bluuebunny/crossref_metadata_2025_split huggingface dataset:
Turnover Intention determinants of EU hospital doctors and nurses: results from the METEOR survey
Authors: Enea M , Maniscalco L , Boone A , Lavreysen O , Godderis L , de Vries N , de Winter P , Kowalska M , Szemik S , Matranga D 
Published: October 2023

Abstract

Background
To contrast effectively the shortage of healthcare workers in the EU, it is essential to find the determinants of the intention to leave the hospital (ITL) by analyzing the role of burnout (BO), job satisfaction (JS), and other individual characteristics and working-related variables. This study aims to estimate the prevalence of ITL for physicians and nurses in Europe, to investigate the determinants of ITL, and to suggest possible job retention policies.

Methods
The METEOR survey is a cross-sectional study on 8 hospitals of Belgium, The Netherlands, Italy, and Poland. Data collection was from May to September 2022. The theoretical model was the Job demands-resources model and validated questionnaires were used. ITL was assessed as agreement with the sentence “I intend to leave my current hospital for another one in the near future” and the response items were scored on a 5-point Likert scale. Two multivariable logistic models for ITL were estimated for both physicians and nurses, including JS, BO, and workers’ individual and hospital characteristics as covariates.

Results
The study included 381 physicians, and 1351 nurses. Physicians and nurses who agreed with ITL were 17% and 9%, respectively. Logistic models for physicians showed that by increasing JS (OR = 0.31, p &lt; 0.001) as well as age (OR = 0.91, p &lt; 0.001), and living with partner (vs alone) (OR = 0.56, p &lt; 0.039), the odds of ITL decreased. For nurses, the model revealed that by increasing JS (OR = 0.27, p &lt; 0.001), as well as age (OR = 0.97, p &lt; 0.001), and equipment (OR = 0.56, p &lt; 0.039), the odds of ITL decreased.

Conclusions
Our survey showed high prevalence of ITL for both nurses and physicians. Recruitment and retention policies, at the micro/meso/macro-levels are needed. It is strategic to support healthcare workers’ categories at higher risk of ITL, such as the younger physicians and nurses.

Key messages
• Our survey found significant individual and work environment characteristics playing a role to explain ITL.
• We provide an estimate of ITL prevalence of hospital physicians and nurses in EU.
HIV testing cascade among men who have sex with men at higher HIV risk in Serbia
Authors: Baros S , Simic D 
Published: October 2023

Abstract

Background
Successful HIV prevention requires motivation, access, and effective use by priority populations. Accessible and non-stigmatizing HIV voluntary counseling and testing (VCT) is the first step towards timely diagnosis. In Serbia, there is a concentrated HIV epidemic among men who have sex with men (MSM), with 49.2% of new diagnoses being detected late in 2021, based on initial CD4 cell count. We examined key aspects related to HIV testing among a high-risk sample of Serbian MSM to improve national HIV prevention guidelines.

Methods
A bio-behavioral cross-sectional respondent-driven sampling study among MSM in 4 cities in Serbia was conducted in 2021 (N = 1,300). We analyzed HIV testing among MSM who had unprotected anal sexual intercourse (UAI) in the last 12 months. The motivation pillar was operationalized as adequate knowledge of where VCT services can be obtained, the access pillar was operationalized as having ever had HIV testing, and the effective use of the VCT service pillar was operationalized as HIV testing in the last 6 months.

Results
Of all MSM reached, 63.8% had practiced UAI in the last 12 months, of whom 66.47% knew where to access VCT services. Of these, 88.9% had even been tested for HIV, yet only a quarter (25.5%) had been tested in the last 6 months. Therefore, only 15.1% of MSM who practiced UAI in the last 12 months had been recently tested for HIV.

Conclusions
HIV testing rate is high among Serbian MSM if they have adequate knowledge of where VCT services can be obtained. However, even though community-based VCT among MSM is subsidized by the Ministry of Health of the Republic of Serbia, the effective use of the VCT services is very low among high-risk MSM. This suggests that VCT service promotion must be transformed to be both visible and culturally sensitive to the Serbian MSM community. VCT protocols should also encourage regular testing (at least every 6 months) for those most at risk for HIV acquisition.
Enhancing men's awareness of testicular diseases: A feasibility trial and process evaluation
Authors: McCarthy M , Hegarty J , Davoren M , Dahly D , Shiely F , Harrington J , Shorter G , Murphy D , Cooke E , Saab M M 
Published: October 2023

Abstract

Background
Testicular cancer is the most common cancer in men aged 18 to 44 years. Symptoms of testicular cancer can mimic those of benign diseases like epididymitis and torsion. Men's awareness of testicular diseases is often lacking and their intention to seek help for testicular symptoms is sub-optimal. Athletes involved in field games like hurling are at risk for testicular trauma and diseases. The aim of the enhancing men's awareness of testicular diseases (E-MAT) study was to explore the feasibility of conducting a definitive trial to test the effect of E-MATVR (intervention; virtual reality [VR] game) compared to information delivered electronically E-MATE (control; information in PDF format) on testicular knowledge and self-examination among athletes.

Methods
In total, 74 participants were recruited from nine Gaelic Athletics Association (GAA) sports clubs in County Cork in Ireland using social media posts and posters. Participants were individually randomised to either E-MATVR or E-MATE. Outcomes were measured at T0 (baseline), T1 (immediately post-test) and T2 (3 months post-test).

Results
Testicular awareness increased significantly between T0 and T1 (p = 0.01) in both groups. Testicular awareness further increased at T2 for E-MATE participants. All participants in E-MATVR (n = 37, 100%) agreed that the VR headset was easy to use and that they were engaged to learn, while almost all E-MATE participants (n = 33, 89%) agreed with these statements. Most participants in both arms agreed that the time it took to complete the intervention was reasonable (p = 0.036). All participants were either extremely satisfied or somewhat satisfied with their overall experience of participating in the study.

Conclusions
VR may be effective in enhancing men's awareness of and help-seeking intentions for testicular diseases. A future definite trial is warranted to test the effect of E-MATVR.

Key messages
• VR may be effective in promoting the wellbeing of hard-to-reach populations, particularly among young men, to help raise awareness and promote testicular self-examination and early help-seeking.
• VR may help detect testicular diseases early, reduce treatment costs, and improve overall health outcomes.
Determinants of infectious disease-related knowledge among adolescents in Armenia
Authors: Sargsyan Z , Grigoryan Z , Harutyunyan T 
Published: October 2023

Abstract

Background
Adolescence is an important period of life, characterized by increasing level of responsibility and independent decision-making, hence it is crucial to explore the infectious disease (ID) related knowledge, which may affect lifelong healthy behavior and control over own health in adulthood. We assessed the level of knowledge for common IDs and explored associated factors among 15-17 years old adolescents in Armenia.

Methods
We conducted a survey among adolescents from three public and one private high schools from capital Yerevan and an adjacent province in 2023. The instrument included items on measles, HIV, TB, influenza, HPV, and socio-demographics. Summative scores were calculated for each ID knowledge, and the scores were combined for measles, HIV, and TB. Univariate and multivariable regression explored socio-demographics associated with each of the scores.

Results
Overall, 368 students completed the survey, most of them being females (64.4%). Nearly 85% have heard about measles and half of them knew that vaccination is the most effective preventive measure (44.5%). About 89%, 78%, and 29% of the adolescents heard about HIV, TB and HPV, respectively, and even few of them identified the correct paths for their transmission and prevention. Almost all (96.5%) heard about influenza, yet 44.1 % reported antibiotics being effective against it. The percent knowledge scores for measles-HIV-TB, influenza, and HPV were 39.7%, 56.3%, and 10.3%, respectively. In the adjusted analysis across all socio-demographics, only the private school type was associated with higher mean score for measles-HIV-TB (p &lt; 0.001), while no differences were found in relation other ID scores.

Conclusions
There is substantial lack of awareness about the most common infectious diseases among adolescents in Armenia. Targeted interventions should address the knowledge gaps among adolescents and promote safe infectious disease-related behaviors.

Key messages
• There is substantial lack of awareness about the most common infectious diseases (measles, HIV, TB, HPV, influenza) among adolescents in Armenia.
• Targeted interventions should address the infectious disease knowledge gaps among adolescents and promote safe infectious disease-related behaviors.
Parental oral health knowledge and plaque index of their children in rural communities of Armenia
Authors: Atanyan A , Muradyan D , Mkrtchyan M , Karbouian K , Paranjkhoo P , Yeretzian S T , Lylozian H , Demirchyan A 
Published: October 2023

Abstract

Background
While the prevalence of oral diseases in high-income countries is decreasing, the opposite is true in low and middle-income countries. Parental awareness about oral health has been shown to be an important contributor to children's oral health. This study evaluated the association between parental oral health knowledge and the oral health status of their children aged 6-10 years in two rural communities of Armenia.

Methods
This cross-sectional study included two main components: telephone survey among parents measuring sociodemographic, oral health knowledge, and behavioral variables, and clinical examination of children's oral health. Multivariable linear regression was used to identify the adjusted association between parental oral health knowledge score and children's oral health measured by plaque index.

Results
A total of 400 pairs of parents and children participated in the study. The mean plaque index among children was 3.1 (out of the maximum 5.0), demonstrating abundant coverage of teeth with plaque. The mean parental knowledge score was 6.9 (out of the maximum 9.0), indicating above-average oral health awareness. The items with the lowest proportion of correct responses were the belief that caries is preventable, the importance of daily flossing, and using fluoride-added toothpaste/water for preventing caries, with 75.1%, 60.4%, and 59.9% of correct answers respectively. The multivariable analysis found negative association between parental oral health knowledge score and children's plaque index (B= -0.24, p = 0.039), when controlling for other significant variables.

Conclusions
The study confirmed the importance of parental oral health knowledge for the oral health of their children and highlighted the knowledge gaps that should be addressed. The high prevalence of dental plaque among the children emphasized the need for complex interventions, including educational activities, preventive clinical procedures, and improved access to dental care.

Key messages
• In two rural communities of Armenia, there was a clear link between parental oral health knowledge and oral health status of their primary schoolchildren measured by plaque index.
• Well-focused educational interventions targeting parents of primary schoolchildren combined with children’s better access to dental care are recommended for improving their oral health.
Comprehensive Sexuality Education in Italy: results from a pilot activity, April 2023
Authors: Chinelli A , Galipò R , Meli P , Bellini S , Catucci N , Farinella M , Paparatto G , Musco A , Martinelli D , Tavoschi L 
Published: October 2023

Abstract

Background
Comprehensive Sexuality Education (CSE) is a key strategy to promote adolescents’ sexual and reproductive health (SRH) in school context. However, CSE is not part of Italian school curricula. This study, funded by the Ministry of Health, describes the preliminary results of a CSE pilot activity in upper secondary schools (USS), in 4/20 Italian regions, started in February 2023.

Methods
The pilot activity has been developed by an interdisciplinary team of academics, public health professionals and civil society organisations (CSOs) with expertise in SRH promotion in schools. It consisted of 5 interventions on the following topics: 1) adolescence and healthy relationships; 2) sexual identity and diversity; 3) sexual consent and contraception; 4) sexually transmitted infections (STIs) prevention and sexual health services; 5) insights into topics chosen by the students. The evaluation consisted of pre-post tests on knowledge and satisfaction.

Results
The results refer to preliminary analysis of 551 pre-tests, 443 post-tests and 329 satisfaction questionnaires. Knowledge significantly increased in 13/15 items investigated. Highest increment of correct answers was found in items related to HIV/AIDS treatment (+41.1%) and STIs symptoms (+37.5%). No increment was observed in items asking the meaning of empathy and stereotype. Among the pre/post-test open questions, “What is sexuality?” showed broader texts and less uncertainty in the post-test answers compared to the pre-test (9.1% vs 1.7%). 90% of students appreciated “very much” talking about STIs and 72% liked the possibility to talk to adults other than teachers.

Conclusions
This study represents one of the first attempts to provide evidence-based data to promote CSE in Italy. Early results reveal short-term positive outcomes (e.g. increased knowledge and decreased uncertainty). However, more data and advocacy are needed to support the introduction of CSE in Italian school curricula.

Key messages
• Comprehensive sexuality education is fundamental to promote sexual health among young people, especially in school context.
• Italy needs to develop and implement a standardised, evidence-based, comprehensive sexuality education intervention to be included in school's curricula.
Multimorbidity patterns in older migrants and natives across Europe
Authors: Jang S Y , Oksuzyan A , van Lenthe F J , Loi S , Myrskylä M 
Published: October 2023

Abstract

Background
Multimorbidity patterns in immigrants may differ from the native population due to their biological traits and experience in origin and receiving countries. This study addresses the descriptive patterns of multimorbidity by gender and immigration background and compares the prevalence of each multimorbidity pattern between immigrants and natives.

Methods
This study utilizes longitudinal data from the Survey of Health, Ageing, and Retirement in Europe (SHARE) from waves 2 to 8 in individuals aged 50 to 79 from 28 European countries. We estimate the prevalence of single chronic diseases and two-disease combinations. Further, we estimate the risk ratio of the estimated prevalence between immigrants and natives for comparison.

Results
This study finds varying multimorbidity patterns based on immigration background. Our results show that combinations including stomach ulcers or diabetes are distinctly more prevalent in immigrants than in natives for both genders, except for the “diabetes-cardiovascular” patterns among men. Further, we observe a higher prevalence of the “dementia-diabetes” combination among immigrant men at their younger ages, which eventually converges toward the native level in older age groups. However, these patterns of multimorbidity combinations in immigrants versus natives vary by origin and the receiving country.

Conclusions
A chronic health condition in the immigrant population can have a stronger amplifying or buffering effect on the risk of having another chronic disease than their native-born counterparts.

Key messages
• Multimorbidity patterns in immigrants differ from the native population due to their biological traits and experience in origin and receiving countries.
• A chronic health condition in the immigrant population can have a stronger amplifying or buffering effect on the risk of having another chronic disease than their native-born counterparts.
Sexually and Non-sexually Transmitted Infections and The risk of Prostate Cancer
Authors: Sawaya M , Cordinaduverger E , Lamy P , Rébillard X , Tretarre B , Menegaux F 
Published: October 2023

Abstract

Introduction
Prostate cancer (PCa) is by far the most common type of cancer among men in western countries. However, relatively little is known about its etiology despite the high morbidity and mortality rates, where only advanced age, ethnicity, and family history of prostate cancer are well-established non-modifiable risk factors. It has been suggested that chronic inflammation may be involved in the development of prostate carcinogenesis. Therefore, our objective was to investigate the role of sexually and non-sexually transmitted infections in the occurrence of prostate cancer with a specific interest in the aggressive types based on data from EPICAP.

Methods
EPICAP is a population-based case-control study conducted in the département of Hérault, France, between 2012 and 2014. A total of 819 incident cases and 879 controls were interviewed face-to-face using a standardized questionnaire gathering information on known or suspected risk factors of prostate cancer and personal history of specific sexually and non-sexually transmitted infections: Gonorrhea, Syphilis, Trichomonas, Herpes, Mononucleosis, Epstein Barr, Varicella-zoster, and Dengue. Odds Ratios (OR) and their 95% confidence interval were estimated using multivariate unconditional logistic regression.

Results
No association emerged for the history of sexually transmitted infections (OR 1.04, 95%CI: 0.84-1.25) and non-sexually transmitted infections (OR1.09, 95%CI: 0.89-1.34) and the risk of prostate cancer. Even for all the infections studied separately, there was no association with the risk of low-grade or high-grade prostate cancer.

Conclusions
Our results showed that sexually or non-sexually transmitted infections do not seem to be risk factors for prostate cancer in the EPICAP study. Therefore, further investigation is needed to help advance our understanding of the role of chronic inflammation in the etiology of prostate cancer, with a particular focus on its most aggressive types.
Health inequality and protective factors for post COVID-19 condition among older adults in Europe
Authors: Ohno M , Dzúrová D 
Published: October 2023

Abstract

Background
COVID-19 affected people and countries disproportionately and continues to impact health of people. The aim of this study was to investigate protective health and social factors for post-COVID conditions in adults aged 50 years and older in Europe using longitudinal data from the Survey of Health, Ageing and Retirement in Europe (SHARE), which were collected from June to August 2021.

Methods
A study sample of 1,909 respondents who self-reported a positive COVID-19 test result was included in our multiple logistic regression models. Binary logistic regression was performed to assess whether having no post COVID-19 condition was associated with sociodemographic factors (sex, age, education and region) and health-related factors (BMI, comorbidity and COVID-19 vaccination status).

Results
In the fully-adjusted model, male sex (OR 1.54; CI1.24, 1.90), having tertiary or higher education (OR1.42; 95% CI 1.05, 1.92), healthy weight (BMI 18.5 to 24.9 kg/m2)(OR 1.46; 95% CI 1.11, 1.93), no underlying health condition (OR 1.68; CI 1.31, 2.15), COVID-19 vaccination (OR 1.39; CI 1.11, 1.75) and living in countries other than Visegrad group (OR 2.03; CI 1.53, 2.69) showed protective effects against post COVID-19 conditions. BMI in the high education group (mean 26.7 kg/m2) differed significantly as compared to medium (mean 28.3 kg/m2) and low education groups (mean 28.7 kg/m2). BMI of respondents without comorbidity (mean 26.5 kg/m2) was significantly lower than respondents with comorbidities (ranging from 27.4 to 29.0 kg/m2). Significant differences were observed in education levels and BMI between the Visegrad group and Non-Visegrad group (p&lt;.001).

Conclusions
Our study suggests that high education attainment is a predictor for no post COVID-19 conditions and is associated with lower BMI and fewer underlying comorbidities. Health inequality associated with education attainment was particularly relevant in the Visegrad group.

Key messages
• Maintaining healthy weight and vaccination may protect older adults from post COVID-19 condition.
• Our results highlight health inequality in which BMI was associated with comorbidities and educational attainment.
Consulting a midwife when not pregnant: what happened in France after the 2009 reform?
Authors: Franc C , Panjo H , Roquebert Q 
Published: October 2023

Abstract

Background
While access to gynecologists in France has become very difficult for most women, demography of midwives is dynamic (+ 10.5% between 2013 and 2018), especially in ambulatory positions. In the same time, in 2009, a healthcare reform in France extended the skills of midwives. While they have been historically associated to care for pregnancy and childbirth, midwifes have been authorized from then to intervene for the gynecological follow-up of non-pregnant women. This paper explores how this reform affects the probability of women to consult a midwife when not pregnant, and the heterogeneity of this effect according to women's characteristics.

Data and Methods
Using longitudinal administrative data on the healthcare consumption of French women, we reconstruct pregnancy periods and control for a rather large number of individual characteristics (age, health status, outpatient care expenses, rate of extra fees born, region, index of a taxonomy of the French living areas, etc.). We use a generalized estimating equations (GEE) probit regression model to study the change in the probability of non-pregnant women aged 15 to 55 to consult a midwife between 2007 and 2017.

Results
We find that the probability of consulting a midwife for reasons other than pregnancy increases after the 2009 reform, particularly since 2012, and increasingly so. This increase is particularly important for women having a recent pregnancy, suggesting that midwives are their own “sales representatives”. The increase is also especially high in rural areas and deprived periurban areas. It can be related to the very poor healthcare supply in these two types of areas that are both characterized by a low supply of care, particularly for healthcare specialists.

Key messages
• The 2009 reform broadening the scope of midwives’ skills is illustrated in practice through an increase in the use of midwives outside pregnancy by all women and this concerns all types of territories.
• the increase appears rather slow, given the significant rationing of gynecological care in many areas due to financial barriers and lack of professionals.