bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of community outreach programme on improving cancer related preventive health behaviour
Authors: Niranjan V , Fitzpatrick P , Morrogh R , O’Hagan K
Published: October 2022

Cancer services were negatively affected due to the Covid-19 pandemic and will have likely delayed early detection and diagnosis. The Irish Cancer Society (ICS) planned and delivered a number of cancer roadshow events in 4 deprived regions in Ireland to address improvements in awareness of cancer signs, importance of screening, positive lifestyle changes and encourage medical care-seeking behaviour. Health checks (blood pressure, BMI & CO2 monitoring) and motivational interviews were carried out by ICS nurses and trained ICS volunteers. Data was collected via anonymous questionnaire from participants and volunteers. SPSS was used for analysis. 98 people (54 male, 44 female) participated; 87.7% found the information provided useful, 84.7% approved of the health check and 72.5% stated that they would likely make changes to their current lifestyle to reduce their cancer risk. Moderate/high understanding of cancer signs and symptoms and moderate/high awareness of cancer risk factors both rose post event (from 62.2% to 81.6% (p < 0.001) and from 49% to 61.2% (p < 0.001) respectively). If symptomatic for cancer 77.6% of participants would likely visit their GP and 73.5% would likely contact ICS. Younger people (aged ≤40 years) were more likely to consider consulting a healthcare professional if symptomatic (p = 0.027) and to contact the ICS (p = 0.007) for more information. High numbers of participants (98.9%) and volunteers (95.2%) recommended a nationwide roll out. Volunteers reported moderate/high levels of public engagement; the most common topics discussed were own treatment experience, cancer screening, information on making lifestyle changes and ICS services. Volunteers reported the need for more training and improvements to some organisational aspects. More rigorous cancer health promotion programmes are required to counter disrupted cancer services. Our results suggest such cancer roadshow events are both feasible and beneficial at this time post pandemic.

Key messages

• Health literacy is continuous process to achieve positive health outcomes.

• Reaching out to people in different setting is acceptable and potentially effective.
What influences the intention to get vaccinated against COVID-19 in the Western Balkans?
Authors: Jeremic Stojkovic V , Cvjetkovic S , Stevanovic A , Jankovic J , Matovic-Miljanovic S
Published: October 2022

Background

Although effective vaccines against COVID-19 have been developed with the unprecedented speed, insufficient vaccine uptake suggests that many people are unwilling to get vaccinated worldwide. The aim of this study was to assess factors influencing intention to get vaccinated against COVID-19 in five Western Balkans countries.

Methods

Total of 700 unvaccinated respondents aged 18-75 participated in the study. Intention was assessed by a single item gauging the likelihood of getting vaccinated on a 5-points Likert scale. Multiple linear regression was used to determine whether socio-demographics (gender, age, religiousness, educational level, employment status, presence of chronic diseases) and attitudes towards vaccination predict intention to get vaccinated.

Results

Proportion of respondents willing to get vaccinated against COVID-19 ranged from 22.6% in Serbia to 40.4% in Montenegro. In Bosnia and Herzegovina and Albania stronger intention to get vaccinated in the future was associated with confidence in vaccine safety (β=.24, p<.01 and β=.20, p<.01 respectively) and efficacy (β=.28, p<.01 and β=.26, p<.001), higher feeling of danger of the disease (β=.21, p<.05 and β=.17, p<.05) and higher social responsibility (β=.35, p<.001 and β=.18, p<.01). Confidence in vaccine efficacy (β=.34, p<.001) and social responsibility (β=.24, p<.01), accompanied with higher sense of susceptibility to the disease (β=.13, p<.05), were significant predictors of intention in Serbia. In North Macedonia willingness to get the vaccine was significantly associated only with social responsibility (β=.09, p<.001), while in Montenegro age was the single predictor (β=-.32, p<.001);

Conclusions

Results of this study suggest that vaccination campaigns should focus on specific set of socio-psychological factors in each country, enhancing confidence in vaccine efficacy and appealing to collective responsibility as most prevalent determinants of vaccination intention in Western Balkans.

Key messages

• Specific set of socio-psychological factors influenced vaccination intention in each country.

• Most prevalent factors influencing intention to get vaccinated against COVID-19 were confidence in vaccine efficacy and social responsibility.
Coronavirus-related health literacy and knowledge among German fourth-graders
Authors: Bollweg T , Okan O
Published: October 2022

Background

Little is known about how easy it is for children to deal with coronavirus-related information, or to what degree children have accurate knowledge about the virus. However, both might influence children’s preventive behaviors. Thus, this study explores children’s coronavirus-related health literacy (CHL) and related knowledge.

Methods

In a classroom survey among fourth graders’ in North-Rhine Westphalia, Germany (07/21 - 11/21), 4 items were used to assess CHL. 5 items were used to measure coronavirus knowledge, while also assessing the frequency of speaking about the coronavirus with parents. Sociodemographic characteristics were recorded, including family affluence (FAS). Bivariate correlations are reported.

Results

n = 364 students are included (49.5% female), the mean age is 9.5 years (SD=.69). 47.5% of the sample find it rather difficult or very difficult to find information about the coronavirus, while this share is 36.1% for understanding, and 39.1% for appraising coronavirus information. 22.4% say it’s difficult to not infect themselves or others (applying information). Dealing with coronavirus-related information is more difficult for children who less frequently talk to their parents about the virus (ρ = 0.166, p<.01) and have lower family affluence (r=.119, p<.05). While certain misbeliefs are rare (“the coronavirus doesn't exist”; 3.9% agreement; “Children can't get infected”; 3.0%), the belief that eating healthy prevents an infection (15.6%), that all infected people have coughs and fever (62.8%), and that a face mask doesn't help prevent an infection (44.3%) are more prevalent. Children who have a home language other than German state more inaccurate knowledge (p<.05).

Conclusions

This study suggests that children’s needs for accessible and understandable information on the coronavirus were met only party. Also, certain misbeliefs are prevalent which might undermine adherence to preventive measures. More research is needed to verify these findings.

Key messages

• In our sample, children’s needs for accessible and understandable information on the coronavirus were met only party.

• Misbeliefs about the coronavirus are prevalent which might undermine preventive measures.
Longitudinal analysis of Israeli nurses’ perceptions, trust & emotions during the COVID-19 pandemic
Authors: Bord S , Shaharabani S , Baruch H , Admi H
Published: October 2022

Background

The nursing sector is the largest human resource in the healthcare system providing direct patient care. The Covid-19 pandemic has forced nursing teams into a sustained state of emergency, and with it, much uncertainty and risk taking.

Aims

Examining the emotions, risk and threat perceptions, trust in the healthcare system and compliance with Ministry of Health (MOH) regulations among nurses at two points in time during the COVID-19 pandemic in Israel.

Methods

Research questionnaires were distributed to nurses at the height of the pandemic’s first wave (March-May 2020). Among the respondents, 140 agreed to continue with the follow-up study. During the pandemic’s third wave (January 2021), the research questionnaire was re-sent to these respondents. Of these, 80 filled-in the second questionnaire.

Findings

Naturally, there was a higher level of experience among the nursing staffs in dealing with the virus in the second as compared to the first period in time. During the first wave, approximately a fifth of the participants (21%) reported that they had cared for patients who had been confirmed as having COVID-19, while during the third wave, most of the participants (66%) reported caring for people who had been confirmed as having contracted the virus. The findings demonstrate significantly lower levels of compliance with regulations and risk perception, and a significantly higher level of emotions in the third wave as compared to the first. However, there was no change in the level of trust in the healthcare system or in the pandemic-related threat perception.

Conclusions

The findings provide us with some information regarding the process the nursing staffs have undergone (and are still undergoing) in dealing with the pandemic, and may point at a ‘pandemic fatigue’ amongst them. This concept relates to progressively lower regulation compliance levels appearing over time, affected by the target population’s emotions, experiences and perceptions.

Key messages

• It is important to assist the nurses’ emotional regulation with the help of professionals in the organization, form colleagues’ support groups and ensure management recognition of the situation.

• Resilience-raising steps should be taken, for example by ensuring rest times and sufficient medical and protective equipment.
Transformation-oriented leadership in German hospitals: beneficial attributes and competencies
Authors: Kleine J , Köppen J , Maier C
Published: October 2022

Introduction

Due to a shortage of health professionals and economic pressure, many German hospitals are required to transform the clinical work environment to increase job satisfaction, but also to attract and retain health professionals. Leadership is a key factor for the successful implementation of organization-wide change. The aim of this study was to identify the attributes and competencies among leaders that are beneficial for implementing and managing hospital-wide transformations.

Methods

A qualitative study design. In 2020, 18 face-to-face, semi-structured interviews were conducted with chief nursing officers, ward managers, nurses and physicians in five German hospitals which have started implementing a hospital-wide transformation (e.g. Magnet® or Pathway®). Interviews were recorded and transcribed verbatim. Data were analyzed in Atlas.ti using the content analysis method according to Mayring.

Results

Results show five beneficial leadership elements to instigate and steer hospital-wide transformation: (1) Charismatic leaders are role models and idealists with well-communicated visions that are grounded in clinical practice and reflect the clinical practitioners. (2) Mentally strong leaders have courage, stamina, and are resilient. (3) Empowering leaders are highly supportive and increase the intrinsic motivation of employees. (4) Imparting interprofessional appreciation refers to leaders who cultivate a respectful relationship with persons from other professional groups and recognize their daily performance. (5) Agile leaders are well and quickly accessible for employees and respond situationally to changing demands in everyday work.

Conclusions

Interviewees described characteristics of hospital leaders as success factors for establishing and maintaining continuous change processes. Charismatic and supportive leaders are critical to transform the hospitals’ culture and values. In addition, equitable interprofessional collaboration is of utmost importance.

Key messages

• Charismatic, agile, empowering leaders can have a positive impact on system-wide change processes.

• The successful transformation of hospitals’ work environment needs interprofessional appreciation and the mutual acknowledgement of competences.
Migration from Latin America to Italy and EU: the issue of health professionals
Authors: De Caro W , Corvo E
Published: October 2022

Introduction

The estimated shortage of more than 15 million health and social care professionals, including over 6 million nurses, together with the significant phenomenon of international migration of such professionals, emerged, during COVID-19, with even more evidence. During the pandemic the danger of a collapse of health systems in many areas due to a shortage of staff was manifest. This leads, among other reasons for several professionals to migrate from South America to Italy and Europe.

Methods

an integrative review analysis (2011-2021), of trend in terms of legislation and policy documents were conducted using health and social database and gray literature. 34 different documents were included in this review.

Results

Several initiatives have been developed to establish international and/or bilateral obligations among countries in terms; however, this showed to be insufficient. There is confusion in terms of the necessity of harmonizing rules, nursing curricula, monitor systems, and innovative rules for recognition. With covid-19 and the increase in shortage of health professionals, a number of countries decide to reduce the general criteria of recognition.

Conclusions

It is time to develop specific actions aimed at setting up a passport for public health and health care professionals which allows guaranteeing prior certification and accreditation of skills by independent agencies. There is the need to set up a joint effort/actions among different stakeholders such as Government, Higher Education institutions, International Labor health market actors, and NGOs in the field of migration, labor, and training of public health and health care professionals to better meet health needs worldwide

Key messages

• it is necessary balancing the rights of individuals to migrate with the potential loss of essential health care services in source countries.

• migration and shortage of nurses is a serious ethical issues.
Determination of Admission Criteria for Global Public Health Master at the University of Georgia
Authors: Lobjanidze T , Skhvitaridze N , Antia K , Lobjanidze M , Nonikashvili M , Shakarishvili G
Published: October 2022

Background

Recent events in the world, wars, pandemics, have once again raised the issue of the need for competent human resources in global public health (GPH). In Georgia, there are master’s degree programs in public health where global health is mostly offered as an elective or core course of the curriculum. University of Georgia (UG) is involved in the ERASMUS + project in GPH (BACE). UG initiated to create new GPH Master Program, which will be response towards local, regional and international challenges and demand.

Objective

Main objective of developing GPH program was to address and meet national and international global health education needs and challenges. The aim of the study was to identify evidence-based prerequisites for the MPH in GPH (UG). We conducting document review based on the GPH competency model (GPHCM) and evaluated: 1) GPH & MPH programs of the top 20 world university ranking (THE/2022); 2) CUGH associated programs; 3) Georgian MPH programs; 4) Georgian education documents (such as Georgian National Qualifications Framework (GNQF)); 5) Main directions of career development in global health. In addition, interviews with national experts were conducted (in education, employment, program leaders) using the Delph method.

Results

Study found that depending on the scope and content of the program, prerequisites for obtaining MPH in GPH varies. In addition to English competence and a high GPA, working or research experience or interviews or additional exams or other are required. In Georgia, there is no adopted GPHCM, but GNQF allows the establishment of MPH in GPH. UG new Master program (120 ECTS) will include 99 ECTS core (including research practicum & thesis) and 21 ECTS elective courses based on 6 domains of GPHCM. The program will mostly focus on population health management at a global level.

Conclusions

Study findings suggest any undergraduates with appropriate conditions could be eligible for admission to the UG (MPH in GPH).

Key messages

• UG admission prerequisites for Health Science undergraduates: National entrance exam, English proficiency B2, working experience and motivation letter.

• UG additionally admission prerequisites for Health Science undergraduates: basic knowledge epidemiology and medical terminology (if credits available or test).
Prevalence and risk factors of hepatitis C virus infection in Armenia, 2021
Authors: Demirchyan A , Sahakyan S , Aslanyan L , Mushegyan L , Muradyan D , Mozalevskis A , Sargsyants N , Ghukasyan G , Petrosyan V
Published: October 2022

Background

Liver damage caused by hepatitis C virus (HCV) is common, especially in low- and middle-income countries. Chronic HCV infection is among the leading causes of chronic liver disease, cirrhosis and hepatocellular carcinoma. Data on prevalence and risk factors of HCV infection are important for planning effective interventions to fight the virus. This study investigated the prevalence of HCV, its genotypes and factors associated with chronic HCV infection in Armenia.

Methods

The study included 3838 individuals 18 years and older selected via stratified two-stage cluster sampling from all regions of Armenia. Anti-HCV antibodies were detected using a third generation immunoassay. Those testing positive were further tested by Polymerase Chain Reaction and genotyping. Shortly after testing, the participants underwent a telephone survey. Logistic regression model was fitted to identify factors associated with chronic HCV infection.

Results

The participants mean age was 49.5 years, 70.0% were female. The prevalence of HCV antibodies weighted by age and sex was 1.9% (95% CI 1.5, 2.3), and chronic HCV infection - 0.7% (95% CI 0.4, 0.9), with genotype 3 being the most common (41.7%), followed by genotypes 2 (37.5%) and 1 (20.8%). The prevalence of both antibodies and chronic infection were higher among 50-69 years old (3.4% and 1.3%, respectively). In weighted analysis, the risk factors for chronic HCV infection included male sex (95% CI 1.23, 11.59), having tattoos (95% CI 1.10, 7.80), and reporting liver disease (95% CI 1.24, 14.61). Being employed was protective (95% CI 0.14, 0.93).

Conclusions

This study was the first attempt to measure the prevalence of HCV infection among the general population of Armenia, creating prerequisites for estimating the HCV-related disease burden and developing strategies to cope with it. The identified risk factors demonstrate that there is still room for strengthening safety measures to prevent the transmission of HCV in Armenia.

Key messages

• The prevalence of HCV antibodies is 1.9% among adult population of Armenia, increasing with age. Over one-third of seropositive cases have chronic infection caused by HCV genotypes 3, 2 or 1.

• Having tattoos is associated with higher risk of being infected with HCV, demonstrating the need for strengthening safety measures during similar procedures to prevent viral transmission.
Costs of delivering human papillomavirus vaccination in Tanzania
Authors: Struckmann V , Stephani V , Hsiao A , Mbbando D , Changalucha J , Baisley K , Levin A , Hutubessy R , Watson-Jones D , Quentin W
Published: October 2022

Background

Cervical cancer caused by human papillomavirus (HPV) is the most frequent cancer in women in many low-income countries.Tanzania implemented a national HPV vaccination program in 2018 using a two-dose quadrivalent HPV vaccine. This study aimed to (1) estimate financial and economic costs of a two-dose vaccination program based on experiences with the national vaccination program, (2) estimate costs of a one-dose vaccination schedule to enable future cost-effectiveness analyses, and (3) assess the effect of alternative assumptions for future vaccination coverage rates on estimated costs of vaccination.

Methods

The WHO Cervical Cancer Prevention and Control Costing (C4P) tool was used to estimate the incremental costs of the national vaccination programme from the perspective of the Tanzanian government using data collected via surveys, workshops, and interviews with local stakeholders. Deterministic sensitivity analyses were performed to estimate the effect of alternative assumptions for coverage rates and delivery strategies and to assess the impact of a potential one-dose vaccination schedule.

Results

The total financial and economic costs were US$10,117,455 and US$45,683,204, respectively, at a financial cost of $5.17 per two-dose fully immunized girl (FIG), and an economic cost of $23.34 per FIG. Under the assumption of a one-dose vaccination schedule, costs per FIG would reduce to financial costs of $2.51 and economic costs of $12.18.

Conclusions

The overall cost of Tanzania’s HPV vaccination program was lower per vaccinee than previous demonstration projects in the region suggest. These data provide important baseline data for Tanzania’s HPV vaccination program to date and may serve as a guide for improving coverage going forward. The findings may also aid in the prioritization of funding for countries that have not yet added HPV vaccines to their routine immunizations.

Key messages

• If a single dose regimen were found to be as effective as a two-dose series, it would result in significant cost savings as well as an increase in the number of girls that could be reached.

• School-based vaccinations resulted in the lowest price per fully immunized girl, but other settings are needed to achieve equitable high coverage of HPV vaccination in Tanzania.
Improving childhood vaccination in minorities: a realist review of health system interventions
Authors: Essa-Hadad J , Gorelik Y , Edelstein M
Published: October 2022

Background

Most minority populations in Europe have lower childhood vaccine uptake than the general population. Improving uptake in these populations requires specifically developed, context-specific interventions. As part of the EU-funded RIVER-EU project, we conducted a realist review to identify interventions effective at improving vaccine uptake among underserved communities.

Methods

We searched MEDLINE, EMBASE, CINAHL, COCHRANE, and Proquest for articles published between 2005 and 2022, using combination keyword searches in English. Following title and abstract screening, full texts were assessed for relevance. We also searched grey literature and references of references. Data extraction and analysis was performed by two reviewers. Programme theories were generated from included articles and data extraction were carried out paying particular attention to context, mechanisms, and outcome configurations.

Results

From 1942 screened titles we selected 87 studies for full-text review of which 34 were included. We identified 10 primary intervention categories: parental and youth education; clinic outreach; quality improvement; health provider training; school-based education; technology interventions; cash incentives; home visits; comic books; community leaders education; and consent policy changes. The analysis highlighting contextual factors enabling or hindering each intervention category’s success is ongoing.

Conclusions

Several intervention categories can potentially improve vaccine coverage among underserved minority populations. We will describe their effectiveness and the contextual factors contributing to their success or failure to inform the development of tailored interventions targeting these populations.

Key messages

• Improving vaccination in underserved minority populations requires identification of effective interventions, barriers/enablers to their success, specific to the context in which they are implemented.

• Appropriately tailored health system interventions are effective at improving vaccine uptake among underserved minority communities.
Measles, rubella, mumps and chicken pox seroprevalence of health workers in a second level hospital
Authors: Guerrero Fernández de Alba I , Soler Iborte E , Padilla Matas R , Diaz Campanón J , Rivera Izquierdo M , Perez de Rojas J
Published: October 2022

Healthcare workers are a professional group subject to a risk of occupational exposure to a variety of infectious agents. From a public health perspective, their immune status has a great impact on the worker’s own health, on the patients and on the general population. Measles, mumps, rubella, and chickenpox are vaccine-preventable diseases caused by viruses. Seroprevalence surveys are a powerful evaluation tool that provide information on the frequency, distribution, and dynamics of communicable diseases. In this study, the prevalence of immunity to measles, mumps, rubella, and varicella viruses was analyzed in healthcare workers in a General Hospital of Granada (Spain). A cross-sectional study examining the seroprevalence was carried out in a population of health professionals incorporated into the General Hospital between January 2021 and February 2022. 260 professionals were studied, classified into groups according to age: 20-29, 30-39. Serum determination of IgG to measles virus was performed using a marketed chemiluminescent immunoassay. The resulting seroconversion rates were: 66.54% measles, 89.75% rubella, 84.62% mumps, and 88.08% chickenpox. The lowest rates were observed for measles, resulting in a minimum among professionals between 20-29 years of age, with a seroconversion rate of 65.4%. In general, women had a higher percentage of antibodies against measles. The highest rates were for the varicella virus, reaching up to 93.18% among health professionals between 30-39 years old. Considerable decrease in titers of antibodies against measles is observed in healthcare workers, especially in the age group 20-29 years, which may be due to the loss of serological protection as time goes by since vaccination with the 2nd dose of Triple Viral, possibly due to the absence of contact with the wild virus. It will be necessary to assess the need for new vaccination strategies in certain population groups such as healthcare workers based on their risk of exposure.

Key messages

• It will be necessary to assess the need for new vaccination strategies in certain population groups.

• More seroprevalence studies are necessary to update the status of protection against infectious disease.
Public Health Response to Outbreaks of Highly Pathogenic Avian Influenza (H5N1)
Authors: Quintyne K , Kelly C , Brabazon E , Harrison K , White E
Published: October 2022

Aim

Human infections from highly pathogenic avian influenza (HPAI) H5N1 are associated with significant morbidity and mortality internationally. This study aimed to use routinely available data to examine key strategies to prevent H5N1 transmission to humans during outbreaks in poultry in residents in Cavan, Louth, Meath and Monaghan.

Study design

Cross-sectional based study.

Methods

Data were obtained from Health Protection Team (HPT) in the Department of Public Health (DPH), HSE North-East and Department of Agriculture, Food, and the Marine (DAFM). Data entry and analyses were conducted using Microsoft Excel 2016.

Results

The public health response focussed on contact tracing, monitoring, and follow-up for household, farm-workers, and DAFM staff exposed on the affected farms. A total of 157 contact episodes were identified. Contacts received advice about active monitoring from their last exposure. A total of 111 (80%) were recommended chemoprophylaxis for exposure to HPAI H5N1. During the active monitoring period, two contacts developed acute respiratory symptoms, and parainfluenza 3 and rhino/enterovirus were identified in these individuals respectively.

Conclusions

The findings of this study, using routinely gathered data, highlighted that collaboration between public health and DAFM at regional and national level was key to rapid response to these outbreaks of HPAI in domesticated poultry. In addition, the public health response was successful in preventing H5N1 transmission from domesticated birds to humans.

Key messages

• HPAI H5N1 virus infections transmissions from poultry to humans is low.

• Effective public health measures are crucial to further mitigate the risks to an absolute minimum.
COVID-19 sequelae among competitive athletes: a systematic review
Authors: Corona VF , Gualano MR , Valz Gris A , Rossi MR , Regazzi L , Ricciardi W
Published: October 2022

Background

During the COVID-19 pandemic, several professional athletes from different sports were infected by SARS-CoV-2. The aim of this systematic review was to evaluate the currently available scientific evidence regarding the cardiological, pulmonary, psychological, and combined sequelae, in professional athletes.

Methods

The present systematic review was performed following the PRISMA statements, thereby searching on 3 databases: PubMed, ISI Web of Science, Scopus. Primary studies published between January 2020 and March 2022, investigating symptomatic and instrumental sequelae in competitive athletes after COVID-19 infection, were included.

Results

A total of 1,957 articles were screened, finally 18 were included (6 cohort studies, 2 case-control studies and 10 cross-sectional studies). Studies’ sample size ranged from a minimum of 12 to 1908 athletes playing different sports. In addition, the studies examined the following type of sequelae: 12 cardiological, 2 psychological, 1 pulmonary and 3 combined. Regarding the cardiological field, the prevalence of anomalies in instrumental examinations ranged 0-27.89% for first level tests (echocardiography, electrocardiogram, troponin), and 0-6.21% for second level tests (cardiac magnetic resonance). The prevalence of myocarditis and pericarditis in the athletes ranged from 0 to 3.33%, whereby the prevalence of myocarditis was in the range 0-2.32% and that of pericarditis in the range 0-2.22%.

Conclusions

The results show that post SARS-CoV-2 infection cardiac sequelae have a quite low prevalence among competitive athletes included in our review, but it would be important to set up a gradual and continuous testing approach to preserve sports performance. Public health framework, such as vaccination campaign, is important both at European and international level in order to address potential consequences of infectious diseases among competitive athletes.

Key messages

• It is important to monitor all COVID-19 sequelae in European competitive athletes playing different sports.

• Considering anti-COVID-19 vaccination in competitive athletes as an important preventive measure, to limit the circulation of the virus and the physical consequences that may occur.
Qualitative research for improving Access to Vaccination for Newly Arrived Migrants (AcToVx4NAM)
Authors: Karnaki P , Dalma A , Katsas K , Papaevgeniou N , Linos A
Published: October 2022

Background

Increasing vaccination uptake among vulnerable groups constitutes a high priority across Europe. Access to Vaccination for Newly Arrived Migrants (AcToVx4NAM) is a 3-year project (Grant n 101018349, 3rd EU Health Programme) with a mission to increase vaccination uptake in Newly Arrived Migrants (NAM) regardless of legal status. AcToVx4NAM will improve health system Vaccination Literacy (VL) and vaccination access, by making access conditions more equitable and guaranteed.

Methods

Across 8 countries research took place to identify barriers, enablers and solutions to system level problems. Qualitative analysis through focus groups and interviews took place with professionals who work with NAMs including administrative personnel, cultural mediators, policy officers as well as physicians, nurses, social and mental health care professionals. Research examined barriers across the different dimensions that constitute the ActoVax4NAM General Conceptual Framework namely Entitlement, Reachability - Adherence (vs. hesitancy), Achievement of vaccination (execution and completion) and Evaluation.

Results

A number of common system level barriers were identified related to gaps in the registration process and problems in reaching people eligible for vaccinations. Not all NAMs face the same problems in terms of accessing the health system (i.e asylum seekers vs economic migrants). Communication breaks exist between the various services involved with delivering care and vaccination to NAMs while the lack of appropriate culturally sensitive and appropriate informative material still remains. The role of non-medical personnel in promoting vaccinations was emphasized as well as the importance of evaluating and disseminating best practice.

Conclusions

Findings direct to specific evidence based solutions with an emphasis on tailored made to specific needs activities.

Key messages

• Shift focus from individual level barriers to system level barriers considering all hubs of the vaccination process.

• Address vaccination needs of NAM early to stress the importance of prevention in the health integration process.
Cognitive consequences of sport-related traumatic brain injuries in adolescents in Slovakia
Authors: Hažerová D , Kažičková B , Špajdel M , Puteková S , Martinková J , Doktorová G , Sivčo P , Pham PT , Peráčková J , Peráček P
Published: October 2022

Background

Many sports are associated with an increased risk of traumatic brain injury (TBI), often in a form of repeated minor trauma. While the pathophysiological changes of the brain after TBI have been relatively well studied, data on cognitive aspects are relatively scarce. The main objective of this study was to measure the cognitive consequences of repeated heading in a controlled set of training exercises in 21 years old football players.

Methods

The study design is quasi-experiment. Participants consisted of male football players (N = 27) and were tested under 3 conditions: before the sports activity, after the sports activity not involving heading, after the sport activity focused on heading. To monitor the cognitive changes we used neuropsychological methods: the Trail Making Test (TMT), the Verbal reproduction test. Blood samples were taken to analyse the presence of biomarkers (glucose). Linear regression and repeated-measures ANOVA were used for statistical analysis.

Results

The data showed significant relationships between the glucose level (before and 1-hour after the heading) and the TMT (part B) score /(F(1,22)=6.03; p=.001; R-square=.223/. Based on TMT (part B) scores, the cognitive flexibility and glucose lowered after the sessions. For both parts of TMT we found significantly worse scores after both training sessions compared to baseline testing (Part A: F(2,46)=189.354; p<.001; Eta2=.892; Part B: F(2,46)=10.191; p<.001; Eta2=.307). Post-hoc tests revealed slightly worse results in the TMT (part A) after non-heading than after the heading training which means, that the focused attention was affected. In the TMT (part B) no difference was found between the results after non-heading and heading training.

Conclusions

This study has a unique potential to highlight the relations between biomarkers and psychological abilities and their possible changes caused by heading, which may have beneficial as well as damaging impact on the body and cognitive functioning.

Key messages

• The findings of this study suggest a potential relationship between repeated minor head trauma and cognitive performance in young adults.

• Besides physiological changes, cognitive impact on cognitive performance may be a consequence of repeated minor head trauma; further study is required to elucidate these associations.
Parental Knowledge on Prevention of SUID
Authors: Nazaruk D , Palacios A , Marshall N , Choongo J
Published: October 2022

Background

According to the 2018 America’s Health Ranking Annual Report, the U.S. infant mortality rate (IMR) was 5.9 deaths per 1,000 live infant births, which placed the U.S. at No. 33 out of 36 countries with the world’s largest economies in 2018. The IMR in Georgia has been on the rise since 2014. Even though there was a sharp decline in sudden unexpected/unexplained causes of death (SUID) beginning in 1990, the decrease has considerably slowed down since 1999. In 2017, the top ten leading causes of infant death were responsible for 67.8% of all infant deaths in the United States. Sudden Infant Death Syndrome (SIDS) and death from unintentional injuries were in third and fourth place. Therefore, the purpose of this research is to utilize qualitative research guided by the Socio-Ecological model to understand better how prepared first-time mothers are to take care of their infant upon hospital release.

Methods

An intensity sampling was utilized to recruit participants. The inclusion criteria for the participants included first-time mothers with children under one year of age, women, Georgia residents over 18 years of age, and English speaking. A semi-structured guide was based on research queries and the ideological concepts of the Socio-Ecological Model. For the qualitative data examination, the thematic analysis was performed. All the interviews were transcribed verbatim and coded by using the program NVivo 11.

Results

A total of 25 women participated in the study. We will finish the data analysis by the end of May, 2022. The results of this qualitative study will help to fully understand the knowledge, perceptions, skills, and confidence of mothers about infant care.

Conclusions

The study’s results will help develop an information guide on primary infant care. Besides, health professionals and community organizations can utilize the study results to determine the information and support needed for new mothers.

Key messages

• The results of this qualitative study will help to fully understand the knowledge, perceptions, skills, and confidence of mothers about infant care.

• This study’s results will help develop an information guide (electronic or/and printed) on primary infant care based on first-time mothers’ needs.
Timing and social patterning of weaning practices in Cyprus: BrEaST start in life longitudinal study
Authors: Economou M , Kolokotoni O , Hadjigeorgiou E , Paphiti-Demetriou I , Hadjiona V , Kouta C , Lambrinou E , Hadjipanteli I , Middleton N
Published: October 2022

Background

Introduction of solids in the infant diet, according to WHO recommendations, should initiate onwards of sixth months. Evidence, however, suggests that solids introduction occurs earlier even if breastfeeding continues. With low breastfeeding rates, Cyprus is ranking last in Europe and little is known about the timing and socio-demographic pattern of solid introduction.

Methods

Using the retrospective event calendar method at the 4th and 6th month after birth, the timing of initiation of solids was estimated among a consecutive sample of 350 mother-baby dyads from all public (N = 5) and 29 (of 35) private maternity clinics. The likelihood of early introduction according to socio-demographic characteristics and breastfeeding self-efficacy (measured at birth and 1st month) was estimated in logistic regression models.

Results

Three out of ten women (30.8%) had initiated solids before the 4th month and only 20% hadn't by the 6th month. Almost half of non-Cypriot mothers (47.1%) initiated solids earlier than the 5th month, twice more likely compared to 25.1% of Cypriot mothers (OR: 2.45 95% CI: 1.30-4.57). There was a stepwise association with educational attainment with mothers with tertiary education more likely to initiate solids later (OR: 2.76 95% CI: 1.33-5.71) compared to those with at most secondary education. A similar social gradient was observed with income but was not statistically significant in multivariable models, while no association was observed with mode of birth (55.9% by C/S). Even though low breastfeeding self-efficacy at first month was predictive of earlier initiation, surprisingly, primiparous or multiparous mothers without previous breastfeeding experience were more likely to initiate solids later.

Conclusions

Early introduction of solids with a clear social gradient suggests the need for strengthening the currently weak community-based interventions to improve weaning practices, including screening for breastfeeding self-efficacy.

Key messages

• Four in five mums in Cyprus introduce solids before the 6th month with one in three introducing solids in the infant’s diet before the 4th month, with a clear social gradient in the patterning.

• Community-based intervention programmes are needed to improve weaning practices, including screening for low breastfeeding self-efficacy in a country with low breastfeeding rates.
Women’s preferences in the low-risk pregnancy management: Discrete Choice Experiments from Tuscany
Authors: Bonciani M , Corazza I , Ferrari A , Batinelli L , Pennucci F
Published: October 2022

During the last years, organizational models to assist women during pregnancy have changed. The physiological management of low-risk pregnancy is gaining momentum thanks to increased available evidence. Therefore, a need to assess women’s acceptance of these new proposals is emerging. This study aims to explore women’s preferences during pregnancy and childbirth. We enrolled women from the continuously active survey on the maternity pathway in Tuscany, Italy. We designed Two Discrete Choice Experiments (DCE) and administered them through web-based surveys. We sought to catch women’s preferences on health professionals to be involved, team-based or exclusive assistance, the physical proximity of healthcare services, and cost per service. We also explored women’s decision-making autonomy and pain management during labour and childbirth. Additionally, we investigated women’s information needs on the physiological model of low-risk pregnancy management through qualitative methods. Mixed logit models on the DCEs results show that women prefer being assisted during pregnancy and childbirth by healthcare services that are free of charge, easily accessible from a geographic point of view, and provided by a gynaecologist. The interaction effects reveal statistically significant differences for some sociodemographic variables of respondents and maternity pathway attributes. Besides, qualitative analyses highlight that women are interested in the physiological management of low-risk pregnancy according to their level of knowledge, confidence and safety feelings, and beliefs concerning non-medicalization and autonomy. The main findings of this study point out several implications for policy and managerial practice to effectively implement the physiological model of low-risk pregnancy management.

Key messages

• This study proves that costs, travel distance, and type of health professional are the main determinants of women’s elicited preferences during pregnancy and childbirth.

• Policymakers and healthcare managers should consider these findings in organizing and providing maternal and childbirth health services to foster the physiological management of low-risk pregnancies.
Sexual education in the school setting: an overview of the Italian situation
Authors: Cappelletti T , Lo Moro G , Elhadidy HSMA , Bert F , Scaioli G , Siliquini R
Published: October 2022

Background

There is an important interaction between sexuality and many life factors. A good sexual education at school can improve knowledge and behaviour in young people giving them a healthy sexual life. Unlike most European countries, sexual education in Italy is not compulsory in the school curriculum, so this study explored the Italian regional initiatives realised over a span of 15 years.

Methods

A review of grey literature was conducted on Public Health Administrations/Regions websites of each Italian region, focusing on official documents containing training catalogues for schools. The search was conducted in December 2021, including documents produced between 2006 and 2021. We used the topics recommended by UNESCO as quality markers for the projects found.

Results

Among the 20 Italian regions, 12 had at least one programme. A total of 39 projects were found. All UNESCO topics were covered, with notable differences between north, centre and south of Italy, which had the lowest number of projects. Most of the projects (23) were carried out only once, the others were repeated at least for two years in a row. Contraception, along with love, marriage, partnerships, and family, were the main topics discussed during sexual education programs in schools (92%), followed by biological aspects, body awareness, and anatomy (83%); birth, disability, human rights, and online media were less common (33%). Regarding the target, disability, human rights, and mutual consent were deepened only for middle and high school students.

Conclusions

Considering the fundamental importance of sexual education, there is an important lack in promotion and planning in Italy. There is a large discrepancy between the northern and southern regions and it is necessary to implement and standardize the offer of sexual education programs in schools.

Key messages

• Unlike the European average, In Italy there is an important lack on sexual education, whit large discrepancies between the northern and southern regions, putting the latter at disadvantage.

• Contraception, marriage, couples, and family were the main topics discussed during sexual education programs in schools; birth, disability, human rights, and online media the least.
Implementing the Bloom Trial: Community health nurses’ perceptions of potential barriers
Authors: Brautsch L , Kierkegaard L , Carlsson RR , Bonnesen CT
Published: October 2022

Background

The overall aim of the Bloom Trial is to develop and test a program promoting healthy weight development during infancy within the community health nurse setting in Denmark. Many interventions are poorly implemented, and to ensure adequate implementation support, previous studies have suggested to assess barriers and organizational readiness before intervention start. The aim of the present study is to assess barriers for implementing and sustaining the Bloom Trial among program adopters and implementers.

Methods

Telephone interviews with managing health nurses (adopters) and health nurses (implementors) from twenty Danish municipalities were carried out (n = 22) in 2017. Moreover, two workshops with health nurses, and continuously meetings with implementation science experts were conducted in 2021-2022.

Results

Barriers were identified on different levels. Organizational barriers within the work of health nurses included lack of time, economic resources, project fatigue, and political priority. Furthermore, health nurses lacked relevant tools to guide parents about promoting healthy weight development. Interpersonal barriers between health nurses and parents were identified as the difficulties of having conversations about healthy weight development, especially if the parents or health nurses were overweight themselves. Cultural differences including language barriers and different perceptions of for example healthy food choices were also found.

Conclusions

The findings are central for ensuring that the Bloom Trial is relevant and applicable to the setting of health nurses in Danish municipalities. This is crucial for ensuring successful adoption, implementation, and prolonged sustainability.

Key messages

• The study pinpoints key barriers (e.g. lack of time, project fatigue and cultural factors) of implementing an intervention promoting healthy weight in the community health nurse setting in Denmark.

• Involving community health nurses’ perceptions aim at increasing the chances of producing a relevant and successful implementation strategy.