bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of peer-education on the willingness to vaccinate against COVID-19 among high school students
Authors: Pasek O , Michalska J , Piechowicz M , Stoliński M , Ganczak M 
Published: October 2021

Abstract

Introduction
The willingness to vaccinate against COVID-19 among adolescents remains low. Peer-education about SARS-CoV-2 may positively influence attitudes to vaccinate among this group.

Objective
To assess the influence of peer-based educational intervention on the willingness to vaccinate against COVID-19 among Polish high school students.

Methods
In the Polish Lubuskie province, a peer education campaign was introduced among final year high school students from 24 randomly selected schools. Before and after the 45-minute lecture, conducted online by 13 medical students in 51 classes with science and other programs, the willingness to vaccinate was checked using an anonymous questionnaire. The p-value was calculated with the use of chi-square and Wilcoxon signed rank tests.

Results
Out of 883 students, 638 responded (72%); 268 males (42%), mean age: 18.4±0.6 years, 69% lived in cities with &lt;100,000 inhabitants, 32% were in the science program. The willingness to vaccinate improved from 31.8% to 35.2% after education (p &lt; 0.001); in females from 29.7% to 33.1%; in males from 34% to 37.7% (p &lt; 0.002; p &lt; 0.01 respectively). Before intervention 43.5% students living in the large cities and 26.5% in small cities wanted to be vaccinated, this increased to 48.0% and 29.5% respectively (p &lt; 0.003; p &lt; 0.005) after intervention. There were significant between-locations and between-programs differences in the willingness to vaccinate before and after intervention (p &lt; 0.001; p &lt; 0.001 and p &lt; 0.001; p &lt; 0.001 respectively). The improvement in the science program was from 44.3% to 47.8%; in the other programs from 26.1% to 29.5% (p &lt; 0.01; p &lt; 0.002 respectively).

Conclusions
Adolescents' willingness to vaccinate against COVID-19 was alarmingly low, especially among females, students from small cities and attending the non-science program. Concise integrated teaching designed to address mistrust and knowledge deficiencies can be effective in improving the uptake.

Key messages
Research provide data about students’ attitudes towards COVID-19 vaccination and indicate the need for universal educational campaigns. Online education is an effective method which may substantially increase COVID-19 vaccination rate in Poland.
Mental health promotion in France during the Covid19 pandemic
Authors: Arwidson P 
Published: October 2021

Abstract
Public Health France have put in place a psychobehavioural surveillance system quickly after the beginning of the first lockdown in March 2020. Aside questions about people's perceptions about the pandemic (worry, perceived level of risk...), and their protective behaviours (social distancing, hand washing...), a module of questions on mental health (anxiety, depression and life satisfaction) was introduced. 22 rounds of this survey called CoviPrev have now been undertaken. This survey has been instrumental in raising the awareness by the government on the negative impacts of the pandemic on the mental health of the French population. We have designed, scientifically tested a media campaign to support the population's mental health. This campaign is now on air. This is the first national mental health media campaign since 2007. We hope it will initiate a long-term communication strategy aimed at promoting the mental health of the population.
Othering of Forced Migrant Women in Maternal Care. Becoming a Mother – Being constructed as Other: Results of a qualitative study in Germany
Authors: Engelhardt M , Gaudion M , Kamhiye J , Borde T 
Published: October 2021

Abstract
Refugee women are legally entitled to all necessary medical services related to pregnancy - including medical check-ups, childbirth costs, and midwifery assistance. However, studies indicate that they face structural barriers to maternal care access and are at greater risk of having poor pregnancy outcomes. This study aimed to explore the role of attributions of Otherness and practices of Othering in maternal care and the consequences for the quality of maternal care for forced migrant women in Germany. Qualitative semi-structured problem-centered interviews were conducted in three regions. The study sample includes 64 health care professionals (social workers, midwives, gynecologists) as well as 15 forced migrant women who recently gave birth to a child. Interviews were analyzed via framework analysis to identify perceptions, attitudes, and contextual conditions of providing maternal care to female refugees and to examine their experiences in the German maternity health care system. Most professionals showed an implicit, rarely questioned notion of an ostensible center of motherhood and parenthood. The qualitative results show how forced migrant women are constructed as other to this presupposed center of mothers. The practice of Othering occurs individually by health care professionals as well as structurally by the German asylum system and health care system. Both exclusionary and benevolent processes of Othering come into play. The effects of those attributions of Otherness are described from the perception of refugee new mothers concerning their pathways, resources, and obstacles in maternal care. Opportunities to achieve adequate maternal care for mothers and parents constructed as others from an ostensible and rarely questioned center of motherhood and parenthood are presented and discussed. To face diversity in maternal care, the notion of the center needs to be critically discussed as well as different aspects of consequences of Othering.
Excess all-cause mortality from January to August 2020: a temporal analysis in 20 countries
Authors: Demetriou CA , Achilleos S , Quattrocchi A , Gabel J , Heraclides A , Kolokotroni O , Constantinou C , Pagola Ugarte M , Nicolaou N , Rodriguez-Llanes JM 
Published: October 2021

Abstract

Analysis of all-cause mortality is an important tool to investigate the impact of the COVID-19 pandemic. This study aims to investigate the magnitude and potential determinants of excess all-cause mortality, from January until August 2020, using national mortality databases from 20 countries part of the C-MOR consortium. Excess weekly mortality for 2020 was calculated by comparing observed against expected weekly number of deaths for 2020. Expected 2020 weekly mortality was estimated using 2015-19 data based on a time series model adjusting for time trend and seasonality. The excess mortality was visualized against a stringency index (SI), based on nine government response indicators, downloaded from the Oxford COVID-19 Government Response Tracker. Brazil, Cyprus, France, Ireland, Italy, countries of the UK, Spain and the USA showed a substantial increase in the observed mortality during 2020, which lasted from 1 (Cyprus) to 7 (England and Wales, Scotland) weeks. Australia, Denmark and Georgia observed fewer than expected deaths, whereas in Austria, Estonia, Israel, Norway, Slovenia and Ukraine 2020 mortality was as expected. Italy, Spain, UK and Brazil enforced high SI measures at least after 3 weeks from the first COVID-19 death. Sweden and the USA did not apply high SI measures for the duration of this study. In Austria, Estonia, Israel, Norway, Cyprus, Georgia, Slovenia and Ukraine, measures of high SI were implemented within 2 weeks of the first COVID-19 death. The decreased mortality in Australia is probably attributed to different seasonality patterns coupled with strict control measures. Several but not all countries showed excess all-cause mortality. Excess mortality was shown to be influenced by the seasonality patterns of each country, as well as the promptness of governments to apply high SI control measures. As the pandemic continues, the lessons learned from the first months of the pandemic can prove useful to minimize increases in all-cause mortality.

Key messages
Some countries showed excess all-cause mortality between January and August 2020, whereas others displayed either negligible excess mortality or even a decrease in all-cause mortality. Excess mortality may be partly attributed to delayed application of strict control measures whereas lack of excess mortality may be due to seasonality and/or strict control measures.
One Health in Urban environment- public health challenge for the future
Authors: Jevtic M , Savic S 
Published: October 2021

Abstract
Urban environment is a specific one in which are citizens and also their pets and other animals looking for a mutual place for a qualitative life. Humans are trying to make their life as good as possible, bringing the “nature” inside urban environment, but not always thinking through if urban environment will have effect on that “nature” - pets and plants in houses. The availability of data on number of pets in urban environments is being studied. It is estimated that in a city of 500.000 inhabitants, there are around 17.000 dogs, but number of cats is even more challenging to find. Which towns are the highlighted ones with developed culture of cohabitation? The ones with equally developed conditions for the life “of all. WHO (1990) suggests that dog ecology and related anthropological aspects can serve to establish background information for the planning and implementation of dog population management schemes and for the control of zoonotic diseases. Dog population density is related to different habitats, cultures, and social conditions of human populations (Fielding and Plumridge 2005). For example, Albert and Bulcroft (2015) in their study underline the important social and emotional roles that pets play in the urban household. People in cities demonstrate high levels of attachment, caring, and intimacy towards their pets. Pets are viewed as important members of households and owners are willing to spend high budget of money on needed medical or preventive care for their pets. One health concept in an urban environment has a specific significance from overcoming common risks for humans and animals point of view. The risk of infectious diseases is probably the most common one, including zoonotic diseases. This risk can even be a life threating one. There is also the risk of non-infectious diseases and influence of the mental health of owners to pet's life. Also, the influence of owner's life style to the life of pets - eating, walking and other habits.
Ghana: health system review 2021
Authors: Opoku D , Edusei AK , Agyei-Baffour P , Teddy G , Polin K , Quentin W 
Published: October 2021

Abstract

A health system review provides a detailed description of a health care system and of reform and policy initiatives in progress or under development. The health system review of Ghana serves as an effort to also assess the system's performance towards the attainment of universal health coverage (UHC). A workshop was organized in 2018 to develop a template for writing the health system review of Ghana. This serves as a pilot study to test the feasibility of using a template somewhat like that of the WHO European Observatory on Health Systems and Policies for writing health system reviews of African countries. The health system review of Ghana is the first to be written for an African country modelled after the HiT reviews by the European Observatory. One key characteristics of the health system of Ghana is the introduction and reform of the national health insurance scheme (NHIS) in 2003 and 2012 respectively. About 40% of the population are enrolled and 60% enrolled are exempted from premium payments. Ghana has since 2010 scaled-up a national telemedicine programme, becoming one of the first adopters and innovators in Africa to integrate digital health technologies into mainstream health care system. Since 2018, Ghana has implemented the NHIS mobile renewal service, which allows payment of health insurance coverage using mobile money technologies. Ghana is one of the first countries to introduce a nationwide health insurance in Africa. The NHIS is one significant effort towards health systems strengthening and achieving UHC. Enrolment in in the NHIS contributes to better access to health care and improved financial protection. However, not only is population coverage low, but there is a serious concern about the system's financial sustainability. A promising approach is to improve the mobile-money based intervention through the high mobile-phone penetration rates in Ghana to enable more effective household saving arrangements towards UHC.

Key messages
Ghana presents important lessons, including the introduction of a national health insurance. This contributes to better access to health care and improved financial protection. Ghana is exploiting the use of mobile phone technologies and has become one of the first adopters and innovators in Africa to integrate digital health technologies into mainstream health care system.
Associations of university student life challenges with mental health and self-rated health
Authors: Porru F , Schuring S , Bültmann U , Portoghese I , Burdorf A , Robroek S 
Published: October 2021

Abstract

Background
Mental health problems are highly prevalent among university students. Stress due to student life challenges may be a risk factor for poorer health. This study investigates to what extent student life challenges and changes therein are associated with mental health and self-rated health.

Methods
In a longitudinal study with 568 Italian university students mental health was assessed using the Mental Health Inventory-5 (MHI-5) and self-rated health with a single item from the Short Form 36 Health Survey (SF36) (score ranges: 0-100) at baseline and at six months follow-up. Student life challenges were investigated using six subscales (score ranges: 1-4) of the Higher Education Stress Inventory (HESI). A between-within linear regression model was used to investigate whether a higher exposure to life challenges was associated with poorer health (between individuals) and whether changes in student life challenges were associated with changes in health (within individuals).

Results
Higher exposure to student life challenges was associated with poorer mental health (b ranging from -5.3 to -10.3) and self-rated health (b ranging from -3.1 to -9.6). An increase in student life challenges within individuals was associated with poorer mental health and self-rated health, in particular for high workload (b up to -5.9), faculty shortcomings (b up to -5.7), and unsupportive climate (b up to -5.6).

Discussion
Exposure to student life challenges and changes therein are associated with university students' health. Our findings suggest that student life challenges may be a target for interventions to improve mental health and self-rated health among university students.

Key messages
Mental health and self-rated health differ between students and change within-them. Higher exposure to student life challenges is associated with poorer health, and an increase in student life challenges is associated with a decrease in health.
Heatwave-related morbidity in Australia: Effect modification by Individual and Area-level factors
Authors: Varghese B , Beaty M , Bi P , Nairn J 
Published: October 2021

Abstract

Background
Heatwaves are associated with increases in mortality, emergency department visits, and hospital admissions. However, evidence regarding heatwave impacts on general practice (GP) visits is limited. The objectives of this study were to quantify the impact of heatwaves on GP visits in Australia and identify the individual and area-level factors that modify the heatwave-GP visits association.

Methods
Warm-season (October-March) GP visits data (2011-2016) were obtained from the Australian Bureau of Statistics. Using a case-crossover approach we assessed the effect of heatwaves (defined using Excess Heat Factor) on GP visits at the Statistical Area Level 2 (SA2) spatial unit (reflecting suburbs), as well as effect modification by individual and area-level factors. Results are reported as percent increase in GP visits during severe/extreme heatwaves compared with non-heatwaves.

Results
Nationally, GP visits increased by 4% (95%CI: 3-4%) during severe/extreme heatwaves. But impacts varied with the highest effect observed in Canberra (16.4%; 95%CI:15.4-17.4%), Adelaide (14.9%; 95%CI: 14.3-15.4%), and regional Victoria (13.5%; 95%CI: 13-14%). A gradient of impact was found within locations, for example, vulnerable SA2s nationally were featured by a higher proportion of populations with no air-conditioning, low income, limited English proficiency, living alone, and a prevalence of diabetes and circulatory diseases. Individual-level factors included those: living alone, with limited English proficiency, with diabetes, hypertension and using anti-coagulants and diuretic medications.

Conclusions
Heatwaves increase GP visits in Australia, with impacts varied between locations and populations, affecting certain areas and individuals disproportionately. Our results using an individual and area-level linked data suggest that local area and individual vulnerabilities should be incorporated when developing place-based interventions combating heatwave-health impacts.

Key messages
Heatwaves increase GP visits in Australia, but with spatial variability across and within locations. Individual and area-level factors contribute to heatwave-vulnerability.
Climate change and the city: analysis of the urban heat island effect on mortality in Valencia, Spain
Authors: Boned Fustel P , Cuesta Peredo C , Boned-Ombuena A , Carreiro G , Fustel Rodríguez M 
Published: October 2021

Abstract

Background
Heatwaves are increasing due to climate change and they are responsible for more fatalities than any other extreme meteorological phenomenon. An excess of mortality can occur during heatwaves, and it is usually higher in cities than in rural areas. This can be partly explained by the urban heat island effect, a human-induced modification of the local temperatures. This study assessed the effects of the July 2017 heatwave -one of the highest in recent years according to Heat Index available data- in Valencia (Spain).

Methods
Analytic, observational, and retrospective study on the effects of the 27-31 July 2017 heatwave in the city and province of Valencia on population mortality. Observed and expected number of deaths in our population were compared, using the same period of 2013 as a reference, and Standardized Mortality Ratio (SMR) was calculated for the capital city (urban area) and the province (suburban and rural areas) of the Valencian Region (Spain).

Results
The analysis showed a significant excess of mortality in the city of Valencia (787,808 pop) during the July 2017 heatwave, with an SMR of 1.634 (95% CI 1.356-1.952). In that period 116 deaths occurred, mean age 79.7 years, 50,7% women. By age groups, the population above 65 years was identified as the most vulnerable, with an SMR of 1.607 (95% CI 1.311-1.949). The mortality excess was 8% higher among men compared to women, although the difference was not significant. No significant increase in mortality was found in the province of Valencia (1,752,899 pop).

Conclusions
The July 2017 heatwave in the Region of Valencia brought an excess of mortality in its capital city, which did not take place in rural areas. Elderly are especially vulnerable to these extreme temperature events. Our findings raise awareness on the importance of climate change mitigation and adaptation measures, especially as regards its effects in urban areas. The regional heatwave protocol for nursing homes was enhanced.

Key messages
Adverse climate events are increasing due to global warming. The July 2017 heatwave in the Region of Valencia brought an excess of mortality in its capital city, especially among elderly. This study raises awareness on the need for climate change mitigation and adaptation measures, especially as regards the urban heat island effect.
Effects of high temperatures on poor mental health outcomes: a systematic review and meta-analysis
Authors: Liu J , Varghese B , Hansen A , Bi P 
Published: October 2021

Abstract

Background
In the context of warming temperature and increased prevalence of mental disorders, a growing body of literature suggests the adverse effects of high temperatures on mental health. However, no study has quantitatively summarised the evidence. This study therefore systematically reviews the epidemiological evidence and summarises the quantitative effects of high temperatures on mental health outcomes, including mortality and morbidity.

Methods
A systematic search of peer-reviewed epidemiological studies in five databases that linked high temperatures and mental health was conducted on literature published till November 2020. A range of mental health conditions were defined using ICD-10 classifications. We included studies that examined the quantitative association between temperatures and mental health mortality or morbidity (i.e. hospital admissions, emergency presentations) in the general population. Random-effects models were used to summarise the percentage changes in mental health outcomes per 1 °C temperature increase.

Results
The keyword search yielded 4560 citations from which 34 studies were included in the meta-analysis. For 1 °C increase in temperature, the risk of mental health-related mortality and morbidity increased by 2.2% (95%CI: 1.5-2.9%) and 0.9% (95%CI: 0.7-1.5%). The greatest risk was associated with mortality attributed to substance-related mental disorders (4.6%; 95%CI: 0-10.1%), and organic mental disorders (3.3%; 95%CI: 2-4.6%). A 1 °C temperature rise was also associated with a statistically significant increase in morbidity such as mood disorders, organic mental disorders, and schizophrenia. Higher risk was evident for elderly and populations living in tropical and subtropical climate zones.

Conclusions
Our results suggest that exposure to high temperatures increases the risk of poor mental health outcomes. These risks will likely increase with a warming climate.

Key messages
High temperatures are associated with poor mental health outcomes, including mortality and morbidity. The findings reinforce the need for preventive intervention to protect vulnerable populations.