bluuebunny/crossref_metadata_2025_split huggingface dataset:
Process evaluation of The Breastfeeding Trial. What factors impact the intervention delivery?
Authors: Rossau H K , Gadeberg A K , Strandberg-Larsen K , Nilsson IMS , Villadsen S F 
Published: October 2023

Abstract

Background
Breastmilk is the ideal nutrition for infants, and breastfeeding is an important health promoting behaviour. In Denmark, most mothers initiate breastfeeding but many cease within the first months resulting in just 14% reaching the World Health Organization recommendation of six months exclusive breastfeeding. A large-scaled, cluster-randomized intervention study implemented in the Danish health visiting programme aimed to extent the duration of breastfeeding and reduce social inequality. To elucidate how the intervention was implemented, a process evaluation of the intervention was conducted.

Methods
Following the MRC guidelines for process evaluation, we used a mixed methods approach to assess the delivery of the intervention, and facilitators and barriers in the context that affected the implementation. Data from questionnaires distributed to the health visiting managers of 21 Danish municipalities and 242 health visitors employed there, and data from three focus groups with health visitors and eight individual interviews with mothers in the intervention informed the process evaluation.

Results
Preliminary findings from questionnaires imply that the training program slightly enhanced health visitors’ breastfeeding support competencies. However, health visitors explained in the focus groups that they provided support as usual. A contextual factor hindering the implementation was change of personnel. Having had favourable experiences with the intervention acted as facilitator. Findings from interviews with mothers indicated a high fidelity in the distribution of intervention materials and partner involvement.

Conclusions
Preliminary findings of this study show variability in how the intervention was implemented throughout the intervention sites. This evaluation will assist in the interpretation of the results of the effectiveness study and inform policy makers about if and how this intervention could be scaled up.

Key messages
• Health visitors in intervention clusters seemed to have gained competencies in breastfeeding support; however, expressed that they provided support ‘as usual’.
• Change of personnel acted as a barrier, while having had positive experiences with the intervention acted as a facilitator.
Alcohol per capita and prevalence of alcohol exposed pregnancies: systematic review and meta-analysis
Authors: Burton E , Kelly S , Kearney P M , Moffat M , Morris J , Popova S , Rankin J , O'Mahony M 
Published: October 2023

Abstract

Background
Alcohol is a teratogen that crosses the placenta. While studies have estimated the global burden of alcohol use in pregnancy, reliable and valid data on alcohol consumption during pregnancy in many countries is lacking. Alcohol consumption per capita (APC) data are available worldwide. This systematic review, by investigating the association between APC and alcohol consumption in pregnancy by country, aims to evaluate the accuracy of using APC data to predict the prevalence of prenatal alcohol exposure (PAE).

Methods
This study combines studies identified in a systematic review by Popova et al. 2017 and a systematic search of MEDLINE from 2015 through 6th October 2022, to identify additional papers. Papers identified in either search were on the prevalence of PAE or fetal alcohol syndrome (FAS). Two authors independently screened titles, abstracts, full-text articles and performed data extraction and quality assessment. APC data,per country, by year, was obtained from the World Health Organization (WHO) website. A meta-analysis, assuming a random effects model will be performed. Sensitivity analyses, including restricting by population, timing of exposure, time and method of ascertainment of alcohol consumption will be carried out.

Results
Of 24,935 PAE and 12,231 FAS prevalence articles identified, 400 PAE studies and 77 FAS studies met the inclusion criteria. Studies represent data from 1959-2020 from all 6 WHO regions, with APC between 0.012-14.78. Preliminary analysis suggests a statistically significant correlation between prevalence of alcohol consumption during pregnancy and APC.

Conclusions
Preliminary results from this study suggest that publicly available data on APC can be used to predict the population-based prevalence of alcohol use in pregnancy in different countries. Effective policies and interventions are required to reduce APC and thus, alcohol use in pregnancy and associated detrimental child health outcomes around the globe.

Key messages
• Knowing the prevalence of FAS and its main risk factor- prenatal alcohol use, will inform the setting of priorities for public health policy, public health initiatives, and health-care planning.
• By investigating the association between alcohol intake in pregnancy and APC we will assess whether APC can predict alcohol intake in pregnancy.
Association between influenza vaccination and antibiotic prescription in pediatric population
Authors: Arzilli G , De Angelis L , Baglivo F , Forni S , Gambioli A , Gemmi F , Rizzo C 
Published: October 2023

Abstract

Introduction
A major cause of antimicrobial resistance (AMR) is inappropriate antibiotic consumption in humans. The scientific literature is discordant on the impact of the indirect effect that influenza vaccination in the pediatric population in counteracting AMR. This study aims to evaluate the impact of influenza vaccination on antibiotic prescriptions in the pediatric population in Tuscany (Italy) for the 2019-20 influenza season.

Methods
A retrospective cohort study was performed from current data obtained from the Tuscany Regional Health Authority. We recruited all the children between 6 months-6 years old who underwent influenza vaccination between September 2019 and April 2020. Each vaccinated child was matched with an unvaccinated by Propensity Score Matching for sex, age, area of residence, exemptions, previous hospitalization, and deprivation index. The consumption of beta-lactam antibiotics and macrolides (main drugs used for pediatric respiratory infections) between 15 days after vaccination and the end of the study period was measured for each child. The outcome is the number of antibiotic prescriptions per 100 weeks at risk. The association between influenza vaccination and antibiotic consumption was measured by estimating relative risk from a Poisson regression model.

Results
The study population consisted of 23,034 vaccinated children. Antibiotic prescriptions were 2.27 per 100 weeks at risk in the unvaccinated and 3.01 per 100 weeks in the vaccinated. Antibiotic prescribing in vaccinated children was higher than in the unvaccinated, with a relative risk of 1.33 [CI 95% 1.29-1.35; p &lt; 0.00001].

Conclusions
The results show a higher prescription of beta-lactams and macrolides in children vaccinated with influenza vaccine than in unvaccinated children during the study period. This result may depend on factors that cannot be measured with the available data, such as the number of visits to the pediatrician and the medical's propensity to prescribe antibiotics.

Key messages
• The results of this study showed that vaccinated children had a higher rate of antibiotic prescriptions than unvaccinated children.
• Factors not measured, such as the frequency of pediatrician visits and medical prescribing habits, may have influenced the higher rate of antibiotic prescriptions in vaccinated children.
Pandemic experiences and mental health among young people in Ireland: lessons from Teenpath COVID
Authors: Lee S J , Muhammed U , Ahmed Z , Pirghasemi P , Tambe K , Stanistreet D 
Published: October 2023

Abstract

Teenpath COVID is a mixed-methods, participatory study exploring the experiences of young people in Ireland since the COVID-19 pandemic and its impacts on existing health inequalities. As part of an exploratory sequential research design, we conducted a stakeholder analysis, online survey, and participatory arts programme evaluation to identify cross-cutting issues impacting the health and well-being of young people in Dublin and across Ireland. Interviews conducted with stakeholders spanning youth service, public health, and education sectors, and young people aged 16-25 explored individuals’ experiences of the pandemic; adaptations to working and maintaining engagement online; key concerns about young people's health and wellbeing; and priorities for future research and policy. Thematic analysis identified impacts of the pandemic on health inequalities with potential policy implications. This informed a subsequent online survey exploring young people's mental health since the pandemic, and an ethnographic case study of a participatory arts programme exploring key issues important to young people in Dublin. Our findings suggest the pandemic has impacted predominantly on young people's mental health and access to youth mental health services; disruption to work, education and social and peer support networks; and health behaviours. Protective measures, from accessing and maintaining social support networks, to developing coping strategies were important for young people's mental health. However the extent to which these were possible was shaped significantly by individuals’ personal circumstances at the time. These findings show the importance of social participation and support for young people in navigating the uncertainties and difficulties of growing up in a pandemic. Participatory approaches can be a pathway for aligning healthy priorities and policy that contributes unique and rich insights into community health, and places young people at the centre of change.

Key messages
• Young people in Ireland have experienced significant impacts to their mental health since the COVID-19 pandemic began, particularly regarding disruptions to education and social support networks.
• Participatory approaches to research and youth engagement with young people is important for gathering high quality and diverse data on complex topics such as mental health and health inequalities.
Reducing the impact of COVID-19 on physical activity and mental health
Authors: Ambrosio L , Faulkner J , Lambrick D , Morris J , Compton E , Portillo M C 
Published: October 2023

Abstract

Background
During the COVID-19 pandemic the United Kingdom government released regular guidance on limiting the spread of COVID-19. People, including those with long term conditions, were told to use physical distancing, self-isolation and/or shielding during COVID-19 to protect themselves and others. A consequence of these interventions was to exacerbate poor lifestyle behaviours, namely less physical activity.

Objectives
To propose recommendations to support and sustain their physical activity of people with long term conditions during and after COVID-19 or other pandemics.

Methods
A mixed methods project was conducted. An online quantitative survey with 368 people in the United Kingdom was conducted, followed by 26 online semi-structured interviews.

Results
The study demonstrated that online resources are not accessible for all populations. During COVID-19 pandemic, provision of PA information was most commonly available online. Also, COVID-19 lockdowns meant the sudden loss of opportunities to be active along with the social interaction and motivation usually in place to support activity. Finally, physical activity guidelines should be more specific. Local and national government guidelines were identified as unclear for those living with long term conditions and should be more specific regarding what people who were shielding could and could not do.

Conclusions
Based on the findings, more suitable and accessible physical activity guidelines for people with long term conditions is recommended. Also, prioritizing vulnerable groups is recommended to support physical activity to avoid the worsening of emotional wellbeing, and quality of life. Finally, government and public health authorities should consider charities and long term conditions voluntary organizations to design bespoke physical activity recommendations and guidelines for those shielding at home and living with long term conditions.

Key messages
• Government and public health authorities design bespoke PA recommendations for those living with LTCs.
• Simple strategies such as ‘move more and sit less’ or ‘breaking up sitting time’ could be promoted as safe and accessible options for those living with LTCs.
Modelling health effects of air pollution in Ukraine
Authors: Schutte L , Belis C , Van Dingenen R , Turos O I , Petrosian A A 
Published: October 2023

Abstract

Background
Air pollution places a burden on health, climate, national economies and well-being in the European Union (EU) and EU candidate countries. Ukraine was the country with most deaths per 100,000 inhabitants attributable to atmospheric air pollution in 2017 according to the World Health Organisation. Harmonisation of air quality monitoring regulations and control methods with EU standards is important to lower the burden of air pollution in Ukraine.

Methods
This study applies the JRC-Fast Scenario Screening Tool (JRC-FASST) with ground air quality measurement data in order to study how premature mortality in Ukrainian cities is affected by the pollutant PM2.5 pre- and during COVID-19. Furthermore, a scenario analysis at country level is carried out to evaluate past and projected trends of mortality in Ukraine under three different air quality policy scenarios.

Results
The preliminary results show that estimated PM2.5 attributable mortality is significantly lower in the year 2020 compared to 2019 in all studied cities. Both at a country level and at a city level, ischemic heart disease is the main cause of death associated with PM2.5 attributable all-cause mortality.

Conclusions
Increasing the body of research on the health effects and costs of air pollution in Ukraine is important to acquire evidence in support of further alignment of Ukrainian air quality policies with those of the EU.
Multidimensional poverty and depression among with and without Disabilities
Authors: Yeob K E , Kim S Y , Park J H 
Published: October 2023

Abstract

Background
Traditionally, poverty has been measured based on an individual income, however it is now accepted that income gives too narrow a view of an individual's overall living standards and other indicators of living standards are needed. Multidimensional poverty measures are a useful tool for policymakers in order to identify target populations for policies aiming to improve equity and reduce chronic disadvantage.

Methods
We analyzed the Korea Welfare Panel Study, a nationally representative survey. Poverty variables were selected based on monetary and non-monetary categories. The six poverty dimensions were income, education, housing, medical care, social relationships, and employment. Depressive symptoms were measured using the Korean version of CES-D-11.

Results
All dimensions of poverty and depression had higher rates in people with disability than non-disabilities in the order of income (+33.1%p), education (+27.2%p), social relationships (+9.7%p), and medical care (+6.5%p). Depression rate was also higher for people with disability (p &lt; .0001). The factors influencing depression of people with and without disability by multidimensional poverty were somewhat different. The disabled and non-disabilities with poverty of social relationships were equally more likely to have a depression (aOR=7.33, &lt;.0001, aOR=3.85, &lt;.0001), however, the non-disabled with medical care poverty were more likely to have a depression (aOR=6.76, &lt;.0001) than without medical care poverty, and the disabled with employment poverty were about 3 times more depressed (aOR=3.67, &lt;.0001) than with employment poverty.

Conclusions
This study suggest that access to various aspects of life, as well as income support, should be considered in policy making for resolving the poverty problems and mental health among people with disabilities.

Key messages
• There were disparities in the prevalence of multidimensional poverty and depression in the people with disabilities, especially those with severe disabilities.
• The main factors influencing depression of people with disability by multidimensional poverty were social relationships and employment poverty.
Which needs assessment tool to use? Review of the needs assessment tools for service evaluation
Authors: Makivić I , Selak Š , Kragelj A 
Published: October 2023

Abstract

Background
Needs assessment enhance patient-centered care quality and is important within evaluation process, as well as for implementation of new services. Needs assessment tools can help clinicians to plan treatment and also to assess subsequent service impacts. Aim of the present research was to review quantitative tools for mental health needs assessment, that are either self-reported or can be used by professionals or researchers.

Methods
A comprehensive literature search in two bibliographic databases was carried out following the PRISMA protocol. Additional search was performed in specific review papers. Included papers are quantitatively assessing the needs of people with mental health problems and exclude people with dementia or disabilities. Also other inclusion and exclusion criteria were applied.

Results
The majority of all studies were published in English (n = 234). The majority of research papers (n = 163) were conducted in Europe between 2000-2010, while in other countries the trend followed the year 2011. Preliminary results are showing that there are 29 different tools for needs assessment and 17 of them can be used at the system level also as an outcome measure. The most frequently used tool for assessing the needs that can be also used as an outcome measure was Camberwell Assessment of Needs (CAN) also in combination with Health of the Nation Outcome Scales (HoNOS). As well Cardinal needs schedule (CNS) and Resident Assessment Instrument Mental Health (RAI-MH) were used more than once.

Conclusions
When choosing an appropriate assessment tool, it is vital to use the most widely used ones, focusing on validated tools (culturally adapted), tools modified for specific populations (elderly, children, etc.) and also to bear in mind the ultimate goal that the service is aiming. CAN, HoNOS and CNS are assessing psychiatric and social care needs comprehensively. While RAI-MH is also a tool that is supporting seamless approach to person-centered care.

Key messages
• When choosing an appropriate assessment tool, it is vital to use the most widely used ones, focusing on validated tools and tools modified for specific populations.
• When choosing an appropriate assessment tool, it is important to focus on the ultimate goal the service is aiming.
Use and attitudes towards digital technologies in addiction rehabilitation in the SARS-CoV-2 pandemic
Authors: Brünger M , Schall F , Köhn S , Spyra K , Burchardi J 
Published: October 2023

Abstract

Background
Before the start of the pandemic, digital technologies were hardly used in addiction rehabilitation in Germany - also due to the lack of a legal framework. During the SARS-CoV-2 pandemic, the funding agencies enabled their use. The aim of the study is to describe the use of and attitudes towards digital technologies in addiction rehabilitation from the perspective of both clinic management and rehabilitation patients.

Methods
Clinic management of all 1044 outpatient and inpatient addiction rehabilitation clinics in Germany were asked in summer 2022 to complete an online questionnaire on the use of and attitudes towards digital technologies in addiction treatment. 415 clinics provided answers (response rate 40%). In addition, 460 rehabilitation patients from 34 different clinics were questioned in written form (mean age 46.0 years (SD: 13.3), 73% male; 81% alcohol addiction).

Results
According to the clinic management, digitally conducted therapies were carried out in individual therapy (inpatient: 22% vs. outpatient 62%), group therapy (4% vs. 37%), family-oriented interventions (55% vs. 51%), and pre-admission interviews (45% vs. 45%). Among the rehabilitation patients, 10% in inpatient and 37% in outpatient rehabilitation stated that they had used digitally conducted therapies. 87% of the clinic management felt that digital therapy offers were useful during the pandemic, and 84% were in favour of using them beyond the pandemic. Among rehabilitation patients, the approval rate was 85% and 59% respectively.

Conclusions
Digital technologies were used for different therapy services in addiction rehabilitation. The majority of both clinic management and rehabilitation patients were in favour of this, even beyond the pandemic. For further use after the pandemic, the establishment of a legal, financial and organisational framework is required. Non-inferiority studies (comparing digital to face-to-face) could add to the evidence.

Key messages
• Digital technologies were used for therapeutic purposes (e.g. individual therapy, group therapy, family-oriented interventions) by a large proportion of addiction clinics during the pandemic.
• The majority of clinic management and rehabilitation patients are in favour of the use of digital technologies in addiction rehabilitation even beyond the pandemic.
Econometric models derived from meta-analysis to estimate VSL and VOLY associated to air pollution at a global level: preliminary results
Authors: Ciarlantini S , Frontuto V , Verri C , Pezzoli A , Belis C 
Published: October 2023

Abstract
Epidemiological research has shown a strong correlation between air pollution and risk of premature death. Among the damage costs of air pollution, premature mortality is by far the largest contributor, hence accounting for the number of deaths linked to poor air quality has become a key environmental indicator. Monetizing reductions in risks of death through cost-benefit analyses can be useful to create efficient public policies aiming at improving air quality. The benefits of prevented mortalities can be expressed in terms of a Value of a Statistical Life (VSL), an economic parameter representing individuals’ willingness to exchange wealth for mortality risk reduction. In addition, the monetary Value Of a Life Year (VOLY) is also an important parameter to be measured, as it considers the change in life expectancy associated with air pollution. However, determining reliable estimates of VSL and VOLY can be challenging, as the methods employed in different studies can vary widely between, and even within, countries. Furthermore, most countries have insufficient and unreliable VSL and VOLY estimates. Lack of country-specific data and common methodology makes it difficult to assess climate policy at a global scale. To address this gap, a meta-analysis of existing literature is conducted to develop econometric models for estimating VSL and VOLY on a global level. The comprehensive search of articles and databases revisits established quantification methodologies for air pollution related mortality, which results in an extensive database of empirical data on VSL and VOLY estimates. Based on this new and updated database, transfer functions of VSL and VOLY are estimated for specific pollutants and different countries, according to each country's distinctive characteristics.