bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 vaccination in prison settings: a model to design tailored vaccine delivery strategies
Authors: Tavoschi L , Mazzilli S , Petri D , Busmachiu V , Stylianou I , Meroueh F , Stöver H , Rosello A , Ranieri R , Baglietto L 
Published: October 2022

Abstract

Introduction
Vaccinations are one of the most powerful preventive tools discovered by modern medicine. Although expanded programmes of immunization are well established in EU/EEA, significant immunity gaps and suboptimal coverage are registered among specific populations, including people living in prisons (PLP). PLP are also at increased risk to vaccine-preventable diseases (VPD) with potential outbreak in prison, e.g. flu, COVID-19, as well as other VPDs such as HBV. The EU-funded project RISE-Vac, aimed at collecting models of care developed during the pandemic to design tailored vaccine delivery strategies that could be extended beyond the sole COVID-19 vaccine.

Methods
Through a survey to healthcare staff working in prisons in six countries of the EU/EEA (Cyprus, France, Germany, Italy, Moldova, UK) we collected information on the implementation of COVID-19 vaccination program. The following areas were investigated: challenges & barriers encountered, workload distribution, education & training activities for prison staff and PLP, referral strategies after release, immunization information system.

Results
The respondents reported that in prisons COVID-19 programs have been implemented efficiently. Strategies for optimal management of the vaccination campaign included: week-day dedicated to vaccination services when vaccines were delivered and immediately administered to overcome cold chain challenges; new staff recruitment & task shifting; administration of booster doses within prison premises for released individuals; distribution of informational material both to PLP & prison staff.

Conclusions
Our results show that universal immunisation campaigns are feasible, acceptable and effective in places of detention when there is commitment to implementing them. Evidence from the pandemic situation may inform future provision of expanded immunization programmes.
Preventing HIV infection in pregnancy: a comprehensive ANC-based intervention in Western Uganda
Authors: Theuring S , Jahn LS , Kengonzi A , Kabwama SN , Rubaihayo J 
Published: October 2022

Abstract

Introduction
Pregnant women in sub-Saharan Africa represent a high-risk group for HIV infection, but most endemic countries including Uganda do not engage specific HIV prevention measures in pregnancy. This longitudinal study aimed to assess outcomes of a comprehensive, ANC-embedded strategy to prevent seroconversions during pregnancy in Western Uganda.

Methods
HIV-negative ANC clients were administered an HIV risk assessment tool, followed by individual risk counselling. They received a fixed appointment for repeat HIV testing after three months. Those attending ANC without partners obtained formal partner invitation letters. At follow-up after three months, women not attending repeat testing were reminded via text message. Post-intervention risk behavior engagement was captured. We analyzed uptake of the intervention, HIV incidence rate, and associations with risk behavior.

Results
Of 1081 participants, 116 (10.7%) reported risk behavior engagement at first ANC visit, 148/1081 (13.7%) were accompanied by partners. The repeat test visit was attended by 848/1081 (78.5%) women, 42 (5.0%, p &lt; 0.001) reported post-intervention risk behavior engagement, and 248 (29.4%, p &lt; 0.001) were accompanied by partners. Seroconversion occurred in two women. In multivariable logistic regression, rural facility clients compared to urban ones (aOR 3.96; 95%CI 1.53-10.26), and women with positive or unknown partner HIV-status (aOR 2.86; 1.18-6.91) and partner alcohol abuse (aOR 2.68; 1.15-6.26) had increased odds for engagement in risk behavior despite the intervention.

Conclusions
After our intervention, risk behavior in pregnancy was reduced by half, and partner attendance had doubled compared to baseline. Our cohort showed a 0.76/100 women-years HIV incidence rate compared to 2.85 in pre-intervention data from the same setting. Clients from rural settings and women experiencing precarious partner situations require special attention to reduce risk behavior engagement during pregnancy.

Key messages
• HIV incidence in pregnancy in Western Uganda can be significantly reduced through a comprehensive, ANC-based counselling intervention.
• Pregnant women from rural settings and those experiencing precarious partner situations require special attention regarding sexual risk behavior.
Inequalities in the disease burden in Scotland: an area level analysis
Authors: Grant I , Fletcher E , McCartney G , Thrower M , Wyper G , Stockton D 
Published: October 2022

Abstract
In the context of increasing demand for evidence-based policy, attempts to address or mitigate the effects of disadvantage have been usefully informed by comprehensive indices of multiple deprivation. These indices combine indicators on a range of dimensions of deprivation to classify neighborhoods or localities. Through combining information on fatal and non-fatal health loss, burden of disease studies allow planners and policy-makers to have a better understanding of the contribution of different diseases and injuries to the total burden of disease. These estimates can be augmented through studies, stratified by investigating inequalities in the burden of disease due to area-based deprivation. Doing so, helps contribute to discussions about where prevention and service activity should be focused to address health inequalities. The Scottish Burden of Disease study uses the Scottish Index of Multiple Deprivation (SIMD) as means to report on of the extent of inequality in the burden of disease in Scotland between people living in the areas of greatest, and of least, multiple deprivation. The SIMD quantifies deprivation based on data zones, a geographical unit comparable to a postcode. Using pooled and weighted data from seven domains (employment, income, crime, housing, health, education and geographic access), each data zone is given a composite rank out of 6,505 data zones. The composite rank was then converted to a decile, with 1 assigned to the 10% most deprived data zones and 10 to the 10% least deprived. In this presentation we will show the key steps involved in undertaking an area-based analysis of health inequalities in the burden of disease in Scotland using results from the Scottish Burden of Disease 2019 study, and from our monitoring of COVID-19 disability-adjusted life years.
Essential EU mobile workers in the Dutch food supply chain: occupational safety and health policies during and after the Covid-19 pandemic
Authors: deLange T , Mantu S , Skowronek N , Berntsen L 
Published: October 2022

Abstract
The pandemic has revealed the dependence of many labour markets on EU mobile ((im)migrant) workers, particularly in sectors designated as essential for national economies. Despite many EU workers falling under the label of ‘essential workers’, they are nonetheless vulnerable to unhealthy and unfair working and living conditions linked to the type of work they perform (manual), the conditions of their employment (highly flexible) and their lack of social networks that makes them dependent on their employers for housing and health. Taking EU mobile workers in the meat and distribution sectors, two specific Food Supply Chain sectors in the Netherlands, as a case study, this contribution discusses how in the Netherlands protection during the Covid-19 pandemic was organized for this group of workers in relation to protective measures at the work place, quarantining, pay during periods of quarantine and protection against job loss, and access to public health services (testing, vaccines), topics that generated a great deal of insecurity among EU mobile workers. The analysis is based on data provided by a survey among 153 EU mobile workers (May-July 2021), 35 interviews with Polish and Romanian workers, and 50 interviews with national stakeholders. The aim is to problematize the disjuncture revealed by the pandemic between an EU legal regime that prioritizes mobility and national arrangements around welfare and social protection that leave many mobile workers vulnerable. We argue that EU free movement of workers needs to be flanked by measures to ensure that the people who move do so under decent and fair conditions.
Healthcare services access during the COVID-19 pandemic among older people
Authors: Bertuccio P , Vigezzi GP , Signorelli C , Zucchi A , Cavalieri d'Oro L , Stuckler D , Iacoviello L , Gallus S , Odone A 
Published: October 2022

Abstract
The COVID-19 pandemic strongly impacted older people, not only in terms of clinical outcome but also in care provision. Investigating trends of changes in healthcare services access among older subjects during the pandemic, along with studying potential determinants, is of utmost interest to identify the most at-risk individuals. We used data from LOST in Lombardia, a cross-sectional study conducted on a representative sample of 4,400 older adults (aged 65 or more) in autumn 2020. Data were collected about lifestyles, mental health, and access to healthcare services before and during the pandemic. To investigate potential determinants of changes in healthcare access, we presented prevalence ratios (PRs) estimated through multivariable log-binomial regression models. Twenty-one per cent of the participants increased telephone contacts with general practitioner (GP), 9.6% specialist visits for a fee, while 22.4% decreased GP visits, 7.5% ED access, 6% hospitalisations, 12.3% outpatient visits, 9.1% diagnostic exams. The prevalence of the cancellation or delay of medical appointments by the patient's decision was 23.8%, with higher proportions among men, among individuals aged 75 or over as compared to those aged 65-74, and among individuals with a higher self-reported economic status (p-value&lt;0.05). People with comorbidities more frequently cancelled or postponed visits, reduced ED access or hospitalisations. Moreover, individuals with worsened mental health status showed a higher prevalence to cancel or delay visits and to reduce ED access. The decrease in healthcare provision and consultations could result in mortality and morbidity excess. Our results should inform targeted intervention to bridge the gaps and overcome the health inequalities that the pandemic has deepened. Exploring the underlying reasons and determinants for healthcare avoiding or delaying among the most vulnerable groups is crucial for epidemic preparedness and planning future interventions.
Changes in retail food environments around schools over 12 years in Flanders, Belgium
Authors: Smets V , Vandevijvere S 
Published: October 2022

Abstract

Background
Food environments influence food preferences, in particular among children. Besides their homes, children spend most of their time in and around the school. This study mapped changes in retail food environments around primary and secondary schools in Flanders between 2008 and 2020. In addition, associations between those indicators and children's weight status were assessed.

Methods
The food environment near primary and secondary schools was mapped using three spatial indicators: 1) The density of different types of food retailers within 1000m road distance from the school entrance, 2) the percentage of schools with at least one food retailer of a certain type within 1000m road distance from the entrance, and 3) the median walking distance from the school entrance to the nearest food retailer of a certain type. Associations between the density of convenience stores, as well as fast food outlets around the schools and the weight status of the schools’ children were assessed using generalized linear models adjusted for level of urbanization, socio-economic status of children at school level and sex.

Results
Food environments near schools in Flanders were found to be unhealthy, with a significant increase in fast-food outlets and convenience stores between 2008 and 2020. Food environments near schools with a higher proportion of children from a poor socio-economic background were found more unhealthy than those near schools with a lower proportion of such children, regardless of the urbanization level. A significant positive association was found between the density of fast food outlets as well as convenience stores around primary schools and the weight status of children aged &lt;6 years and 6-12 years.

Conclusions
Food environments around schools in Flanders became more unhealthy over time and were associated with children's weight status. The government therefor has the responsibility to create healthy food environments near schools to protect children's health.

Key messages
• The food environment near schools became more unhealthy between 2008 and 2020.
• The food environment near schools was associated with younger children's weight status.
Validity of self-reported diseases from health surveys: comparisons with registry data in Denmark
Authors: Rosendahl H , Lau CJ , Davidsen M , Ekholm O , Christensen AI 
Published: October 2022

Abstract

Background
The validity of self-reported disease prevalence estimates in health surveys may be low when compared to data from medical records in administrative registers. Such discrepancies reflect a low content validity of the survey question, which may ultimately compromise the application of these survey data for public health purposes. The aim of the present study was to examine the agreement of self-reports of seven diseases with data from administrative registers, both overall and by sociodemographic characteristics.

Methods
Prevalence estimates of self-reported current and/or previous diabetes, asthma, rheumatoid arthritis, osteoporosis, myocardial infarction, apoplexy, and cancer, respectively, were derived from the Danish National Health Survey in 2017 (n = 183,372 adults aged ≥16 years). Individual-level data were linked to registry data on the same diseases. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), kappa, and total agreement between self-reported and registry-documented prevalence estimates were examined.

Results
For all included diseases, the specificity was &gt;92%, and the sensitivity varied between 59% (cancer) and 95% (diabetes). NPV was &gt;94% for all diseases and PPV varied between 13% (rheumatoid arthritis) and 93% (cancer). Total agreement varied between 91 % (asthma) and 99% (diabetes), whereas kappa was lowest for rheumatoid arthritis (0.21) and highest for diabetes (0.88). Sociodemographic variables were significantly associated with total agreement with sex, age, and educational level exhibiting the strongest associations.

Conclusions
Overall, total agreement, specificity, and NPV between self-reported and registry-documented disease prevalence estimates are high, but PPV and kappa vary greatly between diseases. The latter findings reflect a low content validity of the applied survey question for specific diseases. This should be taken into account when interpreting similar results from surveys.

Key messages
• The validity of self-reported disease prevalence estimates may be low when compared to data from medical records. We found positive predictive values and kappa to vary greatly between diseases.
• Future studies should aim at designing survey questions properly in order to ensure a high content validity of the applied question.
Universal screening for postpartum depression? Inequalities and barriers among immigrant mothers
Authors: Marti Castaner M , Hvidtfeldt C , Møller Olsen JM , Nørredam M , Fredsted Villadsen S 
Published: October 2022

Abstract

Background
Postpartum depression (PPD) is a serious public health concern affecting 12% of women globally. Early detection is necessary to provide timely support. In Scandinavian countries, universal screening is recommended. However, migrant women, who are at increased risk of PPD, seem to be screened less often. Still, there is limited knowledge about 1) how acculturation relates to screening, and 2) how healthcare providers navigate PDD screening with migrant women.

Aims and methods
We used a mixed-methods approach to explore whether and why inequalities in PPD screening using the Edinburgh postpartum depression scale (EPDS) may exist in the context of universal PPD screening within the free home-visiting program in Denmark. Data from 77,694 infants and their mothers participating in the Danish home-visiting program (2015-2018) was used to examine the prevalence of participation in PPD screening and its association with migrant status and acculturation factors. We interviewed 16 health visitors to examine qualitatively challenges and strategies used when assessing PPD among immigrant mothers.

Results
Immigrant women were 80% more likely to lack screening (adj. RR 1.81-1.90). All factors indicating lower acculturation, such as shorter length of residence, older age at migration, and having studied abroad were independently associated with increased risk of lack of screening. Thematic analysis of qualitative data showed how cultural and linguistic differences and organizational constraints limit health visitors’ ability to assess immigrant women's mental health needs. Although health visitors often used EPDS as an opener to talk about mental health, they did not use it as an ‘assessment’.

Conclusions
This study shows inequalities in PPD screening than may result in reduced use of mental health services among immigrant women. The experiences of health visitors shed light on how to improve the identification of PPD among immigrant mothers.

Key messages
• Migrant women in Denmark, even those who have migrated as children, are at risk of being left out of PPD screening programs.
• Limited organizational support and cultural competences makes PPD screening among immigrant women not feasible for maternal health visitors.
The consequences of the COVID-19 pandemic on the health and wellbeing of the youth: a systematic review
Authors: Bosmans M , Marra E , Baliatsas C , de Vetten-Mc Mahon M , Dückers M 
Published: October 2022

Abstract

Introduction
The coronavirus outbreak and resulting restrictive measures have a major impact on population health. Research results suggest that the impact on the youth is especially great. In this review of international literature we investigated the impact of the COVID pandemic on the health and wellbeing of the youth, with a special emphasis on identifying vulnerable groups.

Methods
This review looked at the impact on five domains; physical health, (health)care needs, mental health, social effects and other effects. We also identified protective and risk factors. We searched the databases of Pubmed, PsychInfo and Embase for longitudinal empirical studies in May 2021.

Results
For all topics together, 145 papers were included. Results show that the corona crisis had a negative impact on the physical and mental health of the youth. Many young people exercised less, ate less healthy and suffered more from depression, anxiety and loneliness. Young people who already had mental or physical health problems were more vulnerable and experienced more negative results of the corona crisis. The crisis worsened existing problems. Other factors that exacerbate problems are poverty and poor family functioning. The impact is the largest for youths with multiple problems. At the same time, young people seem resilient. Many had no or few health problems during the studied period (roughly the first year of the pandemic), or their health problems decreased when restrictions were lifted.

Discussion
More attention is needed for preventive interventions that prevent health problems, promote health and that support the youth to maintain and build their resilience. Special attention should be paid to vulnerable groups when targeting these interventions.
Multimorbidity, low income and unmet need for healthcare: a national study of 41,135 older adults
Authors: Alemu F , Thornton J , Ali S 
Published: October 2022

Abstract
The aims of this study were: (1) to identify the determinants of unmet need for access to primary care in middle-aged and older adults; and (2) to examine the reasons for unmet need. We used data from the Canadian Longitudinal Study on Aging (CLSA), a nationally representative survey of adults aged 45 to 85 years. Respondents were asked if they ‘needed health care during the last 12 months but did not receive it’. For those who replied ‘Yes’, the survey asked for the reason(s) for not receiving the needed care. Out of 41,135 respondents, 3,468 had unmet need for healthcare in the last 12 months. Among respondents with 0, 1, 2 and ≥3 morbidities, the proportion reporting unmet need was 2.5%, 5.3%, 5.1% and 9.1% respectively. After adjusting for covariates, the odds ratios (ORs) for unmet need for 1, 2 and ≥3 morbidities (compared to no morbidity) were 1.25 (95% CI: 0.87 to 1.78; p = 0.23), 1.57 (95% CI: 1.13 to 2.17; p &lt; 0.05) and 2.03 (95% CI: 1.51 to 2.73; p &lt; 0.05), respectively. For income groups, the ORs for unmet need (compared to &gt;$150,000/year) were 0.94 (95% CI: 0.79 to 1.12) for $100,000-$150,000, 1.02 (95% CI: 0.87 to 1.20;) for $50,000-$100,000, 1.30 (95% CI: 1.09 to 1.55) for $20,000-$50,000, and 1.39 (95% CI: 1.08 to 1.78) for &lt; $20,000. Other statistically significant determinants of unmet need included age (older adults were less likely to have unmet need), sex (females were more likely), having a family physician (less likely) and perceived physical and mental health (poor health more likely to be associated with unmet need). The most common reasons for unmet need were: ‘long wait time’ (52.1%) and ‘doctor did not think it was necessary’ (16.7%). Multimorbidity and low-income are associated with higher odds of unmet need among older adults. This disparity is partly due to not having a regular family physician and long wait time to see a doctor. Reducing these barriers are critical to reducing inequalities in health outcomes.