bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 knowledge among Ukrainian refugees in Poland
Authors: Pasek O , Ganczak M , Sikora A , Sobieraj E , Duda-Duma Ł , Pyzio K , Goławski J 
Published: October 2022

Abstract

Background
The constantly growing refugee population may constitute public health threat in Poland in the context of COVID-19 pandemic. This study objective was to investigate COVID-19 knowledge among Ukrainian refugees in Poland.

Methods
This cross-sectional study was carried out between March-April 2022 among Ukrainian refugees registering in Zielona Góra, Poland. An anonymous, self-administered questionnaire was used which included 10 questions related to COVID-19 knowledge. Each correct answer was given 1 point.

Results
Response rate was 96.0%, 190 Ukrainians responded (mean age 37.8±15.7 years; 42.1% males); 52.1% were living in the cities &gt;50,000 inhabitants; 61.6% reported high SES; 39% higher education; 44.2% were married. The mean knowledge score was 3.47 (SD ± 2.2), 15.8% collected &gt;50% points. The knowledge level was higher among those with higher SES (p &lt; 0.0001) and higher education (p = 0.003); 31.7% stated that SARS-CoV-2 is an animal-human transmitted disease (more with high SES, p = 0.004), 55.0% considered COVID-19 as highly contagious disease (more living in bigger cities, p = 0.04), 26.3% reported that SARS-CoV-2 infection ensures lifetime immunity (more unmarried, p = 0.02); 24.7% correctly stated that compared with 18- to 30-year-olds COVID-19 mortality rate is about 10 times higher in those who are &gt;65 years (more with higher education and high SES; p &lt; 0.05, p = 0.01 respectively), 44.4% - that COVID-19 treatments are now available (more with high SES and higher education; p = 0.03 both). Regarding prevention, 37.0% reported that FFP3 is the most protective type of mask, 43.3% that vaccines effectively protect against COVID-19 (more with high SES; p = 0.006, p &lt; 0.001 respectively).

Conclusions
COVID-19 knowledge among Ukrainian refugees in Poland was far unsatisfactory, in particular among those with lower education and lower SES. Educational campaigns are urgently needed to effectively raise the knowledge level in this vulnerable group to better control the pandemic.

Key messages
• This study results may be used by public health experts to expand educational campaigns targeting Ukrainian refugees in Poland.
• COVID-19 education oriented to Ukrainian refugees in Poland should specifically address deficits of knowledge identified in this study.
Exposure of pre-school aged children to schistosomiasis: a call for public health strategies
Authors: Hameister J , Solonirina MJ , Rasamoelina T , Rakotozandrindrainy R , Rakotoarivelo R , Rausche P , Puradiredja DI , May J , Fusco D ,   freeBILy consortium
Published: October 2022

Abstract

Background
Schistosomiasis is a disease of poverty, prevalent in tropical regions and emerging in Europe. Mass drug administration (MDA) is a common strategy to fight the disease. Pre-school aged children (PSAC) are conventionally considered not to be at high risk of infection and thus usually excluded from MDA. However, chronic infections at young ages can result in serious health consequences. Our study aims to better understand the schistosomiasis transmission routes in PSAC and risk perceptions among caretakers in the endemic context of Madagascar.

Methods
This is a cross-sectional sub-study embedded in the clinical trial freeBILy. Using a mixed methods approach, 86 women and their two-year-old children in four communities of the Amoron’ I Mania and Itasy regions of Madagascar in April 2022 were interviewed using structured questionnaires, focus group discussions and in-depth-interviews. Additionally, structured observational data were collected on the behaviours of 20 PSAC around waterbodies in the communities where notes and anonymised photos were taken.

Results
Preliminary analysis shows that knowledge of schistosomiasis, its transmission routes and effects is limited. Risky behaviours of children were reported during the observations. They joined their mothers during daily activities and spent between 3-60 mins in rivers, lakes and rice fields. The exposure time to potentially contaminated waters was sufficient to represent a risk for infection.

Conclusions
Even though our preliminary results show that PSAC are at risk of schistosomiasis infection, they are currently excluded from systematic public health interventions. The lack of risk awareness among caretakers in endemic countries calls for actions to establish tailored programs on health literacy and education. Treatment should be considered for PSAC as well as the implementation of awareness campaigns, both locally and globally given the re-occurrence of schistosomiasis in countries outside the tropics.

Key messages
• Pre-school aged children are exposed to the risk of early infection with schistosomiasis.
• Public health programs against schistosomiasis should address pre-school aged children in endemic countries and in health promotion strategies globally.
Safe Hands 3.0: new tool to prevent healthcare associated infection
Authors: Valero-Ubierna C , Perez deRojas J , Marin Caba E , Martinez Bellón D , Gutierrez Linares S 
Published: October 2022

Abstract

Background
Healthcare associated infection (HAI) is a Public Health problem. Hands of healthcare workers are a key for transmission. Compliance with WHO 5 moments for hand hygiene (HH) has been emphasized, but there are other aspects: appropriate use of gloves and healthy hands skin of professionals. Gloves protect the professionals but it may increase cross-transmission. Hands dermatitis is a handicap for the use of alcohol-based handrubs. Data collection and analysis, to have a good communication system to improve training, information and to get feedback from professionals are necessary. The aim of this work is to develop the Safe Hands 3.0 Project in a General Hospital.

Methods
Preventive Medicine and Public Health Department carried out a descriptive study carried out in a 477-bed General Hospital in last semester 2021. Compliance with HH and the possible causes of non-compliance were assessed with observations and knowledge surveys included appropriate use of gloves in healthcare practice and the impact on hand in professionals. The surveys were carried out using Lime Survey for mobile devices and Google for WhatsApp.

Results
From 550 observations of HH compliance for the WHO 5 moments is less than 40%. Half of non-compliance was due to inappropriate use of gloves. 266 surveys answered highlighting the need for continued training. Survey on hand skin health perception was answered by 182 professionals, 44% reported dermatological issues and 81% notice that their work damaged their hands skin. A corporate logo was created, use the hospital website and a structured Communication Plan for its implementation.

Conclusions
To prevent HAI transmission, the concept of Hand Hygiene is limited. Safe Hands 3.0 Project comes up with a bundle of care: proper use of gloves, compliance the WHO 5 moments and skin care of healthcare workers’ hands. Update data management and a corporate communication plan with social networks is necessary to improve training and compliance.

Key messages
• A bundle of care is the key for Safe Hands: proper use of gloves, compliance the WHO 5 moments and skin care of healthcare workers’ hands.
• Update data management and a corporate communication plan with social networks is necessary to improve training and compliance.
Flu immunization during pregnancy: a cross-sectional study among Italian healthcare providers
Authors: Licata F , Angelillo S , Della Polla G , Pelullo CP , Napolitano F , Di Giuseppe G , Romeo M , Bianco A 
Published: October 2022

Abstract

Background
Flu vaccination during pregnancy has been proven to be effective in preventing illness and hospitalization in both pregnant women and newborns. However, flu vaccination uptake is still suboptimal. The study aimed to assess if healthcare providers (HCPs) are knowledgeable about flu vaccination recommendation during pregnancy and if they routinely recommend the vaccination.

Methods
The present survey was carried out among obstetricians-gynaecologists (OBs), midwives and primary care physicians (PCPs) in the Southern part of Italy. Data were collected through an anonymous self-administered questionnaire that included professional information, knowledge, perceptions and practices on flu vaccination during pregnancy.

Results
96 participants were hitherto enrolled (36.5% OBs, 35.4% PCPs and 28.1% midwives). Among the responders, 63.5% and 66.7% knew that flu vaccination can be administrated during any trimester of pregnancy and reduces the risk of preterm birth and miscarriage, respectively. Alarmingly, more than a fifth (22.9%) of the sample believed that vaccines during pregnancy are more dangerous than safe and only 67.7% routinely recommend the flu vaccine to all women regardless of their stage in pregnancy. Among HCPs who did not recommend the flu shot, the most frequently reported reasons were that flu vaccine recommendation was outside the scope of their practice (62.5%), that women are more hesitant about vaccines during pregnancy (37.5%) and lack of time (25%).

Conclusions
The preliminary results highlight alarming gaps in knowledge (e.g. immunization timing) and suboptimal routine recommendation of the flu vaccine that represents a missed opportunity. Indeed, it has been demonstrated that when women are offered vaccination, most tend to accept it.

Key messages
• Unmotivated concerns about vaccine safety during pregnancy have to be addressed among HCPs to enhance flu recommendation and, subsequently, immunization coverage in pregnant women.
• Strategies to disseminate evidence-based recommendations to HCPs regarding flu immunization during pregnancy have to be implemented and evaluated in order to improve public health.
Impact of COVID-19 on flu vaccination among pregnant women in a Teaching Hospital in Rome
Authors: Nachira L , Bruno S , Carducci B , Villani L , Pascucci D , Quaranta G , Damiani G , Federico B , Lanzone A , Laurenti P 
Published: October 2022

Abstract

Background
According to WHO, UNICEF, GAVI and the Sabin Vaccine Institute data, the COVID-19 pandemic caused the disruption of routine vaccinations in at least 68 countries. In March ‘20, the WHO published a guide to help countries continuing their provision safely to prevent unnecessary visits and hospitalizations: especially flu vaccination is paramount to reduce respiratory illnesses and their burden on healthcare systems. For the flu season 2021-22, the Italian Ministry of Health recommended prioritizing flu vaccination for pregnant women. This study aims at comparing flu vaccination rates between pre-pandemic and pandemic periods in pregnant women attending a birthing preparation course at the Fondazione Policlinico Universitario A.Gemelli IRCCS (FPG) in Rome.

Methods
A repeated cross-sectional study was carried out in FPG during two flu epidemic seasons (October ‘19-January ‘20 and September ‘20-January ‘21), when two different cycles of birthing preparation courses were held (face-to-face and online, respectively). Pregnant women and their partners attending them were offered flu vaccination at FPG. A χ2 test was performed to compare vaccination rates, with statistical significance set at p = 0.05.

Results
In 2019-20, 48 out of 119 women and 39 men out of 119 attending the course accepted flu vaccination, while in 2020-21 they were respectively 88 out of 317 and 89 out of 317. Overall vaccination compliance among pregnant women was significantly higher in 2019-20 than in 2020-21 (40.3% and 27.8% respectively, p = 0.012), while the difference was not significant among their partners (32.8% and 28.1% respectively, p = 0.337).

Conclusions
The COVID-19 pandemic negatively affected flu vaccination adherence among the pregnant women involved. Fear of contagion and access to facilities closer to their home could be potential key drivers. These results represent an important warning on flu vaccination attitudes during the pandemic: more actions are needed to improve compliance.

Key messages
• COVID-19 might have hindered access to immunization services for at-risk populations, such as that of pregnant women.
• From a Public Health point of view, more actions are needed to harmonize interactions between hospitals and local national health services to improve vaccination compliance.
The impact of Covid-19 vaccines on fertility-A systematic review and metanalysis
Authors: Zaçe D , La Gatta E , Petrella L , Shukhovtseva A , Di Pietro ML 
Published: October 2022

Abstract

Introduction
Despite literature’s proofs about their safety, concerns arose regarding adverse events due to Covid-19 vaccines, including the possible impact on fertility, accentuated by misinformation and anti-vaccine campaigns. The aim of this study was to evaluate the Covid-19 vaccines’ impact on male and female fertility.

Methods
PubMed, Scopus, Web of Science, Cochrane and Embase databases were searched for eligible studies until March 7th, 2022. Primary studies investigating the Covid-19 vaccines impact on male and female fertility, were included. Studies’ quality was assessed by the Newcastle-Ottawa and the Before and After Quality Assessment scales for cohort and pre-post studies, respectively. Random-effect meta-analyses were performed for parameters considered in ≥ 2 studies, calculating means, p-values and 95% Confidence Intervals (CIs). I2 statistics was used to assess statistical heterogeneity.

Results
Out of 1406 studies screened, 20 studies were included in the systematic review. These studies, conducted in Israel (35%), USA (30%), Russia (25%), China (5%) and Italy (5%), were of poor (15%), moderate (75%) and good (10%) quality. Meta-analyses among five studies considering several vaccines were performed for pre- and post-vaccination sperm progressive motility ((49%, 95% CI 36-67% vs 49%, 95% CI 39-61%; p = 0.963) and concentration (64.39 mln/ml, 95% CI 47.51-87.28 and 72.00 mln/ml, 95% CI 51.22-101.21; p = 0.03). Subgroup meta-analyses based on the type of vaccine showed no significant difference: between vaccinated with mRNA vaccines and non-vaccinated regarding biochemical pregnancy rates; pre- and post-vaccination with Gam-COVID-Vac regarding testosterone, FSH and LH levels; pre- and post-vaccination with BNT162b2 vaccines regarding sperm volumes.

Discussion
There is no scientific proof of any association between Covid-19 vaccines and infertility in men or women. Misinformation and doubts about vaccines should be properly addressed.

Key messages
• The doubts regarding Covid-19 vaccines’ impact on both male and female fertility resulted to be unfounded. Covid-19 vaccines remain the most important weapon to fight the pandemic.
• It is important to keep providing to public opinion and health care providers evidence-based scientific information, in order to effectively combat misinformation and anti-vaccines campaigns.
Predicting low cognitive ability at age 5 using machine learning methods and birth cohort data
Authors: Bowe A , Staines A , McCarthy F , Lightbody G , Murray D 
Published: October 2022

Abstract

Background
Early intervention is essential to address disparities in cognitive development. Current developmental screening will not detect the vast majority of children who go on to have below average cognitive ability at school age. In this study, we applied the random forest (RF) algorithm, a highly interpretable machine learning method, to birth-cohort data to train a model to predict low cognitive ability at 5 years of age using perinatal features.

Methods
Data was from 1,070 participants in the Irish population-based BASELINE birth cohort. A RF model was trained to predict an intelligence quotient (IQ) score &lt;90 at age 5 years using a broad selection of maternal, infant, birth, and sociodemographic features, all of which could be easily measured at a population level in the perinatal period. Feature importance was examined using mean decrease in Gini impurity, mean decrease in accuracy, and mean minimal depth. Recursive feature elimination was used to develop a parsimonious model. Internal validation was performed using 10-fold cross validation repeated 5 times.

Results
The most predictive features for low cognitive ability at 5 years of age were the total years of maternal schooling, infant Apgar score at 1 minute, socioeconomic index, maternal BMI, and units of alcohol consumed in the first trimester. A parsimonious RF model based on 11 features showed excellent predictive ability, with a sensitivity of 0.89 and a specificity of 0.98, providing a foundation suitable for external validation in an unseen cohort.

Conclusions
Machine learning approaches to large existing datasets can provide accurate feature selection to improve risk prediction. Further validation of this model is required in additional cohorts, representative of the general population. Accurate risk prediction can facilitate targeted screening and intervention.

Key messages
• The application of machine learning to large population-based data can improve feature selection and accuracy in risk prediction models.
• Accurate risk prediction may enable early intervention to address disparities in cognitive development. Individual interventions must occur in conjunction with population level policy changes.
Factors promoting or limiting self-determined childbirth: midwives’ perspectives in Germany
Authors: Tallarek M , Spallek J 
Published: October 2022

Abstract

Background
Claims for self-determined childbirth (SDC) have gained increasing scientific, political and societal attention. However, research on SDC is limited. This study analyzes and compares midwives’ experiences and perspectives on factors that promote or limit SDC in hospitals, birthing centers and during home births in Germany. We argue that these insights are essential in order to foster self-determination and to avoid its violation.

Methods
A qualitative case study was conducted based on semi-structured face-to-face interviews with midwives working in hospitals, birthing centers, and offering home births in Germany. In total, nine interviews were conducted in 2021 and have been audiotaped, transcribed, anonymized and analyzed by use of Thematic Analysis.

Results
The results indicate eight inter-related categories, each of which imply promoting and limiting factors: 1) Structural/ legal conditions; 2) Perception of birth (e. g. as natural or medical process; required competence and control); 3) Trust and atmosphere; 4) Getting acquainted/relationship building; 5) Birthing person’s socioeconomic position; 6) Birthing person’s preparation/ education; 7) Birthing person’s capability of decision making and expression; and 8) Behavior of accompanying persons. Moreover, we identified midwives’ strategies to extend possibilities of choice. Several factors clearly differ depending on the birth setting.

Conclusions
The opportunities for SDC seem to differ according to the setting (e.g. institutional routines), inter-personal relations (e.g. getting acquainted, trust), and individual factors (e.g. socioeconomic position, capabilities). Hence, political, institutional and individual strategies may support SDC in consideration of the above factors. Measures may, among others, include the improvement of information processes, the reduction of economic barriers, relationship building before and during birth as well as respective structural adjustments.

Key messages
• Self-determination (SD) in childbirth is influenced by several factors at individual, inter-personal, institutional and macro level.
• Individual, institutional and political strategies may support SD.
Factors associated with the closure of German obstetric units and its effects on accessibility
Authors: Hoffmann J , Scholten N , Dresbach T 
Published: October 2022

Abstract

Background
An increase in regionalization of obstetric services is being observed worldwide. This study investigated factors associated with the closure of obstetric units in hospitals in Germany and aimed to examine the effect of obstetric unit closure on accessibility of obstetric care.

Methods
Secondary data of all German hospital sites with an obstetrics department were analyzed for 2014 and 2019. Multivariate logistic regression was performed to identify factors associated with obstetrics department closure. Subsequently, the driving times to a hospital site with an obstetrics department were mapped, and different scenarios resulting from further regionalization were modelled.

Results
Of 747 hospital sites with an obstetrics department in 2014, 85 obstetrics departments closed down by 2019. Only the annual number of live births was observed to be a factor significantly associated with the closure of obstetrics departments (odds ratio: 0·995; confidence interval: 0.993-0.997). Areas in which driving times to the next hospital site with an obstetrics department exceeded the 30 and 40 min threshold increased from 2014 to 2019. Scenarios in which only hospital sites with a pediatrics department or hospital sites with an annual birth volume of ≥ 600 were considered resulted in large areas in which the driving times would exceed the 30 and 40 min threshold.

Conclusions
The annual number of live births is a factor significantly associated with the closure of obstetrics departments. Despite the closure, good accessibility is maintained for most areas in Germany. Although further regionalization may ensure high-quality care and efficiency, it will have an impact on accessibility.

Key messages
• Despite the closure of many obstetric departments, regional accessibility to obstetric care remains good for most areas in Germany.
• Further regionalization may ensure high-quality care and efficiency but will have an impact on accessibility.
Childhood obesity prevention in schools and municipalities – the digital planning tool WEPI
Authors: Schröder M , Berner R , Babitsch B , Hassel H 
Published: October 2022

Abstract

Background
The development of theory-based prevention efforts is complex and often not feasible in the daily work of project planners. Planning tools such as the Intervention Mapping Approach (IMA), which is a gold standard for project planning, cannot be used in practice without preconditions. How can prevention planning be evidence-based but also practical? Against this background, the research project WEPI was developed, funded by the Federal Ministry of Health, Germany. WEPI is a digital planning tool based on the IMA, that guides municipalities and schools in planning childhood obesity prevention efforts.

Methods
From April 2019 to October 2020, the planning tool was developed. In October 2020 and February 2021, WEPI was tested for the first time by selected municipalities (n = 4) in Bavaria and schools (n = 4) in Lower Saxony. Based on this, the modified planning tool was tested for a second time throughout Germany (05-11/2021). Handling and acceptance were evaluated in a questionnaire survey.

Results
The first test showed that content and technical aspects needed to be optimised in order to bring scientific demands and practical feasibility together. Six municipalities and eight educational institutions participated in the second test phase. The respondents (n = 14) indicated that WEPI facilitates structured project planning (86%) and supports collaboration with colleagues (64%). 93% would use the planning tool again. WEPI offers evidence-based methods for practical implementation as well as a download area, including a template for a project application or a project summary. This service was also evaluated as very helpful (64%).

Conclusions
Through step-by-step guidance, WEPI facilitates evidence-based project planning and ensures planning quality. Effort and benefit are in good proportion. Further optimisations are needed to improve the user-friendliness.

Key messages
• WEPI provides a comprehensive roadmap, helping practitioners to approach a structured project planning.
• Practitioners’ participation promotes acceptance and provides a user-friendly development.