bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge and attitudes towards vaccination in the Croatian adolescent population
Authors: Miskulin I , Pavic Z , Miskulin M , Matic Licanin M , Lanc Curdinjakovic V , Zukanovic G , Pavlovic O 
Published: October 2023

Abstract

Background
Adolescents are a large and vulnerable group for infectious and other diseases. A good insight into their specific needs and their understanding of disease and prevention is necessary to adapt vaccination strategies for this population subgroup characterized by constant change and evolution. This study aimed to explore knowledge and attitudes about vaccination among the Croatian adolescent population.

Methods
This online cross-sectional questionnaire study was conducted from January 2021 to April 2021 in a convenient sample of adolescents from the northwestern part of Croatia. The knowledge was assessed through a specially designed validated questionnaire. The Vaccination Attitudes Examination Scale (VAX) was used to assess attitudes towards vaccination in the study population, where the higher scores on the VAX scale reflect more negative attitudes toward vaccination.

Results
The study included 1012 adolescents (29.2% males and 70.8% females). The median age of all subjects was 17.0 (interquartile range 17.0 - 18.0) years. According to the knowledge, there were 29.5% of students with poor, 53.9% of students with average and 16.6% of students with good knowledge about vaccination. The median VAX scale score was 50.0 (interquartile range 43.0-59.0). Male adolescents more frequently had poor knowledge about vaccination (P = 0.028), while female adolescents had more negative attitudes towards vaccination (P = 0.001). The study revealed that there was a positive correlation between poor knowledge and more negative attitudes towards vaccination in the studied population (P &lt; 0.001; rs = 0.260).

Conclusions
The study showed that a large proportion of Croatian adolescents have poor knowledge about vaccination and negative attitudes toward vaccination. Public health programs specially designed for this vulnerable population subgroup are needed to successfully tackle observed negative indicators.

Key messages
• Public health interventions directed towards the suppression of negative attitudes about vaccination must involve younger population subgroups, such as adolescents.
• Positive attitudes as well as better knowledge about vaccination among adolescents are crucial preconditions for adequate vaccination coverage.
Impacts of climate change and environmental pollution: a public health foresight study
Authors: Staatsen B , Betgen C , Strak M , Houthuijs D , Limaheluw J , Hall L , Mulder Y 
Published: October 2023

Abstract

Background
In the Netherlands, the National Public Health Foresight Study (PHF) is published every 4 years, as starting point for national and local public health policy development. A priority topic in the PHF2024 is climate change and living environment. The important transitions (energy, food, mobility, housing) that are required all require space and thus pose a societal challenge for the future quality of the living environment.

Approach
We use a mixed method approach to identify main trends and impacts on public health:
- analysis of Demographic, Economic, Socio-cultural, Technological, Ecological and Political developments (DESTEP) based on a literature review and expert consultation;
-organization of focus group discussions with young people (N = 41);
-analysis of mortality data in relation to temperature;
-evaluation of trend-scenarios.

Results
Direct and indirect health impacts of climate change will become more visible in the next 30 years. These need not all be negative. For example, an earlier edition of the PHF already showed that the increase in temperature may lead to less deaths in winter but more deaths in summer. In the PHF we will focus not only on adverse health consequences, but also identify opportunities for health improvement through climate mitigation and adaptation. Similarly we will look into related developments like energy and mobility transitions, that may (partly) result in health gains, depending on how they will be implemented and who will be affected. For example, we will look into possible improvement of air quality and its impact on health. The preliminary findings of our focus group study suggest, however, that young people are mostly pessimistic regarding developments in our living environment. This is particularly the case for climate change; young people fear that this may cause severe events. Nevertheless, they have high expectations regarding technological advancement in the energy sector.

Key messages
• Foresight studies should not focus on risk alone but also identify possible health promoting developments in the living environment.
• Expert views and views of lay people, in particular youth, may not necessarily be identical. Both need to be addressed in foresight studies.
Using indoor temperature in heat health warning systems: Deployment in community housing in Canada
Authors: Oetomo A , Kaur J , Wang K , Berry P , Butt Z , Morita P 
Published: October 2023

Abstract

Background
Heat waves are a major global public health concern and present a significant challenge to society, especially to underserved populations and those aged 50+, due to their increasing frequency and intensity. They also add significant burdens to the healthcare system's resources, and it has been shown that most deaths occur indoors. Still, our warning systems are based on outdoor temperature measurements. We developed a real-time indoor temperature alert ecosystem to capture indoor temperatures that may aid in assessing and responding during a heat wave.

Methods
We placed ecobee thermostats into homes with community housing partners and local health authorities (N = 70), recorded indoor temperature data in near real-time, and administered three surveys during the study period. We investigated: (i) indoor temperatures trends during the heatwave season of 2022 in Vancouver and Ottawa, Canada; (ii) behaviours of participants during the study; (iii) housing characteristics; (iv) delivery of time-sensitive temperature alerts to enable check-ins, and (v) perceptions to heat risk and methods of communication.

Results
Initial results show different observations that include: a) unsafe indoor temperatures were reached and persisted (&gt;26 °C and 31 °C) despite a milder heat wave season (in British Columbia); b) gaps in understanding of best practices to stay safe exist; c) home characteristics increase risk of overheating; d) coordinating check-in can protect individual health; and e) ensure individuals are protected during extreme heat events. Results suggest that indoor temperature provides vital information to inform heat health response plans.

Conclusions
The smart thermostat technology can be retrofitted into homes in Canada as it is commercially available. This study presents a scalable solution for monitoring indoor temperatures; it demonstrates they can be used to monitor indoor temperature exposure conditions to prevent deaths during extreme heat events.

Key messages
• This study presents a scalable solution for monitoring indoor temperatures, demonstrating how smart thermostats can monitor indoor temperature conditions to prevent deaths during extreme heat events.
• Indoor temperatures pose significant risks to health; this study seeks to understand indoor temperature exposures to guide public health resource allocation during extreme heat events.
The silent support marathon: men’s role and experience in pregnancy after prior pregnancy loss
Authors: Koert E , Schmidt L , Nielsen H S 
Published: October 2023

Abstract

Introduction
Pregnancy loss (PL) occurs in ∼25% of pregnancies. The negative psychosocial impact of PL on women is well documented and there is growing evidence that men are negatively impacted as well. After a PL, most couples try to become pregnant again. In a subsequent pregnancy, both partners report feeling anxious about the safety of the new pregnancy and worried about miscarrying again. After PL, partners are the main source of support for women but we know less about their role in a subsequent pregnancy. The research question that guided this abstract was: What is men's role and experience in a new pregnancy after prior PL?

Methods
Dyadic (joint) interviews were conducted with 15 couples over four time points in a new pregnancy after PL (once after pregnancy test, once in each trimester). The participants were recruited from a national cohort study of couples with PL in Denmark. Interviews were conducted in person or online. For this abstract, data specific to men's role and experience was extracted and analyzed using thematic analysis.

Results and analysis
An overall theme: “the silent support marathon” reflected the men's role as supporters of their pregnant partners. Men described a feeling of exhaustion and needing endless stamina to support their partners through the ups and downs of the conception and pregnancy process. They described internal pressure and perceived pressure from their partners to be the “strong” one. Being strong was both a coping strategy and a burden. Men coped by trying to remain optimistic about the pregnancy but also not getting their hopes up. Men also felt they were “silent” and their needs were invisible and unacknowledged by health care providers in the new pregnancy. They wished for tools and advice on supporting their partner and coping with their own worries and anxieties about the pregnancy. They wanted health care providers to acknowledge their role in the process and to take a “couple focused” approach.

Key messages
• Men play an important role in supporting their partner with the worry and anxiety in a new pregnancy after PL. However they are impacted by pregnancy worries as well.
• A couple focused approach is needed to promote overall family health and well-being.
Establishment of a social listening mechanism on refugee crisis
Authors: Timotin A , Mita V , Paladi A , Chihai V , Lozan O 
Published: October 2023

Abstract

Background
The Russian invasion of Ukraine in February 2022 captured the public attention. For the Republic of Moldova, a border country that sheltered the highest number of refugees reported to its local population, managing the refugee crisis became a challenge, including countering mis- and disinformation with major impact on public health. The paper aims to identify the social listening mechanism that allows to track rumors regarding the refugees crisis and propose recommendations for adapting public messages.

Methods
The Social Listening soft Talkwalker was used to monitor and identify conversations on the refugee crisis in the Republic of Moldova between September 2022-March 2023, by developing a search syntax (with a health focus on services, vaccination, Covid-19, etc.). A second step was a qualitative analysis of the messages and comments, with recommendations.

Results
A total of 131,5K of results were detected with a 1.1 million Engagement. The performance remained constant, with sporadic peaks (3 most evident) and decreases on weekend days. The net sentiment is negative (-25,8 %), being dominated by anger, followed by fear and sadness. In general, prevail messages of support for the Ukrainian people, but there are also harsh criticisms of the authorities. One of the propagated ideas is that too little is being done for the local population and more support is being shown for refugees. Netizens tend to comment or share material for expressing their political views. Posts about the refugee crisis (creating better conditions in maternity hospitals or employing refugees), are less popular than those about the military conflict as a whole. Potential stigma issues have to be analyzed regarding displaced persons from Ukraine.

Conclusions
Undermining trust in the authorities is a good opportunity for disinformation, that's why the subject should be fact-checked. Enhancing communication of public authorities is essential.

Key messages
• Refugee crisis have a major impact on public health and social listening help managing it effectively. The mechanism developed (including the search syntax) can be adapted for other countries.
• The research shows how monitoring conversations on social media regarding refugees can help authorities counter mis and disinformation and adapt their public messages.
A mixed methods evaluation of a digital antenatal quality improvement intervention in Nepal
Authors: Das S , Karmacharya B , Karki S , Shakya R , Shrestha A , Shrestha A , Penn-Kekana L , Radovich E , McCarthy O , Campbell O 
Published: October 2023

Abstract

Background
Quality antenatal care plays an important role in reducing maternal and perinatal mortality. Electronic decision support systems (EDSS) aim to promote adherence to evidence-based practices. The evaluation aimed to assess the effectiveness of the intervention on improving quality of antenatal care (ANC) and understanding of implementation process and intervention effects.

Methods
The study was conducted in primary health care settings in Nepal. Theory of change framework was used for mixed-method evaluation. Quantitative and qualitative data were collected at multiple time points. Data were integrated using concurrent triangulation to develop explanations about the implementation process and the observed effects.

Results
Guided by our theory of change, we identified eleven themes that help to understand how the EDSS was used in the real context, and why the EDSS was not much effective in bringing the desired changes that was required to improve quality of ANC. EDSS appear to slightly influence ANC staff behavior, however, training ANC staff in using the EDSS did not necessarily lead to confidence in using it and ANC staff used the EDSS as recordkeeping system. We found mixed evidence on ANC staff believe that the EDSS offers benefits to their work. Inflexibility of EDSS during ANC consultation caused difficulties adapting to women's need and challenging to integrate the EDSS in ANC staffs’ workflow and daily activities. Inadequate linkage of the EDSS with existing health systems impaired the EDSS guided clinical performance.

Conclusions
There is some indication that the EDSS have the potential to increase the quality of care. However, the EDDS alone are not enough to bring the adequate change in ANC staff delivery of quality care. Active participation of government and grassroot level understanding of health system would be essential considering conducting further research taking in account the resources, and other factors that hinders the EDSS utilization.

Key messages
• Concurrent triangulation helps to understand that digital health intervention is not enough to bring intended changes in the quality-of-service delivery at health facility.
• Understanding of context and ground reality is essential to improve the quality of care and enhance the performance of healthcare providers.
Justificatory explanations: a step beyond explainability in machine learning
Authors: Guersenzvaig A , Casacuberta D 
Published: October 2023

Abstract

AI systems may have many potential negative effects, so understanding how they generate results is important. AI explainability is a crucial but highly technical field that might be inaccessible to many experts in (public) health. We present a non-technical approach to the issue and is focused on the conceptual foundations for decisions made by developers and stakeholders during the system's lifecycle. To illustrate, imagine an app that tracks snoring to offer health recommendations. A classical explainability approach would be to evaluate the quality of the training dataset and the model itself. We argue that if we want to understand the system, we also need to look at the notion of “health” as it is its basic conceptual underpinning. We believe that these conceptual foundations as well as rich descriptions of goals and purposes that are pursued can be integrated into what we call ‘justificatory explanations'. These would illustrate how key concepts influence design and development decisions offering thus valuable insights into the workings and outcomes of the explained system. ‘Justificatory explanations’ are declarative statements written in plain language that provide a high-level account of the team's understanding of the relevant key concepts related to the project's main domain and how these understandings drive decision-making during the lifecycle stages. We propose that ‘justificatory explanations’ should be incorporated into the technical documentation that usually accompanies the release or deployment of a system. In short, ‘justificatory explanations’ complement other efforts around explainability by highlighting the reasons the person or persons designing, developing, selling and deploying the system consider to have plausible justificatory power for the decisions that were made during the project. This increased conceptual awareness may be beneficial to all, even to those without a background in mathematics, and data and computer science.

Key messages
• Explainability in AI should go beyond the data and the model to integrate design decisions.
• Justificatory reasons about the system should be provided in plain language.
Five years after the Earthquake and nuclear accident: Loss and its psychological effect
Authors: Tsuchiya Y , Tsujiuchi T 
Published: October 2023

Abstract

Background
On March 11, 2011, the Great East Japan Earthquake hit Tohoku. The Fukushima nuclear power plant accident forced many people to relocate, leaving their hometowns. This study focused on the sense of loss and its psychological effect on the people of Fukushima five years after the earthquake and nuclear accident.

Methods
Quantitative and qualitative analysis from a questionnaire survey including the IES-R scale and open-ended questions.

Results
1021 people participated in this study. At the time of the survey, 490 people relocated within Fukushima prefecture and 531 people left. During the nuclear accident, 632 participants were close to the nuclear power plant; 407 participants reported actual nuclear accident experiences such as exposure to blast ashes, seeing the explosion, hearing explosive sounds and escaping. People lost family members (n = 112) and homes (n = 338) due to the tsunami and earthquake; 439 lost jobs after the earthquake and 410 had economic difficulties; 736 reported their sadness over losing hometowns; 391 people showed IES-R scores over 25, suggesting potential PTSD (Post Traumatic Syndrome). From a multivariate analysis, psychological distress was significantly affected by nuclear accident experience (OR = 1.43, p = 0.04), lost jobs (n = 1.57, p = 0.01), economic difficulty (OR = 1.68, p &lt; 0.01), hometown loss (OR = 1.58, p &lt; 0.05), feeling difficulty living (OR = 3.84, p &lt; 0.01) and social isolation (OR = 1.74, p &lt; 0.01). For hometown loss, significant factors were lost houses (n = 596, p &lt; 0.01), friends (n = 590, p &lt; 0.05), life (n = 421, p &lt; 0.01), family relationships (n = 377, p &lt; 0.01), community (n = 403, p &lt; 0.01) and futures (n = 310, p &lt; 0.01). From qualitative analysis,”I relocated with the children, leaving behind my husband which I regret (a mother with children)” and others.

Discussion and conclusions
After natural disasters, nuclear accidents and wars, people suddenly lose their special monitoring and support are necessary for affected people.

Key messages
• Many people still suffer from PTSD after the Nuclear Power Plant accident after 5 years.
• Many people suffer from a variety of loss such as loss of hometown, friends, family and others due to migration from Fukushima.
Offspring hospitalization for substance use and changes in parental mental health in Finland
Authors: Bishop L , Almquist Y B , Pitkänen J , Martikainen P 
Published: October 2023

Abstract

Background
Prior research indicates that parental psychiatric disorders increase their offspring's risk of substance use problems. Though the association is likely bidirectional, the effects of an adult child's substance use on parental mental health remain understudied. We examined parents’ psychotropic medication use trajectories by parental sex and educational attainment following a child's alcohol- or narcotics-attributable hospitalization.

Methods
We identified Finnish residents, born 1979-1988, with a first hospitalization for substance use during emerging adulthood (ages 18-29, n = 12,851). Their biological mothers (n = 12,283) and/or fathers (n = 10,765) were followed for the two years before and after the hospitalization. Psychotropic medication use was measured in three-month periods centered around the time of child's hospitalization, and the probability of psychotropic medication use at each time point was assessed using generalized estimating equations logit models.

Results
Among mothers, the predicted prevalence of psychotropic medication use increased during the year before, peaked during the 0-3 months after hospitalization, and remained at a similarly elevated level until the end of follow-up. The prevalence among fathers increased gradually and linearly across follow-up, with minimal changes evident either directly before or after the hospitalization. Parents’ educational attainment did not modify these trajectories.

Conclusions
Our results highlight the importance of considering linked lives when quantifying substance use-attributable harms and underscore the need for future research examining the intergenerational spillover effects of substance use in both directions, particularly in mother-child dyads.

Key messages
• Adult children’s substance use has a detrimental impact on maternal mental health, irrespective of the mother’s socioeconomic position.
• The study highlights the importance of considering the intergenerational spillover effects when quantifying the burden of substance use-attributable harms.