bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal pre-pregnancy weight and infant spontaneous movement: is there an association?
Authors: De Pasquale L , Palandri L , Marrozzini L , Trevisani V , Scasserra M R , Bertoncelli N , Facchinetti F , Iughetti L , Lucaccioni L , Righi E 
Published: October 2024

Abstract

Introduction
Maternal pre-pregnancy overweight status might create a chronic systemic inflammatory environment for the foetus, impairing neurons development. The Motor Optimality Score-Revised (MOS-R) is an established tool to assess infant spontaneous movement at 3-5 months helping predict later neurodevelopmental outcomes in infants, including language, minor neurological dysfunction or learning difficulties at school age. The aim of our study was to investigate if maternal BMI together with other characteristics were potentially associated with MOS-R score at 3-5 months in a sample of newborns representative of physiologic full-term pregnancies.

Methods
128 mother-children couples were enrolled in the Hospital of Modena, Italy. Mothers’ socio-demographic characteristics and BMI pre and during pregnancy were collected. MOS-R was assessed in infants within 9-18 weeks post term age (Median 13, IQR 12-14). Descriptive statistics, bivariate associations and multivariate analysis were performed.

Results
In our sample, 94.5% of infants (44% females) had a MOS-R≥25 (optimal score), 3.9% a MOS-R between 23-24 and 1.6% a MOS-R&lt;23. In bivariate analyses pre-pregnancy BMI≥25 and weight gain higher than recommended during pregnancy were associated with MOS-R&lt;25 (p &lt; 0.05); being unemployed before and during pregnancy and having pregnancy during COVID lockdown were associated with reduced “age adequate movement repertoire” subcategory (p &lt; 0.05). In multivariate analysis, pre-pregnancy BMI≥25 remained the only factor significantly associated with lower scores (p &lt; 0.05).

Discussion
Our sample of healthy infants showed a typical range of spontaneous movements reflecting neural integrity. However, lower MOS-R scores were associated with pre-pregnancy overweight. This finding reinforce the importance of enhancing public health actions targeted at keeping a weight in the normal range to protect from a large number of unhealthy conditions both the mother and the offspring.

Key messages
• Pre-pregnancy weight appears associated with infant spontaneous movement in 3-5 months infants.
• Public health actions targeted at keeping female weight in the normal range must be strengthen.
Electromagnetic fields exposure and neuropsychological effects in young people
Authors: Polanska K , Jankowska A , Scieszko M , Politanski P 
Published: October 2024

Abstract

Background
In recent years, there has been a large increase in the use of communication/connected devices and technologies. This raises a question about radiofrequency electromagnetic fields (RF-EMF) exposure levels and neuropsychological effects of RF-EMF in young people. The aim of this study was to assess the pattern of use of communication/connected devices and technologies and its impact on cognition and mental health of early school age children in Poland.

Methods
The study population consists of 293 children from Polish Mother and Child Cohort (REPRO_PL). The study was based on questionnaire data covering type and duration of usage of communication/connected devices and technologies by mothers during pregnancy and children at age of 7 years. The environmental exposure to RF-EMF was also taken into account. Based on such data RF-EMF exposure was assessed. Child emotional and behavioral assessment was done by Strengths and Difficulties Questionnaire whereas IQ and psychomotor development of children was performed by psychologist using Intelligence and Development Scales.

Results
About 75% of young people used smartphones (2% for voice calls and 7% for Internet browsing at least one hour per day). Tablet or laptop use was declared by 59% and 56% of respondents, respectively. More than 10% declared that they use these devices at least one hour a day. The main factors determining the use of new technology devices were parental age and education (p &lt; 0.05) and the age at which youth started school education (p = 0.06). In multivariable regression model higher level of RF-EMF was associated with total difficulties and emotional problems (p &lt; 0.05).

Conclusions
This study presents the pattern of use of new technology devices by early school age children in Poland and the association between the exposure to RF-EMF and child mental health.

Key messages
• The use of communication/connected devices and technologies is common among young people in Poland.
• The exposure to RF-EMF can increase mental health problems among young people.
Reform of the Irish health system towards Universal Health Coverage and the role of the private sector
Authors: O’Donoghue C 
Published: October 2024

Abstract

Introduction
Ireland stands as a compelling case study of a High Income Country setting out on Universal Health Coverage (UHC) reforms. The Irish health system has historically been a two-tier system with a large private sector and a high proportion of the population holding private health insurance (48% in 2023). The reform programme Sláintecare, adopted as a policy direction by all political parties, aims to introduce UHC, strengthen primary care capacity, address inequitable access and decentralise decision-making. The overall aim of this study is to chart the progress of the Sláintecare reforms, from their introduction in May 2017 up to December 2023, and to explore how they have changed throughout implementation.

Methods
A document analysis was undertaken using the READ approach. Department of Health publications, Budget reports, Service Plans, National Development plans, minutes of Health Service Executive committee meetings and transcripts of the Joint Committee of Health sessions in the Irish parliament were uploaded to NVivo and a content analysis was conducted, utilising predetermined themes.

Results
Areas that have made the most significant progress include the expansion of community care and lowering of some out-of-pocket costs. Since implementation began, one approach the government has taken has been to use the private sector to fill capacity gaps in the public system. For example, strategies for reducing waiting lists and using community diagnostics have largely used the private sector. However, through using the private sector, money is taken away from building capacity in the public system, which was the original goal of Sláintecare.

Conclusions
The private sector plays a significant role in providing care in Ireland and leveraging this for the benefit of public patients could play a positive role towards UHC, provided that funding for a purchaser-providers type model for some services from the government could be guaranteed into the future.
Young North African migrants in Europe: exploring their health and the adequacy of health services
Authors: Jackson Y , Rocilla Arachega E , Broers B , Chamay Weber C , Rigumye O , Pinon M 
Published: October 2024

Abstract

Background
Over five million people from North Africa (NA) lived in Europe in 2019, including youth characterized by intense trans-border mobility, precarious living conditions and high-risk behaviours such as prostitution and illegal activities. This population challenges health professionals and institutions ability to deliver medical care and health information remains scarce. This scoping review aims to better understand NA adolescents and young adult (aged 12-25) health status, access to and use of healthcare.

Methods
Following the Arksey and ÓMalley process and based on the Population-Concept-Context framework, we searched the CINAHL, Cochrane, Embase, PubMed, PsycINFO and Web of Science databases for peer-reviewed articles and non-index reports. We systematically tracked references.

Results
Initial search returned 5319 articles of which we included 13 (2 Spanish, 2 French, 3 German). All reported about observational studies. Nine of 13 papers included males only and 11 focused exclusively on unaccompanied minors. They reported about physical health conditions related to poverty such as dental caries, iron deficiency and dermatological conditions (n = 5) or infectious diseases, notably tuberculosis (n = 7). Trauma-related mental health conditions were frequently reported (n = 7), including post-traumatic stress disorder and alcohol, cannabis or benzodiazepines harmful use with frequent overlapping presentations. Three studies discussed multi-pronged barriers to healthcare, emphasizing the importance of transcultural approaches and attention to social factors.

Conclusions
Embedded into multiple factors of vulnerability, poor physical and mental health is commonly associated with young NA migrants. Evidence is limited in scope and quality notably about females and young adults. There is an important gap about optimal strategies to deliver tailored health services, notably to respond to complex mental health needs.

Key messages
• The complex health needs and barriers to care of young NA migrants in Europe are not adequately documented, understood, and addressed.
• Particular attention should be paid to trauma-related mental health conditions.
An observational study in Roma women in Greece: measuring health factors in an understudied group
Authors: Zota K , Dalma A , Tzirita S , Kouvari M , Katsas K , Zioga E , Drougos N , Karnaki P , Veloudaki A 
Published: October 2024

Abstract

Background
The Roma have always been one of the most vulnerable and at the same time understudied minority groups in Europe, living under difficult conditions and experiencing discrimination. The aim of the present work was to summarize the health and lifestyle profile of Roma women living in various regions of Greece.

Methods
A multi-center, observational study was implemented in April-June 2022, in the context of a national program entitled “Empowering Young Roma Women in matters of health, prevention and human rights: a new methodological approach”. Roma women, living in 5 areas of Greece, and health professionals working with Roma groups were considered as eligible to participate. A two-step, methodological approach was followed: a. qualitative study with Focus Groups and b. questionnaire-based survey.

Results
In total, n = 41 participants in FGs, and n = 99 responders in survey were recorded. 40% of participants were smokers (&gt;10-15 cigarettes/day). Main quitting reasons, were “to set a good example and cost’. Increased consumption of ultra-processed foods and beverages, low plant-based foods intake, frequent breakfast omission and eating-out were reported by the vast majority of participants. Only 15% of responders had undergone typical, gynecological, screening tests while 1 in 5 responders used contraception. Regarding vaccinations, even if about 8 in 10 women seemed to comply with the obligatory vaccines for their children, a high vaccination reluctancy in 70% of the study sample was recorded in case of vaccination in adulthood.

Conclusions
This study stands one of the very few that underscore the vulnerability of Roma women in terms of poor health literacy, unhealthy lifestyle behaviours and low motivation to typical preventive measures. Improving access to primary health care services and tailored, culturally sensitive training is crucial.

Key messages
• Social inclusion of the increasing population of Roma women is crucial.
• Health promotion, taking into consideration Roma women’s special needs, shall be a decisive factor of this process.
Health status by time of arrival among Ukrainian refugees in Norway
Authors: Labberton A S , Ozeryansky L , Helland Y , Skogheim T S , Hansen T M 
Published: October 2024

Abstract

Background
Over 75000 refugees from Ukraine have come to Norway since February 2022. Previous studies show that the refugees have poor health for several domains, and reports suggest that those fleeing Ukraine at later stages have even poorer health. However, more systematic knowledge is lacking. This study aimed to measure self-reported health in a sample of adult refugees from Ukraine according to month of arrival to Norway in 2022.

Methods
Data were collected via an online, digital questionnaire, in a cross-sectional study design between 28.10.22 - 31.01.23. Recruitment was via multiple potential physical and social media contact points, including asylum reception centres, municipalities, non-profit organisations, and Facebook groups for refugees in Norway. The survey included self-reported health outcomes: overall health, oral health, presence of long-term illnesses or disabilities, and a short version of Hopkins Symptom Checklist (HSCL-5).

Results
Among 727 respondents, 82% were female, 65% aged 30-49 years, 69% had higher education and 53% responsibility for children in Norway. 383 arrived February-April (T1), 200 May-August (T2) and 144 September-December (T3). Compared to T1, later periods had higher proportions of males, a younger age distribution and lower proportions with higher education. Proportions reporting poor/very poor overall health, presence of long-term illness, and long-term disability were highest in T3. Oral health and HSCL-5 showed an opposite trend, with lower proportions reporting poorer health in both later periods. Respondents in T3 were still more likely to report poor health and long-term illnesses after adjusting for sex, age and education.

Conclusions
Respondents arriving later in 2022 generally reported poorer long-term health, but less psychological distress than those arriving earlier. These findings may help to inform planning of health services to refugees from Ukraine, especially in areas receiving large numbers of refugees.

Key messages
• Refugees from Ukraine arriving earlier to host countries appear to have generally better health compared to those arriving later.
• Refugee health services should plan and scale accordingly when large numbers of refugees are expected as a result of international crises.
Impacts of an interpretation fee on immigrants’ access to healthcare: A Danish survey study
Authors: Nielsen M R , Jervelund S S 
Published: October 2024

Abstract

Background
In 2018, a fee for healthcare interpretation was introduced for immigrants living in Denmark for more than 3 years to incentivize learning Danish faster. The fee entails out-of-pocket costs ranging from 26-225 EUR per consultation, outpatient visit, or hospital admission. Little evidence is available on how immigrants experience impacts of the fee on their access to healthcare. The study aims to address this gap.

Methods
Using survey data collected among newly arrived immigrants (n = 486) at 26 cluster-randomly selected language schools in 2021, we analysed prevalence and socio-demographic background of immigrants reporting interpretation needs, and self-reports about whether the fee had caused immigrants to refrain from seeking healthcare, using ad hoc interpreters, and trying to learn Danish faster.

Results
In the study population, 19% (95% C.I. 14-26%, n = 95) reported interpretation needs. Refugees and their families (OR: 10.2, 95% C.I. 5.3-19.7) more often reported interpretation need compared with EU/EEA immigrants, as did immigrants with low education (OR: 1.9, C.I. 1.2-2.8), low income (OR: 2.6, C.I. 1.6-4.5) or poor self-perceived health (OR: 3.2, C.I. 1.1-9.2), adjusted for gender, age, region of residence, and length of stay. Among immigrants needing interpretation, 42% (C.I. 32-53%, n = 69) reported having refrained from seeking healthcare due to the fee, 73% (C.I. 55-86%, n = 119) using ad hoc interpreters, and 77% (C.I. 59-89%, n = 126) trying to learn Danish faster.

Conclusions
Findings suggest that the policy aim of incentivizing resettlement country language acquisition is partly met, but that the fee has unintended consequences in terms of hampered access to healthcare and increased use of ad hoc interpreters, raising concerns about unmet health needs and poorer quality of care, especially for vulnerable immigrants. Potential benefits of the policy should be carefully evaluated against severe negative impacts on immigrants’ access to healthcare.

Key messages
• Healthcare interpretation fees appear to be incentivizing acquisition of the resettlement language, but at the same time severely hamper access to care.
• The fee appears to disproportionately affect vulnerable immigrants, including refugees and their families and immigrants with low education, low income, and poor health.
Immigrants and nurses’ perspectives on the barriers in using health promotion services in Finland
Authors: Nekouei ML M , Lindström J , Turunen H 
Published: October 2024

Abstract

Background
The incidence of chronic diseases and health disparities is high among immigrants. Lack of access to health promotion services targeting the needs of the immigrant population was reported. This study aimed to explore the perspectives of immigrants and nurses on the barriers to using health promotion services in Finland.

Methods
A qualitative study with 12 focus group interviews was conducted in various cities across Finland. A total of 69 participants, including 46 adult immigrants and 23 registered nurses, were selected through purposive sampling. A semi-structured interview was used. Interviews were transcribed verbatim and analyzed using content analysis.

Results
The analysis generated four themes: insufficient individual factors (i.e., knowledge, skills), restraining cultural norms (i.e., unhealthy cultural habits, gender disparities), inadequate health promotion services (i.e., lack of resources, structural limitations), and negative environmental impacts on health behavior (i.e., sweet foods and beverages, cold weather).

Conclusions
The findings suggest reinforcing health promotion services to prevent chronic diseases among the immigrant community. Providing health education resources that are culturally tailored helps improve immigrants’ knowledge to make healthier decisions in their own lives after migration. Moreover, it is recommended to introduce the health care system of the host country and healthy habits during the integration process, along with language training.

Key messages
• Improving equity in using health promotion services for immigrants requires reforms.
• More strategies are needed to prevent chronic diseases among immigrants in Finland.
Understanding and addressing the needs of refugee and asylum-seeking children and young people
Authors: Stevens A 
Published: October 2024

Abstract

Issue/problem
Europe is home to an increasing number of refugee and asylum-seeking children at risk of health and wellbeing needs due to their life experiences. They are frequently marginalised, impoverished, and face barriers accessing the healthcare and support they need. Bevan, an English social enterprise providing health and wellbeing services to Inclusion Health populations, carried out a needs assessment of migrant children registered at one of its General Practices to determine challenges and opportunities to ensuring their right to health. The knowledge and learning generated is relevant across sectors; organisations and geographical boundaries.

Description of the problem
The assessment included a literature review, audit of child new patient health checks, service mapping, multi-agency stakeholder interviews and a consultation event with unaccompanied minors. Findings informed Bevan’s Migrant Children and Young People (CYP) Strategy, local service development and system-wide recommendations.

Results
Key areas of concern identified included mental health; safeguarding; development; nutrition; and inter agency working. Challenges to meeting needs were complex and included national policies, poor provider understanding of rights and entitlements, language and cultural barriers, health service waiting lists, housing and silo-working.

Lessons
Responding to findings Bevan invested in an in-house CYP mental health service and CYP social prescriber, opened a drop-in clinic and wellbeing service for unaccompanied minors, and initiated orientation and health information sessions for new arrivals with peer advocate support. Bevan now hosts a city-wide cross-sector Migrant CYP stakeholder group and collaborates with regional and national partners to develop resources to promote the health of migrant CYP.

Key messages
• The needs assessment enabled development of a responsive integrated service for migrant CYP that meets their health needs and addresses their social determinants of health.
• The Migrant CYP stakeholder group has improved inter-agency working, helped identify service gaps, increased advocacy opportunities, and facilitated co-creation of solutions to meet population needs.
Multidisciplinary approach to asylum seekers health assessment: a 5-year experience in Modena, Italy
Authors: Paduano S , La Torre M , Borsari L , Kahfian Z , Incerti F , Carlei A , Liguori A , Bargellini A , Filippini T 
Published: October 2024

Abstract

Background
Asylum seekers’ well-being represents a global health issue. They face significant challenges to their physical and mental health due to their migratory path. In the Modena province (Northern Italy), a multidisciplinary approach has been applied to the care of asylum seekers by Department of Public Health (DPH), with a team of specialists in infectious diseases, dermatology, gynaecology, obstetrics, psychology and preventive medicine. Asylum seekers receive a first visit, including medical and psychological assessment and screening for infectious diseases. Ad hoc pathways are also active for asylum seekers who need secondary-level care. This study aims to investigate the health status of asylum seekers referred to Modena Centre.

Methods
This cohort study enrolled asylum seekers hosted in Modena between November 2018 and May 2023. During the first visit, personal and anamnestic data were collected aided by cultural mediators, along with clinical assessment. Furthermore, Tuberculin-Skin-Test (TST) and blood tests for HBV-HCV-HIV-Syphilis were performed.

Results
A total of 646 migrants were included, 94% were males with a median age of 26 years (range: 15-50), the majority from Bangladesh (39%). Females were mostly from Ivory Coast (36%), median age of 30 years (range: 17-45). Most conditions were treated at the primary care level and were related to cutaneous disease (22%), only 11% of subjects required second-level diagnostics. Positive TSTs were 41% (N = 265). Of them, 55.5% (N = 147) also tested positive for QuantiFERON-TB. Screening for infectious diseases revealed positivity rates of 4% for HBsAg, 1% for HCVAb, 0.8% for HIV and 1.4% for TPPA+RPR.

Conclusions
The multidisciplinary approach is the innovative and strength point of this protocol for asylum seekers’ health ensuring prompt management of pathologies after their arrival. Moreover, data collection is useful for improving intake services and implementing public health programs for vulnerable individuals.

Key messages
• The innovation of this protocol for asylum seekers’ health lies in its multidisciplinary approach.
• Clinical data collection will support health policies’ choices to protect vulnerable individuals.