bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving childhood vaccination in minorities: a realist review of health system interventions
Authors: Essa-Hadad J , Gorelik Y , Edelstein M 
Published: October 2022

Abstract

Background
Most minority populations in Europe have lower childhood vaccine uptake than the general population. Improving uptake in these populations requires specifically developed, context-specific interventions. As part of the EU-funded RIVER-EU project, we conducted a realist review to identify interventions effective at improving vaccine uptake among underserved communities.

Methods
We searched MEDLINE, EMBASE, CINAHL, COCHRANE, and Proquest for articles published between 2005 and 2022, using combination keyword searches in English. Following title and abstract screening, full texts were assessed for relevance. We also searched grey literature and references of references. Data extraction and analysis was performed by two reviewers. Programme theories were generated from included articles and data extraction were carried out paying particular attention to context, mechanisms, and outcome configurations.

Results
From 1942 screened titles we selected 87 studies for full-text review of which 34 were included. We identified 10 primary intervention categories: parental and youth education; clinic outreach; quality improvement; health provider training; school-based education; technology interventions; cash incentives; home visits; comic books; community leaders education; and consent policy changes. The analysis highlighting contextual factors enabling or hindering each intervention category’s success is ongoing.

Conclusions
Several intervention categories can potentially improve vaccine coverage among underserved minority populations. We will describe their effectiveness and the contextual factors contributing to their success or failure to inform the development of tailored interventions targeting these populations.

Key messages
• Improving vaccination in underserved minority populations requires identification of effective interventions, barriers/enablers to their success, specific to the context in which they are implemented.
• Appropriately tailored health system interventions are effective at improving vaccine uptake among underserved minority communities.
Measles, rubella, mumps and chicken pox seroprevalence of health workers in a second level hospital
Authors: Guerrero Fernández de Alba I , Soler Iborte E , Padilla Matas R , Diaz Campanón J , Rivera Izquierdo M , Perez de Rojas J 
Published: October 2022

Abstract

Healthcare workers are a professional group subject to a risk of occupational exposure to a variety of infectious agents. From a public health perspective, their immune status has a great impact on the worker’s own health, on the patients and on the general population. Measles, mumps, rubella, and chickenpox are vaccine-preventable diseases caused by viruses. Seroprevalence surveys are a powerful evaluation tool that provide information on the frequency, distribution, and dynamics of communicable diseases. In this study, the prevalence of immunity to measles, mumps, rubella, and varicella viruses was analyzed in healthcare workers in a General Hospital of Granada (Spain). A cross-sectional study examining the seroprevalence was carried out in a population of health professionals incorporated into the General Hospital between January 2021 and February 2022. 260 professionals were studied, classified into groups according to age: 20-29, 30-39. Serum determination of IgG to measles virus was performed using a marketed chemiluminescent immunoassay. The resulting seroconversion rates were: 66.54% measles, 89.75% rubella, 84.62% mumps, and 88.08% chickenpox. The lowest rates were observed for measles, resulting in a minimum among professionals between 20-29 years of age, with a seroconversion rate of 65.4%. In general, women had a higher percentage of antibodies against measles. The highest rates were for the varicella virus, reaching up to 93.18% among health professionals between 30-39 years old. Considerable decrease in titers of antibodies against measles is observed in healthcare workers, especially in the age group 20-29 years, which may be due to the loss of serological protection as time goes by since vaccination with the 2nd dose of Triple Viral, possibly due to the absence of contact with the wild virus. It will be necessary to assess the need for new vaccination strategies in certain population groups such as healthcare workers based on their risk of exposure.

Key messages
• It will be necessary to assess the need for new vaccination strategies in certain population groups.
• More seroprevalence studies are necessary to update the status of protection against infectious disease.
Public Health Response to Outbreaks of Highly Pathogenic Avian Influenza (H5N1)
Authors: Quintyne K , Kelly C , Brabazon E , Harrison K , White E 
Published: October 2022

Abstract

Aim
Human infections from highly pathogenic avian influenza (HPAI) H5N1 are associated with significant morbidity and mortality internationally. This study aimed to use routinely available data to examine key strategies to prevent H5N1 transmission to humans during outbreaks in poultry in residents in Cavan, Louth, Meath and Monaghan.

Study design
Cross-sectional based study.

Methods
Data were obtained from Health Protection Team (HPT) in the Department of Public Health (DPH), HSE North-East and Department of Agriculture, Food, and the Marine (DAFM). Data entry and analyses were conducted using Microsoft Excel 2016.

Results
The public health response focussed on contact tracing, monitoring, and follow-up for household, farm-workers, and DAFM staff exposed on the affected farms. A total of 157 contact episodes were identified. Contacts received advice about active monitoring from their last exposure. A total of 111 (80%) were recommended chemoprophylaxis for exposure to HPAI H5N1. During the active monitoring period, two contacts developed acute respiratory symptoms, and parainfluenza 3 and rhino/enterovirus were identified in these individuals respectively.

Conclusions
The findings of this study, using routinely gathered data, highlighted that collaboration between public health and DAFM at regional and national level was key to rapid response to these outbreaks of HPAI in domesticated poultry. In addition, the public health response was successful in preventing H5N1 transmission from domesticated birds to humans.

Key messages
• HPAI H5N1 virus infections transmissions from poultry to humans is low.
• Effective public health measures are crucial to further mitigate the risks to an absolute minimum.
COVID-19 sequelae among competitive athletes: a systematic review
Authors: Corona VF , Gualano MR , Valz Gris A , Rossi MR , Regazzi L , Ricciardi W 
Published: October 2022

Abstract

Background
During the COVID-19 pandemic, several professional athletes from different sports were infected by SARS-CoV-2. The aim of this systematic review was to evaluate the currently available scientific evidence regarding the cardiological, pulmonary, psychological, and combined sequelae, in professional athletes.

Methods
The present systematic review was performed following the PRISMA statements, thereby searching on 3 databases: PubMed, ISI Web of Science, Scopus. Primary studies published between January 2020 and March 2022, investigating symptomatic and instrumental sequelae in competitive athletes after COVID-19 infection, were included.

Results
A total of 1,957 articles were screened, finally 18 were included (6 cohort studies, 2 case-control studies and 10 cross-sectional studies). Studies’ sample size ranged from a minimum of 12 to 1908 athletes playing different sports. In addition, the studies examined the following type of sequelae: 12 cardiological, 2 psychological, 1 pulmonary and 3 combined. Regarding the cardiological field, the prevalence of anomalies in instrumental examinations ranged 0-27.89% for first level tests (echocardiography, electrocardiogram, troponin), and 0-6.21% for second level tests (cardiac magnetic resonance). The prevalence of myocarditis and pericarditis in the athletes ranged from 0 to 3.33%, whereby the prevalence of myocarditis was in the range 0-2.32% and that of pericarditis in the range 0-2.22%.

Conclusions
The results show that post SARS-CoV-2 infection cardiac sequelae have a quite low prevalence among competitive athletes included in our review, but it would be important to set up a gradual and continuous testing approach to preserve sports performance. Public health framework, such as vaccination campaign, is important both at European and international level in order to address potential consequences of infectious diseases among competitive athletes.

Key messages
• It is important to monitor all COVID-19 sequelae in European competitive athletes playing different sports.
• Considering anti-COVID-19 vaccination in competitive athletes as an important preventive measure, to limit the circulation of the virus and the physical consequences that may occur.
Qualitative research for improving Access to Vaccination for Newly Arrived Migrants (AcToVx4NAM)
Authors: Karnaki P , Dalma A , Katsas K , Papaevgeniou N , Linos A 
Published: October 2022

Abstract

Background
Increasing vaccination uptake among vulnerable groups constitutes a high priority across Europe. Access to Vaccination for Newly Arrived Migrants (AcToVx4NAM) is a 3-year project (Grant n 101018349, 3rd EU Health Programme) with a mission to increase vaccination uptake in Newly Arrived Migrants (NAM) regardless of legal status. AcToVx4NAM will improve health system Vaccination Literacy (VL) and vaccination access, by making access conditions more equitable and guaranteed.

Methods
Across 8 countries research took place to identify barriers, enablers and solutions to system level problems. Qualitative analysis through focus groups and interviews took place with professionals who work with NAMs including administrative personnel, cultural mediators, policy officers as well as physicians, nurses, social and mental health care professionals. Research examined barriers across the different dimensions that constitute the ActoVax4NAM General Conceptual Framework namely Entitlement, Reachability - Adherence (vs. hesitancy), Achievement of vaccination (execution and completion) and Evaluation.

Results
A number of common system level barriers were identified related to gaps in the registration process and problems in reaching people eligible for vaccinations. Not all NAMs face the same problems in terms of accessing the health system (i.e asylum seekers vs economic migrants). Communication breaks exist between the various services involved with delivering care and vaccination to NAMs while the lack of appropriate culturally sensitive and appropriate informative material still remains. The role of non-medical personnel in promoting vaccinations was emphasized as well as the importance of evaluating and disseminating best practice.

Conclusions
Findings direct to specific evidence based solutions with an emphasis on tailored made to specific needs activities.

Key messages
• Shift focus from individual level barriers to system level barriers considering all hubs of the vaccination process.
• Address vaccination needs of NAM early to stress the importance of prevention in the health integration process.
Cognitive consequences of sport-related traumatic brain injuries in adolescents in Slovakia
Authors: Hažerová D , Kažičková B , Špajdel M , Puteková S , Martinková J , Doktorová G , Sivčo P , Pham PT , Peráčková J , Peráček P 
Published: October 2022

Abstract

Background
Many sports are associated with an increased risk of traumatic brain injury (TBI), often in a form of repeated minor trauma. While the pathophysiological changes of the brain after TBI have been relatively well studied, data on cognitive aspects are relatively scarce. The main objective of this study was to measure the cognitive consequences of repeated heading in a controlled set of training exercises in 21 years old football players.

Methods
The study design is quasi-experiment. Participants consisted of male football players (N = 27) and were tested under 3 conditions: before the sports activity, after the sports activity not involving heading, after the sport activity focused on heading. To monitor the cognitive changes we used neuropsychological methods: the Trail Making Test (TMT), the Verbal reproduction test. Blood samples were taken to analyse the presence of biomarkers (glucose). Linear regression and repeated-measures ANOVA were used for statistical analysis.

Results
The data showed significant relationships between the glucose level (before and 1-hour after the heading) and the TMT (part B) score /(F(1,22)=6.03; p=.001; R-square=.223/. Based on TMT (part B) scores, the cognitive flexibility and glucose lowered after the sessions. For both parts of TMT we found significantly worse scores after both training sessions compared to baseline testing (Part A: F(2,46)=189.354; p&lt;.001; Eta2=.892; Part B: F(2,46)=10.191; p&lt;.001; Eta2=.307). Post-hoc tests revealed slightly worse results in the TMT (part A) after non-heading than after the heading training which means, that the focused attention was affected. In the TMT (part B) no difference was found between the results after non-heading and heading training.

Conclusions
This study has a unique potential to highlight the relations between biomarkers and psychological abilities and their possible changes caused by heading, which may have beneficial as well as damaging impact on the body and cognitive functioning.

Key messages
• The findings of this study suggest a potential relationship between repeated minor head trauma and cognitive performance in young adults.
• Besides physiological changes, cognitive impact on cognitive performance may be a consequence of repeated minor head trauma; further study is required to elucidate these associations.
Parental Knowledge on Prevention of SUID
Authors: Nazaruk D , Palacios A , Marshall N , Choongo J 
Published: October 2022

Abstract

Background
According to the 2018 America’s Health Ranking Annual Report, the U.S. infant mortality rate (IMR) was 5.9 deaths per 1,000 live infant births, which placed the U.S. at No. 33 out of 36 countries with the world’s largest economies in 2018. The IMR in Georgia has been on the rise since 2014. Even though there was a sharp decline in sudden unexpected/unexplained causes of death (SUID) beginning in 1990, the decrease has considerably slowed down since 1999. In 2017, the top ten leading causes of infant death were responsible for 67.8% of all infant deaths in the United States. Sudden Infant Death Syndrome (SIDS) and death from unintentional injuries were in third and fourth place. Therefore, the purpose of this research is to utilize qualitative research guided by the Socio-Ecological model to understand better how prepared first-time mothers are to take care of their infant upon hospital release.

Methods
An intensity sampling was utilized to recruit participants. The inclusion criteria for the participants included first-time mothers with children under one year of age, women, Georgia residents over 18 years of age, and English speaking. A semi-structured guide was based on research queries and the ideological concepts of the Socio-Ecological Model. For the qualitative data examination, the thematic analysis was performed. All the interviews were transcribed verbatim and coded by using the program NVivo 11.

Results
A total of 25 women participated in the study. We will finish the data analysis by the end of May, 2022. The results of this qualitative study will help to fully understand the knowledge, perceptions, skills, and confidence of mothers about infant care.

Conclusions
The study’s results will help develop an information guide on primary infant care. Besides, health professionals and community organizations can utilize the study results to determine the information and support needed for new mothers.

Key messages
• The results of this qualitative study will help to fully understand the knowledge, perceptions, skills, and confidence of mothers about infant care.
• This study’s results will help develop an information guide (electronic or/and printed) on primary infant care based on first-time mothers’ needs.
Timing and social patterning of weaning practices in Cyprus: BrEaST start in life longitudinal study
Authors: Economou M , Kolokotoni O , Hadjigeorgiou E , Paphiti-Demetriou I , Hadjiona V , Kouta C , Lambrinou E , Hadjipanteli I , Middleton N 
Published: October 2022

Abstract

Background
Introduction of solids in the infant diet, according to WHO recommendations, should initiate onwards of sixth months. Evidence, however, suggests that solids introduction occurs earlier even if breastfeeding continues. With low breastfeeding rates, Cyprus is ranking last in Europe and little is known about the timing and socio-demographic pattern of solid introduction.

Methods
Using the retrospective event calendar method at the 4th and 6th month after birth, the timing of initiation of solids was estimated among a consecutive sample of 350 mother-baby dyads from all public (N = 5) and 29 (of 35) private maternity clinics. The likelihood of early introduction according to socio-demographic characteristics and breastfeeding self-efficacy (measured at birth and 1st month) was estimated in logistic regression models.

Results
Three out of ten women (30.8%) had initiated solids before the 4th month and only 20% hadn't by the 6th month. Almost half of non-Cypriot mothers (47.1%) initiated solids earlier than the 5th month, twice more likely compared to 25.1% of Cypriot mothers (OR: 2.45 95% CI: 1.30-4.57). There was a stepwise association with educational attainment with mothers with tertiary education more likely to initiate solids later (OR: 2.76 95% CI: 1.33-5.71) compared to those with at most secondary education. A similar social gradient was observed with income but was not statistically significant in multivariable models, while no association was observed with mode of birth (55.9% by C/S). Even though low breastfeeding self-efficacy at first month was predictive of earlier initiation, surprisingly, primiparous or multiparous mothers without previous breastfeeding experience were more likely to initiate solids later.

Conclusions
Early introduction of solids with a clear social gradient suggests the need for strengthening the currently weak community-based interventions to improve weaning practices, including screening for breastfeeding self-efficacy.

Key messages
• Four in five mums in Cyprus introduce solids before the 6th month with one in three introducing solids in the infant’s diet before the 4th month, with a clear social gradient in the patterning.
• Community-based intervention programmes are needed to improve weaning practices, including screening for low breastfeeding self-efficacy in a country with low breastfeeding rates.
Women’s preferences in the low-risk pregnancy management: Discrete Choice Experiments from Tuscany
Authors: Bonciani M , Corazza I , Ferrari A , Batinelli L , Pennucci F 
Published: October 2022

Abstract

During the last years, organizational models to assist women during pregnancy have changed. The physiological management of low-risk pregnancy is gaining momentum thanks to increased available evidence. Therefore, a need to assess women’s acceptance of these new proposals is emerging. This study aims to explore women’s preferences during pregnancy and childbirth. We enrolled women from the continuously active survey on the maternity pathway in Tuscany, Italy. We designed Two Discrete Choice Experiments (DCE) and administered them through web-based surveys. We sought to catch women’s preferences on health professionals to be involved, team-based or exclusive assistance, the physical proximity of healthcare services, and cost per service. We also explored women’s decision-making autonomy and pain management during labour and childbirth. Additionally, we investigated women’s information needs on the physiological model of low-risk pregnancy management through qualitative methods. Mixed logit models on the DCEs results show that women prefer being assisted during pregnancy and childbirth by healthcare services that are free of charge, easily accessible from a geographic point of view, and provided by a gynaecologist. The interaction effects reveal statistically significant differences for some sociodemographic variables of respondents and maternity pathway attributes. Besides, qualitative analyses highlight that women are interested in the physiological management of low-risk pregnancy according to their level of knowledge, confidence and safety feelings, and beliefs concerning non-medicalization and autonomy. The main findings of this study point out several implications for policy and managerial practice to effectively implement the physiological model of low-risk pregnancy management.

Key messages
• This study proves that costs, travel distance, and type of health professional are the main determinants of women’s elicited preferences during pregnancy and childbirth.
• Policymakers and healthcare managers should consider these findings in organizing and providing maternal and childbirth health services to foster the physiological management of low-risk pregnancies.
Sexual education in the school setting: an overview of the Italian situation
Authors: Cappelletti T , Lo Moro G , Elhadidy HSMA , Bert F , Scaioli G , Siliquini R 
Published: October 2022

Abstract

Background
There is an important interaction between sexuality and many life factors. A good sexual education at school can improve knowledge and behaviour in young people giving them a healthy sexual life. Unlike most European countries, sexual education in Italy is not compulsory in the school curriculum, so this study explored the Italian regional initiatives realised over a span of 15 years.

Methods
A review of grey literature was conducted on Public Health Administrations/Regions websites of each Italian region, focusing on official documents containing training catalogues for schools. The search was conducted in December 2021, including documents produced between 2006 and 2021. We used the topics recommended by UNESCO as quality markers for the projects found.

Results
Among the 20 Italian regions, 12 had at least one programme. A total of 39 projects were found. All UNESCO topics were covered, with notable differences between north, centre and south of Italy, which had the lowest number of projects. Most of the projects (23) were carried out only once, the others were repeated at least for two years in a row. Contraception, along with love, marriage, partnerships, and family, were the main topics discussed during sexual education programs in schools (92%), followed by biological aspects, body awareness, and anatomy (83%); birth, disability, human rights, and online media were less common (33%). Regarding the target, disability, human rights, and mutual consent were deepened only for middle and high school students.

Conclusions
Considering the fundamental importance of sexual education, there is an important lack in promotion and planning in Italy. There is a large discrepancy between the northern and southern regions and it is necessary to implement and standardize the offer of sexual education programs in schools.

Key messages
• Unlike the European average, In Italy there is an important lack on sexual education, whit large discrepancies between the northern and southern regions, putting the latter at disadvantage.
• Contraception, marriage, couples, and family were the main topics discussed during sexual education programs in schools; birth, disability, human rights, and online media the least.