bluuebunny/crossref_metadata_2025_split huggingface dataset:
Professional Public Health Practice in Spain - Insights from the Spanish Public Health White Paper
Authors: Llimós M , Segura-Benedicto A , Urbanos R , Satue E , Barbaglia G , García-Benavides F 
Published: October 2023

Abstract

Issue/Problem
The public health professionals has gained attention during the COVID-19 pandemic. However, the weakness of Spain's public health structures has been exposed during the crisis, which is partly due to the delay in modernising institutions and the low percentage of GDP dedicated specifically to theses public health institutions. In addition, there is a lack of specific training for public health practitioners to acquire the necessary multidisciplinary competences for high quality public health practice.

Description of the problem
The Spanish Society of Public Health and Health Administration (SESPAS) has developed a white paper of the public health profession. The main objective is to contribute to strengthening the professional practice of public health by identifying some of its problems and agreeing on possible solutions. The specific objectives were to frame public health as a profession, to describe the socio-demographic characteristics of the people affiliated to the associations federated in SESPAS, to carry out a qualitative analysis of the discourse of public health professionals on its meaning, and developing conclusions and recommendations to address public health challenges.

Results
The demographic and employment data of the 3,467 people belonging to seven SESPAS societies show that, overall, about 60% are women and 40% were under 50 years of age. Undergraduate degrees were Medicine (35.9 %), Nursing (17.4 %) and Pharmacy and Veterinary Medicine (10.4 %), other life science degrees (4.3 %). Key aspects of the meaning of public health, training, employability and career and institutionalisation of public health were collected through 19 interviews and 6 focus groups.

Lessons
In order to agree on the conclusions and recommendations, a meeting was organised with the participation of 29 members of SESPAS. A total of 25 conclusions and 24 recommendations were drawn.

Key messages
• White paper is a step forward in the strengthening of public health in Spain.
• Public health should develop leadership and advocacy skills for people's health from a multidisciplinary and cross-sectoral practice.
Behavioural risk factors and psychophysical well-being among University students in Pavia Colleges
Authors: Vigezzi G P , Blandi L , Cacitti S , Bertuccio P , Mosconi G , Casali L , Cena H , Politi P , Rigano F , Odone A 
Published: October 2023

Abstract

Pavia, Italy, is one of the oldest university city campuses in Europe and the venue for 16 Colleges, hosting around 2,500 Italian and international students (10% of the whole student population). Colleges represent a distinctive identity of the city and quite a unicum in the Italian academic system. Since leaving their parents’ homes and starting University has an impact on young adults’ health behaviours, potentially impairing their future life pathways, we investigated students’ health status and well-being through a rigorous assessment of lifestyles and behavioural risk factors. A cross-sectional online survey was designed and administered to students living in Pavia's Colleges. The questionnaire was structured into five sections, aimed at collecting information on university careers, lifestyles and behavioural risk factors, psychological well-being, and experience in residences during the COVID-19 pandemic. Where available, validated structured scales were used to gather specific study's endpoints (i.e., IPAQ, Audit-C, Medi-Lite, GHQ-12, BHS and 3-item loneliness scale). Of the 1199 students enrolled between March and August 2022, 814 subjects participated in the study. Regarding the most common behavioural risk factors, smokers were 25.2% of our sample, while at-risk alcohol consumption and regular cannabis use stood at 42.9% and 4.0%, respectively. Around 17% of the students gambled 1-2 times/week, and 4.5% did not take measures to prevent sexually transmitted infections. In terms of psycho-physical well-being, the level of physical activity was inadequate in 11.7% of the subjects, and the results of the mental health tests showed a risk for loneliness (3-item loneliness score≥6) in 36.9% and for hopelessness (BHS≥6) in 17.7%. Our findings may provide useful information to tailor the most appropriate health promotion and health education interventions so as to design a culture for well-being across the whole lifespan.

Key messages
• Our study offers a comprehensive overview of the student population residing in colleges, providing representative data.
• Promoting healthy behavioral risk factors early in life, with a life course perspective, is crucial to enhancing individuals’ chances for a healthy life.
Impact of a digital therapeutic on adult asthma
Authors: Bijlani A , Mauger D , Goodheart C , dOrsay G , Suman J 
Published: October 2023

Abstract

Background
Asthma impacts 334 million people globally. Medication adherence is estimated at 50% worldwide. Digital therapeutics (DTx) may improve medication adherence and health outcomes.

Methods
Prospective, single cohort observational study of 104 adults with asthma managed on inhaled corticosteroids. Subjects had 90-day access to Aptar Digital Health respiratory platform: HeroTracker to monitor adherence, spirometer for lung function, and BreatheSmart mobile app with real-time alerts. Primary outcomes: asthma control, rescue medication use. Secondary outcomes: controller medication adherence, patient feedback.

Results
Subjects completed Asthma Control Test (ACT) at baseline (T0); 96% (N = 100) completed ACT at 90 days (T1). Between T0 and T1, ACT scores increased significantly (baseline: 16.5 ± 4.7; ΔT0 to T1: + 2.8, 95% CI (2.0, 3.6), p-value &lt;0.001); rescue medication use decreased 44% ((95% CI: 14.1, 63.5), p-value = 0.008); adherence to controller medication decreased 10.7% ((95% CI: 6.4, 15.1), p-value &lt;0.001). 82.5% of subjects reported platform very/somewhat easy to use, 97.5% rated spirometer very/somewhat easy to use, 92.5% reported alerts very/somewhat helpful. Platform rating mean score = 7.825/10 (1-10; 10=high).

Conclusions
DTx may improve asthma control and decrease rescue medication use. T1 medication adherence was 17% higher than global medication adherence. Patient feedback was positive.

References
1. Enilari, O., Sinha, S. (2019). The global impact of asthma in adult populations. Ann Glob Health, 85(1), 2, 1-7.
2. Kim, J., et al. (2018). Medication adherence: the elephant in the room. US Pharm, 43, 1, 30-34.

Key messages
• DTx promoted improvement in ACT scores and decreased rescue medication use.
• DTx platform feedback was positive.
Adverse childhood experiences and pain in early adolescence: A study in the Generation XXI cohort
Authors: Abrahamyan A , Lucas R , Talih M , Soares S , Severo M , Fraga S 
Published: October 2023

Abstract

Background
The cross-sectional association between Adverse Childhood Experiences (ACEs) reports and adult pain conditions is well-established. Studies in children are scarce, yet evidence indicates that ACEs may trigger a health-damaging cascade, especially in stress-sensitive developmental stages of higher brain plasticity. We aimed to examine the associations between ACEs and pain experiences in childhood and adolescence.

Methods
Participant data from the third (2016-17) and fourth waves (2018-20) of the Generation XXI birth cohort study (2005-06) was used. ACEs were reported by children aged 10 and 13 using a 15-item questionnaire. Recent pain experiences (i.e., presence of pain episodes, number of pain sites, and pain intensity) were measured using structured questionnaires. Pain episodes were reported a week prior to the interview at age 10 and in the previous three months at age 13. Adjusted odds ratios (aOR) and 95% confidence intervals (CI) were obtained from binary and multinomial logistic regression analyses.

Results
ACEs reported until the age of 10 were associated with pain experiences (i.e., presence of pain episodes, number of pain sites, and pain intensity), with higher number of events conferring a greater risk of experiencing pain at age 10 (aOR 3.18 for ≥6 ACEs; 95% CI [2.19, 4.74]). ACEs until age 10 were associated with pain reports at 13 years. Further, each point increase in ACEs at age 10 increased 9% the odds of reporting pain at age 13 (OR 1.09; 95% CI [1.07, 1.12]). No interaction was observed between ACEs score at ages 10 and 13 was (OR 0.99; CI [0.98-1.00]), showing that the effect of ACEs at age 10 on recent pain at age 13 was not moderated by the ACEs at age 13.

Conclusions
Adverse experiences occurring during the first years of life may predict pain conditions later in life.

Key messages
• A dose-response association was observed between the cumulative number of ACEs and reports of pain in 10-year-old children.
• Embodiment of ACEs starts as early as childhood, and pain related to ACEs begins earlier than previously reported.
Digital psychosocial assessment of youth in Australian hospitals: From aspiration to implementation
Authors: Waller D , Ho J , Fong C K , Iskander A , Towns S , Bailey S , Zolfaghari E , Feuerlicht D , Ross K , Steinbeck K 
Published: October 2023

Abstract

Background
Some of the leading causes of morbidity and mortality for Australian youth arise from modifiable psychosocial concerns. Psychosocial assessment can help identify young people at risk and support actions that protect wellbeing. The gold standard assessment for youth is the HEEADSSS interview. Australian governments recommend the HEEADSSS interview for young people in health settings, but adoption is still in its early stages. Recently, a digital self-assessment version of the HEEADSSS (the e-HEEADSSS) was piloted at the Sydney Children's Hospital Network. A program of research has been established to evaluate outcomes and consider broader implementation.

Methods
Study 1 involved a retrospective analysis to compare the HEEADSSS interview and the e-HEEADSSS. Documentation from 146 matched records collected at the Sydney Children's Hospital Network were analysed to compare approaches. Study 2 utilised a qualitative design to evaluate patient and staff barriers and facilitators to implementation and scale-up of the e-HEEADSSS. Patients (n = 8) and staff (n = 8) participated in online semi-structured interviews.

Results
Study 1 found the e-HEEADSSS improves assessment uptake and sensitivity compared to face-to-face interviews and takes less time. Disclosure rates were higher for all psychosocial categories especially in sensitive areas of emotions, drug use, sex, and safety. Study 2 found strong support for the e-HEEADSSS from patients and staff. Key benefits included design, functionality, reduced time, convenience, improved disclosure, perceived privacy, improved fidelity, and reduced stigma. Key challenges were available resources, continuity of staff training, clinical pathways, and risks of off-site completions.

Conclusions
The e-HEEADSSS shows promise as a psychosocial screening tool to support intervention for young people. More work is required to appropriately scale and sustain implementation of the e-HEEADSSS within the Australian health system.

Key messages
• Digital psychosocial assessments show promise for supporting the mental and physical health of adolescents and young adults.
• Implementation of digital psychosocial assessments within the Australian health system requires considered support.
Parental imprinting
Authors: Capitani E , Marin O , Alaimo L , Montomoli E , Nante N 
Published: October 2023

Abstract

Background
Parental identity formation is rooted in childhood experiences and internalised relationships with one's family. The present study aims to investigate the possible correlations between the outcomes of experienced motherhood and the woman's internalised parenting style.

Methods
A retrospective observational study was conducted on an Italian sample of mothers enrolled through an online questionnaire administered from July to September 2022. The Parental Bonding Instrument was used, consisting of 25 items, 12 of which refer to caring (max score 36) and 13 to overprotectiveness (max score 39). From the combination of the scores calculated for the two dimensions, four possible patterns of maternal parenting style can be obtained (affectionate bonding, optimal parenting, controlling without affection, negligent parenting).

Results
The sample consisted of 1828 mothers (average age 38). Our sample shows that 15.54% of the women have a mother with an affectionate bond, 32% an optimal mother, 36.54% a controlling mother without affection and 15.92% a neglectful mother. Those who have an affectionate mother have a lower likelihood of developing depression (OR:0.6;C.I.:0.4-0.9).Those who have an optimal mother have a higher likelihood of breastfeeding (OR:1.3;C.I. 1.1-1.7).Those with a controlling mother without affection have a higher probability of suffering from anxiety (OR:1.4;C.I.:1.2-1.7).Those with a controlling mother without affection have a higher probability of suffering from depression (OR:1. 7;C.I.:1.3-2.1).Those with a neglectful mother have a higher probability of suffering from anxiety (OR:1.3;C.I.:1.1-1.7).Those with a neglectful mother have a higher probability of developing depression (OR:1.7;C.I.:1.3-2.3).

Conclusions
Our data shows the existence of a statistically strong correlation between the variables related to the psycho-emotional sphere and the four attachment patterns.

Key messages
• The parental imprint received has repercussions on various aspects related to one's motherhood and influences its events and outcomes.
• Mental health is also influenced by the parental imprint.
Evaluation of the Ministry of Health's pilot program - A personal pregnancy follow-up service
Authors: Satran C , Bord S , Cohen A , Tzadik H , David R , Nattiv O , Madjar B 
Published: October 2023

Abstract

Background
The Israeli Ministry of Health has developed a unique pregnancy follow-up (PF) service in the Haifa District Infant-Parent Centers, including a fixed nurse attending the necessary examinations and services, supporting and guiding the woman throughout her pregnancy.

Aim
To examine the differences between the participants who received PF within the pilot program (research group) and those who received standard PF (control group) regarding health behaviors, receiving information and attitudes regarding health behaviors, professional support, and satisfaction with the service.

Methods
Questionnaires were filled in by 293 mothers to infants- 38% of which belonged to the research group and 62% to the control group. There were no significant differences between the two groups’ characteristics.

Findings
Significant differences were found between the groups regarding receiving information and support, and some of the attitudes and behaviors, as well as a difference in satisfaction, in favor of the research group; e.g., 95% of the participants in the research group were vaccinated against Pertussis, as compared to 85% of the control group (z = 2.47, p&lt;.001). Process model for parallel mediation revealed that receiving PF in the research group was associated with (1) More positive attitudes (Effect=0.06, SE = 0.04 CI=0.01,0.15) and receiving information (Effect=0.18, SE = 0.08 CI=0.02,0.33), which in turn were associated with more reported health behaviors (Total indirect effect=0.30, SE = 0.09 CI=0.14,0.49); (2) Receiving more support (Effect=0.16, SE = 0.04 CI=0.09,0.26), as well as more information (Effect=0.10, SE = 0.05 CI=0.01, 0.19), which in turn were associated with higher satisfaction with the PF (Total indirect effect=0.25, SE = 0.05 CI=0.16,0.36).

Conclusions
The findings indicate the pilot program's success in promoting pregnant women's health, among other things, due to the guidance and support provided by a fixed dedicated nurse.

Key messages
• Personal pregnancy follow-up is efficient for supporting and guiding women during a sensitive period for their fetus’ and their own health, and encourages compliance with health behaviors.
• It is recommended to implement the program in additional districts, and to examine the findings among a wider and more diverse sample.
Women’s health report for Belgium: addressing the information gap
Authors: Scohy A , Mogin G , Guariguata L , Nayani S , Schmidt M , Van den Borre L , De Pauw R , Gorasso V 
Published: October 2023

Abstract

Issue
In the last years, Belgian policy makers have become increasingly concerned about health problems affecting only women (e.g. endometriosis) or affecting women in different ways than men (e.g. cardiovascular diseases). The current monitoring tools on the health status in Belgium routinely present information disaggregated by sex. Nevertheless, there is a need to go further than a mere comparison of men and women and strive for gender-sensitive health reporting.

Description of the problem
To address the information gap pertaining to the health of girls and women, a women's health report for Belgium was developed. The goal of this report is to identify and highlight health issues specific to women or affecting them differently and possible knowledge and data gaps.

Results
The report highlighted several data gaps, e.g. prevalence of endometriosis and polycystic ovary syndrome, and several opportunities to fill them. The process also uncovered available but underused data on women-specific issues, including fertility treatments, abortions, and contraception. Among the main results, an analysis on girls (11-18 years old) showed an alarming difference in health status compared to boys, starting from a young age and increasing throughout adolescence. For example, girls reported experiencing more psychosomatic symptoms more often than boys with the difference increasing with age. Girls reported more often a negative perception of their health (22%) compared to boys (15%) and more often depressive symptoms (47%) than boys (31%). Conversely, boys were twice as likely to meet WHO recommendations on physical activity.

Lessons
This first report on women's health in Belgium highlighted the need to collect better information on women-specific issues and the need to promote the use of existing data. Results showed that gender differences in health emerge and increase during adolescence. We strived to put results into context to produce knowledge and recommendations for policymakers.

Key messages
• Developing a women’s health report allowed to highlight data gaps and underuse of existing data.
• Specific interventions should target teenage girls.
Health-Related Quality of Life and Sleep Habits of Children with Overweight or Obesity
Authors: Kleppang A L , Abildsnes E , Haraldstad K , Stea T H 
Published: October 2023

Abstract

Background
Obesity is a major public health challenge affecting children of all ages worldwide. Being overweight or obese can have severe negative psychological impacts and a significant reduction in health-related functioning. To improve health-related quality of life (HRQoL) and sleep habits for children with overweight/obesity, it is important to design and implement effective interventions. Few studies have included parents as behavioral agents to improve sleep habits and quality of life in children and adolescents with overweight/obesity.

Methods
This 6-month, non-randomized, cluster-controlled trial included 166 Norwegian children aged 5-13 years with overweight/obesity and their parents. The intervention group received individual family counselling and participated in physical activity groups and nutrition courses. A frequency questionnaire was filled out by parents, and the sleep habits questionnaire (CSHQ) and Kidsscreen-10 index (proxy version) were used to assess HRQoL.

Results
The results indicate that, overall, the children had good HRQoL. The mean average scores for HRQoL were 50.0 (standard deviation (SD): 8.1) for the intervention group and 49.0 (SD: 10.1) for the control group, which are broadly in line with normative data. For sleep habits, the mean average score was 43.8 (SD: 11.6) for the intervention group and 45.1 (SD: 11.7) for the control group. No significant changes in HRQoL and sleep habits were reported as a result of the intervention.

Conclusions
The children with overweight/obesity reported overall good HRQol at baseline and somewhat worse for sleep habits than the general population. No increase in quality of life or sleep quality was found in the intervention group compared to the control group in children with overweight/obesity.

Key messages
• The HRQoL among the children with overweight/obesity was good, but there were clinically relevant challenges related to sleep.
• No increase in HRQoL and sleep habits were found after the intervention.
ChatGPT & clinical decision-making: a cross-sectional study on Italian Medical Residency Test
Authors: Conrado F , Scaioli G , Lo Moro G , Rosset L , Bert F , Siliquini R 
Published: October 2023

Abstract

Background
The increasing application of artificial intelligence (AI) in healthcare offers significant opportunities for improving clinical decision-making and medical education. This study assesses the performance of ChatGPT, a large language model (LLM), on the Italian State Exam for Medical Residency (SSM) test, to evaluate its potential as a tool for medical education and clinical decision-making support. Given the high stakes of medical decision-making, understanding the capabilities of AI tools like ChatGPT in this context is crucial.

Methods
A cross-sectional study design was employed, analyzing 136 questions from the official SSM test. ChatGPT's responses were compared to the performance of medical doctors who took the test in 2022. Questions were classified into clinical cases (CC) and notional questions (NQ). The study assessed ChatGPT's overall accuracy, performance on CC and NQ, and compared its results with participating medical doctors.

Results
ChatGPT achieved an overall accuracy of 90.44%, with higher performance on clinical cases (92.45%) compared to notional questions (89.15%). ChatGPT's performance was higher than 99.6% of the medical doctor participants.

Conclusions
Based on the data, ChatGPT shows promise as a useful tool in clinical decision-making, particularly in clinical reasoning. This study recommends further research to explore the potential applications and implementation of LLMs in medical education and medical practice, as well as the initiation of procedures and policies for their safe and effective integration into healthcare systems.

Key messages
• ChatGPT outperforms 99.6% of medical doctors in the Italian State Exam for Medical Residency, demonstrating potential as a clinical decision-making tool.
• Further research is needed to explore LLM implementation in medical education and practice, and to develop policies for safe AI integration.