bluuebunny/crossref_metadata_2025_split huggingface dataset:
Building a comprehensive online course series to enhance infodemic management globally
Authors: Purnat T , Bertrand-Ferrnadis C , Wilhelm E , Utunen H , Briand S , Nguyen T 
Published: October 2023

Abstract

Background
Infodemic management has become key to supporting public health prevention and response to epidemics. 91% of WHO Member States declared having capabilities to track and address infodemics and health misinformation (WHO pulse survey). However, the scientific field of infodemiology is quickly evolving, and the practice of infodemic management consequently requires the health workforce to have a multidisciplinary and cross-functional skill set and to update it regularly.

Objectives
Since 2020, WHO and its partners have developed an innovative global blended training program and created a network of over 1300 infodemic managers from 142 countries. To keep the pace of science development, WHO has created an additional series of online courses allowing frontline workers easy, self-paced, and free access to updated and evidence-based infodemic management frameworks and best practices.

Results
Mid-2023, a comprehensive “infodemic management” channel, including eight interconnected courses, will be launched on the award-winning platform OpenWHO.org. The first course, “Infodemic management 101”, has already attracted more than 21000 enrolments in English. The seven additional two-hour courses will allow health workers to learn how to generate an infodemic insights report, address health misinformation, be efficient in the field, or co-construct efficient interventions with communities. The course series will be available in English, French, and Spanish.

Conclusions
This new e-learning program will enhance practice in infodemic management in all countries, even those with low bandwidth. Health workers can access the courses on OpenWHO from anywhere, at any time, and no fees.

Key messages
• Infodemic management requires the health workforce to have an updated multidisciplinary and cross-functional skill set.
• The new comprehensive WHO course series on infodemic management, available in three languages, will help to build skills and competencies for frontline health workers.
Violence against healthcare workers: a health system approach and international comparative study
Authors: Kuhlmann E , Falkenbach M , Lotta G , Tenbensel T , Dopfer-Jablonka A 
Published: October 2023

Abstract

Background
Violence against healthcare workers is a global health problem threatening healthcare workforce retention and health system resilience in a fragile post-COVID ‘normalisation’ period. There is an urgent need for action to make violence against healthcare a greater priority. Our novel contribution to the debate is a comparative health system and policy approach, aiming to explore major trends and identify policy gaps.

Methods
We have chosen a most different systems comparative approach concerning the epidemiological, political, and geographic contexts. Brazil (under the Bolsonaro government) and the United Kingdom (under the Johnson government) serve as examples of countries that were strongly hit by the pandemic in epidemiological terms while also displaying policy failures. New Zealand and Germany represent the opposite. A rapid assessment was undertaken based on secondary sources and country expertise.

Results
We found similar problems across countries. A global crisis makes healthcare workers vulnerable to violence. Furthermore, insufficient data and monitoring hamper effective prevention, and lack of attention may threaten women, the nursing profession, and migrant and minority groups the most. There were also relevant differences. No clear health system pattern can be identified. At the same time, professional associations and partly the media are strong policy actors against violence.

Conclusions
All countries in our sample failed to respond effectively to growing violence and improve the prevention and protection of healthcare workers. Much more involvement from political leadership is needed; attention to the political dimension and all forms of violence are essential. Violence against HCWs is and will remain a problem long after the pandemic subsides. If political action is not taken, healthcare workers will have an additional reason to leave their profession and workplace, thus reinforcing the healthcare workforce crisis.

Key messages
• Getting prevention of violence against healthcare workers and effective protection right, enhances the retention of the existing workforce and will attract new generations of healthcare workers.
• Governments must prioritise developing feasible and effective policy responses to tackle the risk factors that healthcare workers face at the workplace and on social media.
Information networks of healthcare professionals in Europe on older adult vaccines: Network analysis
Authors: Wennekes M D , Eilers R , Stein M L , Caputo A , Gagneux-Brunon A , Gavioli R , Nicoli F , Biesheuvel J , Vokó Z , Timen A 
Published: October 2023

Abstract

Background and objectives
Healthcare professionals (HCP) have a key role in raising awareness and informing older adult patients about vaccines. However, HCPs are sometimes unaware of existing vaccines or have little knowledge on them. This study aimed to identify the information flows within HCP networks and to find out which HCPs play a key role in interprofessional information transfer.

Methods
An online questionnaire was distributed in Hungary (HU), Italy (IT), the Netherlands (NL) and France (FR) among HCPs, such as general practitioners (GP), medical specialists (MS), public health physicians (PHP), pharmacists, specialists elderly care (SEC) and nurses. The questionnaire included a case study in which a new vaccine for older adults was about to be made available. HCPs were asked whom they would contact for additional information and by whom they would be contacted on their turn, to reveal the information flow. Data were analyzed using social network analysis, comparing the results between countries.

Results
Preliminary results show the top three information providers. These were identical for NL and IT, with the MS being contacted by the highest number of different HCP-types, followed by the GP and PHP. FR and HU had GP ranked first and MS second. The PHP ranked also third in HU, but in FR it was the geriatrician instead. The main requesters of information were pharmacists (IT, HU), GPs (NL) and community nurses (FR). Hospital nurses (IT, FR), SEC (NL) and GPs (HU) ranked second on the number of HCP-types they would contact for information on a new vaccine.

Conclusions
In each country GPs and MS were the most important information providers in the HCP network when a new vaccine is introduced. Main information requesters varied per country and were pharmacists, GPs, nurses, and SEC. Thus, GPs were both main information providers and requesters (NL, HU).

Key messages
• Our study identified the HCP-(information)network regarding (new) vaccines for older adults. GPs and MS are the main providers of information, while pharmacists, nurses, and GPs are main requesters.
• Identifying the HCPs in the information network makes it possible to specifically target key HCPs and to provide them with tailormade information on new vaccines.
Turnover intention of foreign trained physicians in German rehabilitation facilities
Authors: Jansen E , Schmidt J , Marquardt M 
Published: October 2023

Abstract

Germany's medical specialist shortage is an acute challenge, especially in the rehabilitation segment. One countermeasure is to recruit foreign trained physicians (FTP), but high turnover of FTP is a burden on the departments that train them and integrate them professionally. Preliminary research showed that currently one in three physician positions in German Pension Insurance (DRV) contract facilities is filled by FTP. This paper examines the turnover intention of FTP in German rehabilitative departments. In spring 2022, we conducted an online survey of FTP that captured sociodemographic and professional biographical data, turnover intention, satisfaction, difficulties with professional integration and structural characteristics. The data was evaluated in a subgroup analysis using chi-square tests. The sample includes n = 145 FTP, 119 stating no turnover intention and 27 with turnover intention. More than half of FTP with turnover intention wished to move to an acute care hospital. They are significantly (p &lt; 0.05) younger, have worked in Germany and in the institutions for a shorter time, and have studied in more countries than FTP without turnover intention. The latter are proportionally more likely to have a German specialist title and management responsibilities. FTP with turnover intention are far less satisfied, particularly with career prospects and institution location. Structurally, FTP with turnover intention are proportionately more likely to be based in peripheral regions than conurbations, which are where all FTP without turnover intention are based. FTP with turnover intention have reported a much higher rate of discrimination by non-physician colleagues.

Key messages
• The results reveal a group of ‘established FTP’ whose professional integration has been successfully completed.
• FTP with turnover intention are comparatively younger, career-oriented physicians for whom work in the rehabilitation facility is a career springboard to gain a foothold in acute care clinics.
Injury related hospitalization: evidence from one year retrospective study
Authors: Pitskhelauri N , Kereselidze M , Akhobadze K , Chkhaberidze N , Chikhladze N 
Published: October 2023

Abstract

Background
Injury remains a significant global public health issue, especially in low- and middle-income countries (LMICs). According to the IHME data Georgia has slightly higher rates of Injury-related DALYs, then WHO European Region average and significantly exceed the average of the Upper Middle Income countries group, to which country belongs according to the World Bank classification. The aim of the study was to explore the epidemiological characteristics of injury in Georgia.

Methods
This study was designed in the framework of NIH-Fogarty International Trauma Training Program iCREATE. Hospitalization Database of the National Center for Disease Control and Public Health of Georgia for 2021 was used for the retrospective study. Hospitalization database includes data from all hospitals of the country. Injury related cases were identified using ICD-10 classifications (S and T codes).

Results
A total of 564411 patients, among them 29228 injured patients were admitted in all hospitals of Georgia in 2021. 61% of injured patients were males and 39% females, retrospectively with ratio 1:1.5. The mean age of injured patients was 42(±25) and the highest hospitalization was in the age group of 30-34. The leading cause of injuries was falls (51.9%) followed by accidental exposure to other and unspecified factors (15.5%) and road traffic injuries (9.5%). Most of injured patients (45%) were treated in the capital of Georgia, Tbilisi. The most common source of hospital arrival was ambulance (47%), followed by private/public transport (46%), the 7% of patients needed referral from one hospital to another. The average of LOS was 4 days. 1% of patients died, among them 67% were males and 33% females. The most common mechanism of fatal injuries was falls (47%), followed by transport accidents (24%).

Conclusions
This study provide baseline information about epidemiological characteristics of Injuries based on hospitalization database and identify direction for the future research.

Key messages
• In Georgia there is a need for elaborating relevant preventive interventions of injuries in population.
• In LMICs there is a lack of data on Injuries which are essential for elaborating relevant preventive interventions.
How do midwives deal with women’s preferences during childbirth in Germany? An action model
Authors: Tallarek M , Jost A , Spallek J 
Published: October 2023

Abstract

Background
Midwifery care is increasingly discussed in terms of its ability to promote a self-determined childbirth. The degree of self-determination (SD) depends on the extent to which women's preferences are negotiated and implemented. From the perspective of midwives in different obstetric settings in Germany, this study answered the research question: “How do midwives deal with women's preferences during birth?”.

Methods
11 semi-structured face-to-face interviews were conducted with active midwives. The sample showed a high variance in terms of obstetric settings (clinics, birth centers, home births), regions, and participants’ characteristics (e. g. experience, age). All interviews were recorded, transcribed, anonymized, and analyzed using the Grounded Theory Methodology (Strauss/Corbin, 1994).

Results
A model consisting of 7 steps was developed: 1) Interpret the situation; 2) Prioritize relevant parameters; 3) Determine a frame of possibilities; 4) Match the preference(s) to the frame of possibilities; 5) Negotiate preference(s); 6) Continuously monitor contextual/situational changes; 7) Adjust the frame of possibilities. The actions are related to contextual conditions (structural; interpersonal; personal; health situation; course of birth; understanding of birth). The model shows how midwives can promote SD even if prior preferences are discarded or modified at birth.

Conclusions
The model describes how midwives in Germany deal with women's preferences during birth, which factors they consider decisive in doing so, and how SD may be promoted despite of discarded or modified preferences. Further research should examine the role of relationship building, test the model with regard to its generalizability, and use it to analyze and support person-centered midwifery care.

Key messages
• The model describes how midwives in different obstetric settings in Germany deal with women’s preferences during birth and, thereby, influence self-determination.
• Midwives can promote self-determination also if prior preferences are discarded, modified, or redeveloped at birth.
The relationship between parental mental health and preschoolers’ stress hormone and development
Authors: Kang Y S , Chien L C , Zou M L , Lin W Y , Hsu H W , Lin W C , Chen Y H 
Published: October 2023

Abstract

Background
Hair cortisol concentration (HCC) has been identified as a biomarker that reflects chronic physiological stress. However, research on the association between mental health and HCC has been limited and yielded inconsistent results. This study thus aims to investigate the relationship between parental mental health and HCC and explore the relationship between parental mental health and HCC in preschoolers and their development.

Methods
Data from the ongoing project of Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan (LEAPP-HIT) conducted in Taipei between 2017 and 2022 was utilized. A total of 131 families completed a self-reported questionnaire and provided hair samples from early pregnancy to four years postpartum. Of these families, 68 were followed up until the postpartum years and provided information on their preschoolers’ developmental outcomes. Multiple regression was utilized for analyses.

Results
We found that paternal eudaimonia was significantly negatively associated with paternal HCC (r= -0.49, p &lt; 0.05) and maternal anxiety (r = 0.21, p &lt; 0.05) and perceived stress (r = 0.39, p &lt; 0.05) were significantly positively associated with maternal HCC. Furthermore, maternal higher HCC was associated with preschoolers’ higher HCC (β = 0.34, 95%CI=0.05-0.53) and higher risks of preschoolers’ suspected developmental delay (odds ratio (OR)=3.25; 95%CI=1.02-10.3).

Conclusions
Poorer mental health was associated with elevated cortisol levels in mothers and fathers. Maternal higher HCC was positively associated with preschoolers’ HCC and their higher risks of suspected developmental delay. We thus highlight the importance of early screening and health education programs during pregnancy for both mothers and fathers to reduce parental stress and the following risks of developmental delay in preschool-aged children.

Key messages
• Parental Hair cortisol may effectively reflect the association between mental health and physical stress.
• Maternal higher HCC was associated with preschoolers’ higher HCC and higher risks of preschoolers’ suspected developmental delay.
‘Why did nobody ask us?’, parents’ views on childhood vaccines: A co-production research study
Authors: Skirrow H , Foley K , Lewis C , Bedford H , Whittaker E , Haque H , Choudary-Salter L , Costelloe C , Saxena S 
Published: October 2023

Abstract

Background
Inequalities in childhood vaccine uptake exist in the United Kingdom but previous surveys of vaccine attitudes have underrepresented parents of children with low vaccine uptake. We aimed to explore parents’ views and experiences of vaccinating their child and how the COVID-19 pandemic had impacted childhood vaccine attitudes.

Methods
We worked with Mosaic Community Trust, an ethnically diverse women's community group using a participatory approach to co-develop a questionnaire for parents with children aged under 10 years old. We targeted recruitment at parents living in the North-west London area, where vaccine uptake has been historically low and continues to be lower compared to regionally and nationally. The questionnaire was promoted through local community networks alongside targeted social media promotion. We then held four parents’ focus groups in 2023, co-facilitated by Mosaic.

Results
Between Jun-Oct 2022, 518 parents completed the questionnaire (64% UK born and 30% from ethnic minorities). Most parents (92%) believed childhood vaccines were important and 16% had delayed or refused a childhood vaccine. In both the questionnaire and the focus groups (n = 22), parents reported that lack of reminders and difficulties booking or going to appointments impacted uptake. They also wanted easier access to trusted health professionals to answer vaccine questions. In both the questionnaire responses and focus groups some parents reported that COVID-19 had changed their childhood vaccine views either highlighting their importance, increasing parents’ questions, or increasing mistrust.

Conclusions
Parents report practical barriers impact vaccine uptake including difficulties booking or attending childhood vaccine appointments. Parents should be offered easy access to trusted healthcare professionals to answer their questions about vaccines particularly in the aftermath of the COVID-19 pandemic which has negatively affected some parents’ views on childhood vaccines.

Key messages
• Parents want easy access to trusted healthcare professionals to answer their questions about childhood vaccination particularly since the COVID-19 pandemic.
• Parents report that difficulties booking & attending vaccine appointments are key reasons for late or missed childhood vaccination in the UK.
Grandparental income and adverse neonatal outcomes in Finland in 2000 − 2015
Authors: Remes H , Metsä-Simola N , Martikainen P 
Published: October 2023

Abstract

Background
Pre-term births and other adverse neonatal outcomes are a major burden to healthcare systems, and they also contribute to long-term health problems. Socioeconomic inequalities in these outcomes are well-documented, but whether grandparental characteristics influence them over and above parental characteristics remains unclear.

Methods
We used population register data on all singleton children of non-migrant origin, born in Finland in 2000 − 2015 (n = 341,715), linked to their both biological parents and all four grandparents, including an indicator for deceased kin members. We examined whether grandparental income predicted grandchildren's neonatal outcomes (preterm birth, low birth weight, small for gestational age, congenital malformations) in addition to parental income, once accounting for sociodemographic family characteristics such as parental age, parity, education, family structure, and maternal smoking.

Results
We found a consistent association between lower income and adverse neonatal outcomes, for both mothers and fathers, as well as maternal and paternal grandparents. The gradient was stronger among young mothers (under age 25), e.g., the prevalence of being born small for gestational age was 11% for the highest parental or grandparental income quintile, while for the lowest it ranged from 13 to 15%. Overall, the income gradients clearly attenuated in adjusted models, but remained. Preliminary results suggest grandparental characteristics mainly influence grandchild outcomes through the middle generation, but depending on the outcome, partly independent associations remain.

Conclusions
Even in the context of a Nordic welfare state, offspring of lower income grandparents are at higher risk of adverse neonatal outcomes, particularly when born to young mothers. This influence mainly, but not fully, passes through the parental generation, suggesting more support should be offered to expecting parents with low income and from disadvantaged backgrounds.

Key messages
• Lower grandparental income predicts higher risk of adverse neonatal outcomes, particularly when born to young mothers.
• Expecting parents with low income and disadvantaged family background should be supported to reduce adverse neonatal outcomes.
Self-reported emotional and behavioural problems among adolescents with migrant parents in Lithuania
Authors: Racaite J , Antia K , Winkler V , Lesinskiene S , Dambrauskaite E , Tracevskyte I , Surkiene G 
Published: October 2023

Abstract

Background
The mental health effects of parental emigration on adolescents who stayed behind in Eastern European countries are not fully understood. This study examines the emotional and behavioural difficulties of stay-behind adolescents in Lithuania.

Methods
The data collection took place January 2022-April 2023 from adolescents between the ages of 12 and 17 who attended 25 schools from 15 regions in Lithuania. This cross-sectional study was approved by the Biomedical Research Ethics Committee, No. 2021/11-1378-861. Parents and adolescents provided informed consent to participate in the study. Self-reported Strengths and Difficulties Questionnaire (Goodman, 2005) and a questionnaire on demographics and health status, were collected. Descriptive statistics and t-tests were calculated by using Stata (version 15.1).

Results
The sample consisted of 728 adolescents (response rate 52,6%), with a mean age of 14.5 years (SD 1.63), 43.4% males and 54.7% females. Of the total sample, 35,7% lived in rural areas, 84,8% had siblings and, 15.7% had at least one migrant parent. Most staying behind adolescents had migrant fathers (83.3%), and (90,6%) maintained regular online communication with their emigrated parents. Compared to peers living with parents, staying behind adolescents obtained significantly higher emotional and behavioural problems total score (12.3, SD 5.5 vs 10.7, SD 5.5, respectively), with a p-value of 0.006. In addition, adolescents with migrant parents had significantly higher scores than their peers living with parents on the emotional subscale (3.2, SD 2.5 vs 2.5, SD 2.4) and problems subscale (2.9, SD 1.7 vs 2.5, SD 1.7), with a p-value of 0.02 for both subscales.

Conclusions
This study found higher emotional and behavioural problems among stay-behind adolescents compared to those living with parents in their home country. The findings emphasize the need to implement supportive interventions and increase awareness of these issues in society.

Key messages
• Stay-behind adolescents in Lithuania experience higher emotional and behavioural problems than their peers living with parents in home country.
• Greater focus should be given to the emotional health of stay-behind children and adolescents in migrant-sending countries.