bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender-specific personal values and life priorities: Insights from the Bedouin minority in Israel
Authors: Shibli H , Aizik I , Or Sharvit Z , Shapira S
Published: October 2023

Introduction

Personal values play a crucial role in shaping health behaviors and decision-making. The study aimed to explore the values and priorities of the Bedouin minority in Israel using the Portrait Values Questionnaire (PVQ-21). While the PVQ-21 is widely used, few studies have examined its use among minority populations in Israel.

Methods

A cross-sectional survey was conducted among 331 Bedouin participants in Southern Israel. Participants completed the PVQ-21 questionnaire, which measures four key values related to self-transcendence (universalism and benevolence), self-enhancement (achievement and power), openness to change (self-direction, stimulation and hedonism), and conservation (security, conformity and tradition).

Results

The overall PVQ-21 score was significantly higher (p < 0.001) among Bedouin males (6.40±0.67) than females (5.92±0.89). Gender differences were significantly higher among men in self-transcendence (7.02±0.9 vs. 6.02± 1.21, respectively) and conservation (7.04±0.73 vs. 6.11±1.07, respectively), but not in self-enhancement and openness to change. Specifically, significant differences (p < 0.05) in conservation values were observed between residents of recognized towns and residents of newly recognized/unrecognized villages (6.66±1.07 vs. 6.42±0.95, respectively). Religiosity, marital status, and education were significantly associated with self-transcendence and conservation values.

Conclusions

This study provides valuable insights into the personal values and priorities of the Bedouin minority in Israel. The results suggest that Bedouin women prioritize values related to benevolence and conservation, which may reflect the traditional gender roles and expectations within Bedouin society. Recognizing the cultural context and unique value orientations within minority populations is essential for developing effective and inclusive health promotion strategies that can contribute to reducing health disparities and improving overall well-being.

Key messages

• Gender differences in personal values among Bedouin minority in Israel highlight the importance of understanding cultural context.

• Recognizing the value priorities of minority populations is crucial for developing effective and inclusive health promotion strategies that address health disparities.
Community Perspectives to Inform Substance Use Prevention Practice
Authors: Morse A , McGuigan K , Brady A , Hargey C , Higgins K
Published: October 2023

Problem

The Market is a highly cohesive working-class community in South Belfast. Queen's Communities and Place (QCAP) has partnered with the Market as an anchor community to co-develop research to generate actionable data to alleviate public health challenges. Both the Market Development Association (MDA) and QCAP's research findings identified substance use (SU) as a key issue and delivered Northern Ireland's first peer naloxone training in December 2022. However, a long-term strategy aligned with residents’ vision is necessary.

Methods

The MDA and QCAP co-hosted an event in February 2023 asking attendees 4 questions to guide small group discussion: •What is the current situation with SU in the Market? •Why do these problems exist? •What are service gaps? •What should the MDA and QCAP do to help?

QCAP staff conducted a qualitative analysis of the discussion notes and presented the results to the MDA to guide intervention development.

Results

Residents had nuanced knowledge of SU in the area and feelings of both powerlessness against larger forces and optimism for change if given the necessary resources. The analysis revealed 3 key themes: the breadth of the issue in the community; a lack of supportive services; and a need for demographically tailored SU education.

Lessons

QCAP and the MDA have a better understanding of area's concerns about SU and hopes for addressing it. Short and long-term actions are planned: •Event series for parents covering drugs circulating, signs of SU, and overdose intervention steps. •Materials added to the existing “community indicators dashboard” publicised through QR codes posted at key locations. •Programming for youth co-developed with the area's new youth forum. •Seeking funding for a “health navigator” based in the community to connect residents with services they need. •Building connections with local GPs using a local champion model to reduce provider burden.

Key messages

• Communities have strong understanding of their public health challenges and can effectively guide the development of intervention strategies.

• It is feasible to derive meaningful and informative feedback to direct public health action through shared power in research and community-engagement.
Loneliness, ageism and mental wellbeing in nursing homes during the COVID-19 pandemic
Authors: Rodríguez-Blázquez C , Rojo-Perez F , Rodriguez-Rodriguez V , Forjaz M J , Fernandez-Mayoralas G , Martin S
Published: October 2023

Background

The measures imposed during the COVID-19 pandemic, especially social distancing, had important effects on feelings of loneliness. The objective of this work is to assess the perception of loneliness in older adults living in nursing homes during the pandemic, how it has changed during the pandemic and its explanatory factors.

Methods

The data come from the cross-sectional project “Protective environments of the elderly in health crises”, carried out in the Community of Madrid (Spain) in 2021. The variables used were the frequency of feelings of loneliness and its change during the pandemic, as well as socio-demographic, health, emotional and contextual characteristics. Descriptive statistics and logistic regression analysis were calculated.

Results

The sample consisted of 447 people; mean age was 83.8; 63.1% were women; half of the sample were widowed; 40% had an educative level lower than primary. Almost 3 out of 10 residents stated that they often or always/almost always felt alone. In the regression model, loneliness was negatively associated with age, number of medications, emotional balance, coping ability, self-perception of aging, and engaging in rewarding activities; while having a low assessment of mobility in the residential environment was positively associated. In addition, 28% of the participants who declared loneliness, also felt lonelier than before the pandemic. The variables associated with change in feelings of loneliness were age, self-perception of aging and a low assessment of the residential environment.

Conclusions

The restrictions on mobility and social relationships during the COVID-19 epidemic have affected older people who were living in residences, with an increase in the feeling of loneliness related to demographic, emotional and contextual variables. Interventions on the design of residential spaces can mitigate the effects of isolation and loneliness related to health crises such as COVID-19 pandemic.
Identifying the Gaps Between Public Health Training and Practice: A Workforce Competencies Analysis
Authors: Bashkin O , Otok R , Kapra O , Czabanowska K , Leighton L , Dopelt K , Davidovitch N , Tulchinsky T , Barach P , Mor Z
Published: October 2023

Background

The COVID-19 pandemic has reinforced the critical needs for a well-qualified and proficient workforce to provide comprehensive, high-quality health services, reach minorities, reduce health inequalities, and confront emerging health challenges. We aimed to generate insights on how best to enhance the compatibility between Public Health (PH) training program competencies and the implementation of competencies required by employers in addressing emerging public health needs.

Methods

We conducted an online survey, adapted from the WHO-ASPHER Competency Framework for the PH Workforce, among Israeli PH managers from August to November 2021. The survey was pretested using a modified Delphi method process. The final survey comprised 44 PH competencies divided into ten categories and was formulated to mirror Essential Public Health Operations (EPHOs). Reliability of items ranged from Cronbach's α = 0.56 to α = 0.86. Forty-nine managers participated (37.6% response rate) in the assessment of PH competencies and the core organizational PH health operations. Participants were employed at regional health departments or governmental offices (51%), followed by Ministry of Health headquarters and other governmental offices (29%).

Results

Analysis of the EPHOs revealed a high deficiency in Advocacy Communication and Social Mobilization for health competencies. Collaborations & Partnership and, Leadership & System Thinking were the most reported insufficient competencies, particularly in health departments and research institutes. Governmental offices reported Organizational Literacy & Adaptability competencies being deficient. Deficiencies were more impactful as the level of expertise increased.

Conclusions

There is an urgent need for PH professionals to acquire versatile and innovative competencies in response to ever-changing health threats. Using a validated survey backed by an expert consensus, our analyses profiled the work needs of many PH workforce employers.

Key messages

• Leaders of PH services and PH higher education programs should discuss actionable ways to collaborate, redesign and better adapt educational programs to the evolving and demanding field needs.

• Continuous evaluation of PH competencies can prepare a competent PH workforce ready to confront new health challenges and adapt to the changing population health.
Competency framework on simulation model-based decision-making for Master of Public Health students
Authors: Hrzic R , Cade M V , Wong BLH , McCreesh N , Simon J , Czabanowska K
Published: October 2023

Background

Simulation models support decision-making by helping public health practitioners evaluate the potential effects of interventions in complex systems and their ultimate health impacts. However, many public health professionals remain unfamiliar with constructing simulation models and how best to use their outputs for decision-making due to a lack of training. This study developed a competency framework on simulation model-supported decision-making targeting Master of Public Health students.

Methods

The study was conducted in three phases: a literature review, a two-stage online Delphi survey, and an online consensus workshop. A draft competency framework was developed based on 28 peer-reviewed publications. A two-stage online Delphi survey involving experts in simulation modelling, health policy, and public health education was conducted to validate the domains and competencies in the framework. Finally, an online consensus workshop was held to evaluate the competency framework and discuss its implementation in education.

Results

The literature-based draft framework included twenty competencies related to project planning, stakeholder engagement, problem definition, evidence identification, participatory system mapping, model calibration, and the interpretation and dissemination of model results. The Delphi surveys included four and twelve European experts each and identified additional competencies in assessing uncertainty and generalisability. The online consensus workshop included six experts and recommended expertise and profile differentiation to enhance the framework's utility for public health training.

Conclusions

The competency framework developed in this study is critical to including simulation model-supported decision-making in public health training. Developing self-assessment tools will refine the competency framework through expertise and profile differentiation and support developing appropriate educational interventions.

Key messages

• Public health professionals need training in simulation model-supported decision-making to evaluate the health impact of various interventions more effectively.

• The developed competency framework is critical to including simulation model-supported decision-making in public health training but needs expertise and profile differentiation for implementation.
Deafness and Communicative Barriers with reference to University Courses in the Rehabilitation area
Authors: Sabato M , Sandroni S , Marceca M
Published: October 2023

Introduction

Deafness frustrates communication. It creates a communication deficit/barrier between the deaf person and the hearing community. Without appropriate training of Healthcare staff in effective communication strategies, this gap can marginalize/exclude the Deaf Community by denying them access to necessary Healthcare provision with adverse outcome for diagnostic and therapeutic success. This study highlights the pressing need for and desire of Healthcare staff for training in effective communication strategies, the willingness of University Healthcare Degree Course Directors to explore this, and the perspective of the Deaf community itself, entitled to equal access to Healthcare

Material and Methods

Using the Google forms platform, online questionnaires were given to the 3 stakeholders all over Italy: Deaf people DP; Rehabilitation Healthcare Staff RHS; University Degree Course Directors in Rehabilitation UDCDR. Data Analysis was carried out using the Google Forms program, SPSS program Windows7 Excel Spreadsheet.

Results

252 RHS (89% women) participated, (92.9%) interested in Courses about Communication with Deaf People (57% of these had deaf patients, but only 45% had specific training). 39 DCHR took part (39,4% Heads of Speech Therapy courses and 35,3% Heads of Developmental Neuro-Psychomotricity Therapy courses). These Heads do not foresee training courses on the subject, even though 92% of them consider it quite/ very important for their students’ formation. 23 DP participated (69% aged 18-45); 56% report having received simplistic communications solely because they are deaf; 78% had problems in establishing a relationship of trust with health staff, due to communication barriers.

Conclusions

Both health workers and deaf people identify significant training needs to overcome communication barriers. Apropos, the UDCDR involved show their willingness to pursue further study of this.

Key messages

• This study highlights the need to train health workers in essential communication strategies with deaf people, to reduce the significant barriers that prevent their access to appropriate therapy.

• There is a need for training in effective communication strategies between deaf people and Rehabilitation Health Professionals. Training should be duly adapted to provide all inclusive Healthcare.
Do the future health professionals feel prepared to care for the increasingly diverse population?
Authors: Sorensen J , Lykke Hindhede A , Maheswaran S , Norredam M , de Montgomery C , Krasnik A
Published: October 2023

Background

Migrant and ethnic minority populations in Europe are growing, leading to a demand for health systems and health educations to accommodate the growing diversity. However, many medical educations in Europe, including Denmark, have not yet incorporated diversity competence training into their curriculum. The aim of the study is to investigate whether Danish medical students feel adequately prepared to provide care and address the needs of the increasingly diverse population.

Methods

An online survey was conducted by email to 5234 students in four medical Master programs in Denmark or were undergoing clinical internship. Reminders were distributed by email, shared in Facebook groups and were presented during lectures where cards with QR codes for the survey were distributed. Data collection took place during spring 2023. The survey questions were adapted from the validated Recidency Training In Cross-Cultural Care questionnaire (University of Boston and Harvard University), with adjustments from the University of Hawaii.

Results

Across universities 64% - 80% of the participating medical students and young physicians reported that they felt very or somewhat unprepared when it comes to care for patients who are new immigrants. Additionally, 57%-83% of the participants felt very or somewhat unprepared in providing care for patients with a distrust of the Danish health care system. In total, 31% reported feeling helpless at times or often in the last year when providing care to patients from a culture different from their own.

Conclusions

Our findings indicate that many Danish medical students and young physicians feel challenged and unprepared when it comes to providing care to migrants and ethnic minority patients. The variation between universities may reflect differences in curriculum and patient composition.

Key messages

• The increasing diversity of European populations is a challenge to the medical profession and not yet sufficiently reflected in Danish medical training.

• Medical schools need to ensure development and integration of diversity competence training in the medical programs in order to support inclusive health care services.
EUREST-RISE: An innovative networking and training project on European Tobacco Control
Authors: Vardavas C , Plyta Z , Lagou I , Aslanoglou K , Marou V , Papathanasaki K , Vardavas A , Vogiatzidaki S ,   on behalf of the EUREST-RISE Consortium
Published: October 2023

Aim and objective

The world's leading contributor to avoidable illness and premature death is thought to be smoking and other tobacco use. An integrated set of research projects are suggested as part of EUREST-RISE to aid in the training of researchers in the analysis of tobacco product systems, their processes and functions, and the relationships between important design elements and their evaluation in user populations.

Methods

Currently in its first phase of execution, EUREST-RISE is a Marie Sklodowska Curie Action (MSCA) funded under Grant Agreement (Number:101008139). In the framework of particular research objectives addressed within tasks of each WP, interdisciplinary knowledge transfer will be achieved through the intersectoral secondment of researchers and their reintegration to their home institution.

Results

By offering a special framework for collaboration on joint research and innovation projects in three areas, EUREST-RISE expects to achieve its goal of developing a cohort of scholars with cutting-edge practical training in European tobacco product regulatory science. A) Exchange of information about the use of big data bases to address tobacco control concerns from a product-level or population-level viewpoint, including EU Common Entry Gate product-level data and European secondary population-based databases B) offer research and training on the application of sensory and chemical analyses for the evaluation of flavors in heated tobacco products, e-cigarettes, and tobacco products C) train researchers in advocacy activities and policy integration, facilitate training in peer to peer communication, and training on communication to media and the general public.

Conclusions

A network of excellence in European tobacco product regulation science is anticipated to be created via the EUREST-RISE initiative.

Key messages

• Conflicts of Interest: None.

• Funding: The EUREST-RISE Project takes place with the financial support of the European Union, under a Grant Agreement (Number:101008139, PI: Dr Vardavas).
Psychosocial literacy at work: The role of digital data
Authors: Fernandes C , Cotrim T , Pereira A
Published: October 2023

The burden caused by poor psychosocial working environments on the working population, organizations, societies, and economies are a major challenge to occupational health, and fair work. A key enabler for accelerating the promotion of healthy and safe workplaces is the enhancement of psychosocial health literacy at work, to support not only workers and organizations but also communities and countries to understand, recognize and take effective actions to protect and promote their own psychosocial health and sustainability. Digitalization, on the other hand has been an enabler for knowledge creation and added value to information. The present work proposes a methodology that combines digital big data on psychosocial health of the Portuguese working population (PWP), allied with quantitative and qualitive approaches to the design of psychosocial literacy at work tailored interventions. In the promotion of psychosocial safe working environments collaborative co-design models are often recognized has effective because the process undertakes meaningful engagement with workers, enlarged community, health and safety professionals and decision makers, to uncover specific wisdom and ensure tailored psychosocial work literacy interventions. Each organization is unique and undertakes its own “personality”, so individualized interventions for dealing with the organization individual psychosocial profile are the most effective way to design such interventions. The digital data from the PWP are allied with a qualitative tailored approach admitting results maximization by using digital big data and algorithm calculation for several values and cluster identification incorporating individual and organizational specificities, using the data from the Portuguese Observatory on Occupational Factors (Popsy@Work). Its intended to raise awareness on the need to democratize the access to psychosocial health at work.

Key messages

• Digital big data on psychosocial health monitoring, reporting and foresight, allows the promotion of robust metrics and reference values for the Portuguese working population.

• Psychosocial literacy at work is potentiated by collaborative co-design models – aligning digital big data and qualitative individualized approaches.
Subjective and objective measurements of nurses’ stress and recovery
Authors: Rantanen N , Sanmark E , Oksanen L-M , Lieslehto J , Myllymäki T , Geneid A , Lallukka T
Published: October 2023

Objectives

High workloads and stress of healthcare workforce are global phenomena. We aimed to study work related stress and recovery of nurses with both subjective and objective methods, also aiming to examine if associations exist between subjective high work stress and need for recovery, and objectively measured stress and recovery.

Methods

Study sample comprised 65 nurses employed in the City of Helsinki. Heart rate variability (HRV) measurements were conducted for 3 consecutive days with ECG-based device in real-life setting, including 2 workdays and 1 day off. Objective stress and recovery were assessed from HRV and HRV-based stress and recovery variables. Participants filled out an electronic survey, where work stress was measured with Effort-reward imbalance scale and recovery after work with Need for recovery scale.

Results

Proportion of nurses with effort-reward ratio >1, indicating work stress, was high (84.6%), as was proportion of those with high need for recovery (64.6%). High need for recovery (score ≥54.5) was associated with lower RMSSD during sleep (p = 0.014) and higher absolute stress index (p = 0.009) on workdays. In high need for recovery group, stress balance (p = 0.040) and relaxation percentage (p = 0.033) were significantly lower on workdays than day off. In moderate work stress group, stress balance (p = 0.042), relaxation percentage (p = 0.041) and absolute relaxation index (p = 0.035) were lower on workdays than day off. No significant differences were observed within other groups.

Conclusions

Majority of participants suffered from work stress or high need for recovery. Based on our results, nurses’ high need for recovery is reflected in lower sleep time HRV, indicating worse physiological recovery. In those with high need for recovery, physiological recovery was also worse on workdays when compared with day off. Our findings highlight the importance of recovery, and in the future, nurses’ recovery and work stress should be increasingly monitored.

Key messages

• Nurses’ high need for recovery is reflected in lower sleep time heart rate variability.

• Nurses’ recovery and work stress should be increasingly monitored.
Embedding physical activity into the undergraduate curricula of a Portuguese medical school
Authors: Mendes R , Barbosa A , Caldas Afonso A , Beirão I , Barros H
Published: October 2023

Background

One of the strategies endorsed by the World Health Organization and the European Commission to promote physical activity (PA) is to incorporate PA content into the curricula of healthcare professionals.

Objectives

As part of the VANGUARD project (supported by the European Union Erasmus+ Programme), we aimed to analyse the acceptability of a course on PA and health among undergraduate medical students. The School of Medicine and Biomedical Sciences of the University of Porto (ICBAS) was invited to participate. An online survey was administered in June-July 2022 to solicit the input of the students regarding the importance and the operational procedures of implementing a PA and health course into their curricula.

Results

A total of 77 students answered the survey (median age of 21.0 years [interquartile range, P25-P75, 20-24], 75.3% female). Students rated the importance of incorporating PA content in their medical degree program with a median (P25-P75) of 5 (4-5) on a scale of 1 to 5. Most students expressed an interest in PA and mental health (88.3%), cancer (75.3%), cardiovascular disease (75.3%), diabetes (68.8%), and pregnancy (68.8%). In terms of the operational aspects, students expressed their preference for a course offered in the second year (33.8%); as part of the epidemiology and public health discipline (27.3%); optional (58.4%); through a hybrid learning system (49.4% [face-to-face activities + online live sessions + online self-paced learning]); taught in Portuguese (66.2%); with face-to-face assessments (55.8%); with continuous evaluation (77.9%); and using quantitative grading (62.3%).

Conclusions

Medical students showed considerable acknowledgement regarding the importance of incorporating PA and health into their curricula. Additionally, they provided guidance on developing and implementing a course on this topic. A course is going to be offered to the students and proposed to the Council of Portuguese Medical Schools to be scaled up nationally.

Key messages

• Medical students considered PA and health as a very important topic for curricula.

• Medical students have specific preferences for embedding new courses in their curricula.
Promoting healthy learning: A participatory health promotion project with healthcare students
Authors: Schloemer T , Domenik L , Dreyer A-C , Scheu L
Published: October 2023

Background

Health promotion is of great importance during education to prepare future health professionals for their work. Students need to cope with long periods of sitting, stress and high workload through practical training in the healthcare sector. Based on students’ experiences, we developed a project to promote healthy learning at a University of applied Sciences for Health in Germany.

Objectives

The project is part of an ongoing quality improvement in education initiative. Our aim was to inform students about health promotion in everyday study life. Based on a participatory approach, 3 employed occupational therapy students designed two videos with their peers. For evaluation, we sent three e-mails and conducted a survey among all 1730 students from 17 to 30 April 2023. Questions related to three aspects: how much students like the videos, whether they find them helpful, and whether they intend to use them in their everyday studies.

Results

Students identified two video topics: 1. Ergonomic adjustment of the desk with tips for improvement at no or low cost; 2. A short exercise programme to take part in, tailor-made for breaks between lectures or learning phases. 193 students opened the survey, 92 completed the questionnaire. The ergonomics video was rated good to very good by 83 (90%) of the participants; 83 (90%) found it helpful to optimize their workplace. 62 students (67%) wanted to adapt their workplace, 30 (33%) did not, already had an optimal workplace or abstained. The exercise video was rated good to very good by 76 (83%); 78 (85%) of the participants found it helpful. While 61 (66%) wanted to use it in their daily student life, 34% did not, used other exercises or abstained.

Conclusions

A consultation with the students in the project revealed that the survey's low response rate reflects the general burden of e-mail floods and study workload. Tailored videos were rated by most participants as helpful in promoting health in everyday study life.

Key messages

• Tailored health promotion is of great importance for healthcare students. Measures need to be affordable and easy to integrate in everyday student life.

• Participatory approaches to health promotion for students are essential, because students’ expertise for student life leads to measures that best suit their needs.
Romanian students’ knowledge on radiation protection
Authors: Prejbeanu I M , Purcaru S , Cara M L , Prejbeanu D F
Published: October 2023

Since March 2022, Romania has become a country in the vicinity of a military conflict (there are 649 km border between Romania and Ukraine). As the Russian Federation threatens with using its nuclear arsenal against Ukraine or NATO member states, the risk the Romanian population to be exposed to high radioactivity levels (including radioactive iodine) has to be taken into consideration. In this context, in April 2022 the Romanian Ministry of Health decided to provide iodine tablets to all people under the age of 40; it also launched a public information campaign aimed to advise people on how to avoid radiation exposure, including how to take iodine tablets. One year after this campaign, we evaluated the students’ knowledge on potassium iodide (KI) administration. A number of 828 students (in Medicine, Dentistry, Nursing, Pharmacy, Sciences, Electronics, and Philology), 68% females, aged 20-24 years, answered a 12-item questionnaire on KI administration. The results show 78.3% of the subjects associated KI administration with a nuclear accident/use of nuclear weapons; about 70% knew they can have KI from the pharmacist's using a prescription from the general practitioner. Only 38.6 % of the students correctly mentioned the age of KI administration; 41.1% knew a single dose administration is necessary. About 63% of the respondents knew KI is necessary to protect the thyroid; 53.1% mentioned thyroid cancer as the risk of KI non-administration. As expected, most correct answers were given by students in health-care specialties, while the less correct - by students in Philology (p < 0.001). Surprisingly, best informed medical students were respondents from Nursing, followed by those in Medicine, Pharmacy, and Dentistry (p < 0.01). Even students are considered a well-informed population group, the results indicate more than half of the subjects miss important information concerning radiation exposure attitude.

Key messages

• Nowadays nuclear weapons use is a threat everybody should be aware of.

• Information is an essential tool to make people able to protect themselves against radiation exposure.
Mothers’ perceptions of barriers and opportunities for health-promoting lifestyle one year postpartum
Authors: Fuchs-Neuhold B , Holasek S
Published: October 2023

Background

Pregnancy is often seen as an opportunity for women to transition to a health-promoting lifestyle but maintaining healthy habits can be challenging in the postpartum period. This study aims to explore women's experiences with lifestyle changes related to diet, physical activity, mental health, and social health one year after delivery.

Methods

Semi-structured face-to-face interviews with women one year postpartum (n = 24; mean age 33.58 ± 0.88; mean BMI (kg/m2) 23.18 ± 3.09) recruited through a longitudinal study in Austria were recorded and transcribed verbatim. Qualitative content analysis with an inductive approach was used to analyze the data.

Results

Five overarching themes related to the research question emerged, including ‘social relationships and partnership,’ ‘responsibilities, stressors, and time,’ ‘diet, exercise, and sleep patterns,’ ‘mental illness,’ and ‘family and external support.’ Women's views on lifestyle changes reflect the diversity of different personalities and life circumstances. However, the results suggest that women find it difficult to transfer their good intentions from pregnancy to postpartum behavior, regardless of their initial motivation.

Conclusions

This study highlights the need for individualized health supports that provide flexibility, such as telehealth, to address nutrition, psychological and physiological changes, feelings of distress, and lack of support. Health professionals and support systems can provide targeted, evidence-based interventions and support for this population by understanding how the transition to motherhood affects mothers’ lifestyles and health habits. Overall, the study provides valuable insight into the challenges and opportunities that mothers face postpartum and can inform the development of evidence-based interventions to promote their health and well-being.

Key messages

• There is a need for individualized health support (e.g. telehealth) that provides flexibility in the postpartum period for maintaining a health-promoting lifestyle.

• Understanding postpartum transition enables health professionals and support systems to provide evidence-based interventions for maternal well-being.
Type of delivery, birthweight, breastfeeding and overweight: the 2019 Italian results
Authors: Nardone P , Ciardullo S , Spinelli A , Buoncristiano M , Andreozzi S , Bucciarelli M , Salvatore M A , Galeone D ,   The OKkio alla SALUTE Group 2019
Published: October 2023

Introduction

According to recent studies, childhood obesity can be affected by type of delivery, birthweight and breastfeeding. The data from the surveillance system OKkio alla SALUTE, coordinated by the Italian National Institute of Health, have been used to investigate this association. OKkio alla SALUTE, promoted by the Italian Ministry of Health, is part of the WHO European Childhood Obesity Surveillance Initiative.

Methods

The study population are children aged 8 or 9 years in the third grade of all primary schools. A stratified cluster sample design, with class as the sampling unit, was used. Children were weighed and measured by trained local health staff and were classified as overweight or obese using the age and sex-specific International Obesity Task Force cut-offs. Parents of children completed a brief questionnaire to assess risk behavior, including information about the birth and the first few months of life of their child.

Results

In 2019, the sixth round of data collection involved 47,219 children and 50,370 parents with a response rate higher than 94%. 20.4% (95% CI 19.9-20.9) of 8-9 years old children were overweight and 9.4% (95% CI 9.0-9.7) were obese. The prevalence of obesity has decreased steadily since 2008 to 2019. The prevalence of overweight and obesity was higher for children born by caesarean section (33% vs 27% by vaginal childbirth), increased with birthweight (for birthweight >4,000 kg: 39.4% vs for birthweight<2,500 kg: 25.1%) and among children who had been breastfed never or less than 1 month (33.6% vs breastfeeding 6 months and above: 28.9%). Logistic regression analysis confirms the association between characteristics at birth/breastfeeding and overweight/ obesity.

Conclusions

Type of delivery, birth weight and breastfeeding seem to play a role in the prevalence of childhood overweight and obesity. Although these results may be affected by recall bias, this is unlikely to materially affect the results.

Key messages

• Type of delivery, birth weight and breastfeeding seem to play a role in the prevalence of childhood overweight and obesity.

• Information on breastfeeding and other characteristics at birth that might be associated with overweight and obesity is essential for tracking progress in countries.
Ramadan during pregnancy and offspring health over the life course: A systematic review
Authors: Van Ewijk R , Pradella F
Published: October 2023

Background

The Muslim population in Europe is increasing, with by now more than 5% of the population being Muslim. During pregnancy, many Muslim women choose to adhere to the Ramadan fast. Research on health effects of Ramadan during pregnancy on the offspring has been conducted through two separate literature strands. One compares offspring of women who chose vs didn't choose to fast and focuses on birth outcomes. The other strand uses an ITT-approach, classifying Muslims as potentially vs certainly not exposed based on their birthdates relative to Ramadan. The ITT-studies’ design allows to also study later-life health. This review combines both strands and evaluates their ability to identify causal effects between Ramadan during pregnancy and offspring health.

Methods

A systematic literature search using PubMed, EconLit and Web of Science plus a Google Scholar search yielded 35 eligible studies. Data were extracted and quality assessed using a checklist.

Results

Non-ITT studies often struggle to adequately address bias from self-selection in treatment, with a high risk of confounding and unknown direction of bias. ITT studies, while producing results biased toward zero, are likely to reveal causality and relied on large datasets, leading to high statistical power. Studies meeting the quality threshold find limited evidence of effects on birth outcomes, such as birthweight, but show increased child mortality rates and worse adult health outcomes along several dimensions. These effects tend to increase in magnitude with age, which is congruent with fetal programming theory.

Conclusions

Medical advisories, guidelines and previous literature reviews mostly focused on non-ITT studies that primarily examined birth outcomes. However, health effects mostly show up at later ages. Consequently, adverse long-run effects are often overlooked, and pregnant Muslims remain not fully informed of potential health impacts on their offspring of their Ramadan fasting decisions.

Key messages

• Many pregnant Muslims decide to fast during Ramadan. Rigorous quality checking of the research on offspring health effects is needed to provide informative evidence for the growing Muslim population.

• Adverse health effects of Ramadan during pregnancy mostly become visible only years after birth. Medical advisories tend to focus on evidence on birth effects, overlooking long-term adverse effects.
Gaps, demands and fragmentation – exploring the marketisation of Finnish maternity care
Authors: Jones M
Published: October 2023

Background

Public maternity services are considered a source of pride in Finland. They comprise of publicly funded community-based clinics that are free at the point of delivery. The services play an important role in the care of the pregnant parent and the monitoring of foetal growth and development. However, maternity services have not been immune to the strains faced by public services, such as funding cuts and staff shortages. Over recent years, an increasing number of private providers have begun to offer maternity care. These include large healthcare companies and small midwife-led services. The aim of this study is to better understand various developments fuelling the maternity service market in a country that offers free maternity care. This study provides new insights from the perspective of professionals providing private services. I ask: what needs are private providers attempting to respond to and how? Additionally, I explore the role of private services in creating new demands and how the expanding market may contribute to the fragmentation of maternity care.

Methods

The materials consist of individual interviews with health professionals (n = 20) conducted during the spring of 2023 and analysed using thematic analysis.

Results and conclusions

Preliminary findings suggest that private providers are attempting to respond to needs that are currently neglected by the public sector. These include a gaps in specialist care, emotional care and care quality. Hence, those with disposable income are able to purchase services and products that are not available in the public sector. The existence of this market also contributes to the growing demand for laboratory tests, screening and ultrasounds without medical indication. Expectant parents use private and public services in various combinations, but a lack of formal collaboration between different service providers can lead to fragmented care if health information is not shared between professionals.

Key messages

• Finnish maternity services are expanding and diversifying as increasing number of private providers begin to offer pregnancy care.

• Private services attempt to respond to expectant parents’ wishes. However, market expansion can also contribute to the increased demand for screening and the fragmentation of care.
Syrian Women Knowledge and Attitudes Towards Hepatitis B Prevention
Authors: Bohsas H , Alibrahim H , Swed S , Nour Nasif M , Hossam El Din Moawad M , Albakri K , Badr Almoshantaf M , Kazan L , Hafez W , Bakkour A
Published: October 2023

Background

Globally, mother-to-child transmission during childbirth is the most prevalent transmission method of hepatitis B (HBV). However, early immunization following birth is a safe and effective method of preventing this disease. This study evaluates Syrian mothers’ and pregnant females’ knowledge, attitude, and practice regarding HBV prevention and immunization.

Methods

This online cross-sectional study was performed in Syria between 2 October and 12 November. The inclusion criteria for this study were Syrian pregnant women who visited obstetrics and gynaecologist clinics for prenatal care, delivery, and postpartum checkups. The survey was adapted from a previous study, which contains 33 items divided into three sections. Data were analyzed using descriptive and multivariate logistic regression.

Results

This study enrolled 419 participants with a mean age of (28.4±5.9). More than half of the participants agreed that HBV could be transmitted from mother to her child at birth, and about two-thirds of them agreed that HBV vaccination is necessary for their infant (87.4%). Among participants with a university education degree, 35.7% revealed good knowledge, while only 12.3% of respondents with a primary school education level have good knowledge. More than half of housewife participants have shown positive attitudes (52.4%). Females with academic careers have a higher probability of good knowledge and positive attitudes than housewife women (OR = 107.09, P value<0.05) and (OR = 16.31, P value<0.05), respectively.

Conclusions

Syrian women have a moderate knowledge level about HBV prevention, with gaps in knowledge and attitudes among low-educated women. Performing local awareness campaigns about HBV and its vaccination for women can increase their knowledge and attitudes about this topic. Obstetric care providers should provide more information for pregnant females about HBV prevention for their children which may limit the occurrence of this phenomenon.

Key messages

• Syrian women have moderate knowledge of HBV prevention for their children, while lower-educated women have gaps in knowledge and attitudes.

• Local awareness campaigns about HBV and its vaccination for women can improve their knowledge and attitudes.
Associations of famine exposure in early life with height in two consecutive generations in China
Authors: Yao W Y , Yu Y F , Li L , Xu W H
Published: October 2023

Background

Poor nutrition early in life is associated with short stature, which is known to be associated with increased risk of cardiovascular disease and mortality in later life. Less evidence is available about whether early life nutrition affects height growth in the subsequent generation.

Objective

We aimed to investigate associations of famine exposure in utero and early-childhood with height across two generations.

Methods

We used the China Health and Nutrition Survey data and included 5,401 participants (F1) born in 1955-66 (the calendar year around the Chinese Great Famine in1959-61) and their 3,930 biological offspring (F2). We classified F1 participants into subgroups by famine exposure status (unexposed/exposed) and timing (fetal-/childhood-exposed) according to their birth year, and grouped F2 by their parents’ exposure. Linear regression models were conducted to evaluate the associations of famine exposure with adult height of F1 and F2. Linear mixed effect models with fractional polynomial functions were performed to estimate the difference in height between exposure groups of F2 during childhood.

Results

Participants (F1) exposed to famine in utero or childhood were shorter than those unexposed by 0.41 cm (95% CI: 0.03, 0.80) and 1.12 cm (0.75, 1.48), respectively. Offspring (F2) of exposed fathers were also shorter than those of unexposed parents by 1.07 cm (0.28, 1.86) during childhood (<18 years) and by 1.25 cm (0.07, 2.43) in adulthood (≥18 years), and those with exposed parents had a reduced height during childhood by 1.29 cm (0.68, 1.89). The associations were more pronounced among child offspring of highly-educated F1, particularly for paternal exposure and among female offspring (all p for interaction < 0.05).

Conclusions

The findings support the intergenerational effect of famine exposure in early life on height in Chinese populations, and indicate public health significance to improve nutritional status of mothers and children in the long run.

Key messages

• Exposure to famine in uteri or early-childhood were associated with a shorter height during adulthood and in their offspring.

• The adverse impact of famine exposure was more pronounced among child offspring of highly-educated F1, particularly for paternal exposure and among female offspring.
The role of parental composition in improved birth outcomes during the COVID-19 pandemic in Finland
Authors: Oberndorfer M , Luukkonen J , Remes H , Martikainen P
Published: October 2023

Background

In some high-income contexts, the COVID-19 pandemic was associated with improved birth outcomes, which was hypothesised to be caused by a positive effect of the pandemic on maternal health. Conversely, an improvement in birth outcomes may have been driven by pandemic-induced compositional changes in parental characteristics, which are associated with health outcomes at birth. Research on this consequence of the COVID-19 pandemic is critical for understanding pandemic-induced changes in population health (inequalities) and planning of public service provision.

Methods

We analysed population-wide data on birth outcomes and parental sociodemographic characteristics from Finland collected between January 2015 and December 2021 (n = 336,000). The total effect of pandemic-induced compositional changes on birth weight and preterm birth rate was estimated by segmented regression models using three conception cohorts: a) conceived prior to May 2019, b) conceived between June 2019 and February 2020 (to account for in-utero exposure to the pandemic), and c) conceived during the pandemic between March 2020 and February 2021 (to prevent selection bias).

Preliminary Results

Adjusting for secular trends and seasonality, and accounting for in-utero exposure to the pandemic, the estimated effect of parental compositional change on average birth weight was 36.5 grams [95%CI: 24.8; 48.3]. Correspondingly, this compositional change was associated with a 16.2% [95%CI: 8.8%; 23%] lower risk of preterm birth for babies conceived during the pandemic.

Conclusions

Pandemic-induced changes in parental composition drove the modest increase in birth weight and substantial reduction in preterm births for babies conceived during the pandemic. Should the postponed pregnancies among population groups at risk for worse birth outcomes eventually realise post-COVID-19, health care and educational systems may need to prepare for cohort-specific variations in service demand.

Key messages

• Improvement in birth weight and preterm birth rate among babies conceived during the COVID-19 pandemic were driven by pandemic-induced changes in parental composition.

• Further research using natural experimental designs on this compositional change and health outcomes can inform future public service provision.