bluuebunny/crossref_metadata_2025 huggingface dataset:
Training to improve the vaccination offer: the experience of the AcToVax4NAM project
Authors: Marchetti G , Russo M L , D’Angelo F , Gatta A , Mondera F , Bartolucci C , Aloise I , Scarso S , Tosti M E , Marceca M
Published: October 2023

Background

Developing training activities material with the aim of strengthening vaccination literacy and cultural aware approach among “Professional-FOR-health”, all health and social care workers and other professionals working in the field of the immunization of Newley Arrived Migrants (NAMs), is part of the activities of the project “Access To Vaccination for Newly Arrived Migrants”-AcToVax4NAM (Grant n.101018349, 3rdEU Health Programme).

Objectives

The Italian project Team, Sapienza University of Rome and Italian National Health Institute, designed the framework for training to strengthen the healthcare system Vaccination Literacy and responsiveness among Professional-FOR-health, in order to increase the capacity building skills and cultural sensitivity of the healthcare system in promoting active immunization of NAMs. The training materials were shared to all Consortium Countries (Cyprus, Germany, Greece, Italy, Malta, Poland, Romania, Spain) to be implemented in their context.

Results

The targets of the training activities are health professionals responsible for vaccination, professionals from other services that meet NAMs or promote vaccination (GPs/FPs), professionals active in the target area (NGOs). We designed a blended training, face to face sessions, web sessions should alternate. The topics are “Vaccine Literacy”, “Cultural awareness/migrant sensitivity”, “Health promotion tools with community-based approach” and “Entitlement to vaccination for NAMs/NAMs profile”. 4 evaluation tools were constructed: a pre- and post-test learning, an exploratory survey on the level of vaccine literacy of the organisations involved, a satisfaction questionnaire.

Conclusions

Each country will construct, based on the resources made available, a course that is as adherent as possible to the context of its own country and target group. This type of training can be the groundwork for the changes needed to make the NAMs vaccination process more guaranteed and inclusive.

Key messages

• It is important to stimulate a training process that enables health professionals to reconnect their daily experiences with a broader context of thinking, for a real empowerment process.

• As learners’ cannot be seen as mere recipients of notions and information, their needs, motivations and experiences should be put right at the centre of the training process.
The socioeconomic impact of in-silico models for implantable medical devices: a conceptual framework
Authors: Eisenberg S , Czypionka T , Kraus M , Reiss M , Rösler D
Published: October 2023

The use of in-silico technologies for implantable medical devices has gained importance in the last decade. From a medical perspective, the term ‘in-silico’ mainly refers to computer simulations of clinical trials based on virtual cohorts. So far, there is a lack of a concept how the impact of in-silico models on socioeconomic factors can be evaluated. As part of the EU-funded project SIMCOR, one objective was to conceptualize the impact of in-silico on implantable medical devices. We applied an iterative process described in Jabareen (2009) to build a conceptual framework based on concepts from a comprehensive literature review and expert interviews from academia, companies, and regulatory bodies. Repeated steps of literature work, exploratory interviews and discussion sessions among the research team led to the final framework that was validated by feedback from experts at the end. The conceptual framework describes the impact from in-silico technologies along the product development cycle of implantable medical devices through impact channels up to socio-economic endpoints referring to firm, market, health system and society. Since the whole conceptual framework has multiple complex impact channels that create a kind of network, each impact channel is explained with its ramifications. One channel reveals that underrepresented patient groups in clinical trials might benefit from in-silico models by enabling to model rarer anatomical configurations and leading to medical device development for a broader range of population. The conceptual framework provides the basis for the quantification of the impacts of in-silico models that is expected to increase the acceptance of these models among different stakeholders. The potential benefits as well as disadvantages can be better estimated and classified from different perspectives. The use of in-silico models is expected to enable access to implantable devices faster and to a larger population group.

Key messages

• The framework reveals opportunities of in-silico models for different stakeholders, e.g., entrepreneurs, regulators, that might lead to an increased development, use and acceptance of such models.

• The framework indicates that in-silico models are expected to accelerate implantable medical device development, increase patient safety, and gain faster access for larger population groups.
Community health workers in Belgium
Authors: Masquillier C , Op de Beeck E , Vroonen L , van Iseghem T , Bastiaens H , van Olmen J , Verhaege N , Wouters E
Published: October 2023

Despite the fact that Belgium implemented various reforms to make Primary Health Care (PHC) more affordable and accessible, inequalities in access to care are still increasing. The COVID-19 pandemic has additionally exacerbated the access to care challenges for people living in socio-economic vulnerable circumstances in Belgium. In order to achieve Sustainable Development Goal 3 (Good health and well-being for all), a healthcare system innovation is clearly needed. The COVID-19 pandemic provided impetus for introducing community health workers (CHWs) throughout Belgium at the start of 2021 - instigated by the Belgian Federal Government and executed by Intermut. The CHWs are, however, not fully integrated in the healthcare system. This presentation will provide an overview of the current state of CHWs in Belgium. To explore the potential of integrating CHWs in the Belgian health system, the research team is designing a new CHW-model. Since the country is also confronted with increasing health demands and limited budgets, there is impetus to tap into the potential of innovations from low and middle-income countries (LMICs). A review of health innovations in LIMCs and a theoretical analysis on the required characteristics of such a new model resulted in a CHW intervention - inspired by the Family Health System in Brazil and Re-engineering PHC in South Africa. The CHWs play a central part in both countries’ innovative health models which use designated health teams - consisting of one physician, one nurse, one nurse aide, and from four to twelve full-time CHWs. Each team interacts with all households in a geographically defined community. The team is the first entry point into the healthcare system and provides a wide range of primary care services to all individuals in a household over the life course in a pro-active manner. In this presentation we will show, how we can learn from innovation CHW-models in LMICs to address access to healthcare challenges in Belgium.
Ensuring health and wellbeing of Ukrainian refugees in the UK: the role of initial health assessments and local authority involvement
Authors: Deal A , Lau K , Hargreaves S
Published: October 2023

Since the beginning of the crisis in Ukraine, local authorities in the UK have facilitated the resettlement of over 150,000 Ukrainian refugees (as of February 2023) to the country. In this presentation, Anna Deal will discuss a UK case study based on her recent research working closely with local authorities in London to conduct a health and wellbeing needs assessment, exploring the situation facing Ukrainians and other key nationality groups on arrival. This presentation will focus on identified health and social needs of Ukrainians and current healthcare provision, including initial health assessments and catch-up vaccination delivery, for Ukrainians on arrival and how this varies under different local authorities. It will conclude by summarising key challenges faced in delivery of services and recommendations and implications for improving service delivery, both in the UK and other European countries hosting Ukrainian refugees.
Can housing conditions and features affect well-being? A review through Indoor Environmental Quality aspects and Mental Health implications
Authors: Rebecchi A , Gola M , Riva A , Capolongo S
Published: October 2023

The purpose of the scoping review is to explore the relationship between housing conditions, Indoor Environmental Quality (IEQ), and mental health implications on human well-being. In fact, time spent at home increased due to the recent COVID-19 lockdown period, and social-sanitary emergencies are expected to grow due to the urbanization phenomenon. Thus, the role of the physical environment in which we live, study, and work, has become of crucial importance, as the literature has recently highlighted. This scoping review, conducted on the electronic database Scopus, led to the identification of 366 articles. This, after the screening processes based on the inclusion criteria, led to the final inclusion of 31 papers related specifically to the OECD area. The review allowed the identification of five housing conditions [house type, age, and floor level; housing qualities; household composition; neighborhood; green spaces] that, by influencing the IEQ parameters, had impacts on the mental health outcomes addressed. By synthesizing the contributions of the review, a list of design recommendations has been provided. These will serve as a basis for future researchers, from which to develop measures to reduce inequalities in housing by making them healthier, more resilient, and salutogenic.
Inequalities in oral health service utilisation in Ireland: results from the Healthy Ireland Survey
Authors: Cosgrave E , Sheridan A , Kavanagh P , McAuliffe U , Burke S , Harding M , Johnson H
Published: October 2023

Background

Good oral health is important for overall health and wellbeing; poor oral health disproportionately affects disadvantaged groups and is associated with various non-communicable diseases, many of which have shared risk factors, including diabetes and cardiovascular disease. Regular dental attendance with risk assessment optimises oral health. Due to an ageing dentate population, demands on oral health services are predicted to increase in Ireland. This cross-sectional assessment of oral health service utilisation aimed to inform equitable national resource allocation.

Methods

Secondary analysis of the Healthy Ireland Survey 2022, a telephone-delivered survey of a representative sample of the Irish public aged ≥15 years, was conducted. Prevalence of dental attendance in the preceding year was measured with 95% Confidence Intervals (CIs). Logistic regression determined factors associated with dental attendance using Adjusted Odds Ratios (aORs).

Results

Response rate was 40.4% (N = 7,455). Most participants (81.3%) self-reported good or very good overall oral health; 49.3% had attended dental services in the previous year. Compared to comparative counterparts those of higher educational level (aOR 1.28 95% CI 1.09-1.50), those with private health insurance (aOR 1.66 95% CI 1.48-1.86) and those with no missing teeth (aOR 2.91 95% CI 2.19-3.85) were significantly more likely to have attended dental services in the previous year. Conversely, compared to those aged 25-34 years, those aged 65+ had significantly lower odds of dental attendance in the previous year.

Conclusions

Disparities in oral healthcare utilisation identified in this study suggest potential unmet population oral health needs. Combined with population ageing and a growing scarcity of dentists available to provide care to disadvantaged groups such coverage gaps are key considerations for Irish oral healthcare planning, namely implementation of Ireland's National Oral Health Policy ‘Smile agus Sláinte’ 2019.

Key messages

• In this nationally representative cross-sectional survey of Irish adults notable disparities in oral health service utilisation were evident, especially among older adults.

• Aligning with the universal health coverage agenda, suggested unmet population oral health needs are key considerations for national and international oral healthcare planning and resource allocation.
Ethnic disparity in cancer mortality in adult Fijian women, 2013-17
Authors: Dearie C , Figueroa C , Linhart C , Rafai E , Dobbins T , Morrell S , Taylor R
Published: October 2023

Background

Fiji, population 884,887 (2017 census), is a Pacific Island country with two dominant ethnic groups: 62% Indigenous Fijians (i-Taukei) and 31% Fijians of Indian descent (FID). Cancer mortality by ethnicity for women aged 30-69 years was investigated.

Methods

Proportional mortality and probability of dying (PoD30-70) from cancer (ICD-10: C00-D48) for women aged 30-69 years were calculated from empirical unit mortality data by ethnicity. PoD30-70 is the cumulative mortality risk derived from the cumulative rate, from mortality rates by 5-year age group.

Results

Cancer was reported as the underlying cause in 21% of deaths of Fijian women aged 30-69 years; 25% for i-Taukei and 14% for FID women. This ethnic disparity was consistent across cancer sites, including breast, cervical/uterine and ovarian cancers. Empirically derived PoD30-70 from all cancers (ICD-10 C00-D48) was 9.6% (95%CI: 9.1-10.1%) for Fijian women; higher for i-Taukei (12.1%; 95%CI: 11.4-12.8%) than FID women (6.6%; 95%CI: 5.9-7.2%). Globocan 2020 estimates the highest PoD30-70 from all cancers in women was 10.8% in Malawi; for Fiji, Globocan estimates of 9.2%, from 2008-2012 mortality rates applied to the 2020 population, are comparable to empirically derived PoD30-70. From empirical data, PoD30-70 from breast cancer for Fijian women was 2.9% (95%CI: 2.6-3.1%), higher in i-Taukei (3.8%; 95%CI: 3.4-4.2%) and lower in FID women (1.7%; 95%CI: 1.4-2.1%). Globocan 2020 estimates of PoD30-70 due to breast cancer was highest in Barbados (3.6%), followed by Fiji (3.4%). PoD30-70 due to cervical/uterine and ovarian cancer was approximately double for i-Taukei (3·2 and 1·0%) compared to FID women (1·5 and 0·5%).

Conclusions

PoD30-70 due to breast cancer and all cancers was higher in i-Taukei Fijian women than in other countries and was double that of FID women. High incidence and late diagnosis contribute to high cancer mortality; differences between i-Taukei and FID women require further investigation.

Key messages

• Probability of dying due to breast cancer, and all cancers, was higher for i-Taukei women in Fiji than for women in other countries, and double that of Fijian women of Indian descent.

• High incidence and late diagnosis contribute to high cancer mortality; further investigation is required to determine how these, and other potential factors, contribute to ethnic differences.
Virtual Reality simulation training improves health professionals’ knowledge in STEMI critical care
Authors: Licata S , Deroma L , Fresco C , Di Chiara A
Published: October 2023

Background

In Friuli-Venezia Giulia (FVG, Italy, 1.2M inhabitants), the STEMI network has been implemented with a regional educational programme since 2018. However, each step leading to a fast-track reperfusion needs specific interactions between critical care teams on the scene and in hospital that theoretical training cannot provide.

Objectives

A new educational tool, based on virtual reality (VR), was developed to train emergency nurses and doctors on the STEMI pathway. Each training session consisted of a VR simulation, dynamically driven by an instructor, where a nurse-doctor pair had to provide first aid to a patient with chest pain. A plenary debriefing followed each session. Before and after the training, all participants filled out a questionnaire on the STEMI pathway (21 multiple-choice items on technical and organizational issues) to evaluate the course theoretical effectiveness. This research is part of the EASY-NET program, co-funded by the Ministry of Health and the participating Regions (NET-2016-02364191).

Results

Between Oct ’22 and Jan ’23, 48 nurses and 14 doctors were trained and filled in both pre- and post-training questionnaires. Before the training, the median number of correct answers was 15 (IQR 13-16), after the course it rose to 16 (IQR 15-17, p < 0.0001); doctors performed better than nurses both at pre- (16, IQR 15-17 and 14.5, IQR 12.5-16, respectively; p = 0.017) and post-test (18, IQR 15-18 vs 16, IQR 15-17; p < 0,0001) but both categories significantly improved their scores (p = 0.019 and p = 0.0001). The main improvement was observed for items concerning the Case Manager's actions after ECG, (right answers: 58 post-test vs 45 pre, p = 0.0016), morphine administration, (37 vs 25, p = 0.0073), and therapy in vagal reaction (46 vs 35, p = 0.0116).

Conclusions

An innovative VR simulation training improves the theoretical knowledge of the critical care pathway of STEMI in healthcare teams, which may lead to a better approach to this disease.

Key messages

• A new Virtual Reality simulation tool is useful for the training of doctors and nurses in patients with STEMI.

• Simulation tools based on Virtual Reality can improve health professionals’ theoretical knowledge in critical care pathways.
Body dissatisfaction in the classroom context and adolescent psychological complaints
Authors: Granvik Saminathen M , Wahlström J , Låftman S B , Modin B , Rajaleid K , Löfstedt P
Published: October 2023

Background

Body dissatisfaction, which refers to negative feelings towards one's own body shape, size, weight, or appearance, has been indicated to be a risk factor for a range of adverse health-related outcomes among youth. Although previous research has investigated the link between adolescents’ own body image and psychological outcomes, the contextual effect of body dissatisfaction on individual health has not been explored. The purpose of this study was to examine if the concentration of students with a negative body image in the classroom was associated with individual students’ psychological complaints.

Methods

Data was obtained from the 2017/18 Swedish Health Behaviour in School-aged Children (HBSC) study, a cross-sectional survey among 13- and 15-year-olds (n = 2,619 in 145 school classes). Body image was captured by one question on perceived body size and one question on weight change attitude/behaviour. Psychological complaints were measured by self-reports on the frequency of feeling low, irritable, nervous, and having difficulties falling asleep, which were summed to an index. Gender, school grade, socioeconomic status, and immigration background were included as covariates. Two-level random intercept linear regression models were performed.

Results

The proportion of students in the classroom with a negative body image was associated with higher levels of psychological complaints (dissatisfaction with perceived body size b = 0.02, p < 0.05; desire/attempts to change weight b = 0.02, p < 0.01), even when adjusting for the corresponding measures at the student level. These associations were driven by the class-level dissatisfaction related to perceiving oneself as too fat or wanting to lose weight.

Conclusions

The study found that body dissatisfaction among classmates was associated with psychological complaints in individual students. Reducing body dissatisfaction among adolescents could improve the well-being not only of the individual but also of their peers.

Key messages

• The study found that the proportion of classmates who reported body dissatisfaction was associated with individual-level psychological complaints.

• Interventions aimed at reducing body dissatisfaction among adolescents have the potential to improve the well-being of both the individual and their peers.
Behind the screens: What underlies the experience of social media as a stressor among adolescents
Authors: Andersen AIO , Finserås T R , Hjetland G J , Sivertsen B , Skogen J C
Published: October 2023

Background

Social media (SOME) use has been linked to psychological problems in some studies, but the results are mixed. Digital stress may explain the link between SOME and mental health, but the underlying components that constitute the subjective stress experience that may stem from SOME use remain uncertain. Different conceptualizations of digital stress have been proposed, and frequent suggestions include aspects of availability stress, approval anxiety, fear of missing out (FOMO) and time-wasting.

Method

A survey was conducted with 3568 students (62% girls) at upper secondary schools, to explore potential underlying components related to SOME as a perceived stressor among Norwegian adolescents. The study used linear regression models to analyze predictors of SOME as a stressor, grouped into two main composite measures: ‘FOMO and affected by use’ and ‘Addiction and interference'. In a nested longitudinal sample (n = 432), a first-differencing model was estimated to test the longitudinal associations between the factors and SOME as a perceived stressor.

Results

SOME was perceived as a stressor at least sometimes for 31 % of the adolescents, with 16 % for girls and 6 % of boys reporting SOME as a considerable stressor. Collectively, ‘FOMO and affected by use’ and ‘Addiction and interference’ explained 38% of the variance SOME as a perceived stressor. In longitudinal analyses, a one unit increase in the composite score ‘FOMO and affected by use’ yielded a 0.52 (p < 0.001) standard deviation increase in SOME as a perceived stressor, while the corresponding estimate was 0.30 (p < 0.001) for ‘Addiction and interference'.

Conclusions

Our findings highlight important aspects of SOME use that may underlie the subjective stress experience - both in cross-sectional and longitudinal analyses. Our results are consistent with previous findings and indicate that those aspects are important targets for action for both girls and boys.

Key messages

• Our study sheds light on the components that contribute to social media as a perceived stressor among adolescents, highlighting important targets for action.

• The findings suggest that fear of missing out, affected by use, subjective addiction and interference are significant predictors of social media stress, with implications for both girls and boys.
Future-self vividness influences acceptance of camera-based active and assisted living technologies
Authors: Tham N , Brady A-M , Dinsmore J
Published: October 2023

Background

Camera-based active and assisted living (AAL) technologies are an eminent solution to the accruing burdens of population ageing but are hardly accepted by older adults. The technology's privacy implications and perceived usefulness are established antecedents to its acceptance. However, one understudied barrier to acceptance is a failure in future self-identification. Specifically, to the extent that the wellbeing benefits of camera-based AAL technologies largely accrue to the future (rather than the present) self, older adults who have less (versus more) vivid impressions of their future selves may be less willing to accept the technology today.

Objectives

To assess the unique contribution of future self-vividness to the prediction of older adults’ acceptance of camera-based AAL technologies.

Methods

A cross-sectional online survey collected data from n = 183 community-dwelling older adults (mean age = 64.2, 51.9% male). Hierarchical logistic regression was used to evaluate the association of future self-vividness and acceptance, independent of demographics, privacy concerns, and the perceived usefulness of camera-based AAL technologies.

Results

Future self-vividness was positively associated with an increased likelihood of acceptance (OR = 2.54, 95% CI 1.26-5.11) even after controlling for the effects of demographics, perceived usefulness, and privacy concerns. Compared to a demographics-only model (Nagelkerke R2 = .256) and subsequent model that included privacy concerns and perceived usefulness as additional predictors (Nalgekerke R2 = .439), the addition of future self-vividness added significantly to the prediction of acceptance (χ2 = 7.58, p = .006, Nalgekerke R2 = .495).

Conclusions

Acceptance of camera-based AAL technologies is uniquely influenced by future self-vividness. Enhancing the vividness with which older adults envisage their future selves may be an important strategy to promote acceptance and use of camera-based AAL technologies.

Key messages

• Future self-vividness is uniquely associated with the acceptance of camera-based AAL technologies.

• Interventions that enhance future self-vividness may promote acceptance of AAL technologies.
Fifty shades of food colours – Associations with cancer risk in a French cohort
Authors: Srour B , Javaux G , Coumoul X , Huybrechts I , Hercberg S , Deschasaux-Tanguy M , Touvier M
Published: October 2023

Background

Colour additives are frequently used in foods. A randomised controlled trial showed that some of them resulted in increased hyperactivity in children. Experimental studies suggested the activation of inflammation, oxidative stress, and genotoxicity. Since estimating dietary exposure to colour additives is challenging, no prospective epidemiological study had investigated their association with cancer risk so far.

Methods

This study included 102,485 French adults from the NutriNet-Santé cohort (78.8% female, 2009-2022). Exposure to food colours was estimated using repeated 24h dietary records linked to comprehensive, brand-specific food composition databases on additives. Associations with incident cancer risk were assessed using multivariable Cox models adjusted for common confounders.

Results

3,511 incident cancer cases were diagnosed during the follow-up (including 1,026 breast, 431 prostate, and 279 colorectal cancers). Exposure to total food colour additives was associated with higher overall and breast cancer risks: HR higher vs non-exposure = 1.11 (1.02-1.22) and 1.25 (1.05-1.48), respectively. Positive associations with overall cancer were also observed with carotenoids food additives E160 (HR = 1.15 (1.05-1.25)) and curcumin E100 (HR = 1.10 (1.10-1.20)). Positive associations with breast cancer risk were observed with carotenoid additives (HR = 1.21 (1.04-1.42)) and carmine E120 (HR = 1.27 (1.08-1.49)). Plain caramel E150a was positively associated with colorectal cancer risk (HR = 1.52 (1.08-2.14)).

Conclusions

In this large cohort, we observed positive associations between the exposure to several types of food colour additives and overall, breast and colorectal cancer risks.

Key messages

• These findings provide pioneering epidemiological evidence regarding the link between food colours and cancer risk.

• Should they be corroborated, these results could have significant public health implications, given the widespread presence of these cosmetic additives in ultra-processed foods.
Stalling life expectancy trends in Europe and decomposition analysis of mortality data
Authors: Kabir Z , O'Brien S
Published: October 2023

Background

Life expectancy (LE) is an important population health metric over the life course. LE has increased significantly, over the past two centuries but has showed signs of slowing recently in Europe, the United Kingdom, and the United States. Several drivers have been suggested to be causing the slowdown, including slowing improvements in cardiovascular mortality. We set out to investigate trends in LE across Europe from 1990-2019, and how deaths from different causes have contributed to annual average change in LE across two time periods: 2007-2009 to 2012-2014 and 2012-2014 to 2017-2019.

Methods

Data were obtained from the Global Burden of Disease (GBD) Study 2019, which are in public domain. The GBD Study is a comprehensive global epidemiologic data resource employing standardized methodology for comparability. Joinpoint regression analysis was utilised to identify trends. The Arriaga decomposition method was applied to produce estimates of the contribution of different age groups and underlying causes of death to changes in LE at birth for the two periods.

Results

Overall, LE in Europe was 72.6 years in 1990- increasing to 78.3 years in 2019, with significant variations within EU countries. However, LE showed a slower pace from 2012 onwards in Europe- much slower in Western Europe, and more pronounced among females. LE in females fell from an annual increase of 0.38% between 2003-2012 to 0.16% between 2012-2019, and LE in males showed a similar pattern (from 0.66% between 2004-2012 to 0.26% between 2012-1019). Overall, improvements in mortality from almost all causes of death slowed, with LE contributions from improvements in ischemic heart disease (IHD) reduced by half.

Conclusions

LE is slowing down in Europe, especially in the Western region. Females and the elderly are facing the brunt of the slowdown. Slowing improvements in IHD mortality are the primary driver of the LE slowdown.

Key messages

• Life expectancy has overall improved in Europe but has slowed down from 2012 onwards- more pronounced among females and in Western Europe.

• The decomposition analyses showed that improvements in mortality from all causes of death slowed, life expectancy contributions from improvements in ischemic heart disease (IHD) reduced by half.
Understanding Ukrainian refugees’ wellbeing and adaptation in Denmark
Authors: Vereshchakina V , Castaner M M , Schonemann A M , Norredam M
Published: October 2023

Background

Since the Russian invasion in Ukraine, nearly 8 million of Ukrainians have feld to EU countries. From the beginning of the crisis, local authorities in the Denmark have facilitated the resettlement of over 30,000 Ukrainian refugees. Denmark, has implemented a special law to speed up the asylum process, access to healthcare, and integration. Yet, there is limited knowledge about whether and how these efforts work in practice and how Ukrainian refugees experience adapting to the Nordic Country.

Aims and methods

Grounded in participatory research this study aimed to understand the health and psychosocial needs of Ukrainian refugees living in Denmark and to generate strategies for improving their psychosocial wellbeing. We have conducted two workshops (N = 11 participants) and 15 in depth interviews (in progress) with Ukrainian refugees living in Copenhagen. The workshop and interviews inquired about experiences of fleeing and settling in Denmark, living conditions, psychosocial needs, and experiences accessing healthcare and integration services, and actions to improve their adaptation. Qualitative data was analyzed using thematic network analysis.

Results

Informed by from Ryan's Resource Based model of refugee adaptation, preliminary results show three main aspects that challenge the adaptation of Ukrainians. Mismatch between the state's integration demands and refugees needs and goals, difficulties navigating healthcare system, housing conditions and mistreatment by housing staff. These challenges are particularly relevant for refugees that lack a network in Denmark, and contribute to experiences of accumulated daily stress and worry.

Conclusions

Results show how despite the increase efforts to support aces to healthcare, housings, and integration services; challenges remain. Findings will help to identify strategies in these three areas to improve the wellbeing and adaptation of Ukrainian refugees.

Key messages

• We identified several obstacles to Ukrainian refugees’ access to health care in a Danish context.

• Obstacles in access to healthcare lead to re-stress and may have devastating consequences to Ukrainian refugeeś health.
Building towards vaccine acceptance: Community
co-design framework
Authors: Creagh Piper S , McCallum A , Naboulet J P
Published: October 2023

Background

Vaccine hesitancy is a global public health threat. As the COVID-19 pandemic progressed, vaccines, particularly mRNA vaccines, have reduced overall disease severity and death but population coverage has fallen short and uncertainty about vaccination grown. Miscommunication, neglect of health inequities, failure to address vaccine access and other concerns sufficiently have affected trust between populations and healthcare systems. We built on existing models of increasing vaccine acceptance to develop a more comprehensive explanatory model for testing and evaluation.

Methods

We reviewed the literature on vaccine hesitancy/acceptance models in English and French from PUBMED, ScienceDirect and Google Scholar. We explored their application using the Irish case study, including the Irish tailored communication model, and used the findings to build our model.

Results

Previous models had gaps in issues considered, planning and implementation. Many neglected wider determinants or health system responsibilities, treating vaccine acceptance as a one-dimensional issue not a continuum. While the need for vaccination programmes to be redesigned to counter known health inequities, gaps in health literacy, access difficulties, exclusionary practices and mistrust of authorities was recognised, few studies addressed these issues. Our analysis also identified the importance of co-creating delivery models with communities. The resulting model supports prioritisation of communities and individuals in line with need, exposure risk and barriers to immunisation.

Conclusions

Emergency vaccination programmes require greater depth of shared communication and decision making between populations, practitioners, and policy makers. Our model, which incorporates tailored communication, provides a framework for building vaccine acceptance, widening and welcoming participation in development, design, delivery, and improvement.

Key messages

• Improving vaccine acceptance requires a whole system approach, addressing issues identified in the literature and in practice to improve the design of immunisation programmes.

• To establish an active/robust two-way communication mechanisms which provide rapid feedback between communities and health authorities, to improve programmes and tailor them to meet emerging needs.
Socio-demographic factors and COVID-19 vaccination uptake in Umbria region: a population-based study
Authors: de Waure C , Primieri C , Chiavarini M , Giacchetta I , Bietta C
Published: October 2023

Introduction

The study of factors associated with vaccination uptake at population level is of great relevance to inform decision making. It is well known that several factors, might be linked to vaccine hesitancy and therefore final vaccine uptake. Nevertheless, contextual factors might be known querying available databases. This study is aimed to investigate the role of these factors, in particular socio-demographic ones, in COVID-19 vaccination initiation and completion.

Methods

A population-based study was conducted on the overall Umbrian resident population registered to the Regional Healthcare Service as of February 28th 2021 (N = 866,678), excluding children under 5 years of age and those who obtained a certificate of COVID-19 vaccination exemption or were not alive at the date of endpoints assessment. The uptake of at least one dose and the completion of primary vaccination cycle was analyses as of February 28th 2022. The following socio-demographic characteristics were investigated as potential associated factors: sex, age, citizenship (Italian vs not-Italian), exemption for chronic condition/disability, holding a general practitioner (GP) or a family pediatrician (FP) and Deprivation Area Index based on education, unemployment, non-home ownership, one parent family and overcrowding.

Results

Considering eligible populations, people who did not initiate and complete vaccination were 11.8% and 1.2% respectively. The same factors were found to be associated to both endpoints: being female, younger, and not-Italian citizen, not holding an exemption for chronic disease/disability and a GP/FP and leaving in a most deprived area. The associations were stronger in respect to vaccination initiation.

Discussion

The results of this study, which is representative of the whole population of an Italian region and not based on survey data, confirm the available evidence and add knowledge on COVID-19 vaccination uptake that might serve to inform future vaccination campaigns

Key messages

• This population-based study shows that there are socio-demographic differences in COVID-19 vaccination uptake in term of both initiation and completion of full primary vaccination cycle.

• Socio-demographic differences in vaccination uptake can be addressed in future vaccination campaigns using the information available from population-based databases.
Trend in HPV-related hospitalization in years 2015-21 in a Southern Italian Region
Authors: Di Martino G , Cedrone F , Di Giovanni P , Trebbi E , Tognaccini L , Romano F , Staniscia T
Published: October 2023

Background

The Human papillomavirus (HPV) is the most common cause of sexually transmitted infections in the general population. Genotypes are classified into two main class, high-risk and low-risk genotypes, according to their capacity to induce cancers. The low-risk class (types 6-11) is associated to anal and genital lesions. The high-risk is responsible for up to 4.5% of all new cancer cases yearly. The aim of this study was to evaluate the incidence of HPV-related hospitalizations and its trend in a Southern Italian Region in years 2015-2021.

Methods

It was a retrospective study performed in Abruzzo Region, Italy. All admissions performed during years 2015-2021 were extracted from the hospital discharge record. The study included genital warts, head-neck cancers, anal cancers, cervical cancers, genitourinary cancers and penile cancers. Annual hospitalization rates for each HPV-related disease were calculated per 100,000 inhabitants using the related attributable fractions. The Joinpoint model was used to evaluate the time trends of standardized rates and the average annual percent change (APC).

Results

During study period, totally 5492 HPV-related admissions were performed. The great part was related to cervical cancer (3386 cases) and to genital warts (638 cases). The great reduction was reported among genital warts, decreased from 8.5 admissions in 2015 to 5.9/100,000 in 2021 with APC of -8.03 (95%CI -11.91 - -0.33). The other most important reduction was referred to anal cancer (APC -4.79, 95%CI -16.91 -6.43) and genitourinary cancers (APC -3.72, 95%CI -11.21-7.20). Considering the first year of pandemic (year 2020), the great part of considered diseases reported a decrease, particularly among cervical cancer (PC -10.8 from 2019 to 2020).

Conclusions

HPV-related hospitalizations decrease in Abruzzo during study period. These results could be useful to policy maker in improving vaccination coverage and screening adherence.

Key messages

• HPV-related hospitalizations represent a heavy burden for healthcare services.

• During years 2015-21, a decrease in HPV-related hospitalizations was observed.
Enhanced glacial earthquake catalogues with supervised machine learning for more comprehensive analysis
Authors: Pirot Emilie , Hibert Clément , Mangeney Anne
Published: October 2023

Polar regions and Greenland in particular are highly sensitive to global warming. Impacts on Greenland’s glaciers may be observed through the increasing number of calving events. However, a direct assessment of the calving activity is limited due to the remoteness of polar regions and the cloudy weather which makes impossible a recurrent observation through satellite imagery. To tackle this issue, we exploit the seismological network deployed in Greenland which actively records seismic signals associated with calving events, hereinafter referred to as glacial earthquakes. These seismic signals present a broad frequency range and a wide diversity of waveform which make them difficult to discriminate from tectonic events as well as anthropogenic and natural noises. In this study, we start from two catalogues of known events, one for glacial earthquake events which occurred between 1993 and 2013 and one for earthquakes which occurred in the same time period, and we implement a detection algorithm based on the STA/LTA method to extract signals’ events from continuous data. Then, we train and test a machine learning processing chain based on the Random Forest algorithm which allows us to automatically associate the events respectively with calving and tectonic activity, with a certain probability. Finally, we investigate 844 selected days spanning time of continuous data from the Greenland regional seismic network which results in a new, more exhaustive, catalogue of glacial earthquakes expanded of 1633 newly detected glacial events. Moreover, we extensively discuss the choice of the features used to describe glacial earthquakes, in particular the 39 new features created in this study which have drastically improved our results with 7 of the 10 best features being in the added set. The perspective of further expansion of the glacial earthquake catalogue applying the processing chain discussed in this paper on different time spans highlights how combining seismology and machine learning can increase our understanding of the spatio-temporal evolution of calving activity in remote regions.
Spectral induced polarization responses of carbonate precipitation in gel-saturated media with and without electron conductors
Authors: Garcia Alejandro , Asenath-Smith Emily , Glaser Dan R , Slater Lee
Published: October 2023

Interest in the use of carbonate precipitation for the purposes of soil stabilization, carbon capture and environmental remediation has created a need for geophysical techniques capable of characterizing the 3-D extent of precipitation in the subsurface. The use of spectral induced polarization, a geophysical technique sensitive to mineral precipitation and dissolution processes, has been investigated in previous studies; nevertheless, debate still exists regarding measured induced polarization (IP) signals relating to the formation of calcite. In this study, calcite was precipitated within gel-saturated media through highly controlled double-diffusion methods. Three experiments were conducted to study both the inherent IP response of calcite in isolation, as well as the IP response when precipitated within a low-polarizability background medium (quartz sand) and a high-polarizability medium (a sand–magnetite mixture). The results support that in isolation, the polarization of the electrical double layer surrounding individual calcite grains is not a significant contributor to IP signatures from calcite precipitation. However, under certain circumstances the precipitation of calcite, in the quartz-sand and sand–magnetite mixtures, can produce a strong IP response when the precipitation blocks a current conduction pathway. If metallic mineral grains are present then they may act as conduits for current if they become embedded in an insulating calcite wall, creating a significant electrode polarization which dominates the IP signal. Equivalent circuit models indicate that the precipitation of calcite as a thin planar front normal to the current path is analogous to a simple lossy capacitor blocking most DC current but being thin enough to measurably polarize. Circuit models also suggest that the total impedance seen from the sand–magnetite sample is simply the sum of the impedance of the disseminated grains and the grains encased in the calcite front. The encased grains also have a higher relaxation time which may indicate a different polarization mechanism than from disseminated magnetite.
Seismoelectric response of 2-D elastic/poroelastic coupled media: a phenomenological approach
Authors: Bucher F , Monachesi L B , Castromán G A , Zyserman F I
Published: October 2023

In this paper, we address the study of the seismoelectric response of an elastic medium in contact with a poroelastic half-space. In particular, we advance in the understanding of the generation mechanism of the interface response (IR) and the evanescent electromagnetic (EM) fields occurring at the contact between both media, by proposing a seismoelectric phenomenological model (SPM). Essentially, the model consists of a sequence of electric dipoles that are activated successively, simulating the seismic-to-EM energy conversion taking place with the arrival of a seismic wave at the interface separating the media. We obtained SPM responses for different scenarios and acquisition configurations and compared them with responses computed using a code based on the finite-elements method, which solves the seismoelectric equations in the compressional P and vertical shear SV waves coupled with the transverse-magnetic (TM) fields (PSVTM) mode. The SPM successfully represents not only the evanescent wave but also the IR within the elastic medium. In particular, we show that the SPM is able to faithfully reproduce the relative amplitudes of both events and their radiation patterns with a minimum computational cost. In this way, it provides a novel insight in the study of the physical phenomenon behind the seismoelectric conversions.
Enhancedb-value time-series calculation method using data-driven approach
Authors: Yin Fengling , Jiang Changsheng
Published: October 2023

The temporal evolution analysis of b-value of the magnitude–frequency distribution (MFD) is essential for seismic risk analysis. However, ensuring the accuracy and rationality of these analyses depends on various factors, including data quality, data selection and the appropriate computation period partitioning. This study extends the data-driven b-value time-series calculation method, TbDD-BIC, by exploring different model selection techniques. To evaluate the method's effectiveness, we conducted assessments using both synthetic earthquake catalogues and actual seismic data. Our results indicate that selecting a proportion of optimal models (e.g. 5 per cent of the total number of models) using the Akaike information criterion (AIC) and computing the ensemble median yields accurate b0-values of the synthetic earthquake catalogue. This proposed method offers objective calculation rules and precise identification of abrupt b-value changes, enhancing seismicity simulation and seismic hazard analysis.