bluuebunny/crossref_metadata_2025 huggingface dataset:
European guidelines for the management of tuberculosis screening in migrants: a systematic review
Authors: Pinheiro M , Moreira D , Valente C , Cruz M , Aguiar A , Duarte R
Published: October 2024

Background

This systematic review assesses the current available evidence across the WHO European region on the effectiveness and cost-effectiveness of the different approaches used for TB screening and also explores the facilitators and barriers that migrants face during screening programs.

Methods

We conducted an extensive, comprehensive, and systematic literature search across multiple databases, including MEDLINE, Cochrane, Scopus, and ISI Web of Knowledge, without any restrictions on publication date or language. In addition, we reviewed grey literature and reports from WHO. The data were meticulously analyzed using RStudio, with a focus on screening effectiveness indicators, such as infection and disease detection rates, uptake, coverage, and cost-effectiveness economic analyses.

Results

Our review included 43 studies covering over 8 million migrants from 11 countries. The findings demonstrate that while screening uptake was high, coverage varied, and completion rates for preventive treatments were low. Economic analyses supported the high cost-effectiveness of the screening programs, particularly when integrating both active TB and LTBI screening strategies.

Conclusions

The implementation of uniform screening protocols could potentially streamline efforts, reduce TB transmission, and offer substantial public health and economic benefits, making this research highly relevant for policymakers and healthcare providers.

Key messages

• An important strength of this study lies in its pioneering approach of current recommendations regarding screening for latent tuberculosis infection and active TB within the WHO European region.

• This is the first study that provides a comprehensive overview of screening interventions across 11 countries and incorporates studies with large sample sizes (n > 8 million migrants).
Scoping Review of Pre-Exposure Prophylaxis and Post-Exposure Prophylaxis in HIV Prevention in Türkiye
Authors: Cavdar S
Published: October 2024

Background

Pre-Exposure Prophylaxis (PrEP) is a medical -antiretroviral- prevention method that reduces the risk of HIV transmission during sexual intercourse or injection drug use. Post-exposure prophylaxis (PEP) refers to taking medicine after risky exposure. The European Centre for Disease Prevention and Control (ECDC) has recommended the integration of PrEP into the existing HIV prevention packages since 2015. In Türkiye, first PrEP Guideline was published in 2022. The aim of this study is to evaluate the literature gap on the PrEP and PEP for HIV prevention research in Türkiye.

Methods

This study was conducted in October 2023. Searches were performed using the keywords ‘HIV, AIDS’ and ‘Pre-exposure prophylaxis, PrEP, Post-exposure prophylaxis, PEP’ in PubMed, Web of Science, Scopus, TRDizin, and Dergipark for all years. ‘Türkiye, Turkey, Turkish’ were added into the keywords in international indexes, without using country filters. Inclusion criteria were research on PrEP or PEP for HIV, research conducted in or using data from Türkiye, publications in English/Turkish. Exclusion criteria were non-HIV topics, non-Turkish data, non-English/Turkish publications. Lists were merged, duplicates were removed. Inclusion-exclusion criteria were conducted at title and abstract level. Full texts of the included articles examined for bibliometric characteristics, study types, and key results.

Results

1014 publications yielded, 993 evaluated, and 17 fully reviewed. Four discussed Türkiye’s PrEP practices (2018-2023); three analyzed PEP regimens; three were reviews on PrEP/PEP in Türkiye (2016-2022). Two original research articles explored PrEP awareness among Türkiye’s men having sex with men (2022) and infectious disease physicians’ attitudes toward PrEP (2020). Studies showed gaps in PrEP information and service access.

Conclusions

There are limited studies published on PrEP and PEP in HIV prevention in Türkiye. This study highlights the need for local research on the topic.

Key messages

• Evaluation of Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP) publications highlights gaps in HIV prevention research.

• Limited literature on PrEP and PEP in HIV prevention emphasizing the need for further studies and improved access to PrEP information.
Hand hygiene intervention in the prevention of healthcare associated infections
Authors: Ben Cheikh A , Ghali H , Bhiri S , Balhi S , Khefacha S , Ben Rejeb M , Said Laatiri H
Published: October 2024

Background

Healthcare associated infections are a major cause of morbidity and mortality in intensive care units. Observance hand hygiene is singled out as a key element in interruption of these infections. The present study aimed to assess whether hand hygiene intervention program in intensive care unit at the Sahloul University Hospital of Sousse is able to decrease healthcare associated infections.

Methods

We carried out a pre-experimental study among patients hospitalized in seven intensive care units at the Sahloul University Hospital of Sousse during two distinct periods of 3 months, the first in 2019 and the second in 2021. During these two periods, we monitored only patients hospitalized in the ICU for more than 48 hours and incidence of healthcare associated infections was compared. Healthcare associted infections were defined as infections occurred at least 48 hours after admission to the intensive care units. The hand hygiene promotion intervention, done during the year 2020, was based on 3 axes (training sessions, procedures writing and professional practicesevaluation).

Results

Incidence of healthcare associated infections decreased significantly in post-intervention (p = 0.000). The decrease of Ventilator-associated pneumonia was significantly higher than other types of infections(p = 0.042). Extended Spectrum B-Lactamase Producing Enterobacteriaceae infections and Ceftazidim resistant Pseudomonas Aeruginosa infections decreased significantly in after intervention (p = 0.000).

Conclusions

The results of our study showed that improved hand hygiene resulted in a reduction in healthcare associated infections.

Key messages

• Observance hand hygiene is singled out as a key element in interruption of healthcare associated infections.

• Improved hand hygiene resulted in a reduction in healthcare associated infections.
International and intercultural training on the use of Art Therapy for Dementia Care
Authors: Giusti M , Vannini I E , José H , Sousa L , Natzik M H , Persiani N
Published: October 2024

In 2023 more than 55 million people had dementia worldwide, with nearly 10 million new cases every year. Currently art therapy has been widely adopted in the assistance of people with dementia because of the positive outcomes in terms of reducing depressive and behavioural symptoms and of improving the patients’ overall quality of life. In literature there was a knowledge gap on social and health professionals’ training for being able to effectively use art therapy in relation with different origins of people with dementia in a multi-ethnic world. This research aimed to assess the impact of promoting joint international and intercultural training session for social workers and health professionals’ students. The used methodology was a prospective research-intervention study with the conductions of two seasonal schools (Florence - Italy in July and Ankara - Tukey in October 2023) on the use of art therapy in the different stages of dementia disease within the Erasmus+ Project DementiaCare (2021-1-TR01-KA220-HED-000027648). Each seasonal school was attended by 25 students from Italy (5), Portugal (5), Slovenia (5), and Turkey (10) to ensure an international and intercultural approach. Pre- and post- test results showed the increased knowledge of students on the theoretical notions on dementia care and art therapy. Positive opinion on the projects developed by mixed group of students (with representants of the 5 involved universities) manifested the enforcement of their relational competences and skills mutually adapting their way of doing and communication register to the multi-ethnic and multi-cultural group’s needs. Evidence showed how mutual knowledge among social and health professionals with different cultures and their joint training allowed these professionals to be able to provide an integrated and effective assistance to every patient with dementia, personalizing assistance according with their different traditions and historical memories.

Key messages

• Art therapy has been adopted as non-pharmacological approach in dementia care to mitigate progression of symptoms’ severity, serving as alternative tool for self-expression for patients.

• Conducting joint international and intercultural training sessions for social and health professionals in art therapy enabled them to develop a respectful, multi-ethical approach to dementia care.
Factors influencing washing hands during the COVID-19 pandemic in the Ukraine population
Authors: Kim Y J , Lee J W , Kim K B , Noh J W
Published: October 2024

Background

Washing hands is recommended as one of the key preventive measures for reducing the transmission of COVID-19 and other infectious agents. The World Health Organization (WHO) consistently emphasized that handwashing is one of the most effective methods to prevent COVID-19. However, research on Ukraine handwashing has been limited. This study aims to investigate factors influencing the practice of regular handwashing in Ukraine during the COVID-19 pandemic.

Methods

This study analyzed 800 households from the 2020 Ukraine Multi-Sector Needs Assessment (MSNA) survey data. The survey, conducted from January to February 2020, was administered by the REACH Initiative. The data was analyzed using Stata/MP version 16.1.

Results

As the number of household members increases, especially when the head of the household is female, the likelihood in adoption of washing hands more regularly increases significantly. People who take between 30 to 59 minutes to arrive at healthcare facility by walking, compared to those who take less than 15 minutes showed significantly decreased likelihood in washing hands more regularly.

Conclusions

While social distancing measures and travel restrictions have reduced contact possibilities with friends and colleagues, families represent the smallest social unit, making complete isolation within them difficult. Hence, the number of household members increases, there may be a higher tendency to wash hands more frequently due to the virus. Given that women exhibit higher levels of concern and fear regarding the pandemic, it is interpreted that they are more likely to wash their hands more frequently. Also households living more than 5km from the nearest health facility face higher barriers in accessing health care. They are more likely to wash their hands less due to low access to medical information.

Key messages

• The number of household members, the gender of the head of the household, and access to health facilities can affect COVID-19 prevention behaviors, such as hand washing.

• Hand washing can prevent infectious diseases as well as various germs, so it is required to implement policies that can make them a habit.
Experiences of treating people with persisting symptoms after COVID-19: a focus group study
Authors: Goes A , Santos M , Silva J , Moniz M , Soares P , Leite A
Published: October 2024

Background

A proportion of people who had COVID-19 infection continue to suffer with persistent symptoms. The long-term effects of COVID-19 are recognised as heterogeneous and complex, challenging health services. This study aims to explore the experiences of healthcare professionals dealing with patients suffering from persisting symptoms following COVID-19 infection and their views on the healthcare services response.

Methods

We held 4 focus groups (n = 19) with healthcare professionals by video-call. Healthcare professionals were recruited using a snowball strategy, taking level of care, healthcare area, and nature of function as diversification criteria. Participants were invited to tell their experiences regarding the following topics: experiences and challenges in providing care to patients with persisting symptoms following COVID-19 infection; usual care pathways; models of care. Data were recorded, transcribed, and anonymized. The qualitative data were submitted to thematic analysis following an inductive approach. A computer-assisted qualitative data analysis software (MaxQDA) was used.

Results

Based on thematic analysis, 4 core themes emerged: uncertainty; new condition, usual challenges; variable standards implementation; personalized and multilevel care. This new condition challenged health services and health professionals to keep adjusting and updating responses in a context of uncertainty, but at the same time revealed the usual challenges and needs for providing timely and integrated care. Health services burden challenges the implementation of care standards. This heterogeneous condition demands a multi-level response, including general information and advice, enabling self-management, and providing rehabilitation.

Conclusions

Healthcare professionals envision an heterogenous condition, bringing uncertainty to healthcare services. More research, training, and information to the population is required for an appropriate response.

Key messages

• Persisting symptoms following COVID-19 challenged an already overwhelmed health system, bringing barriers to healthcare standards implementation.

• The heterogeneous nature of the condition and the healthcare services burden may leave some people to chance, demanding a diverse set of care.
Investigation of a Norovirus GII outbreak in a primary school in Portugal,2023
Authors: Cristovão F , Marques R , Peixoto V , Ourique M , Rodrigues N , Martins Correia D
Published: October 2024

Background

The onset of acute gastroenteritis cases among students in a primary school class on September 19, 2023, prompted an immediate response from the local Public Health unit. A collaborative effort was initiated to investigate and contain the outbreak.

Methods

Epidemiological questionnaires were distributed to 166 students and 8 staff members, defining cases as individuals exhibiting symptoms including diarrhoea, vomiting, or nausea between September 19th and September 24th, 2023. Additionally, stool samples were collected from three individuals.

Results

Out of 166 students and 8 staff members, 39 individuals met the case definition, resulting in attack rates of 22% (37/166) and 25% (2/8) among students and staff, respectively. Laboratory analysis confirmed two cases of Norovirus GII among the tested specimens, with five students requiring medical attention.

Conclusions

Our investigation underscores the significance of continuous epidemiological surveillance and swift implementation of infection control measures in school settings. The detection of Norovirus transmission emphasizes the necessity for rigorous adherence to infection control best practices. Our findings advocate for sustained technical support from public health authorities to prevent and manage similar outbreaks effectively.

Key messages

• Study on Norovirus outbreak in a primary school highlights the imperative of infection control measures, emphasizing the importance of ongoing support from public health authorities.

• The Norovirus outbreak investigation underscores the vital role of surveillance and swift response in containing infectious diseases within educational settings safeguarding all.
Preventing unintentional injuries in children: the parents’ beliefs matters (CHILD Vigilance)
Authors: Alves T , Papadakaki M , Strukcinskiene B , Silva S , Braz P , Aniceto C , Vagionaki K , Chliaoutakis J , Matias-Dias C
Published: October 2024

The CHILD Vigilance project is a European study supported by the Injury Prevention & Safety Promotion Section of the European Public Health Association (EUPHA INJ) and aims at assessing parenting knowledge and attitudes that are relevant to supervision and risk taking in children. For children the majority of these injuries occur in or around the home when their safety is the responsibility of a parent or other caregiver. The study aims contribute to the epidemiological knowledge of injuries through the study of the perceptions of parents and caregivers of children and adolescents. A descriptive, observational, cross-sectional study was developed under the CHILD Vigilance project, developed at European level within the scope of the Injury Prevention & Safety Promotion Section of the European Public Health Association. The information was collected by survey, from parents’ associations and schools in the EU countries represented in the EUPHA INJ Section. A total of 916 valid responses were obtained, involving 1229 children (51,4% male; mean age 7,8 years). Falls were perceived as the most common type of unintentional injuries in pre-schoolers and school-age children (47,8% in Greece; 63,5% in Portugal; 74,8% in Lithuania). However it was found differences in these countries as to the most common type of injury in adolescents, pointing out road traffic crashes (41.2% in Greece vs 39.5% in Portugal) and poisonings in Lithuania (38,1%). Some differences were also observed between these countries as to the most common causes of death. In Greece and Lithuania diseases were reported the main cause in the pre-schoolers (62,5%; 35,1%) and in primary education (55,1%; 29,7%), being injuries pointed as the most frequent cause only in the oldest. The study emphasizes the need to invest in the identification of appropriate determinants of child unintentional injuries and harmonised injury outcomes across global initiatives.

Key messages

• The lack of data regarding to parents’ knowledge on injury prevention involving children highlight the need to conduct this type of studies.

• The need for adequate epidemiological data on the burden of child injuries and validated tools to accurately measure injuries.
Economic evaluation of Polygenic Risk Scores in healthcare interventions: a systematic review
Authors: Siena L M , Riccio M , Rosso A , Baccolini V , Migliara G , Isonne C , Leone I , Marzuillo C , Villari P
Published: October 2024

Background

Polygenic Risk Scores (PRS) quantify genetic susceptibility to diseases, promising personalized healthcare. This review explores current evidence regarding the economic evaluation of strategies based on PRS or other polygenic risk stratification approaches, scrutinizing their methodologies.

Methods

The study protocol was registered in PROSPERO (CRD42023442780). A systematic search in PubMed, Scopus, and Web of Science identified full economic evaluations of intervention based on polygenic risk stratification strategies. The quality of the included articles was assessed using the Drummond checklist. This study was supported by the EC and MUR under PNRR - M4C2-I1.3 Project PE_00000019 ‘HEAL ITALIA”.

Results

Nineteen articles were included in the analysis, with oncological conditions being the most frequently investigated (13), followed by cardiovascular conditions (3). In nearly 80% of the studies, PRS was employed for screening interventions, with the general population being the primary target in 14 out of the 19 studies. All the economic analysis models investigated cost-utility in terms of QALYs, with Markov models and microsimulations being the most common structures. The majority of these models were based on simulated cohorts derived mostly from North American or European data, with 9 adopting a healthcare system perspective and 6 a societal perspective. Although delivery strategies for PRS testing were rarely addressed, PRS costs were included in nearly all studies. Indirect costs were examined in fewer than half of the studies. In 12 out of 19 studies, the conclusions claimed the cost utility of PRS involving strategies.

Conclusions

Despite the technique’s potential, evaluations of various strategies based on PRS approaches yield heterogeneous conclusions regarding cost-utility. Our study highlights the factors contributing to this heterogeneity and underscores the need for further exploration, ideally prioritizing real-world data.

Key messages

• PRS strategies evaluations vary in cost-utility conclusions, highlighting the need for further investigation.

• Real-world data and practical implications should be prioritised in PRS research.
Preventing battery ingestion in children: public health strategies and technological innovations
Authors: Gregori D , Baldas S , Lorenzoni G
Published: October 2024

Background

Accidental ingestion of button batteries can cause severe and sometimes fatal injuries, such as chemical burns, esophageal perforations, and long-term complications. In response to this challenge, prevention strategies have evolved. A recent example of safety-targeted technological innovation includes new coin lithium batteries with more secure packaging, a non-toxic bitter coating to deter ingestion, and a ‘color alert technology’ that activates a blue dye upon contact with saliva. These features are designed to discourage ingestion and facilitate the rapid identification of an injury, allowing for timely medical intervention.

Methods

This abstract reviews the public health strategies proposed or implemented to prevent this serious type of injury, augmented by an analysis of data from the Susy Safe registry, which identified 1,115 cases of battery ingestion in children, and an additional 94 cases from the literature, totaling 1,209 injuries.

Results

The review of existing prevention strategies highlights various approaches, including public awareness campaigns, enhanced product regulations, and the implementation of stricter safety standards for batteries and devices. Analysis of Susy Safe data helps characterize the issue, underscoring the frequency and circumstances of battery ingestions and provides an empirical basis to assess the effectiveness of existing prevention strategies and to guide the development of new policies. The combination of technological improvements and legislative initiatives could represent a significant breakthrough in preventing these dangerous injuries.

Conclusions

While technological innovations are promising, effective prevention of battery ingestion will require a multifaceted approach that integrates technology, education, public policy, and regulatory oversight. Collaboration among manufacturers, lawmakers, health professionals, and the community is essential to reduce the incidence of these medical emergencies.

Key messages

• Accidental ingestion of button batteries can cause severe and sometimes fatal injuries.

• The combination of technological improvements and legislative initiatives could represent a significant breakthrough in preventing button batteries in children.
Cost of fall injuries in traffic are for pedestrians and bicyclists - municipal respons needed
Authors: Lauritsen J
Published: October 2024

Motivation

Pedestrians and bicyclists have been posting in news and social media with reflections on municipal efforts to clean bicycle paths and sidewalks in icy and wet conditions. The municipality have lowered budgets for these cleaning efforts in recent years.

Methods

Analysis of A&E department registration data with the Nomesco core dataset allows for separation of location, age, sex, time of day and date of injury. Injury severity is classified according to diagnosis of treatment (minor/major). Cost calculations are based on national scales from the Ministry of Transport (ambulance/police/treatment/rehabilitation). Cold weather was defined as lowest day temperature < 5 degree C (Danish Metereological service DMI).

Results

During 2023 all pedestrians or bicyclists (n = 2516) treated at the A&E following an incident on sidewalks, streets or bicyclepaths (population 225.000) were included. Non-serious were (total/cold weather): sidewalks (699/266), bicyclepaths (414/117), streets (762/277). Serious: sidewalks (290/130), bicyclepaths (123/32), streets (228/100). Assessment of economical costs was DKK: Non-serious were (total/cold weather): sidewalks (20.8/7.9), bicyclepaths (12.4/3.5), streets (22.7/8.3). Serious: sidewalks (42.2/18.9), bicyclepaths (17.9/4.7), streets (33.2/14.6).

Discussion and conclusions

The economic burden for the population and municipality far exceeds the costs for cleaning the streets, bicyclepaths and sidewalks in icy and wet conditions. With appropriate injury surveillance and communication to municipal authorities revised cleaning principles was decided at the political level

Key messages

• Appropriate and focused injury registration is needed for targeted political level decision.

• Standardized and targeted economic calculations are persuasive in the political arena at the local level.
The profile and aberrant driving behavior of juvenile traffic law violators in Greece
Authors: Vagionaki K , Lioliou S , Kounali V , Stefanakis A , Stefanakis G , Toraki M , Gnardellis C H , Chliaoutakis J , Papadakaki M
Published: October 2024

The majority of juvenile offenses in Greece are related to road traffic violations. Juveniles in Crete region are required to attend an educational program offered by LaHeRS lab (HMU), in collaboration with the Prosecutor’s Office as part of reformative measures. The current presentation reports on the profile and aberrant driving behavior of juvenile offenders who attended the program between 2023-2024. The Driver Behavior Questionnaire (DBQ) was administered to 181 juvenile offenders. Participants were males (97.8), with a mean age 18.6 (SD = 1.2), resided in rural settings (51.8%) and secondary students 60.7%. The mean age of the first offence was 15.8 (SD = 1.1, min 13 - max 18). Participants scored low in all DBQ scales (covered violations mean=6.1, sd = 7.5; unintentional violations mean=0.9, sd = 1.6; lapses mean=8.9, sd = 10.5). No statistically significant difference was found in DBQ scores between those who had and did not have a driver’s license, as well as between those from urban or rural areas. The three DBQ subscales significant correlated (p < .001). Among other risky behaviors, 54.9% reported exceeding the legal speed limit, 66.3% reported aggression feelings when driving behind a slow vehicle, 34.5% used mobile phones while driving, 17.7% reported alcohol use while driving. Surprisingly, 85.5% stated high confidence addressing risks on the roads.

Key messages

• Early interventions on aberrant driving behavior among adolescents is crucial.

• Educational programs should be tailored to address the unique needs of juvenile traffic law violators.
Home-based nursing care: what do we know about multidrug-resistant organisms in this setting?
Authors: Langeveld T , Haverkate M , de Haan F , Timen A
Published: October 2024

Background

The burden and complexity of home-based nursing care have intensified due to earlier discharges from hospitals and patients living longer at home with increasing co-morbidities. This growing population of vulnerable patients, combined with the worldwide increase in the prevalence of multidrug-resistant organisms (MDROs), poses a new burden on home-based nursing staff. Home-based nursing care differs significantly from hospitals and nursing homes, challenging implementation of infection prevention and control (IPC) measures. It is therefore important to gain insight into the attitudes, experiences and needs of home-based nursing staff. Also, to better understand the scope of MDRO carriage and transmission in this setting, including its challenges.

Methods

Cross-sectional studies were conducted in the Netherlands including a survey and focusgroup study among home-based nursing staff, supplemented by a report of cases of MDRO clusters.

Results

We have identified several factors adding to the complexity of responding to an MDRO outbreak with involvement of home-based nursing care. First, inapplicable recommendations in guidelines/protocols or from infection preventionists, often aimed at intramural care. Second, nursing staff questioned the proportionality of IPC measures, potentially influenced by behaviour of colleagues and patients. Third, inadequate information transfers about patients carrying MDROs. Fourth, uncertainty about the roles and responsibilities of involved healthcare professionals. Finally, the need for organisational support in providing education and sufficient resources, and clarity about financial aspects.

Conclusions

Insights from these studies have aided in aligning upcoming MDRO guidelines for home-based nursing care in the Netherlands, which factor in the above mentioned complexity. Furthermore, these findings can aid in future strategies to prevent or respond early in MDRO outbreaks with involvement of home-based nursing care.
Harming the innocent: estimating the number of children affected by parental problem gambling
Authors: Bickl A , Stefan N , Buth S , Schwarzkopf L
Published: October 2024

Background

The impact of parental problem gambling on children and adolescents encompasses negative outcomes in psychological, financial, behavioral, physical health, and family relationship domains. For Germany, estimates on the number of co-affected minors are lacking.

Methods

Within the population-representative Germany-wide “Glücksspielsurvey 2023” (i.e., “Gambling Survey 2023”), we assessed parenthood in survey participants with gambling disorder (GD; according to DSM-5) as well as the number of minors (age <18 years) living a) together with a person with gambling disorder (shared household) or b) apart from a parent with gambling disorder (separate household). Using a “minimum maximum approach,” we performed a weighted extrapolation to estimate the number of co-affected minors in the German resident population (range 18 to 70 years of age) and the prevalence of parental GD among Germany-residing minors.

Results

46.8% (n = 132) of survey participants with GD report shared households with minors and 16.3% (n = 46) separate households. The average number of minors concerned was 1.55 (SD = 0.07) in shared and 1.51 (SD = 0.13) in separate households. This translates into 480,294 to 701,766 co-affected children in shared households (3.4% to 4.9% of Germany-residing minors) and 91,742 to 124,618 co-affected children in separate households (0.6% to 0.9% of Germany-residing minors).

Discussion and conclusions

Taking shared and separate households into account, one in 20 Germany-residing minors is co-affected by parental GD. Acknowledging that impaired psychosocial wellbeing in the context of parental GD could persist into adulthood of co-affected minors, this issue ought to be recognized as a major public health concern. To reduce related harm, children of people with GD should be best possibly integrated into the care process by offering additional help and support strategies explicitly addressed at this vulnerable population.

Key messages

• Parental problem gambling significantly impacts a substantial portion of German minors, with approximately one in 20 being affected, highlighting the urgent need for attention to this issue.

• Recognizing parental gambling’s long-term impact on minors, it’s crucial to implement support strategies in care to address their needs effectively.
Using diversity, equity and inclusion school practices to mitigate child health inequities in Canada
Authors: Honorato Albuquerque Torres C , Dabravolskaj J , Veugelers P J , Maximova K
Published: October 2024

Background

The burden of unhealthy lifestyle behaviours and mental disorders disproportionately affects children in deprived neighbourhoods. In Canada, school practices addressing diversity, equity and inclusion (DEI) are promoted to address such inequities. We aimed to assess whether DEI school practices can help mitigate the impact of neighbourhood deprivation on children’s lifestyle behaviours and mental health.

Methods

In 2023 we gathered survey data from 1497 grade 4-6 children (aged 9-12) in 22 elementary schools located in deprived neighbourhoods in Alberta, Canada. Children reported their diet, screen time, physical activity, and mental health. Principals reported on the implementation of DEI practices in schools (full vs. partial). School postal codes were used to derive tertiles of the Canadian Index of Multiple Deprivation, comprised of four dimensions that capture: 1) residential instability; 2) economic dependency; 3) ethno-cultural composition and 4) situational vulnerability of neighbourhoods.

Results

Overall, 45% of schools had fully implemented DEI practices. These schools were located in more deprived neighbourhoods for residential instability (55%), economic dependency (71%), ethno-cultural composition (60%), and situational vulnerability (64%). Children in more deprived neighbourhoods reported more sugar consumption, more screen time, and poorer mental health, compared to children in less deprived neighbourhoods. However, in those neighbourhoods where DEI practices were fully implemented, the adverse effects of neighbourhood deprivation were alleviated, whereby children reported less sugar consumption, less screen time, and better mental health.

Conclusions

The implementation of DEI school practices can help mitigate the adverse effects of neighbourhood deprivation on children’s physical and mental health, particularly in deprived neighbourhoods.

Key messages

• School practices targeting diversity, equity, and inclusion are more commonly implemented in schools located in deprived neighbourhoods.

• Diversity, equity, and inclusion school practices mitigate the adverse effects of neighbourhood deprivation on children’s lifestyle behaviours and mental health.
Covid-19 pandemic and student academic performance: a systematic review and meta-analysis
Authors: Gianfredi V , Scarioni S , Marchesi L , Ticozzi E M , Ohene Addo M , D’errico V , Fratantonio L , Liguori L , Pellai A , Castaldi S
Published: October 2024

Background

The COVID-19 pandemic led to widespread disruptions in educational systems globally, forcing a transition to remote learning modalities. This systemic change raised concerns about its potential impact on the academic performance of students in developmental ages. This systematic review and meta-analysis aimed to evaluate the association between the COVID-19 pandemic and academic performance among developmental-age students, quantifying the effect size using Cohen’s d.

Methods

We searched PubMed/MEDLINE, Scopus, and Embase for studies published up to December 2023 that assessed the impact of the COVID-19 pandemic on academic performance. The review was performed following the PRISMA 2020 guidelines. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale. The pooled effect size was calculated using Cohen’s d, with its 95% confidence interval. The protocol has been registered in PROSPERO.

Results

Out of 3671 retrieved articles, 30 studies met the inclusion criteria, and 13 were suitable for meta-analysis, involving a combined total of 4,893,499 students. The Cohen’s d was -0.07 (95% CI = -0.10 to -0.03; p < 0.001), indicating a small but statistically significant decline in academic performance associated with the pandemic. Subgroup analyses revealed that mathematics suffered the most significant impact, with a Cohen’s d of -0.14 (95% CI = -0.18 to -0.10; p < 0.001). All the included studies were judged as moderate-high quality.

Conclusions

The COVID-19 pandemic has had a negative effect on the academic performance of students of developmental ages, particularly in mathematics. These findings highlight the need for targeted interventions to mitigate the educational setbacks caused by the pandemic, especially in core subjects where the decline in performance was most pronounced.

Key messages

• The COVID-19 pandemic has significantly disrupted educational systems worldwide, resulting in a small but statistically significant decline in academic performance among students of developmental ages.

• The shift in educational delivery during the pandemic particularly affected learning outcomes in mathematics more than in other subjects.
Is there a maximum transfer time for safe planned home births? Building evidence to
Authors: Carroll C , Campillo ISL , Keane J , Corcoran P , Greene R , Kavanagh P
Published: October 2024

Evidence-based assessment of suitability for planned home birth (PHB) is a critical component of safe, effective home birth services. This study aimed to build an evidence base to inform transfer time recommendations for the Health Service Executive (HSE) Home Birth Service in Ireland. Transfer rates, time and distance were described for women who began labour at home with the HSE Home Birth Service between 2012 and 2021. Binary logistic regression was used to identify factors associated with intrapartum transfer and to examine the relationship between transfer time and outcomes. A survey on home birth policy and practice was issued to informants in countries offering comparable services to the HSE. Of 2,000 women initiating labour at home, 376 (18.9%) required intrapartum transfer, with transfer rates of 48.2% and 10.1% for primiparous and multiparous women, respectively. Primiparity (aOR: 8.95, 95% CI 6.89-11.7, p < 0.001) and maternal body mass index ≥30 (aOR: 1.93, 95% CI 1.14-3.20, p = 0.013) significantly increased the odds of intrapartum transfer. Serious adverse outcomes were rare in those requiring intrapartum transfer. No statistically significant increase in poor outcomes was detected with increasing transfer time; however, statistical power to detect small but important effects was limited. In other home birth services, transfer time is explicitly considered when assessing suitability; information provided to women includes details on transfer rates and times. While this study did not find a threshold time associated with increased risk of adverse outcomes for PHB, it has highlighted the significance of transfer time in shared decision-making on birthplace. Women considering PHB should receive parity-specific information on outcomes including transfer rates. This work highlights the pivotal role of Public Health in ensuring that evidence is combined with expert judgement and womens’ preferences to provide high quality, accessible, person-centred services.

Key messages

• Transfer time plays a key role in supporting shared decision-making for women considering a home birth.

• This study identified opportunities to extend the comprehensiveness of assessment of suitability for planned home births using local and international evidence.
National survey to estimate seroprevalence for toxoplasmosis among pregnant women in France, 2021
Authors: Mazzilli S , Tourdjman M ,   ENP study group
Published: October 2024

Background

Toxoplasmosis during pregnancy can result in congenital malformations and fetal death. In France, universal antenatal screening and monthly re-testing of seronegative pregnant women has been established since the 1970s. However, decreasing Toxoplasma gondii seroprevalence among pregnant women and lower incidence of congenital toxoplasmosis may challenge the cost-effectiveness of such programs. The aim of this study was to estimate the current seroprevalence among pregnant women participating in the 2021 national perinatal survey (ENP).

Methods

All adult women giving birth in France between 15-21 March 2021 were invited to participate in the ENP. Data collected included demographic information, nationality, socio-economic status, education level and Toxoplasma gondii serology. We classified a woman as seropositive if she had IgG antibodies prior to pregnancy or seroconverted during it. Univariable and multivariable regression analyses using Poisson model were conducted to estimate prevalence ratios (PRs) and identify significant factors associated with seropositivity.

Results

Among the 15,605 participating women, 0.22% seroconverted during pregnancy. The overall seroprevalence was 25.95%. Seropositivity was higher with increasing age (∼5% per 5 years), among residents of French overseas territories Guadeloupe/Saint Martin (PRs:1.07; 95%-CI: 1.03-1.10), La Réunion (PRs:1.10; 95%-CI: 1.08-1.13) and Mayotte (PRs:1.27; 95%-CI: 1.23-1.31), with lower education (PRs:1.22; 95%-CI: 1.04-1.42) and African nationality (PRs:1.11; 95%-CI: 1.02-1.20).

Conclusions

High seroprevalence for Toxoplasma gondii was found in older women, which may reflect their higher risk of past exposure. The observed geographical differences in seroprevalence may mirror dietary and environmental diversity. Declining seroprevalence among pregnant women in France can affect screening effectiveness and warrants a comprehensive review to determine appropriate future prevention strategies.

Key messages

• Older women and residents of French overseas territories show higher toxoplasmosis seroprevalence, possibly due to past exposure risks and diverse diets/environments.

• Declining toxoplasmosis seroprevalence among pregnant women in France can affect screening effectiveness and warrants a comprehensive review to determine appropriate future prevention strategies.
Reduction of screen induced myopia by parental interventions
Authors: Iyer V , Hermans RCJ , Polling J R , Klaver CCW , Reijneveld S A
Published: October 2024

Background

Excessive use of digital devices, including smartphones and tablets, has been shown to increase the risk of myopia in children. Gaps persist in understanding parental attitudes towards handheld screen use and effective interventions guiding eye health policies. This study examined the associations between parental behavior related to myopia and children’s handheld screen use.

Methods

Data obtained from 395 parents of pre-adolescents (Mean age 10.63; SD 1.09) were used, collected from an online community panel. Parents reported on various behavioral determinants related to myopia and their child’s screen time: knowledge, attitude, risk perception and self-efficacy. They reported on their child’s frequency and amount of screen use. Logistic regression analysis was used to assess associations between variables, using parental efforts to reduce screens as outcome measure.

Results

Of the 395 participating 9-12 year-olds, 73.4% of the children spent up to two hours a day on recreational handheld screens, 26% more than two hours. Of the parents surveyed, 28.1% perceived the risk of screen-induced myopia as significant, prompting 62.6% of them to take active measures to minimize screen time. The more knowledge parents had on child myopia the more they attempted to reduce screen time (OR = 2.57; 95% CI [1.57-4.19], p = <.001). Moreover, a more negative attitude towards screens was significantly related to attempting to reduce screen time (OR = 1.26; 95% CI[1.17-1.35],p = <.001).

Key messages

• These findings emphasize a need to address parental knowledge and attitude towards myopia and screen time reduction.

• We recommend increasing knowledge, influencing attitude and searching for alternatives as a part of behavioral change strategies.
Mental health benefit uptake of women before and during the perinatal period in Austria
Authors: Kern J , Zechmeister-Koss I , Edlinger M , Hörtnagl C , Paul J , Lampe A
Published: October 2024

One in five women may experience a perinatal mental illness (PMI) during pregnancy and up to one year after giving birth, during the so-called perinatal period. Although there is strong evidence that this can have a negative effect on the children’s future health, many mothers do not receive any treatment. To determine whether and what type of mental health services women in Austria claim during the perinatal period, the uptake of five key mental health insurance benefits was analysed using pseudonymised health insurance data from Austria’s largest insurance, ÖGK. In 2017 and 2018, 131,025 ÖGK insured women gave birth, representing 80% of all births in Austria in the two years. Of these women, almost 20% claimed at least one benefit during the perinatal period. Including the year before pregnancy this number increased to 25%. Most often, only one benefit was claimed in only one of the analysed periods (the year before pregnancy, pregnancy, and the year after birth). Psychotherapy was claimed most often, while hospital admissions occurred the least. Further, the youngest (≤ 20 years) and the oldest (≥ 41 years) women claimed benefits more frequently than at other ages. After adjustment for the shorter pregnancy period, benefit uptake was generally highest during pregnancy and lowest after giving birth. Considering the shortage of specialised perinatal mental health services in Austria, the uptake of the five analysed types of services was high and corresponds to international prevalence figures on PMI. The actual number may be even higher, considering the services and the women not covered in the available data. As there is a lack of a perinatal mental health infrastructure and specialised healthcare staff in Austria, this warrants further investigations into the quality of care provided to the women and more training and education concerning mental problems occurring during the perinatal period.

Key messages

• Around a quarter of women claim mental health benefits during the perinatal period, most often psychotherapy services.

• Substantial demand for mental health services during the perinatal period calls for comprehensive infrastructure and quality assessments of available options.
Nicotine use in Polish adolescents and sociodemographic factors correlations - PolNicoYouth study
Authors: Miller M , Tyrańska-Fobke A , Balwicki Ł
Published: October 2024

Background & aim

Almost 36% of Polish smokers started their addiction before the age of 17. Polish youth exhibit a higher prevalence of e-cigarette use (29.5%) than traditional cigarettes (26.2%). This study aimed to outline the prevalence of tobacco and nicotine product use based on usage frequency, poly-product use patterns among ever/former/naive users.

Methods

In the 2020 cross-sectional study, secondary school students from 200 schools, were selected nationwide using a stratified and random approach, making the sample representative of the entire Polish population. Data were collected through Computer-Assisted Web Interviews, using a questionnaire based on the Global Youth Tobacco Survey. Bayesian linear regression was used to assess correlations.

Results

The study consisted of 16,712 pupils aged 15-18. Almost 30% of participants admitted to current e-cigarette usage. Questions on parental smoking habits showed that 45.95% of parents smoke traditional cigarettes, 13.89% use e-cigarettes, and 13.80% use heated tobacco products (HTP). There was a very strong positive correlation between the female gender and the initiation of smoking with regular cigarettes (log[BF]=10.76). A very strong positive correlation between those studying in vocational schools and with initiation with regular cigarettes during initiation (log[BF]=18.13), while high school students had a greater association with e-cigarettes (log[BF]=11.08). There was also a very strong positive correlation between adolescents initiating smoking with regular cigarettes when their parents are also regular cigarette smokers (log[BF]=8.11) - no corresponding correlations were observed for e-cigarettes and HTP. There is a moderate positive correlation indicating a relationship between younger age (15 vs 18) and initiation by e-cigarette (log[BF]=1.8).

Key messages

• The type of nicotine product used by adolescents for nicotine initiation correlates differently with various socio-demographic factors and the type of nicotine product used by parents.

• Taking these relationships into consideration enables the development of tailored nicotine prevention.