bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical students’ vaccine hesitancy, knowledge and attitudes: A cross-sectional study
Authors: Giustolisi F , Modica Fiascaro A , Palella M , Oliveri Conti G , Ferrante M , Fiore M 
Published: October 2023

Abstract

Background
Despite physicians being in a unique position to address concerns about vaccine hesitancy (VH), there are hesitant and concerned physicians about vaccination safety and utility. This study aimed to investigate medical students’ knowledge, VH and their association: besides students’ attitudes towards vaccines.

Methods
VH, knowledge, and attitudes towards vaccines were collected using an anonymous self-administered questionnaire. Cronbach's alpha of questionnaire domains was 0.70, 0.80 and 0.78 for VH, knowledge and attitudes, respectively. The opinion answers were added to calculate vaccine Hesitancy Index (HI &lt; 18=low, 19-22=medium, &gt;23=high).

Results
Although the frequency of hesitant students decreased from the first to the fifth year, unfortunately a percentage of future doctors with a non-negligible HI level persisted (medium HI level: 31.3%, high HI level 14.9%). We found a negative association between the percentage of students aware of recommended vaccines for healthcare professionals (chickenpox 74.5%vs 57.5%, p = 0.00; measles, mumps, and rubella 92.8%vs83.5%, p = 0.03; meningococcus 79.7%vs 67.7%, p = 0.00) and HI (low vs high). Furthermore, we found a positive association between the frequency of students who had not been vaccinated (varicella 2.3%vs3.9%, p = 0.00) or who did not know if they were (varicella 8.2%vs22.8%, p = 0.00; Hepatitis B 11.4%vs20.5%, p = 0.02; Tdap 4.6%vs15.0%, p = 0.00) and HI (low vs high). Overall, the reason for not getting vaccinated given by most students was ‘I didn't have time’ (flu: 60.8%vs66.9%) showing a positive association with HI. Conversely, a negative association was found with the reason ‘The vaccine is not free’ (flu 71.4%vs0.0%) that is higher HI corresponded to less vaccine knowledge.

Conclusions
Actions are needed in the future on the education of medical students as well as on the role they perceive themselves to have in responding to patient hesitation, and on their level of confidence in doing so.

Key messages
• Physicians are in the best position to understand hesitance patients, to respond to their worries and concern, and to find ways of explaining to them the benefit of vaccination.
• Widespread and interdisciplinary training on vaccine hesitancy, risk communication, infodemiology and community engagement are needed.
Segmentation analyses as an effective tool to improve tobacco prevention and cessation
Authors: Wieber F W , Müller S , Ackermann K , Furchheim P , Zysset A , Meyer M , Dratva J 
Published: October 2023

Abstract

Background
Defining and understanding target groups is a key for successful tobacco prevention and cessation programs. While most campaigns and interventions only take basic demographic and socioeconomic characteristics of the target groups into account, additional knowledge about behavioral or psychographic characteristics (e.g., motives) is needed. Therefore, we developed and tested profiles of adolescents and adults.

Methods
A systematic literature review revealed 219 articles with criteria that relate to (not) smoking. These criteria were consolidated in 8 expert interviews, 8 qualitative group discussions and 47 interviews with children and adolescents and in 53 interviews with actual and past adult smokers and included in a questionnaire that 2'732 adolescents and 2'899 adults (representative sample) filled in.

Results
Segmentation analyses revealed five adolescent and four adult profiles that show systematic pattern regarding demographics, socioeconomics, social resources/independence, hobbies, psychological well-being/stress, and smoking behavior /intention to quit. Segments were replicated with data from a national tobacco cessation program. Segment-specific messages were derived and experimentally tested.

Conclusions
The successfully developed target group profiles are available as a tool for tobacco prevention experts to improve current and future tobacco prevention and cessation activities.

Key messages
• Defining and understanding target groups is a key for successful tobacco prevention and cessation programs.
• The successfully developed target group profiles are available as a tool for tobacco prevention experts to improve current and future tobacco prevention and cessation activities.
Health Literacy Interventions in cancer care: A review of systematic reviews
Authors: Jeitani C , Van den Broucke S , Leemans C 
Published: October 2023

Abstract

Background
Health literacy (HL), refers to the cognitive and social qualities that influence an individual's motivation and capacity to acquire, comprehend, and apply information to improve their own health. Therefore, interventions targeting HL may allow a better understanding of the illness leading to better-adapted behaviors. Interventions targeting HL in an illness such as cancer may be essential due to the high disease burden, the availability of cancer screening programs, the complexity of multimodal therapy, and the emphasis on cancer clinical trials. This study will review systematic reviews that look into different HL interventions in oncology and hematology targeting patients, health care professionals, and/or organizational HL. The objective of this study is to highlight the already studied factors and their effectiveness, in addition to highlighting the missing factors in light of recent findings on different concepts within HL.

Methods
A literature search was performed using terms such as Cancer AND health literacy AND Interventions AND patients or medical staff, or medical organizations in five different multidisciplinary databases. Reviews that constituted studies that targeted interventions in the oncology population and explicitly mentioned HL as a factor or an outcome were included.

Results
A hundred and thirteen studies were retrieved. Seven studies fit the criteria and were therefore included. The ongoing study's preliminary results show no intervention studies targeting organizational HL. Most reviews included interventions at the patient level. The effectiveness of the interventions varied among studies. Most HL interventions targeted patient communication skills training.

Conclusions
Most of the interventions to date target HL through patient education and communication making it difficult to apply HL in the entirety of its definition, clinically.

Key messages
• Interventions considered as Health Literacy interventions often target solely patient education.
• A call for better use of the term Health Literacy is needed in order to address the different aspects of englobed by HL through its definition and its application.
2.Q. Workshop: Difficult to reach – populations: How to recruit for qualitative and/or quantitative studies?
Authors:   Organised by: University of Bergen (Norway),   Chair persons: Claire Collins (Ireland)
Published: October 2023

Abstract

Background
Migrants are often described as a difficult-to-reach group for research and become underrepresented or their representation is biased in most research projects. Researchers face challenges related to language barriers, intercultural communication, participant health literacy level, time, participant expectations, differences in education levels, cultural heritage, and values. Other challenges may be related to techniques (sending follow-up emails, phone calls, or face-to-face contact with participants). Improving the recruitment of a representative sample of participants is critical for conducting qualitative and quantitative research that includes the diverse populations we live in. Over the last five years, our research group conducted two large projects among Syrian refugees, including surveys, interviews, and interventions: the CHART project (Changing Health and health care needs Along the Syrian Refugees’ Trajectories to Norway) and the Integration for Health project. Both projects encountered challenges in recruitment but managed to recruit as intended. Based on our positive experiences conducting these studies, this workshop aims to share lessons learned to overcome recruitment challenges during the recruitment and data collection phases and to learn from other researchers with positive experiences.

Aim
To gain knowledge and improve skills in recruiting and addressing participants described as hard to reach in research and to reflect upon the best ways of accessing hard-to-reach populations.

Timetable
• Who are the hard-to-reach populations in public health and why? Esperanza Diaz - 10 min
• Moderated conversation by Claire Collins. Presenters: Ayan Sheikh-Mohamed, Wegdan Hassan, and Khadra Yasien Ahmed, who present challenges from their studies- what we have done well and what not -20 minutes.
• Work in groups: further sharing of experiences with participants and lessons to carry home - 20 minutes.

Key messages
• This workshop will increase awareness, knowledge, and skills in how to understand your target population.
• Build trust and share various tools for recruiting hard-to-reach populations to increase the success of public health research.

Speakers/Panelists
Wegdan Hasha
University of Bergen, Bergen, Norway
Khadra Yasien Ahmed
Department of Global Public Health and Primary Care, University of Bergen, Norway
Ayan Bashir Sheikh-Mohamed
Department of Global Public Health and Primary Care, University of Bergen, Norway
Esperanza Diaz
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
Defining doctoral training competencies
Authors: OLeary N , Clarke M 
Published: October 2023

Abstract

Background
Structured Population Health, Policy and Health Services Research Education (SPHeRE) is a national doctoral training programme for scholars undertaking research in population health, policy, and health services research (PHPHSR) research in Ireland. The programme has a formative impact on the future of PHPHSR. To ensure graduates are equipped to meet the needs of 21st century public health research, we undertook a review of two interconnected areas, the research priorities and training curriculum underpinning the programme.

Objectives
Our overall aim is to provide exemplary PHPHSR training, enabling graduates address current and future PHPHSR needs via cutting edge research. To achieve this, we set the following objectives:
1. Identify key PHPHSR priorities for stakeholders including researchers, funders and public health agencies
2. Update the curriculum to reflect research priorities and evolving needs for PHPHSR graduates

Results
To achieve both objectives we used parallel complimentary methods. We began by reviewing literature for research prioritisation and curriculum review. Both processes were undertaken as team endeavors and are in the process of being written up as scoping reviews. As such we are also contributing to the knowledge base in the area of PHPHSR doctoral training, while also updating our own programme. Key findings included the need for continuous stakeholder engagement in setting research priorities, to ensure focus of training is orientated towards emerging needs. In terms of curriculum the need for competency focused curriculums emerged clearly. For example, leadership skills are increasingly required. While traditionally seen as incidental, these now need to be integrated within the curriculum. To achieve this we are consulting with stakeholders using a range of participatory methods such as World Café.

Conclusions
Literature review and stakeholder engagement are key components of evidence-based doctoral training programmes.

Key messages
• PHPHSR Doctoral training is a rapidly evolving area.
• Comprehensive research prioritisation and curriculum review are required ensure doctoral training remains fit for purpose.
How do hospitals deal with nursing shortages? Insights from the northern German-Dutch border region
Authors: Schnack H , Tuinman A , Brouwer S , Finnema E , Ansmann L 
Published: October 2023

Abstract

Background
In many countries, hospitals are confronted with nursing shortages. So are hospitals in Germany and the Netherlands as neighboring countries with dire consequences for the hospital. Simultaneously, competition for nurses is high, and hospitals are looking for innovative measures to deal with nursing shortages. This study examines how nursing shortages affect hospitals in the Northern German-Dutch border region and what strategies they use to attract and retain nurses.

Methods
A sequential mixed-methods study with n = 55 key informants (e.g., nursing directors or human resources managers) from hospitals in the northern German-Dutch border region was conducted. Data was collected by questionnaire followed by qualitative interviews from April to August 2023. The survey data was analyzed descriptively and the interview data via content analysis. To integrate the qualitative and quantitative results, joint displays were used. The quantitative and preliminary qualitative results will be presented at the conference.

Preliminary results
First descriptive results indicate that nursing shortages are associated with an increase in overtime, a rise in sick leave and a worsening of the working climate. Preliminary data suggests that recruiting via personal contacts and via social media is seen as an effective recruitment measure to tackle nurse shortages. However, cross-border recruitment of Dutch or German nurses is hardly used by the hospitals. To retain nurses, the interviewed key informants pointed out the importance of flexible working hours, professional development, and a good working climate.

Conclusions
As nurse shortages affect nurses and patient care in hospitals likewise, hospitals are forced to invest in positive and healthy workplaces to attract and retain nurses. The study therefore supports hospitals in the northern German-Dutch border region in sharing best practices and is a starting point to encourage hospitals in exchanging ideas across the border.

Key messages
• Cross-border comparison of nurse shortages shows that Dutch and German hospitals face similar challenges.
• Potential for addressing the nursing shortage arises from cross-border recruitment of German or Dutch nurses.
Zero projects: compliance and evaluation of direct observation checklist as surveillance method
Authors: Erro-Iturri B , Loroño-Ortiz G , Jiménez-Onsurbe M , Carbajal-Domínguez S , Gonzalez de Viñaspre-Remirez I , De Luz-Sanchez Y , Hernandez-Gonzalez A , Barberena-Iriarte C , Rico-Pisuerga M A , Páramo-Andrés S 
Published: October 2023

Abstract

Background
The multimodal projects: “Zero Urinary Tract Infection” (Z-UTI), “Zero Resistance” (Z-R), “Zero Pneumonia” (Z-P) and “Zero Bacteraemia” (Z-B) consist in implementing a bundle of evidence-based recommendations to prevent healthcare-associated infections (HAIs) and acquisition of multidrug-resistant bacteria (MDR-B) during patient's intensive care unit stay. They have been instituted in our tertiary hospital for several years and in order to assess compliance, we perform surveillance based on direct observation checklist. The aim was to examine compliance of recommendations and to evaluate direct observation as surveillance method.

Methods
Descriptive analysis of audits performed between 2020-2022. Compliance was estimated as the average of “yes”-marked percentage. Recommendations with “yes”-marked below 50% were excluded. Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis of direct observation checklist was conducted.

Results
Regarding Z-R (n = 129 observations) compliance was 86.5%.”Giving information about isolation to family” was excluded registering 55.4% “not seen”-marked. In Z-P (n = 262 obs.) compliance was 82.3%. “Hand hygiene and sterile technique for bronchial secretions aspiration” was excluded registering 48.2% “not seen”-marked. As for Z-UTI (n = 607 obs.) compliance was 92,5% (excluded: 4 standards with 78.2% “not seen”-marked). In Z-B (n = 988 obs.) compliance was 78.5% (excluded: 4 standards with 80.6% “not seen”-marked; 1 standard with 49.5% “not appropriate”-marked). Surveillance of projects by direct observation allows in-the-moment feedback but some recommendations could be checked as “not seen” due to observation's schedule. Lack of time and people involved could threaten surveillance. However, HAIs and MDR-B are a major public health problem to deal with.

Conclusions
Study demonstrates good compliance of recommendations, existing standards with high “not seen” percentages. SWOT analysis gives guidance on doing effective surveillance.

Key messages
• Due to increasing concern of MDR-B acquisition and HAIs, is crucial to develop projects including evidence-based recommendations to prevent this major public health problem.
• Once we develop a strategy we must become able to monitor it and moreover, evaluate how we are doing surveillance in order to improve and make changes if necessary.
Factors associated with utilization of focused antenatal care (FANC) services in Nigeria: 2013 -2018
Authors: Haruna-Ogun O 
Published: October 2023

Abstract

Background
The global burden of maternal mortality is high, hence measures such as focused antenatal care (FANC) has been put in place to reduce pregnancy-related deaths. However, attendance of FANC is low in many sub-Saharan African countries, including Nigeria. Many women in Nigeria fail to attend the minimal number of contacts with health professionals. However, the factors associated with utilization of FANC services are yet to be clearly understood. Thus, the objective of this study was to examine trends in the use of FANC services and the factors associated with its use among women in Nigeria.

Data and Methods
The 2013 and 2018 dataset of the Nigerian Demographic and Health Survey was analysed in this study. Univariate, bivariate, and multivariate analysis were conducted.

Results
The study found that between 2013 and 2018, the number of women receiving FANC increased by more than 5%, from 51.5% to 56.8%. Furthermore, the results showed that, in both surveys, attainment of post-primary level of education, residing in urban areas, living in a wealthy household, and residing in the Southern region of the country were significantly associated with utilization of FANC. However, household wealth and women's level of education were the greatest predictors of FANC utilization in both surveys.

Conclusions
Policy intervention aimed at addressing women with low antenatal care attendance is critical in improving maternal health in Nigeria. It is also important for government at all levels to implement policies that ameliorate the economic conditions of women, promote education of girls and women, improve healthcare delivery in rural settings, improve the number of antenatal care facilities and ensure equitable distribution of FANC facilities and providers across the various regions and places of residence in the country.

Key messages
• Focused antenatal care has the potential of improving pregnancy-related outcome because it enables health professionals to detect and manage abnormalities. However, attendance is low in Nigeria.
• Using a nationally representative dataset, the study explored the factors associated with focused antenatal care. The result showed that socio-economic characteristics are crucial to use or non-use.
The impact of the international code of marketing of breast-milk substitutes in Ghana and Tanzania
Authors: Lima Constantino J , Biesma R , Pichler S , Kramer L 
Published: October 2023

Abstract

Background
Measures that promote and protect breastfeeding have a major impact on child survival rates, as it was estimated that increasing breastfeeding rates can reduce child mortality by 13% in Africa. The International Code of Marketing of Breast-Milk Substitutes is an important measure to protect and promote breastfeeding and the safe use of commercial milk formulas. Ghana and Tanzania adopted measures that are substantially aligned with the Code into national legislation in 2000 and 1994, respectively.

Methods
In this study, we estimate the effects of the Code implementation through national laws on child mortality in Ghana and Tanzania by using the synthetic control group method and performing placebo tests to assess statistical inference. The main outcome is the effect of the national laws on overall child mortality and secondary outcomes are the effect of the laws on child mortality by lower respiratory infections and diarrhea in both countries.

Results
Two-sided inference tests showed a statistically significant treatment effect for deaths by lower respiratory infections in Ghana (p = 0.0476; LTE = - 0.8423) and one-sided inference tests showed statistically significant treatment effects for deaths by lower respiratory infections in Ghana (p = 0.0476; LTE = -0.8423) and Tanzania (p = 0.0476; LTE = - 5.1627), and for diarrhea in Tanzania (p = 0.0476; LTE = - 8.1694). To corroborate our results, we also performed the analysis for two major causes of child mortality that are not affected by the intervention, namely congenital diseases and birth asphyxia and trauma birth, for which we did not find significant treatment effects.

Conclusions
The results demonstrate that the Code had a potentially beneficial impact on child mortality in Ghana and Tanzania and corroborate previous research that the Code is a necessary but insufficient step to alone improve child health outcomes.

Key messages
• The results show that the implementation of the Code had a potentially beneficial impact on child mortality in Ghana and Tanzania.
• Policymakers should consider implementing or strengthening the Code within countries in order to improve child and health outcomes.
Early menarche and overweight: evidence from the Italian Health Behaviour School-aged Children Study
Authors: Marconi D , Lipari D , Nardone P , Ciardullo S , Pierannunzio D , Vieno A , Dalmasso P , Lazzeri G 
Published: October 2023

Abstract

Background
Globally, the prevalence of obesity has increased in the last years and tends to be higher in richer countries. Overweight (including obesity) interests all the ages, including childhood and adolescence. Our study aimed to investigate the correlation between body mass index (BMI) and age at menarche.

Methods
We used a unique standardized national dataset on adolescent girls (21 regions) participating in the Italian Health Behaviour in School-aged Children Study (HBSC). HBSC is a European surveillance supported by WHO, conducted every 4 years. Two independent nationally representative survey datasets: one on 15-year-olds (n = 6907 year 2017/2018) and one on 11-year-olds (n = 9506 year 2013/2014) were analysed. The survey instrument was the self-report questionnaire. Median age at menarche and 95% confidence intervals (CIs) were estimated by means of Kaplan-Meier analysis. Hierarchical models were used to assess the relationship between BMI and age at menarche (months). “Region-level obesity” was measured as the prevalence of overweight/obesity (%) in each region. We evaluated the relationship with socioeconomic status (SES) through the Family Affluence Scale.

Results
Region-level median age at menarche ranged between 12 years/5 months and 13 years/4 months. Region-level prevalence of overweight among 15-year-old girls ranged between 6% and 24%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta= -0.81; 95% CI, -0.92 to -0.70). Individual and class-level measures of BMI accounted for 215.2% of the region-level variance in age at menarche. The coefficient of Family Affluence differed significantly 0.25 (0.09 to 0.41).

Conclusions
Our results show that being overweighted in pre-adolescence is associated with the early puberty.
Strong social inequalities were observed, with adolescents from lower SES are likely to be overweight or obese In line with all the other European countries.

Key messages
• Weight status can influence menarche.
• Policies to reduce socioeconomic inequalities are needed to prevent health problems.