bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Influencing Depression in People with Disabilities:Individual and Interpersonal Levels
Authors: Cho J H , Choi E H , Yeob K E , Kim S Y , Lee Y S , Park J H
Published: October 2024

Depression is an increasingly important social problem, and this also applies to the disabled, a health-vulnerable group. Although the distribution and influencing factors of depression may be different among the disabled population (young adults vs. the elderly, older adults with disabilities vs. disabilities due to old age), only the high prevalence of depression among the disabled is generally reported. This study seeks to determine the distribution and influencing factors of depression in disabled people according to sociodemographic standards. This study employed data from the 2021 Panel Survey on People with Disabilities (National Unit Survey) to investigate the influence of individual-level factors (health behaviors, health level, environment) and interpersonal-level factors (social network) on depression. Multivariate logistic regression analysis was performed while controlling for demographic sociological factors and disability characteristic factors. The experience of depression was among elderly disabled individuals (age 50+: 40.9%) than younger ones (age 19-49: 36.1%), and in disability with aging (49.3%) versus aging with disabilities (39.2%) (P < 0.05). Chronic diseases, daily living assistance, living environment, and emotional support from family and neighbors affected both young and elderly disabled individuals. Specifically, among the elderly disabled, exercise frequency (aOR=0.78; [CI]0.63-0.97), social network size (aOR=0.87; [CI]0.82-0.93), and social interaction frequency (aOR=0.68; [CI]0.51-0.91) were significant. Disability with aging was influenced by exercise frequency (aOR=0.29; [CI]0.09-0.95) and emotional support (aOR=0.37; [CI]0.17-0.77) from peers. older adults with disabilities were affected by not only individual-level factors (exercise frequency) but also both functional (emotional support) and structural (size of social network, frequency of meetings) aspects of their interpersonal social networks.

Key messages

• Depression experiences among older adults with disabilities are influenced by both functional and structural social networks.

• Developing depression prevention strategies for people with disabilities requires a customized approach that takes into account age-specific characteristics.
Starting Right, an evidence-based assessment of children in municipalities healthcare centers
Authors: Haraldstad K , Mølland E , Abildsnes E , Westergren T
Published: October 2024

During the last century, children’s health has evolved significantly, with mental health issues becoming a prominent public health concern. Childhood health problems profoundly impact quality of life (QoL), development, school functioning, and social interactions, affecting society broadly. In Norway, child and school health services offer free comprehensive care within the municipal primary health care system, prioritizing health promotion and prevention to address social health inequalities. The Norwegian Starting RightTM project recruits’ children aged 6 months to16 years and their parents, emphasizing early intervention and support to reduce health inequalities and promote well-being. In the Starting RightTM project, online proxy- and child-reported questionnaires are used to support public health nurses (PHNs) in assessing children’s health and development in routine follow- up. Parents and children receive an SMS text message asking them to answer an online questionnaire before attending their regular appointments in child or school health services. Validated instruments measure the development (ASQ, ASQ-SE), mental health (SDQ) and health-related quality of life (HRQoL), (KIDSCREEN -27). By mapping children and adolescents’ health and through discussions with PHNs, parents and children may be more involved in children’s health and development and may increase their Health Literacy. The primary objective of the proposed project is to develop child and school health services and improve children’s health and HRQoL. The ongoing project is the first to systematically assess development, health and HRQoL in children and adolescents in Norway through ordinary services, and to do so longitudinally. At present, >2000 children have been included. The large sample size combined with a broad multi- and interdisciplinary approach is unique from a national perspective. The upcoming workshop will showcase findings from this innovative study.
Latent tubercolosis infection in the migrant population: an Italian surveillance experience
Authors: Pagliantini G , Montomoli E , Frazzetta R , Fattorini M , Massini C , Rosadini D , Guerreschi E , De Luca A , Urso A D’ , Nante N
Published: October 2024

Background

The Special Reception Center (“Centro Accoglienza Straordinario” or CAS in Italian) concept was born in Italy in 2014 to receive the large number of migrants arriving in Italy. There are around 3100 centres are in Italy, of which 200+ in Tuscany. Each Center’s objective is to support migrants’ social integration through Italian language and job orientation courses. On arrival at a facility, migrants undergo diagnostic and lab tests to highlight potentially infectious diseases; among these, tuberculosis is one of the most frequently encountered. Therefore, the objective of the study is to estimate the prevalence of Latent Tuberculosis Infections (LTBIs) among migrants hosted in CAS centers.

Methods

From May-December 2023, Amiata Senese, Val d’Orcia and Valdichiana Senese Public Health Unit staff, according to national and departmental guidelines, implemented a number of health surveillance protocols, with close attention to latent tuberculosis infection. This protocol includes the Mantoux TB skin test at the CAS: in case of positivity, subjects are directed to further exams (chest X-ray, TB-IGRA blood test, infectious disease specialist consultation) in order to implement a therapy.

Results

From May-December 2023, 259 migrants (241 males and 18 females) received the TB skin tests. Average subject age was 26. Pakistan was the most represented nation of origin with 130 migrants (50%), followed by Bangladesh (9.7%) and Ivory Coast (7.3%). 77 migrants showed a positive TB skin test result (29.7%): of these 56 (i.e. 21.6% of the migrants screened) were also positive to the TB-IGRA blood test and treated for LTBI.

Conclusions

The high prevalence of LTBIs found in the referenced CAS indicates the need to continue/extend these surveillance protocols. Implementing successfully this procedure requires the involvement of a range of professionals from the socio-health sector within a process necessarily coordinated by the Disease Prevention Department.

Key messages

• Screening and surveillance of infectious diseases among migrant population represent a major public health issue for European health systems.

• Detection and treatment of Latent Tubercolosis Infections require a multiprofessional and integrated approach, coordinated by the Disease Prevention Department.
Civic participation and self-reported health: An intersectional comparative study in Europe
Authors: Rossetti F , Charafeddine R
Published: October 2024

Background

Civic participation has been associated with better self-reported health (SRH). However, how does the association between civic participation and SRH vary by sex and migration status? This study aims to examine the association between social and political determinants of health and SRH in an intersectional perspective.

Methods

We use data from 26 countries in the 2022 EU Statistics on Income and Living Conditions (EU-SILC) (n = 425,178, 18-80 y.o.), following an intercategorical approach. Eight intersectional groups are created based on sex, migration status and being socially/politically active (participation in activities related to active citizenship or in formal/informal voluntary activities). Multilevel (ML) logistic regression models are employed to assess the association between these groups and SRH, controlling for age and educational level.

Results

24.6% of the sample indicate to be socially or politically active, with significant differences between sexes and migration status. A higher proportion of non-migrant active men report good SRH compared to the other intersectional groups (95.2%). Preliminary results from the ML logistic models show that being active increases the likelihood of good SRH (OR = 1.77, 95% CI 1.72-1.83). Migrant active women report better SRH than their non-active counterparts (OR = 1.27, 95% CI 1.12-1.44).

Conclusions

Findings suggest that being socially/politically active has a positive impact on SRH, especially among foreign women living in European countries. The study highlights the importance of considering civic (both political and social) participation as health determinant and the need of investing in social capital as a way of health promotion, tackling health inequalities and the marginalisation of at-risk groups.

Key messages

• Civic participation might strengthen individuals’ health, including among migrant women.

• Public health policies should consider civic participation as significant determinant of individuals’ health, as well as a way of tackling health inequalities.
Chronic pain over time among Syrian refugees resettled in Norway
Authors: Sima Y , Strømme E M , Diaz E
Published: October 2024

Background

Chronic pain disproportionately impacts vulnerable groups such as migrants and refugees. This study investigates the long-term changes in chronic pain experienced by Syrian refugees in Norway and explores the factors influencing these changes.

Methods

This prospective cohort study used data from the CHART and Integration for Health studies, with data collection at three points: in Lebanon (Wave-1), one year (Wave-2), and four years post-arrival in Norway (Wave-3). All participants who completed surveys at these timepoints were included (n = 132). Chronic pain was measured by asking about pain lasting at least six months. Mixed-effects logistic regression was used to examine changes in prevalence and assess how age, gender, educational level (categorized as low, ≤9 years, and high, >9 years), and mental health symptoms (anxiety, depression, and post-traumatic disorders) affect these changes.

Results

Between Wave-1 and Wave-3, the proportion of participants reporting chronic pain increased from 31% to 53%, with an odds ratio of 3.6 (95% CI 2.2 - 5.8). There was an interaction between changes in chronic pain over time and participants’ educational level, where the increase in pain prevalence over time was more pronounced among participants with lower educational levels than higher levels. No modification with the other factors were detected.

Conclusions

The study observed an increase in the number of participants reporting chronic pain over time. Low educational level at baseline emerged as a useful indicator for identifying those at higher risk of chronic pain. Understanding this correlation can be crucial for guiding preventive strategies and optimizing resource allocation to assist those most vulnerable.

Key messages

• Chronic pain disproportionately impacts vulnerable groups such as refugees.

• Refugees with lower education levels at baseline were more likely to experience chronic pain over time.
Community Health Worker Service: addressing the needs of Gypsy/Travellers in Scotland
Authors: Biazus Dalcin C , McFadden A , Vidal N
Published: October 2024

Background

Members of the Gypsy/Traveller community in the United Kingdom face significant health inequalities compared to the general population, including lower life expectancy, higher rates of morbidity and suicide and poorer infant and child outcomes. This study evaluated the implementation of community-based lay workers in Scotland - the Gypsy/Traveller Community Health Worker (CHW) service.

Methods

This multi-method qualitative study (December 2021 to August 2023) included 16 individual interviews, five focus groups, one workshop, two informal discussions, and one site visit. Participants were stakeholders, CHWs, and members of the Gypsy/Traveller community. Additionally, 116 documents were analysed. The framework method, Proctor’s implementation outcomes and thematic analysis were used for data analysis.

Results

CHWs reached approximately 1,000 individuals across six National Health Services (NHS) Boards. The implementation outcomes showed that the intervention was accepted and feasible. A third-sector organization (Black and Minority Ethnic Carers of People Project - MECOPP), played a crucial role in successfully delivering the CHW service. This innovative intervention employed members of the Gypsy/Traveller community as lay healthcare workers to break down barriers to accessing healthcare and other services (e.g., uptake of cervical screening, vaccination, housing, and sanitation). The CHWs were trusted, ensured healthcare information was culturally appropriate and successfully addressed discriminatory behaviours in health and social care. Limited resources pose challenges to the sustainability of the service.

Conclusions

The Gypsy/Traveller CHW service enhanced prevention, acted as a bridge between communities and health systems and addressed the wider determinants of health. The Gypsy/Traveller community still faces discriminatory, racist, and stigmatising behaviours, which further impede the quality, delivery, and accessibility of care.

Key messages

• The Community Health Worker service was acceptable and feasible in the Gypsy/Traveller community, acting as a bridge between community and health systems and increasing access to services.

• Community Health Worker Service is an important strategy for delivering healthcare support through their sector organizations to address historical discrimination against minority ethnic groups.
Serbia multidisciplinary approach for surveillance and risk identification – The “One Health” information for action
Authors: Djuric P , Jovanovic V , Drakulovic M , Despot M , Malinic J , Beljin A , Protic J , Divljakovic A , Milosavljevic S , Mebonia N
Published: October 2024

Issue/problem

To date, Serbia has not detected locally acquired Dengue cases. Since a competent Dengue virus vector Aedes albopictus (Ae. albopictus) has been detected since 2017, imported cases have the potential to trigger local transmission.

Description of the problem

To ensure preparedness and timely response in the event of an epidemic signal in Serbia, we described the imported Dengue cases and analysed the geographical distribution and density of the vector. Probable and confirmed imported cases meeting the 2018 EU case definition were reported via the National Notifiable System between January 2019 and December 2023. We monitored the density and geographical spread of mosquitos, including Ae. albopictus, which were collected during May-October 2022 and 2023. Mosquito genera were determined according to morphological criteria and DNA barcoding.

Results

During the investigation period, physicians reported three probable and four confirmed imported Dengue cases; the mean age was 28.4 (standard deviation (SD)=11.5) years and 57% were male. Cases had travelled in Southeast Asia (n = 6) and the Caribbean (n = 1). The mean time interval from symptom onset to seeking medical care was 3.6 (SD = 2.1) days and from symptom onset to laboratory confirmation 7.4 (SD = 6.3) days. We collected 1994 Ae. albopictus mosquitoes in 308 sampling sites across 12 Serbian regions. We observed the highest number of mosquitoes in September (38%, p < 0.001) and in the Belgrade region (81%, p < 0.001). In 2022, we detected Ae. albopictus mosquitos in seven regions and in 2023 in nine.

Lessons

Ae. albopictus mosquitoes were widely distributed in Serbia, with the highest presence during September and in the capital region. The importation of Dengue cases from affected countries underscores the need for enhanced integrated and “real-time” surveillance linked with vector control activities.
Climate Change Impacts on Respiratory Health: Bridging Inequalities in Children and Adults
Authors: Matkovic V
Published: October 2024

Respiratory diseases rank as the third leading global cause of mortality, with climate change exacerbating their prevalence and severity. Wild fires, floods, extreme heat events, infectious diseases, urban air pollution and aeroallergen exposure contribute to respiratory health deterioration. Vulnerable populations, including individuals with pre-existing lung conditions and children, bear a disproportionate burden of these effects. We centrepiece the connection of climate change to respiratory health inequalities, while bridging the evidence gap regarding increasing extreme heat and cold events, ambient and indoor air pollution exposure with significant ramifications on respiratory health. Specifically, we will showcase research on the tailored, multidisciplinary NCD prevention package named FRESHAIR4Life, targeting air pollution exposure in mid- to late adolescents from disadvantaged populations. Given the high burden of non-communicable diseases (NCDs) and air pollution exposure as major contributors, urgent preventive interventions are required, particularly in disadvantaged populations. Initiating preventive interventions during adolescence is considered an optimal window of opportunity for long-term health benefits. Furthermore, we will present a robust evidence base delineating climate change’s impact on lung health among vulnerable European populations. We will discuss how narratives on climate-induced lung health issues are co-created with affected communities and stakeholders to facilitate policy translation. The aim of these presentations is to break silos among health professionals, fostering collaboration from the respiratory community to the public health community. Through lung health collaborations we seek to deepen understanding and catalyze action to address the intersection of climate change, respiratory health, and inequalities, ultimately working towards a healthier and more equitable health for all.
Diet quality trajectories from infancy to age 18 and their association with diet quality at age 26
Authors: Tarro S , Vahtera J , Pentti J , Pahkala K , Lagström H
Published: October 2024

Background and objectives

Dietary habits during childhood and adolescence show strong stability. However, no studies have investigated dietary trajectories from infancy to adulthood. We therefore aimed to 1) identify diet quality trajectories from age 1 to 18 years and 2) explore how trajectories are associated with diet quality at age 26 years.

Methods

The study included 620 individuals from the Special Turku Coronary Risk Factor Intervention Project (STRIP), started in infancy (n = 1062). Food and nutrient intake was assessed annually from age one to age 18, and again at age 26 using 4-day food records. A food-based diet score (range 0-33) was calculated to indicate diet quality. Group-based modelling was used to model trajectories of diet quality between the ages of 1 and 18 years. Linear regression analyses were used to investigate associations between the diet quality trajectory groups and diet quality at age 26 years.

Results

By the age of 18, we found five diet quality groups: 1) low (19% of participants) with a mean diet score of 12 points, 2) decreasing (25%) with a mean diet score of 15 points, 3) increasing (15%) with a mean diet score of 16 points, 4) intermediate (31%) with a mean diet score of 18 points, and 5) high (10%) with a mean diet score of 22 points. The diet quality trajectory groups were associated with 0.4 (decreasing), 2.5 (medium), 3.8 (increasing) and 4.1 (high) points higher diet scores at age 26 compared to the low diet quality trajectory group (p < 0.001 for all).

Discussion

Five distinct dietary trajectories were found from infancy to late adolescence, with a clear difference between the groups with the lowest and highest diet quality. However, the differences in diet quality levelled out by the age of 26 years. Our results suggest that diet quality established already in childhood moderately predicts diet quality into adulthood.

Key messages

• Diet quality established in childhood moderately predicts diet quality in young adulthood.

• Five distinct dietary trajectories were found from infancy to late adolescence, with a clear difference between the groups with the lowest and highest diet quality.
Dietary Pattern Trajectories in French Adults Over Time (2014-2022): Role of Socioeconomic Factors
Authors: Toujgani H , Berlivet J , Berthy F , Allès B , Fouillet H , Touvier M , Lairon D , Mariotti F , Baudry J , Kesse-Guyot E
Published: October 2024

While dietary transitions towards more plant-based diets are urgently needed, few studies have investigated current diet trajectories, based on observed longitudinal data. This study investigated current dietary transitions of French adults over an 8 years period (2014-2022), while assessing the nutritional quality of the consumed foods and the role of diverse socio-economic factors. Consumption data from 17,187 NutriNet-Santé cohort participants weighted for the French Census were collected using a food frequency questionnaire in 2014, 2018, 2022. Adopting a gender-specific approach, consumption changes in 23 food groups were assessed over time. The nutritional quality was evaluated using the cDQI score, categorizing foods into ‘healthy’ and ‘unhealthy’. The socioeconomic analysis targeted four food groups (red meat, processed meat, legumes and wholegrain products), strongly linked to mortality risk and recognized as significant markers of the sustainable diet transition. All analyses were conducted using multi-adjusted mixed-effects models. Consumption of some healthy plant-based foods (nuts +59 %, legumes +22%, wholegrain products +7%) significantly increased over time; while consumption of some unhealthy foods (red meat -19%, refined cereals -18%, sweet drinks -15%) decreased. Conversely, consumption of prepared and mixed dishes (+16%), processed meat (+35%) and butter (+100%) increased. These changes differed in magnitude between sexes and translated into an improved food quality score (cDQI). Occupational status was linked to longitudinal changes in food consumption, showing increased intake of plant-based foods among students and higher socio-professional categories. Our findings provide accurate data on trends and factors for targeted initiatives, guiding strategic interventions for a sustainable dietary transition.

Key messages

• Plant-based food consumption increased while unhealthy food intake, both plant and animal-based, decreased; Gender differences were observed in baseline consumption and the extent of changes over time.

• Occupational status was linked to longitudinal changes in food consumption. Increased intake of plant-based foods was observed among students and higher socio-professional categories.
Development of rapid methods to monitor nutritional standards in sustainable healthy public catering
Authors: Barocco G , Croci E , Bucci F G , Forciniti G , Longo T , Steinbock D , Marsi A , Bogoni P , Calabretti A
Published: October 2024

Background

The WHO and FAO in the Second International Conference on Nutrition stress the role of nutrition standards for public facilities catering services (CS) and in the Sustainable Healthy Diet guiding principles (SHD) underline synergies among foods, nutrients present in dietary patterns and their bioavailability, degree of food processing, and subsequent health impact. In Italy almost one in 10 people eat a meal in CS every day. In accordance with SHD, the Italian Ministry of Health (MH) in the national guidelines for CS indicate activating procedures for the conservation of nutritional qualities (NQ) of micronutrients and bioactive substances. The central purchasing body of the Region of Friuli Venezia Giulia have applied these criteria, introducing the process of critical control points of nutrient analysis (NACCP) in the Public Procurement for the school catering of 69 municipalities and for all 18 regional hospital with more than 3 million meals per year served. The aim of the project was to develop rapid and cheap methods for monitoring the NQ of meals by applying the NACCP process.

Methods

150 samples of pasta, milk and also vegetables, meat, fish with different degrees of processing, were taken from the CS and analysed both with chemical techniques and with optical rapid techniques (1300 analyses).

Results

The samples were subjected to conventional analyses to determine the oxidation state and the content of characterizing molecules such as polyphenols, histamine, and total compounds of Maillard. The same samples were then analyzed by color measurements. The results showed a good correlation between the two analytical systems, in particular the color measurements and the Maillard compounds and the color measurements and the oxidation state.

Conclusions

Project findings can be applied in the NACCP process to rapidly cost-effectively monitor the nutritional quality of CS meals, and adhere to WHO and FAO the SHD guiding principles and MH guidelines for CS.

Key messages

• The development of rapid methods of monitoring the nutritional standards of public catering can implement sustainable food systems thereby promoting the healthy diets recommended by the FAO and WHO.

• Rapid methods of monitoring nutritional standards represent an innovative component in improving the culture of food and nutritional security in public catering.
Predicting food consumption using contextual factors: An application of machine learning models
Authors: Tran N R , Zhang Y , Leech R M , McNaughton S A
Published: October 2024

Background

Improving diet quality relies on making manageable adjustments to eating behaviours. Personalised nutrition interventions hold promise for modifying behaviour. Machine learning (ML) offers a novel approach to examining dietary behaviours in personalised nutrition by leveraging data on past behaviours and environmental contexts. This study aims to investigate whether contextual factors at eating occasions (EO) can predict food consumption to enhance diet quality.

Methods

Cross sectional data from the Measuring Eating in Everyday Life Study (MEALS) were analysed (n = 675, 18-35y). A smartphone food diary app recorded dietary intakes at EO for 3-4 non-consecutive days, also capturing social-environmental (e.g., activity) and physical-environmental factors (e.g., consumption location). Participant characteristics were collected via an online survey. Food groups intake (servings per EO) followed Australian Dietary Guidelines. This study benchmarked two established models, gradient boost decision tree and random forest, which have previously shown high performance in similar tasks. Performance was evaluated using 10-fold cross-validation, measuring mean absolute error (MEA), root mean square error (RMSE), and R squared. Feature importance analysis identified key variables for predicting food consumption.

Results

ML predicts most food groups at EO using contextual factors, with slight differences between actual and predicted consumption (<1 serving per EO). For fruits, dairy, and meat, MEA values were 0.35, 0.34, and 0.56 servings, respectively (RMSE values: 0.61, 0.50, and 0.80 servings). Self-efficacy, age and consumption location were influential in most ML models.

Conclusions

ML offers insights into contextual factors and food consumption, suggesting directions for precision nutrition interventions. Future research should identify positive influences of contextual factors on dietary behaviours and incorporate these insights into interventions.

Key messages

• Machine learning can effectively predict food consumption based on contextual factors at eating occasions.

• Understanding the influence of contextual factors such as consumption location on food consumption can inform the development of precision nutrition interventions aimed at improving diet quality.
Associations between general practice and outpatient care continuity in people with multimorbidity
Authors: Beaney T , Clarke J , Woodcock T , Barahona M , Majeed A , Aylin P
Published: October 2024

Background

Relational continuity in primary and secondary care is linked to better health outcomes for patients, but it is unclear whether metrics of continuity in each setting are associated. Our study examined the association between relational continuity in general practice (GP) and continuity of hospital outpatient specialties in people with clusters of multimorbidity.

Methods

We used GP records from the Clinical Practice Research Datalink, linked to Hospital Episode Statistics outpatient records. Included were patients ≥18 years, with two or more of 212 Long-Term Conditions (LTCs), registered throughout 2019 and with at least three GP and three outpatient appointments. The Continuity of Care Index (COCI) was calculated separately for visits to the same i) GP and ii) hospital specialty, where 0 represents no continuity and 1 represents all visits to the same GP or specialty. We assessed the association between the indices using univariable and multivariable fractional logit regression. We calculated expected COCI scores for each LTC and assessed variation in the COCI between LTCs assigned to one of 15 clusters of co-occurring diseases derived previously. A sensitivity analysis repeated analysis using the Sequential Continuity (SECON) score, which captures longitudinal continuity.

Results

Of 1,135,903 patients, 56.2% were ≥60 years. The median (IQR) COCI in GP was 0.22 (0.11-0.40) and in outpatients was 0.33 (0.20-0.52). Although statistically significant (p < 0.001) the relationship between the two measures was clinically insignificant in both univariable and multivariable models. No strong relationships were found between COCI scores and LTC clusters. Similar patterns were found using the SECON score.

Conclusions

We found no strong association between continuity of care in GP and outpatient settings, and no clear patterns with LTC clusters. This suggests that lack of continuity in secondary care is not compensated for by increased continuity of care in primary care.

Key messages

• We found no meaningful association between measures of continuity of care in general practice and hospital outpatient settings.

• Our findings suggest that lack of continuity of outpatient care is not compensated for by increased continuity in primary care.
The Scourge of measles
Authors: Latif S
Published: October 2024

Once considered a disease of the past, the resurgence of measles in England has garnered significant attention in recent weeks and months. The uptake of routine childhood vaccines including the measles, mumps and rubella (MMR) vaccine is the lowest it has been in a decade and is well below the 95% uptake needed to protect the population and prevent outbreaks. This is giving this serious disease a chance to get a foothold in our communities. From having never seen a case of measles in their life time doctors in England are now notifying cases of measles based on clinical suspicion. Since October, we have seen a rapid increase in both measles cases and outbreaks of measles across England (the total number of cases confirmed since October 2023 to date is 1109) and it has been declared a national incident. The abstract highlights the consequences of vaccine hesitancy, illustrated by case studies of outbreaks of measles among susceptible populations such as schools and prisons and the steps being taken to control the spread. Social media misinformation, distrust in healthcare authorities, and concerns over vaccine safety are some of the factors shaping parental attitudes towards MMR vaccination. In response to these challenges, the abstract underscores the importance of targeted interventions aimed at addressing vaccine hesitancy, such as community engagement initiatives, tailored communication strategies, and healthcare provider training. By emphasizing the critical role of MMR vaccination in preventing measles resurgence, this abstract advocates for a collaborative approach involving healthcare stakeholders, policymakers, and the public to combat to combat this preventable yet persistent threat to public health.
Factors of mental health patients’ uptake in social prescribing: a mixed methods study in Portugal
Authors: Hoffmeister L , Gama A , Gonçalves B , Canas A M , Figueiredo C , Dias S
Published: October 2024

Successfully addressing mental health challenges demands comprehensive, community-driven solutions. Social prescribing (SP) emerges as an innovative approach, fostering integrated care by connecting healthcare patients to community resources. Research in this topic proved effects of SP in mental health and well-being promotion, but factors influencing patients’ uptake remain underexplored. This study examined the factors associated with the uptake in patients with mental health needs in SP project in Portugal. This mixed methods study examined registries data of 403 patients referred to SP for mental health needs. A logistic regression was used to analyse sociodemographic characteristics and referral details associated with SP uptake. Semi-structured interviews were conducted with stakeholders to explore challenges and facilitators of users uptake. Most users were female (71.7%) and elder (average age 64.4 years, SD ± 20.0). Mental health needs included social isolation, loneliness, anxiety, and depression. 43.7% of referred patients had diagnosed mental illnesses and 55.8% attended at least one SP appointment. SP uptake was more likely among patients referred for social and financial support (OR 2.02; 95%CI 1.32-3.07; p = 0.001) and referred during the Covid-19 period (OR 1.64; 95%CI 1.08-2.49; p = 0.020). increased the probability of SP uptake. In contrast, SP uptake was less likely among those having diabetes (OR 0.49; 95%CI 0.28-0.88; p = 0.016). Health professionals’ proactive engagement with patients facilitated uptake in SP, yet challenges arose from users’ complex needs, low awareness, motivation, and acceptance of non-traditional responses such as community-based activities, along with mistrust of their effectiveness. SP has the potential to foster mental health and well-being through person-centred holistic care, yet challenges in uptake related to health and psychosocial factors must be addressed to optimize the SP positive impacts.

Key messages

• Factors influencing the uptake of patients with mental health needs in SP initiative in Portugal involved need of social and financial support, pandemic period and health professionals’ attitudes.

• Despite SP potential, for effective implementation it is key to address challenges, like complexity of patients’ needs, awareness gaps and patient mistrust, to maximize its positive outcomes.
Birth registry-based cohort study of COVID-19 in pregnancy and adverse maternal outcomes in Georgia
Authors: Skhvitaridze N , Gamkrelidze A , Manjavidze T , Brenn T , Rylander C , Getsadze R
Published: October 2024

Georgia experienced an increase in maternal deaths (MD) during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, which warrants further investigation. This study aimed to assess associations between timing of SARS-CoV-2 infection during pregnancy and MD, post-delivery intensive care unit (ICU) admission, and caesarean section (CS) delivery. We performed a national birth registry-based cohort study of pregnant women who had completed 22 weeks of gestation and delivered between February 28, 2020, and August 31, 2022. The data were linked to coronavirus disease 2019 (COVID-19) testing, vital, and immunization registries. Pregnant women were classified into three groups: confirmed SARS-CoV-2 infection from conception through 31 days before delivery; confirmed infection within 30 days before or at delivery; and women negative for SARS-CoV-2 infection or without any test results (reference group). Multivariable logistic regression was used to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs). Among 111,493 pregnant women, 16,751 had confirmed infection during pregnancy, and 7,332 were fully vaccinated against COVID-19 before delivery. Compared to the reference group, those with confirmed infection within 30 days before or at delivery experienced increased odds of MD (aOR: 43.11, 95% CI, 21.99-84.55), post-delivery ICU admission (aOR: 5.20, 95% CI, 4.05-6.67), and CS delivery (aOR: 1.11, 95% CI, 1.03-1.20).

Key messages

• Pregnant women in Georgia with confirmed SARS-CoV-2 infection within 30 days before or at delivery experienced a considerably higher risk of MD and post-delivery ICU admission.

• Most pregnant women were not vaccinated against COVID-19 and these findings should alert stakeholders that adherence to public health preventive measures needs to be improved.
Understanding and monitoring vulnerability during pregnancy at population-level
Authors: Molenaar J , Struijs J , Kiefte-de Jong J C
Published: October 2024

Background

Detecting and addressing vulnerability during pregnancy is important to optimize the first thousands days of children’s lives and prevent health inequities. We aimed to gain insight into vulnerability during pregnancy and determine the best data to predict vulnerability.

Methods

In the Netherlands, two studies were done using nationwide routinely collected data and self-reported Public Health Monitor-data. The first study utilized all data to identify classes of vulnerability among 4172 pregnant women through Latent Class Analysis. The second study predicted multidimensional vulnerability at population-level using solely routinely collected data first, and step-by-step incorporating self-reported data. Random Forest (RF) analysis was employed, and model performance was assessed using Area Under the Curve (AUC) and F1-measure.

Results

Five vulnerability-classes were found: ‘healthy and socioeconomically stable’, ‘high care utilization’, ‘socioeconomic vulnerability’, ‘psychosocial vulnerability’, and ‘multidimensional vulnerability’. Women in the ‘multidimensional vulnerability’-class shared multiple risk factors across domains and lacked protective factors. They more often had adverse outcomes such as premature birth. In the next study, the initial RF-model achieved an AUC of 0.98 in distinguishing multidimensional vulnerability, with an F1-measure of 0.70. Adding self-reported data improved model performance. Strong predictors were self-reported health, socioeconomic characteristics and healthcare utilization.

Conclusions

Several vulnerability classes can be distinguished among pregnant women. The co-existence of risk factors and lack of protective factors leads to more adverse outcomes. Effective public health strategies should include both medical and social care and support. Next, it seems possible to predict multidimensional vulnerability using data that is readily available, providing a foundation for longitudinal monitoring and policy formulation.

Key messages

• Considering the combination of both social risk and protective factors related to vulnerability during pregnancy is necessary.

• Routinely collected data could provide insight in the prevalence, geographical distribution and trends in multidimensional vulnerability during pregnancy at population-level.
Associations between maternal origin, breastfeeding and health service use: a mediation analysis
Authors: Muhumed I , Meinilä J , Klemetti R , Adebayo F , Virtanen S , Erkkola M
Published: October 2024

Background

The influence of maternal health utilization on breastfeeding practices is well established. However, research shows that immigrant women tend to face challenges in accessing maternal health services. Our aim was to examine any variation in maternal and child health service utilization between immigrant and native-born mothers as well as to examine potential mediation roles of service utilization on the association between maternal origin and breastfeeding practices.

Methods

We used a nationwide FinChildren (2020) survey on parents with infants focusing on Somali (n = 29), Arabic (n = 81) and Russian speaking (n = 181) parents and their infants. We compared them with native Finnish speakers (n = 7508). We used Process Macro to conduct mediation analysis.

Results

Almost 25%/ of Somali-/Arabic-speaking mothers reported not taking their infants to routine child health clinic visits. The proportion was 0.4% for native-born mothers and 1.6% for Russian-speaking mothers (p < 0.001). Around 18% of Somali-/Arabic-speaking mothers and only 0.6% of the native-born mothers reported not utilizing child health clinic services in the past year (p < 0.001). Somali-/Arabic speaking mothers were more likely to receive breastfeeding support from maternity clinics and native-born mothers from maternity hospital or peer support groups. Russian-speaking mothers were most satisfied with the received child healthcare services while Somali/Arabic-speaking mothers were least satisfied with these services (p < 0.001). Only participating in breastfeeding peer support groups had mediation effects on association between maternal origin and breastfeeding practices.

Conclusions

This study shows that immigrants mothers, particularly Somali/Arabic speaking mothers use less the maternal health services particularly routine health visits. It is essential to encourage them to use the services to be able to monitor the health of both mother and the child.

Key messages

• Somali-/Arabic-speaking mothers are in a vulnerable position when it comes to utilizing healthcare services.

• This study call for more research exploring factors contributing to this.
Workers’ experiences of pregnancy loss: qualitative insights from a mixed-methods study
Authors: Kelly-Harrington R , Hennessy M , Leitao S , O’Sullivan M , Dalton-O’Connor C , Donnelly M , Murray C , Nuzum D , O’Donoghue K
Published: October 2024

Background

Pregnancy loss affects approximately one in four pregnancies. The workplace is an important context to consider in pregnancy loss experiences as most women of reproductive age are in paid employment. Currently in the Republic of Ireland (ROI) there are no statutory leave entitlements if a pregnancy ends <24 weeks. Given the lack of research in this area internationally, we aimed to explore workplace experiences of early pregnancy loss.

Methods

In 2023, we conducted an online mixed-methods survey study (Mar-Apr), followed by qualitative interviews (Jun-Sept). People who experienced a pregnancy loss <24 weeks-whilst working and living in ROI in the preceding five years-were eligible to participate. The survey was distributed through professional/social networks and contained quantitative and qualitative questions-addressing pregnancy loss, experiences of workplace supports, and desired supports. Survey participants were asked to indicate their willingness to participate in a follow-up interview and were purposively sampled. The interview topic guide focused on specific aspects of workplace experiences which required further exploration following preliminary analysis of survey responses. Qualitative data were analysed in NVivo using reflexive thematic analysis.

Results

Most survey participants (N = 913) were female (74%), employed full-time (86%) and experienced a first-trimester miscarriage (75%). We conducted interviews with 13 people, across a range of demographics. Three initial themes were identified: (1) Personal experiences of pregnancy loss and dealing with emotional and physical impacts at work; (2) Challenges with the social side of pregnancy loss-disclosure and workplace interactions; (3) Workplace supports (4) Public policy and awareness.

Conclusions

Our analysis highlights the need for statutory leave, appropriate workplace policies and procedures, and education and training to better support workers who experience pregnancy loss.

Key messages

• There is a gap between workers’ needs and workplace supports regarding pregnancy loss <24 weeks gestation. Statutory leave, workplace policies and procedures, and education and training, are needed.

• There is a need to discuss pregnancy loss in workplaces and society, to raise awareness and reduce the stigma/taboo on the topic. Recognition from Government is crucial to promote this.
Experiences of access to care, diagnosis and rehabilitation among a multiethnic patient population with long-COVID in Denmark
Authors: Goldschmidt M , Torensma M , Beune E , Agyemang C , Rostila M , Benfield T , Norredam M , Bredmose E
Published: October 2024

Background and aim

The aim of the study was to explore the experiences of accessing care, diagnosis, and rehabilitation among patients with long-COVID in a multiethnic population in Denmark.

Methods

Qualitative research using semi-structured interviews among a purposive sample of 18 people diagnosed with long-COVID, according to the NICE guideline, in the Capital Region of Denmark. Participants were sampled to secure variation in sex, age, ethnicity, migration status and education. Our interview guide was developed using the theoretical framework of candidacy. Interviews were transcribed verbatim, and member checked, and subsequently analyzed using thematic framework analysis and NVivo software.

Results

The analysis generated four categories: i) living with long-COVID, ii) access to care, iii) experiences in the healthcare system, and iv) experiences with rehabilitation. A main category was identified from these categories: limited knowledge of COVID resulting in uncertainty, which challenged nearly all aspects of access to diagnosis, care and rehabilitation among the informants. In particular, ethnic minorities experienced that their motives for seeking care were questioned or had the experience of differential treatment. In general, participants perceived to be themselves responsible of recovering, while also struggling with the mental, social and work-related consequences of their long-COVID.

Conclusions

Our study demonstrated how the emergence of a new viral disease with unknown long-term sequelae results in a group of patients who to a great extend carry the burden of getting better themselves. More research into relevant diagnosis, care and support for long-COVID patients is needed, especially among ethnic minorities.
Differences in incidence, nature of symptoms, and duration of long COVID among hospitalised migrant and non-migrant patients in the Netherland: a retrospective cohort study
Authors: Chilunga F , Appleman B , van Vugt M , Klaverda K , Smeele P , van Es J , Wiersinga W J , Rostila M , Prins M , Stronks K
Published: October 2024

Background and aim

Comprehensive data on long-COVID across ethnic and migrant groups are lacking. We investigated incidence, nature of symptoms, clinical predictors, and duration of long-COVID among COVID-19 hospitalised patients in the Netherlands by migration background.

Methods

We used COVID-19 admissions and follow up data (January 2021-July 2022) from Amsterdam University Medical Centers. We calculated long-COVID incidence proportions by migration background and assessed for clinical predictors via robust Poisson regressions. We then examined associations between migration background and long COVID using robust Poisson regressions and adjusted for derived clinical predictors, and other biologically relevant factors.

Results

1886 patients were included. 483 patients had long-COVID (26%, 95% CI 24-28%) at 12 weeks post-discharge. Symptoms like dizziness, joint pain, and headache varied by migration background. Clinical predictors of long-COVID were female sex, hospital admission duration, intensive care unit admission, and receiving oxygen, or corticosteroid therapy. Long-COVID risk was higher among patients with migration background than Dutch origin patients after adjustments for derived clinical predictors, age, smoking, vaccination status, comorbidities and remdesivir treatment.

Conclusions

There are significant differences in occurrence, nature of symptoms, and duration of long-COVID by migration background. Studies assessing functional limitations and access to post-COVID healthcare are needed to help plan for appropriate and accessible healthcare interventions.