociodemographics.

Results

Among the 292 respondents, a sizeable proportion (90%) reported having received first aid training. Of these, 35.1% (95% CI 29.2-41.1%; p < 0.001) had personally experienced a road traffic accident, and 64.5% (95% CI 58.1-70.1%; p < 0.001) had witnessed one. It is noteworthy that a fifth of those involved in accidents had employed the skills acquired from first aid training, which included applying a dressing to a wound, bleeding control, and immobilising a fracture. Correspondingly, an equivalent percentage of bystanders administrated aid, with the majority of them performing basic airway management. However, the findings revealed that a significant proportion of participants (79.3%) did not engage in providing first aid. The primary rationale stated was the assessment that it was nonessential.

Conclusions

Despite the growing road safety challenges and many respondents witnessing or being involved in accidents, only a quarter of those trained in first aid actually provided assistance. Considering the increasing number of deaths and severe injuries, it is crucial to assess the need for frequent first aid training and the population’s proficiency in first aid.

Key messages

• Bystanders’ competence in administrating first aid can mitigate the adverse effects of road traffic accidents.

• Among other road safety measures, investments in first aid training can be beneficial in reducing fatalities and severe injuries.
Association between frailty and fear of falling among the elderly in Latvia
Authors: Bukova-Zideluna A , Villerusa A , Springe L , Baltmane D
Published: October 2024

Background

Frailty and fear of falling in the ageing population represent notable public health challenges. Fear of falling among the elderly population is a significant concern, as it can lead to decreased mobility, loss of independence, and increased risk of injury. Frailty intensifies this fear, as frail individuals often have reduced strength, balance, and coordination, making them more susceptible to falls.

Methods

Data from the population-based survey SHARE with respondents aged 50+ in Latvia of Wave 9 (collected 2022) was analysed. Frailty was assessed using the SHARE-Frailty Instrument. Fatigue, appetite, walking difficulties, and physical activity were self-reported and grip strength was measured using a hand grip dynamometer. Fear of falling was evaluated using visual material.

Financed by the project RSU internal and RSU with LSPA external consolidation No.5.2.1.1.i.0/2/24/I/CFLA/005, Postdoctoral Grant Associated factors of frailty and fall-related mortality in the older population in Latvia No.RSU-PG-2024/1-0005.

Results

The sample comprised 1439 older adults from Latvia (60.4 % female) with a mean age of 67.9 (95% CI 67.5 - 68.4). Based on SHARE-FI, frailty and pre-frailty prevalence were 7.2% and 44.5% respectively. In the study, 11.3% of females and 6.5% of males interviewed reported experiencing fear of falling. Frailty was correlated with fear of falling in 43.7% of frail individuals and 11.5% of pre-frail individuals. After adjusting for age and gender, those with pre-frailty and frailty had greater odds of fear of falling.

Conclusions

Understanding the interaction between the fear of falling and frailty in older adults can guide the development of public health policies and initiatives that aim to mitigate the fear of falling and, consequently, reduce the prevalence of frailty. Promoting healthy ageing behaviours, such as regular exercise, balanced nutrition, and social engagement, can help prevent frailty and its associated risks.

Key messages

• Fear of falling results in limitation of activities, intensification of physical decline, and increased susceptibility to frailty.

• Encouraging healthy ageing underscores the significance of early recognition of frailty symptoms and accessing suitable support.
Can a mindfulness programme in schools for students with ADHD symptoms improve emotional well-being?
Authors: Holopainen M , Hintsanen M , Lahti J , Vahlberg T , Volanen S-M
Published: October 2024

Background

This study employs a cluster randomized controlled trial to investigate the effectiveness of a universal mindfulness-based intervention (MBI) in classrooms in improving emotional well-being and emotion regulation among adolescents with elevated ADHD symptoms.

Methods

The study comprised 342 students: 164 in an MBI group, 128 in a relaxation control group, and 47 in an inactive control group. Positive and negative emotional states and the emotion regulation strategies of rumination, acceptance, catastrophizing, positive reappraisal, and self-kindness were measured at the pre- (T0) and post-intervention (T9) and the 26-week follow-up (T26). Linear mixed models were used to analyze the intervention effects among all participants and separately by gender and ADHD symptom type.

Results

The results showed that compared to the controls, there was a beneficial effect on the MBI group concerning acceptance at T9; acceptance remained at the baseline level in the MBI group but decreased in the inactive control group. In contrast, in the inactive control group, rumination decreased at T9, and positive reappraisal increased at T26 compared to the MBI group. The MBI had no detectable effects on self-kindness, catastrophizing, or positive/negative emotional states. Findings on the emotion regulation strategies varied by gender. In boys, the MBI increased acceptance at T9 compared to the inactive control group, whereas in girls, the programme reduced catastrophizing at T9 and T26 compared to the active control group. Contrary in boys, MBI group exhibited less reduction in catastrophizing at T9 compared to the inactive control group.

Conclusions

Universal MBIs may have some beneficial effects on emotion regulation in adolescents with elevated ADHD symptoms. Both girls and boys might be responsive to universal MBIs as part of the school curriculum, however not all consequences are positive (especially in boys).

Key messages

• Universal MBIs in classrooms may have some beneficial effects on emotion regulation among adolescent with elevated ADHD symptoms; however, the results are contradictory and more research is needed.

• Even though, universal MBIs may have some benefits, they may require modifications to lead to more beneficial effects on emotional well-being when used with this subgroup of students.
Prescribing contraceptives to minors without parental knowledge and consent
Authors: Peled-Raz M , Goldstick O
Published: October 2024

Background

Sexually active adolescents may seek oral contraceptives without parental consent, posing challenges due to minors’ confidentiality and consent regulations. This is especially the case under the un-nuanced Israeli legal scheme regarding adolescents’ care.

Methods

Israeli OBGYNs were contacted through mailing lists and social media groups and asked to fill an online questionnaire regarding their experience and protocols concerning prescription of contraceptives to minors. They were also asked about their comprehension of the relevant legal obligations, the importance they ascribe to different ethical interests and considerations, as well as their training.

Results

Of the 177 responding gynecologists, 75% consulted minors about contraceptives during the past year, most of them without any training on providing care to adolescents. More than a third of respondents believed that parental involvement wasn’t legally required, while only 8% thought it mandatory for all minors under the age of 18. Most (75%) would ‘almost always’ prescribe contraceptives without parental knowledge upon request, while 20% never would. No correlation was found between respondents’ practices and their perception of the legal obligations. Participants agreed that the risk to the health of the minor due to having sex without contraceptives is of utmost importance. Those willing to prescribe gave greater weight to minor’s autonomy consideration, while those who do not prescribe were more concerned with the acts legal ramifications. The majority set the age of 15 as the threshold for consistently prescribing contraceptives to minors without parental involvement.

Conclusions

Access to contraceptives for mature minors without parental involvement is vital. There is great need for education and training for healthcare providers on providing medical treatment to adolescents, as well as for the development of policies and guidelines, addressing adolescents’ health disparities.

Key messages

• Israeli legal requirements challenge and hinder adolescents’ care as well contradict OBGYNs ethical and professional beliefs.

• There is great need for education and training, as well as for the development of policies and guidelines, addressing adolescents’ health disparities.
Anemia in pregnancy and adverse maternal health outcomes - birth-registry based study from Georgia
Authors: Skhvitaridze N , Gamkrelidze A , Manjavidze T , Brenn T , Anda E , Rylander C
Published: October 2024

Anemia in pregnancy is an important public health challenge; however, it has not been thoroughly studied in Georgia. We assessed the prevalence of anemia during pregnancy across Georgia and the association between anemia in the third trimester of pregnancy and adverse maternal outcomes. We used data from the Georgian Birth Registry and included pregnant women who delivered between January 1, 2019, and August 31, 2022 (n = 158,668). The prevalence of anemia (hemoglobin (Hb) < 110 g/L) at any time during pregnancy was calculated per region. Women in the third trimester were classified into three groups, based on their lowest measured Hb value: no (Hb ≥ 110 g/L, reference group); mild (Hb 100-109 g/L); and moderate to severe anemia (Hb < 99 g/L). Adjusted odds ratios (aOR) with 95% confidence intervals (CIs) were calculated for the associations between anemia status and post-delivery intensive care unit (ICU) admission and preterm delivery. The prevalence of anemia occurring at least once during pregnancy was 40.6%, with large regional differences in anemia prevalence (25.1%-47.0%). Of 105,811 pregnant women with Hb measurements in the third trimester, 71.0% had no anemia; 20.9%, mild anemia; and 8.1%, moderate or severe anemia. The odds of post-delivery ICU admission did not increase linearly with decreasing Hb value (P for trend .13), and the relationship was inverse for preterm delivery (P for trend .01).

Key messages

• A considerable proportion of pregnant women in Georgia have anemia during pregnancy, and the prevalence and quality of reporting differ across regions.

• To accelerate national progress toward the SDGs and mitigate the consequences of anemia, equal countrywide access to high-quality ANC programs and complete registration of Hb values should be ensured.