bluuebunny/crossref_metadata_2025_split huggingface dataset:
Uncovering the health system burden of pneumococcal infections in adult and elderly populations
Authors: Desson Z , Levi J , Margheri F 
Published: October 2024

Abstract

Background
Health system resources dedicated to vaccination and infectious disease prevention are often directed towards infants and children, through extensive childhood vaccination schedules. This focus has led to the near eradication of several preventable childhood diseases and had positive impacts on population health, but despite this track record of success, the ability of our health systems to make vaccinations accessible throughout the full life course has been less consistent. This project aims to address this issue by providing new data about the burden that pneumococcal infections, which are vaccine-preventable, have on adult and elderly populations.

Methods
This research aims to uncover the health system burden of invasive pneumococcal disease and pneumococcal pneumonia at all levels of the health system in 5 EU countries (Austria, Belgium, France, Italy & Portugal). This involves a survey of managers and care providers working in hospitals, long-term care facilities, and primary care centres who may be affected by the health system impacts of pneumococcal infections. The survey covers several dimensions of health service delivery to collect a broad range of data on existing disruptions. The survey was translated into the study country languages and its formulation was further validated through interviews with experts in each study country to ensure that it can capture context-specific health system insights. The data collected through this survey will be further enhanced through a series of in-depth interviews before being synthesised, analysed and eventually published in a detailed report.

Results
Data collection begins as of 15 May 2024, and full results are expected to be published and available for the EPH Conference in November 2024. The results of this research will offer valuable evidence to public health professionals, health managers and policy-makers across Europe who are working to improve life-course access to pneumococcal vaccination.

Key messages
• Effective vaccination programmes for adult and elderly populations require expanding focus beyond childhood.
• Data about the health system burden of pneumococcal infections in adult and elderly populations improves evidence-based decision-making and public health services.
Infectious disease prevention among internally displaced people: Perspectives from Lviv, Ukraine
Authors: Shumylo K , Ivanchenko N , Kuziuk M , Aaronson W , Tomosky A M 
Published: October 2024

Abstract

Background
The ongoing war in Ukraine has increased the risk of infection spikes, especially among internally displaced people. The healthcare challenges in the war context necessitate teaching the population of preventative measures, which have become the primary vector of the activities of the Ukrainian Regional Centers for Disease Control and Prevention.

Objectives
The research aimed to highlight the activities of the Lviv Regional Center for Disease Control and Prevention (CDC) in relation to internally displaced people.

Methods
The research project analyzed the incidence rate of infectious diseases and vaccination coverage data among the population and internally displaced people in the region. The data were collected from monthly reports of CDC’s departments and alert messages sent by primary care institutions to the CDC.

Results
According to the Single register of internally displaced people (IDP), 13% of internally displaced people were permanently staying in the Lviv region (the second place was Zakarpattia region - 9% of IDP, and the third was Kyiv - 7% of IDP). In the Lviv region, 237,000 people registered as forcibly displaced. Total, over 700, 000 people are in the area, including the unregistered and 68,000 children. In 2022-2023, the morbidity rates among IDPs did not exceed the rates among the general population in the area. Each IDP residence place had its physician; 11 thousand IDPs were vaccinated, and 3,235 of those were children. In general, 46 mobile medical brigades worked on-site in the Lviv region. Only one spike of gastrointestinal infection was registered. CDC employees provided lectures and workshops on hygiene and food storage in 56 IDP residence places.

Conclusions
The review results show that coordination between CDCs, local physicians, and mobile medical brigades in the IDP residence areas prevents outbreaks of infectious diseases and swiftly responds to emerging threats.

Key messages
• The tragic events in Ukraine resulted in healthcare access issues. Lviv CDC, fighting at its own forefront, quickly assessed the risks and efficiently managed the potential hazards.
• The Lviv region remains one of the biggest hubs in Ukraine for the temporary residence of internally displaced people, with CDC employees ensuring that preventive measures are effectively carried out.
Social determinants and drivers of use of SARS-CoV-2 self-tests in a French national cohort study
Authors: Garnier S , Warszawski J ,   the EpiCov study group
Published: October 2024

Abstract

Background
Self-tests for SARS-CoV-2 became quickly available after the onset of the epidemic. They were especially recommended for high-risk and hard-to-reach populations. This study examines whether self-tests successfully reached vulnerable groups during first months of availability in France.

Methods
The EpiCov study is a national population-based cohort study conducted in France during the Covid-19 pandemic. Primary outcome variable was use of self-test at last SARS-CoV-2 test, among those who reported testing at least once between May-July 2021. Univariate and multivariate binomial weighted logistic regressions were run, stratified by age group (16-24 yrs, 25-59, 60+), to identify social determinants and drivers of use of self-tests.

Results
Overall, 11% of the population who tested for SARS-CoV-2 between May-July 2021 reported using a self-test as last test. Demographic factors were highly predictive of use of self-tests among 25-59 y/o, but not among younger and older age groups. Use of self-tests was highest among 16-24 y/o, people with higher education, lowest population density areas, and people with high overall frequency of testing. Use was lowest among 60+ y/o, unemployed and retired people, and first-generation immigrants. When stratifying by age, 16-24 y/o with high perceived Covid-19 risk were more likely to use self-tests (aOR 1.99, 95% CI 1.10-3.59). Among 25-59 y/o, in-person workers were more likely to use self-tests than remote workers (aOR 1.91 [1.20-3.05]). Among 60+ y/o, employed people were more likely than retired people (aOR 3.97 [2.30-6.85]).

Conclusions
With higher utilization in low population density areas and among frequent testers, convenience may be a primary driver of use of self-tests. Additional drivers include perceived risk among younger people and exposure at work for those ≥25 yrs. Inequities in use were observed, with lower use among people with low education, older age, and immigrants.

Key messages
• Use of self-tests in France during the Covid-19 pandemic was low among vulnerable population groups, including people with lower education, immigrants, and older individuals.
• Drivers of use included geographical access to healthcare services, perception of risk among younger respondents, and exposure at work among adults aged ≥25 years.
Cross-sectional study of bystander roles in school bullying incidents in the United Arab Emirates
Authors: Elkonaisi I , AlKetbi A , Abdullahi A S , AbuHamada B , Elbarazi I , Grivna M 
Published: October 2024

Abstract

Background
School bullying is a widespread public health issue with far-reaching consequences on the psychological well-being and academic performance of students. This study focuses on the perspective of bystanders to better understand their role in the dynamics of bullying in school environments in the United Arab Emirates.

Methods
We employed a multi-stage random sampling approach to collect data from students in grades 6 to 9 at the sample of public and private schools in Al Ain, using a validated self-report questionnaire. IBM SPSS software version 28.0 was used for the analysis using appropriate statistical tests.

Results
Out of 728 surveyed students, 290 (40%) were from private and 438 (60%) from public schools. A total of 425 (58%) of students were bystanders observing bullying incidents across all schools, with 65% of males versus 45% of females witnessing such events. Physical bullying was the most frequent type of bullying observed by 67% of students. The classroom was most often location, 75% in private schools and 61% in public schools. Verbal abuses such as making fun and name-calling were commonly reported. Bullying targeting physical appearance was particularly noted, with 31% of bystanders stating that bullying was due to perceptions of a student’s face being ‘funny’ and 21% due to beliefs about weight. 59% felt sad, and 29% didn’t go to school as a result of the bullying. Reporting to teachers was limited (25%).

Conclusions
The high prevalence of bystanders in school bullying incidents in Al Ain was observed, especially among male students. The results emphasize the critical need for comprehensive anti-bullying programs that include bystander intervention strategies to promote a supportive and inclusive educational environment.

Key messages
• Many of students are witnessing bullying, highlighting the need for effective intervention programs.
• Empowering bystanders is crucial in preventing bullying and enhancing the safety at schools.
Social support for women undergoing induced abortions in Belgrade, Serbia
Authors: Gazibara T , Dotlic J , Maksimovic N , Maksimovic J , Bila J , Tulic L , Stojnic J , Miloradovic M , Plavsa D 
Published: October 2024

Abstract

Background
Having an unwanted pregnancy requires social support to help women ease the stress and stigma of having an induced abortion. The study aimed to investigate the main providers of social support to women having induced abortions.

Methods
Women undergoing induced abortions from 2022 to 2024 in a University clinic in Belgrade were invited to participate. Data were collected using an anonymous questionnaire examining socio-demographic data of women and sources of social support.

Results
This study included 433 women out of which 50.1% informed their mothers about the abortion, 23.1% their fathers, 87.3% their partners, 42.3% their friends, and 1.6% women told no one about the abortion. A total of 40% of women were supported to undergo the abortion by their parents, 80.1% by their partner, 34.9% by friends, and there were 2.1% of women who did not get any support to perform abortion. There were significantly more (p = 0.001) mothers (163 vs. 54), fathers (87 vs. 13), partners (331 vs. 47), and friends (136 vs. 47) who were informed about the abortion and also supported women compared to those who did not provide support. Getting support for the abortion by the parents was associated with younger age, not being in a relationship, and not having children. Support of the partner was linked to older age, higher education, being unemployed, being married with more children, and having abortions previously. Being supported by friends or not being supported at all did not correlate with socio-demographic data of the investigated women.

Conclusions
Women are generally supported by their family and friends in their decision to have induced abortions. This study identified socio-demographic factors that impact the choice of principal supporting person when undergoing induced abortion.

Key messages
• Partners are the main source of social support for married women who had induced abortion.
• Parents are principal social supporters for single younger women undergoing induced abortion.
Youth insights on a digital crowdsourcing intervention to reduce HIV stigma in Kazakhstan
Authors: Sun Y , Landers S E , Yang S , Mergenova G , Sarsembayeva L , Balabekova O , Davis A 
Published: October 2024

Abstract

Background
In Kazakhstan, nearly a quarter of new HIV infections occur among adolescents and young adults (AYA). Testing can reduce the spread of HIV, yet AYA have low testing rates in Kazakhstan, due in part to HIV-related stigma. This qualitative paper explores participants’ perceptions of digital crowdsourcing content designed to reduce HIV stigma and promote HIV self-testing among AYA in Kazakhstan.

Methods
We conducted semi-structured interviews with 20 AYA who participated in a digital crowdsourcing intervention. Questions focused on AYA’s perceptions of the crowdsourced content they viewed for the intervention, namely their likes, dislikes, the perceived impact of the content, and areas for improvement. Qualitative data analysis was conducted using a thematic approach.

Results
Findings revealed a perceived need for more youth-developed digital interventions. AYA favored artistic, interactive content featuring health specialists, youth characters, or real-life stories. Short videos and images were AYA’s favorite content formats. Many AYA showed less interest in longer videos and text-heavy content, finding them hard to understand. Most participants reported improved knowledge of HIV, reduced stereotypes related to HIV, heightened interests in HIV topics, more willingness to get tested, and changes of attitudes towards people living with HIV. Recommendations for future interventions include tailoring content to different AYA age groups and creating more engaging and easily digestible content.

Conclusions
This study highlights the potential of crowdsourced digital interventions in promoting HIV knowledge and awareness of HIV-related stigma among AYA in Kazakhstan. AYA appreciated youth-developed, interactive content that included real-life stories and artistic visual presentations.

Key messages
• This study highlights the potential of crowdsourced digital interventions in promoting HIV knowledge and awareness of HIV-related stigma among AYA in Kazakhstan.
• AYA appreciated youth-developed, interactive content that included real-life stories and artistic visual presentations.
Maternal health in conflict-affected settings: a case study from a frozen conflict zone
Authors: Agopian A , Musheghyan L , Sargsyan Z , Abrahamian D , Dorian A 
Published: October 2024

Abstract

Background
Reproductive, maternal, newborn and child health are negatively impacted in conflict-affected settings, and may be acutely affected in frozen conflicts due to fragile health systems and uncertain geopolitical contexts. To better understand maternal health in a frozen conflict zone, we examined maternal health outcomes in Nagorno-Karabakh during a ceasefire period prior to the forced displacement of the entire population.

Methods
Multistage cluster sampling was used to sample 1023 households in Nagorno-Karabakh during the summer of 2022. From each household, one woman, age 18 to 49, participated in an interviewer-administered survey. Maternal health outcomes were assessed among all married women who had ever given birth. Women with at least one child under 5 years were also asked about their most recent pregnancy.

Results
Among all married women, 85.5% had ever given birth, 19.0% ever had a miscarriage, and 2.8% ever had a stillbirth. Of the 299 women with at least one child under 5, 97.7% received antenatal care, of which 90.4% had at least 4 visits. Over half experienced toxicosis (51.8%), 16.4% high blood pressure, 13.0% anemia, and 6.4% hemorrhage during their most recent pregnancy. The most common delivery complications were uterine scarring (19.7%), breached birth (7.0%), prolonged labor (6.4%) and hemorrhage (5.7%). Age was found to be a significant factor, with the odds of toxicosis (p = 0.039) and breached birth (p = 0.009) decreasing, yet the odds of miscarriage (p = 0.001) and hypertension (p = 0.007) increasing with age.

Conclusions
Almost all women reported adequate antenatal care with birth outcomes comparable to global statistics, demonstrating the ability of Nagorno-Karabakh to provide sufficient maternal healthcare while in a frozen conflict. Fortifying and ensuring access to maternal and reproductive healthcare, particularly antenatal care, is vital for ensuring the health and wellbeing of women and children in conflict-affected settings.

Key messages
• Women in Nagorno-Karabakh received antenatal care and experienced birth outcomes similar to global rates, demonstrating the value of access to reproductive healthcare in conflict-affected settings.
• Future studies should examine the impact of forced displacement on the women of Nagorno-Karabakh to better understand the effect of conflict on reproductive and maternal health.
Generalised and visceral obesity metrics and ankle-brachial systolic blood pressures during pregnancy
Authors: Giannakou K , Fakonti G , Kyprianidou M , Viswambharan H , Kain K 
Published: October 2024

Abstract

Background
Increased body mass index (BMI) (generalised obesity) and waist-to-height ratio (WHtR) (visceral obesity) are associated differently with brachial and ankle blood pressures in the general population. Ankle blood pressures are associated with blood glucose in pregnancy. This study investigates the relationship between BMI and WHtR with the brachial and ankle blood pressures separately during pregnancy.

Methods
Pregnant women were recruited during antenatal visits at an antenatal clinic in Bradford Royal Infirmary, UK, and their BMI, waist circumference, systolic, and diastolic blood pressure were clinically measured by staff in the second trimester. Additionally, blood pressure readings from both arms (left and right brachial arteries) and ankles [dorsalis pedis artery (DP) and posterior tibial artery (PT) on both sides] were obtained using Doppler by research staff.

Results
A total of 179 women participated, with an average BMI of 28.5 Kg/m2 (SD = 4.97) and average WHtR of 0.61 (SD = 0.08). BMI exhibited a positive correlation with all blood pressure measurements (r = 0.165 to 0.419, p &lt; 0.05), while WHtR demonstrated significant correlations only with the right brachial, left PT, systolic and diastolic blood pressures (r: 0.170 to 0.271, p &lt; 0.05). Moreover, BMI significantly associated with all blood pressure measurements in linear regression models, after adjusting for various sociodemographic and other factors, whereas WHtR significantly predicted only right brachial and left PT and some of the other blood pressure measurements.

Conclusions
BMI, and to a lesser extent WHtR, are associated with both brachial and ankle blood pressure measurements during pregnancy. These findings underscore the importance of recognizing the varying impacts of cardiometabolic risk factors for early detection and management of potential complications in pregnancy and the postpartum period.

Key messages
• BMI & WHtR are associated differently with brachial and ankle blood pressures in pregnancy.
• Further exploration of combined non-invasive measurements like BMI, WHtR, brachial, and ankle blood pressures in early pregnancy for gestational diabetes mellitus and other co-morbidities is needed.
Use of specialist health care among Norwegian-born children with one immigrant parent
Authors: Kjøllesdal M , Helland Y , Sheikh N , Indseth T 
Published: October 2024

Abstract

Background
An increasing number of children grow up with one immigrant and one native born parent. We know little about health in this group. Our aim was to compare the risk of receiving diagnoses of physical health conditions in specialist health care among Norwegian-born children with one immigrant parent compared to Norwegian background children.

Methods
Data from Medical Birth Registry of Norway were linked to data from the Norwegian Patient Registry (diagnoses in specialist health care), and Statistics Norway (parental country of origin, education, and household income). We estimated hazard ratios (HR) with Cox proportional hazard regressions, with Norwegian background children as reference category, adjusted for sex, birth year, parental education, and household income.

Results
Children with an immigrant parent had lower hazards than Norwegian background children of diagnoses of most types of infections, but higher hazards of some, including tuberculosis, and skin infections. They also had higher hazards than Norwegian background children of receiving diagnoses of obesity and other nutritional deficiencies, and skin diseases, but lower hazards for other conditions, including chronic lower respiratory disease, disease of the digestive system, and visual or hearing impairment. The hazards of diagnoses of any neurological condition, sleeping disorders and epilepsy were lower among children with an immigrant mother, but higher among those with an immigrant father. Differences between children with one immigrant parent and Norwegian background could not be explained by differences in parental education or household income.

Conclusions
Children of one immigrant parent do not overall use specialist health care for physical health issues more than other children.

Key messages
• Awareness of diagnoses given most frequently to children of one immigrant parent can help promote timely diagnoses and adequate use of services, which is important for prevention of later illness.
• Barriers to health care use among children of immigrants should be further researched.
Neighborhood environment and falls: a longitudinal Japan gerontological evaluation study
Authors: Matsumoto Y , Hanazato M , Matsuoka Y , Chen Y R , Yoshida H , Matsumoto K , Kondo K 
Published: October 2024

Abstract

Background
Older adults who experience falls are at a high risk of injury and death and require long-term care. Notably, the risk of falls varies among different neighborhood environments. No prior longitudinal studies have examined the association between falls and neighborhood environment at the community level. Identifying such associations will help prevent people falling by improving their neighborhood environment. Herein, we aimed to identify neighborhood environmental factors associated with falls among older adults in Japan.

Methods
We analyzed the data of 27,346 older adults living in 416 communities who participated in the 2010, 2013, and 2016 Japan Gerontological Evaluation Study surveys. The dependent variable was the occurrence of falls in 2016, and the explanatory variables were the mean scores of each of eight community-level neighborhood environment variables, categorized into tertiles (high, middle, and low groups) in 2013. Our model was adjusted for covariates (e.g., sex, age, and socioeconomic status) using the variables from 2010. A multilevel Poisson regression analysis was performed to obtain the relative risk (RR) and 95% confidence interval (CI) between the neighborhood environment and falls. Missing variable values were supplemented by multiple imputations.

Results
Older adults living in neighborhood environments with more parks or foot paths suitable for exercise or walking had a lower risk of falling after 3 years compared to those living in neighborhood environments with fewer parks or foot paths (RR: 0.89; CI: 0.80-0.99). For the variable ‘locations difficult for walking, such as hills or steps’, older adults in the middle group had a lower risk of falling than those in the low group (RR: 0.94; CI: 0.88-0.99).

Conclusions
Parks or foot paths are important environmental improvements that may prevent falls. Having hills or steps in the neighborhood could be beneficial when properly integrated into the environment.

Key messages
• Older adults with access to parks, footpaths, and challenging terrains suitable for exercise and walking, had a lower risk of falling.
• These findings could be applied in urban designs to prevent falls among older adults.