bluuebunny/crossref_metadata_2025 huggingface dataset:
Infertility in the Capital Region of Denmark: Prevalence and population characteristics
Authors: Eliasen M H , Grønkjær M , Schmidt L , Elsborg P , Toxværd C G , Vassard D
Published: October 2024

Background

Infertility is a disease defined by failure to achieve a pregnancy within 12 months of trying. Infertility has-until now-not been monitored in Denmark for three decades. The aim of this study was to assess the prevalence of infertility in persons aged 25-44 years in the Capital Region of Denmark, and to describe characteristics of persons with infertility.

Methods

Life-long experience of infertility was assessed in the Danish Capital Region Health Survey 2021, including 56,245 participants from the general population aged ≥16 years (response rate 54.9%). In this study, only persons aged 25-44 years who had tried to have children (thus knowing their fertility) were included, resulting in 8,203 participants. Characteristics of persons with infertility were assessed using national registries (socio-demographics) and questionnaire data (health status). Descriptive analyses and multivariate logistic regression models weighted for survey design and non-response were performed.

Results

Among persons aged 25-44 years, who had tried to have children, 20% had experienced infertility. Among those, 44% did not achieve the children they wanted. Infertility was most common among women (22%) and persons aged 35-44 years (21%). No associations were observed between infertility and ethnicity, education, and employment status. Persons with infertility were more likely to have poor physical health, have higher level of stress symptoms and have obesity compared with persons in same age group, who had tried to have children but not experienced infertility.

Conclusions

Infertility is very common in the general population and is associated with unmet fertility desires as well as poor physical health and high stress level. These findings highlight the importance of focusing on and prioritizing treatment and prevention of infertility and emphasize the need for further research in and continued monitoring of infertility.

Key messages

• Infertility is very common in the general population and associated with unmet fertility desires and poor health highlighting the importance of prioritizing treatment and prevention of infertility.

• Continuous monitoring of infertility in the general population is essential as well as further research into risk factors and consequences of infertility.
Surveillance of surgical site infections using artificial intelligence
Authors: Ladios Martin M , Delgado de los Reyes J A , Fernandez de Maya J , Belso Garzas A , Soler Oliva V M , Roig Perez V , Vilela Vilar F , Aznar Zamora F M , Torres Sanchez A M
Published: October 2024

Background

Surgical site infection (SSI) is a major health problem associated with high morbidity and mortality, the consequences of which can be very serious for the patient and costly for the organisation. Surveillance systems provide insight into the incidence of SSI, the analysis of which enables improvement plans to be established to reduce it. Traditionally, surveillance systems have been based on manual medical record review for evidence of the presence of surgical infection.

Objectives

To create and validate a global SSI diagnostic algorithm and to optimise the SSI workload of Preventive Medicine services.

Methods

The study population included patients undergoing surgical procedures of rectal surgery, colon surgery, knee replacement surgery, hip replacement surgery, coronary bypass and valve surgery, at the Hospital Universitario Vinalopó in Elche (n = 1240). Data mining was used to collect clinical, microbiological and postoperative follow-up values from the electronic medical record. Machine Learning techniques were used to train (n = 1054) and validate the model (n = 186). Time spent on SSI surveillance of the preventive medicine service was measured.

Results

Model performance after validation was: sensitivity of 0.83 specificity of 0.87, accuracy of 0.87, an F1 score of 0.45, and an area under the curve of 0.87. The time spent by preventive medicine staff in identifying patients with surgical site infection decreased from 168 person-hours per procedure per quarter to 34 person-hours, a 77% reduction in the workload allocated to this task.

Conclusions

This project not only improves surveillance efficiency, but also optimises the workload in Preventive Medicine services very significantly.

Key messages

• This project improves the efficiency of surgical site infection surveillance and significantly optimises the workload in preventive medicine departments.

• It makes it possible to extend surveillance to new surgical procedures and to work more intensively on preventive measures.
Cognitive performance in breast cancer survivors: a ten-year follow-up
Authors: Lopes C , Costa A , Araújo N , Rocha J , Lopes C , Oliveira V , Ferreira A , Pereira S , Lunet N
Published: October 2024

Background

Cognitive impairment (CI) has been widely reported as a frequent non-fatal cancer outcome. 15% to 25% of breast cancer (BCa) patients may have CI; however long-term variations of cognitive performance during and after the cessation of the treatments remains unclear. The present study aims to describe the evolution of cognitive performance in BCa survivors that are still in follow-up at breast cancer clinic, 10 years after diagnosis.

Methods

506 women with BCa admitted to the Portuguese Institute of Oncology, Porto, in 2012, were evaluated with the Montreal Cognitive Assessment (MoCA) before any treatment, after one, three, five, and ten years. Patients with a MoCA score ≤1.5 standard deviation below the mean of age- and education-specific norms were considered to have probable cognitive impairment (PCI). The 10-year follow up started in October 2022, and is still in progress (as of March, 118 were evaluated). All women that are still being followed at IPO-Porto for consultations and treatments were evaluated with MoCA assessment.

Results

PCI prevalence at the 10 years was 43.0% (95%Confidence Interval: 34.1%-52.7%). Several pathways for cognitive performance were identified throughout the 10-year follow-up: 58 women (49.2%) never had PCI at baseline assessment or during follow-up; 19 women (16.1%) had PCI at baseline, from whom 5 (4.2%) had PCI in all evaluations, 2 (1.7%) did not have PCI in any follow up evaluation, 2 (1.7%) had PCI during follow up, but not at 10 years and 3 (2.5%) had PCI again only at the 10-year follow-up; 5 women (4.2%) did not have PCI at baseline but had PCI at least once during follow-up but not at 10 years, and 24.6% had PCI for the first time at 10 years.

Conclusions

The results show a high prevalence of PCI 10 years after diagnosis with a significant part being new cases. These results highlight the need for including regular assessments of cognitive performance as a part of the clinical follow-up of BCa survivors.

Key messages

• There is a high prevalence of cognitive deficits in breast cancer suvivors 10 years after diagnosis.

• Including cognitive evaluations of breast cancer survivors during clinical follow up are recommended.
Systematic review of clinical effectiveness and safety of abdominal aortic aneurysm screening in men
Authors: Foley E , Jordan K , Lopez A , Carrigan M , Maher A , O’Neill M , Ryan M , Spillane S
Published: October 2024

Background

Abdominal aortic aneurysm (AAA) is characterised by a bulging in the aortic wall. AAA is typically asymptomatic until aneurysm rupture, which is associated with a very high mortality rate (approximately 80%). In the context of an ageing population and increasing life expectancy, innovative approaches to early detection and intervention are needed. The aim of this review was to assess the clinical effectiveness and safety of one-time ultrasound screening for AAA in men.

Methods

Systematic searches were conducted in electronic databases and grey literature sources. The primary outcomes of interest were AAA-related mortality, AAA rupture, all-cause mortality, rate of surgical repair and safety. The following study designs were included: systematic reviews, randomised controlled trials (RCTs), comparative observational studies and population-based non-comparative observational studies.

Results

Results from a systematic review by the US Preventive Services Task Force analysed 4 population-based RCTs, showing that one-time population-based screening for AAA in men (≥ 65 years) led to significant reductions in AAA-related mortality (OR = 0.65, 95% CI: 0.57 to 0.74), AAA rupture (OR = 0.61, 95% CI: 0.54 to 0.69) and emergency surgeries (OR = 0.53, 95% CI: 95% CI: 0.44 to 0.64) at 13-15 years follow-up, relative to no screening. Separate to this systematic review an additional 24 studies reported on clinical effectiveness, safety and psychosocial harms of AAA screening. Limited evidence from these studies suggest screening was associated with a reduction in AAA-related mortality and rupture but also transient psychological distress in some cases.

Conclusions

One-time ultrasound screening in men ≥65 years appears to offer benefits in terms of reducing AAA ruptures and AAA-related mortality, though the balance of benefits and harms requires careful consideration. In an ageing population, AAA screening could be transformative, by reducing mortality and rupture risks.

Key messages

• One-time ultrasound screening for AAA in older men (≥ 65 years) can reduce AAA-related mortality and rupture.

• In the context of an ageing population in Europe, AAA screening could be transformative, but benefits must be weighed against potential risks.
‘Positive disruption’: catalysing system-wide work on health inequalities through embedded research
Authors: Passey A , Woodall J
Published: October 2024

Background

This presentation explores embedded research as an innovative model for bridging system-level knowledge to action gaps in public health. Embedded researchers (ERers) are university-employed researchers co-located in public health organisations, who work to boost capacity in these organisations to tackle inequalities by better use of evidence in decision-making, evaluation and service improvement

Methods

Drawing on the initial phase of the role and wider literature, we qualitatively reflect on strengths and limits of a system-level ERer model. Most ERer evidence draws on a one-to-one organisational model. This presentation explores a different model of an ERer embedded in and working across a public health system (health services, municipality, third sector) in a large city in north England

Results

Our focus is on catalytic features of the ERer role (1) positionality: being embedded at system-level gives fuller understanding of inter-organisational connections and of the implications of emergent system changes; (2) convening: bringing together partners improves mutual awareness and builds interest in collectively pursuing research aligned to identified population health needs and public health priorities in the city; (3) co-production to build capacity: working with a new cross-organisational partnership to collectively address issues constraining opportunities to pursue system-level research; working with the municipality to explore the production/use of research to inform decisions on approaches towards health inequalities. This includes work on links between public health and other functions focused on social determinants of health

Conclusions

This presentation outlines distinctive consequences of system-level embedded research in a city-wide public health system. It critically appraises the transferability of this model of knowledge production and mobilisation at the intersection of system and cross-organisational action on health inequalities.

Key messages

• System-level embedded research is an innovative model for helping to bridge system-level knowledge to action gaps in public health.

• The model has catalytic benefits and transferability potential, although this needs to be considered in relation to the specific context for proposed system-level embedded research.
Methods to Handle Missing depression (PHQ-8 Score) Values among Adults in the United Arab Emirates
Authors: Al Balushi M , Ahmad A , Javaid S , Grivna M , Al Maskari F , Sherman S , Abdulle A , Piano F , Ali R
Published: October 2024

Background

The UAE Healthy Future Study (UAEHFS) is one of the first large prospective cohort studies in the Gulf region which examines causes and risk factors for chronic diseases among adult UAE nationals. Missing values are often unavoidable in empirical research and can in many cases, lead to bias. The aim of this study is to estimate the percentage of depression in the UAEHFS pilot data using the eight-item Patient Health Questionnaire (PHQ-8) variables, using different statistical methods.

Methods

Five common statistical machine learning methods of handling missing values were included in this analysis. These are mode imputation, k-nearest neighbor (KNN) imputation, classification, and regression trees (CART), random forest (RF) imputations, and random sample from observed values (Sample). 100 multiple imputations were used.

Results

487 (94.2 %) eligible participants were included in the analysis. 231 (44.7%) were included in the complete case analysis. The median age was 30 years (Interquartile-Range: 23 - 38). More males (67.8%) than females included in the analysis. The estimated percentage of depression was 8.4%, 8.9%, 9.9%, 12.5%, 15.4% and 17.9% by the mode, complete case, sample, RF, CART, and KNN respectively. In additional analyses, the estimated proportions of depression were 11.5% by the Complete Case, 11.9% by KNN, 13.2% by K-means clustering, and 13.2% by Random Forest.

Conclusions

The estimated percentage of depression in the UAEHFS pilot data varies between the applied methods of handling missing values. This shows that the problem of missing values in the variables is not negligible. Further research is needed using multiple imputations in the main UAEHFS dataset after completing recruitment.

Key messages

• For the depression missing values, we recommend using multiple imputations not to generate data but to prevent the exclusion of observed data.

• To have a better estimate of the percentage of depression, is recommended to use different machine learning methods.
Co-administration of COVID-19 and flu vaccines in healthcare workers: results from three campaigns
Authors: Pascucci D , Lontano A , Marziali E , Nurchis M C , Vetrugno G , Damiani G , Ricciardi W , Laurenti P
Published: October 2024

The COVID-19 pandemic, along with seasonal influenza, highlights the need for innovative public health strategies. Co-administering COVID-19 and influenza vaccines offers advantages for healthcare workers (HCWs), streamlining vaccination efforts and enhancing public health resilience. Recent evidence supports the safety and efficacy of this approach, endorsed by health authorities worldwide. However, its acceptance remains a concern. This study explores HCWs’ acceptance of vaccine co-administration in three campaigns post the introduction of the anti-SARS-CoV-2 vaccine. During three consecutive flu seasons from October 2021 to January 2024, a cross-sectional study was conducted in a large Italian teaching hospital. Data for 2021/2022, 2022/2023 and 2023/2024 were compared, focusing on healthcare workers present in all datasets. McNemar’s test examined changes in acceptance of co-administration. In addition, a conditional logistic regression model was designed to assess the determinants of co-administration through the vaccination campaigns in the three years. During these vaccination campaigns 7457 HCWs were observed (62.78% women, median age 43). Co-administration surged, particularly in 2022/2023, showing a 280.71% increase, consistent across all professional categories (p < 0.001). Controlling for gender and professional category, acceptance of coadministration showed a significant association respectively with “open days” twice a month (OR 2.9 CI [2.7; 3.6]) and a hospital vaccination clinic two days a week on weekdays (OR 4.5 CI [4.1; 5.4]) compared to conducting vaccinations at a clinic open everyday during the campaign period; no association was highlighted with age. This study investigates a facet of an increasingly significant topic, demonstrating that co-administering vaccines for SARS-CoV-2 and influenza is emerging as an effective strategy in annual vaccination campaigns, thanks to its safety and the streamlining of logistical and organizational processes.

Key messages

• The co-administration of vaccines offers a promising strategy to enhance vaccination rates among healthcare workers.

• By identifying factors influencing acceptance, it aims to inform targeted interventions for maximizing vaccine uptake and public health resilience.
Evaluating the psychological antecedents of vaccination in applicants to primary health care centers
Authors: Özbaş C , Tokatlı Doğan M , Baran Aksakal F N
Published: October 2024

Background

Vaccine acceptance can be enhanced by understanding the psychological antecedents of vaccination. The 5C model identifies relevant factors: confidence, complacency, constraints, calculation, and collective responsibility. This study aims to evaluate these factors among primary health care center applicants in Ankara.

Methods

A total of 1712 individuals aged 18 and over, who visited primary health care centers, participated in the study. The face-to-face survey included questions about sociodemographic characteristics, Vaccination Psychological Antecedents Scale, individuals’ attitudes and behaviors towards vaccination, and internet usage. Factors with a significance level of p < 0.20 from previous analyses were assessed using multivariate logistic regression analysis. The factors influencing the decision to get vaccinated without hesitation when necessary were investigated.

Results

The likelihood of getting vaccinated without hesitation in necessary situations is higher among those with higher income than expenditure(OR:1,517, 95%CI=1,094-2,104), those without chronic diseases in their family(OR:1,411, 95%CI=1,109-1,795), and those who do not actively use social media(OR:1,380, 95%CI=1,051-1,813). Additionally, an increase in the confidence score(OR:1,276, 95%CI=1,239-1,315) and the collective responsibility score(OR:1,096, 95%CI=1,058-1,134), was associated with an increased likelihood, while an increase in the calculation dimension(OR:0,928, 95%CI=0,895-0,962) was associated with a decreased likelihood.

Conclusions

Income status, presence of chronic illness in the family, active social media usage, confidence, collective responsibility, and calculation are factors influencing vaccine acceptance without hesitation. Communication strategies based on trust and collective responsibility should be developed to improve vaccine acceptance. The risk factors causing vaccine hesitancy among social media users should be investigated, and measures should be taken.

Key messages

• Develop trust-based, collective responsibility-focused communication to boost vaccine acceptance.

• Investigate and address social media-driven vaccine hesitancy.
Risk factors for COVID-19 among healthcare workers: a hospital-based cohort study in Portugal
Authors: Gaio V , Santos A J , Amaral P , Faro Viana J , Antunes I , Paiva A , Henriques C , Melo A , Guiomar R , Machado A
Published: October 2024

Background

Healthcare workers (HCWs) have an increased risk of transmitting SARS-CoV-2 infection to frail patients and are also at higher risk of exposure. Hence, it is essential to understand the risk factors for infection of HCWs to limit adverse events occurring in healthcare facilities. This study aimed to identify risk factors for symptomatic COVID-19 infection among HCWs in the hospital context.

Methods

We used data from a hospital-based cohort study followed between December 2020 and January 2022 in three central Portuguese hospitals. Following the study protocol, RT-PCR testing was performed whenever an HCW reported any symptom compatible with COVID-19. Characteristics of infected (at least one positive RT-PCR with symptoms) versus non-infected HCW were compared using the Chi-square test.

Results

A total of 3034 HCWs were followed during 13 months and 533 had a positive test for SARS-CoV-2. A higher percentage (> 40 %) of infections were in individuals without a primary vaccination scheme. Other than age, no differences were found regarding individual characteristics: infected HCWs had a higher percentage of individuals aged 18 to 50 years old compared to the non-infected HCWs (74.7 % versus 66.2 %, p < 0.001). Regarding work functions, no differences were found for self-report of working in direct contact with COVID-19 patients. Additionally, the percentage of HCWs who declared to perform tracheal intubation procedures was similar in infected versus non-infected HCWs (6.2 % versus 8.9 %, p = 0.080).

Conclusions

Infected HCWs were younger than the non-infected. HCWs working in direct contact with patients or performing tracheal intubations didn’t exhibits increased rates of infection suggesting the success of preventive measures and other standard procedures in limiting infection transmission in healthcare facilities.

Key messages

• HCWs working in direct contact with COVID-19 patients or performing tracheal intubations were not the most infected personnel.

• Preventive measures and other standard procedures were successful in limiting COVID-19 infection transmission in healthcare facilities.
Information on HIV and Narration of U=U: a mixed method analysis on social media in Italy
Authors: Casigliani V , Santoro A , Chinelli A , Agostini A , Giupponi G , Zollo F , Tavoschi L
Published: October 2024

Background

Media play a pivotal role in disseminating accurate information, particularly regarding U=U (Undetectable = Untransmittable), to increase awareness and reduce stigma. This study analyses HIV Italian communication on Facebook and Instagram, with a focus on U=U evidence.

Methods

A mixed-method analysis examined posts on HIV, with linked articles, from Italian news sources from 01/2009 to 04/2023. News sources were categorised as “reliable” or “unreliable” using independent third-party classification. Topic analysis identified the main topics in the posts, while an inductive content analysis was conducted on linked articles regarding U=U. The language and the accuracy in explaining U=U was evaluated through a checklist.

Results

A total of 10,539 Facebook and 749 Instagram posts were analysed, with 716(7%) and 18(2%) from unreliable sources respectively. Reliable and unreliable content surged around World AIDS Day(WAD) on both platforms. On Facebook, the frequency of unreliable content increased over time, whereas on Instagram it was rare and recent. On Facebook, topics varied between reliable and unreliable sources. The 3 most frequent topics from reliable sources were WAD, voluntary HIV spread, and public figures with HIV; those from unreliable sources were Death and Migrant People; Luc Montagnier and COVID-19 Conspiracies; Public Figures with HIV. On Instagram, the first 3 topics were the Italian National Institute of Health and Prevention, WAD, and public figures with HIV. A total of 68 articles nominating U=U were found and analysed, revealing 4 main areas: U=U definition, Prevention, Impact on people living with HIV, and Stigma. The accuracy in explaining U=U was generally low, with 6 articles(8.8%) providing only a definition.

Conclusions

HIV communication in Italy is limited and centered around WAD, with persisting bias. The dissemination of the U=U evidence is lacking. Urgent action is needed to shift the narrative and emphasize this evidence

Key messages

• HIV communication in Italy is limited and concentrated around World AIDS day.

• The U=U evidence is poorly disseminated, often providing only a definition and medical explanation.
Development of Digital Health Gender and Sexual Health Literacy scale
Authors: De Caro W , Di Biagio P , Di Carlo M , Corvo E
Published: October 2024

Introduction

Health literacy, as the ability to obtain, process and understand health information, including gender and sexuality awareness, appears to be underdeveloped in terms of measurement tools and thematic materials. The literature indicates the existence of serious deficits in gender and sexual health literacy at all levels, with implications for relationships with citizens and patients.

Methods

Delphi study agreement was conducted and a pool of potential scale items was generated, reflecting a range of skills and abilities within each domain. Items were carefully worded to ensure clarity, cultural sensitivity and relevance to different gender identities and sexual orientations. Expert review and cognitive pre-testing were employed to refine item wording, assess content validity, and ensure that the 10-item scale was comprehensible and relevant to the target population.

Results

The theoretical development of the 10-item Digital Health Gender and Sexual Health Literacy Scale was successfully completed. The scale items were designed to provide a comprehensive measure of an individual’s ability to navigate the digital landscape for gender and sexual health information.

Conclusions

The theoretical validation of the Digital Health Gender and Sexual Health Literacy Scale (DiGeSHeL) provides the community with a promising tool to assess individuals’ confidence and ability to use digital technologies for sexual health information and resources. However, further research is needed to validate the scale and test its reliability with a diverse group of participants. Once validated, this scale could be a valuable tool for sexual health promotion programmes to identify gaps and evaluate the impact of digital literacy interventions.

Key messages

• Gender and sexual literacy are crucial for health.

• Health literacy as six vital sign.
Navigating Co-design in Children’s Health Literacy Interventions in Schools
Authors: van Boxtel W , Jerković-Ćosić K , Chin A Paw M
Published: October 2024

Today’s society exposes children to vast amounts of health-related information, presenting significant challenges in navigating this content. European health literacy (HL) research underscores the primary school’s role in educating children’s HL. Several HL interventions have been developed for a school setting and few have used co-design with adolescents. However less is known about co-designing HL activities with children. Therefore, this study aims to identify barriers and facilitators for co-designing HL activities with 9 to 12-year-old children in school settings. We use 4 phases of design-based research for the process of co-designing learning activities with multiple teams of 6-8 children in school settings. First, children Reflect on HL and empathize and define skills they want to design activities for. They Design activities through ideation and prototyping. We use a variety of creative methods for the sessions and analyses, such as body mapping and affinity mapping. The evaluation of the effectiveness regarding HL and learning outcomes will be performed in Test and Evaluate phases. Our preliminary results show that children need short and clear assignments for the sessions to reach the goals. Children are enthusiastic to participate and like the methods used in the session, although the concept of HL is sometimes difficult to comprehend. It is challenging for children to come up with creative and appropriate elements for activities without correct health information. We are awaiting results from Test and Evaluate phase on the effect on HL levels and learning outcomes. Children are able to co-design HL activities together with HL and health promotion researchers. By giving children a voice and hands-on experience in the design process, we are able to create activities that are suitable for the target population. This co-design process will be evaluated and adapted to an intervention for the “healthy school” program in the Netherlands.

Key messages

• By co-designing HL activities children actively learn about health literacy.

• Children are important and capable co-designers for HL activities when working together with HL researchers.
Stakeholders’ perspectives on informed decision-making for migrant women in CC prevention programs
Authors: Veeravagu T , Hamdiui N , Stein M L , Al-Rubaie N , van Wijk J , Bouman MPA , Crutzen R , Timen A
Published: October 2024

Background

This study gathered the perspectives of stakeholders regarding participation in cervical cancer (CC) screening and human papilloma virus (HPV) vaccination among migrant women in the Netherlands. Considering their perspectives by developing interventions that are tailored to migrant women’s information needs regarding CC screening and HPV vaccination will support informed decision-making.

Methods

In total five focus group discussions were held with community leaders, healthcare professionals and communication experts separately. The focus group discussions were transcribed verbatim in Dutch, and analyzed thematically according to the Grounded Theory.

Results

The analysis resulted in six themes. The first theme describes the existing views and misconceptions regarding CC (screening) and HPV vaccination in the target population according to the stakeholders. The second theme is about the current approach of informing about these health programs, and its belonging barriers. Theme three dives into the differences within the target population, such as generations and level of language. Theme four describes the conditions to which interventions should adhere. In theme five and six suggestions for interventions were introduced, focused on the target population and their (social) network respectively.

Conclusions

The results of this study showed that stakeholders are willing to play a role to support informed decision-making regarding CC (screening) and HPV vaccination among migrant women, but they need more training to support. Community leaders express a need for training to gather more medical knowledge of CC and its prevention programs. Healthcare professionals expressed a need for more insight into the practical, cultural, religious and emotional aspects that play a role within this target population. Communication experts emphasize the need for customized information materials and a more district-oriented approach.

Key messages

• Stakeholders operating at different levels are willing to play a role in increasing informed decision-making regarding CC screening and HPV vaccination.

• Migrant women’s (social) network need more training and support to be able to provide tailored information regarding CC screening and HPV vaccination.
Public and professional attitudes to the digitisation of health and social care in Ireland
Authors: Murphy D , Novak I , Hyland D , Burke E , Higgins M , O’Carroll K , Weir L , Flynn R
Published: October 2024

Background

The European Commission has set targets for all EU citizens to have access to electronic medical records by 2030. In Ireland the Sláintecare health reform programme has set goals around the use of digital technologies in health and social care. The Health Information and Quality Authority (an independent authority established to drive high-quality and safe care for people using health and social care services in Ireland) in partnership with the Health Service Executive (public healthcare provider) and the Department of Health (Ministry) conducted a National Engagement on Digital Health and Social Care. The aim of this engagement was to understand the opinion, attitudes and comfort levels of the public and professionals working in health and social care around digitisation of health and social care.

Methods

The National Engagement on Digital Health and Social Care used a mixed-method approach to data collection. There were two surveys, a national telephone survey with a representative sample of the public (n = 2009) and an online survey with professionals working in health and social care (n = 1020). There were separate focus groups with professionals and with the public, including representatives of minority groups.

Results

Preliminary results indicate that the public and professionals have positive attitudes to digital health and social care. Of the public surveyed 73% said that they are likely to access their online health record. Professionals feel that when the public have access to information via an online health record they will be better informed about their health (88%). Both the professionals and public feel that it is important to ensure patient choice around the format and delivery of care.

Conclusions

The research provides valuable insights and gives the public and professionals a platform to voice their opinions and have a meaningful impact on how digital health and social care is developed and implemented in Ireland.

Key messages

• This research provides unique insights and a deeper understanding into the attitudes of Irish public and professionals working in health and social care towards digital health.

• Research findings will inform national policy, legislation and recommendations on the use of digital health tools in Ireland.
Nocturnal Artificial Light Exposure in Expectant Mothers and Risk of Congenital Glaucoma
Authors: Kim Y K
Published: October 2024

Background

While the impact of light pollution on human health is gaining recognition, its role in transmitting the effects of maternal exposure to the fetus remains unclear. This study is to investigate the association between exposure to artificial light at night (ALAN) during pregnancy and risk of congenital glaucoma.

Methods

All birth cohorts spanning from 2008 to 2011 in urban areas of South Korea, comprising over 90% of the total population, were identified in the Korean National Health Insurance database. Average levels of ALAN at the residential addresses of mothers during pregnancy were estimated using time-varying satellite data for a composite view of persistent night-time illumination at ∼1 km2 scale.The odd ratios (ORs) and 95% confidence intervals (CIs) of the association between residential ALAN and risk of congenital glaucoma - was computed using logistic regression. These calculations were adjusted for socio-demographic factors and area-level risk factors (night-time traffic noise and particulate matter with an aerodynamic diameter ≤ 10 μm).

Results

A total of 745,458 mother-father-child trios (mean [SD] age of the mothers, 32.4 [3.8] years; 387,275 [52.0%] boy) were included in the study. In fully adjusted models, an IQR (21.8 nW/cm2/sr) increase in ALAN level was associated with an OR of 1.12 (95% CI: 1.05, 1.19) for incident congenital glaucoma. The exposure-response curve demonstrated an upward slope with a threshold at approximately 62 nW/cm2/sr.

Conclusions

In this nationwide population-based case-control study, higher levels of residential ALAN during pregnancy were associated with increased risk of congenital glaucoma. Future studies with more detailed information on exposure, individual adaptive behaviors and potential mediators are warranted.

Key messages

• This study indicates an association between elevated levels of ALAN exposure in pregnant women and a heightened risk of congenital glaucoma in their offspring.

• These results are consistent with a growing body of evidence underscoring the detrimental effects of ALAN on health, reinforcing its potential role as a risk factor for congenital glaucoma.
Social Inequalities in mental health service use and perceived helpfulness: A global analysis across 111 countries
Authors: Henking Christoph
Published: October 2024

Social inequalities in mental health are evident in the prevalence of mental health problems, but also the utilisation and patents’ perceived benefits of treatment. However, the extent of these disparities on a global scale and whether there are country-level differences in the predictors of mental health service use remain unknown. This study uses data from the Wellcome Global Monitor 2020, a nationally representative survey encompassing 111 countries and 117,088 individuals. We examine the association of socio-economic factors (such as household income and education), psycho-social factors (including stigma perception and trust in health professionals), and country-level variables (such as GDP, Gini coefficient, and health expenditure) with mental health service use and perceived effectiveness of treatment. Multi-level logistic regression models were employed for analysis. The utilisation of mental health professions of people with depression or anxiety symptomology is higher in HICs (predicted probability of 62% CI[0.60 - 0.65]) compared to LIMCs (predicted probability of 33% CI[0.31 - 0.34]). Higher country GDP (OR = 1.26 CI[1.08-1.47]) and health expenditure (OR = 1.11 CI[1.04-1.19] per percentage of health expenditure) are associated with higher treatment utilisation. On the individual level, those in the wealthiest quintile are more likely to engage with mental health professionals (OR = 1.25[1.14-1.36]) and perceive this treatment as highly beneficial (OR = 1.23[1.07-1.40]). Trust in healthcare practitioners and perceived stigma are also associated with mental healthcare use. This analysis shows strong patterns of mental healthcare use and perceived benefits depending on the wealth of the country, health expenditure and individual socio-economic status. Moreover, disparities in treatment utilization and effectiveness are also influenced by trust in healthcare professionals and perceived mental health stigma.
Declining trends of overweight and obesity in 4-year-olds during 2007-2022 in Northern Sweden
Authors: Kuisma Löfbom J , Sandström O , Ivarsson A , Lohr W , Lundberg E , Silfverdal S A , Vaezghasemi M
Published: October 2024

Background

Overweight among preschool children is a huge public health issue. The prevalence of both childhood overweight and obesity increased during the COVID-19-pandemic. Our aim was to study the development of overweight and obesity among 4-year-olds in Västerbotten, Sweden, from 2007 until 2022 with special focus on the COVID-19-pandemic and the year after.

Methods

This is a repeated cross-sectional study that utilized individual data from most 4-year-old children living in Västerbotten County, Sweden in 2007-2022, implying that the children were born 2003-2108. We included encrypted and anonymized individual anthropometrical data from the routine 4-year-old Child Health Care visit. There were 47 004 4-year-old children living in the county and we included data from 42 584 children, 21 966 boys and 20 618 girls at the age of 46-51 months.

Results

Overweight and obesity decreased over the study period. In 2007 the prevalence of overweight was 13.4% for boys and 14.9% for girls and obesity 3.7% for boys and 2.7% for girls. In 2022 the prevalence of overweight had declined to 9.5% for boys and 12.1% for girls and the prevalence of obesity to 1.8% and 2.1%, respectively. During the COVID-19-pandemic the prevalence of overweight and obesity for both boys and girls increased and then rapidly returned to the pre-pandemic level in 2022.

Conclusions

In a setting with free standardized Child Health Care, we present a clear decline in the prevalence of overweight and obesity among Swedish preschool children over time. As in other settings the prevalence of overweight and obesity increased during the COVID-19-pandemic, but we also report a rapid decline in overweight and obesity after the pandemic. It is essential to understand the underlying mechanisms responsible for this favorable trend.

Key messages

• We present clear decline in the prevalence of overweight and obesity in preschool children over time in a setting with free standardized Child Health Care.

• It is important to understand the possible mechanisms of the favorable trend of decrease of the prevalence of overweight and obesity in children pre- and post-pandemic.
Diabetes, hypertension, and hospitalizations during pregnancy: a multivariate analysis
Authors: Falcone V , Nisticò F , Arniani S , Messina G , De Luca A , D’urso A , Nante N
Published: October 2024

Introduction

The study analyzes the correlation between socio-demographic variables and pathologies encountered by women during pregnancy. The presence of these pathologies is recorded at the time of compiling the CAP (Certificate of Assistance for Birth).

Methods

Data analysis pertains to the Certificate of Assistance for Birth (CAP) concerning residents in the territory of AUSL South-East Tuscany in the years 2021 and 2022. The number of women of childbearing age in Tuscany in 2022 is 150,959, while the number of births analyzed in the study is 9,053. The study conducts multivariate analysis between socio-demographic variables and pathological outcomes.

Results

Controlling for age, citizenship and other factors, the risk of gestational diabetes is significantly higher (p < 0.05) among mothers: over 40 years old (OR = 1.56), with citizenship in PFPM countries (OR = 1.60) and particularly, compared to Italians, among women from Indian subcontinent (OR = 3.73) and the Maghreb (OR = 2.04), with lower educational levels (OR = 1.28) compared to graduates, obese (OR = 2.43). The risk of gestational hypertension is significantly higher (p < 0.05) among mothers: over 40 years old (OR = 1.71), obese (OR = 2.50), nulliparous (OR = 1.60). The risk of one or more hospitalizations during pregnancy is significantly higher (p < 0.05) among mothers: not employed (OR = 1.31) and homemakers (OR = 1.32) compared to employed, from Indian subcontinent (OR = 1.82) and the Maghreb (OR = 1.75) compared to Italians, with gestational hypertension (OR = 2.06).

Conclusions

Unlike gestational diabetes and hospitalizations during pregnancy, gestational hypertension does not show significant associations with the mother’s socio-demographic characteristics. However, gestational diabetes and hospitalizations during pregnancy are correlated with different variables: they are more common among women over 40, foreigners, homemakers, with lower educational levels, obese, and with low family economic status.

Key messages

• It has been observed that some variables are also risk factors for adult age pathologies, such as diabetes and hypertension.

• The importance of Early Childhood Development and early interventions can improve children’s health and well-being.
Psychosomatic complaints at age 15-16 and subsequent depression and anxiety disorders
Authors: Wahlström J , Låftman S B , Östberg V
Published: October 2024

Background

In recent years, the prevalence of self-reported mental health issues such as psychosomatic complaints has risen among adolescents in several countries, including Sweden. Despite this trend, a gap in the understanding remains regarding the implications of these complaints, including their ability to predict more severe mental health conditions. Depression and anxiety represent common mental health disorders among youth today, significantly affecting daily functioning. In light of this, the current study aims to investigate the association between self-reported psychosomatic complaints at age 15-16 and the likelihood of being diagnosed with depression or anxiety by age 20.

Methods

Data was drawn from Futura01, a cohort study of Swedish adolescents who attended grade 9 in 2017 (n = 5,225). Information on psychiatric diagnoses was obtained from the Swedish National Patient Register. Psychosomatic complaints were captured through self-reported frequencies of headache, stomach ache, and difficulties falling asleep, which were aggregated into an index (ranging from 3-15). Covariates included sex, parental education, parental country of birth, family type, and prior diagnoses of ADHD, depression, and anxiety. Binary logistic regression analyses were performed.

Results

The findings show that higher levels of psychosomatic complaints at age 15-16 were prospectively associated with increased odds of being diagnosed with depression (OR = 1.28, 95% CI 1.22-1.34) as well as anxiety (OR = 1.30, 95% CI 1.25-1.35) by age 20, even after adjusting for prior diagnoses and other covariates.

Conclusions

This study highlights the potential for psychosomatic complaints during adolescence to act as early indicators of future mental health disorders. Recognising the importance of these complaints and implementing public health interventions targeting mental health issues among youth could help improve mental health outcomes in late adolescence and young adulthood.

Key messages

• Adolescents reporting frequent psychosomatic complaints at age 15-16 were more likely to receive subsequent specialised care due to a depression or anxiety diagnosis in a Swedish sample.

• Interventions directed at youth experiencing frequent psychosomatic complaints may have a beneficial impact on their future mental health outcomes.
Can a Universal Mindfulness Programme Improve Well-Being in Adolescents?
Authors: Qvick J , Hintsanen M , Vahlberg T , Volanen S-M
Published: October 2024

Background

Approx. 14% of adolescents experience mental health disorders. Mindfulness-based interventions (MBIs) could be one way to support adolescents’ well-being. We investigated the effectiveness of a 9-week school-based mindfulness intervention on adolescents’ well-being, moderated by gender, grade, and independent practice.

Methods

In total 3519 Finnish adolescents (aged 12 - 15) from 56 schools were randomized into intervention, active (relaxation), and inactive (normal school curriculum) control groups. Well-being was assessed with two life satisfaction measures (Life Satisfaction [OECD] and The Satisfaction with Life Scale-Child [SWLS-C]) and positive and negative affects (Positive and negative affects [PANAS]) at baseline, at 9 weeks and 26 weeks and analyzed using multilevel linear modeling.

Results

Significant improvement in life satisfaction (SWLS-C) was found at 9 weeks in the MBI group (β = 0.38, 95 % CI 0.08-0.68, p = 0.009) compared to the active control. Furthermore, MBI demonstrated an increase in life satisfaction (OECD) among boys (β = 0.25, 95 % CI 0.04-0.46, p = 0.016) and 6th graders (β = 0.26, 95 % CI 0.04-0.49, p = 0.015) at 9 weeks compared to the active control. Additionally, MBI participants engaging in independent practice at least once a week had a higher increase in positive affect at week 26 compared to both the active (β = 3.01, 95 % CI 0.55-5.47, p = 0.009) and inactive control groups (β = 2.81, 95 % CI 0.23-5.40, p = 0.026). Those practicing MBI almost daily also demonstrated a higher increase in positive affect at week 26 compared to the active control group (β = 2.95, 95 % CI 0.28-5.62, p = 0.023).

Conclusions

MBI in the school context seems to have the potential to increase the well-being of adolescents, especially those who commit to regular independent mindfulness practice. Gender and grade may moderate the effects of MBI. Therefore, we need to better understand how gender and age influence the effectiveness of MBI.

Key messages

• The findings indicate the need to further examine potential mediators and moderators that may influence the effectiveness of MBI on adolescents.

• According to this study, regular mindfulness practice in schools appears to be a promising way to improve well-being of adolescents.