bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changes of physical and emotional wellbeing of public health workers during the Covid-19 pandemic
Authors: Lingiene R , Buckus R , Stukas R 
Published: October 2023

Abstract

Background
During the Covid-19 pandemic, healthcare workers’ mental health was affected by enormous challenges in work environment. The study aimed to analyze the physical and emotional wellbeing of the Lithuanian National Public Health Center (NPHC) workers before and during the COVID-19 pandemic. It assesses the relationship between self-assessed well-being and sociodemographic factors.

Methods
An online questionnaire including 8 statements on health and physical and 13 statements on emotional wellbeing was distributed to all 396 NPHC workers. Answers to the statements were provided on a 5-point Likert scale. Wilcoxon Signed Ranks Test, Mann-Whitney Test and Sperman's rank correlation were used for assessment on relationships.

Results
Our final sample included 343 (86,6%) NPHC workers. The self-assessment of health and physical wellbeing of the total 8 statements determined that 81.5% of respondents rated it worse during the pandemic (p &lt; 0.001). The self-assessment of the emotional wellbeing of the total 13 statements showed that 84.7% of respondents rated it worse during the pandemic (p &lt; 0.001). There were statistically significant relationships between self-assessment scores during the pandemic and public health workers’ age and work specificity. University degree workers showed significantly higher negative changes both in health and physical wellbeing (p &lt; 0.001) and in emotional wellbeing (p = 0.001) compared with non-university degree workers.

Conclusions
The health and physical and emotional wellbeing of the workers of NPHC during the Covid-19 pandemic have significantly deteriorated. It suggests, that measures ensuring public health workers remain physically and mentally healthy during future crises such as COVID-19, are necessary.

Key messages
• Health and physical and emotional wellbeing of public health workers during the Covid-19 have deteriorated.
• Measures that ensure public health workers remain healthy during future crisis are necessary.
'I became the nurse I dreamed to be': Posttraumatic growth of hospital nurses during COVID-19
Authors: Inchi L , Admi H , Bord S , Sharabani S 
Published: October 2023

Abstract

Background
The unexpected COVID-19 pandemic outbreak has shaken the personal and professional lives of people worldwide. Nurses, as the largest healthcare workforce and in the closest proximity to patients, are at high risk of being infected, facing life-threatening situations while being exposed to secondary traumatic stress from direct care of others who are also experiencing traumatic events.

Aim
To explore the lived experiences of frontline hospital nurses as direct caregivers of COVID-19 patients, during four waves of the pandemic.

Methods
The grounded theory approach was employed to generate a theory of nurses’ lived experiences during four waves of the pandemic using the constant comparative method of analysis. Semi-structured interviews were conducted with 23 nurses from nine tertiary hospitals in Israel, between August and September 2021. Interviews were video recorded and transcribed verbatim. Criteria for establishing trustworthiness were applied.

Results
Nurses experienced the COVID-19 pandemic as (1) A direct and secondary threatening event; unexpected, uncertain with poor conditions and resources; (2) Paradoxical negative and positive changes were experienced such as threats to life vs. valuing life; social distancing vs. improved relations; and professional challenges vs. growth; (3) Nurses gained meaningful professional growth such as awareness of their professional strengths and limitations; choosing the optimal career path, and restructuring their nursing identity and image.

Conclusions
This study shed some light on nurses’ positive experiences during their struggle during the COVID-19 pandemic without neglecting the impact of adverse experiences on nurses. The phenomenon of secondary traumatization in nursing is still undervalued and needs to be explored and addressed. The pandemic provided nurses with a rare opportunity to redefine the meaning of being a nurse and experience professional growth.

Key messages
• Nursing leadership should consider nurses’ emotional needs and include affective-cognitive processing of traumatic events as part of the professional curricula in nursing education and at workplace.
• Public recognition of the added value of nurses strengthened nurses’ professional identity and image. This process of developing the future state of the nursing image must be continued internationally.
Beyond one-sided expectations of integration: Rethinking international nurse migration to Germany
Authors: Peppler L , Feißt M , Schneider A , Apelt M , Schenk L 
Published: October 2023

Abstract

Background
Like most countries, Germany is currently recruiting international nurses due to staff shortages. While these are mostly academic, the academisation of nursing in Germany has only just begun. This allows for a broader look at the participation of migrant nurses: How do care teams deal with the fact that immigrant colleagues are theoretically more highly qualified than long-established colleagues?

Methods
Case studies were conducted in four inpatient care teams of two hospitals in 2022. Qualitative data include 26 observation protocols, 4 group discussions and 17 guided interviews. These were analysed using the documentary method and validated intersubjectively.

Results
Due to current academisation efforts in Germany and the immigration of academised nursing staff from abroad, the areas of activity and responsibility of nursing in Germany are under negotiating pressure. This concerns basic care for example, which in Germany is provided by skilled workers, but in other countries is mostly provided by assistants or relatives. The question of who should provide basic care, whether all nurses or only nursing assistants, documents the struggle between an established and a new understanding of care. In this context, the knowledge and skills of migrant and academicised care workers become a crucial aspect in the struggle for a new professional identity for care in Germany.

Conclusions
The specific situation in Germany makes it possible to show the potential for change that international care migration can constitute for destination countries. The far-reaching process of change of German nursing is given a further dimension not only by its academization, but by the immigration of international and academically trained nursing staff, where inclusive or exclusive effects can already be observed.

Key messages
• The increasing proportion of migrant nurses accelerates the current discussion on nursing in Germany.
• Conflict areas show up in everyday work of care teams and must be addressed there.
Enhancing pharmacy student injection training with the CARD™ system
Authors: Bucci L , Crown N , Gudzak V , Logeman C , Taddio A 
Published: October 2023

Abstract

Background
Immunization stress-related responses (ISRR) such as fear, pain and fainting contribute to negative immunization experiences and non-compliance in about 20% of un-immunized people. We introduced the CARD™ (Comfort, Ask, Relax, Distract) system - the first vaccine delivery framework demonstrated to reduce ISRR - to 240 second year pharmacy students undergoing mandatory immunization injection training and subsequent elective practical experience delivering immunizations in 2022 at the University of Toronto, Canada.

Objectives
The objective was to explore pharmacy students’ perceptions and behaviours following CARD™ education within the injections training course and then after participating as immunizers at influenza pop-up clinics.

Results
Eighteen pharmacy students participated after the injections training course and 19 participated after the pop-up clinics. Students reported CARD™ was aligned with client needs and preferences and national professional standards. They believed it was important to address ISRR and had higher confidence in their ability to support clients during immunization. Students reported deeper understanding of CARD™ after practical experience, including inviting client participation rather than imposing coping strategies.

Conclusions
We are the first group to incorporate evidence-based education about reducing ISRR to training curricula of pharmacy students. We demonstrated that students value education about CARD™ and that including a practical component is important to implementation fidelity. This information is relevant for injection training programs across disciplines and countries.

Key messages
• Incorporating CARD™ in injections training and experiences is acceptable to pharmacy students.
• Reducing ISRR promotes more positive experiences for clients and immunizers.
Pornography associated with youth violence
Authors: Rueda-Bello F , Alarcón-Rascón G E , Rivera-Luna A D , Martinez-Melchor M , Montalvo-Yepez S A , Marquez-Celedonio F G , Villegas-Dominguez J E , Trujillo Peña G J 
Published: October 2023

Abstract

Background
Violence is a very present situation in the various contexts of humanity, with Veracruz, Mexico being one of the most violent states in the country. There are studies that suggest that the consumption of pornography may be associated with an increased risk of violent behaviors due to physiological stimuli and legitimizing the behaviors observed in it. Objective: to determine the association between addiction to pornography and violence in young people from Veracruz, Mexico.

Methods
A cross-sectional, observational, prospective and analytical study was carried out between November and April 2023. Young people between the ages of 12 and 25, residents of Veracruz, Mexico were included; subjects with known psychiatric diagnoses were excluded. Data collection was carried out using Google Forms, applying the ‘Buss and Perry’ violence test (A.Cronbach 0.87) and the ‘EMAP’ pornography addiction test (A.Cronbach 0.95). SPSS v22 software was used for data analysis, X2 test with Odds Ratio (OR) and 95% confidence interval (95%CI) and MannWhitney U test.

Results
1399 subjects were included, with an age of 19.3±2.8 years, 514 participants indicated consuming pornography (all digitally). Pornography addiction was identified in 495(35.3%) subjects and 399(28.5%) with moderate or higher violence. Addiction to pornography was shown to be a factor associated (OR/CI95%) with moderate or higher levels of physical (1.4/1.-1.7), verbal (1.3/1.0-1.6) or general (1.3/1.0-1.7) violence.), anger (1.3/1.0-1.7), hostility (1.4/1.1-1.8), as well as severe physical violence (1.3/1.0-1.7), in the same way that pornography consumption was associated with moderate or superior levels of physical and verbal violence, anger, hostility and violence in general (p &lt; 0.05).

Conclusions
The use of pornography and addiction to it facilitate the presence of physical and verbal violence, anger, hostility and violence in general in moderate or greater intensity, as well as severe physical violence.

Key messages
• Access to pornography through digital media facilitates the presence of violent behavior in young people, so it is necessary to find ways to regulate access to pornography.
• It is necessary to establish strategies to provide education to young people, in order to educate and help the interpretation that young people can give to this type of explicit material.
Association between language barrier and inadequate prenatal care utilization among migrant women
Authors: Eslier M , Deneux-Tharaux C , Schmitz T , Luton D , Mandelbrot L , Estellat C , Radjack R , Azria E 
Published: October 2023

Abstract

Background
Language barriers may limit access to care and thus be associated with increased risk of adverse maternal and perinatal outcomes. Our objective is to assess the association between this language barrier and inadequate prenatal care utilization among migrant women.

Methods
The analysis took place in the French multicentre prospective PreCARE cohort, conducted in four university hospital maternity units in the northern Paris area, having a professional interpreting service. This cohort included 4803 migrant women registered and giving birth between 2010 and 2012. Migrants’ language barrier was categorized in three groups: no, partial or total. Inadequate prenatal care utilization was assessed according to the modified Adequacy of Prenatal Care Utilization Index through multivariable logistic regression models.

Results
Among the 4803 migrant women included, 16.3% had a partial and 3.8% a total language barrier. Migrants with language barrier had resided less time in France, experienced social deprivation and undocumented status more frequently than those with no language barrier. Compared to migrants with no language barrier, those with partial (RR 1.23, 95%CI 1.13-1.33) and total (RR 1.28, 95%CI 1.10-1.50) language barrier were at higher risk of inadequate PCU. Adjustment for maternal age, parity, and region of birth did not modify these association, which were noted particularly among socially deprived women.

Conclusions
Migrant women with language barrier have a higher risk of inadequate prenatal care utilization than those without. These findings underscore the importance of targeted efforts to bring women with language barrier to prenatal care.

Key messages
• Compared with migrant women with no language barrier, those with such barrier, either total or partial, have a higher risk of inadequate prenatal care utilization.
• These findings underscore the importance of targeted efforts to bring women with language barrier to prenatal care.
Irrational nutrition as a risk factor during pregnancy and childbirth
Authors: Stefanova P , Georgiev A , Vasileva R , Kostadinov Sergey 
Published: October 2023

Abstract

Introduction
Nutrition is a factor influencing pregnancy, birth and late fetal development. In Bulgaria, there is a tendency to increase both malnutrition and obesity. This leads to an increase in pregnancy complications. Questions related to nutrition during pregnancy are part of the National Program for Antenatal Care in Bulgaria. The aim is to study the factors associated with eating disorders in pregnant women.

Material and methods
A documentary study and a direct individual survey were conducted among hospitalized pregnant women at Pleven University Hospital. The questions touch on socio-economic, health and educational aspects.

Results
Only half (48%) are at an optimal weight. The percentage of pregnant women with malnutrition is high (24%). The highest proportion of malnourished pregnant women are teenagers (35%), and those over 30 are overweight (27%). The study proved the link of malnutrition with low social and economic status, low/no education. Obesity prevails in the group of unskilled workers (45%). Malnutrition is characteristic of teenage pregnancy (35%), living alone (80%), for ethnically isolated groups (Roma 71%) or living in small settlements (52%). The scope of antenatal care among the respondents is only 28%. Deviations in nutrition led to frequent hospitalizations (52%), anemia (39%), spontaneous abortions (59%). Women with eating disorders more often suffer from infections during pregnancy (46%) and complications in the puerperium (52%). No association was found with preterm birth, premature rupture of the amniotic sac, and low birth weight.

Conclusions
There is a significant share of pregnant women with eating disorders in Bulgaria. The proportion of malnourished pregnant women increases, increasing the risk of complications. Proper nutrition of pregnant women depends on socio-economic factors, education, employment.

Key messages
• In Bulgaria, a National program for antenatal care, including problems with the diet of pregnant women, has been introduced.
• The high proportion of pregnant women with improper nutrition increases the risks for pregnant women and newborns.
Socioecological correlates of parental lifestyle patterns during the prenatal period
Authors: Lecorguillé M , Charles M A , Lioret S , Heude B 
Published: October 2023

Abstract

Background
There is growing evidence that family lifestyle patterns in early life are associated with the risk of child obesity. However, beyond the influence of socio-economic position, scarce are studies on the social determinants of such lifestyle patterns. The aim was therefore to investigate the socio-ecological correlates of parental lifestyle patterns in pregnancy.

Methods
We selected 1,110 families from the EDEN birth cohort, recruited in two maternity hospitals in France between 2003 and 2006. In a previous work, we identified two parental lifestyle patterns characterized by 1) “high parental smoking, low maternal diet quality, and low leisure physical activity 2) “low parental body mass index and high gestational weight gain”. Within the framework of both socio-ecological and hierarchical approaches, we conducted multivariable linear regression analyses, with socio-ecological factors added progressively from the most distal to the most proximal, i.e. urban environment variables (block 1); socio-economics, geographic origin, parents’ age, parity (block 2); and psychological factors or access to health care (block 3).

Results
Parents with a higher socio-economic position (education level, household income), first-time or older mothers and those having attended antenatal sessions had lower scores on the first pattern. Multiparous women, with an intermediate level of education, and older fathers had lower scores on the second pattern. No major associations were reported with urban environment or psychological factors.

Conclusions
Beyond the expected socio-economic gradient of family lifestyle patterns, we report novel insights into potential levers specific to the prenatal period, such as the opportunity of parenting preparation to engage in healthy behaviours. Analyses will be replicated in three other European cohorts, if confirmed, these findings will be valuable to increase the effectiveness of future childhood obesity prevention strategies in early life.

Key messages
• Higher socio-economic conditions and attendance of parenting preparation classes are associated with healthier family lifestyle in pregnancy.
• The identification of potential facilitators and barriers for family lifestyle in early life will help for further translation to effective childhood obesity prevention and implementation strategies.
Changes in adolescent physical activity levels pre and post COVID-19 in Ireland
Authors: Ng K , Woods C B 
Published: October 2023

Abstract

Background
The World Health Organisation (WHO) recommends moderate to vigorous physical activity (MVPA) for at least, on average, 60 minutes per day, and muscle strengthening exercises at least three times a week for adolescent health. Lockdowns, sports club and school closures during COVID-19 limited children's PA opportunities. The aim of this study was to examine changes in PA behaviour among students in schools undertaking a PA intervention (the Active School Flag: ASF) over three consecutive years.

Methods
ASF is a whole school intervention. Its aim is to increase student PA opportunities and thus, PA levels. ASF implementation team includes students, teachers and school management. Using a repeated cross-sectional panel study design, all students in five pilot ASF schools were invited to complete the ASF whole-school survey in September 2019, 2020 and 2021. Descriptive statistics, contingency tables and multi-logistic regression analyses evaluated changes in PA behaviour over time.

Results
Students in five schools (N = 7530, 33% male; 65% female, 2% other) took part. Physical inactivity (WHO guidelines for only 0-2days) dropped from 25% in 2019 to 22% in 2020 and 23% in 2021. Analysis by gender showed females to be most active in 2020 (p = .004). No significant changes, over time, were found for muscle-strengthening exercises. Four out of the five schools reported a significant increase in active travel and a decrease in car transport behaviour from 2019-2021, no gender differences were found.

Conclusions
COVID-19 public health restrictions varied over the duration of this study (higher in 2020 than at other time points). Little or no change in overall PA or muscle-strengthening exercises was established, yet significant increases in active transport to and from school were reported. Further research should explore mechanisms and the potential of a displacement hypothesis for types of PA change during this time.

Key messages
• COVID-19 movement restrictions, such as lockdowns, school and sports club closures contributed to increases in active transport to and from school, while other forms of PA remained largely unchanged.
• The Active School Flag may be an effective programme to reduce the amount of students who are physically inactive.
Impact evaluation of KOICA MNCH project in Jimma Ethiopia using a difference in differences analysis
Authors: Kim K H 
Published: October 2023

Abstract

Background
The maternal mortality ratio in Ethiopia is 412, which is higher than its neighboring countries. To address this issue and improve the health of women of childbearing age, the Maternal Neonatal and Child Health (MNCH) project was implemented in Jimma zone, Oromia, Ethiopia with support from the Korea International Cooperation Agency (KOICA). The objective of this study is to measure the impact of the project on maternal health in Jimma, Ethiopia.

Methods
The study employed DID analysis to measure the impact of the project on five key variables, including ANC 4, institutional delivery, satisfaction with MCH-related services, pregnancy-related knowledge, and delivery-related knowledge. A total of 789 participants were randomly selected for the baseline survey from both the intervention and control groups in 2017. The same groups were surveyed again one year later using the same study design for the endline survey.

Results
The study found that the trends in ANC4 and the level of satisfaction with the MCH service provided were similar in both the intervention and control groups. However, significant impacts were observed in terms of institutional delivery, pregnancy-related knowledge, and delivery-related knowledge. The odds ratio for institutional delivery was 2.83 (p &lt; 0.01) for women in the intervention group compared to the control group. Similarly, the odds ratio for pregnancy-related knowledge was 0.67 (p &lt; 0.01), and the odds ratio for delivery-related knowledge was 1.70 (p &lt; 0.01) for women in the intervention group compared to the control group.

Conclusions
The study concludes that the KOICA MNCH project partially achieved its objective, as the intervention had a positive impact on institutional delivery and maternal knowledge levels. However, the insignificant impact on ANC4 and the level of satisfaction with MCH services suggest the need for further intervention to fully address maternal health issues in Ethiopia.

Key messages
• This study is significant because it has provided empirical evidence that maternal health projects implemented in the Jimma Zone of Ethiopia can positively impact various aspects of maternal health.
• The results of this study can serve as a valuable reference for policymakers and healthcare professionals involved in designing and implementing maternal health interventions.