bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental health knowledge and help-seeking intention in Irish farmers
Authors: Firnhaber J , O'Connor S , Malone S , O'Shaughnessy B , McNamara J , Breslin G
Published: October 2023

Background

Despite farmers’ vulnerability to poor mental health and high suicide rates internationally, they are often reluctant to seek help. Available mental health services are ineffective unless farmers reach out and engage with them. Barriers such as stigmatizing beliefs, masculine norms and skepticism towards professional help often prevent help-seeking. The current study examined mental health literacy, help-seeking intention and attitudes towards seeking help in Irish farmers.

Methods

Irish adult farmers (N = 351) completed a cross-sectional survey online or in-person at farming events. The Multicomponent Mental Health Literacy scale, Mental Help-Seeking Intention Scale and Attitudes Toward Seeking Professional Psychological Help Short Form were used. Prevalence assessments and descriptive analyses were completed and non-parametric tests were used to examine the differences between age, gender, education, income and health issues.

Results

Many did not know how to contact a local clinic (53.8%), obtain suicide prevention hotline number (24.2%), where to get services (24.8%) or useful information on mental illness (21.8%). Farmers had low literacy (M = 17.8) and intentions to seek help (M = 13.1), with women displaying higher literacy (p<.001, r=.17) and more positive attitudes towards help-seeking (p=.005, r=.15). Third level education was associated with higher literacy (p=.007, r=-.18) and positive attitudes to help-seeking (p=.024, r= -.12). Past help-seeking was associated with higher literacy (p=.043, r=.11) positive attitudes (p=.022, r=.12) and greater help-seeking intention (p=.028, r=.12). Those with mental health (p=.036, r=-.11) or substance use issues (p=.023, r=-.12) had lower help-seeking intention.

Conclusions

Farmers had low literacy and perceived significant barriers to help-seeking. Interventions targeting literacy, knowledge of, and access to health services are important, particularly for men and less-educated farmers.

Key messages

• Low literacy and knowledge of services prevents farmers from seeking help.

• Farmers, particularly those who are men or less educated, require urgent intervention targeting literacy.
Health literacy profiling of parents in two disadvantaged inner-city areas in the United Kingdom
Authors: Belfrage S , Faulkner J , Husted M , Fraser S , Patel S
Published: October 2023

Background

Health literacy refers to the ability to understand, access and use health information and services. Limited parental health literacy is associated with ineffective preventive behaviours and worse child health outcomes. Limited financial and social resources are associated with low health literacy. Profiling the health literacy strengths and limitations of individuals allows the multidimensional nature of health literacy to be considered and highlight patterns of need. This study aims to identify the health literacy profiles of parents using family hubs in two disadvantaged UK regions using the Optimising Health Literacy and Access framework.

Methods

A mixed method study using the Health Literacy Questionnaire Parent (HLQ-Parent) and semi-structured focus groups was conducted among parents attending family hubs or libraries in two cities. Hierarchical cluster analysis was conducted to identify clusters with varying health literacy strengths and needs based on the HLQ-Parent domains. Clusters were translated into health literacy profiles using HLQ-Parent patterns and demographic data. Then, using an explanatory sequential approach, vignettes were created to represent the different health literacy profiles.

Results

Participants’ (n = 175, age range 18-59 yrs., mean age 33 yrs., 98% female) lowest mean HLQ-Parent score in city 1 was present in domain 4 “Social support for health” and domain 2 “Having sufficient information to manage my child's health” in city 2. Eight clusters were identified each with unique health literacy profiles. Both cities had one cluster (44% of participants) scoring highly on all domains and one cluster (20% of participants) reported difficulties across all domains.

Conclusions

Eight distinct health literacy profiles were identified among parents attending family hubs. These profiles in vignette format will facilitate the co-design and co-development of parental health literacy interventions.

Key messages

• This study emphasises the health literacy challenges faced by parents in disadvantaged areas, and the potential barriers they face in navigating and using health services for their children.

• The vignettes developed in this study provide an authentic description of the health literacy profiles of parents in this context proving a promising starting point for co-designing interventions.
Nutrition-related competences in Austria - data from an Austria-wide survey
Authors: Schuetze D , Griebler R , Link T , Benedics J , Schindler K
Published: October 2023

Background

A healthy diet is a key factor in people's long-term health. The nutritional health literacy and food literacy of the population play a crucial role in this. In 2021, comprehensive data on these competences were collected for the first time in Austria.

Methods

Almost 3,000 people were surveyed online. Nutrition health literacy was assessed with the newly developed Nutrition Health Literacy Scale (NHL) and food literacy with the Self-Perceived Food Literacy Scale (SPFL). Scores and subscores were calculated. Associations between socio-demographic and socio-economic factors and the competences surveyed were assessed using t-tests, variance analysis, correlations and multivariate regression models.

Results

In terms of nutritional health literacy, respondents score an average of 60 out of 100 points, with judging (51 points) and applying (60 points) nutritional information being the most difficult. In the area of food literacy, respondents score an average of 62 out of 100 points. The most challenging areas are ‘choosing the healthier’ (44 points), ‘healthy snacking’ (52 points) and ‘healthy eating in exceptional circumstances’ (54 points). In both areas, men and people with less formal education score lower. In the case of nutritional health literacy, people aged 65 and over have greater difficulties. Conversely, this group performs better in the area of food literacy. Differences by income can only be seen for nutritional health literacy, to the detriment of low-income groups.

Conclusions

Possible options for action include the provision of quality-assured and target-group-specific information, the implementation of appropriate tools to facilitate the assessment of foods, and measures to strengthen assessment skills, digital health literacy, food and nutrition skills.

Key messages

• The survey showed that there is potential for improvement in both nutritional health literacy and food literacy.

• The biggest challenge is to evaluate and use nutritional information and to stick to a healthy diet without making exceptions.
PRALIMAP-CINECO Cohort: 10-year post-intervention weight trajectories of PRALIMAP-INES adolescents
Authors: Omorou A , Mannneville F , Langlois J , Böhme P , Beguinet M , Dosda A , Briançon S , Legrand K , Lecomte E , Spitz E
Published: October 2023

Background

Between 2012 and 2015, the PRALIMAP-INES trial was carried-out in the France including 1143 adolescents aged 13-18 years old and aimed at reducing weight social inequalities in adolescence. The main result showed that a proportionate universalism principle is an effective way to reduce weight social inequalities in adolescence. About 10 years later, the PRALIMAP-Cineco study aims to investigate the social, economic, educational and health trajectories among PRALIMAP-INES participants.

Methods

Young adults are contacted by clinical research team and invited to participate to the follow-up. If they agree, they are asked to complete a self-reported questionnaire (sociodemographic, diet, tobacco, alcohol, physical activity, sedentary behaviour, quality of life) and then invited to realise a medical visit for global check-up including weight measures.

Results

Inclusion is currently in progress and 248 participants are contacted (Male: 130, 52.4%). The mean BMI is 28.5±5.4 kg/m2, 40% of overweight and 30.7% obesity. Among overweight/obese adolescents, 80.1% remain overweight/obese (50.5% of overweight adolescents remain overweight while 67.6% of obese remain obese in adulthood) and 19.9% switch to normal weight in adulthood. No significant difference is observed between advantaged with standard intervention (81.3%) and less advantaged with strengthened intervention (80.7%) groups.

Conclusions

Post-intervention follow-up suggest that overweight/obesity in adolescence is strongly predictive of overweight/obesity in adulthood without differential trajectories according to socioeconomic status. It would be very interesting to investigate the profile of overweight adolescents who switch to normal to understand the determinants of this favourable trajectory.

Key messages

• Adolescents with overweight or obesity are more likely to be overweight or obese in adulthood confirming the need of early age public health prevention programmes.

• Lifelong prevention is also necessary to ensure more effective public policy.
University students’ skills and beliefs about the online learning during the quarantine in Greece
Authors: Andrie E , Kostaki E G , Sakellari E , Leontopoulou S , Lagiou A
Published: October 2023

Background

During the COVID-19 outbreak, all educational institutions worldwide, used online learning to support the public health response to this pandemic.

Objectives

To assess students’ beliefs and skills about online learning experience during COVID-19 pandemic of undergraduate students in Greece and to investigate which sociodemographic characteristics were associated with students’ beliefs and skills of online learning.

Methods

A 15-item questionnaire was administered to 1,103 undergraduate students at University of West Attica and University of Ioannina during 2021. The survey requested demographic and socioeconomic information and information related to online learning beliefs and skills during the COVID-19 pandemic. Factor analysis, estimation of factors’ reliability and validity and univariable and multivariable linear regression analysis were carried out using Stata 13.1 and SPSS 23.0 programs.

Results

A total of 1.103 valid questionnaires were retrieved. 73.6% of the students were females, 56.8% aged 18-21 years old and 95.9% had Greek nationality. Factor analysis identified 2 factors, interpreted as “general beliefs about online learning,” and “acquisition of skills”. The Cronbach alpha of the instrument was 0.934. Multivariable regression analysis showed that males, students aged > 21 years old, those with Greek nationality and those who were very satisfied with their living conditions during quarantine reported having more confidence in prerequisite “skills”. Moreover, students aged > 21 years old, those studying non-health sciences, those who were very satisfied with their living conditions and those whose decision concerning their place of residence was influenced by health reasons related to the pandemic and financial reasons, had more positive “beliefs” about online learning.

Conclusions

The outcomes of our study will help decision-makers understand students’ attitudes and motivation toward online learning and improve ongoing online courses.

Key messages

• Our study provides important new information in respect of the university students’ skills and beliefs towards online education during the quarantine in Greece.

• Students’ perceptions of online courses could be a crucial predictor of the ultimate effectiveness of online learning and could thus have implications on improving ongoing online courses.
Evaluation of the impact of the complex intervention ‘10,000 Steps Duesseldorf’: Replication study
Authors: Schmitz E , Matos Fialho P M , Vomhof M , Icks A , Lang A , Kuss O , Weyers S , Pischke C
Published: October 2023

Background

The World Health Organization (WHO) recommends 150-300 minutes of moderate physical activity (PA) per week (approximately 7,000-10,000 steps/day). In Germany, fewer than half of all adults achieve this goal. This highlights the need for population-based intervention approaches to promote regular daily PA. The aims of this replication study are to adapt, implement and evaluate a community-based complex PA intervention originally developed and successfully implemented in Belgium. The following research questions are investigated:

1. Is the intervention ‘10,000 Steps Ghent’ adaptable and transferrable to the German context?

2. Is the intervention ‘10,000 Steps Duesseldorf’ effective for the promotion of PA among residents of city districts selected for the study compared to city districts of a control city?

Methods

The intervention includes components at different intervention levels (i.e., individual level: website; organizational level: promotion of PA e.g., in companies, senior citizens’ associations; community level: media campaign, environmental changes, e.g., signage in parks). To investigate the effects of the intervention, PA-levels were assessed via telephone interviews and pedometers in two representative samples of adults aged 25-75 years in the cities of Duesseldorf (intervention) and Wuppertal (control) at baseline (April 2021 - March 2022). The one-year follow-up will start in May 2023.

Results

376 participants in the intervention and 253 in the control city districts completed baseline (60% female, 32% wore accelerometers in addition to the pedometers). First study results will be presented at the annual European Public Health Conference after the trial is completed.

Conclusions

To our knowledge, this study is the first research project aiming to replicate the effects of a complex PA intervention successfully implemented in another European country.

Key messages

• Results regarding the adaptation and transferability of a complex PA intervention originally developed and implemented in Belgium will be presented.

• Results regarding the impact of the community-based complex intervention ‘10,000 Steps Duesseldorf’ on residents’ PA levels will be shown.
Using Machine Learning to Improve Physical Activity: A Systematic Review
Authors: Kozan Çıkırıkçı E H
Published: October 2023

Background

Many diseases that threaten public health can be prevented with policies to improve physical activity. To improve physical activity, the implementation of individual interventions at the societal level remains limited. At this point, technological devices as mobile phones, which provide access to all individuals, enable widespread implementation of public health interventions and the cost-effective use of resources. In recent years, Machine Learning has been used in various areas of health promotion, including improving physical activity. This systematic review was conducted to examine the effect of machine learning on health outcomes related to physical activity.

Methods

Studies on this topic from 2013 to 2023 have been accessed by five database searches. The methodological quality of the studies was assessed using the Critical Appraisal Checklists for experimental and quasi-experimental studies, developed by the Joanna Briggs Institute. This study was conducted by following the Preferred Reporting System for Systematic Reviews and Meta-Analyses.

Results

This systematic review included thirteen studies with a total sample size of 2945 individual. In the study, it was found that using machine learning algorithms can help to detect physical actvivity level and intensity, increase the daily step count, predict adherence to the physical activity goal, develop physical activity skills, increase the duration of daily cycling time, accessing accurate and real-time data on physical activity, personalize physical activity recommendations and identify the types of gaits.

Conclusions

Machine learning can be used to improve physical activity by providing more personalized and effective recommendations, using real-time feedback, and gamifying physical activity to increase motivation and adherence. Machine learning holds promise in the field of health promotion and has the potential to improve physical activity for individuals and communities.

Key messages

• Machine learning approaches are effective methods in determining and improving the level of physical activity on a public scale.

• In terms of public health initiatives, using machine learning to improve physical activity is a cost-effective and efficient approach.
Master program in Lifestyle Medicine: new approach in healthcare in Lithuania
Authors: Kalediene R , Vaiciunas T
Published: October 2023

Background

Many studies have proven that lifestyle medicine approach is more effective in preventing, arresting, and reversing chronic diseases than the traditional curative approach.

Objectives

The first European Union Master degree in Public Health of Lifestyle medicine was established at Lithuanian University of Health Sciences (LUHS) in 2016. The program aims at preparing mediators in unifying classical community-focused public health with person-oriented health services. These health specialists are able to manage risk factors, change individual behaviors related to chronic noncommunicable diseases (NCD's), and work as members in medical teams, especially in primary health care services, public health settings and private sector.

Results

This program started a new tradition of studies in public health area with advanced competencies in non-pharmaceutical interventions, addressing the roots of NCD's, rather than management of the outcomes. Up to recently, nearly 100 graduates completed the program. It became one of the most popular Master programs at LUHS. The major challenge faced, was introduction of this new approach into Lithuanian healthcare system, demonstrating the need and the effectiveness of the newly trained specialists in the process of health management both for politicians, health care professionals and society. In 2019, lifestyle medicine professionals were officially integrated into primary healthcare sector as team members of physicians. The major success was achieved at the structural level in 2023, when minister of health of Lithuania signed the order that each team of family physicians is obliged to employ lifestyle medicine professional and allocate specific tasks and resources to this new member of the primary health care team.

Conclusions

Lithuanian healthcare system is now ready to employ lifestyle medicine professionals. It is expected that they will contribute to health improvement of Lithuanian population.

Key messages

• Lifestyle medicine program trains highly needed professionals for Lithuanian healthcare system.

• Healthcare system is now ready to employ lifestyle medicine professionals.
Training Maltese inspectors in using hospital standards: a Maltese and Dutch public collaboration
Authors: Delnoij D , Farrugia J , Cachia J , Gauci C
Published: October 2023

Background

The Maltese Department for Health Regulation sought the support of the Dutch National Health Care Institute in drafting acute hospital standards and in training respective inspectors in applying those standards. The aim was to create SMART standards for public and private hospitals thereby diminishing preventable suffering and waste.

Objectives

The project started in 2018 with a situational analysis of Maltese hospital care and of training needs, followed by interactive workshops with key stakeholders, and the subsequent development of draft standards. Due to COVID-19, the work was curtailed during 2020-2021. Over the course of 2022 draft standards have been finalized, a three-day training was delivered including mock inspections of Dutch hospitals, followed by a final session in January 2023 in which the inspectors received feedback from the Dutch faculty on their use of the draft standards in the Maltese setting.

Results

The licensing standards describe tasks and responsibilities of hospital leadership with respect to quality and safety, as well as reporting structures such as key performance indicators, and incidents that affect patient care. The training focused on the importance of Safety-II regulation. Interviews took place to explore inspectors’ experiences. Inspectors reported that using these standards facilitates open communication. They are in a better position to enter into a more meaningful and constructive dialogue with hospital management and professionals on how they can safeguard quality of care.

Conclusions

During the development of the hospital standards and the training, inspection team members have gained a clear vision on their role and position towards healthcare providers, and of their responsibilities in stimulating proactive quality and safety management and a learning culture in Maltese hospital care. The standards outline will support the licensing authority to protect patient safety through a collaborative regulatory approach.

Key messages

• The interactive work done by Maltese experts and Dutch policy advisors resulted in explicit quality standards for public and private hospitals.

• The training has empowered inspectors to foster a governance structure in acute hospitals, to encourage an accountable and learning culture and to enter into an open dialogue on quality and safety.
Immersive simulations to teach infodemic management: WHO global infodemic manager trainings
Authors: Purnat T , Wilhelm E , Bertrand-Ferrandis C , Briand S , Nguyen T
Published: October 2023

Background

When teaching infodemic management (IM) to health professionals and emergency response staff, teaching only technical skills is not sufficient because infodemics affect health workers both professionally and personally. Infodemic response also requires lateral thinking to problem-solve and thus requires experiential learning to teach IM competencies. WHO has developed, delivered and continuously improved a simulation-based training approach to teach IM to health workers and public health practitioners.

Objectives

To deliver an effective immersive IM simulation the following components must be considered: Designing the simulation world; Designing the tasks in the simulation world; Introducing humor and causing infodemic experience; Teaching cultural humility and ensuring psychological safety; Providing support to trainees; Considerations for virtual vs in-person delivery; Preparing and assembling the delivery team; Delivering the performance and simulation experience.

Results

WHO has designed delivered and evaluated teaching immersive simulations in in-person, online and hybrid formats, in English and French, with over 1400 trainees in 4 online and 4 offline trainings. Building and delivering an immersive world requires a team of people with different skills but a common vision and training philosophy. The facilitator team must build rapport between trainees quickly and offer multiple ways how trainees can ask for help, and encourage experience sharing and encourage further diffusion of materials, concepts and training approaches within the trainee community.

Conclusions

WHO immersive teaching simulations for infodemic management competence building have used human-centered design and flipped classroom approaches in design and delivery of the learning and teaching programmes. Simulations have been adapted to other languages, topics, and adapted to regional cultural contexts.

Key messages

• Simulation teaches trainees how information overload and infodemics impact both health workers and communities they serve.

• Immersive teaching simulations providing a wrap-around experience that is fun and safe for experimenting and learning by participants.
Building a comprehensive online course series to enhance infodemic management globally
Authors: Purnat T , Bertrand-Ferrnadis C , Wilhelm E , Utunen H , Briand S , Nguyen T
Published: October 2023

Background

Infodemic management has become key to supporting public health prevention and response to epidemics. 91% of WHO Member States declared having capabilities to track and address infodemics and health misinformation (WHO pulse survey). However, the scientific field of infodemiology is quickly evolving, and the practice of infodemic management consequently requires the health workforce to have a multidisciplinary and cross-functional skill set and to update it regularly.

Objectives

Since 2020, WHO and its partners have developed an innovative global blended training program and created a network of over 1300 infodemic managers from 142 countries. To keep the pace of science development, WHO has created an additional series of online courses allowing frontline workers easy, self-paced, and free access to updated and evidence-based infodemic management frameworks and best practices.

Results

Mid-2023, a comprehensive “infodemic management” channel, including eight interconnected courses, will be launched on the award-winning platform OpenWHO.org. The first course, “Infodemic management 101”, has already attracted more than 21000 enrolments in English. The seven additional two-hour courses will allow health workers to learn how to generate an infodemic insights report, address health misinformation, be efficient in the field, or co-construct efficient interventions with communities. The course series will be available in English, French, and Spanish.

Conclusions

This new e-learning program will enhance practice in infodemic management in all countries, even those with low bandwidth. Health workers can access the courses on OpenWHO from anywhere, at any time, and no fees.

Key messages

• Infodemic management requires the health workforce to have an updated multidisciplinary and cross-functional skill set.

• The new comprehensive WHO course series on infodemic management, available in three languages, will help to build skills and competencies for frontline health workers.
Violence against healthcare workers: a health system approach and international comparative study
Authors: Kuhlmann E , Falkenbach M , Lotta G , Tenbensel T , Dopfer-Jablonka A
Published: October 2023

Background

Violence against healthcare workers is a global health problem threatening healthcare workforce retention and health system resilience in a fragile post-COVID ‘normalisation’ period. There is an urgent need for action to make violence against healthcare a greater priority. Our novel contribution to the debate is a comparative health system and policy approach, aiming to explore major trends and identify policy gaps.

Methods

We have chosen a most different systems comparative approach concerning the epidemiological, political, and geographic contexts. Brazil (under the Bolsonaro government) and the United Kingdom (under the Johnson government) serve as examples of countries that were strongly hit by the pandemic in epidemiological terms while also displaying policy failures. New Zealand and Germany represent the opposite. A rapid assessment was undertaken based on secondary sources and country expertise.

Results

We found similar problems across countries. A global crisis makes healthcare workers vulnerable to violence. Furthermore, insufficient data and monitoring hamper effective prevention, and lack of attention may threaten women, the nursing profession, and migrant and minority groups the most. There were also relevant differences. No clear health system pattern can be identified. At the same time, professional associations and partly the media are strong policy actors against violence.

Conclusions

All countries in our sample failed to respond effectively to growing violence and improve the prevention and protection of healthcare workers. Much more involvement from political leadership is needed; attention to the political dimension and all forms of violence are essential. Violence against HCWs is and will remain a problem long after the pandemic subsides. If political action is not taken, healthcare workers will have an additional reason to leave their profession and workplace, thus reinforcing the healthcare workforce crisis.

Key messages

• Getting prevention of violence against healthcare workers and effective protection right, enhances the retention of the existing workforce and will attract new generations of healthcare workers.

• Governments must prioritise developing feasible and effective policy responses to tackle the risk factors that healthcare workers face at the workplace and on social media.
Information networks of healthcare professionals in Europe on older adult vaccines: Network analysis
Authors: Wennekes M D , Eilers R , Stein M L , Caputo A , Gagneux-Brunon A , Gavioli R , Nicoli F , Biesheuvel J , Vokó Z , Timen A
Published: October 2023

Background and objectives

Healthcare professionals (HCP) have a key role in raising awareness and informing older adult patients about vaccines. However, HCPs are sometimes unaware of existing vaccines or have little knowledge on them. This study aimed to identify the information flows within HCP networks and to find out which HCPs play a key role in interprofessional information transfer.

Methods

An online questionnaire was distributed in Hungary (HU), Italy (IT), the Netherlands (NL) and France (FR) among HCPs, such as general practitioners (GP), medical specialists (MS), public health physicians (PHP), pharmacists, specialists elderly care (SEC) and nurses. The questionnaire included a case study in which a new vaccine for older adults was about to be made available. HCPs were asked whom they would contact for additional information and by whom they would be contacted on their turn, to reveal the information flow. Data were analyzed using social network analysis, comparing the results between countries.

Results

Preliminary results show the top three information providers. These were identical for NL and IT, with the MS being contacted by the highest number of different HCP-types, followed by the GP and PHP. FR and HU had GP ranked first and MS second. The PHP ranked also third in HU, but in FR it was the geriatrician instead. The main requesters of information were pharmacists (IT, HU), GPs (NL) and community nurses (FR). Hospital nurses (IT, FR), SEC (NL) and GPs (HU) ranked second on the number of HCP-types they would contact for information on a new vaccine.

Conclusions

In each country GPs and MS were the most important information providers in the HCP network when a new vaccine is introduced. Main information requesters varied per country and were pharmacists, GPs, nurses, and SEC. Thus, GPs were both main information providers and requesters (NL, HU).

Key messages

• Our study identified the HCP-(information)network regarding (new) vaccines for older adults. GPs and MS are the main providers of information, while pharmacists, nurses, and GPs are main requesters.

• Identifying the HCPs in the information network makes it possible to specifically target key HCPs and to provide them with tailormade information on new vaccines.
Turnover intention of foreign trained physicians in German rehabilitation facilities
Authors: Jansen E , Schmidt J , Marquardt M
Published: October 2023

Germany's medical specialist shortage is an acute challenge, especially in the rehabilitation segment. One countermeasure is to recruit foreign trained physicians (FTP), but high turnover of FTP is a burden on the departments that train them and integrate them professionally. Preliminary research showed that currently one in three physician positions in German Pension Insurance (DRV) contract facilities is filled by FTP. This paper examines the turnover intention of FTP in German rehabilitative departments. In spring 2022, we conducted an online survey of FTP that captured sociodemographic and professional biographical data, turnover intention, satisfaction, difficulties with professional integration and structural characteristics. The data was evaluated in a subgroup analysis using chi-square tests. The sample includes n = 145 FTP, 119 stating no turnover intention and 27 with turnover intention. More than half of FTP with turnover intention wished to move to an acute care hospital. They are significantly (p < 0.05) younger, have worked in Germany and in the institutions for a shorter time, and have studied in more countries than FTP without turnover intention. The latter are proportionally more likely to have a German specialist title and management responsibilities. FTP with turnover intention are far less satisfied, particularly with career prospects and institution location. Structurally, FTP with turnover intention are proportionately more likely to be based in peripheral regions than conurbations, which are where all FTP without turnover intention are based. FTP with turnover intention have reported a much higher rate of discrimination by non-physician colleagues.

Key messages

• The results reveal a group of ‘established FTP’ whose professional integration has been successfully completed.

• FTP with turnover intention are comparatively younger, career-oriented physicians for whom work in the rehabilitation facility is a career springboard to gain a foothold in acute care clinics.
Injury related hospitalization: evidence from one year retrospective study
Authors: Pitskhelauri N , Kereselidze M , Akhobadze K , Chkhaberidze N , Chikhladze N
Published: October 2023

Background

Injury remains a significant global public health issue, especially in low- and middle-income countries (LMICs). According to the IHME data Georgia has slightly higher rates of Injury-related DALYs, then WHO European Region average and significantly exceed the average of the Upper Middle Income countries group, to which country belongs according to the World Bank classification. The aim of the study was to explore the epidemiological characteristics of injury in Georgia.

Methods

This study was designed in the framework of NIH-Fogarty International Trauma Training Program iCREATE. Hospitalization Database of the National Center for Disease Control and Public Health of Georgia for 2021 was used for the retrospective study. Hospitalization database includes data from all hospitals of the country. Injury related cases were identified using ICD-10 classifications (S and T codes).

Results

A total of 564411 patients, among them 29228 injured patients were admitted in all hospitals of Georgia in 2021. 61% of injured patients were males and 39% females, retrospectively with ratio 1:1.5. The mean age of injured patients was 42(±25) and the highest hospitalization was in the age group of 30-34. The leading cause of injuries was falls (51.9%) followed by accidental exposure to other and unspecified factors (15.5%) and road traffic injuries (9.5%). Most of injured patients (45%) were treated in the capital of Georgia, Tbilisi. The most common source of hospital arrival was ambulance (47%), followed by private/public transport (46%), the 7% of patients needed referral from one hospital to another. The average of LOS was 4 days. 1% of patients died, among them 67% were males and 33% females. The most common mechanism of fatal injuries was falls (47%), followed by transport accidents (24%).

Conclusions

This study provide baseline information about epidemiological characteristics of Injuries based on hospitalization database and identify direction for the future research.

Key messages

• In Georgia there is a need for elaborating relevant preventive interventions of injuries in population.

• In LMICs there is a lack of data on Injuries which are essential for elaborating relevant preventive interventions.
How do midwives deal with women’s preferences during childbirth in Germany? An action model
Authors: Tallarek M , Jost A , Spallek J
Published: October 2023

Background

Midwifery care is increasingly discussed in terms of its ability to promote a self-determined childbirth. The degree of self-determination (SD) depends on the extent to which women's preferences are negotiated and implemented. From the perspective of midwives in different obstetric settings in Germany, this study answered the research question: “How do midwives deal with women's preferences during birth?”.

Methods

11 semi-structured face-to-face interviews were conducted with active midwives. The sample showed a high variance in terms of obstetric settings (clinics, birth centers, home births), regions, and participants’ characteristics (e. g. experience, age). All interviews were recorded, transcribed, anonymized, and analyzed using the Grounded Theory Methodology (Strauss/Corbin, 1994).

Results

A model consisting of 7 steps was developed: 1) Interpret the situation; 2) Prioritize relevant parameters; 3) Determine a frame of possibilities; 4) Match the preference(s) to the frame of possibilities; 5) Negotiate preference(s); 6) Continuously monitor contextual/situational changes; 7) Adjust the frame of possibilities. The actions are related to contextual conditions (structural; interpersonal; personal; health situation; course of birth; understanding of birth). The model shows how midwives can promote SD even if prior preferences are discarded or modified at birth.

Conclusions

The model describes how midwives in Germany deal with women's preferences during birth, which factors they consider decisive in doing so, and how SD may be promoted despite of discarded or modified preferences. Further research should examine the role of relationship building, test the model with regard to its generalizability, and use it to analyze and support person-centered midwifery care.

Key messages

• The model describes how midwives in different obstetric settings in Germany deal with women’s preferences during birth and, thereby, influence self-determination.

• Midwives can promote self-determination also if prior preferences are discarded, modified, or redeveloped at birth.
The relationship between parental mental health and preschoolers’ stress hormone and development
Authors: Kang Y S , Chien L C , Zou M L , Lin W Y , Hsu H W , Lin W C , Chen Y H
Published: October 2023

Background

Hair cortisol concentration (HCC) has been identified as a biomarker that reflects chronic physiological stress. However, research on the association between mental health and HCC has been limited and yielded inconsistent results. This study thus aims to investigate the relationship between parental mental health and HCC and explore the relationship between parental mental health and HCC in preschoolers and their development.

Methods

Data from the ongoing project of Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan (LEAPP-HIT) conducted in Taipei between 2017 and 2022 was utilized. A total of 131 families completed a self-reported questionnaire and provided hair samples from early pregnancy to four years postpartum. Of these families, 68 were followed up until the postpartum years and provided information on their preschoolers’ developmental outcomes. Multiple regression was utilized for analyses.

Results

We found that paternal eudaimonia was significantly negatively associated with paternal HCC (r= -0.49, p < 0.05) and maternal anxiety (r = 0.21, p < 0.05) and perceived stress (r = 0.39, p < 0.05) were significantly positively associated with maternal HCC. Furthermore, maternal higher HCC was associated with preschoolers’ higher HCC (β = 0.34, 95%CI=0.05-0.53) and higher risks of preschoolers’ suspected developmental delay (odds ratio (OR)=3.25; 95%CI=1.02-10.3).

Conclusions

Poorer mental health was associated with elevated cortisol levels in mothers and fathers. Maternal higher HCC was positively associated with preschoolers’ HCC and their higher risks of suspected developmental delay. We thus highlight the importance of early screening and health education programs during pregnancy for both mothers and fathers to reduce parental stress and the following risks of developmental delay in preschool-aged children.

Key messages

• Parental Hair cortisol may effectively reflect the association between mental health and physical stress.

• Maternal higher HCC was associated with preschoolers’ higher HCC and higher risks of preschoolers’ suspected developmental delay.
‘Why did nobody ask us?’, parents’ views on childhood vaccines: A co-production research study
Authors: Skirrow H , Foley K , Lewis C , Bedford H , Whittaker E , Haque H , Choudary-Salter L , Costelloe C , Saxena S
Published: October 2023

Background

Inequalities in childhood vaccine uptake exist in the United Kingdom but previous surveys of vaccine attitudes have underrepresented parents of children with low vaccine uptake. We aimed to explore parents’ views and experiences of vaccinating their child and how the COVID-19 pandemic had impacted childhood vaccine attitudes.

Methods

We worked with Mosaic Community Trust, an ethnically diverse women's community group using a participatory approach to co-develop a questionnaire for parents with children aged under 10 years old. We targeted recruitment at parents living in the North-west London area, where vaccine uptake has been historically low and continues to be lower compared to regionally and nationally. The questionnaire was promoted through local community networks alongside targeted social media promotion. We then held four parents’ focus groups in 2023, co-facilitated by Mosaic.

Results

Between Jun-Oct 2022, 518 parents completed the questionnaire (64% UK born and 30% from ethnic minorities). Most parents (92%) believed childhood vaccines were important and 16% had delayed or refused a childhood vaccine. In both the questionnaire and the focus groups (n = 22), parents reported that lack of reminders and difficulties booking or going to appointments impacted uptake. They also wanted easier access to trusted health professionals to answer vaccine questions. In both the questionnaire responses and focus groups some parents reported that COVID-19 had changed their childhood vaccine views either highlighting their importance, increasing parents’ questions, or increasing mistrust.

Conclusions

Parents report practical barriers impact vaccine uptake including difficulties booking or attending childhood vaccine appointments. Parents should be offered easy access to trusted healthcare professionals to answer their questions about vaccines particularly in the aftermath of the COVID-19 pandemic which has negatively affected some parents’ views on childhood vaccines.

Key messages

• Parents want easy access to trusted healthcare professionals to answer their questions about childhood vaccination particularly since the COVID-19 pandemic.

• Parents report that difficulties booking & attending vaccine appointments are key reasons for late or missed childhood vaccination in the UK.
Grandparental income and adverse neonatal outcomes in Finland in 2000 − 2015
Authors: Remes H , Metsä-Simola N , Martikainen P
Published: October 2023

Background

Pre-term births and other adverse neonatal outcomes are a major burden to healthcare systems, and they also contribute to long-term health problems. Socioeconomic inequalities in these outcomes are well-documented, but whether grandparental characteristics influence them over and above parental characteristics remains unclear.

Methods

We used population register data on all singleton children of non-migrant origin, born in Finland in 2000 − 2015 (n = 341,715), linked to their both biological parents and all four grandparents, including an indicator for deceased kin members. We examined whether grandparental income predicted grandchildren's neonatal outcomes (preterm birth, low birth weight, small for gestational age, congenital malformations) in addition to parental income, once accounting for sociodemographic family characteristics such as parental age, parity, education, family structure, and maternal smoking.

Results

We found a consistent association between lower income and adverse neonatal outcomes, for both mothers and fathers, as well as maternal and paternal grandparents. The gradient was stronger among young mothers (under age 25), e.g., the prevalence of being born small for gestational age was 11% for the highest parental or grandparental income quintile, while for the lowest it ranged from 13 to 15%. Overall, the income gradients clearly attenuated in adjusted models, but remained. Preliminary results suggest grandparental characteristics mainly influence grandchild outcomes through the middle generation, but depending on the outcome, partly independent associations remain.

Conclusions

Even in the context of a Nordic welfare state, offspring of lower income grandparents are at higher risk of adverse neonatal outcomes, particularly when born to young mothers. This influence mainly, but not fully, passes through the parental generation, suggesting more support should be offered to expecting parents with low income and from disadvantaged backgrounds.

Key messages

• Lower grandparental income predicts higher risk of adverse neonatal outcomes, particularly when born to young mothers.

• Expecting parents with low income and disadvantaged family background should be supported to reduce adverse neonatal outcomes.
Self-reported emotional and behavioural problems among adolescents with migrant parents in Lithuania
Authors: Racaite J , Antia K , Winkler V , Lesinskiene S , Dambrauskaite E , Tracevskyte I , Surkiene G
Published: October 2023

Background

The mental health effects of parental emigration on adolescents who stayed behind in Eastern European countries are not fully understood. This study examines the emotional and behavioural difficulties of stay-behind adolescents in Lithuania.

Methods

The data collection took place January 2022-April 2023 from adolescents between the ages of 12 and 17 who attended 25 schools from 15 regions in Lithuania. This cross-sectional study was approved by the Biomedical Research Ethics Committee, No. 2021/11-1378-861. Parents and adolescents provided informed consent to participate in the study. Self-reported Strengths and Difficulties Questionnaire (Goodman, 2005) and a questionnaire on demographics and health status, were collected. Descriptive statistics and t-tests were calculated by using Stata (version 15.1).

Results

The sample consisted of 728 adolescents (response rate 52,6%), with a mean age of 14.5 years (SD 1.63), 43.4% males and 54.7% females. Of the total sample, 35,7% lived in rural areas, 84,8% had siblings and, 15.7% had at least one migrant parent. Most staying behind adolescents had migrant fathers (83.3%), and (90,6%) maintained regular online communication with their emigrated parents. Compared to peers living with parents, staying behind adolescents obtained significantly higher emotional and behavioural problems total score (12.3, SD 5.5 vs 10.7, SD 5.5, respectively), with a p-value of 0.006. In addition, adolescents with migrant parents had significantly higher scores than their peers living with parents on the emotional subscale (3.2, SD 2.5 vs 2.5, SD 2.4) and problems subscale (2.9, SD 1.7 vs 2.5, SD 1.7), with a p-value of 0.02 for both subscales.

Conclusions

This study found higher emotional and behavioural problems among stay-behind adolescents compared to those living with parents in their home country. The findings emphasize the need to implement supportive interventions and increase awareness of these issues in society.

Key messages

• Stay-behind adolescents in Lithuania experience higher emotional and behavioural problems than their peers living with parents in home country.

• Greater focus should be given to the emotional health of stay-behind children and adolescents in migrant-sending countries.