bluuebunny/crossref_metadata_2025_split huggingface dataset:
Administrating first aid in road traffic accidents in Bulgaria: a cross-sectional study
Authors: Radeva N , Rohova M , Bakhova A , Romanova H 
Published: October 2024

Abstract

Background
Bulgaria had the highest road mortality rate among European Union members in 2023, having previously ranked second after Romania. Research has consistently demonstrated that prompt pre-hospital care can significantly reduce the adverse effects of road traffic accidents. Thus, we conducted a cross-sectional study to explore the involvement of trained road traffic casualties and bystanders in administering first aid.

Methods
The study, carried out between April and December 2021, collected data via an online survey administered to members of the Scientific and Academic Cooperation Council by the State Agency Road Safety. The survey encompassed a range of topics, including first aid training, involvement in traffic accidents, behaviour of bystanders, administration of first aid, and sociodemographics.

Results
Among the 292 respondents, a sizeable proportion (90%) reported having received first aid training. Of these, 35.1% (95% CI 29.2-41.1%; p &lt; 0.001) had personally experienced a road traffic accident, and 64.5% (95% CI 58.1-70.1%; p &lt; 0.001) had witnessed one. It is noteworthy that a fifth of those involved in accidents had employed the skills acquired from first aid training, which included applying a dressing to a wound, bleeding control, and immobilising a fracture. Correspondingly, an equivalent percentage of bystanders administrated aid, with the majority of them performing basic airway management. However, the findings revealed that a significant proportion of participants (79.3%) did not engage in providing first aid. The primary rationale stated was the assessment that it was nonessential.

Conclusions
Despite the growing road safety challenges and many respondents witnessing or being involved in accidents, only a quarter of those trained in first aid actually provided assistance. Considering the increasing number of deaths and severe injuries, it is crucial to assess the need for frequent first aid training and the population’s proficiency in first aid.

Key messages
• Bystanders’ competence in administrating first aid can mitigate the adverse effects of road traffic accidents.
• Among other road safety measures, investments in first aid training can be beneficial in reducing fatalities and severe injuries.
Association between frailty and fear of falling among the elderly in Latvia
Authors: Bukova-Zideluna A , Villerusa A , Springe L , Baltmane D 
Published: October 2024

Abstract

Background
Frailty and fear of falling in the ageing population represent notable public health challenges. Fear of falling among the elderly population is a significant concern, as it can lead to decreased mobility, loss of independence, and increased risk of injury. Frailty intensifies this fear, as frail individuals often have reduced strength, balance, and coordination, making them more susceptible to falls.

Methods
Data from the population-based survey SHARE with respondents aged 50+ in Latvia of Wave 9 (collected 2022) was analysed. Frailty was assessed using the SHARE-Frailty Instrument. Fatigue, appetite, walking difficulties, and physical activity were self-reported and grip strength was measured using a hand grip dynamometer. Fear of falling was evaluated using visual material.
Financed by the project RSU internal and RSU with LSPA external consolidation No.5.2.1.1.i.0/2/24/I/CFLA/005, Postdoctoral Grant Associated factors of frailty and fall-related mortality in the older population in Latvia No.RSU-PG-2024/1-0005.

Results
The sample comprised 1439 older adults from Latvia (60.4 % female) with a mean age of 67.9 (95% CI 67.5 - 68.4). Based on SHARE-FI, frailty and pre-frailty prevalence were 7.2% and 44.5% respectively. In the study, 11.3% of females and 6.5% of males interviewed reported experiencing fear of falling. Frailty was correlated with fear of falling in 43.7% of frail individuals and 11.5% of pre-frail individuals. After adjusting for age and gender, those with pre-frailty and frailty had greater odds of fear of falling.

Conclusions
Understanding the interaction between the fear of falling and frailty in older adults can guide the development of public health policies and initiatives that aim to mitigate the fear of falling and, consequently, reduce the prevalence of frailty. Promoting healthy ageing behaviours, such as regular exercise, balanced nutrition, and social engagement, can help prevent frailty and its associated risks.

Key messages
• Fear of falling results in limitation of activities, intensification of physical decline, and increased susceptibility to frailty.
• Encouraging healthy ageing underscores the significance of early recognition of frailty symptoms and accessing suitable support.
Can a mindfulness programme in schools for students with ADHD symptoms improve emotional well-being?
Authors: Holopainen M , Hintsanen M , Lahti J , Vahlberg T , Volanen S-M 
Published: October 2024

Abstract

Background
This study employs a cluster randomized controlled trial to investigate the effectiveness of a universal mindfulness-based intervention (MBI) in classrooms in improving emotional well-being and emotion regulation among adolescents with elevated ADHD symptoms.

Methods
The study comprised 342 students: 164 in an MBI group, 128 in a relaxation control group, and 47 in an inactive control group. Positive and negative emotional states and the emotion regulation strategies of rumination, acceptance, catastrophizing, positive reappraisal, and self-kindness were measured at the pre- (T0) and post-intervention (T9) and the 26-week follow-up (T26). Linear mixed models were used to analyze the intervention effects among all participants and separately by gender and ADHD symptom type.

Results
The results showed that compared to the controls, there was a beneficial effect on the MBI group concerning acceptance at T9; acceptance remained at the baseline level in the MBI group but decreased in the inactive control group. In contrast, in the inactive control group, rumination decreased at T9, and positive reappraisal increased at T26 compared to the MBI group. The MBI had no detectable effects on self-kindness, catastrophizing, or positive/negative emotional states. Findings on the emotion regulation strategies varied by gender. In boys, the MBI increased acceptance at T9 compared to the inactive control group, whereas in girls, the programme reduced catastrophizing at T9 and T26 compared to the active control group. Contrary in boys, MBI group exhibited less reduction in catastrophizing at T9 compared to the inactive control group.

Conclusions
Universal MBIs may have some beneficial effects on emotion regulation in adolescents with elevated ADHD symptoms. Both girls and boys might be responsive to universal MBIs as part of the school curriculum, however not all consequences are positive (especially in boys).

Key messages
• Universal MBIs in classrooms may have some beneficial effects on emotion regulation among adolescent with elevated ADHD symptoms; however, the results are contradictory and more research is needed.
• Even though, universal MBIs may have some benefits, they may require modifications to lead to more beneficial effects on emotional well-being when used with this subgroup of students.
Prescribing contraceptives to minors without parental knowledge and consent
Authors: Peled-Raz M , Goldstick O 
Published: October 2024

Abstract

Background
Sexually active adolescents may seek oral contraceptives without parental consent, posing challenges due to minors’ confidentiality and consent regulations. This is especially the case under the un-nuanced Israeli legal scheme regarding adolescents’ care.

Methods
Israeli OBGYNs were contacted through mailing lists and social media groups and asked to fill an online questionnaire regarding their experience and protocols concerning prescription of contraceptives to minors. They were also asked about their comprehension of the relevant legal obligations, the importance they ascribe to different ethical interests and considerations, as well as their training.

Results
Of the 177 responding gynecologists, 75% consulted minors about contraceptives during the past year, most of them without any training on providing care to adolescents. More than a third of respondents believed that parental involvement wasn’t legally required, while only 8% thought it mandatory for all minors under the age of 18. Most (75%) would ‘almost always’ prescribe contraceptives without parental knowledge upon request, while 20% never would. No correlation was found between respondents’ practices and their perception of the legal obligations. Participants agreed that the risk to the health of the minor due to having sex without contraceptives is of utmost importance. Those willing to prescribe gave greater weight to minor’s autonomy consideration, while those who do not prescribe were more concerned with the acts legal ramifications. The majority set the age of 15 as the threshold for consistently prescribing contraceptives to minors without parental involvement.

Conclusions
Access to contraceptives for mature minors without parental involvement is vital. There is great need for education and training for healthcare providers on providing medical treatment to adolescents, as well as for the development of policies and guidelines, addressing adolescents’ health disparities.

Key messages
• Israeli legal requirements challenge and hinder adolescents’ care as well contradict OBGYNs ethical and professional beliefs.
• There is great need for education and training, as well as for the development of policies and guidelines, addressing adolescents’ health disparities.
Anemia in pregnancy and adverse maternal health outcomes - birth-registry based study from Georgia
Authors: Skhvitaridze N , Gamkrelidze A , Manjavidze T , Brenn T , Anda E , Rylander C 
Published: October 2024

Abstract

Anemia in pregnancy is an important public health challenge; however, it has not been thoroughly studied in Georgia. We assessed the prevalence of anemia during pregnancy across Georgia and the association between anemia in the third trimester of pregnancy and adverse maternal outcomes. We used data from the Georgian Birth Registry and included pregnant women who delivered between January 1, 2019, and August 31, 2022 (n = 158,668). The prevalence of anemia (hemoglobin (Hb) &lt; 110 g/L) at any time during pregnancy was calculated per region. Women in the third trimester were classified into three groups, based on their lowest measured Hb value: no (Hb ≥ 110 g/L, reference group); mild (Hb 100-109 g/L); and moderate to severe anemia (Hb &lt; 99 g/L). Adjusted odds ratios (aOR) with 95% confidence intervals (CIs) were calculated for the associations between anemia status and post-delivery intensive care unit (ICU) admission and preterm delivery. The prevalence of anemia occurring at least once during pregnancy was 40.6%, with large regional differences in anemia prevalence (25.1%-47.0%). Of 105,811 pregnant women with Hb measurements in the third trimester, 71.0% had no anemia; 20.9%, mild anemia; and 8.1%, moderate or severe anemia. The odds of post-delivery ICU admission did not increase linearly with decreasing Hb value (P for trend .13), and the relationship was inverse for preterm delivery (P for trend .01).

Key messages
• A considerable proportion of pregnant women in Georgia have anemia during pregnancy, and the prevalence and quality of reporting differ across regions.
• To accelerate national progress toward the SDGs and mitigate the consequences of anemia, equal countrywide access to high-quality ANC programs and complete registration of Hb values should be ensured.
Mixed-method study of women’s experiences of Respectful-Disrespectful Maternity Care in Cyprus
Authors: Middleton N , Papairaklidiou I , Kapsou M , Hadjigeorgiou E , Kinni P , Karanikola M , Nicolaou C , Kolokontroni O ,   RESPECT project team
Published: October 2024

Abstract

Background
Since the WHO reports on Disrespect and Abuse (D&A) in childbirth, there was an increase in studies across Europe exploring women’s experiences. Even though contentious, a 2024 EU Committee report adopts the term obstetric violence. With the highest caesarean section (C/S) in the EU, the birth environment in Cyprus raises questions about informed choices.

Methods
The RESPECT mixed-method study gained insights into the experiences of women in Cyprus with focus groups (N = 6, 28 women) and survey (online and in-person) tapping on Rights for Respectful Maternity Care (RMC), as measured by Person-Centred Maternity Care scale (PCMC), autonomy in decision making (MADM), dignity and respect (MoRi) and mistreatment (MIST).

Results
Among 516 responses (61% first childbirth, 38.5% vaginal, 15% public sector, consistent with official statistics), the 35-item PCMC (range 0-100%) represents a continuum of quality standards deviations (Med=81, IQR=61-92). Lowest scores were recorded for “Communication & Autonomy”, with 28.5% reporting ‘feeling pushed into a decision’, with associations observed with younger age, first-time birth, mode and place of birth, highlighting social inequity. Based on MADM, 23.8%, 14.1% and 14.7% women were classified as having moderate, low or very low autonomy. For mistreatment, 32.0% reported at least one of 11 indicators, most commonly privacy violations and no freedom of movement. Formula feeding against wishes (13.6%), vaginal examinations (11.6%) and episiotomy (7.8%) where most common among 33.7% reporting procedures without consent. Deductive content analysis of narratives according to RMC triangulate findings of weak shared decision-making processes.

Conclusions
Given that C/S reduction was identified as a national priority in Cyprus, the RESPECT findings can widen the conversation about quality improvement and form the basis to engage with local stakeholders in an open-dialogue about RMC, guided by participatory action research principles.

Key messages
• In the medicalized birth environment of Cyprus, women report a range of sub-optimal practices, with ethical implications, primarily affecting the right to autonomy.
• Adopting the Respectful Maternity Care framework, the findings can stimulate and shape quality improvement efforts in a participatory and inclusive process with local stakeholders.
Association between infant feeding behavior and maternal choice of breastfeeding type
Authors: Abonce Bautista K A , Cordero Garcia P , Ruiz Garcia F , Ceballos Vela M C , Viñas Dozal J C , Villegas-Dominguez J E , Lopez Hernandez F , Vázquez Hernández K 
Published: October 2024

Abstract

Introduction
Feeding in infants is a fundamental process influenced by the mother-child relationship during the early months of life. The regulation of feeding behavior, and hunger and satiety cues may be interpreted by the mother, potentially relating to the type of feeding chosen.

Objectives
To determine the association between infant feeding behavior and the type of breastfeeding chosen by the mother.

Methods
A cross-sectional and prospective study was conducted, including mothers with children aged between 6 and 18 months. Those with medical contraindications for immediate postpartum breastfeeding or with suspension of exclusive breastfeeding during the first 6 months of life due to medical prescription were excluded. The Baby Eating Behavior Questionnaire was used to evaluate the baby’s enjoyment of food, appetite response, eating speed, and satiety response.

Results
108 mothers were included, with 87% in agreement with exclusive breastfeeding (EBF), 43.3% using breastfeeding as the primary feeding method, and only 33.3% practicing EBF during the first 6 months. Food response (FR) scored 19.6 (±4.3), enjoyment of food (EF) 17.6 (±2.1), satiety response (SR) 7.1 (±2.0), eating speed (ES) 8.8 (±2.3), and appetite (AP) 4.2 (±0.7). Comparing FR, EF, SR, ES, and AP scores between those who practiced EBF and those who did not showed p &gt; 0.05. sociodemographic characteristics, perinatal factors, stance on EBF, number of hours per day with the child, feeding location, poor technique, breastfeeding pain and lack of medical guidance, all showed p &gt; 0.05 when comparing between those who practiced EBF and those who did not; in contrast to perceiving that the baby wanted to breastfeed (2.5/1.0-6.2), having time to feed (3/1.2-7.2) and having no health problems (10/1.2-78.7) all with p-value &lt;0.05.

Conclusions
The mother’s perception identifying the baby’s desire to breastfeed, having time to feed the baby and not having health problems favor exclusive breastfeeding.

Key messages
• Maternal perception plays an important role in deciding to give SCI, so it is the physician’s job to educate the mother so that she has additional arguments for choosing SCI.
• The infant’s feeding behavior does not have a significant impact on the mother’s behavior in choosing SCI feeding.
Breastfeeding duration, children’s diet and physical activity in immigrant children living in Lisbon
Authors: Loesch R Becker , Banha Alves I , Neto Conceição M , Oliveira Martins M R 
Published: October 2024

Abstract

Background
In 2023, 25% of children born in the Lisbon metropolitan area were from foreign mothers. Children of immigrant parents often face an unbalanced diet and unhealthy lifestyle, preventing them from reaching their full potential. The aim of this study was to analyse the associations between migrant status and breastfeeding duration, fruit and vegetable consumption and physical activity in children living in the Lisbon metropolitan area, Portugal.

Methods
Cross-sequential cohort study in Lisbon Region. Between May 2022 and April 2024, 729 children (49.4% immigrants) born in 2018 and 2020 were enrolled in the study. Data were collected in a face-to-face interview with the parents using a structured questionnaire with information on children’s diet (fruit and vegetable consumption) and physical activity. We used X2, Mann-Whitney U and t-tests to compare immigrant and non-immigrant children. Adjusted odds ratios (aOR) with a 5% level were estimated by logistic regression.

Results
Immigrant children (49.4%) live in socio-economically disadvantaged families. Breastfeeding practices are more common among migrant mothers with a higher median duration of exclusive breastfeeding (6 versus 4 months, p &lt; 0.001) and a higher median duration of breastfeeding (14 versus 8 months, p &lt; 0.001). Parental migration background is associated with the frequency of fruit (p = 0.039) and vegetable (p &lt; 0.01) consumption and with the practice of physical activity (p &lt; 0.01). The odds of consuming three or more portions of fruit are 1.37 times higher for non-immigrant children, and the odds of consuming two portions of vegetables are higher for non-immigrants than immigrants (aOR=2.04, p &lt; 0.01). Practicing sports is most frequent in non-immigrants (aOR =2.25; p &lt; 0.01).

Conclusions
Migrant status was associated with a less healthy lifestyle in childhood for children living in the Lisbon metropolitan area.

Key messages
• Breastfeeding is an essential source of nutrition for children, especially in socio-economically disadvantaged families.
• The migrant status is often associated with inequalities in childhood, challenging immigrant children to achieve their full potential.
Mapping the Out-of-Pocket Healthcare Costs for Terminal Cancer Patients across Europe
Authors: Tur-Sinai A , Bentur N 
Published: October 2024

Abstract

Background
In many countries, including those with universal health insurance, cost-sharing for healthcare is prevalent, resulting in out-of-pocket expenses for cancer patients. However, the proportion of government contribution to national healthcare expenditure varies across countries. This study aims to determine the prevalence and magnitude of out-of-pocket expenditure among cancer decedents in their final year of life and to assess whether decedents’ characteristics or their country’s welfare regime have a greater impact on out-of-pocket expenditure.

Methods
SHARE data was analyzed for individuals aged 50 and above from seven European countries (including Israel) who passed away from cancer. Interviews were conducted with the decedents’ family members to gather information about out-of-pocket expenditure on behalf of their deceased relatives.

Results
The study identified 1,950 cancer decedents with an average age of 74.4 (S.D.=9.39), of which 58.0 percent were male. In their last year of life, 58 percent of the decedents incurred out-of-pocket expenditure on healthcare services. The welfare regime is found to be the primary factor influencing the likelihood of out-of-pocket expenditure, while patients’ characteristics have minimal impact. The proportion of out-of-pocket expenditure varies significantly across welfare regimes, with the highest probability observed in the Continental and Social Democratic regimes and the lowest in the Mediterranean and East European regimes.

Conclusions
A country’s welfare regime plays a crucial role in determining the generosity of its public healthcare spending and its ability to alleviate the financial burden on the households of cancer patients. Increasing public funding for cancer care may reduce patients’ out-of-pocket expenditure in all countries, particularly in those where out-of-pocket expenditure is the highest.

Key messages
• A country’s welfare regime significantly impacts the likelihood and magnitude of out-of-pocket healthcare expenditure for cancer patients in their last year of life.
• Increasing public funding for cancer care may help reduce the financial burden on patients and their families, particularly in countries with high out-of-pocket expenditure.