bluuebunny/crossref_metadata_2025_split huggingface dataset:
“We want to get out” – A qualitative study on reasons for nurses’ early retirement intentions
Authors: Kaihlanen A-M , Aktas E , Sadauskas M , Sezgin D 
Published: October 2024

Abstract

Background
Nurses, the largest workforce in healthcare, play a central role in health systems. There is a severe global shortage of nurses, which is expected to worsen as a significant portion approaches retirement age. Early retirements can harm care quality and healthcare access, thus significantly impacting public health. Identifying reasons is crucial to prevent this trend. This study examined factors behind nurses’ early retirement intentions.

Methods
A descriptive qualitative study was conducted in an Irish hospital (July to September 2023) including individual interviews with 10 nurses aged 55 and over. A thematic analysis was conducted collaboratively by three researchers to identify key factors influencing nurses’ intentions to retire early.

Results
Five main themes emerged: 1) Health concerns, encompassing physical strain and psychological stress, significantly influencing early retirement intentions; 2) Struggling to balance job demands with personal responsibilities such as caring for ageing parents due to inflexible work schedules; 3) Need for more support from senior leaders to address staffing shortages and investment in aging nurses’ career and retirement planning to make staying more desirable and easier; 4) Feelings about nurses’ experience being undervalued in the evolving healthcare; and 5) Facing constant heavy responsibility in guiding new nurses, while simultaneously fearing patient safety risks and encountering generational differences.

Conclusions
Developing support systems for ageing nurses, encompassing strategies to ease workload strain, enhancing career opportunities, and promoting intergenerational collaboration are critical for reducing early retirement trends and sustaining a resilient healthcare workforce. By implementing tailored approaches, such as flexible scheduling and mentorship programs for ageing nurses, healthcare organisations can promote workforce longevity and enhance public health outcomes through improved care delivery.

Key messages
• Health challenges and struggles in work-life balance influence early retirement intentions among nurses, urging flexible work arrangements and improved recognition and leadership in healthcare.
• To extend work careers, organisations must invest in ageing nurses’ career and retirement planning, value experience, and acknowledge potential challenges and benefits in intergenerational nursing.
Preferences regarding the Booster Dose of Covid-19: a cross-sectional study in Central Italy
Authors: Guarducci G , Mereu G , Gemmi F , Galletti G , Guerreschi E , Sergi A , Nante N 
Published: October 2024

Abstract

Background
Examining information sources, communication channels, and preferred content formats is crucial for adapting and improving future communication strategies in vaccination campaigns. This study aims to evaluate the information and communication preferences regarding the booster dose of Covid-19 among employees of the Central Tuscany Local Health Authority (CT-LHA).

Methods
From July to October 2022, a questionnaire was administered to 7,000 out of approximately 15,000 CT-LHA employees. The questionnaire analyzed communication, organizational, and access aspects regarding preferences for the Covid-19 booster dose. The sample was stratified into healthcare workers (HCWs) and non-healthcare workers (NHCWs). Chi-squared tests were performed using STATA, with the significance level set at 95%.

Results
The returned questionnaires were 1,885 (26.9%), with the majority being HCWs (64.4%). HCWs rated the quality of communication significantly lower compared to NHCWs, who rated it very high (p &lt; 0.05). HCWs also rated the ease of booking the Covid-19 booster dose and access modalities to vaccination significantly lower than NHCWs (p &lt; 0.05). NHCWs expressed a preference for receiving scientific information from Ministry of Health tutorials, while HCWs preferred information from their general practitioner (p &lt; 0.05). HCWs preferred to receive organizational information from healthcare management, while NHCWs preferred information from vaccination physicians (p &lt; 0.05). Additionally, HCWs preferred company operating procedures for disseminating information, whereas NHCWs preferred corporate communications circulars (p &lt; 0.05).

Conclusions
HCWs and NHCWs showed differences in perceived quality of communication, ease of access to vaccination services, and preferred sources of information. HCWs rated the quality of communication and access to vaccination services lower than NHCWs. This results suggest the need for tailored communication strategies to effectively reach both groups.

Key messages
• Health organizations need to develop targeted communication approaches that address the specific needs and preferences of their employees.
• Flexibility and adaptability are crucial to adapt communication methods and channels to strengthen vaccination initiatives and promote public health outcomes.
Organizational peer support for second victims in Vienna, Austria: The KoHi-project
Authors: Klemm V , Rösner H , Krommer E , Strametz R 
Published: October 2024

Abstract

Background
Healthcare workers negatively affected by adverse events are known as Second Victims (SV). The Second Victim Phenomenon (SVP) is widespread globally and can result in various consequences, such as anxiety, loss of confidence, and defensive medicine. To address this, the KoHi-project offers organizational peer support for SVs at the Clinic Hietzing (KHI) in Vienna, Austria.

Methods
A five-hour training program prepared 122 volunteers as peer supporters (KoHis) at KHI. Initial assessment (KoHi-I) in 2019 using the SeViD-questionnaire was followed by a repeat (KoHi-V) in 2022. Additionally, peer supporters underwent quantitative evaluations after training (KoHi-II), each session (KoHi-III), and after three sessions (KoHi-IV). KoHi-I-III were descriptively analyzed, while KoHi-IV and -V await evaluation.

Results
Initial study showed a 43% SVP prevalence at KHI. Most KoHis joined for ethical reasons and skill improvement, displaying high motivation. Post-training, they reported increased competency in supporting SVs. KoHi-III showed 53.3% of sessions initiated by KoHis, often triggered by personal distress. KoHis rated their support as highly helpful (M = 8.57 on a ten-point Likert-scale) and felt minimal burden (M = 3.42 on a ten-point Likert-scale) afterward. No significant correlations were found.

Conclusions
SVP is widespread at KHI. The five-hour training adequately prepared KoHis. Underreporting or underutilization of the program is suspected, possibly due to self-stigmatization of SVs. Being a peer supporter appears safe for KoHis. Psychological safety of voluntary supporters should be prioritized in hospital peer support programs. European hospitals lack organizational support for SVs, highlighting the importance of interventions like KoHi.

Key messages
• The SVP is common among healthcare workers at KHI.
• The implemented organizational peer support seems to not negatively impact the voluntary peer supporters’ wellbeing.
Analysis of medical doctor supply in Bulgaria, Croatia, Romania, and Serbia in the last two decades
Authors: Stevanović A , Šantrić-Milićević M 
Published: October 2024

Abstract

Introduction
The shortage of medical doctors in Europe has become a priority issue, especially in the Eastern European region, where many countries are making large investments to ensure adequate supply. Training future medical professionals is a lengthy and costly process that significantly impacts healthcare accessibility and quality. As part of the project of the Laboratory for Strengthening Capacity and Performance of Health System and Workforce for Health Equity, we aimed to assess the changes in the medical doctor supply in several Balkan countries over the last two decades.

Methods
Data on the total number of graduated medical doctors (MD) and their rate per 100,000 population from 2000 to 2021 was retrieved from the Eurostat database. This open-access database contains the reported number of students who have graduated from medical schools for each year and selected countries (Bulgaria, Croatia, Romania, and Serbia). The standard methods of descriptive statistics were used to perform the analysis.

Results
During the observed period, the number of MDs graduating annually and their rates per 100,000 population have increased in all countries. Romania leads with the highest rate of MD graduates at 26.18 per 100,000 people, followed by Bulgaria (22.74), Serbia (19.15), and Croatia (16.56). From 2000 to 2021, Bulgaria experienced the highest increase in the number of medical doctor graduates, with a rise of 169.1% in absolute numbers and 200.9% in rate. In contrast, Serbia had the lowest increase, with only a 135.5% rise in the total number of medical doctor graduates and a rate increase of 152.3%.

Conclusions
In the last 20 years, Bulgaria, Croatia, Romania, and Serbia have seen an increase in the number of MD graduates and their rate per 100,000 population. Policymakers should consider the investments and education trends of medical professionals in relation to their employment and migrations to predict the future supply of doctors in this region.

Key messages
• Bulgaria, Croatia, Romania, and Serbia have seen an increase in the number of MD graduates and their rate per 100,000 population in the last twenty years.
• Considering the trends in the number of newly graduated doctors, policymakers should address additional factors to ensure an adequate supply of medical doctors.
A Good Practice for Learning with Public Health Professionals Globally: Humphrey Fellowship Program
Authors: Cavdar S 
Published: October 2024

Abstract

Background
International collaborations are valuable yet often undervalued assets that enhance the quality of public health education and bolster the development of the public health workforce.

Objectives
The Humphrey Fellowship Program, part of the Fulbright Exchange Program, facilitates mid-career professionals’ visits to US-based host universities for an academic year. Fellows engage in a semi-structured fellowship period to achieve self-defined goals, emphasizing professional development, expanded experience, and intercultural exchange. This study advocates for the program’s contribution to enhancing public health education.

Results
Currently, two universities host fellows in public health. Over decades, fellows have engaged with faculty and professionals, participated in classes and meetings, visited institutions for development purposes, and completed US-based affiliations, contributing significantly to their own and the public health workforce’s advancement. This interaction-based learning approach aids in navigating social and ethical challenges by fostering a deeper understanding of public and global health issues across countries.

Conclusions
The Humphrey Fellowship Program in public health stands as a commendable model. Similar initiatives could be beneficially replicated in the European region, leveraging local and global successes to strengthen ties with public health education institutions, student communities, and beyond.

Key messages
• Programs that facilitate international interactions can enhance public health professionals’ understanding of global perspectives.
• The Humphrey Fellowship Program in the US stands as a commendable practice for mid-career public health professionals, contributing significant value to the education at host universities.
Public Health In Conflict And War: A Response To An Ever Evolving Landscape
Authors: Conyard K F , Codd M B , Mason-Jones A , Cunningham C , Middleton J 
Published: October 2024

Abstract

Background
The bases for this proposal are the current and ongoing conflict and war situations around the world, causing turmoil for nations and hardship and public health crises for people. We can no longer ignore the critical and time-sensitive need to address issues of Public Health (PH) in conflict and war in our education and training programmes.

Objectives
To consider appropriate themes and topics in Conflict and War that should be included in PH education and training programmes; and to consider how and where they are best represented. Member schools of the Association of Schools of PH in the European Region (ASPHER) were asked to provide details of their curricula relating PH in Conflict and War. Submissions on this topic were received from over 10 schools. Information was collated into logical themes, to which elements of the curriculum were mapped. In a modified Delphi process, respondents were asked for their level of agreement for inclusion in a curriculum and at what level content should be delivered.

Results
Findings from the survey allowed identification of seven main themes from topics provided: Contextual Factors; Preventive Strategies; Emergency Preparedness; Impact and Response; Conflict Resolution and Solidarity, Rehabilitation and Recovery. Respondents had high levels of agreement that content should be included in curricula and be delivered at every level in PH education and training.

Conclusions
PH education and training have been deficient in not including PH in Conflict and War as a subject area in programmes. The knowledge and expertise developed of necessity in some places can be shared across the ASPHER network and beyond to increase awareness of the PH considerations of conflict and war.

Key messages
• Public health in war and conflict zones is critical due to unique challenges and urgent needs of affected populations.
• An Integrated curriculum is vital for addressing conflict’s long-term health impact and preparing skilled workforce for health, resilience, action and laying the path to peace.
Factors associated with the intention to vaccinate children: a Finnish population survey on influenza
Authors: Hussein I , Vänskä S , Sivelä J , Leino T , Nohynek H 
Published: October 2024

Abstract

Background
Influenza vaccination for children aged 6 months to 6 years is included in the national vaccination programme in Finland. Although all vaccines in the programme are free of charge, national coverage of influenza vaccination among children under 3 years and 3-6 years during 2020/21 was 43% and 35% respectively, with regional differences. Our aim was to assess factors underlying parental vaccination intention in order to increase influenza vaccine uptake among children in Finland.

Methods
We conducted a survey among parents (n = 17,844) of eligible children (aged 6 months-6 years), selected randomly from five Finnish municipalities. Children and their parents were selected from high and low coverage areas, and the study was conducted in February-March 2022. Logistic regressions were used to determine associations between vaccination intention and e.g., sociodemographic factors, attitudes and knowledge. Linkage to the national vaccination register was used to confirm realisation of vaccination intention after the study.

Results
Participation rate was 13% (n = 2,322 parents). Influenza knowledge, trust in official information, responding parent’s education level, adherence to the vaccination programme, number of children and changes in attitudes towards vaccination since COVID-19 were all associated with intention to vaccinate. Vaccination intention for children was 64% and realised vaccination 51%.

Conclusions
Despite the low participation rate, both vaccinated and unvaccinated children were represented. Influenza vaccine uptake is not dependent on a single factor. Our results identified the need for open dialogue between parents and healthcare professionals, as the lack of vaccine being offered by healthcare professionals was the most reported reason for not vaccinating.

Key messages
• Parental vaccine decision-making in settings where the vaccination is given free of charge is complex, and not always driven by intention to vaccinate.
• Most parents had the intention to vaccinate, but some children still ended up not receiving their influenza vaccine.
Epidemiological characteristics of the 2019 Measles outbreak in central Tunisia
Authors: Ben Nasrallah C , Maatouk A , Grira S , Kacem M , Dhouib W , Abroug H , Zemni I , Ben Fredj M , Bouanène I , Belguith Sriha A 
Published: October 2024

Abstract

Background
Measles is still an important public health problem worldwide causing significant morbidity and mortality. Measles represents a vaccine-preventable disease. In Tunisia, vaccination against measles was launched in 1983. In spite of the progress made towards measles elimination, Tunisia experienced an outbreak in 2019. We aimed to describe the measles outbreak in the central region of Tunisia in 2019.

Methods
We carried out a descriptive study using surveillance data from January to December 2019 in four governorates in Tunisia (Monastir, Mahdia, Kairouan, and Kasserine). All suspected measles cases and declared to regional directorate of primary health care were included. A suspected measles case was defined as any person with fever and generalized maculo-papular rash plus one of the following symptoms: cough or coryza or conjunctivitis. A laboratory confirmed measles case is a suspected case of measles that has been confirmed positive by testing (IgM+).

Results
A total of 2,688 suspected cases were recorded, of which 369 cases were (14.7%) were confirmed measles through serological testing. The sex ratio was 1.06 for suspected cases and 1.12 for measles cases. Infants under one year old accounted 42.2% of suspected cases. The majority of suspected cases (67.3%) were not vaccinated. Among confirmed measles cases, positivity rates were 81.8% for unvaccinated, 70.0% for those with one dose and 27.2% for those with two doses. The hospitalization rate was 61.5 %; highest rates were observed in infants under one year of age (65.7%) and in the age group over 38 years (69.0%). In total, 27 deaths were reported. The highest lethality rate was observed in the age group under 12 months (2%).

Conclusions
The 2019 measles outbreak in Tunisia highlighted that this disease remains a serious viral infection. Unvaccinated populations could be a potential source for new outbreaks, imposing substantial public health burdens.

Key messages
• The country needs to establish a national review committee to monitor measles elimination status.
• To address future challenges, immunity gaps in the population should be closed.
The disease severity and death outcomes of COVID-19 outpatient cases in Almaty, Kazakhstan 2021-2022
Authors: Kozhekenova N , Semenova Y , Santric-Milicevic M , Glushkova N 
Published: October 2024

Abstract

Background
The global pandemic COVID-19 presented a serious burden on primary health care. We analyzed the association between the age, sex, and comorbidity on the severity and outcomes of COVID-19 in outpatient care in Almaty, Kazakhstan, between 1.1.2021 to 31.12.2022.

Methods
We assessed Odds ratio and 95% Confidence interval (OR, 95% CI) in a retrospective analysis of data on 174.540 COVID-19 patients on outpatient follow-up collected from an primary care electronic database (108,234 women and 66,306 man). Among outpatients 88.9% (n = 155,127) had mild disease, 8.3% (n = 14,537) asymptomatic; and moderate/severe disease was observed in 2.8% of cases.

Results
Among the COVID-19 outpatients, the incidence of diabetes mellitus was significantly higher in women (3.1%) then man (2.4%) (p &lt; 0.001), obesity was more common in women (0.6%) than in men (0.4) (p &lt; 0.05), and arterial hypertension was more common in men (10%) versus women (6.2%) (p &lt; 0.001). The probability of developing moderate/severe disease increased significantly with age, especially in those 60 years and older, where it was 9 times higher (p &lt; 0.001, OR = 9.01, 95% CI: 7.7-10.5), and where the probability of lethal outcome was very high (OR = 61.8, 95% CI: 8.5-446.2, p &lt; 0.001) too. The odds of developing moderate/severe COVID-19 were 1.4 times higher in patients with diabetes mellitus (p &lt; 0.001, OR = 1.43, 95% CI: 1.27-1.6), 2.5 times higher in obese patients (p &lt; 0.001, OR = 2.51, 95% CI: 1.9-3.15), and in patients with chronic obstructive pulmonary disease (p &lt; 0.001, OR = 2.5, 95% CI: 2.13-3.02), and the presence of arterial hypertension increased the risk 1.2-fold (p &lt; 0.001, OR = 1.16, 95% CI: 1.07-1.26).

Conclusions
In Almaty outpatients, an association between the moderate and severe COVID-19 and age and comorbidity (diabetes mellitus, obesity, arterial hypertension, and COPD) was found, which underscores the necessity of more research on primary care organization and delivery in health emergencies.

Key messages
• An increase of severe COVID-19 in elder outpatients and with comorbidity emphasizes the need for their effective protection.
• The research on the impact of various factors on the disease severity and outcomes in outpatients can assist in optimizing primary care.
Influenza vaccine effectiveness in Ireland during two influenza seasons, 2022/23 and 2023/24
Authors: Marron L , McKenna A , O’Donnell J , Domegan L 
Published: October 2024

Abstract

Background
Live Attenuated Influenza Vaccine (LAIV) is recommended in Ireland for all children aged 2-17 years. Quadrivalent influenza vaccine is recommended for all others eligible for vaccination, including those aged ≥18 years with underlying medical conditions and all aged ≥65 years. We aimed to estimate influenza vaccine effectiveness (IVE) against Acute Respiratory Infection (ARI) presentations to primary care due to influenza over two influenza seasons in Ireland, to inform vaccination recommendations and communication campaigns.

Methods
We undertook a test-negative design case control study within the national sentinel surveillance General Practice network, as part of the European Vaccine Effectiveness Burden and Impact Studies (VEBIS) network. We compared influenza vaccination status among influenza Polymerase Chain Reaction (PCR) positive cases with influenza PCR negative controls, amongst patients consulting with ARI. We verified vaccination status using the national influenza vaccination database. We estimated end of season IVE for 2022/23, and mid-season IVE (up to 7th April 2024) for 2023/24, using multivariable logistic regression and adjusting for age, onset time, medical condition, and sex.

Results
In 2022/23, there were 288 cases and 765 controls. In 2023/24 there were 515 cases and 1,482 controls. Overall vaccination coverage was 23% in both seasons. Coverage in 2-17 year-olds was 10% in 2022/23 and 12% in 2023/24. In 2022/23, overall IVE was 42% (95%CI 9-54) and 50% (95%CI -30-83) in 2-17 year-olds. Overall IVE in 2023/24 was 37% (95%CI 16-54) and was 67% (95%CI 28-87) in 2-17 year-olds.

Conclusions
Influenza vaccination reduced medical attendance to primary care with ARI due to influenza, demonstrating benefits of vaccination, particularly among children. Influenza vaccination should continue to be offered and promoted to recommended groups, including children.

Key messages
• This study suggests that influenza vaccination protected population health and the health service from medical attendance to primary care with acute respiratory infection due to influenza.
• Higher influenza vaccine effectiveness was observed in children aged 2-17 years. These findings can inform influenza vaccination programmes with LAIV for children in Ireland and internationally.