bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health status, healthcare use and prevention in Travellers in Nouvelle Aquitaine, France, 2019-2022
Authors: Mondeilh A , Brabant G , Haidar S , Saboni L , Ruello M , Lesieur S , Castor C , Autes-Treand E , Le Strat Y , Vandentorren S 
Published: October 2024

Abstract

Background
The poor health status of underserved populations is compounded by low vaccination uptake, leading to a greater risk of epidemics. On October 2017, a measles outbreak started in the southwest of France among under-vaccinated social groups, including Travellers. We aimed to describe the health status, healthcare use and child measles-mumps-rubella (MMR) vaccination coverage in Travellers according to their environmental and living conditions.

Methods
A cross-sectional study with a three-stage random sample design was conducted between October 2019 and March 2022 in the Nouvelle-Aquitaine region in France. Trained social workers administered face-to-face questionnaires to collect data on adults and children. Anthropometric measurements, vaccination records, and data using an environmental exposure questionnaire were also collected.

Results
The participation rate was high (73.6%), with 1030 adults and 337 children included. Concerning the adults, 36.6% had obesity, 14.4% reported diabetes, 24.7% hypertension, and 14.4% major depression. The prevalence of major depression was significantly higher in adults living in precarious and unauthorized housing than in those with adequate housing (19.8 vs. 14.7%, p = 0.03). The unmet health care needs in the last 12 months was 48.4%. With regard to children, 45.3% had full (i.e., 2-dose) MMR vaccination coverage at 24 months and 17.9% had obesity. Finally, 74.5% of the households experienced housing insecurity, and 22.2% did not have a supply of drinking water.

Conclusions
Traveller children and adults faced deleterious environmental and living conditions potentially affecting their health, healthcare use, and vaccination coverage. These results demonstrate the need for urgent interventions for underserved populations which take into account their difficult living conditions.

Key messages
• Travellers have a greater burden of chronic diseases than the general French population and measles-mumps-rubella vaccination coverage among Traveller children is lower than in the general population.
• The more precarious the housing, the more likely Travellers are to report having a chronic disease (social exclusion gradient).
Preventing dementia is possible. The fraction of cases attributable to modifiable factors in Italy
Authors: Masocco M , Minardi V , Contoli B , Asta F , Gallo R , Possenti V , Lombardo F , Vanacore N 
Published: October 2024

Abstract

Background
Worldwide, approximately 50 million people live with dementia. The Lancet Commission, in its latest report in 2020, identifies 12 ‘modifiable’ risk factors associated with dementia, estimating that they account for about 40% of overall dementia cases. The study aimed to estimate the population attributable fraction (PAF) of dementia cases in Italy due to these factors.

Methods
Relative risks (RR) of each factor and formulas for estimating PAF are derived from the Lancet Commission’s report. Prevalence data were obtained from the Italian surveillance systems PASSI and PASSI d’Argento (PdA), which provide information on 11 of the 12 identified risk factors. The total sample 2017-19 included 86,494 individuals aged 18-64 and 48,516 individuals aged over 65. The Communality, used for ‘weighted’ estimates of PAFs, was calculated via principal components analysis of the inter-risk-factor tetrachoric correlation matrix, using data derived from the overall PASSI and PdA sample.

Results
In Italy, it is estimated that 39.5% of dementia cases are attributable to 11 of the 12 modifiable risk factors, equivalent to 445,150 out of 1,126,961 estimated cases as of January 1, 2023. Among the risk factors with the greatest impact are hypertension before the age of 65 (weighted PAF=6.3%); sedentariness after the age of 65 (weighted PAF=5.9%); low education in youth (weighted PAF = 5%); depression and social isolation after the age of 65 (weighted PAF=4.5% and 4.4%), as well as diabetes (weighted PAF=3.9%) and smoking (weighted PAF=2.4%).

Conclusions
Although it is necessary to to gather further evidence on the role and mechanisms of action of each factor, the importance of prevention and promotion of health and social well-being in the field of dementia is now evident.

Key messages
• Having an overall national sample of adults and elderly people is a unique tool that allows an estimation of dementia cases attributable to modifiable risk factors.
• Dementia prevention may also be possible by acting on modifiable risk factors.
Associations between school engagement and mental well-being among Finnish parent-child dyads
Authors: Tuomela S K , Nordmyr J , Söderberg P , Forsman A K 
Published: October 2024

Abstract

Background
To understand how individual differences in mental well-being emerge for children and adolescents, it is important to understand the amenable factors in the context in which the development takes place - that is, for children, primarily in the family and in school. There is a notable gap in the research exploring the positive impacts of school factors on parent-child dyads and their mental well-being, and if there are any associations between school engagement and the mental well-being of parents and their children.

Methods
Data from 307 parent-child dyads were included in the study, the data stemming from a Finnish l research project (CONSENSUS) encompassing longitudinal survey data collection among both children in grades 4-6 and their parents. By exploring bivariate correlations and using the Actor-Partner Interdependence Model (APIM), the present study aims to investigate actor and partner effects of school engagement and mental well-being among parents and their child in grade 4-6.

Results
Preliminary results show that there are statistically significant correlations between parents’ and their children’s mental well-being, but that there are no significant correlations between children’s school engagement and parental school engagement. Further, statistically significant actor effects emerge between children’s school engagement and mental well-being, and between parental school engagement and mental well-being.

Conclusions
By clarifying the interaction between school engagement and mental well-being in parent-child dyads, this study not only contributes to the theoretical understanding of these constructs but also offers insights that can inform future development of mental well-being promotion interventions aimed at families and educational settings in Finland and elsewhere.

Key messages
• This study offers an innovative exploration of the links between mental well-being and school engagement among 274 Finnish parent-child dyads.
• Results show various interactions between school engagement and mental well-being among the parent-child dyads, with implications for interventions intended to support well-being in families.
Malnutrition in Guinea-Bissau: a country wide representative cross-sectional study
Authors: Silva C , Abecasis A 
Published: October 2024

Abstract

Background
According to the WHO, malnutrition refers to deficiency, excess, or imbalance in a person’s intake of energy and/or nutrients. Children under five are especially vulnerable to malnutrition. The problem is widespread, but it is particularly prevalent in West African countries, where a prevalence of 30% stunting, 6.7% wasting and 2.4% overweight was described in 2022. In this study, we aimed to evaluate malnutrition in Guinea-Bissau (GB), a low-income country in West Africa.

Methods
We conducted a cross-sectional study between May and June 2023 on a representative sample of 1608 children aged 6 to 59 months, who had access to health care in all 11 regions of GB. Nutritional status was assessed by evaluating weight for height/length, weight for age, height/length for age, and hemoglobin concentration was determined using a portable hemoglobin analyzer. Furthermore, semi-structured questionnaires were applied to children’s parents, including questions on sociodemographic and behavioral factors, such as ethnicity, parental literacy, health care, and dietary patterns.

Results
802 boys and 806 girls were included in the study, with a mean age of 26 months. Malnutrition rates were comparable to those described in other West African countries. We found wasting rates of 8,3%, stunting rates of 24,3%, low weight rates of 17,4%, and overweight rates of 2,4% among children under five. Importantly, 55.9% of the children had anemia: 23.6% had mild anemia, 31.1% had moderate anemia, and 1.2% had severe anemia. Statistical analyses are underway to investigate factors associated with malnutrition.

Conclusions
An important challenge in global health is combating malnutrition in all its forms. The identified prevalence of malnutrition in GB is high and emphasizes the importance of developing strategies and policies with local authorities so that the Sustainable Development Goals and Global Goals of Nutrition can be achieved and health outcomes improved.

Key messages
• Collaboration essential: researchers, policymakers, healthcare, and local authorities must unite for targeted malnutrition interventions.
• Sustainable development in GB hinges on addressing malnutrition among its children through concerted efforts.
Integration of Whole genome sequencing in pediatric healthcare: an Italian HTA
Authors: Nurchis M , Heidar Alizadeh A , Raspolini G M , Damiani G 
Published: October 2024

Abstract

Diagnosing pediatric rare diseases poses challenges due to ambiguous symptoms and genetic complexities. Next-generation sequencing (NGS) technologies, like Whole exome sequencing (WES) and Whole genome sequencing (WGS), offer faster and more accurate diagnoses, enhancing clinical utility. However, WGS implementation faces hurdles including complexity and socio-economic impacts. This Health Technology Assessment (HTA) aims to evaluate the integration of WGS, compared to WES, into the Italian NHS for pediatric genetic disorder diagnosis, considering diverse stakeholders and value generation. The EUnetHTA Core Model 3.0 was the primary framework for evaluations. Various methodologies, such as narrative, scoping, and systematic reviews, meta-analysis, GRADE assessment were employed to assess existing evidence. Bayesian cost-effectiveness analyses were adopted for the economic aspects. Summative thematic analysis was used to evaluate organizational aspects of implementing WGS. In respect to non-clinical domains, organizational differences between WES and WGS implementation were seen in respect to procedural steps (i.e., genome rearrangement analysis, data storage) albeit both reduce the need for additional tests. WGS is cost-effective, with Bayesian analysis revealing incremental cost per additional diagnosis lower than the threshold. Ethically, WGS benefits outweigh risks, but comprehensive genetic counseling should address concerns like unsolicited findings and misattributed parentage. Timely genetic diagnosis through genomic technologies may shorten the diagnostic odyssey ensuring brighter futures for children and advancing health care equity. Nevertheless, the implementation of genomic knowledge in clinical practice brings organizational, economic, and ethical issues urging critical reflection in HTA evaluations and a multi-stakeholders involvement.

Speakers/Panelists
Gianfranco Damiani
Università Cattolica del Sacro Cuore, Rome, Italy
Els Maeckelberghe
University Medical Center Groningen, Groningen, Netherlands
João Vasco Santos
University of Porto, CINTESIS, ARS Norte, Porto, Portugal
Sandra García Armesto
Agència de Qualitat i Avaluació Sanitàries de Catalunya, AQuAS, Barcelona, Spain
Wellbeing, career satisfaction, and educational requirements in healthcare assistants in Ireland
Authors: Jalili P , Conyard K F , Wall P , Gormley E , Codd M B 
Published: October 2024

Abstract

Background
The long-term residential care (LTRC) sector in Ireland relies heavily on Health Care Assistants and Carers (HCAs). This workforce has become increasingly diverse in recent years, often relying on non-national temporary workers with varying levels of education. In 2022, of 22,495 HCAs and 5,289 Healthcare Support Assistants working in 563 nursing homes caring for some 30,000 residents, 22% were non-national. Their plight became evident during COVID-19 which had profound consequences in the LTRC sector.

Objectives
In this study, we investigate the recruitment, training, employment terms and conditions of HCAs in Ireland, as well as their general well-being and career satisfaction.

Methods
A cross-sectional study of members of ‘Care Assistance Ireland’, for which ethics approval was granted for an estimated sample of 1,052, is conducted. Validated instruments used are: the Maastricht Instrument for Sustainable Employability (MAISE); Utrecht Work Engagement Scale (UWES); General Wellbeing Schedule (GWBS) and Minnesota Career Satisfaction Survey (MCSS).

Results
The internal consistency reliability (Cronbach’s alpha) of GWBS and MCSS instruments were high. The response rate in the selected sample is estimated circa 60%, the majority being female and qualified. General well-being status will be investigated once all responses are submitted. Spearman correlation is predicated to show moderate to strong positive correlations (0.2-0.9) for all GWBS and MCSS questionnaires questions. While MAISE and UWES are still under investigation. It is predicted that there is variability in the requirements for, and terms and conditions of, employment among HCAs in Ireland, while job security remains a concern.

Conclusions
These findings reinforce the importance of ensuring standards for recruitment, training, job security and well-being for the LRTC workforce. The lack of educational requirements for HCAs in some settings is a critical consideration.

Key messages
• Findings will impel a more agreeable, consistent entry award in the healthcare system.
• It profiles career needs of HCAs outlining the long-term shortfalls preventable with health policy enactments.
From the first European Climate Risk Assessment to action in policy and practice
Authors: Kazmierczak A 
Published: October 2024

Abstract
The first European Climate Risk Assessment (EUCRA), produced by the European Environment Agency in March 2024, engaging nearly 100 authors across Europe, highlights health among the most at-risk sectors. According to the structured risk assessment that was conducted to support the transparent identification of priorities for policy action, more and urgent action is needed to reduce health risks from heat indoors and outdoors; from wildfires and outbreaks of vector- and water-borne diseases. The responsibility for managing risks lies both with the EU and Member States, and the policy readiness varies depending on the risk. The European Climate and Health Observatory, set up to better understand, anticipate and prevent climate risks to human health in Europe, in the most recent report ‘Responding to climate change impacts on human health in Europe: focus on floods, droughts and water quality’ provides in-depth analyses of some climate-related risks to health and presents examples of responses to them in both policy and practice. Both assessments emphasise that without fast and systemic action to increase societal resilience, the health impacts of the changing climate will worsen, affecting already disadvantaged or vulnerable groups the most. Health and health-determining sectors have the opportunity to address the health impacts of climate change by, among others, increasing the climate resilience of health systems; developing, updating and implementing national health adaptation plans; and supporting the education and training of public health and healthcare professionals on climate change threats. At the same time, addressing health impacts from climate extremes requires responses across sectors, actors and spatial scales.
The European Mobile Laboratory: key insights from a decade of outbreak response
Authors: Nelson E , Duraffour S 
Published: October 2024

Abstract
EMLab has responded to emergencies including the West Africa Ebola virus outbreak (2014-2016), the COVID-19 pandemic, and outbreaks of yellow fever, Marburg virus, and Lassa fever. It has deployed mobile labs and experts to many countries, including Guinea, Liberia, Sierra Leone, Nigeria, Uganda, the Democratic Republic of the Congo, Germany, and Greece. With accumulated experience from each deployment, EMLab’s diagnostic expertise has evolved beyond RT-PCR and serological testing to include basic point-of-care tests, haematology, and genomic surveillance capacities, also focusing on interoperability with other response capacities such as EMTs. Critical to mission success, the organization works closely with the WHO and GOARN, and was certified in 2023 as an official German response capacity within the European Civil Protection Pool. The two-year continuous deployment from 2014-2016 was pivotal in shaping EMLab’s evolution, also leading to significant capacity-building efforts in West Africa. In Guinea, for example, a surveillance network of three diagnostic laboratories has been established and successfully detected cases of viral haemorrhagic fevers, including the re-emergence of Ebola virus and the first reported case of Marburg virus in Guinea in 2021. Ultimately, EMLab’s extensive experience demonstrates that effective public health emergency response requires constant evolution, strategic partnerships, and a commitment to building local capacities, paving the way for a more resilient and prepared global health community.
‘Health in all policies”: effect on health outcomes and collaboration among welfare actors
Authors: Villegas-Gomez T M , Sundewall J 
Published: October 2024

Abstract

Background
The ‘Health in All Policies’ (HiAP) approach, introduced in 2006, recognises the impact of policy decisions and actions on population health. It prioritises health and well-being as a core objective of all public policymaking, ensuring that policies promote health equity and social justice. Implementing HiAP requires collaboration among diverse welfare actors beyond healthcare. Thus, reviewing evidence of the effects of HiAP on collaboration among welfare actors and health outcomes is crucial for informing policy and practice intersectoral collaboration to improve population health outcomes. This study addresses the question: What is the existing evidence of the effects of HiAP on better collaboration among welfare actors and improved health outcomes from 2006 to 2023? We conduct a scoping review on peer-reviewed articles following the Joanna Briggs Institute reviewer’s manual, the five-stage framework outlined by Arksey and O’Malley, and adhering to the PRISMA extension for scoping reviews for reporting.

Preliminary results
472 research articles and 68 other documents published from 2006 to 2023 were identified, mainly from Europe and North America. 90% of the reviewed studies focused on collaboration among welfare actors, while 10% examined the effect of HiAP on improved health outcomes. Themes identified in the studies on collaboration among welfare actors include funding, intersectoral partnerships, shared vision, local and national settings, identity and responsibilities, accountability, dedicated staff, Health Impact Assessment, and indicators.

Conclusions
Despite being widely referred to as an effective approach in health policy, there is limited evidence of the effects of HiAP on health outcomes. However, some evidence supports that HiAP contributes to enhanced collaboration among welfare actors, potentially leading to better health outcomes. More evidence is needed that specifically investigates the effects of the HiAP approach on health outcomes.

Key messages
• Most evidence suggests that HiAP has a positive impact on collaboration among welfare actors; however, evidence of its effects on health outcomes is limited.
• Further research that specifically explores the effects of the HiAP approach on improved health outcomes is crucial for informing policy and promoting intersectoral collaboration.
Adolescents witnessing family violence and its association with socio-economic factors
Authors: Tiikkaja S , Tindberg Y , Durbeej N 
Published: October 2024

Abstract

Background
About 200 000 children in Sweden live in families where violence among adults occurs. About 10% of children have witnessed violence family violence Family violence is often more prevalent in low social status families. The present study describes adolescents that have witnessed threats of violence, abusive words or physical/sexual violence in their families, as well as the association between these types of violence and socio-economic factors.

Methods
Data from a school-based survey, in the County of Sörmland (2023), including 15-18-years-old students in 2023 were used. Witnessing family violence was measured by the following item “Have you experienced that an adult in your family has... 1) threatened to use violence against someone else in your family? 2) used abusive words, oppression, or been dominant or controlling against someone else in your family? 3) used physical violence against someone else in your family, such as hitting, pushing, kicking, or sexual violence”. Parental work status, the child’s living conditions and economic stress were used as socio-economic factors. Data were analysed by descriptive methods and logistic regressions.

Results
This study included 3 407 adolescents among which 19% had witnessed any type of family violence. The most prevalent type was witnessing abusive words, (17%), followed by physical/sexual violence (10%) and threats to use violence (9%). Witnessing any type of family violence was associated with all socio-economic variables in univariate analyses, the strongest association was found for having economic stress (OR = 3.30; 95% CI 2.72-4.01), in comparison to not having economic stress. Further adjustments for gender, grade, ethnicity, parental work status and living with both parents attenuated the association, OR = 2.50 (95% CI 2.03-2.07).

Conclusions
Two of ten adolescents have witnessed any type of family violence. These adolescents often belonged to families with low socioeconomic status making them vulnerable.

Key messages
• In this school-based study, 19 % of adolescents had witnessed any type family violence. Having witnessed abusive words was the most prevalent type of family violence.
• There is as strong association between witnessing family violence hand having economic stress among adolescents. These adolescents need to be noticed in their particularly vulnerable situation.