bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health promotion interventions for children and adolescents using e-health: a systematic review
Authors: Bae E , Jang M 
Published: October 2024

Abstract

Background
The utilization of e-health in healthcare interventions has become increasingly prevalent due to its cost-effectiveness. Nevertheless, there is a paucity of evidence regarding the use of e-health in children, as the majority of e-health interventions are focused on adults. This study aimed to identify the components and effects of e-health intervention for the promotion of children’s health and to suggest strategies for their implementation.

Methods
A systematic review was conducted in accordance with the PRISMA guidelines. A literature review of relevant studies published between January 2013 and November 2023 was conducted. A search of databases including PubMed, EMBASE, CINAHL, MEDLINE, and Cochrane Review Library was conducted using a combination of medical subject headings (MeSH) and keywords. A qualitative appraisal of the studies was conducted using the revised Cochrane risk-of-bias tool for randomized trials (RoB 2).

Results
Sixteen studies were selected. Most studies showed good methodological quality. The majority of studies (n = 15) focused on improving children’s physical health, while only one study focused on mental health. There were a variety of components to the intervention, including internet education, web-based home-exercise, serious games, mobile apps, email counseling, and active video games, and only one type of intervention was provided, or a combination with additional methods such as phone calls and counseling. A review of the literature indicates that e-health interventions have been effective in increasing children’s physical activity, reducing weight, relieving stress, and reducing depression.

Conclusions
This study identified the effectiveness of e-health interventions for improving children’s physical and mental health. The use of e-health to promote children’s health should be actively developed and implemented in a variety of clinical and community settings.

Key messages
• E-health interventions have been demonstrated to be an effective means of improving the physical and mental health of children and adolescents.
• It is recommended that health promotion interventions utilizing e-health be developed and tested in a variety of communities and settings for children and adolescents.
Loneliness and Social Isolation: qualitative study among youth in vulnerable situations
Authors: Marques M J , Alves R , Pires J , Bertotti M , Torri E , Dantas C , Dias S 
Published: October 2024

Abstract

Background
Loneliness and social isolation are increasing among young people, particularly those in vulnerable NEET (Not in Education, Employment or Training) situations, potentially leading to poor health and well-being outcomes. We aim to explore these challenges from the perspective of NEET youngsters and link workers who support them in co-creating individual action plans for their social and economic integration.

Methods
Data were collected through in-depth and semi-structured interviews with 15 young people in NEET situations, aged 18-34, and 7 link workers from several social organisations in rural and urban areas in Portugal. The young participants were selected based on their age, educational level, mental health needs, and urban/rural regions. Thematic analysis was used to analyse the interviews.

Results
The results showed a convergence between the perspectives of young people and link workers on the factors that influence social isolation and loneliness, including social and emotional skill deficits, excessive use of social media platforms, and mental health problems. Young people reported to being heavily involved in social media platforms, which often did not translate into meaningful relationships in real life. Youngsters also highlighted the lack of local support and community resources in rural areas. Link workers identified specific challenges young migrants face in community integration, including language barriers (for the youth with a migrant origin) and lack of familiarity with local resources.

Conclusions
This study highlights social media platforms, mental health and social and emotional skill deficits as main factors contributing to the social isolation and loneliness of young people in a NEET situation. This emphasizes the importance of integrated proximity-based interventions that incorporate community resource mapping and local support networks, including mental health support services, and promote multi-sector collaboration.

Key messages
• Social media platforms, mental health needs, and social and emotional skill deficits drive social isolation in NEET youth, stressing integrated, community-focused interventions.
• Proximity-based strategies with community mapping and mental health support enhance NEET youths’ social integration, urging cross-sector collaboration.
Predicting PTSD among labour ward staff: The role of burnout, intent to leave, and emotional support
Authors: Halperin O , Yakov G , Idilbi N 
Published: October 2024

Abstract

Background
Healthcare professionals in delivery rooms frequently encounter stressful situations. Following an examination of how midwives coped and functioned during the unfamiliar and chaotic period of the Covid-19 pandemic, it is crucial to understand their challenges and the support they receive to enhance well-being and patient care. This study aimed to examine the relationship between burnout, intentions to leave, and PTSD (Post-Traumatic Stress Disorder) symptoms among healthcare professionals, and to identify predictors of PTSD.

Methods
We employed a mixed-methods design, consisting of a survey of 196 midwives and gynecologists assessing burnout, intentions to leave, exposure to negative work experiences, and PTSD. Additionally, we conducted 15 semi-structured interviews and 13 interviews with labour ward head nurses.

Results
Most participants experienced difficult events in the delivery room or multiple such events, reporting insufficient emotional support. The main themes identified were stress, fear, anxiety, and frustration. Burnout and a lack of emotional support were significant predictors of PTSD symptoms, with participants highlighting the need for more support to manage complex situations.

Discussion
Addressing burnout through prevention and intervention programs is essential. Emotional support plays a crucial role in mitigating PTSD symptoms, enhancing resilience and well-being among midwives and gynecologists. Implications for Nursing Management: Understanding the psychological impact of stressful situations on healthcare professionals is crucial for guiding policies and interventions aimed at maintaining staff psychological well-being. Midwives’ managers can leverage this research to identify actions that improve staff resilience and cohesion during crises. Strengthening the resilience of health teams is pivotal in providing optimal health services.

Key messages
• Burnout and insufficient emotional support are key predictors of PTSD among healthcare workers in labour wards.
• Enhancing support and resilience for midwives and gynecologists is crucial for their well-being and patient care.
Experts in promotion and prevention - The 100th Anniversary of Finnish public health nurse education
Authors: Saastamoinen J , Putkuri T 
Published: October 2024

Abstract

Issue/Problem
Two key public health issues at present are mental health problems and obesity. Both typically begin before adulthood and once occurred, typically persist. Prevention would be important but also economically and humanely sensible. For this, competent experts in preventive work and health promotion are needed.

Description of the problem
Public health nurse education, originally known as health sister education, was initiated in Finland in 1924, by the Mannerheim League for Child Welfare. The six-month health sister education was targeted at nurses and began from the desire to focus not only on treating diseases but also on promoting health. In the 1940s, education was reformed and in the 1950s significantly expanded. In the 1970s, the professional title changed from ‘health sister’ to ‘public health nurse’. In 1987, the education was extended to 3 years, including the education of registered nurses. In 1992, the education was further extended to 3.5 years. By the beginning of the 21st century, education evolved into 4 years bachelor’s degree.

Results
In 2024, eighteen Universities of Applied Sciences provide public health nurse education in Finland. The 4-year Bachelor of Health Care in Public Health Nursing -degree (240 ECTS credits) also qualifies for a registered nurse. Nearly half of the education consists of clinical training. In addition, registered nurses can supplement their degrees by completing a one-year education (60 ECTS credits) that qualifies them as public health nurses.

Lessons
In Finland, approximately 700 new public health nurses graduate annually. They are trained to work independently as experts in preventive work, health promotion, and public health. Around 9,500 Finnish public health nurses work in settings such as maternity and child health clinics, school health services, occupational health care, and outpatient clinics.

Key messages
• Due to the overcrowding in many healthcare services providing treatment, educating experts in health promotion and disease prevention is crucial now and in the future.
• By ensuring competent experts in health promotion and disease prevention, future healthcare services can continue to provide economically and humanely sensible and effective help for people.
Postgraduate medical education in Public Health: the Italian scenario and a call to action
Authors: Pennisi F , Ricciaridi G E , Minerva M , Signorelli C 
Published: October 2024

Abstract

Introduction
Public health training in Italy takes place within postgraduate medical training in Hygiene and Preventive Medicine. With 39 university schools of public health, spread across 17 of Italy’s 20 regions, the landscape is diverse. The government determines the number of available contracts annually. This study aims to provide an up-to-date analysis of the saturation of places in Public Health programmes, as well as an assessment of mobility trends between northern and southern Italy from 2017 to 2023.

Methods
Data on admissions, withdrawals and resignations were obtained from the Ministries of Universities and Health and from the archives of the ‘Associazione Liberi Specializzandi’ (ALS). Mobility was assessed as moving from the central-northern regions to the southern-islands of Italy, and vice versa, between registration with the Medical Council and specialisation programme enrollment.

Results
Between 2017 and 2023, a total of 2301 residents enrolled across Italy, out of 2953 available positions nationwide. During this period the number of available national places, increased from 180 to 576, impacting overall seat saturation. In 2017, 98.3% of positions were covered, compared to only 46.5% in 2023. Regarding the mobility trend, southern students attending northern schools increased from 8.3% in 2017 to 22.4% in 2023, while northern students attending southern schools decreased from 17.9% to 1%. However, the number of dropouts and withdrawals was higher in the North. Mobility students scored lower than non-mobility students nationally.

Key messages
• From 2017 to 2023, the number of residents enrolled increased, while the allocation rate decreased. There was a shift in mobility patterns, with more southern students moving north.
• Addressing the identified inequalities and understanding the underlying factors driving mobility patterns is crucial for effective planning and allocation of resources.
Point Prevalence Survey of HAIs as a key component of Infection Prevention and Control programs
Authors: Marziali E , Lontano A , Pascucci D , Raponi M , Di Donato M , Corbo M I , Murri R , Fiori B , Cambieri A , Laurenti P 
Published: October 2024

Abstract

Healthcare-Associated Infections (HAIs) are a global concern, requiring surveillance strategies as Point Prevalence Surveys (PPS) to estimate their burden and investigate associated risk factors for targeted interventions in high-risk areas. This study aims to assess the prevalence of HAIs, identify determinants and evaluate antimicrobial use in a teaching hospital in Rome. A PPS was carried out from June 19th to 23rd, 2023, in accordance with the European Centre for Disease Prevention and Control (ECDC) protocol for HAIs and antimicrobial use in European acute care hospitals (version 6.1). Pearson’s chi-squared test was employed to investigate correlations between potential risk factors and HAIs. The survey included 829 patients with an average age of 56.3 years (SD: ±24.6). Of these, 48.4% were female and over half had visited the hospital’s Emergency Department (53.7%). The prevalence of active HAIs was 8.7%, with 72 patients diagnosed. Furthermore, 51.0% of all patients received at least one systemic antimicrobial agent, and 16.7% of those treated had an HAI. Penicillins (39.7%) and third-generation cephalosporins (37.8%) were the most frequently prescribed antimicrobials. The primary HAIs were bloodstream infections (34.1%), followed by urinary tract (27.3%), surgical site (23.9%), lower respiratory tract (6.8%), and gastrointestinal infections (7.9%). Escherichia coli (13.2%), Staphylococcus aureus (9.2%), and Clostridium difficile (6.6%) were the most frequently isolated pathogens. Intensive Care Unit admission, use of medical device, recent antibiotic therapy and prior hospitalization or surgery significantly correlated (p &lt; 0.05) with increased HAIs risk. The detected prevalence of HAIs is lower than the national rates observed in 2022 (10.2%), which have increased since 2016. HAIs surveillance is essential for developing effective infection prevention and control programs and for optimizing resource allocation in hospital settings.

Key messages
• Surveillance of Healthcare-Associated Infections is crucial for developing targeted Infection Prevention and Control programs and optimizing hospital resource allocation.
• Point Prevalence Surveys offer essential information for assessing the burden of Healthcare-Associated Infections and directing intervention strategies in hospitals.
Advancing data-driven decision-making for human papillomavirus (HPV)
Authors: Louette L L 
Published: October 2024

Abstract

Background
HPV is among the most important infections associated with cancers in men and women, including cervical cancer which is the second most common cancer affecting women aged 15-44 years in the EU. Yet, data on vaccine uptake, HPV infection rates and incidence of related cancers is lacking across Europe, obstructing policymakers’ ability to build adequate prevention strategies towards the EU’s goal of eliminating HPV-related cancers.

Methods
Vaccines Europe analysed the landscape of data collection practices for HPV, highlighting discrepancies across Europe as well as successful initiatives.

Results
Our analysis reveals stark gaps in data collection across Europe. Some countries do not report disease levels and vaccination coverage for HPV. When reporting does occur, methods and timelines often differ between countries. Limited data availability exists for vaccination uptake in boys and young adults. This lack of standardisation hinders the comparability and reliability of collected data. It also impedes the integration and analysis of data within and across countries, hindering the development of effective elimination strategies. Concrete actions are needed at EU and national level to further develop and strengthen data collection, sharing and use in decision-making. Our research calls on strengthening ECDC’s role, promoting best practice sharing between countries, ensuring sustained resource allocation for data systems/surveillance, establishing electronic vaccination registries, an EU implementation roadmap to support countries in achieving the objectives of Europe’s Beating Cancer Plan, and translating data into policy recommendations. The Council Recommendation on vaccine-preventable cancers provides a framework for EU Member States to establish electronic vaccination registries and the ECDC to develop an HPV dashboard by the end of 2024.

Key messages
• Current data collection practices leave Europeans more vulnerable in the fight against cancer.
• Robust data can guide policy and support elimination strategies for vaccine-preventable cancers.
Empowering Educators: Italian Nurses’ Knowledge, Attitudes, Practices, and Vaccine Hesitancy
Authors: Renzi E , Panattoni N , Baccolini V , Migliara G , Di Simone E , Marzuillo C , De Vito C , Villari P , Massimi A 
Published: October 2024

Abstract

Background
Vaccine hesitancy (VH) among healthcare workers is a prevalent global phenomenon and a public health concern. The study aims were i) identifying knowledge, attitudes, and practices (KAP); ii) estimating the prevalence of VH regarding recommended vaccines for healthcare workers (HWs).

Methods
Multicenter cross-sectional study of an Italian sample of nurses and nursing students. Following a systematic review (PROSPERO ID:CRD42020212252), a validated questionnaire was used (Cronbach’s alpha=0.82). Two multivariable logistic regression model were built to identify predictors of (1) VH to the recommended vaccine for HWs; (2) acceptance of the fourth COVID-19 vaccine dose.

Results
226 participants were enrolled (169 nurses; 57 students). Regarding KAP: only four nurses (1.8%) had adequate knowledge among vaccine recommended for HWs, whereas 30% (N = 66) reported never having recommended vaccinations during clinical practice. 106 (46%) nurses/students reported VH for at least one of the vaccines recommended for HWs - high levels of VH were recorded for influenza vaccination (N = 88,38.9%) and fourth COVID-19 vaccine dose (N = 100,44.3%). At the multivariable analysis, (1) significant associations with highest levels of VH were found for nurses who reported having at least one child (OR:5.42, 95%CI: 1.64-17.89) and who had not received any dose of influenza vaccination in the last 5 years (OR:13.25, 95%CI: 5.29-33.16). Lowest odds of VH was found for nurses employed in Primary Health Care (OR:0.17, 95%CI: 0.03-0.98); (2) routinely recommending vaccinations during practice (OR:0.38, 95% CI: 0.15-0.95) was associated with acceptance of fourth COVID-19 vaccine dose. Conversely, reliance on social media as the primary information source seemed to be a predictor of COVID-19 vaccine refusal (OR:2.05 95% CI: 1.31-3.20).

Conclusions
Preliminary results identified predictors of VH among nurses, offering insights for organizations to effectively tailor public health interventions.

Key messages
• High levels of vaccine hesitancy among nurses towards recommended vaccines for healthcare workers pose a threat to patient safety.
• Empowering ‘educators’ through focused public health interventions is essential to address factors contributing to vaccine hesitancy among healthcare workers.
A systematic review of practices against healthcare associated infections and antibiotic resistance
Authors: Agodi A , Barchitta M , Campisi E , Di Liberto E , Maugeri A , Magnano San Lio R , Favara G , Vecchi E , D’Ancona F 
Published: October 2024

Abstract

Introduction
Antimicrobial Resistance (AMR) and Healthcare-Associated Infections (HAIs) can be preventable by promoting Infection Prevention and Control (IPC) practices. Despite the available evidence, there are still significant gaps regarding the combined and cumulative effects of AMR drivers, IPC practices and HAIs. To address this issue, we conducted a Systematic Review to evaluate the impact of AMR drivers and the effect of IPC practices on epidemiological variation of HAIs.

Materials and methods
After designing the protocol, the systematic literature search has been performed on PubMed, Scopus, and Web of Science. After obtaining the relevant articles, citations were imported into the Rayyan Systematic Review Software. Subsequently, basing on the predetermined inclusion criteria, articles screening process was conducted firstly evaluating the title and abstract of each article and then by full text reading. The predesigned data extraction template included first author’s last name, year of publication, location, study title, study design, aims of research, involved wards, population groups, type of Multidrug Resistant (MDR) pathogens, interventions, and outcomes.

Results
Literature search strategies identified 3,637 records in the databases consulted. After de-duplication, 2,881 titles and abstracts remained for screening, and 435 full-text articles were assessed for eligibility. Preliminary results show that among the eligible studies 4% had a pre-post study design, 25% focused on Intensive Care Units, 33% investigated antibiotic usage and antimicrobial stewardship, 17% investigated hand hygiene adherence and 10% analysed the compliance to IPC practices.

Conclusions
The knowledge gained from this comprehensive approach will be used to harmonize the AMR drivers explored to improve the general IPC measures. Moreover, this evidence will improve national awareness and will be important in identifying potential interventions on Governance and IPC measures to contrast AMR.

Key messages
• In the battle against AMR, it is crucial to recognize the impacts of its drivers and the effect of IPC practices.
• AMR and HAIs can be prevented through comprehensive IPC programs.
Tackling Pertussis in Schools: A Public Health Unit’s Approach
Authors: Roque Carvalho D , Gomes L R , Veríssimo V , Vital Brito D 
Published: October 2024

Abstract

Issue
Pertussis is a highly infectious bacterial respiratory disease, easily transmitted in closed settings, such as schools. In Portugal, 2019 was the last year with a significant number of cases (83). As pertussis usually follows epidemic cycles from 3 to 5 years, another wave is expected in 2024. Children aged 1-5 years are particularly vulnerable as they no longer benefit from maternal vaccination and have not yet received the 5-year boost recommended in the national schedule.

Description of the problem
In April 2024, the Cascais Public Health Unit (PHU) addressed two possible pertussis cases in preschools. A streamlined response protocol was drafted, including an online contact tracing form and task distribution among response team members, along with templates and a scripted guide for standardized communication.

Results
We were provided a list of close contacts for the children and staff and shared an online form. In the first case, 34 in 35 identified contacts responded to the form, while in the second case, 38 in 55. When comparing both scenarios, the average scripted call duration decreased from 10 to 6 minutes. The PHU response to the first index case took 6 hours, involving 4 physicians and 5 nurses, whereas to the second took 4 hours, involving 3 physicians and 3 nurses. However, implementation requires at least one team member with basic information technology skills to set up the system.

Lessons
Clear communication channels between schools and public health authorities are vital for effective outbreak management. Streamlining communication processes with online forms and scripted conversation guides improved efficiency. Centralised data collection reduced response time and resource requirements in each outbreak.

Key messages
• Established communication channel, standardized data collection, and streamlined protocol allow more effective outbreak management.
• Centralized data collection via digital tools is particularly useful in limited human resources settings.