bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaccination campaign implementation in Madagascar: a Dynamic Sustainability Framework approach
Authors: Pavoncello V , Kislaya I , Andrianarimanana D K , Marchese V , Tsiky Zafinimampera A O , Totofotsy O , Randriamanantany Z A , Rakotoarivelo R A , Puradiredja D I , Fusco D 
Published: October 2024

Abstract

Background
The COVID-19 pandemic has highlighted the need for equitable and timely access to vaccination. Limited evidence is available on how to implement vaccination campaigns (VCs) that are sustainable and responsive to changes in real-world health policy and practice contexts. We present lessons learned from the implementation of a COVID-19 VC in the Boeny region of Madagascar.

Methods
Informed by the Dynamic Sustainability Framework, VC implementation was continuously reviewed during multisectoral stakeholder feedback rounds, key informant interviews, and problem-solving meetings to identify and put key adaptations throughout the campaign process into practice. Outcome indicators include pre- and post-VC vaccine hesitancy and trends in vaccine doses deployed were analyzed using generalized linear models.

Results
Key adaptations of the implementation strategy included community-led awareness-raising and outreach activities also in remote areas, strengthening VC through the training of 340 staff, and addressing gaps identified in the cold chain, waste management, vaccine transportation, and IT equipment. Overall, 24888 COVID-19 vaccines were administered in six months. Changes in campaign strategy increased the number of doses administered by 8% (RR = 1.08; CI 95%: 1.01; 1.15) per week. No changes in vaccine hesitancy post-VC were observed in an unvaccinated population(Δ = 0.02, CI 95%: -0.04; 0.08).

Conclusions
Collaborative and dynamic multi-sectoral VC strategies that combine healthcare-based approaches with pro-active outreach and community-led awareness-raising activities are essential in increasing vaccine uptake in limited-resource settings. Our findings show that despite boosting vaccination coverage, such initiatives may not have an impact on COVID-19 vaccine hesitancy at the community level

Key messages
• Multisectoral stakeholder collaboration and engagement are key to successful vaccination campaign implementation.
• A Dynamic Sustainability Framework approach can be effective in ensuring a continuous fit between campaign and its setting.
The Icehearts Europe Implementation Guide to promote a mentoring programme for youth mental health
Authors: Valli M , Luzi I , Gigantesco A , Del Re D , Cascavilla I , Faella P , Iannaccone A , Ponchon C , Conti D , Capelli G 
Published: October 2024

Abstract

Issue/problem
In Europe, 9 million young people (10-19) suffer from mental disorders and 70% of children and adolescents with mental health problems do not receive appropriate interventions at a sufficiently early age. Moreover, during the Covid-19 pandemic a high prevalence of depressive symptoms, anxiety and sleep disorders was observed in the population aged 4-19 years. The Icehearts Europe project (funding: EU4Health 2022 Programme) aims to disseminate at EU level a long-term programme for supporting health and wellbeing of disadvantaged children and adolescents. It is inspired by the Finnish best practice Icehearts, a 12-year long mentoring programme. Five pilot countries (Italy, Denmark, Spain, Slovenia, Estonia) will test the model to raise European awareness of how it works and to get more countries and organisations involved.

Description of the problem
Icehearts Europe is a preventive mentoring programme based on team sports, recreation and school support activities, with a child-centred community approach. To facilitate its implementation, a practical guide has been developed for grassroots sport and social promotion organisations to help them implement the model in their own contexts. The guide is the result of both a multisectoral cooperation between grassroots sport, health, universities, NGOs, and qualitative study activities (bibliographic research, study visit, group work, analysis of the situation and needs of local contexts).

Results
From February 2024 the Icehearts Europe Implementation Guide is available in six languages at https://www.icehearts.eu/resources. It is now being adapted by the Icehearts Europe partners into an online training programme for managers.

Lessons
The guide has incorporated lessons learnt from the Finnish model, considered as an evidence-based approach. It contains several operational tools to implement Icehearts Europe and can be adopted using different approaches: there is no one-size-fits-all solution.

Key messages
• Developed as a support to the Icehearts Europe piloting partners and as a basis for a fully-fledged online training programme for future Icehearts Europe managers.
• To facilitate the implementation of early interventions to promote health and wellbeing of children and adolescents and enable them to cope with disadvantaged conditions.
Trends in overall and abdominal obesity among Korean adults, 2007-2022: an Age-period-cohort analysis
Authors: Jeong D , Jo G , Oh H 
Published: October 2024

Abstract

Overall and abdominal obesity, often defined as having high body mass index (BMI) and waist circumference (WC), are associated with an increased risk of chronic disease. A comprehensive understanding of trends and contributing factors is necessary to reduce the disease burdens. This study investigated the nationwide trends and independent effects of age, period, and birth cohort on BMI and WC in Korean adults. We conducted hierarchical age-period-cohort (cross-classified random-effects models) analyses using measured BMI and WC data from 85,292 Korean adults (aged ≥19) in the Korea National Health and Nutrition Examination Survey 2007-2022. We also examined whether the age, period, and cohort effects varied by socioeconomic subgroups. In 2007-2022, the age-standardized mean BMI (23.6 to 24.2 kg/m2) and WC (81.7 to 83.5 cm) increased in the overall population. An upward trend was evident among men, while only a slight change was observed in women. The mean BMI was highest at age 47 (25.1 kg/m2) in men and age 60 (24.2 kg/m2) in women and it decreased at older ages. Controlling for age and period effects, mean BMI was lowest among the birth cohorts of 1960-1964 (24.15 kg/m2), with the highest mean BMI observed among the birth cohorts of 1919-1939 (24.97 kg/m2) and 1990-2003 (24.99 kg/m2). The mean WC was highest at age 55 (88.0 cm) in men and age 79 (83.4 cm) in women. Similar U-shaped birth cohort effect was observed with WC, with the lowest mean observed among the birth cohorts of 1960-1964 [82.92 (0.30)]. At most age, period, and birth cohorts, mean BMI and WC were consistently higher among adults at lower income and education. The overall period effect was consistently found in all socioeconomic subgroups, but the gap in BMI between income and education subgroups widened over time. Our findings suggest that BMI and WC slightly increased in overall Korean adults in 2007-2022, with some inequalities among age, sex, birth cohort, and socioeconomic subgroups.

Key messages
• The obesity indices increased from 2007 to 2022, but the cohort effect on BMI and WC showed a U-shaped pattern with the lowest mean among birth cohorts of 1960-1964.
• The obesity prevalence is varied by socioeconomic status, suggesting that more intense interventions may be needed to target the susceptible groups.
Impact of primary course COVID-19 vaccination on hospitalizations in Belgium, a Bayesian approach
Authors: Vermeiren E , Braeye T , Stouten V , Nasiadka L , Billuart M , Van Evercooren I , van Loenhout JAF 
Published: October 2024

Abstract

Background
The Belgian COVID-19 primary course vaccine rollout was prioritized for individuals aged 18-64 years with underlying health conditions (increased risk of severe COVID-19), over their peers of the same age. This led to a 32-day earlier vaccination of prioritized individuals. In this research, we assessed the impact of vaccine rollout prioritization on hospitalizations for COVID-19 in Belgium between April 1st 2021 and June 30th 2021.

Methods
The sample consisted of the Belgian population aged 18-64 years. Individuals were classified by their priority status according to underlying health conditions and by vaccination status, creating weekly changing cohorts. The hospitalization probability was estimated by cohort using a national COVID-19 hospital surveillance. Two counterfactual scenarios were considered: (1) a no vaccination scenario and (2) a scenario in which the vaccine administration occurred at random in both cohorts (a vaccine rollout without prioritization). We used a Bayesian model to jointly estimate cohort-specific hospitalization probability and scenario outcomes.

Results
Out of the sample of 5,448,534 individuals, 22.65 % was prioritized. By May 1st, vaccination coverage was 18% and 2% within the prioritized and the non-prioritized cohort. In scenario 2, coverage within the prioritized was 6% by May 1st. There were 6968 hospitalizations reported through the hospital survey. Our initial scenario-outcomes indicated a reduction in hospitalizations of 3203 (95%CI[2548;3858]) and 919 (95%CI[406;1433]) by the vaccination prioritization, compared to scenarios 1 and 2, respectively.

Conclusions
This research provides insights in the impact of vaccination in a pandemic context in Belgium. We report a significant reduction in simulated COVID-19 hospitalization by vaccine prioritization compared to at random vaccination and no vaccination at all. Currently, we are investigating the effect of age-dependent vaccination next to at random vaccination.

Key messages
• The prioritised vaccination campaign in Belgium led to a significant reduction in hospitalizations.
• Prioritisation based on underlying health conditions is an important public health measure.
Is the medical curriculum failing patients with obesity? - A public health concern
Authors: Sant D 
Published: October 2024

Abstract

Introduction
Despite the global surge in obesity, it often receives insufficient attention in medical curricula, potentially impacting its management. This study aims to assess the preparedness of medical students in managing obesity.

Methods
A cross-sectional survey was conducted by disseminating a mixed-methods anonymous questionnaire to medical students studying at the University in Malta. A sample size of 117 participants was determined a-priori. Descriptive statistics and chi square testing were conducted. and coupled with thematic two-stage coding analysis of qualitative data.

Results
189 participants were recruited. The majority expressed dissatisfaction with the teaching of obesity and its management during the MD course (pre-clinical = 90%; clinical = 74.4%, p = 0.006). Clinical students expressed dissatisfaction regarding the adequacy of their pre-clinical education (82.65%) and clinical attachments (70.40%), in equipping them with the theoretical knowledge and foundational skills necessary for managing patients with obesity. No significant difference between clinical and pre-clinical students’ knowledge was noted except concerning diagnostic criteria (preclinical: 63.33% versus clinical: 89.90 %; p &lt; 0.001). Thematic analysis highlighted the importance of curricular obesity teaching, need for a holistic approach towards obesity, and hesitancy in treating patients with obesity.

Conclusions
The gap between medical students’ perceived readiness and the growing obesity epidemic is a public health concern. Without proper training, future doctors may struggle to manage obesity, posing risks to health outcomes and healthcare systems. Urgent curricular reforms are necessary to prioritize obesity education and ensure physicians are equipped to address obesity, to meet national needs. This requires collaboration among stakeholders, especially post-COVID-19, to align medical education with public health needs while addressing the severity of the obesity epidemic in Europe.

Key messages
• A gap between students’ attitudes and their understanding of obesity education was identified in this study, indicating a need for curriculum reform.
• This presents a critical public health issue, as it leaves the new generation of doctors ill-equipped to address the growing obesity epidemic across European countries.
Strengthening youth mental health capacities in Albania: Training primary healthcare professionals
Authors: Qirjako G , Qosja A , Çumashi R , Meksi A , Hala R , Zikaj L , Qirjako S , Tollozhina E , Pilika A , Tomini E 
Published: October 2024

Abstract

Background
Addressing mental health issues among children and adolescents globally is crucial, necessitating interventions at the primary healthcare (PHC) level. The training programme in Albania equipped PHC professionals with skills for early identification, support, and referral for youth mental health issues. Given the global prevalence of such challenges, our intervention serves as a valuable model for enhancing mental health services in communities.

Objectives
The training aimed to develop the capacities of Albanian PHC professionals in improving mental health and psychosocial wellbeing among youth. Through innovative training sessions using participatory action methods, it was sought to answer key questions: How can Albanian PHC professionals better identify and support youth mental health issues? What innovative approaches can enhance mental health training for Albanian healthcare personnel? How can community engagement be strengthened to support youth mental health initiatives in Albania?

Results
Following the programme, 525 healthcare professionals in Albania received training, showing improved knowledge and skills in youth mental health support. They emphasized the importance of community engagement, standardized documentation, and specialized mental health services. Preliminary results indicate increased awareness and readiness among Albanian PHC professionals to address youth mental health needs.

Conclusions
The programme underscores the significance of equipping Albanian PHC professionals with comprehensive skills to tackle youth mental health challenges. Lessons learned have broader implications for strengthening mental health services globally, emphasizing collaboration, standardized protocols, and targeted interventions.

Key messages
• Strengthening PHC capacity in Albania improves early identification and support for youth mental health, enhancing overall wellbeing.
• Tailored training and community engagement are vital for effective mental health interventions at the grassroots level in Albania.
A matter of measurement? Segregation and all-cause mortality in Sweden’s three metropolitan regions
Authors: Cederstrom A , Dunlavy A 
Published: October 2024

Abstract

Background
Residential segregation can be operationalized and measured in many ways, along distinct dimensions. There are multiple mechanisms through which segregation and health mutually affect each other. Consequently, contextual health effects of segregation may vary depending on how segregation is measured.

Methods
We used longitudinal Swedish register data to compare associations between local measures of residential segregation (migrant density, migrant isolation, and the mutual information index) and all-cause mortality among the adult migrant and native-born populations in Sweden’s three largest metropolitan regions between 2004-2016.

Results
Among migrants, modest positive mortality gradients were observed across measures of migrant density and isolation, where a higher level of segregation was associated with higher risks of all-cause mortality (Q5 RR ranged from 1.08-1.20 across cities and measures). However, these effects were largely attenuated by individual-level socioeconomic factors, and reversed when further controlling for neighborhood economic deprivation (Q5 RR ranged from 0.74-0.87). Among the native-born, a positive gradient for mortality was found (Q5 RR ranged from 1.31-1.45), although this was reduced when accounting for neighborhood deprivation (Q5 RR ranged from 1.01 -1.11). For both migrants and the native-born, the mutual information index showed no clear association with mortality, although a mortality advantage is observed for migrants in the most segregated areas after individual and neighborhood level adjustments (Q5 RR ranged from 0.73-0.86).

Conclusions
Our findings show that the manner in which residential segregation is conceptualized and operationalized alters associations with health. However, individual and other contextual level confounders are important determinants which influences the patterns. Much of the negative health effects of residential segregation can be perceived through the lack of economic opportunities.

Key messages
• Associations between segregation and all-cause mortality depends on how segregation is conceptualized and measured.
• The mortality disadvantage observed in local areas with high migrant density may be attributed to the lack of economic opportunities in the neighborhood.
Harassment of interns, medical interns and residents: consequences and complaints
Authors: Villegas-Dominguez J , Teczon Castellanos C O , Suárez Hernández N , Andrade Martinez M , Ruiz Garcia F , Viñas Dozal J C , Duarte Cruz V , Sosa Gonzalez Y R , Hernandez Rico M 
Published: October 2024

Abstract

Introduction
Workplace harassment manifests in various forms for healthcare students, potentially leading to modifications in their lives and academic activities.

Objectives
To describe the type of harassment experienced by interns, medical interns, and residents, and its consequences.

Methods
A cross-sectional and prospective study was conducted, including medical interns, social service interns, and residents from Veracruz who reported experiencing harassment in their assigned areas during their last academic year. Direct and virtual invitations were sent through various electronic means.

Results
58 students were included, with 39 (67.2%) being women. 50% reported experiencing psychological abuse, and 65.5% reported experiencing sexual harassment. The most severe sexual harassment incidents included sexual assault with physical force (1.7%) and three instances of non-consensual sexual relations (5.2%), while the most common were sexual jokes/comments (72.4%). Following harassment experiences, 25% of participants reported feeling anxious, 22% stressed, and 17% angry. Students who perceived psychological abuse reported anger (69%), stress (58.6%), and anxiety (58.6%) as the most frequent consequences, while those reporting sexual abuse indicated anger (73.7%), shame (68.4%), and anxiety as primary consequences. The most frequently identified harassers were attending physicians (56.9%), senior students (34.5%), and non-medical personnel (34.5%). Students filed complaints with hospital authorities (6.9%), university authorities (6.9%), and external agencies (5.2%). The individual who experienced sexual assault with physical force did not file any complaint, while only one person reported non-consensual sexual relations to hospital authorities.

Conclusions
It is crucial to establish safe spaces for students within the hospital environment to promote their overall well-being and academic success, as well as to encourage a culture of reporting.

Key messages
• Highlighting the need for intervention within the work teams where our students are placed, promoting a violence-free environment.
• Annexing a therapist as part of the work team could favor the well-being of students, since mental health is one of the main points affected within a violent environment.
Ready to act? Factors associated with nurses’ desire to work in Primary Health Care in Italy
Authors: Renzi E , Panattoni N , Di Simone E , Peltrini M , Baccolini V , Migliara G , Marzuillo C , De Vito C , Villari P , Massimi A 
Published: October 2024

Abstract

Background
The rapid increase in demand for primary healthcare (PHC) services after the pandemic requires reconsidering nursing staff planning and availability. The objectives of the study were to i) identify knowledge, attitudes, practices and work expectations of future nurses in primary care; ii) estimate the prevalence of nursing students who desire to be employed in PHC and Family and Community Health Nursing (FCHN) services after graduation.

Methods
A cross-sectional study is being conducted on a sample of nursing students enrolled in universities in the Lazio Region. A structured instrument was built based on the literature and national regulations and validated (Cronbach’s alpha=0.81).

Results
In this first phase, 163 nursing students were enrolled. The majority of the sample was female (N = 125, 76.7%), with a mean age of 22 (SD ± 5) years and were enrolled in the last year of degree program (N = 85, 52.1%). A total of 49 students (30%) reported adequate knowledge of PHC service reorganization policies and nursing practice in this setting. While 74% (N = 122) of the sample intended to undertake a PHC curricular internship during their degree program, only seven students (4%) participated in one. 52 individuals (30%) expressed their intention to be employed in PHCs after graduation, and 29 (17.8%) indicated their desire to work as FCHN practitioners. The main factors contributing to the undesirability of employment in PHC reported by students were: i) preferring the hospital settings (N = 53, 48%); ii) not having adequate skills to be employed in the PHC (N = 21, 19%); and iii) believing that the PHC does not offer attractive services for nursing practice (N = 14, 13%).

Conclusions
A multivariable analysis will be conducted to identify predictors of nursing students’ desire to work in PHCs after graduation. Preliminary results of the study showed that only one-third of nursing students indicated a desire to work in PHCs.

Key messages
• Only one-third of nursing students express a desire to work in PHC and in Family and Community Health Nursing (FCHN) services post-graduation.
• Collaboration between the PHC workforce, academics, stakeholders, and policymakers is needed to create tailored initiatives that increase the attractiveness of PHC.