bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes in integration and wellbeing by educational background among migrants in Kristiansand
Authors: Ahmed K , Sima Y T , Lunde A , Fadnes L T , Kumar B , Diaz E 
Published: October 2024

Abstract

Background
Integration levels and wellbeing of newly arrived migrants change according to their everyday activities in their new home country. Although migrants have very different educational backgrounds and expectations regarding work in Norway, the compulsory educational activities are the same for all, disregarding their educational background.

Aims
To examine the changes in integration and wellbeing among newly arrived migrants participating in a compulsory integration program in Norway, according to their educational background.

Methods
As part of the Integration for Health project (I4H) we collected information from participants in Kristiansand municipality through a self-filled questionnaire in 2023 (N = 102) repeated six months apart, including questions from the Immigrant Policy Lab Index and the WHO-5 Well Being Index. For both screening tools, higher scores indicate better integration and wellbeing. Information on educational background was dichotomized into either health or non-health (natural and technical) sciences, using health sciences as the reference. We used generalized estimating equations to calculate relative risks (RR) with 95% confidence intervals (CI) adjusted for age and gender.

Results
The mean age was 34 years (SD 8.3) and 59% were women. Mean residency time was 3 years (SD 0.14). In terms of education, 14% had health sciences, and 86% had other educational backgrounds. We did not find change in wellbeing over the six-month period (RR 1.0 (95% CI 0.9-1.1), and this trend was similar for both educational groups (RR 0.9 (95% CI 0.8-1.1). Integration score slightly increased after six months (RR 1.0 (95% CI 1.0-1.1). However, there was no difference by educational background (RR 1.0 (95% CI 0.9-1.0).

Conclusions
Changes in wellbeing and integration among participants in the compulsory introductory program with short residency time, do not seem to vary by educational background in a six-month period.

Key messages
• Schools and introductory programs in the host country can be used as a arena to enhance both the integration and wellbeing of newly arrived migrants.
• Strengthening migrants’ educational opportunities in the new host country is also of importance.
Mental health trajectories among Syrian refugees in Norway: A longitudinal cohort study
Authors: Sima Y T , Strømme E M , Diaz E 
Published: October 2024

Abstract

Background
Refugees encounter various risk factors that can affect their mental health throughout the migration process. However, while most studies focus on mental health challenges at the time of resettlement, only a few explore these changes over an extended period. This study aims to explore changes in mental health among Syrian refugees in Norway and to identify influencing factors.

Methods
This is a prospective cohort study using data from CHART and Integration for Health studies, which followed Syrian refugees granted settlement in Norway. Data collection took place in Lebanon between 2017-2018 (baseline), and at one- and four-years post-arrival in Norway. Assessments for anxiety/depression and post-traumatic stress disorder (PTSD) were conducted using the Hopkins Symptom Checklist (HSCL-10) and the Harvard Trauma Questionnaire, respectively. Mixed-effects logistic regression analyzed temporal changes, with results presented as odds ratio (OR) with 95% confidence intervals (CI). The study also explored the effect modification of outcomes by the following baseline factors: age, gender, education.

Results
A total of 132 participants were included in all three data collection points. There was a decrease in the proportion of participants reporting anxiety/depression (from 30% to 28%, OR 0.1, 95% CI 0.1 - 0.2) four years post-settlement. The proportion of participants reporting PTSD symptoms decreased one year after settlement (from 4% to 3%, OR 0.3, 95% CI 0.1 - 0.7), but increased to 4% four years after arrival, showing no improvement from baseline (OR 0.8, 95% CI 0.4 - 2.0). No interactions were observed between changes over time and baseline variables.

Conclusions
After four years in Norway, Syrian refugees reported improvement in anxiety/depression, but PTSD symptoms worsened. This highlights the need for ongoing support that extends beyond the initial phases of resettlement.

Key messages
• Refugees face various risk factors that affect their mental health throughout the migration process.
• Ongoing mental health support for refugees is essential, beyond the initial resettlement phase.
Toolkit for Translating Health Information: A Resource for Crisis Health Communication and beyond
Authors: Nordstrøm C , Tidemann E 
Published: October 2024

Abstract

Issue/Problem
Translating health information accurately and effectively presented a critical challenge in crisis communication during the pandemic. In linguistically diverse contexts, ensuring access to vital health information is essential for promoting public health outcomes. Addressing this issue, we summarized our experience in a comprehensive toolkit for translating health information, aiming to enhance accessibility, reliability, and relevance across various settings and countries.

Description of the Problem
Our initiative responds to the need for standardized translation practices in the dissemination of health information in Norway. Translation practices in the health sector often lack standardization, leading to inconsistencies, inaccuracies, and risk of less comprehension. Questions guiding our project included: How can lessons learned from the extensive translation work done during the pandemic improve the accuracy and consistency of health information translation in general?

Results
We have developed a practical toolkit tailored to diverse linguistic and cultural contexts. Our toolkit summarizes lessons learned from extensive translation work during the pandemic, supported by validation from experts in the field of translation. The toolkit has been welcomed by other organizations, which underscores the potential of standardized translation tools to mitigate barriers to health communication in multilingual settings.

Lessons
Lessons gleaned from translating information during the pandemic highlight the importance of evidence-based translation practices, knowledge of the target demographic and the integration of cultural considerations into translation workflows. Furthermore, our experience underscores the value of inclusive approaches in development, promotion and distribution of the translated materials.

Key messages
• Standardized translation tools can increase access to vital health information, fostering equitable health outcomes.
• Collaboration and inclusive approaches are key drivers in advancing standardized translation practices for effective health communication.
Empowering Young Roma Women in matters of health and primary care: an innovative training program
Authors: Zota K , Balta M , Zioga E , Drougos N , Kouvari M , Pinotsi D , Karnaki P , Veloudaki A 
Published: October 2024

Abstract

Background
Roma communities are rather diverse groups with different level of knowledge, beliefs and motivations in relation to their health. Raising awareness and self-efficacy of these individuals is a challenging field in the EU public health agenda.

Objectives
To address this challenge, the program entitled “Empowering Young Roma Women in matters of health, prevention and human rights: a new methodological approach” was developed with the aim to empower Roma women in terms of health and prevention topics pilot testing different educational methods. A two-step co-design approach was performed to determine the training content, tools, methods. The training was implemented in 5 areas throughout Greece (Volos, Chalkida, Thiva, Agia Varvara, Zefyri) in Jan-Oct 2023, including 3 phases: a. Train-the-trainers, b. Training the Roma women and c. Training evaluation.

Results
The educational material developed for health and prevention included 4 units (gynaecological health issues, vaccinations, smoking and nutrition). Each unit consisted of a theoretical background to develop the material, a presentation for future trainers, a presentation for trainees, a brochure, and a poster. For the training a new methodological approach was tested i.e. a health professional or Roma women (after being trained) to deliver the training. In total, 548 pre-post questionnaires were collected. Most trainees, understood the content of the training, acquired new knowledge and found the information interesting and possible to include in their daily life. 80% trainees expressed their satisfaction with the overall presentation. Regarding knowledge improvement based on the type of trainer only a slightly greater degree of improvement was observed for Roma trainers.

Conclusions
It is crucial to develop culturally appropriate health interventions by directly working with communities, to understand their particular needs, and to ensure they receive the information needed to make informed decisions.

Key messages
• Maintaining and promoting health is a decisive factor of social inclusion.
• Tailor-made training of ethnic minorities shall be an integral part of the EU public health agenda.
Greenness and mortality in an industrialized area in Southern Italy: a health impact assessment study
Authors: Giannico O V , Mincuzzi A , Bisceglia L , Addabbo F , Catino F , Minerba S , Sardone R 
Published: October 2024

Abstract

Background
In Taranto the effects of industrial installations have been studied, but less attention has been placed on the impacts of green-oriented policies. The “3-30-300” rule states that every citizen should have 30% tree-canopy-cover in their neighborhood and not live more than 300m away from the nearest green space. In this Health Impact Assessment (HIA) study, we aimed to quantify the deaths that could be prevented in population aged ≥20 years by implementing this policy in Taranto.

Methods
Population weighted exposures (PWE) to green spaces (10m) were estimated using the 2022 greenest season NDVI from Sentinel-2 and the 2021 ESA WorldCover within a 300m (WHO 2016) buffer. We set a tree-cover optimal target of 30% and interim targets from 10% to 25%. For each tree-cover target, we set the counterfactual exposure (CE) as the corresponding PWE to NDVI. Age-specific preventable deaths (PD) were calculated by multiplying the baseline deaths (ISTAT) by the preventable fractions (PF). Preventable years of life lost (PYLL) were calculated by multiplying the PD by the specific life expectancy. To compute the 95%CI, we ran 100,000 Monte Carlo simulations to propagate the uncertainties of both CE and ERF to the final estimates.

Results
The PWEs to NDVI and tree-cover-proportion were 0.19 and 8.0%, respectively. For the 30% tree-cover target (currently achieved by the 1.5% of population), the CE (NDVI) and PF (%) were 0.33 (0.32-0.33) and 5.4% (4.1%-6.2%). A total of 126 (97-146) PD and 1270 (976-1474) PYLL were estimated. Three-cover, shrubland and grassland were associated to higher NDVI values, while built-up and deprivation-index were associated to lower greenness. NDVI and summer temperature showed an inverse relationship.

Conclusions
This study as a pioneering effort in Southern Italy. Providing more green space could prevent a substantial number of premature deaths in Taranto, potentially up to 5.4% by achieving a 30% tree-cover.

Key messages
• Providing more green space could prevent a substantial number of premature deaths in Taranto, potentially up to 5.4% by achieving a 30% tree-cover.
• Built-up and deprivation-index were associated to lower greenness. NDVI and summer temperature showed an inverse relationship.
Risk of eating disorders and body image in adolescents in Belgium: is migration status a modifier?
Authors: Eggen M , Yalman G , Holmberg E , Assakali W , Mertens C , Castetbon K 
Published: October 2024

Abstract

Background
The risk of eating disorders (ED) has been linked to body image (BI) dissatisfaction in adolescents. In addition, the origin and host country culture may influence BI dissatisfaction. Our objective was to assess the modifying effect of migratory status on the association between BI and risk of ED in Belgium, a setting characterized by a large proportion of migrant adolescents.

Methods
In the 2022 cross-sectional “Health Behaviour in School-aged Children” (HBSC) study in French-speaking schools, 7,267 adolescents aged 12 to 20 self-completed questionnaires. Risk of ED was determined by an Eating Attitude Test (EAT-7), score ≥5. BI was categorised into 3 groups: “too thin”, “about the right size” and “too fat”. Migratory status was divided into “native”, “2nd generation” and “1st generation” migrants. The association between BI and ED was estimated using logistic regressions adjusted for socioeconomic and psychosocial characteristics. After the inclusion of the “migration*BI” interaction term, migration-stratified logistic regressions were conducted.

Results
Overall, 13.0% of students were at risk of ED. Percentages of ED were 15.7% among those who perceived themselves as “too fat” (vs. “about the right size”: aOR=1.67 [95%CI: 1.34-2.08]) and 19.4% in the “too thin” group (aOR=3.36 [2.54-4.45]). Despite non-significant interaction terms, perceiving themselves as “too fat” (vs. “about the right size”) was not associated with the risk of ED in 1st generation migrants (aOR: 1.24 [0.67-2.29]). Compared with the overall estimation, it was lower in 2nd generation migrants (aOR: 1.43 [1.00-2.03]) while it was slightly higher in natives (aOR: 1.95 [1.45-2.62]).

Conclusions
These findings suggest complex interrelations between BI and risk of ED according to migratory status in adolescents with potential underlying mechanisms involving cultural norms. Promoting positive BI as a possible way for preventing the development of eating disorders need to be further investigated.

Key messages
• This study shows differences of body image dissatisfaction according to the migratory status in adolescents, inducing potential impacts on the risk of eating disorders.
• Better understanding differences in body perception related to cultural background could help prevent risk of eating disorders in adolescents, by promoting positive body image for example.
Variations in access to acute care services by immigrant background and sociodemographic factors
Authors: Hussaini L , Damgaard Skyrud K 
Published: October 2024

Abstract

Background
The Emergency Medical Communication Center (EMCC) plays a vital role in the medical emergency response system by triaging contacts, notifying local physicians, and providing medical advice. The utilization of acute care services and the subsequent care pathway by individuals with immigrant background remains unclear in the Norwegian context. This study aims to investigate whether disparities exist in the acute care pathway for patients with different sociodemographic background who use ambulance services.

Methods
We examined all code red ambulance dispatches for life-threatening emergencies in 2021 in Norway. These ambulance dispatches were linked to primary health care and specialist health care contacts to trace patient pathways and outcomes. Statistical analyses were conducted using linear regression models, adjusted for patient characteristics, such as immigrant background, age, sex, municipality of residence, living condition, socioeconomic status, comorbidity and cause of emergency contact.

Results
Preliminary crude findings indicate that patients with immigrant background are overrepresented in the groups receiving acute primary care only and underrepresented in the groups transferred directly to specialist health care, within 8 hours after ambulance arrival at the patients’ location.

Conclusions
The preliminary results suggest challenges for the EMCC in triaging patients with immigrant background, but further research is needed to explore potential systematic differences. This study aims to improve understanding of disparities in access to acute care and inform targeted interventions to optimize resource allocation in emergency departments.

Key messages
• This study may improve understanding of disparities in access to acute care in Norway.
• This study can inform targeted interventions to improve resource allocation in emergency departments.
COVID-19-related worries: A longitudinal study comparing migrants and non-migrants in Norway
Authors: Benavente Velando P , Fadnes L T , Sandal G M , Mæland S , Lehmann S , Diaz E 
Published: October 2024

Abstract

Background
Health- and economic-related worries during the COVID-19 pandemic contributed to worsening of mental health, particularly affecting migrants in vulnerable situations. However, this differential impact was only clear some months into the pandemic, and there is little evidence about any differences in health and economic worries between migrants and non-migrants as the pandemic developed. To close this knowledge gap, we assessed the changes in COVID-19-related worries reported by migrants compared to non-migrants in Norway throughout the pandemic.

Methods
Our study analyzed data from three time points (April-20, January-21, March-22) for 25,305 participants of the Bergen in Change study, including 509 (2%) migrants from Asia, Africa, or Latin America (LATAM), and 1250 (5%) migrants from other regions. Worries were assessed using questions on COVID-19 infection fear, job security, and economic stability. Analysis methods included descriptive analysis, chi-squared, Sankey plots, and logistic regression, adjusting for age, gender, education, and type of work.

Results
Migrants from Asia, Africa and LATAM reported health worries more often than non-migrants [OR (95%CI) 1.9 (1.3-2.8)] without clear changes over time, 0.9 (0.7-1.3). Migrants from Asia, Africa, and LATAM, as well as from other regions, also reported economic worries significantly more often than non-migrants [3.1 (2.5-3.9) and 2.1 (1.8-2.4) respectively] at baseline. Each additional year into the pandemic increased the odds of economic worries by a factor of 1.3 (1.0-1.6) for migrants from Asia, Africa, and LATAM compared to non-migrants. The odds ratio for migrants from other regions over time was stable, 1.0 (0.9-1.1).

Conclusions
Migrants, especially those from Asia, Africa, and LATAM, reported more pandemic- related worries than non-migrants, and this persisted over time. Identifying and understanding these worries could guide preventive measures to enhance mental health in migrant population.

Key messages
• Throughout the pandemic, migrants reported more COVID-19-related worries than non-migrants, a trend that persisted over time and was greater among migrants from Asia, Africa, and Latin America.
• Identifying the differential impact of COVID-19 on migrants’ groups and understanding the factors involved is essential for guiding healthcare interventions to improve migrant health.
Roma mothers of infant children in the health system - a qualitative study
Authors: Mihailova N , Dokova K , Feschieva N 
Published: October 2024

Abstract

Background
The Roma in Bulgaria constitute the third largest group - 4% of the population. Data on demographic processes by ethnicity are scarce. A national survey in 2003 found significant differences in infant mortality - 9.9‰ for Bulgarian, 18‰ for Turkish, and 28‰ for Roma infants. Poverty among Roma children, risk of poor education, especially for girls, barriers to accessing health services remain high. We aim to reveal the cultural specificity in prenatal behavior and infant care among Roma mothers in the context of the role of the Bulgarian health service.

Methods
In-depth interviews with Roma mothers of infants up to 1 year were utilized for data collection. To ensure heterogeneity among the interviewees, several “nests” with varying socio-cultural status in the Varna district were identified in advance for participants recruitment. A list of interview themes concerning respondents’ relationships with the public health system with an emphasis on the experiences of mothers was drawn up.

Results
Ten interviews with mothers having between 1 and 7 children were conducted in 2023. The mothers recounted discriminatory experiences during their interactions with certain health facilities (maternity wards), which act as barriers to accessing and utilizing health services. Maternity and infant counselling services are highly esteemed with favorable influence on child health outcomes. There has been a positive shift away from early marriage and childbirth towards prioritizing education for Roma girls. Mothers prioritize their children, and there is no neglect in their care. Family relations and support are being upgraded, with Roma fathers becoming involved in child care. Respondents express their educational needs and hopes for community-based support to better cope with their roles as mothers.

Conclusions
Ethno-cultural factors shaping the mother’s role maintain traditional family support, while also reflecting significant modernization that needs societal support.

Key messages
• A glimpse into people’s experiences of the healthcare system - a clue to its effectiveness.
• Тhe ethno-cultural factors in Roma are subject to modernization.
Determinants of health and pregnancy and birth outcomes: an overview
Authors: Falcone V , Nisticò F , De Luca A , Arniani S , Messina G , Nante N , D’Urso A 
Published: October 2024

Abstract

Introduction
This study examines the influence of health determinants on pregnancy and birth outcomes. The aim is to provide a clear and updated view of the overall framework characterizing the birth experience, with crucial implications for clinical practice, research, and health policy.

Methods
Data analysis pertains to the Certificate of Assistance for Birth (CAP) concerning residents in the territory of AUSL South-East Tuscany in the years 2021 and 2022. The number of women of childbearing age in Tuscany in 2022 is 150,959, while the number of births analyzed in the study is 9,053. The study conducts multivariate analysis between factors and pregnancy-related outcomes.

Results
Controlling for age, citizenship and others factors, the risk of cesarean section is significantly higher (p &lt; 0.05) among mothers: over 40 years old (OR = 2.09), with education levels of lower secondary (OR = 1.21) and upper secondary (OR = 1.23) compared to a degree, not employed (OR = 1.25) and homemakers (OR = 1.45) compared to employed, overweight/obese (OR = 1.41), with gestational diabetes (OR = 1.16), smoking during pregnancy (OR = 1.27), with gestational hypertension (OR = 2.81). Controlling for age, citizenship and others factors, the risk of term low birth weight is significantly higher (p &lt; 0.05) among mothers: over 40 years old (OR = 1.76), not employed (OR = 1.76) and homemakers (OR = 1.34) compared to employed, smoking more than 3 cigarettes daily during pregnancy (OR = 1.31) not significant, with gestational hypertension (OR = 5.57), nulliparous (OR = 1.42). Controlling for age, citizenship and other factors, the risk of premature birth is significantly higher (p &lt; 0.05) among mothers: with gestational hypertension (OR = 5.22), nulliparous (OR = 1.89), smoking during pregnancy (OR = 1.59).

Conclusions
The results underscore the importance of carefully monitoring and managing these risk factors during pregnancy to improve outcomes for both mother and baby.

Key messages
• Understanding the determinants that influence birth outcomes plays a fundamental role.
• The importance of Early Childhood Development and early interventions can improve children’s health and well-being.