bluuebunny/crossref_metadata_2025_split huggingface dataset:
Main challenges and measures taken by public health institutions in response to war in Kyiv Region
Authors: Rodyna N , Kuzin I , Husovych M , Maiboroda V , Kozolii I , Kupriianova T , Aaronson W , Hasiuk L , Savchuk R , Tomosky A M 
Published: October 2024

Abstract

Background
The establishment of martial law due to Russia’s military aggression against Ukraine led to specific adjustments in the functioning of the Centers for Diseases Control and Prevention (Ð¡DÐ¡). The negative impact of hostilities is determined by the increased morbidity rate of communicable and non-communicable diseases, insufficient supply of safe drinking water and food to damaged sites, inadequate living conditions, etc.

Objectives
The purpose of the work was to create an effective system for responding to biological, chemical and radiation hazards and eliminating the consequences of an emergency situation in the realities of martial law.

Methods
We used the most common methods, namely descriptive, statistical, microbiological and сhemical laboratory tests.

Results
The activities of the CDC under martial law include daily monitoring studies of environmental objects. The epidemic situation of acute intestinal infection (AII) and other communicable diseases (CD) is constantly analyzed. The Kyiv Oblast CDC became the basic institution for the implementation of the ‘pilot project’ in the direction of sanitary and epidemic assessment and monitoring of environmetal objects in 188 de-occupied areas. The main public health risks were identified: providing the population with high-quality drinking water; low immunization rate of the population; sites for the location of internally displaced persons; natural foci of especially dangerous diseases, such as tularemia, leptospirosis, infection fevers, etc. In 2022, the overall level of CD in the Kyiv region decreased by 44.0% from 2021. The most common nosologies were acute respiratory viral infections and influenza (98.9%), AII (42.4%), tuberculosis (15.3%), Lyme disease (15.3%), and viral hepatitis (14.2%).

Conclusions
Based on the research conducted, mechanisms have been developed for responding to hazards of various origins by public health institutions, including risk assessmant and laboratory studies.

Key messages
• The main focus of the Centers for Diseases Control and Prevention is aimed at effective response to hazards of various origins in order to ensure public health under martial law.
• Risk assessment in de-occupied territories has become an important tool for identifying correct approaches to prevent negative consequences for public health.
The importance of healthcare monitoring systems
Authors: Miotti A M , Tikvina S , Calzavara A , Nesoti M , Zilli E 
Published: October 2024

Abstract

Issue
Healthcare evaluation is an important tool of governance in the health sector that reinforces its key components: evidence-based care, effectiveness, programme standards, performance monitoring, quality improvement, risk and incident management and patient-centered care. One of the evaluation systems used by the Veneto Region (north italian region of about 4.8 million inhabitants) consists of the National Outcomes Programme (PNE) developed by the Italian National Agency for Regional Healthcare Services (AGENAS) on behalf of the Health Ministry.

Description
The PNE is an instrument used to measure, analyze, evaluate and monitor clinical and welfare assistance performances of Italian healthcare facilities. The Veneto Region, in particular, utilizes a regional epidemiologic service to periodically monitor 21 performance indicators based on “treemap” methodology. These indicators are used to assess processes, outcomes and volumes. The data used to monitor these practices derive from the hospital discharge documentation (SDO) and tax registry information system. The aim of this monitoring system is to track any critical situation that is not in alignment with national guidelines and to improve the efficacy, efficiency, appropriateness and safety within the healthcare system.

Results
In the Veneto region, over the course of nearly 10 years, this method of management has led to the development of various training courses that guide clinicians to correctly document and code different diagnosis and treatments. The treemap process of analysis has also made possible various clinical audits that have provided significant policy changes regarding risk and overall health management.

Lessons
Having a constant view of healthcare performance has proven to be helpful not only to identify some common gaps in care given from different facilities on a national level, but also guides different regions to develop specific strategies that lead to quality improvement.

Key messages
• Data on healthcare quality can be used as comparative information and for quality improvement.
• Continuous monitoring of specific performance indicators can help identify difficulties in healthcare facilities and create strategies for long term solutions.
How do industry and other actors undermine tobacco control policies post-adoption? A scoping review
Authors: Matthes B K , Hiscock R , Fitzpatrick I , Alaouie H , Gatehouse T , Gilmore ABC 
Published: October 2024

Abstract

Background
Over recent decades, many countries have strengthened their tobacco control policies. To be effective, full implementation is needed. Tobacco industry interference is widely recognised as a key barrier to tobacco control progress and evidence-based models like the policy dystopia model (PDM) list industry strategies, focusing on those avoiding and undermining policy adoption. While prior research highlighted industry activities post-adoption, these have not been captured systematically. This review aimed to map the efforts of industry, front groups and other actors to undermine the implementation of policies, including marketing, packaging, smokefree and flavour measures.

Methods
We searched six literature databases, relevant bibliographies and grey literature, and consulted experts. We included articles describing one or more attempts to undermine adopted policies, including marketing, packaging, smokefree and flavour. The PDM served as starting point for coding; additional strategies were identified inductively. Strategies were charted against aims and policies.

Results
Several aims and strategies were identified which were similar across policies. Following policy adoption efforts to 1) overturn and 2) weaken measures, and 3) delay implementation continued. Legal strategies were utilised and there were attempts to influence stakeholders. In addition, tobacco industry and other actors sought to 4) undermine policy effectiveness by creating confusion, circumventing policies, and noncompliance, and 5) use implementation as an opportunity to enhance industry reputation.

Conclusions
Interference from tobacco industry and other actors threatens effective tobacco control policy implementation. The public health community must continue to monitor, expose and counter industry conduct after policy adoption. More research is needed to enhance our understanding of how industry interferes in policy implementation, and how this can be pre-empted and countered.

Key messages
• The interference from tobacco industry and other actors following policy adoption threatens effective tobacco control, and needs to be monitored, exposed and countered by the public health community.
• Policymakers and civil servants need to be wary of efforts to undermine tobacco control policies and act to ensure effective policy implementation.
Empowering health literacy: Turkiye’s Health Literacy Action Plan 2022-2026
Authors: Soganda S Y , Oztop M B , Uner S , Ornek M , Kerman G 
Published: October 2024

Abstract

Issue/Problem
The ‘Health Literacy Action Plan 2022-2026’ of the Turkish Ministry of Health addresses the critical public health issue of limited health literacy, leading to increased hospital admissions, inappropriate emergency department use, and poor health outcomes. This underscores a significant challenge in individual health self-management and higher healthcare expenditure within the country.

Description of the Problem
The Health Literacy Action Plan aims to tackle disparities in health literacy levels among people. It employs customized teaching schemes, digital communication, and inclusive healthcare practices to reach every demographic group. The plan seeks to enhance health knowledge and empowerment among Turkish people by increasing access to medical information, simplifying clinician instructions, and promoting closer communication between patients and healthcare professionals.

Results
Comparative evaluation of nationwide surveys conducted in 2017 and 2023 with 15,000 participants shows remarkable improvements. Despite delays due to the pandemic, the action plan led to a notable increase in adequate health literacy levels from 31.9% in 2017 to 46.1% in 2023. Additionally, significant improvements were observed in ailment prevention and health promotion, with health literacy levels in disease prevention increasing from 28.4% to 45.7%.

Lessons
The Health Literacy Action Plan plays a crucial role in developing and implementing multifaceted public health strategies based on data and stakeholder participation. These interventions, requiring continuous monitoring and adjustment, are essential steps toward achieving high-level health literacy.

Key messages
• Strategic health literacy interventions are essential for improving health outcomes and optimizing the use of public resources.
• Evidence-based interventions and ongoing evaluation are key to promoting health literacy.
Navigating Crisis: Resilience and Mental Well-being in Post-COVID Cyprus Students
Authors: Magorokosho N , Heraclides A , Prodromou M , Papaleontiou-Louca E 
Published: October 2024

Abstract

Background
The mental health of university students is identified as a major challenge in public health, exacerbated by the COVID-19 pandemic. The pandemic and its aftermath have brought forth several stresses, which have had a substantial influence on university students’ mental health. Understanding how resilience, which is crucial in coping with adversity, influences students’ responses to these difficult circumstances is critical.

Objectives
This study aims to examine the relationship between resilience and mental health outcomes among university students in the Republic of Cyprus after the COVID-19 pandemic.

Methods
Using a parallel embedded mixed methods approach, resilience was measured using the Conner-Davidson Resilience Scale (CD-RISC) while mental health outcomes were assessed using the Symptom Checklist 90-Revised (SCL 90-R) among a preliminary sample of 470 students. The association between the two was assessed by linear regression analysis, adjusting for potential confounders, and also stratifying by gender.

Results
Preliminary findings from this ongoing study revealed a significant inverse relationship between resilience and mental health (beta= -0.58, 95% CI -0.88, -0.29), regardless of gender, age, or socioeconomic status. Stratifying by gender revealed for males, the association between resilience and mental health is (beta= -0.50, 95% CI -0.98, -0.32), whereas for females, it is (beta= -0.63, 95% CI -1.04, -0.22). In short, the influence of resilience on protecting mental health appears to be slightly more prominent in women than in males.

Discussion
This study enriches our understanding of the intricate interplay between the COVID-19 pandemic, resilience, and mental health outcomes among university students. By prioritizing the psychological well-being of this population group, our findings resonate with the World Health Organization’s advocacy for heightened mental health awareness during crises.

Key messages
• Prevalence of mental health issues post pandemic era among university students.
• Resilience as a buffer for mental health crisis in young adults.
Factors predicting a decrease in suicidality among young people (0-28 years old)
Authors: Gijzen M , Van Bergen D , Jeronimus B , Oldehinkel T 
Published: October 2024

Abstract

Background
Suicide, self-harm and suicidal thoughts (i.e., suicidality) are important public health concerns. Most youth that experience suicidality find a way to overcome these affronts. Preventative public health measures require an understanding of factors that can help youth overcome their suicidality.

Methods
Data come from a Dutch prospective birth-cohort study that surveyed youth from age 11 to 28 (measurements 2-3 years apart). We determined the proportion of youth that experienced suicidality across seven waves and focused on changes in suicidality, and factors associated with changes in suicidality using linear discriminant analysis. We examined a mix of individual, family, peer and socio-cultural factors in line with an ecological framework, e.g. the Interpersonal Theory of Suicide.

Results
Between 4-8% of youth experienced suicidal thoughts and between 2-5% experienced self-harm across time points. Most youth (89%-94% across time points) did not experience changes in suicidality, while between 3-6% experienced a decline of suicidal thoughts and between 2-4% a decline in self-harm across time points. Discriminant analyses could correctly identify ≈90% of subgroup per case (decline, increase, stable suicidality). But, the model was not very accurate in predicting which youth belonged to the declining suicidality subgroup. Functions with best predictive ability indicated the importance of interpersonal factors; belonging to peers, parents, classmates, teachers and religion. Also, overall happiness and positive changes in romantic relationships and family had predictive value.

Conclusions
It remains difficult to distinguish youth who experience a decrease in suicidality. Interpersonal factors may play a role in changes in suicidality, but we need to identify new factors related to declines in suicidality. Future prospective birth-cohort study should consider including factors that may be better predictors of decreases in suicidality and mental health in general.

Key messages
• Factors that contribute to decreases in suicidality will enrich suicide prevention strategies, which have until thusfar mostly been informed by a risk perspective.
• Interpersonal factors might play an important role in changes in suicidality among youth, which indicates we need an ecological perspective on suicidality rather than an individual perspective.
Smartphone addiction among medical students in the University of Monastir, Tunisia
Authors: Zemni I , Bennasrallah C , Kacem M , Garrach B , Dhouib W , Ben Fredj M , Abroug H , Zayene O , Bouanene I , Sriha A 
Published: October 2024

Abstract

Background
Smartphone addiction is a global mental health issue with diverse psychological and socioeconomic concerns. The aim of this study was to determine the prevalence of smartphone addiction and its associated factors among medical students in the university of Monastir, Tunisia.

Methods
We conducted a cross-sectional survey among medical students of the faculty of medicine of Monastir in October 2020. The data were collected through a self-administered anonymous questionnaire that included the SAS-SV scale to assess smartphone addiction levels. A multivariate logistic regression model was employed to identify associated factors. The threshold of statistical significance was set at p &lt; 0.05.

Results
A total of 626 medical students participated in this study, with an average age of 21.76 ± 3.12 years and a sex ratio of 0.41. The prevalence of smartphone addiction was 30.2% (95% CI: 26.0% - 33.79%). Associated factors with smartphone addiction included academic repetition(OR = 4.30; 95% CI [1.38 - 13.42]), fast food consumption scores (OR = 1.55; 95% CI [1.21 - 2.00]),addiction to the Facebook social network (OR = 6.36; 95% CI [1.92 - 21.07]), cohabitation with colleagues (OR = 2.13; 95% CI [1.03- 4.43]), cohabitation with family members(OR = 2.10; 95% CI [1.01 - 4.36]) and stress level (OR = 1.13; 95% CI [1.07 - 1.18]).

Conclusions
This study identified associations between smartphone overuse and other behavioral and mental health indicators. Based on these findings, several interventions should be undertaken to address this growing concern.

Key messages
• The prevalence of smartphone addiction among medical students in the University of Monastir was 30.2% (95% CI: 26.0% – 33.79%).
• The main associated factors with smartphone addiction were academic repetition, fast food consumption, addiction to Facebook, cohabitation with colleagues and with family members and stress level.
Bridging gaps: A closer look at the health of sexual and gender minorities in Austria
Authors: Pfabigan J , Pentz R , Teufl L , Winkler R , Gruber G , Gaiswinkler S 
Published: October 2024

Abstract

Austria has long lacked comprehensive data on the health and well-being of sexual and gender minorities (SGMs). The 2022 LGBTIQ+ Health Report addresses this gap by presenting a comprehensive overview of the health status of SGMs in Austria. To contextualize SGM health issues, a review of the literature, health surveys, and action plans across Europe was conducted in the initial project phase. Then a questionnaire was developed in collaboration with an expert group for quantitative data collection. A total of 1,047 individuals participated in the survey; analyses of the quantitative data were enriched by insights from ten qualitative interviews. Detailed findings cover SGMs’ health status and experiences of discrimination as well as access to healthcare and health-promoting factors. Participants rated their health status lower than the average in Austria. A high number reported encountering discrimination in healthcare, especially among intersex and trans participants. While approximately half of the respondents were satisfied with healthcare provision, around 16% expressed dissatisfaction. Finally, a significant proportion of participants reported having foregone healthcare services at least once despite having health issues. Our work underscores the importance of recognizing the diverse needs of distinct groups within the SGM spectrum. It is crucial to avoid oversimplification by grouping them into a single SGM category as this obscures the unique challenges and inequalities faced by each subgroup. The rapid evolution of terms adds complexity to this work. Moreover, attention should be directed towards intersectionality within these groups as some are hard to reach with an online survey. Navigating the seas of public health innovation, our exploration of SGM health in Austria reveals not only the challenges but also the imperative for inclusive and tailored healthcare strategies.

Key messages
• The 2022 LGBTIQ+ Health Report Austria reveils SGM health realities: lower health status, discrimination, and unmet healthcare needs, urging targeted interventions.
• Acknowledging diverse SGM groups and evolving terminologies, our study underscores the need for nuanced, intersectional healthcare approaches.
Smoking, alcohol, substance, technology, and gambling addiction among university students
Authors: Baran A , Sülü M , Kekilli C , Avcu A , Gündoğdu S , Boz G , Genç M 
Published: October 2024

Abstract

Background
University students turn to addictive substances to cope with the anxiety and stress caused by separation from family, adaptation to a new environment, as well as many economic and social problems. This study aimed to examine smoking, alcohol, substance, technology, and gambling addiction among university students.

Methods
The data of this cross-sectional study were collected between February and March 2024. The study population consisted of 23,446 people studying at Ä°nonu University, and the sample size was calculated as 346 based on a smoking rate of 35.6% among university students. A stratified sampling method was adopted according to the faculty of study, and 366 people were approached regarding the study. The independent variables were age, gender, faculty of study, and smoking status, while the dependent variables were alcohol and substance use status. Descriptive data were expressed in numbers and percentages, and a Chi-square test was used in the statistical analysis.

Results
Of the students in the research group, 56.8% were female, 54.4% were 22 years of age or older, 30.1% reported smoking cigarettes, 7.7% reported drinking alcohol in the last 30 days, 39.2% reported using the internet for five hours or more per day, 3% reported playing various casino games on the internet once a week or more, and 1.4% stated that they used substances. There was no statistically significant difference between alcohol and substance use according to smoking status (p &gt; 0.05).

Conclusions
Approximately one-third of the students in the research group reported smoking cigarettes, and one-tenth reported alcohol use, which is quite high. The high percentage of students who use the internet for five hours or more per day and the low rate of online gambling should be considered in relation to these addictions.

Key messages
• Multidimensional interventions and intersectoral cooperation are required to prevent smoking, alcohol, substance use, technology, and gambling addictions among university students.
• In addition, precautions should be taken to protect students against the risks associated with internet addiction and online gaming.
Promoting Equity: Child & Adolescent Health Service
Authors: Bjørnsen H N , Welde B , Lervold T , Manvik M D , Ringås H S , Høyland M M , Riiser K 
Published: October 2024

Abstract
The health and well-being of children and adolescents face significant challenges, particularly in times of social instability. In response to these challenges, the Norwegian government allocated funding in 2021 to establish a national center for Child and Adolescent Health Promotion Services. Situated within the Norwegian Institute of Public Health, this center focuses on enhancing expertise, professional development, and research within municipal maternity and child health clinics, school health services, and youth health clinics. This presentation delves into the crucial role of Universal Health Promoting Services (UHPS) in mitigating the adverse effects of social inequality on child and adolescent health. By leveraging evidence-based practices and identifying knowledge gaps in health promotion and disease prevention in primary care settings, UHPS serve as catalysts for reducing health disparities and enhancing outcomes among expecting parents, children, and adolescents. Moreover, UHPS plays a vital role in addressing the underlying determinants of health inequality, including social network, lifestyle factors, promotion of health literacy and ensuring accessible health care services for all. UHPS empowers individuals and communities to actively participate in health promotion efforts, fostering a culture of health equity and resilience. Through targeted health education programs, early intervention strategies, and community empowerment initiatives the UHPS work both at a systems and individual level to address social inequality in health. This presentation contextualizes UHPS within a broader picture aimed at promoting child and adolescent health while addressing social inequality in health. By highlighting effective approaches and areas requiring further research, it aims to contribute to the ongoing discourse on optimizing health outcomes for young populations.