bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aedes aegypti surveillance under the International Health Regulations - experience at Madeira Island
Authors: Fialho M , Peixoto B , Moreno J , Carrapatoso M , Moreira J , Melim M 
Published: October 2024

Abstract

Problem
Aedes aegypti was first identified on Madeira Island in 2005, persisting since then. This mosquito transmits various haemorrhagic diseases and caused a Dengue outbreak in 2012-2013. The island has two seaports and one airport that may serve as points of entry or dissemination of these diseases, potentially leading to a new outbreak or international disease spread. We aimed to assess Ae. aegypti presence at the island’s seaports and airport during 2023.

Description
Data was collected from 52 entomological panels produced by the Regional Health Department throughout 2023. This data is publicly available on the Institute of Health Administration’s website. Ovitraps capture eggs, larvae, and pupae of Ae. aegypti, and BGtraps capture adult mosquitos. Positivity refers to the proportion of times an ovitrap recorded eggs in the entomological cycle.

Results
In 2023, there were 204 active ovitraps at the island (17 at the airport, 9 at Funchal’s seaport 8 at Caniçal’s seaport) and 24 BGtraps (2 at the airport, 2 at Funchal’s port and 1 at Caniçal’s port). Weekly reports revealed a median of 2243 (0-14448) eggs and 14 (0-234) mosquitos in all traps. Positivity was higher in the second semester. On average, ovitraps’ positivity at the airport (avg 6.4%; 0-59%) and at Caniçal’s port (avg 2.8%; 0-47%) were lower than the positivity of the island (avg 14.8%). Funchal’s port had a higher positivity than the island (avg 15.9%; 0-67%). Per-ovitrap, the average weekly positivity rate rose by 15%, 10% and 5% at Caniçal’s port, airport and Funchal’s port, respectively, compared to 2012-2022.

Lessons
Ae. aegypti’s eggs prevalence increased in 2023. The high positivity of eggs suggests an increased likelihood of mosquitos nearby. The detection of immature forms triggers actions to prospect the surrounding area for identification and elimination of breeding grounds, as well as the placement of salt in water accumulation areas. This is particularly important at high-traffic areas such as seaports and airports.

Key messages
• The increase in Ae. aegypti egg positivity in 2023 on Madeira Island suggests a higher risk of disease transmission.
• It is essential to prioritize vector control measures at seaports and the airport in Madeira Island.
Usability Insights from the BUMPER Cancer Prevention App Pilot Study: A Mixed-Methods Approach
Authors: Ahmed F , Carbó M , Pinto P , Comesana H , Jarm K , Kuusela H , Rozványi B , Krini M , Zeeb H , Brand T 
Published: October 2024

Abstract

Introduction
As the second leading cause of death in the EU, cancer is expected to see a 55% rise in new cases globally over the next two decades. The European Code Against Cancer (ECAC) and the EU’s Beating Cancer Plan (EBCP) provide resources for understanding and preventing cancer. The BUMPER project aims to develop a cancer prevention App to make the ECAC more accessible to the public.

Objectives
Understand the factors influencing the use of a cancer prevention app among users with different digital health literacy levels and to evaluate the app’s usability.

Methods
Mixed-methods approach was used to gather user feedback. FGDs explored user perspectives on app usage, while a cross-sectional survey assessed usability through task completion on an initial app wireframe. The pilot was conducted across seven EU countries in late 2023.

Results
77 participants participated in the pilots and FGDs across seven EU countries. The average task completion time was approximately 79 seconds. Participants rated their confidence to complete the tasks at 3.96 and difficulty at 2.28 on a scale of 1 to 5. The average task pass rate was 92.11%. Qualitative findings highlighted the need for evidence-based content, user-friendly design, language accessibility, offline functionality, and data security. Participants also stressed the importance of clear instructions, regular updates, and robust tracking features. Despite some challenges, the app was generally well-received, with users appreciating its educational potential and tracking capabilities.

Conclusions
The BUMPER project’s pilot study demonstrated the cancer prevention App being developed as a potential tool for cancer education and awareness. Despite navigational and language challenges, the app was favorably received by a diverse user base, underscoring the need for ongoing improvements in user guidance, comprehension, and functionality to enhance accessibility.

Key messages
• BUMPER project’s cancer prevention app shows promise in pilot study, enhancing cancer education and awareness.
• Despite challenges, the app was well-received, highlighting the need for ongoing improvements to enhance accessibility.
AAL for independent aging: Practical guidelines for smart living environment development
Authors: Bin Noon G , Abhari S , Morgan G , Manning F , Teague J , Morita P P 
Published: October 2024

Abstract

Background
Active Assisted Living (AAL) refers to the use of IoT devices to support quality of life, independence, and healthier living for care recipients. AAL-enabled smart homes have particular potential to help older adults reach their health and independent living goals, but there is a dearth of guidance on practical implementation. Additionally, different technology companies have each developed their own practices, leading to confusion and inconsistency. The objective of this work is to explore requirements for use of AAL in smart living environments for older adults, providing suggestions for best practice for AAL use considering their unique circumstances.

Methods
A review of academic and grey literature was performed to identify existing best practices and gaps for development of AAL-enabled environments. A technology review was also performed on 156 unique devices to understand the AAL tech ecosystem.

Results
Little guidance exists regarding designing smart living environments for older adults, though it exists for the two elements separately. The distinguishing elements are how AAL may connect the older adult to their care network, how the home may accommodate changing health needs, and older adults’ unique vulnerability. Furthermore, a large issue is a lack of interoperability and communication, which must be addressed in order to make AAL systems as low-effort and aligned with older adults’ preferences as possible.

Conclusions
As both tech and older adults’ needs evolve, key requirements of AAL-enabled smart living environments are robust data sharing pathways, planning for modifiability, and protecting the privacy of residents. The findings of this work will be used to identify opportunities for AAL standards development.

Key messages
• AAL-enabled smart homes must be able to accommodate an older adults’ shifting care needs and preferences over time.
• It is necessary to establish how AAL smart home data may be shared with and used by care partners and providers.
Characteristics predisposing to the utilization of Internet websites offering e-prescriptions
Authors: Wojcieszko M , Smoła P , Duplaga M 
Published: October 2024

Abstract

Background
The introduction of e-prescriptions in the Polish healthcare system was accompanied by the emergence of websites offering easy access to medication without adequate medical assessment. This study aimed to analyze the characteristics of Polish users of such services.

Methods
The analysis presented here is based on the online survey conducted in June 2023 among 1661 adult Internet users. The multivariable logistic regression model (MLRM) was developed for the variable reflecting the use of e-prescribing web services (EPWS). Sociodemographic variables, self-assessed health status, the presence of chronic disease (CHR) and disabilities (DIS), the frequency of Internet (IU) and social media use (SMU), and finally, digital health literacy (DHL) were included in MLRM as independent variables.

Results
The percentage of respondents who used EPWS was equal to 18.2% (n = 303). MLRM revealed that age, vocational and income status, CHR, SMU, and DHL were significant predictors of EPWS use. Older respondents were less likely than younger ones to use EPWS (odds ratio (OR), 95% confidentiality interval (95%CI): 0.97, 0.97-0.99. Persons suffering from the chronic disease, when compared to those without such disease, used EPWS less frequently (OR, 95CI: 0.59, 0.43-0.80) and unemployed when compared to employees (OR, 95%CI: 0.53, 0.32-0.88). A higher likelihood of using EPWS was observed among respondents with the highest income in comparison to those from the group with the lowest income (OR, 95%CI: 1.52, 1.02-2.52) and among more frequent social media users (OR, 95%CI: 3.88, 1.90-7.93). Finally, the increase of DHL score by 1 unit was associated with the increase of the likelihood of EPWS use by 9% (OR, 95%CI: 1.09, 1.05-1.12).

Conclusions
A significant number of adult Internet users utilize EPWS in Poland. Lower age, unemployment, and chronic diseases are negative predictors of EPWS use. More intense SMU and unexpectedly higher DHL predispose to the use of such services.

Key messages
• Even persons with high e health literacy are inclined to use web portals offering e-prescriptions.
• The high prevalence of the utilization of e-prescribing websites requires awareness campaigns warning about related potential risks.
How advanced is your digital public health system? A qualitative analysis of suitable indicators
Authors: Maaß L , Badino M , Iyamu I , Holl F 
Published: October 2024

Abstract

Background
Revealing the full potential of digital public health (DiPH) systems necessitates a wide-ranging tool to assess their maturity. Essential domains that need to be considered include the literacy and interest in DiPH tool application by society and the workforce and the legal and ICT maturity of DiPH systems. No review has investigated indicators on these national DiPH system maturity (DiPHSM) domains yet. Our narrative review and qualitative analysis aimed to map the landscape of indicators related to DiPHSM measurement and rank them based on their importance for such assessments.

Methods
As original indicators were not published in scientific databases but as grey literature, we used DuckDuckGo to apply a pre-defined search strategy for 11 countries from all continents classified as having reached level 4 of 5 in the Global Digital Health Monitor. Of the 1484 identified references, 137 were included which named 15806 indicators. Consensus on importance was defined as at least 3 or 4 authors rating an indicator as important.

Results
We recognized 180 indicators on different constructs with importance for DiPHSM analysis, including the availability and use of Smartphones, computers, the Internet or the DiPH intervention, the existence of skilled workforce, infrastructure (investment), and interoperability between interventions, the secondary use of health data, a DiPH strategy and controlling agency, or the application of big data and artificial intelligence for health data collection, analysis, and sharing.

Conclusions
Our study holds the potential to develop more comprehensive tools for DiPHSM assessments. Further examination is required to analyze the suitability and applicability of all identified indicators for diverse healthcare settings. By working towards a uniform evaluation of DiPHSM, we foster informed decision-making among healthcare planners and practitioners, improve resource distribution, and continue to drive innovation in healthcare delivery.

Key messages
• Maturity assessment tools need to consider the complexity of DiPH systems. Thereby, DiPH system evaluations need to be accompanied by analyses of the legal, ICT, and literacy perspective maturities.
• New methods are needed to systematically assess and use multidisciplinary grey literature for research.
Integrating an AI-powered symptom assessment application (SAA) in a hospital network in Portugal
Authors: Kini N , Cotte F , Pereira M P , Pimenta A , Schmude M , Nevell J , Lourenço F D , Besarab A , Monteiro M S , Flores P S 
Published: October 2024

Abstract

Introduction
Patients often struggle to understand medical information and healthcare worker shortage strains health systems. Integrating SAAs that guide patients and provide diagnostic decision support (DDS) to doctors can help. This study evaluates the impact of the SAA ‘Ada’, a class IIa medical device, after its integration into the patient portal of a Portuguese hospital network, CUF, on clinical workflow and patient health.

Methods
This on-going post-market quality improvement study, started in Nov 2023 and has enrolled 664 participants. Participating doctors complete a baseline survey. Consenting patients conduct symptom assessments and answer survey questions within the app. The patient’s symptom report is shared with their physician, who then completes a post-consultation survey.

Results
After using Ada, 86% of patients could enter all their symptoms, 79% felt more prepared for their consultation, and 39% felt less health anxiety (N = 664). In the baseline survey, most doctors utilize online resources (96%) in the absence of a symptom checker, followed by discussions with colleagues (65%) for challenging cases (N = 26). In the post-consultation survey, 95% of doctors found Ada’s condition suggestions reasonable, with only 10% disagreeing with its triage classification. Doctors reported time saving and increased consultation efficiency (64%), and 59% felt more confidence in their diagnosis. A majority said that Ada provided them with additional information about patients (77%). Ada also improved consultation efficiency (74%), preparation (78%), patient engagement (82%), and health knowledge (77%; N = 22).

Conclusions
By providing personalized health information, Ada prepares patients for their consultation, resulting in improved patient engagement and facilitation of clinical conversation. Incorporating a SAA into routine patient care enhances quality of consultation, reduces consultation time, increases efficiency, and provides DDS to doctors.

Key messages
• Digital health enhances patient engagement, clinical efficiency, and diagnostic decision support for doctors in healthcare settings.
• Ada’s personalized health information empowers patients, improves consultations, and reduces health-related anxiety.
Family-based sexual health intervention for adolescents; A systematic review and meta-analysis
Authors: Mataraarachchi D , Shepherd T , Ariyadasa G , Bajpai R , Corp N , Paudyal P 
Published: October 2024

Abstract

Background
Family-based interventions are important in promoting adolescent sexual health outcomes. However, the effectiveness of these interventions in promoting adolescent sexual and reproductive health (ASRH) in Lower and middle-income countries (LMIC) has not been empirically evaluated. This review aimed to summarise the effectiveness of family-based sexual and reproductive health interventions in promoting ASRH in LMIC.

Methods
We conducted a systematic search for studies published in English from 2000 to October 2023 using MEDLINE, PsyINFO, CINAHL, Web of Science, and EMBASE databases. Studies were included if they involved adolescents aged 10-19 years, included family members in a key intervention component, evaluated the effectiveness of the interventions using an experimental or quasi-experimental design, assessed ASRH outcomes reported by adolescents and were conducted in LMIC setting. Standardized mean difference (SMD) and 95% confidence intervals were computed and meta-analyses were conducted using random effect models.

Results
Ten articles involving 2,246 participants were included in the review. The studies were nostly conducted in Africa. Across studies, there was no significant impact of family-based interventions in improving adolescent sexual health knowledge (SMD=0.5, 95%CI: -1.98 to 2.98), attitudes (SMD= -0.05, 95%CI: -1.92 to 1.82), practices (SMD=0.53, 95%CI: -0.69 to 1.75), or sexual communication with their family (SMD= 0.14, 95%CI: -0.42 to 0.7). Although individual studies reported a mixed effect of family-based interventions in improving sexual health outcomes, the pooled results from the meta-analysis showed no significant impact of family-based interventions.

Conclusions
Our review did not find any significant impact of family-based interventions in improving ASRH in LMIC. We recommend interventions using innovative approaches and novel strategies to align with the socio-cultural and economic background of the study setting.

Key messages
• This study found no significant impact of family-based interventions in improving ASRH in LMIC.
• Additional studies, particularly from Asia, using culturally relevant interventions is required in this area.
Implementation Measures to Break the Gender Gap - a Scoping Review
Authors: Mollenhauer J , Sgraja S , Amelung V E , Kloepfer M , Seeland U , Kurscheid C 
Published: October 2024

Abstract

Background
For myocardial infarction, in-hospital lethality is still significantly higher in women than in men in Germany. Medical guidelines and nursing expert standards include recommendations for gender-sensitive care (GSC+), but it is unknown how these are implemented in health care practice. Research question: Which measures facilitate the implementation of GSC+?

Methods
Systematic literature research was conducted on Pubmed, web of science and CINAHL with adequate keywords connected with Boolean connectors.

Results
The initial literature search yielded a pool of 23,508 items. After removing irrelevant articles and duplicates 119 articles were included in the present scoping review. Among fifteen generated dimensions, which are summarized to six main dimensions (education, research & science, politics, LGBTQ+ care & education, institutions of care and career advancement), the included articles are related. Education is the dimension with the most identified articles. Key messages of main dimensions are that GSC+ • must be anchored in compulsory subjects of curricula; • must be considered in research. Researchers need to be aware and should follow a structured framework for generating sex-specific guidelines; • can get gain access to politics through purposeful lobby work; • in terms of LGBTQ+ care should be learnt from health care providers to LGBTQ+ people through case studies; • should be implemented strategical through change agents in institutions of care; • can be enhanced through aware women in leading positions, to implement GSC+ successfully.

Conclusions
The implementation of GSC+ has a positive impact on patient care and could reduce undesirable events or outcomes. To reach the implementation target the politics must set frame conditions and universities, science and health care providers have to integrate them. Moreover, the generation of evidence is important to promote GSC+ so that health care professionals have a defined work assignment for GSC+.

Key messages
• The research results provide a comprehensive overview of the existing literature on implementation measures of gender-sensitive care.
• Healthcare providers are sensitized to gender-sensitive care so that patient care can be further improved.
2.M. Scientific session: Economics of Mental Health in the interplay between health systems and public health
Authors:   Organised by: EUPHA-ECO,   Chair persons: João Vasco Santos (EUPHA-ECO), Vanessa Gorasso (EUPHA-ECO)
Published: October 2024

Abstract

Mental health systems and services are essential components of the public health infrastructure, serving as frontline for prevention and intervention for health overall. Despite this, access to mental health services remains largely inadequate, with the OECD calculating that only about one in three people with mental health problems has access to quality treatment across 19 EU Member States. The economics of mental health play an important role in determining the allocation of resources, the accessibility of services and the overall effectiveness of interventions. Effective planning requires an understanding of population needs, service gaps and utilization patterns, in order to ensure equity and health improvement. In fact, the conceptualisation of the economic dimensions of mental health enables policymakers, practitioners, and stakeholders to make informed decisions that optimize resource utilization and maximize societal benefits. The proposed workshop will build on previous activities of the EUPHA Section on Public Health Economics at EPH, including the recent establishment of a working group on the economics of mental health. The aim of the meeting is to promote the adoption of best practices and methodologies in the conduct of economic studies on mental health. As such, the workshop will provide an opportunity to discuss the unique challenges of economic evaluation in this field and to present relevant ongoing activities by members of the Section and other invited experts.

Key messages
• Mental health, its distribution and at-risk populations influence resource allocation and policy decisions within mental health systems.
• Tackling inequalities in mental health is essential for promoting health equity and social justice, requiring evidence-based interventions and policy initiatives to empower marginalized communities.
What do we know about femicide in Italy? Data and insights from a repeated cross-sectional study
Authors: Gabrielli G , Porru F , Ricciardi W , Gualano M R 
Published: October 2024

Abstract

Background
Gender-based violence represents a huge public health issue, affecting mental, physical health and productivity. It is a significant obstacle to achieving gender equality and the empowerment of all women. While the overall homicide rate is decreasing in Italy, femicide, the intentional killing of women due to gender-related motivations, remains stable over time. This is the first study in Italy to evaluate potential risk factors of femicide, exploring the sociodemographic characteristics of victims and perpetrators of femicides, as well as the geographic distribution across Italy, with insights into differences between the size of municipalities and between geographic areas.

Methods
A repeated cross-sectional study was conducted to investigate femicides in Italy from 2020 to 2023 using data sources from Non Una Di Meno, an Italian NGO, and the Italian National Institute of Statistics.

Results
Our preliminary findings show that the majority (83%) of homicides of women were femicides. On a final sample of 403 femicides, in most cases (94,3%) the victims were more likely to be hit by their current or former partner or by a family member. In 97% of cases perpetrator was a man. In more than 50% of cases, both the victims and the perpetrators were under 55 years old (respectively, 51,8% and 57,9%). Femicide rates was 0.33 per 100,000 women. There appear to be no significant differences between the rates of femicide as the size of the municipality and the geographic macro-area vary, highlighting the extensive spread of the phenomenon throughout the territory.

Conclusions
Our findings show that femicide is a systematic and widespread phenomenon that occurs mostly within the home and needs interventions at the European level to prevent systemic violence against women. Moreover, this study provides methodological considerations to define femicide, suggests improvements to data collection methods and offer insights for future research in this field.

Key messages
• It is important to gather robust data on gender-based homicide, as it represents a public health issue.
• Femicide is a pervasive and systematic phenomenon that predominantly occurs within the home and requires intervention at the European level.