bluuebunny/crossref_metadata_2025 huggingface dataset:
Unplanned emergency department attendances due to home and leisure accidents in the elderly Portugal
Authors: Alves T , Silva S , Braz P , Papadakaki M , Mexia R , Aniceto C , Matias-Dias C
Published: October 2024

Home and Leisure Accidents (HLA) have been identified as a relevant public health issue with individual, societal and economic consequences. So, common cause of injury-related morbidity and mortality, especially among older people. Evidence shows that most of HLA among the older ones are associated with identifiable and modifiable risk factors. However, more detailed information about the context and characteristics of such events is needed. This study aimed to characterize the occurrence of HLA in victims aged 65 and over related to hospital Emergency Department (ED) of the National Health Service in Portugal based on hospital records, through EVITA system. A descriptive analysis of the data was performed. Bivariate comparisons were performed using Pearson’s chi-square test with a significance level of 5%. In this analysis, the statistical program SPSS V.27 was used. During the 2022 year the older people aged 65 and over represented 25% of the total of attendances in the emergency department. In the 2022 year there were 70 452 HLA in people victims aged 65+, constituting 32% of hospital ED attendances by HLA (preliminary data). The results show that 65,9% of the attendances were amongst the age group of 75 years and beyond. More frequently reported in females (64,3%) than in males (35,6%), being these differences statistically significant (p < 0,01). The summer season for both age groups had higher proportion of HLA. In both age groups 65-74 years and 75 years and over most of HLA occurred at home (65,2%; 68,8%), followed by outdoor spaces (12,2%; 6,7%), public area (3,4%; 13,6%) and transport area (9,2%; 5,5%), these differences were statistically significant (p < 0,01). Regarding to the products/agents most involved in the HLA the “floor” was the leading category in age group 65-74 years (27,1%) and in the oldest 75 years and over (43,0%). Considering that globally HLA can be prevented, this information reinforces the importance of this problem and its magnitude.

Key messages

• The older people represented 25% of the total of attendances in the emergency department in the year in analysis. 13% of ED attendances occurred due to HLA.

• The National Injury Surveillance System provides information that allows to know the characteristics and circumstances of HLA that occur in older people.
Mapping barriers and bottlenecks for personalized preventive approaches in health systems worldwide
Authors: Scarsi N , Taha A , Farina S , Osti T , Russo L , Savoia C , Maio A , Villani L , Pastorino R , Boccia S
Published: October 2024

Over the past decades, the growing prevalence of chronic disease globally raised the public health need to plan tailored personalized preventive approaches, mainly through big data and -omic sciences. However, a conspicuous body of literature highlighted the existence of many barriers and bottlenecks hindering their actual implementation in real-word settings. From here, this scoping review of reviews aims to map all known barriers and bottlenecks to the implementation of personalized preventive approaches in European health systems and beyond. PubMed, Web of Science, Scopus and gray literature sources were consulted from 2017 to January 2023, identified barriers and bottlenecks were analyzed against the Consolidated Framework for Implementation Research (CFIR). Out of 11,602 records, 220 were deemed eligible for full-text screening, and a final sample of 34 review studies were extracted. Studies were mainly performed in USA 15 (44%) and UK 3 (9%), followed by Canada 2 (6%), India 2 (6%) and Italy 2 (6%). From our results, the lack of evidence on clinical utility, guidelines, specialized professionals, citizen trust and cultural issues are the most frequently reported barriers to the implementation of personalized preventive approaches worldwide. These in turn affect country specific policies and the applicability of such innovations across different populations, raising the risk of increasing health inequalities and discrimination concerns. Findings confirmed that most translational challenges pertain to primary and secondary prevention levels across several chronic diseases, with particular concerns for non-European ancestry individuals.

Key messages

• The identification of bottlenecks are informative of future precision public health interventions.

• Barriers reported in most of the studies suggest the need to establish a targeted agenda.
Health impact of the Serious Accidents Punishment Act in Korean occupational settings
Authors: Lee J , Yoon B , Oh J , Park H , Sim J , Yoon J
Published: October 2024

Background

Interrupted time series analysis serves as a valuable study design for assessing the efficacy of public health interventions implemented at a specific moment in time at the population level. We aim to elucidate the effects of the Serious Accidents Punishment Act implemented in February 2021 in Korea by analyzing changes in the incidence rates of occupational diseases.

Methods

The monthly data from patients with occupational diseases was extracted from the National Health Insurance Service Cohort database from 2011 to 2023. An Interrupted time series analysis with Poisson segmented regression was used to compare the rates before and after the Serious Accidents Punishment Act introduction in both outpatients and inpatients. Adjustments or stratification variables included sex, age, company size, and injury-related international classification of diseases codes (Injury, poisoning, and certain other consequences of external causes, S00-T88).

Results

Based on injury rates, men’s inpatient injury rates remained stable, but outpatient rates decreased after the act implementation, while women’s injury rates consistently declined in both inpatient and outpatient settings. The Interrupted time series regression analysis indicates that the Serious Accidents Punishment Act led to a significant reduction in both outpatient and inpatient injury rates for men and women, with a marked decline in outpatient rates and hospital admissions among women post-intervention.

Conclusions

The Interrupted time series regression results suggest that the Serious Accidents Punishment Act has been effective in reducing injury-related healthcare usage, highlighting the necessity of gender-specific interventions and the potential impact on lowering inpatient visits, although causality remains uncertain without further analysis.

Key messages

• The Serious Accidents Punishment Act significantly reduced occupational injury rates in Korea, especially among women, demonstrating effective public health intervention.

• Interrupted time series analysis reveals Serious Accidents Punishment Act’s impact on reducing healthcare usage for occupational injuries, highlighting the need for gender-specific approaches.
Loneliness and the prevalence of injuries, falls and fractures in older people
Authors: Ciochoń A , Kozela M , Pająk A
Published: October 2024

The feeling of being alone (loneliness) experienced by older people contributes to deterioration of health, reduced physical and mental fitness, or inability to continue life roles. Loneliness may lead to behaviors that increase the risk of accidents, falls, and fractures, which are particularly dangerous in old age. The aim of this study was to assess the relationship between loneliness and the prevalence of injuries, falls, and fractures in older people. The studied group consisted of 464 people (48% men), aged 62-86 years (mean: 71.6, SD: 6.3), who participated in the Polish part of the HAPIEE Study (Health Alcohol and Psychosocial Factors in Eastern Europe); random subsample examined in 2019-2020. Trained nurses interviewed respondents in their homes. The 3-item UCLA scale (range 3-9, cut-off point≥6) was used to assess loneliness. Data on injuries or accidents in previous 10 years, falls in previous 12 months, history of wrist, hip fracture or undergoing joint surgery/alloplastic was recorded. Multivariable logistic regression analysis was used. There were 460 participants included in the analysis. In 34 participants (7.3%) UCLA score was ≥6. In the previous 10 years, 95 respondents (20.5%) reported an injury or accident, 77 (16.6%) fell in previous 12 months. There were 6 (1.3%) respondents with history of hip fracture, 48 (10.3%) with history of wrist fracture, and 35 (7.5%) with history of joint surgery/alloplastic. No statistically significant relationship between loneliness and the prevalence of injuries, falls and fractures in older residents was found neither in the crude models nor after adjustment for covariates (age, sex, BMI, marital status, having offspring). Loneliness did not predict injuries, falls, and fractures in older urban residents. It seems that perception of being alone is weaker determinant of health as a measure not fully reflecting objective social isolation, which may actually have a greater impact on falls and injuries.

Key messages

• 1/5 of older people have experienced any injury or accident and 17% reported to have fallen in the previous year.

• Loneliness did not predict injuries, falls, and fractures in older urban residents.
Concept of a medical and public health cancer genomics platform
Authors: Specchia M L , Cozzolino M R , Cacciuttolo M G , Ammendolia A , Pastorino R , Boccia S
Published: October 2024

Background

This study aims to produce the concept of an open-access medical and public health cancer genomics platform aimed at aggregating and sharing documentation of ongoing initiatives and data resulting from the CAN.HEAL project, available for EU researchers, healthcare professionals, policy makers, citizens and patients.

Methods

The context (reference sector, stakeholders and research evidences), feasibility (privacy management and data processing), and platform’s end users were analysed; the CAN.HEAL project deliverables were listed and clustered; aspects related to the definition of the overall platform architecture and modules integration were studied.

Results

The project deliverables were catalogued into 8 categories which could be the platform’s cloud interface main labels: results from events, policy papers, newsletters, mapping results and reports, datasets, recommendations and guidelines, use cases, courses and training activities. To define the overall system architecture, the following key activities should be implemented: content management system choice, hosting configuration and setup of the development domain, content management system installation, development of HTML web pages, data entry, data visualisation and graphic layout, and test and debug. To the modules integration purposes the following items should be addressed: creation of a server analytics account; social network integration; activation of additional system for sending newsletters.

Conclusions

Cloud-based data platform allows to securely manage, integrate, analyse and share large datasets. Establishing an infrastructure to help researchers access, store and analyse large amounts of biological data is of paramount importance both to enable advances in research and support health policy making processes. The CAN.HEAL platform could help aligning clinical and population-based interventions for integrating the genome of Europe biobanking initiative into public health genomics for cancer.

Key messages

• Connecting healthcare data can support the challenge of accessing the relevant information needed for the policy and decision making processes to effectively promote population health and wellbeing.

• The set-up of a medical and public health cancer genomics platform promotes the effective translation of genome-based knowledge and technologies into public policy and health services.
Progressing towards personalised medicine: the Genomic Data Infrastructure (GDI) project
Authors: Pascucci E , Causio F A , Pesole G , Chiara M , Morelli M , Tonon G , Nicassio F , Pastorino R , Calabrò G E , Boccia S
Published: October 2024

Funded by the European Commission under the Digital Europe Programme and through co-funding from participating Member States, the European Genomic Data Infrastructure (GDI) aims to support the 1+Million Genome initiative for establishing an effective data infrastructure for genomic data. GDI has the potential to fill the gap between genomic research and clinical practice, promoting the implementation of data-driven precision medicine in Europe with the harmonisation of genomic and related phenotypic and clinical data across adhering countries. Launched in November 2022, the GDI project is a collaborative effort involving partners from 20 European countries, divided into 8 Work Packages across three Pillars. GDI is structured with the development of a framework (Pillar I Long-term sustainability) and the necessary tools (Pillar II 1+MG infrastructure deployment), with the implementations of use cases (Pillar III Application and innovation solution) to support research and innovation, integrate findings into the clinic and healthcare, and improve public health measures. In the first 2 years, we completed the starter kit which we are currently testing with real data. Over the subsequent years, the GDI project aims to provide a federated and sustainable infrastructure for facilitating research that use genomic data. Through authorized secure access, clinicians and researchers can leverage genomic insights for faster and more precise clinical decision-making, diagnosis, and treatments. The GDI project represents a significant opportunity to improve healthcare outcomes and public health measures by leveraging the potential of genomics. By providing secure access to extensive genomic datasets combined with phenotyped data, the infrastructure sets the foundation for international partnerships in personalized medicine. Ultimately, this initiative holds the promise of advancing medical understanding, enhancing patient care, and fostering economic growth across Europe.

Key messages

• GDI drives personalised medicine via international collaboration, building a sustainable infrastructure. Harmonizing data accelerates innovation, improving outcomes and fostering growth in Europe.

• GDI aims to revolutionize healthcare by collecting and harmonizing genomic and clinical data in Europe. It facilitates faster and more precise decisions and treatments, improving healthcare outcomes.
Risk perceptions and risk behavior among children attending a road safety education program in Greece
Authors: Vagionaki K , Lioliou S , Galathri E , Koutsodimitropoulou I , Tsitakis T , Poimenidou S , Markakis G , Gnardellis C H , Chliaoutakis J , Papadakaki M
Published: October 2024

Background

Road Traffic Injuries (RTI’s) are a significant public health concern for children, placing a considerable burden on their well-being. Greece has consistently recorded high numbers of RTI’s among adolescents.

Methods

A university lab (LaHeRS, HMU) offers a road safety education program for primary and secondary students in Heraklion, Greece. The program consists of two parallel sessions (practical training using a driving simulator and activity-based risk-perception training) aimed at enhancing competencies in resilience to peer influence, empowering children to engage in informed decision-making and fostering hazard perceptions skills. The current presentation reports on 800 students who attended the program between October 2023 and April 2024. A structured questionnaire was used to collect data on student’s beliefs, attitudes and practices on road safety.

Results

A total of 800 students attended the program from the broader Crete Region. 50.5% were girls with a mean age of 12.6 (SD = 2.3) years, 60.9% secondary education students, 58% resided in rural areas. 33.9% reported using a motorcycle and 33.8% a car without a driving license. 23.3% reported experiencing a road traffic incident while commuting. 57.1% identified road safety as a problem in their place of residence, only 26.5% felt safe on local streets and only 9.1% considered other road users as watchful. Additionally, 66.8% highly valued helmet use as a precaution in short distances. 71.6% reported always wearing seatbelt in front seats and 68.9% thought seatbelts are important at back seats. 52.1% did not identify themselves as risk takers on the street, and only 22.5% felt competent in avoiding road risks. 32.9% admitted experiencing peer pressure while commuting.

Conclusions

Risk taking behaviors and low use of protective measures are prevalent among school aged children and need to be addressed through targeted road safety education programs and interventions.

Key messages

• Promoting safe behaviors and enhancing risk perception is critical among children and young adolescents.

• Road safety education should be integrated into school curricula, starting from pre-school education.
A review on efficacy of polygenic risk score information on behavioral change and clinical outcomes
Authors: Russo L , Farina S , Perilli A , Adduci A , Cristiano A , Pastorino R , Boccia S , Ioannidis JPA
Published: October 2024

Background

Polygenic Risk Score (PRS) represents a promising advancement in personalized medicine, enabling the inherited risk assessment for disease outcomes based on the effect of various common genetic variants. The utilization of PRS information to promote the adoption of healthier behaviors has witnessed an increase interest in recent years, but its full potential still needs to be fully addressed.

Methods

This systematic review aims to assess the efficacy of disclosing PRS information on individuals’ engagement in risk-reducing interventions. CENTRAL database has been searched up to December 2023 to identify randomized controlled trials (RCTs) comparing the disclosure of PRS results, with scenarios where other or no information is provided. We performed a preliminary meta-analysis on the mean difference of clinical and psychological outcomes between the two arms.

Results

Out of 4419 results, we included 12 studies. Trials focused on primary (83%), secondary (8%) and tertiary (8%) preventive interventions. As for the possible diseases predicted by the PRS, cardiovascular diseases (33%) were the most common (n = 4), along with cancers (33%), diabetes (25%) and metabolic disease (8%). PRS result disclosure was compared to standard care (n = 7), no information provided (n = 4), and family risk (n = 1). By pooling data from four comparable studies, we report a reduction in the mean difference for LDL cholesterol in the intervention group of -6.39mg/dL (95%CI -10.09, -2.70, I²=0%, p < 0.001). No significant changes were observed for systolic and diastolic blood pressure, and weight, in 3 studies and 4 analyzed studies, respectively. An increase in anxiety levels was observed towards the PRS group in 4 studies (SMD 0.24, 95%CI 0.02, 0.46, I² = 66%, p = 0.03).

Conclusions

Preliminary analysis show small or no effects of PRS disclosure on intermediate health or psychological outcomes. Larger trials assessing the potentiality of PRS disclosure are still needed.

Key messages

• From the analysis of twelve preventive trials on the efficacy of PRS on behavior change, we report a positive effect on LDL cholesterol reduction.

• Larger well conducted trials are needed to integrate PRS-based information into future preventive strategies.
A university-based counseling program for perpetrators of family violence in Greece: initial evidence
Authors: Papadakaki M , Kounali V , Vagionaki K , Megge E , Manioti T H , Morfovasili M G , Dimitraki M , Toraki M , Mavridou S G , Vasilaki E
Published: October 2024

Penal mediation is defined in Greek Law 3500/2006 and aims at repairing the harm caused to the victim of family violence and rebuild family relationships. Mediation process starts upon victims’ unreserved consent and perpetrators’ willingness to stop further acts of violence, attend a counseling program and restore any harm/damage caused to the victim. Then the prosecutor ceases the case for 3 years and refers the perpetrator to counseling. If any of the previous conditions are violated during this period the criminal procedure continues at the stage before mediation. A university lab in Crete, Greece (LaHeRS, HMU) offers one of the few in Greece perpetrators’ behavior change programs in collaboration with the Prosecutor’s Office. LaHeRS counseling program consists of a minimum of 24 sessions per offender based on an individual or group approach. Emphasis is placed on perceptions of power and control, anger management, trauma management, emotional expression, and social/communication skills. Each perpetrator is offered 2 sessions (intake/violence documentation and assessment of individual/couples’ needs), 2-3 sessions for psychiatric and risk assessment, 12-15 individual or group counseling sessions (combined with couples’ sessions, as necessary), 2-4 individual social support sessions. Sessions are conducted by trained psychologists and social workers. The current presentation reports on the Intimate partner violence (IPV) cases referred between February 2022 and December 2023. A total of 70 IPV cases attended the program (male n = 65; mean age 43.4; Greek n = 56; urban residence n = 49; children average=1.92). Physical violence was reported in 54 cases and verbal aggression in 43 cases. Four perpetrators had mental health problems and 6 were identified with some form of drug and alcohol misuse. Lack of communication and emotional skills, lack of parent emotional support, gender roles stereotypes and patriarchal attitudes were common among perpetrators.

Key messages

• It is important for perpetrators’ programs to address the underlying causes of criminal behavior to promote positive changes in perpetrators’ lives.

• Effective penal mediation programs require collaboration and partnership between justice agencies, academia and community organizations.
Addressing deficits in malnutrition care in northern Sierra Leone; an educational intervention
Authors: Gabbott L
Published: October 2024

The 2017 Sierra Leone National Nutrition Survey reported poor practice regarding the medical management of severe acute malnutrition and the provision of emergency food to patients, particularly in the northern city of Makeni. We developed a training package for paediatric nurses, aiming to design an easily reproducible format which could be utilised nationally. Our aims were to empower and educate staff to provide more consistent care by challenging the negative cultural perception of malnourished patients and increasing knowledge of key guidelines. A two-day course based around UNICEF guidance on malnutrition was developed with the financial support of the Sierra Leonean office of the World Health Organisation. We sought the advice of local staff on issues impacting the quality of malnutrition care, including cultural barriers, educational limitations and supply issues. Lectures and practical sessions were devised covering recognition, assessment and management. Communication skills were taught using role play, focussing on the key role of nurses in parental education, and nursing skills were reinforced using practical tasks. Local staff identified for their strong teaching and leadership were recruited as instructors and to provide feedback on session design and content. 21 candidates attended from across the region, with the majority based in inpatient feeding units. Candidates completed a pre- and post-course written examination and a qualitative feedback form. Pre-course exam results ranged from 35%-85% with an average of 65%; post-course results showed improvement with a range of 55%-100% and an average of 88%. Candidates rated the course on average 9.7 out of 10 and the written feedback was positive. We subsequently observed positive changes in clinical practice in the inpatient feeding units across the region. Based on these assessments the course achieved its aims. Further study is needed to know if noted clinical improvements were sustained.

Key messages

• Challenging local cultural perceptions of malnourished patients is crucial to establishing improvement in medical care for this group.

• Sustainable educational intervention requires local instructors who can independently deliver teaching, and establishing this cohort at the course inception is critical to its ongoing success.
Professionals’ perspectives on barriers for timely antenatal care for ethnic minority women
Authors: Puthussery S , Verstraeten A , Ilozumba O
Published: October 2024

Background

Antenatal care (ANC) is important to promote health and well-being of women and babies. Women from ethnic minority backgrounds are likely to start ANC later and to attend fewer appointments than recommended compared to white women. These women and their babies are more likely to experience negative health outcomes. This study explored the perspectives of maternity care professionals on barriers for timely ANC initiation for ethnic minority women in the UK (UK) and The Netherlands.

Methods

We conducted qualitative semi structured in-depth interviews with 19 healthcare professionals (eight and eleven from the UK and The Netherlands respectively) including nurses, midwives, general practitioners and obstetricians. All interviews were conducted virtually on Teams or Zoom and were recorded, transcribed and analysed using a thematic approach using ATLAS.ti version 9 software.

Results

Maternity care professionals in the UK and The Netherlands perceived more or less similar barriers for ethnic minority women for timely ANC initiation. As reflected in the accounts, these barriers operated at individual and health system levels, and included negative interactions with antenatal care providers, women’s and community’s lack of trust in the health system, differences in spoken language between women and professionals, cultural differences, role of family and wider networks, and difficulties in reaching care. Perceived measures to facilitate access included skill development of healthcare professionals; educating women and building awareness in the community about how to navigate the healthcare system; integration of preventative psychosocial care into maternity services and continuity of care.

Conclusions

Similarity in perceived barriers and mitigation measures indicated the potential for developing and implementing targeted cross-country interventions to facilitate timely ANC initiation for ethnic minority women in high-income European countries.

Key messages

• Maternity care professionals in the UK and The Netherlands perceived similar barriers for ethnic minority women for timely ANC initiation.

• There is potential for developing targeted cross-country programmes and services to support mothers from ethnic minority backgrounds to start antenatal care on time.
Inequalities in preterm birth by deprivation and ethnicity: A national cohort study in England
Authors: Hindes I , Zenner D , Ibrahim B , Jardine J , Iliodromiti S
Published: October 2024

Background

Preterm birth has decreased in the UK; however, the extent of inequalities remains unclear. This study aimed to quantify socioeconomic and ethnic inequalities in preterm birth rates using routinely collected maternity data in England.

Methods

Retrospective analysis of cohort data from the NHS England Hospital Episode Statistics (HES). All women aged 13-55 with a singleton livebirth (April 2018 to March 2021) at 24-42 weeks were included. Multivariate Poisson regression was used to estimate the rate of preterm birth (livebirth between 24 + 0 and 36 + 6 weeks’) for each ethnic and deprivation postcode group, these were compared to white women from the least deprived 20% of areas. We iteratively developed the model, adjusting for covariates associated with preterm birth. A post-hoc calculation identified the rate of preterm birth for each ethnic group at each level of deprivation.

Results

We identified 1,111,045 livebirths between April 2018 and March 2021. The rate of preterm birth increased with socioeconomic deprivation and was highest at 7.1% per 100 livebirths (95%CI:7.00-7.20) in women living in the 20% most deprived areas, compared to 5.6% (95%CI:5.50-5.74) in women in the 20% least deprived areas. White women had the lowest preterm birth rate at 6.5% (95%CI:6.47-6.58) and South Asian women had the highest rate at 6.9% (95%CI:6.76-7.04) (Table 2). The rate of preterm birth increased according to increased area-level deprivation across all ethnic groups. In areas of high deprivation, the preterm birth rate was similar across ethnic groups. Whereas in less deprived areas, there were marked inequalities between ethnic groups.

Conclusions

Inequalities in preterm birth remain, despite overall decreases in preterm birth. We found area deprivation and individual ethnicity interact to increase the risk of preterm birth in marginalized communities. Interventions need to holistically consider the structural and socioenvironmental determinants of preterm birth.

Key messages

• Area deprivation and ethnicity remain key drivers of inequalities in preterm birth, despite overall decreases in preterm birth.

• To reduce inequalities tailored prevention strategies are needed to address socioenvironmental and structural determinants of preterm birth in high deprivation areas and minoritized ethnicity groups.
Physical fitness in youth: a systematic review of changes during and after the COVID-19 pandemic
Authors: Ludwig-Walz H , Heinisch S , Siemens W , Niessner C , Eberhardt T , Dannheim I , Bös K , Bujard M
Published: October 2024

Background

Restrictions during the COVID-19 pandemic induced changes in the fitness behavior of children and adolescents, which may be associated with long-term public health challenges. This systematic review analyses how physical fitness has changed during the pandemic and to what extent the changes remain in the aftermath of the pandemic.

Methods

We conducted a systematic search in seven databases with a peer-reviewed search string for studies until Dec 2023. Our inclusion criteria encompassed studies with children and adolescents ≤19 years living in the WHO European Region and in which validated measurements were used (single measurements or test batteries). Eligibility screening, data extraction and risk of bias assessment (using ROBINS-E instrument) were all carried out independently by two reviewers. We published an a priori protocol in a peer-review journal and conducted reporting in accordance with the PRISMA 2020 statement. Trial registration: PROSPERO: CRD42023395871.

Results

Our search retrieved 28 studies from 15 WHO European Region countries with an age range from 5 to 19 years. Physical fitness was reported in 21 validated single measurements (e.g. 20 m shuttle run, handgrip strength, standing long jump) and 9 validated test batteries (e.g. Alpha-Fitness Battery, German Motor Test, International Physical Performance Test Profile). The preliminary analyses pointed to a sharp decline in youth physical fitness during the COVID-19 pandemic. After restrictions were eased, physical fitness improved, but remained under pre-pandemic levels, particularly in boys.

Conclusions

The findings indicate a potential suboptimal behavioral adaptation of children and adolescents after the COVID-19 pandemic. Medium and long-term programs to change passive behavior and improve physical fitness are urgently needed. In addition to individual prevention programs, stronger consideration should also be given to schools and sport clubs regarding activities promoting physical fitness.

Key messages

• Physical fitness in children and adolescents remains below pre-pandemic levels after restrictions removal.

• Initiating immediate public health action to increase physical fitness is urgently needed.
Online Forum Conversations on Abortion in Poland: Navigating Medical, Emotional, and Legal Challenges
Authors: Klimiuk K B , Kot A , Balwicki Ł
Published: October 2024

Background

Abortion is a common medical procedure worldwide, but access is restricted in Poland, forcing many women to seek abortions without medical supervision. This can lead to health risks and reflects broader challenges regarding reproductive rights and healthcare.

Methods

We conducted a qualitative and quantitative analysis of online forums discussing abortion to understand the challenges faced by women in Poland. Data was gathered from popular abortion forums identified through Google searches, with a pilot study refining the research focus.

Results

A total of 13,397 responses from 370 threads across 4 forums were analyzed. The most prevalent theme was the ‘Abortion Process Progression,’ indicating a strong need for information and support. Discussions on ‘Emotional and Psychological Aspects’ and ‘Medical and Pharmacological Aspects’ highlighted the need for holistic care. This suggests that legal restrictions and fear of repercussions hinder women’s access to professional assistance, exacerbating health disparities and inequalities.

Conclusions

This study offers a general look at the abortion experiences of Polish women, revealing challenges that often go unnoticed by policymakers and healthcare professionals. By analyzing online forums, it uncovers nuanced issues such as the lack of access to medical supervision, information gaps, and emotional support, highlighting discrepancies between policy and needs. The findings call for decriminalizing abortion, launching educational campaigns to combat misinformation, and strengthening support systems, aligning Poland’s reproductive health services with European Union standards, ensuring women’s access to safe and supportive healthcare.

Key messages

• This study shows how Poland’s restrictive abortion laws push women to online forums, revealing medical, emotional, and logistical challenges, emphasizing the need for care and accurate information.

• The research highlights the need for decriminalizing abortion, addressing misinformation, and support Poland’s reproductive health services with EU standards, ensuring safer care for women.
Inequalities in education in the COVID-19 pandemic: health and education professionals’ perspectives
Authors: Gray N J , Backhaus I L , Manandhar S , Beck M , Chabot C , Jourdan J , Eikemo T A
Published: October 2024

Background

Cycles of school closure and reopening during the COVID-19 pandemic, coupled with remote learning, led to concerns about increasing inequality in education that persist in 2024. The aim of this abstract, within a wider study of safe school reopening, is to explore health and education professionals’ perceptions of inequalities among students during the pandemic.

Methods

In 2021, online semi-structured interviews were conducted in 6 languages with education and health professionals. They explored the: 1-effect of the pandemic on schools/pupils/teachers; 2-reorganisation of schools; 3-experience of implementing infection control measures in schools; 4-intersectoral working; 5-important resources for keeping schools open. Interviews were transcribed verbatim and translated into English where needed. A deductive qualitative analysis was undertaken using the conceptual framework developed by the United Nations H6+ Technical Working Group on Adolescent Health and Well-Being. Domain 3 (safety and supportive environment) includes consideration of equality.

Results

62 interviews were included in the analysis (22 health and 40 education professionals from 28 countries). Professionals perceived greater negative impact on education for specific groups of students. Those with chronic illness stayed out of school for longer than others. Good access to distance learning was difficult for students from rural areas (lack of internet/electricity), disadvantaged families (lack of electronic equipment) or larger families (less learning space at home).

Conclusions

Professionals perceived that school closures intensified the disadvantage experienced by certain groups of students, exacerbating inequalities in education. Targeted catch-up strategies are still needed.

Key messages

• School closure during the COVID-19 pandemic have exacerbated inequalities in education.

• In future health crisis impacting schooling, targeted catch-up strategies would be needed for certain groups of students.
Influenza and COVID-19 vaccines in pregnancy: investigation on associated factors and HAPA theory
Authors: Fallucca A , Immordino P , Ferro P , Mazzeo L , Petta S , Maiorana A , Maranto M , Casuccio A , Restivo V
Published: October 2024

Background

Infections caused by influenza and COVID-19 during pregnancy represent a current public health problem as there are multiple populations at risk of complications: pregnant women, fetus, and future unborn children. The anatomical and physiological remodulation characteristic of pregnancy is responsible for the high pathological burden related to respiratory infections. Co-administration of influenza and COVID-19 vaccines may be beneficial because these two respiratory viruses cocirculate during cold weather. The need to explore pregnant women’s attitudes toward co-administration of influenza and COVID-19 vaccines and to evaluate factors associated with vaccine decision-making led to the conduct of this study.

Methods

In Palermo, Italy, during the 2021-2022 influenza season, a cross-sectional study was conducted to evaluate pregnant women’s intention to adhere to co-administration of influenza and COVID-19 vaccines. The determinants of vaccination attitudes were investigated through the administration of a questionnaire. The Health Action Process Approach theory (HAPA) was adopted to explore the cognitive behavioral aspects.

Results

Overall, 120 pregnant women were enrolled; average age 32 years, 98.2% (n = 118) of Italian nationality and 25.2% (n = 30) with obstetric or pathological conditions of pregnancy at risk. Factors significantly associated with attitudes toward co-administration of influenza and COVID-19 vaccines among pregnant women were: high level of education (OR = 13.96; p < 0.001), expectations of a positive outcome (OR = 2.84; p < 0.001) and self-efficacy (OR = 3.1; p < 0.001).

Conclusions

Vaccines co-administration could represent an advantageous preventive practice to facilitate vaccination logistics and allow full adherence to vaccinations recommended to pregnant women. Effective strategies to promote co-administration of influenza and COVID-19 vaccines could be focused on counselling about the expectation of positive outcomes of vaccine co-administration.

Key messages

• The need to explore pregnant women’s attitudes toward co-administration of influenza and COVID-19 vaccines and to evaluate determinants of vaccine decision-making led to the conduct of this study.

• Vaccines co-administration could represent an advantageous preventive practice to facilitate vaccination logistics and allow full adherence to vaccinations recommended to pregnant women.
Risk factors for the gambling, smoking and alcohol consumption triad in Portuguese adolescents
Authors: Ramos P , Alves J
Published: October 2024

Background

Addiction to gambling, tobacco, and alcohol poses significant risks to mental, social, and physical health, particularly during adolescence, a critical period for habit formation. This study investigates risk factors linked to these habits among Portuguese adolescents.

Methods

This cross-sectional study used the 2019 ESPAD questionnaire, targeting 16-year-old adolescents. The sample comprised 4,365 responses. Descriptive analysis determined the prevalence of gambling, smoking, and alcohol use, as well as social, economic, and behavioral factors. Bivariate associations were assessed using the Exact Fisher test, and multiple logistic regression identified key predictors for the outcome of interest (cumulative presence of gambling, smoking and alcohol consumption). Statistical analysis was conducted with SPSS version 29.0, with a significance level of p < 0.05.

Results

Among adolescents, 6.2% presented probable problematic gambling according to the Lie/Bet test, with 3.7% spending at least 30 minutes a day gambling. In the past 30 days, 14.3% smoked, 42.7% drank alcohol, and 10.5% engaged in binge drinking. The behavioral triad was observed in 56 individuals. Male gender (OR = 2.024; 95% CI: 1.097-3.734; p = 0.024), problematic online gaming behavior (OR = 2.041; 95% CI: 1.005-4.144; p = 0.048) and going out at night at least once a week (OR = 1.439; 95% CI: 1.242-1.669; p < 0.001) significantly increased the risk of the behavioral triad. In contrast, parental control (parents knowing where the adolescent is on Saturday night) had a significant protective effect (OR = 0.162; 95% CI: 0.086-0.303; p < 0.001).

Conclusions

The study underscores the importance of parental supervision to curb risky behaviors in adolescents. It suggests implementing public health programs in schools, leveraging gaming for early screening, and tightening online gambling regulations to mitigate future health risks associated with gambling, smoking, and alcohol use.

Key messages

• Absence of parental supervision, male gender, problematic online gaming and frequently going out at night are risk factors for this behavioral triad.

• Public health strategies are needed to prevent gambling addiction, emphasizing parental awareness, identification of at-risk students, and comprehensive school-based approaches.
An evaluation over time: Dipsalut’s “Program for families”
Authors: Soler E , Estrada M
Published: October 2024

Issue

Dipsalut’s “Program for Families” is a parental skills and positive parenting program aimed at all fathers, mothers, and other adult caregivers of children aged 3 to 12 in the province of Girona, Spain. The Program is based on the Convention on the Rights of the Child (1989), which recommends that states promote programs that develop parenting styles that respect children’s rights to be heard and recognized. Research supports that offering parenting skills to parents contributes to the child’s well-being throughout the growth stage.

Description

The program began in 2018 in a pilot phase that lasted until 2019, when the first evaluation was done to compare different methodologies. After selecting a definitive one (based on the method of Adele Faber and Elaine Mazlish), in 2023, an external evaluation was done, with a follow-up of participants from previous editions. In this evaluation process, we considered the durability of the contents over time, evolutions of assistance, and comparison of the modalities of 4 and 6 sessions. A quantitative methodology has been used through a self-administered questionnaire addressed to the participants (387 responses).

Results

Impact of the program: 78% of parents value the program as having a positive impact on their parenting skills. Durability: there are differences in how the passage of time affects content retention. Impact of attendance: the parenting skills of those who have attended all program sessions last longer. The attendance percentage at all sessions was higher (61.4%) in the four-session modality.

Lessons

Although families do not remember all the tools learned, their confidence, the improvement in the family atmosphere, and the fact that they feel more skilled are maintained over time. Main messages: Families have improved their parenting skills since the program gives them more tools to manage family conflicts, to promote their children’s self-esteem and to encourage their autonomy.

Key messages

• With the positive parenting program, parents increase their self-confidence to manage the challenges of parenting, especially in intra-family communication and conflict management.

• It is essential to promote positive parenting programs with an experiential methodology and maintained over time.
“Friendships fizzled out”: Trajectories and risk factors of youth loneliness following COVID-19
Authors: Rahmon I , Mol M A , van Leersum-Bekebrede L , Dückers M , Marra E
Published: October 2024

Background

Social distancing and isolation during the COVID-19 pandemic left a mark on the social, emotional and cognitive development of youth. We aimed to identify the course of Dutch youth loneliness and its predictors since the Omicron lockdown in December 2021.

Methods

Data were obtained from a repeated cross-sectional panel study between March 2022 and September 2023, in which loneliness was assessed using the 6-item De Jong Gierveld Loneliness Scale. Youth (12-25 years) participating in at least three timepoints were included. A latent class growth analysis (LCGA) was performed to identify trajectories of loneliness. Themes identified in qualitative data (open-ended questions halfway 2022) were recoded into binary quantitative variables to be included in regression analyses. Two-step multivariable multinomial logistic regression was used to determine risk factors per trajectory class. Goodness of fit was assessed using the likelihood-ratio test.

Results

Identified trajectories were: 1) very lonely (n = 140), 2) moderate lonely (n = 373), 3) recovering (n = 511), and 4) not lonely (n = 384; reference). Compared to the other trajectories, youngsters following a moderate or very lonely trajectory had more often little to no trust in the future and more often experienced non-specific symptoms and stress due to various causes. Including perceptions showed that youth in these trajectories experienced a greater impact of the pandemic on their social relationships. The inclusion of perception also improved the model’s goodness of fit (p < 0.001).

Conclusions

Up to 18 months after the COVID-19 pandemic, youngsters that reported loneliness continue to endure its consequences on their social lives. Despite the apparent association between the Omicron lockdown and continuing loneliness, claims about causality should be made with caution. However, findings implicate the importance of political and social recognition of the pandemic’s ongoing impact on vulnerable youth.

Key messages

• Lonely youth experienced a greater impact of the COVID-19 pandemic on their social lives.

• Political and social recognition of the pandemic’s ongoing impact on vulnerable youth is wanted.