bluuebunny/crossref_metadata_2025_split huggingface dataset:
Maternal healthy lifestyle score and psychological well-being: secondary analyses of the PEARS RCT
Authors: Philippe K , McAuliffe F M , Phillips C M 
Published: October 2023

Abstract

Background
The associations between lifestyle behaviours and well-being are still poorly understood, particularly in the antenatal period when women are potentially exposed to increased stress and anxiety. Moreover, lifestyle behaviours have often been investigated individually, while a Healthy Lifestyle Score (HLS) comprising low-risk protective lifestyle behaviours can be useful for studying links between overall lifestyle and health and psychosocial outcomes. Therefore, our aim was to study associations between maternal HLS in early and late pregnancy and psychological well-being. We focused on women with overweight and obesity (OWOB), as they may be at higher risk of psychosocial vulnerability.

Methods
Secondary analyses were conducted with data from the PEARS (Pregnancy Exercise And nutrition Research Study) trial, a randomized controlled trial of a diet and exercise lifestyle intervention with smartphone application support to prevent gestational diabetes. HLSs (scored 0-5) based on information about maternal diet (AHEI-P), exercise (MET-minutes), alcohol consumption, smoking, and sleep habits were created for 334 and 289 mothers in early (14-16 weeks gestation) and late pregnancy (28 weeks gestation), respectively. Higher HLSs indicate a healthier overall lifestyle. Correlations and regression analyses examined HLS associations with well-being (WHO-5, scored 0-100) in early and late pregnancy.

Results
Mean pregravid BMI was 29.2. Mean well-being score was 56.3 in early and 60.7 in late pregnancy. In early pregnancy, 18% of mothers scored 0-2 on HLS, 35% scored 3, and 47% scored 4-5. In late pregnancy, this was 27%, 34% and 39% respectively. Preliminary results show significant positive associations between HLSs and well-being at both time points (r's ranging between 0.16 and 0.29, all p &lt; 0.05).

Conclusions
Higher adherence to healthy lifestyle behaviours in mothers with OWOB was linked with higher well-being throughout pregnancy.

Key messages
• Many pregnant women with OWOB do not adhere to a healthy lifestyle.
• Well-being and a healthy lifestyle are related throughout pregnancy.
Addressing influenza outbreaks in schools
Authors: Sá R , Garganta S , Borges C , Correia M , Emilio D , Rodrigues A P 
Published: October 2023

Abstract

The Public Health Unit (PHU) of Albufeira received a communication from the director of the a public school about the occurrence of flu-like symptoms in a large number of students. No response protocols were in place for laboratorial analysis and control measures in this specific situation. The PHU started the necessary procedures to assess the situation and act according to the information obtained. In collaboration with the school, control measures were implemented, a communication network was established, and informative materials, such as leaflets, on preventive measures against the flu were produced and distributed, as well as pediatric masks and hand sanitizer. In partnership with the national network of sentinel flu doctors, five nasopharyngeal samples (three students, one teacher, and one parent) were also collected for laboratory analysis. Epidemiological investigations have identified 4 confirmed cases of influenza B, 17 probable cases, and one case with missing information. The attack rates were found to be high, with 95% of both students and teacher becoming ill. The research findings indicate that a majority of students exhibited symptoms consistent with flu infection, with fever and cough being the most prevalent. In addition, one parent was tested at the school and was also diagnosed with influenza B, indicating the spread of the virus within the community. Gaps were identified in the scope of public health, including the lack of outbreak response protocols and an effective communication network with schools. In order to address these shortcomings, it is intended to develop action protocols for outbreak scenarios in the school environment and establish a closer response between public health services, and the school community. The innovative approach of the Albufeira PHU can serve as a model for other settings and countries.

Key messages
• Effective collaboration between healthcare providers and schools is essential to mitigate the impact of infectious disease outbreaks in the school environment.
• The development and implementation of outbreak response protocols is critical to ensure a coordinated response to infectious disease outbreaks.
Attitudes towards vaccination and HPV vaccine uptake among Croatian university students
Authors: Miskulin I , Dumic L , Pavic Z , Miskulin M , Dumic J , Simic I 
Published: October 2023

Abstract

Background
The attitudes that underlie vaccine hesitancy are important for predicting individuals’ vaccination behaviour but also for developing effective public health interventions. This study aimed to investigate attitudes towards vaccination among Croatian university students and to evaluate its possible association with human papillomavirus (HPV) vaccine uptake in the same population.

Methods
This cross-sectional questionnaire study was conducted from February to May 2021 period. A validated, anonymous questionnaire that contained questions regarding demographic data, data about HPV vaccine uptake, as well as the Vaccination Attitudes Examination Scale (VAX scale) was self-administered to a cross-faculty representative student sample of the University of Osijek in Eastern Croatia. The higher scores on the VAX scale reflect more negative attitudes toward vaccination.

Results
The study sample included 840 subjects with, a median age of 20 years (interquartile range 20-21), 45.8% males, and 54.2% females. The median VAX scale score was 39.0 (interquartile range 32.0-46.0). The prevalence of vaccination uptake in the studied population was 20.8%. The more negative attitudes towards vaccination were found in students who studied within the scientific area of the social sciences (p &lt; 0.001), students who had a lower average grade of study (p &lt; 0.001), and students who were not vaccinated against HPV (p &lt; 0.001).

Conclusions
The Croatian university students had rather negative attitudes towards vaccination probably reflected by the observed HPV vaccine uptake in this population. Identifying factors that influence general attitudes towards vaccination in the studied population would enable the design of more adequate public health interventions intended to promote HPV vaccine uptake.

Key messages
• Croatian university students have shown strong general vaccine hesitancy as well as low HPV vaccine uptake.
• Better understanding of the attitudes that underlie vaccine hesitancy is important for developing public health interventions created to increase HPV vaccine uptake among Croatian university students.
Trends in incidence of main types of cancer in Bulgarian women (2010-2021)
Authors: Grancharova G , Aleksandrova-Yankulovska S , Draganova M , Saleva M , Anov A , Statev K , Seizov A , Stateva A 
Published: October 2023

Abstract

Background
The burden of cancer worldwide is increasing. In Bulgaria, a biggest problem concerns the cancers of women genital system and breast cancer. The aim of this survey is to analyze the recent trends in cancer incidence related to women genital system and breast cancer and to formulate appropriate conclusions.

Material and methods
The information for this descriptive study was retrieved from population-based cancer data collected by the National Center of Public Health and National Statistical institute. We analyzed the trends in incidence rate (per 1000000 of different types of cancer in women for 2010-2021. Data processing was performed by Microsoft Excel 2016 and IBM SPSS Statistics v.24.

Results
Since 1980 the incidence rate of cancer in Bulgaria has double - from 232.7 per 100000 to over 400 with the highest levels in 2011(448.7), 2013 (461.9) and 2015 (447.2). A slight decrease was observed in 2020-2021 related to lower visits to specialists during the COVID-19 pandemic. Since 2010 the highest incidence rates were registered for breast cancer (101.5 in 2013 and 103.5 in 2015) with no trend to decrease. The new cases of breast cancer account for about 11% of all new cancer cases (10.8% in 2019; 11.5% in 2021). These figures coincide with the average rates in EU-27. Cancer of the uterus takes the second rank. Its rate didn't change significantly during the last decade (varying around 30-31 per 100000). Cervical and ovarian cancers rank third and fourth. They both show slight trends of decrease since 2016: for cervical cancer - from 27.2 per 100000 to 22.5 in 2021; for ovarian cancer - from 20.4 to 15.7 per 100000 women.

Conclusions
Cancers of the genital system and breast cancer account for a large proportion of all new cancer cases in Bulgaria. The heavies burden belongs to cervical cancer and cancer of the uterus. Strong changes in policy actions are needed to tackle with the burden of cancer and to increase the effectiveness of preventive measures.

Key messages
• Bulgaria is among countries with very high incidence rates of cancer among women population, especially incidence rates of breast cancer, cancer of the uterus and cervical cancer.
• Due to economic and political instability, Bulgaria doesn’t have an effective national policy to cope with cancer. National Plan to Fight Cancer was published in 2022 but it is still a project.
Factors influencing the implementation of the EU School Milk Scheme in Irish primary schools
Authors: Greene E , Hunt E , Kilduff O , Murrin C 
Published: October 2023

Abstract

Background
Adequate calcium intake in childhood is essential in optimising peak bone mass, however, children's milk consumption is decreasing in Ireland and in other developed countries. The School Milk Scheme (SMS) promotes children's milk consumption by providing subsidised milk to schools. It is managed by the National Dairy Council in Ireland, who also design and distribute accompanying educational resources. The aim of this analysis is to identify the factors influencing the implementation of the SMS in Irish primary schools.

Methods
This research was conducted as part of an evaluation of the EU School Fruit, Vegetables and Milk Scheme in Ireland. Process evaluations of the implementation of the SMS were conducted through direct observation. Observational data were triangulated with data from feedback questionnaires, collected among school staff members, parents and children in 1st, 3rd and 5th class. Quantitative data were descriptively analysed. Qualitative data from observations and interview comments were coded deductively to domains of the Theoretical Domains Framework (TDF).

Results
SMS implementation was observed in eight schools. Questionnaires were completed by 15 staff members and 50 parent-child dyads from 17 schools. Factors influencing implementation of the SMS were identified across 10 TDF domains. Teachers’ awareness of the SMS educational resources was the most common barrier to their use. Reliability of milk deliveries and having adequate storage for the refrigeration of milk were key factors in influencing programme implementation and acceptability of milk among children.

Conclusions
This analysis identified a range of barriers and facilitators to the implementation of the SMS in Irish primary schools. Teachers are key stakeholders in the delivery of the SMS, highlighting the importance of clear communication between intervention managers and primary school staff members in supporting the implementation of the educational component of the SMS.

Key messages
• This analysis identified areas in which further support may be necessary for the future implementation of the SMS in Irish primary schools.
• The factors identified across 10 domains of the TDF may also be applicable to other dietary interventions implemented in school settings.
Experiences of menstrual health and hygiene in humanitarian and emergency settings
Authors: McCarthy L J , Roura M 
Published: October 2023

Abstract

Background
Menstrual health and hygiene is a crucial area of research, increasingly recognised as a public health and human rights issue. Still, the menstrual health and hygiene needs of some of the most disadvantaged groups, including populations in humanitarian and emergency settings are often unmet.

Aims
To examine through a sustainable development goal lens the current state of knowledge about menstrual health and hygiene needs, as experienced by populations in humanitarian and emergency settings.

Methods
Eligible studies were identified through systematic searching in PubMed, Embase, and Web of Science between March and July 2022, using a combination of terms relating to the experience of menstruation in emergency contexts. Included studies reported the lived experience of menstrual health and hygiene in humanitarian settings and presented qualitative findings. A conceptual framework connecting menstrual health and hygiene and sustainable development goals was employed to extract and analyze data. A qualitative meta-analysis approach was employed to aggregate and synthesize qualitative data.

Results
Eleven studies were included for review. Studies were conducted in Asia (n = 6), Africa, (n = 4), and Europe (n = 1) following natural disasters (n = 2), and in refugee camps among populations fleeing war or conflict (n = 9). Findings indicate an interconnection between menstrual health and hygiene and twelve sustainable development goals. Menstruation was reported as a negative experience. Barriers to adequate menstrual health and hygiene had significant commonalities despite geographical locations. Drying of menstrual products was reported as the most common barrier.

Conclusions
Menstrual periods do not cease to occur during conflict or natural disasters. The interconnection between experiences of menstrual health and hygiene and sustainable development goals should be considered if no one is to be left behind.

Key messages
• This review examines the lived experience of menstruation in populations in humanitarian and emergency settings, through a sustainable development goal lens, addressing a gap in the literature.
• This review identifies barriers to menstrual health in humanitarian and emergency settings, highlighting how they may facilitate or hamper progress in achieving numerous sustainable development goals.
Air pollution costs in Western Balkans’ cities
Authors: Belis C , Matkovic V , Ballocci M , Jevtic M , Millo G , Mata E , Van Dingenen R 
Published: October 2023

Abstract
Poor air quality is responsible for increased risk of mortality which global cost in in 2019 was associated with 4.1 million premature deaths globally. The Western Balkans were selected for this study because the levels of particulate matter and ozone are frequently above the EU Air Quality Directive guidelines. Air pollution health impact (mortality and morbidity) assessment was carried out using the attributable fraction approach based on different relative risk attribution methodologies: concentration response functions (CRF) and integrated exposure responses (IER). Air pollution costs were estimated using the value of statistical life (VSL) and the value of life year (VOLY) attributable to air pollution obtained with the benefit transfer method (BT) from a global database of non-market welfare-based unit costs. The health impact and related external costs attributable to air pollution in 2019 were assessed in 30 urban areas of the Western Balkans region, one of Europe's air pollution hot spots. The evaluation was based on PM2.5, O3 and NO2 concentrations in 2019. The average cost of mortality attributable to PM2.5 in 26 urban areas was above 200 million Euro per city while the ones of O3 and NO2 were 4 times lower than PM2.5. The study results suggest that the economic burden of air pollution per capita and compared to the GDP in the Western Balkans is higher than the one observed in EU27 in the same time window.
Depressive/Anxiety Disorders in People with Early Onset Dementia in South Korea
Authors: Kwon K J , Jo J Y , Cho J H , Choi E H , Yuk H S , Yeob K E , Kim S Y , Park J H 
Published: October 2023

Abstract

Background
Early-onset dementia (EOD) relatively occurs at a young age. We know that the burden of family care and difficulties in economic activities greatly affect not only EOD but also the family. However, the healthcare policy for EOD is still less than that for late-onset dementia (LOD). In addition, there are few studies on mental disorders of EOD using national data in South Korea. We aimed to analyze the current status of depressive/anxiety disorders in EOD using national data and provide basic data for establishing EOD mental healthcare services and policies.

Methods
A total of 3,882,915 EOD and LOD with depressive/anxiety disorders were compared for gender, residential area, health insurance premium, and type of insurance using NHIS DB (National Health Insurance Service Database) from 2016 to 2021.

Results
There were differences according to socio-economic demographic factors for both depressive/anxiety disorders. During the observation period, the diagnosis rate of depressive/anxiety disorders in EOD was higher than LOD. After adjusting for gender, residential area, health insurance premium, and type of insurance, the risk of depressive disorder was 1.87 times higher (i.e., EOD higher, adjusted odds ratio [aOR]: 1.87, 95% confidence interval [CI]: 1.78-1.95) among EOD compared to LOD. The risk of anxiety disorder was 1.24 times higher (aOR: 1.24, 95% CI: 1.16-1.32) among EOD compared to LOD.

Conclusions
During the observation period, the diagnosis rate and risk of depressive/anxiety disorders in EOD were much higher than LOD. Therefore, this study suggests that mental healthcare services for EOD should be provided, treatment burden and economic difficulties should be reduced, and additional research on preventing and treating mental disorders should be conducted.

Key messages
• The diagnosis rate and risk of depressive/anxiety disorders in EOD were much higher than LOD.
• The healthcare policy for EOD is still less than that for LOD.
The effectiveness of school based interventions to prevent psychotic experiences over a year period
Authors: Staines L 
Published: October 2023

Abstract

Prevention is a key step to improving public mental health. Psychotic experiences, transient hallucinations/delusions which occur outside of a psychotic disorder, are relatively prevalent in the general population, particularly in childhood (∼15%) and adolescence (7-8%). They are associated with high psychopathology, increased risk of mental disorders, and suicidal behaviours. Therefore, psychotic experiences are well-placed to be used as a “marker” for prevention interventions. Current knowledge on prevention of psychotic experiences is extremely limited, with one previous study. With such limited information, but such potential benefits, we opted to conduct a secondary data analysis to test three school based interventions for their potential efficacy at preventing psychotic experiences. This study used the Saving and Empowering Lives in Europe study, Irish site (n = 1096). The interventions were a teacher training intervention, an educational tool, and a universal mental health screener and selective referral system (ProfScreen). A minimal intervention arm was used as a control. Schools were randomly assigned to one of the arms, and the students were followed over a year period. ProfScreen showed a 12-month reduction in point prevalence in psychotic experiences. This intervention was also associated with prevention of incident psychotic experiences, and a reduction in depression and anxiety scores in those with psychotic experiences. Ours is the first study to look at school based interventions for psychotic experiences, offering promising evidence for universal screening and selective referral strategies. Notably, the intervention showed improvements for all students in that sample, not just those who attended the clinical referral. This suggests that universal screening may itself support better mental health, and may be an important integrative component to improving mental health at a population level.

Key messages
• Psychotic experiences are a valid marker of vulnerable youth, and prevention of psychotic experiences in schools is possible using a universal screening and selective referral intervention.
• Regardless of if the child was referred/attended services, overall mental health rates improved in this arm, suggesting a universal mental health screening tool in schools itself may be valuable.
Health anxiety and COVID-19: examining changes before and during the pandemic
Authors: Davis Norbye A , Hoftun Farbu E , Terjesen C L , Fleten N , Höper A C 
Published: October 2023

Abstract

Background
Health anxiety has been expected to increase as a consequence of the COVID-19 pandemic. However, few longitudinal studies have examined health anxiety in the general population during this period. The aim of this study was to longitudinally examine health anxiety before and during the COVID-19 pandemic in an adult, working population in Norway.

Methods
We included 353 participants aged 18-70 years with two or more measurements of health anxiety (743 measurements) from the pre-pandemic period (2015 to 11.03, 2020) and/or during the COVID-19 pandemic (12.03, 2020 - 31.03, 2022). We measured health anxiety with the revised version of the Whiteley Index-6 scale (WI-6-R), and the effect of the COVID-19 pandemic on health anxiety scores was estimated with a general estimation equation analysis. Age, sex, education, and friendship were included in subgroup analyses.

Results
We found no significant change in health anxiety during the COVID-19 pandemic compared to the pre-pandemic period in our adult, working population, with a non-significant change of 0.06 points on WI-6-R (95 % CI -0.34 - 0.46). No significant effect of the COVID-19 pandemic on health anxiety scores was found in any subgroup analysis.

Conclusions
Health anxiety remained stable, with no significant change observed between the pre-pandemic period and the first 2 years of the COVID-19 pandemic in an adult, working population in Norway. This corresponds to other longitudinal studies examining mental health in general during the pandemic. The implications from our study can add to public health decision-making and prioritising of healthcare support in times of pandemics, where other consequences of COVID-19, such as social and economic burdens, may require targeted intervention over anxiety about health.

Key messages
• Health anxiety in an adult, working population remained stable during COVID-19.
• Other consequences of the pandemic may require targeted intervention over anxiety about health.