bluuebunny/crossref_metadata_2025_split huggingface dataset:
STI/HIV care in times of COVID-19 according to Dutch healthcare professionals: A mixed methods study
Authors: van Ditzhuijzen J , Reilingh AYAM , Albers TJA , Bos H , de Wit JBF 
Published: October 2024

Abstract

Background
Surveillance data from the Netherlands show that STI/HIV testing decreased at the start of the COVID-19 pandemic, suggesting barriers in access to STI/HIV care. However, the impact of the pandemic on STI/HIV care may be more complex, and key populations could be differentially affected. The aim of this study was to gain more insight into the impact of COVID-19 on STI/HIV care in the Netherlands from the perspective of STI/HIV care providers.

Methods
We investigated whether professionals in STI/HIV care experienced changes compared to pre-COVID in access to care, demand and provision of care, shifts online care, and quality of care. An online survey was completed by 192 STI/HIV care professionals. Additionally, semi-structured interviews were held with 23 STI/HIV care professionals.

Results
According to participants, specific subgroups of priority populations may have had difficulties accessing STI/HIV care during the pandemic especially during lockdowns and at public sexual health services. Professionals were concerned to have lost sight of subpopulations in vulnerable circumstances and that the pandemic may have magnified inequalities in access to STI/HIV care, which may be related to different levels of health and digital literacy required for telephone and video consultations. Furthermore, participants found online care provision was not up to standards and were concerned about follow-up care for patients using private online providers of remote tests.

Conclusions
Professionals experienced that COVID-19 measures may have compounded existing disparities. To minimize inequalities in access to STI/HIV care during a pandemic, it is recommended to prioritize services for people in vulnerable circumstances such as recent migrants and people with low health or digital literacy. More collaboration between and within sectors may help in better organizing healthcare and prevent overburdening of specific sectors.

Key messages
• According to STI/HIV care providers, the COVID-19 pandemic differentially impacted different STI/HIV care sectors, but also increased existing inequalities in access to care for vulnerable groups.
• Professionals experienced that COVID-19 measures impacted the provision of STI/HIV care, access to care for vulnerable populations, and quality of care.
Emergency Department admissions for Acute Respiratory Infections: a retrospective analysis
Authors: Di Serafino F , Zotti N , Carmisciano L , Baglietto L , Porretta A D , Cristofano M , Foltran F , Pistello M , Rizzo C 
Published: October 2024

Abstract

Background
Acute Respiratory Infections (ARIs) have a relevant impact on public health in terms of prevalence and costs associated with the diseases. The COVID-19 pandemic highlighted the need to adopt accurate surveillance systems to respond to new emergencies and meet the demand for access to care. The aim of our work is to describe the accesses at the Emergency Departement (ED) of the Pisa University Hospital (AOUP), Italy, for ARIs, from 2017 to 2021.

Methods
A retrospective analysis of electronic medical records from the AOUP was conducted from January 2017 to December 2021. The analysis focused on ED admissions and positive lab test results, examining their correlation with ED visits caused by ARI. Multiple linear regression models were used to understand the influence of viral laboratory results on ARI-related ED admissions, adjusting the results for age. The study also assessed the contribution of each virus incausing ARI within different age groups.

Results
33,101 (annual average 5,520) ARI admissions in ED were registered, resulting in 7,426 hospital admissions (22.8%, annual average 1,163) with a seasonal pattern between week 42 of each year and week 17 of the following year. The reduction in emergency room admissions in 2020 (weekly average of 78.2, compared to 144.3 in 2017-2019) may be due to the restrictions implemented for the COVID-19 pandemic. Nevertheless, the average weekly rate of ED admissions caused by ARI was 30.8% in 2020, as compared with 21.7% in 2017-2019. Analysis by age group showed a peak of accesses in the last weeks of 2021 for the &lt;1 and 1-4 years old age groups.

Conclusions
Data on ARI-related admissions provide valuable insights into the dynamic patterns of seasonal air-borne infections and age-related vulnerabilities. This could be useful in directing health policies to identify indicators of future epidemic waves, contributing to the ongoing efforts to enhance preparedness and response strategies for respiratory infections.

Key messages
• It is important to create an integrated surveillance system to monitor and respond to ARIs.
• Strategies should prioritise vaccination campaigns, particularly for RSV and influenza.
Primary care nurses’ readiness to promote digital health technology use among patients
Authors: Virtanen L , Kainiemi E , Vehko T , Heponiemi T , Kaihlanen A M 
Published: October 2024

Abstract

Background
Digital health technologies (DHTs) aim to optimise resource allocation and improve public health outcomes as care supplements. However, many patients do not access them independently. Nurses, as central contacts for primary care patients, can integrate digital health assessments, patient portals, remote monitoring, and teleconsultations into practice. Insight into their readiness to promote patients’ use of DHTs is important for efficient dissemination strategies. We examined nurses’ referral of patients to use DHTs and whether digital dedication (enthusiasm, inspiration, and pride for DHTs) and service guidance skills were associated with referral behaviour.

Methods
In spring 2023, the national ‘2023 survey on information systems for registered nurses’ gathered data from 549 nurses in Finnish primary care, comprising registered nurses (62%) and public health nurses (38%). The outcome, frequency of nurses’ DHT referrals, was assessed on a scale ranging from never to daily. We used multivariable ordinal logistic regression to examine associations, adjusted for career length, unit, and location.

Results
Among the nurses, 31% never or seldom referred patients to DHTs, while 19% did so monthly, 32% weekly, and 18% daily. Multivariable model showed that with each one-point increase in digital dedication (scale 1-5), the odds of referring patients to DHTs more frequently increased by 43% (OR = 1.43, 95% CI 1.21-1.70). Nurses who rated their service guidance skills as good (OR = 1.76, 1.01-3.05) or excellent (OR = 2.89, 1.28-6.62) had greater odds of referring patients to DHTs more frequently compared to those with less advanced skills.

Conclusions
Referring patients to DHTs is not a common practice for primary care nurses and can undermine care equity. Nurses’ motivation and knowledge about DHTs should be fostered, which may enhance patient referrals. Developing guidelines to assess patients’ digital capability and needs for effective service coordination is paramount.

Key messages
• Digitally committed and service-aware primary care nurses may refer patients to use DHTs more often than their peers, but we could not consider if suitable DHTs were available for patients encountered.
• Nurses should be motivated to use digital tools and provided with instructions for proficiently coordinating services in order to address patients’ underutilisation of DHTs and promote equitable care.
Understanding Hand Hygiene Knowledge Gaps: Insights from Primary Healthcare in Portugal
Authors: Cachim A , Luz Fortes A , Fernandes I , Antunes M T , Pereira P , Canto S M , Paixão M M 
Published: October 2024

Abstract

Background
Healthcare-associated infections cause a significant burden of disease globally. Hand hygiene is crucial for preventing these infections but despite recommendations, compliance with hand hygiene protocols among healthcare professionals is often inadequate. In Portugal, there have been several initiatives aiming to increase awareness on the importance of hand hygiene practices amongst healthcare professionals including in primary healthcare facilities. Nationally, there are two models of organization of primary healthcare facilities with differences in funding and allocation of resources.

Methods
In this study, the World Health Organization’s Hand Hygiene Knowledge Assessment Questionnaire for Healthcare Professionals was translated into Portuguese and validated with infection control specialists. It was then distributed to primary healthcare professionals in the Northern Lisbon area, in March 2024 to assess knowledge on hand hygiene practices and highlight potential training needs. The responses were analyzed, with the Kruskal-Wallis test carried out, followed by the Mann-Whitney U test when required.

Results
A response rate of 21,5% (65/302) was obtained, with most participants being nurses (58%), followed by physicians (34%). There was a statistically significant difference depending on the model of organization of the primary healthcare unit to which the participant belonged (χ2 = 8.428, p = 0.014, df = 2)., There was no significant difference between the score and the professional category of the participant (χ2 = 5.76, p = 0.12, df = 3).

Conclusions
The findings of this study show that the model of organization of a primary healthcare unit can impact the knowledge of professionals and not just practices. This study also underscores the significance of comprehensive assessments of the context before interventions and the need for further studies to understand how we can better inform future training initiatives.

Key messages
• Organizational differences in primary healthcare units impact hand hygiene knowledge among professionals, emphasizing the need for tailored training initiatives.
• Comprehensive assessments of healthcare contexts, coupled with validated linguistic tools, are crucial for reliable intervention strategies in infection control.
Sleep difficulties as a universal risk factor for injury among adolescents in 46 countries
Authors: Pagnotta V F , Donnelly P D , Gobina I , Elgar F , Ng K , Pickett W 
Published: October 2024

Abstract

Background
Poor sleep is common among adolescents and associated with unintentional injuries. The current evidence base is limited by differences in measures of sleep and injury implemented across studies. We examined the potential universality of the relationship between poor sleep and injury cross-nationally using self-reports from 229,589 adolescents in 46 countries that were collected using common procedures and measures.

Methods
A cross-sectional study was conducted using records from the 2017/18 Health Behaviour in School-aged Children (HBSC): World Health Organization cross-national study. The prevalence of sleep indicators (difficulties in falling asleep, insufficient sleep, social jet lag) and medically treated injuries (overall, multiple) were described across countries and by gender. Multivariable modified Poisson regression analyses were conducted within and across countries to test the consistency of the association between poor adolescent sleep and injuries.

Results
Overall, indicators of poor sleep were reported by nearly half of adolescents, and varied by gender and across countries. Country-level analyses found consistently positive associations between indicators of poor sleep and injuries. Pooled (multi-country) analyses further demonstrated a universality of these relationships across sleep indicators and injury outcomes. The strength of relationships varied by gender, with more robust associations detected among girls compared to boys.

Conclusions
Poor sleep is a robust and mainly consistent risk factor for injury among adolescents across countries and regions. Public health officials and policymakers should therefore recognize adolescent sleep as a health priority. The promotion of sleep hygiene may represent a novel target for injury prevention at regional and national levels.

Key messages
• Poor sleep, in the form of sleep difficulties, insufficient sleep, and social jet lag, were robust and mainly consistent injury risk factors among adolescents across 46 countries.
• Public health officials should recognize sleep hygiene as a novel focus for adolescent injury prevention.
GRADE evidence to decision framework in genomics guidelines: systematic review & appraisal
Authors: Taha A , Russo L , Pezzullo A M , Boccia S 
Published: October 2024

Abstract

Background
Transparent development of clinical practice guidelines (CPGs) is important for genomic medicine, as this field promises to partially challenge the traditional hierarchies of evidence. The GRADE Evidence to Decision (EtD) framework has recently emerged as a transparent and rigorous tool to produce recommendations. Our aim was to survey the genomic CPGs that used the GRADE EtD and appraise the applicability of its criteria and the quality of produced CPGs.

Methods
We systematically searched PubMed, Scopus, Web of Science and the gray literature till 2023 for relevant CPGs. From each eligible CPG, we extracted the reporting of the GRADE EtD criteria: benefits, harms, resource use, cost-effectiveness, acceptability, feasibility, equity and values. The quality of the CPGs were appraised across various domains using the (AGREE) II instrument.

Results
Among 1,144 records, 15 CPGs met inclusion criteria between 2018 and 2023, comprising 66 recommendations. Reporting of GRADE EtD criteria varied. Benefits, harms and their balance were addressed in approximately half of the recommendations 48% and 52% respectively. Feasibility, acceptability and values were also 52%, 47% and 40% respectively, resource use 39%, cost-effectiveness 23%. Equity was addressed in 36% of the recommendations. Quality appraisal of the CPGs also varied, domains were reported as follows: scope and purpose, clarity of presentation, editorial independence 86%, 85% and 84% respectively, rigor of development 77%, stakeholder involvement 72%, while applicability was 59%.

Conclusions
GRADE EtD is applied heterogeneously in genomic medicine CPGs, with difficulty in applying all of its criteria, including benefits and harms. Quality varied across domains with applicability of the CPGs less demonstrated.

Key messages
• Transparent approaches are needed in developing CPGs for genomic medicine.
• Current genomic CPGs fail to address crucial aspects for producing recommendations, including benefits and harms.
Gambling Disorder among Croatian University Students
Authors: Miskulin I , Kovacevic J , Vukoja I , Nujic D , Candrlic S , Pavlovic N , Kotromanovic Simic I , Candrlic M , Bajrektarevic Kehic A , Miskulin M 
Published: October 2024

Abstract

Background
Gambling has become a routine form of entertainment for many young people studying in universities. This study aimed to investigate the prevalence and characteristics of gambling disorder among Croatian university students.

Methods
A cross-sectional study using an anonymous self-administered questionnaire with sociodemographic and socioeconomic questions along with the Croatian version of the South Oaks Gambling Screen questionnaire (SOGS-CRO) was conducted in a representative sample of Croatian university students from Osijek, Eastern Croatia during January, and February 2020.

Results
A total of 844 students participated in the study, 45.6% males and 54.4% females, with a median age of 19.00 years (interquartile range 19.00-23.00 years). Gambling activities were performed by 66.2% of the students, most commonly lotteries, sports bets, and bingo. The final scores of the SOGS-CRO suggested that 21.1% of students may have a gambling disorder, with 16.4% being “probable pathological gamblers” and 4.7% being “problem gamblers”. Playing cards for money, animal bets, stocks bets, slot machines bets, pull-tabs, and other gambling activities such as online or videogames or mobile games present a higher risk of gambling disorder (p &lt; 0.001, p &lt; 0.001, p &lt; 0.001, p &lt; 0.001, p &lt; 0.001, p &lt; 0.001, respectively). Being male, repeating the year of study, being a student in interdisciplinary or technical field of study, and having a mother with gambling disorder (p &lt; 0.001, p = 0.029, p &lt; 0.001, p &lt; 0.001, respectively) were the revealed contributing factors to the development of gambling disorder in study participants.

Conclusions
The study points to the fact that gambling disorder is quite a prevalent public health issue in the Croatian university student population. Specific public health preventive programs need to be designed and implemented in the study population to successfully prevent the development of investigated behavioral addiction.

Key messages
• Public health interventions directed toward the prevention of gambling must involve younger population subgroups, such as university students.
• When designing the preventive programs for the successful prevention of gambling within the university student population selected sociodemographic variables should be considered.
Heterogeneity of postpartum bonding and maternity blues among mothers three days after delivery
Authors: Kozina S , Tomić N , Šunj M , Kaliterna M , Boraska Marasović T , Mastelić T , Kozina T , Pranić S M 
Published: October 2024

Abstract

Background
Findings about risk factors for postpartum depression (PPD) are often inconsistent. The variability could be due to the heterogeneity of characteristics of mothers at risk for PPD in certain populations, which has important mental health implications. We examined the heterogeneity of sociodemographic, pregnancy and labor characteristics in postpartum women referred to follow-up care on the third day after delivery.

Methods
We performed a nested cross-sectional latent profile analysis (LPA) on a convenience sample of women in a tertiary community hospital in Split, Croatia in 2020. Participants completed the first subscales of Postpartum Bonding and Maternity Blues questionnaires, as well as five subscales of the Questionnaire of Family Functioning According to Parents and 12 sociodemographic, pregnancy and childbirth-related variables. LPA identified profiles of mother-infant bonding and postnatal blues, and multinomial regression analysis was used to determine the influence of different profiles.

Results
Of the 318 participants, the best-fitting model had three latent profiles. First (n = 76, 24% of participants) and second (n = 216, 68% of participants) latent profiles showed good postpartum bonding, while second profile showed higher primary blues. Third profile (n = 80, 25% of participants) was characterized by poorer postpartum bonding and elevated primary blues. Only good youth experiences of mothers with their parents (relative risk [RR] 0.26; 95% CI 0.12-0.57; p = 0.001) and good present-day relationships with partners (RR 0.26; 95% CI 0.13-0.52; p &lt; 0.001), significantly decreased the risk for third latent profile classification.

Conclusions
Postpartum bonding and primary blues of women who gave birth three days prior were heterogeneous. This heterogeneity could result in the well-documented heterogeneity of postpartum depression in women, and therefore, be the focus of mental health interventions in similar settings.

Key messages
• We found heterogeneity of sociodemographic, pregnancy, and labor characteristics in postpartum women after delivery, highlighting the variability in risk factors for postpartum depression.
• This heterogeneity could result in the well-documented heterogeneity of postpartum depression in women, and therefore, be the focus of mental health interventions in similar settings.
The role and needs of teachers/schools in infection, prevention and control post covid-19
Authors: Ochili R , Dyer C , Leaver S , Eastwood L , Taborn E , Brown C , Lecky D M 
Published: October 2024

Abstract

Introduction
COVID-19 highlighted the importance of infection prevention and control (IPC) across all settings. As children are important transmitters of infection, teachers and schools play an important role in infection prevention. The aim of this study is to understand attitudes towards, and knowledge of IPC in schools post-Covid, and highlight any gaps in the training and resources needed.

Methods
An online survey of 1000 primary and secondary school teachers was carried out across England. Pearson’s chi-squared test, corrected for survey design, was used to test for differences in proportions across levels of categorical variables. Two qualitative workshops with eight head teachers were carried out to gather more in-depth information.

Results
1000 teachers completed the survey across a range of teaching roles. Respondents reported that IPC measures are now less frequently implemented than during the pandemic. 71% of respondents say their role has changed since the pandemic, now having more responsibility for pupil health and hygiene; higher in primary versus secondary school teachers (31% v 25%; p &lt; 0.05). 1/3 felt this change was permanent; 84% had no IPC training. Knowledge gaps were identified in the areas of IPC roles within schools, and IPC measures. 72% teachers claim they feel better prepared to deal with a public health outbreak compared to pre-pandemic, although 22% do not have an updated IPC policy; 35% had unmet needs.

Conclusions
Schools and teachers play a pivotal role in preventing the spread of communicable disease, highlighted during the COVID-19 pandemic. Teachers need, and more importantly want, more IPC training. Training and updated policies would support the educational workforce who feel their needs are not being met. Providing more streamlined, consistent, clear and concise information from trusted sources is required.

Key messages
• It is imperative to understand educators’ role in IPC in schools as they are key players in supporting local and national efforts to reduce the spread of infections.
• Teachers desire further training with comprehensive information, and up-to-date policies to support their infection prevention and control efforts in educational settings.