bluuebunny/crossref_metadata_2025_split huggingface dataset:
Associations between maternal health literacy and prenatal micronutrient intake in Hungarian women
Authors: Sisák A , Szabó A , Máté Z S , Molnár R , Németh G , Orvos H , Paulik E 
Published: October 2024

Abstract

Background
Adequate level of health literacy (HL) is an important factor in pregnancy. Low HL may increase the risk of maternal and fetal complications (e.g., gestational diabetes mellitus, low birth weight). This study aimed to measure the levels of maternal HL and its associations with the consumption of folic acid (FoA), vitamin D (VD), and omega-3 fatty acids (FAs) during pregnancy in Hungarian women.

Methods
The questionnaire-based study was conducted at the Department of Obstetrics and Gynecology, University of Szeged among women who gave birth between June and September 2023 (N = 294). Sociodemographic, lifestyle, conception and pregnancy related questions were asked. HL was measured by the Maternal Health Literacy Inventory in Pregnancy (MHELIP) questionnaire (after the Hungarian adaptation); it contains 48 items representing four subscales (maternal health knowledge, search for maternal health information, assessment of maternal health information, and maternal health decision making and behavior). Data analysis was performed by SPSS 29.0. (Ethical permission: 5351)

Results
The mean age of women was 31.53 +-4.75 years. During pregnancy 84.5% of women consumed FoA, 61.8% VD and 41.8% omega-3 FAs. The total mean score of MHELIP on a scale 0-100 was 78.93 (95%CI: 77.77-80.08); the score of “search for maternal health information” subscale was the lowest [57.68 (95%CI: 56.20-59.16)], and the score of “maternal health decision making and behavior” was the highest [86.75 (95%CI: 85.62-87.87)]. Omega-3 FAs and VD consumption was significantly higher in women with higher total and subscales mean scores (except “search for maternal health information”), while FoA consumption was significant in case of “assessment of maternal health information”. (The results are preliminary.)

Conclusions
The association between micronutrient consumption and HL supports that using this tool during pregnancy the mothers who needs more support and health information can be identified.

Key messages
• The Maternal Health Literacy Inventory in Pregnancy questionnaire is a reliable tool for measuring health literacy in Hungarian pregnant women.
• Maternal health literacy plays an important role in the healthier lifestyle, including prenatal vitamin/micronutrient consumption.
Association between family empowerment and health literacy among parents with preschool children
Authors: Yanagi N , Satoh H , Sawada Y 
Published: October 2024

Abstract

Background
For parents raising children, obtaining information and working together to solve problems in a family, including those related to the child’s health, is vital (family empowerment). Communicative and critical health literacy is the ability to acquire and utilize information through communication and to critically analyze and use it to manage one’s life. This may enhance family empowerment. We aimed to examine the association between family empowerment and health literacy among Japanese parents.

Methods
Data from parents of preschool children aged 3-6 years were collected through an online survey in September 2023. Family empowerment was measured using the Family Empowerment Scale for Parents (FES-P) with five sub-factors (26 items in total) using a 7-point Likert scale. Communicative and critical health literacy was measured using the Communicative and Critical Health Literacy (CCHL) scale, which includes five items on a 5-point Likert scale. Multivariable regression analysis was used to examine this association. Age, sex, education, income, employment status, number and age of children, and family members were used as covariates.

Results
Participants included 600 fathers and 600 mothers. The mean FES-P score was 116.5 (SD 23.0) and the mean CCHL score was 3.50 (SD 0.69). In the crude model, CCHL was statistically significantly associated with FES-P and all five sub-factors, such as ‘relationship within the family’. After adjustment for all covariates, the association remained significant for FES-P (beta=0.28, p &lt; 0.001) and sub-factors such as ‘relationship with the community’. However, ‘recognition and combined use of services’ was not statistically significant (beta=0.05, p = 0.078). The income level showed a significant association with family empowerment and all sub-factors, independent of health literacy.

Conclusions
Health literacy was associated with family empowerment. Improving health literacy could contribute to strengthening family empowerment.

Key messages
• Improving health literacy could contribute to strengthening family empowerment.
• Financial support may be needed to strengthen family empowerment since income level was associated with it.
Knowledge and perspectives about medicinal cannabis in nurses and nursing students in Portugal
Authors: Cunha-Oliveira A , Paiva C , Santos T , Rosendo I , Rui Pita J 
Published: October 2024

Abstract

Background
The opening up of legislation on medicinal cannabis in recent years has been a determining factor in the growth of this therapy. In Europe, regulation of medicinal use is a reality in several countries. Nurses can play a leading role in its administration, helping to ensure that it is carried out more effectively and assuming a fundamental role in the success of the therapy. It is therefore pertinent to analyze the knowledge of nurses and nursing students in Portugal about medicinal cannabis.

Methods
Quantitative descriptive study. A self-completion questionnaire was drawn up and made available on the google forms platform. It was face-validated, content-validated and approved by the Ethics Committee. The instrument included sociodemographic data, questions about cannabis knowledge and perspectives. Descriptive statistics were analyzed.

Results
Out of a total of 610 responses, 318 were nurses and 292 nursing students. Medical cannabis is considered legitimate by 79.6% of nurses and 84.3% of students. When asked about the functions of the endocannabinoid system, 71.7% of nurses and 79.5% of students said they had no knowledge. 88.7% of nurses and 79.5% of students disagreed that they had sufficient knowledge to advise users on the use of medicinal cannabis. Also, 38.4% believe that their patients use cannabis illegally to manage the symptoms of illnesses.

Conclusions
There is a need for continuing training for nurses and for the undergraduate and postgraduate nursing curricula to include this emerging area.

Key messages
• The results show that this issue is a public health problem. It reinforces the need to formulate public policies in this area and to implement training for nurses and nursing students.
• These measures will be fundamental in preventing the use of illegal cannabis and promoting the safe use of medicinal cannabis.
Prevalence of Tooth Decay and Related Factors Among Primary School Children
Authors: Ghali H , Bhiri S , Souai S , Khouya F , Maatoug A , Selmi H , Youssef K , Ben Rejeb M , Latiri H , Ben Cheikh A 
Published: October 2024

Abstract

Introduction
Tooth decay is considered the fourth most important public health problem in the world. According to the latest studies, the prevalence of this disease is also important in school children. The interest of this work is to study the prevalence of dental caries and its influencing factors in primary school children in the city of Sousse (Tunisia) and to formulate recommendations for the prevention of this phenomenon.

Methods
It is a cross-sectional study conducted among pupils enrolled from 1st and 3rd grade of 3 primary schools in the city of Sousse in April 2022 through a questionnaire filled out by the pupils.

Results
A total of 376 participated in the study. Among them, 52,4% were male. The mean age was 7.4 ± 1.2 years. The prevalence of dental caries in our population was 43.9%. Many factors were associated with dental caries including pupils from public schools (p = 0.000), poor oral hygiene: [lack of tooth brushing (p = 0.000), tooth brushing only 1 time per day (p = 0.000), eating in the evening after brushing the teeth (p = 0.000), lack of changing the toothbrush (p = 0.000)] and unhealthy eating habits (p ≤ 0.05). Consequently, dental caries was significantly higher among children with overweight body mass index (BMI) (90.9%; p = 0.016).

Conclusions
The organization of awareness and information days in schools, the integration of an education program on preventive measures against this phenomenon and the generalization of screening campaigns to detect this disease are necessary measures that should be carried out according to a well determined strategy.

Key messages
• Dental caries prevalence among primary school children in Sousse is significant, highlighting the urgent need for preventive measures.
• Factors such as poor oral hygiene, unhealthy eating habits, and attending public schools contribute to the prevalence of dental caries.
What does international evidence tell us about the health of people with childhood social care (CSC) experiences?
Authors: Allik M , Bradford D 
Published: October 2024

Abstract
International research into the health of people with childhood social care (CSC) experiences has found evidence of worse mental health and emotional-behavioural wellbeing, higher rates of substance use, neurodevelopmental conditions, and avoidable mortality. Lower vaccination rates and worse dental health among those in care has also been reported in few countries. However, research results have been more mixed with regard to some physical health conditions, with higher prevalence of asthma and respiratory ill health among foster children reported in the US but no obvious differences found in the UK. Are there countries where these inequalities are less pronounced, and can we draw such conclusions based on available evidence? When making international comparisons or aiming to give policy advice, we also need to consider the quality of our evidence. Has this been based on small sample sizes or without comparison to other children and adjusting for relevant (socioeconomic) confounders? Most of our current knowledge is also cross-sectional and we do not know if some health conditions precede entry to care and may even be risk-factors for entering social care. Recent longitudinal and cross-sectoral data linkage programmes in many nations (Australia, UK, Canada) have a potential to change this and provide a foundation for evidence-based recommendations for policy and practice.
Light Physical Activity Throughout the Day and Physical Function in Older Adults
Authors: Kim D , Lai T , Liao Y , Park J , Sung M , Jang M , Shin Y , Park H 
Published: October 2024

Abstract

Background
Light physical activity (LPA) plays a crucial role in preventing muscle loss and disability in older adults. Since LPA makes up a significant portion of daily activity, understanding how the timing of LPA influences physical function is important for designing effective health interventions.

Methods
This cross-sectional study investigated the association between the timing of LPA and physical function among 200 older adults (mean age 76.3, 55.5% female) attending the geriatric outpatient clinic at National Taiwan University Hospital. LPA was objectively measured using wrist-worn accelerometers for seven consecutive days. Principal component analysis (PCA) was used to identify distinct patterns of LPA timing. Participants underwent assessments of grip strength, basic mobility, walking speed, and lower limb muscle strength. Multivariable linear regression models were adjusted for potential confounders, including gender, age, moderate-to-vigorous physical activity (MVPA), and accelerometer wear time.

Results
Our findings revealed that higher levels of LPA during the morning to noon period were positively associated with better performance across all four physical function tests. Moreover, after controlling for relevant confounders, increased LPA in the late afternoon and evening was positively associated with enhanced basic mobility, walking speed, and lower limb muscle strength.

Conclusions
This study highlights the importance of considering LPA timing when promoting physical function in older adults, independent of MVPA participation. Encouraging LPA, particularly during the morning to noon period, could be a valuable strategy for maintaining and improving physical capabilities in this population. These findings provide actionable insights for clinicians and health professionals when tailoring physical activity recommendations for older adults within geriatric care settings.

Key messages
• Morning LPA boosts physical function in seniors, enhancing grip, mobility, walking speed, and muscle strength.
• Timing of light activity crucial for older adults’ physical health, with morning to noon activity showing most benefits.
Lesson from the Covid-19 pandemic: do fear and anxiety lower vaccination hesitancy?
Authors: Crnkovič N , Selak Š 
Published: October 2024

Abstract

Background
The prevalence of vaccination hesitancy has become one of the top ten global health problems. During the Covid-19 pandemic several studies reported negative correlation of vaccination hesitancy with fear of Covid-19 and anxiety. Therefore, the study aimed to explore how fear and anxiety can impact one’s intent to get vaccinated.

Methods
In 2021, data from 5999 post-secondary Slovenian students was gathered using a cross-sectional online survey. Binary logistic regression and the Sprearman correlation coefficient was used to explore the relation between Fear of Covid-19 Scale (FCOV), Generalized Anxiety Disorder Questionnaire (ANX) and a question regarding participants’ intentions to get vaccinated.

Results
Results showed that only 39.7% of students expressed intention to get vaccinated as soon as possible and 29.2% exhibited no intentions to do so. Logistic regression indicated that only FCOV had a mild and significant (p &lt; 0.001) impact on students’ intentions to get vaccinated, whereas ANX was found to have only a weak significant (p &lt; 0.01) effect on students’ intentions to do so. Similarly, ANOVA test showed significant differences with small to medium effect of FCOV on intentions to get vaccinated, but no significant differences were found for ANX.

Conclusions
A low percentage of Slovenian tertiary students expressed intentions to get vaccinated as soon as possible for Covid-19, with only fear having been found to have a small to mild effect on students’ intentions to do so. Anxiety, on the other hand, was found to have a small positively predictive effect on vaccination hesitancy, which could reflect affective forecasting error (i.e. believing that the negative consequences of getting vaccinated would be greater than they really are). Therefore, when considering strategies to address the increasing problem of vaccination hesitancy, one must keep in mind that the loss-framed messages might not be sufficient to prompt people to get vaccinated.

Key messages
• Fear of Covid-19 had only a small to medium significant positive effect on students’ expressed intentions to get vaccinated as soon as possible.
• The loss-framed messages might not be sufficient to prompt people to get vaccinated.
Restoring trust in vaccination through collective engagement with key populations in Eastern Europe
Authors: Mandić-Rajčević S , Cvjetković S , Oot L , Tasevski D , Popović D , Meghani A , Wallace H , Cullen-Balogun T , Cotelnic T , Cogswell L 
Published: October 2024

Abstract

Issue/problem
COVID-19 vaccination rates remained below 50% in Moldova, North Macedonia, and Serbia, especially among vulnerable populations like pregnant women and those with chronic diseases. This was strengthened by a lack of targeted communication and training for healthcare workers, and COVID-19 fatigue. Strategies to increase vaccine demand and confidence are a global priority, especially among vulnerable populations.

Description of the solution
From May 2022 to April 2024, the USAID MOMENTUM Routine Immunization Transformation and Equity project employed behavior integration to design a social and behavior change strategy, centering on vaccination as a part of a healthy lifestyle. It was implemented through continuing medical education (CME) and community engagement (CE) workshops with vulnerable populations, supplemented by cross-country learning exchanges. The outcomes provide a framework for public health initiatives aimed at boosting vaccine uptake through innovative, behavior-based methods.

Results
1,618 healthcare professionals, able to reach 2.5 to 4.8 million patients, received training in immunization, COVID-19 vaccines, and quality health service, and 99% indicated confidence in applying the knowledge. 265 CE workshops, engaging 4,079 patients, increased awareness and addressed concerns related to vaccination. Of 3,223 patients who were followed up, 47% reported setting an appointment with their doctor regarding vaccination, 27% discussed vaccination with their partners, and 7% proceeded to receive the COVID-19 vaccine.

Lessons
Behavior Integration helped address key barriers to vaccination and informed the design of strategies (i.e. situating COVID-19 vaccination as part of a healthy lifestyle). Establishing trust with healthcare providers and patients through collective engagement improved health behaviors. Focusing on health as a wider priority helped re-establish the significance of vaccination as part of a healthy lifestyle.

Key messages
• Behavior science and behavior integration helped identify and address barriers, as well as design tailored interventions to improve vaccination demand and confidence.
• Collective engagement, focused on integration of COVID-19 vaccination as part of a healthy lifestyle, achieved results through addressing vaccine hesitance from both sides of the equation.
Health promotion at local level in Portugal: is childhood obesity a concern in municipal programs?
Authors: Pereira M 
Published: October 2024

Abstract

Health promotion programs targeted at distinct health outcomes such as childhood obesity, at local level are increasingly used worldwide. There is a need to better understand the role of local governments (municipalities) as key public health promoters namely in the prevention of obesity in children. This study aims to provide some input regarding this issue in Portugal. In order to achieve this goal, health enhancing programs promoted by Portuguese municipalities in which children could participate were identified. The search of such programs was limited to the municipalities that were part of the Portuguese Network of Healthy Municipalities in 2021 (N = 57). A subsequent document analysis was conducted to describe how municipalities conceptualized children’s health by retrieving information on which topics the programs were focused on, or acted upon, and identify which socio-ecological model levels of health determinants were addressed (or not) by each program. The 77 identified programs were promoted by 30 municipalities and only 11 programs addressed childhood obesity. Most programs focused on the individual health determinants (N = 27) and provided limited information overall, which hindered a more in-depth analysis. The findings suggest that Portuguese municipalities seem to disregard their potential as public health promoters. Childhood obesity is a major public health concern at national level, as reflected in the National Health Plans, but not perceived as such locally. Municipalities are the closest government entities to the population, and it is their responsibility to ensure the population’s quality of life, by addressing the social and environmental determinants of health. Hence, municipalities should instill health concerns in all their actions/interventions, taking in consideration the most recent evidence, specifically in the case of childhood obesity.

Key messages
• This study findings suggest that, despite childhood obesity being a major public health concern at national level, as reflected in the National Health Plans, it is not perceived as such locally.
• There is a need to better understand the role of municipalities as key public health promoters considering they are responsible to intervene on the social and environmental determinants of health.
What long-term health outcomes can we anticipate for children who have been in social care?
Authors: Straatmann V 
Published: October 2024

Abstract
The concept of cumulative disadvantage suggests that setbacks in one area of life not only lead to further challenges within that domain but also increase vulnerability to adversities across different domains, as highlighted in life course studies. In the context of children with a history of childhood social care (CSC) experience, research consistently shows poorer long-term health outcomes compared to peers without such experiences. This disparity persists into middle age and can affect subsequent generations, underscoring the enduring impact of early-life adversity. Dr Viviane S. Straatmann, a social epidemiologist based in Sweden and enriched by her experience in studying the health and social life of vulnerable children in diverse international settings, will offer insights from life-course and intergenerational epidemiological studies. She will explore the intricate web of disadvantages preceding children’s entry into social care, shedding light on the complex interplay between early-life adversity, cumulative disadvantage, and long-term health outcomes. Participants will engage in reflective dialogue on pertinent questions, such as how cumulative disadvantage informs interventions for children with CSC backgrounds, the potential mechanisms underlying the contribution of early-life adversities to long-term health disparities, and the ways intergenerational studies can inform strategies for breaking the cycle of disadvantage.