bluuebunny/crossref_metadata_2025_split huggingface dataset:
The risk and safety profile of electronic nicotine delivery systems (ENDS): An umbrella review
Authors: Asfar T , Maziak W 
Published: October 2022

Abstract

Background
Balancing electronic nicotine delivery systems (ENDS) health communication between limiting the harm for new users while offering current smokers the benefits of reduced-risk products is challenging. This umbrella review aims to summarize the evidence about ENDS risk and safety health profile to inform ENDS health communication strategies.

Methods
Six databases were searched for systematic reviews presenting evidence on ENDS health effects. Ninety reviews divided into 5 categories were included: toxicity = 20, health effects = 40, smoking cessation = 24, transition to combustible cigarettes (CCs) = 13, and industry claims = 4. Findings were summarized narratively. Meta-analyses were conducted when appropriate. Quality assessment was conducted using the Measurement Tool to Assess Systematic Reviews. The Institute of Medicine's Levels of Evidence Framework was used to classify the evidence into high-level, moderate, limited-suggestive, and limited-not-conclusive.

Results
We found high-level evidence that ENDS exposes users to toxic substances; increases the risk of asthma; leads to nicotine dependence; causes serious injuries due to explosion or poisoning; increases smoking cessation in clinical trials but not in observational studies; increases CCs initiation; and exposure to ENDS marketing increases its use/intention-to-use. Evidence was moderate for ENDS association with mental health and substance use, and limited-not-conclusive for its association with cardiovascular, cancer, ear, ocular, and oral diseases, and pregnancy outcomes.

Conclusions
Currently, ENDS communication can focus on high-level evidence related to ENDS association with toxicity, nicotine addiction, respiratory disease, ENDS-specific harm (explosion, poisoning), and anti-ENDS industry sentiment. Further research is needed to assess the full spectrum of ENDS health profiles.

Key messages
• Further research is needed to establish the risk and safety health profile of ENDS with consideration of the wide variety of ENDS, their frequency of use, and different segments of the population.
• More prospective cohort studies that take place over longer time periods and with larger sample sizes are necessary to gauge accurately the short- and long-term health-related risks of ENDS.
Improving the quality of translation for patients with language barriers
Authors: Newell R , George S , Patel M , Dawe H , Roelas M , Wedmore F , Morris M 
Published: October 2022

Abstract

Background
Patients with language barriers have worse health outcomes. To promote equitable care, efforts must be made to ensure effective communication with patients, including providing professional translation. In a busy, overstretched health service this can be difficult to achieve. Language translators can reduce barriers, improve safety and ensure impartiality.

Description of the Problem
Aims - To understand the quality of translation and explore interventions that could improve this in a busy diverse hospital in East London.

Methods
A quality improvement project in the Medical Admissions Unit of the Royal London Hospital was completed over two years. Patients with language barriers were identified, methods of translation were analysed and interventions to improve access to independent translation were introduced.

Results
Cycle 1- All medical admissions over a two-week period were analysed. 36 patients had documented evidence of a language barrier with 7 (19.4%) having independent professional translation. 20 (55.6%) patients had family members providing translation, for 4 patients limited English was used and previous documentation was used for 3 patients.
Cycle 2- Posters and information leaflets were disseminated regarding how to access translation services. There was no improvement in the types of translation used. Only 1 patient had impartial professional translation, out of 43 patients identified.
Cycle 3- Advocates (Bengali speaking professional translators) were made available on the ward twice a week. Results showed no significant improvement, with only 6 (10%) identified having impartial professional translation. However staff and patient feedback has been positive.

Lessons
Impartial professional translation is essential in reducing barriers and delivering equitable health care. This can be difficult to achieve in busy healthcare services. Education alone is not enough. Good accessibility to translation services is paramount in promoting usage.

Key messages
• Healthcare services often fall short of providing impartial professional translation.
• Education alone is not enough. Good accessibility to translation services is paramount in promoting usage.
Designing a bilingual health prevention website: challenges of using a participatory approach
Authors: Jaroof S , Cordel H , Badoro B , Felix B , Rolland M , Bourovali-Zade C , Cailhol J 
Published: October 2022

Abstract

Issue/problem
For some migrants, specific health information tools are needed in order to counterbalance lack of access to information both in countries of origin and of destination.

Description of the problem
Migrants originating from Pakistan and newly arrived in France are highly affected by for instance hepatitis C. Many of them have a low level of litteracy, including health litteracy. We decided to create a bilingual Urdu/French website, to provide information on hepatitis C, but also on sexual and mental health. The project was conceptualized in a participary manner, in order to fit the targeted population needs. The project started in June 2021 and the website is expected to be launched by September 2022. We report here some of the key challenges which emerged when working with such hard-to-reach community.

Results
The participatory approach involving community members consisted of 3 steps. In step 1, we confirmed content needs, and assessed preferences in terms of type of media to be used and media styles. About 30 themes were prioritized and the preferred media was video with formal style. After writing scripts, we organized focus-groups discussions to create culturally-appropriate messages. A third and last step will be the selection of titles and keywords for internet search, after shooting videos.

Lessons
Despite working closely with a Pakistani cultural association and urdu-speaking health professionnals, recruitment of community members for participating in the website design happened to be extremely difficult. Despite initial enthusiasm, interests in the project tended to decrease according to sometimes hidden motivations. Focus groups dynamics were at times affected by significant differences in social situations between participants. Despite these challenges, the participatory process allowed us to reshape part of the content according to the community's communications codes, in order to enhance the efficiency of the messages.

Key messages
• Working with socially disadvantaged community members is crucial in order to reduce social inequalities in health.
• However, caution is needed to anticipate and decrease unfulfilled expectations.
Effect of a client-accessible record on autonomy of parents and adolescents in Dutch care for youth
Authors: Benjamins J , Haveman-Nies A , de Vet E 
Published: October 2022

Abstract

Background
In the Netherlands, since 2015, a paradigm shift towards client-centred ‘care for youth’ initiated a focus on client autonomy, enabling clients to make informed decisions in their care process. Client autonomy is assumed to positively correlate with mental and physical health and can be strengthened by autonomy-supportive behaviour from professionals. Aiming for client autonomy, three organizations developed an electronic health record (EPR-Youth), accessible for parents and adolescents. Although research shows that patient-accessible records contribute to patient autonomy, limited research is available about use of such records among adolescents. We investigated whether use of EPR-Youth in ‘care for youth’ contributed to experienced autonomy among adolescents and parents, and what role professional autonomy-supportive behaviour played.

Methods
A mixed methods design combined baseline and follow-up questionnaires with focus group interviews, over a two-year period. Clients completed a questionnaire about experienced autonomy and portal use at baseline (1202 parents, 202 adolescents) and after one year (914 parents, 89 adolescents). Professionals completed questionnaires about autonomy-supportive behaviour at baseline (N = 100), after 5 months (N = 57) and 24 months (N = 110). After 14 months, focus group interviews were held with a purposive sample of parents (N = 8), adolescents (N = 4) and professionals (N = 12).

Results
Twelve months after introducing EPR-Youth, higher autonomy scores were found among parents (Δ = 0·23; 95%CI=0·18-0·28; p &lt; 0·001) and adolescents (Δ = 0·53; 95%CI=0·34-0·73; p &lt; 0·001). Portal users showed higher scores than non-users. Focus group members reported a positive effect of portal use on client autonomy, which was strengthened by professional autonomy-supportive behaviour.

Conclusions
The use of EPR-Youth was associated with increased autonomy among parents and adolescents. Autonomy-supportive professional behaviour enhanced this effect.

Key messages
• The possible contribution of EPR-Youth to client autonomy is promising, but follow-up research is needed to strengthen evidence.
• Implementation of client-accessible records with the aim to enhance client/patient autonomy needs to address autonomy-supportive professional behaviour to increase impact.
Diabetic ketoacidosis among patients admitted to a general hospital in Ethiopia: a spatial analysis
Authors: Paiola E , Sartorello A , Andreani G , Tsegaye A , Tardivo S , Manenti F , Benoni R 
Published: October 2022

Abstract

Non-Communicable diseases are rapidly increasing in low- and middle-income countries. The number of patients with diabetes is estimated to reach 4.7 million in Ethiopia by 2045. Ensuring access to care is critical to improving the management and clinical outcome of diabetic patients. The study describes the characteristics of patients with diabetic ketoacidosis (DKA) and evaluates the relationship between the severity of clinical presentation and the travel time to the hospital. A retrospective cohort study was conducted on the charts of patients admitted for DKA at St. Luke Catholic Hospital (SLCH), Wolisso, Oromia Region (Ethiopia), between 01/01/2021 and 31/08/2021. Demographic and clinical data were collected. Negative binomial regression was used to explore the relationship between the incidence of admissions for DKA and travel time to the hospital. Logistic regression was used to estimate the odds of insulin treatment. Results were presented with 95% confidence intervals. During the study period, 651 patients were admitted, including 77 (11.8%) for DKA (33 females (42.9%) and 44 males (57.1%)), with no differences based on diabetes type (p = 0.258). The mean age was 35 years (IQR 19.0-52.0). Mean BMI was 18.4 kg/m2 (IQR 15.6-19.5), with no differences based on diabetes type (p = 0.639). Cumulative incidence of hospitalizations was significantly correlated to travel time to the hospital (p = 0.039) with an Incident Rate Ratio of 1.01%[1.00-1.02]. The cumulative incidence ranged from 7.0%[4.5-10.3] in Wolisso to 30.8%[14.3-51.8] in Ameya, the most distant district. The relative probability of insulin treatment was higher with increasing time to SLCH (OR 1.11[1.02-1.21] p = 0.027). The hospitalization rate for DKA was significantly correlated with the travel time to the hospital. Access to care is therefore a key factor for health that should be taken into account by improvement programs and the spatial analysis of travel time could help focus on priority areas.

Key messages
• Spatial analysis can be a robust tool to tailor population healthcare needs on its own topography.
• Health policies must consider that accessibility can influence the severity of clinical presentation.
health service utilization among older population in a terai region of nepal
Authors: Subedi B 
Published: October 2022

Abstract

Introduction
The world is heading towards a larger proportion of older population, indicating an increased risk of diseases, disability, and advanced ageing before death as well as the demand for the health system.

Methods
This study is a community based cross-sectional study, total 329 older people aged 60 years and above were surveyed. Two stage cluster-sampling technique was used. Semi structured questionnaire was used for data collection.

Results
Current study showed that 63.3% of the older population have utilized health services in the past one year. Multivariate analysis showed that, respondents with basic education and secondary education are 0.3(AOR: 0.31, 95% CI: 0.17-0.56) and 0.14 (AOR: 0.14, 95% CI: 0.83-0.26) times less likely to utilize health services, respectively. Similarly, respondents reporting current personnel income above forty thousand are 2.8 (AOR:2.81 95% CI:1.84-4.31) times more likely to utilize health services. Respondents at risk of malnutrition are 2.1(AOR: 2.18, 95% CI: 1.14-4.17) times more likely to utilize health services, similarly undernourished respondents are 3.3 (AOR:3.35,95% CI:1.50-7.51) times more likely to utilize health services as compared to respondents with normal nutritional status. Respondents with chronic disease condition are 11.8 (AOR: 11.89, 95% CI: 6.81-20.74) times more likely to utilize health services as compared to those with no chronic disease condition when holding other variables constant.

Conclusions
There is urgent need to highlight the problems faced by the older population as regards health service utilization and dealing with the identified factors associated with health service utilization among the older population should receive high priority.

Key messages
• Municipality and health facilities should create enabling environment for older population to get necessary health services.
• Awareness program targeting the underprivileged ethnic groups and poor houses are recommended.
COVID-19 vaccination hesitancy in Kazakhstan
Authors: Mergenova G , Rosenthal S , Zhussupov B , Izekenova A , Alekesheva L , Izekenova A , Iskakova B , Myrkassymova A , Bukharbayeva A , Davis A 
Published: October 2022

Abstract

Background
COVID-19 vaccine hesitancy is a major problem worldwide that impedes vaccine uptake. We explored factors associated with vaccine hesitancy in Kazakhstan.

Methods
We conducted a cross-sectional face-to-face survey of 991 adults in Kazakhstan in July 2021, using quota sampling of respondents over 18 years old reflecting the distribution of gender, age, residence type, and geographical regions of Kazakhstan, according to the 2020 census.

Results
Over two third (68.4%) of the sample was vaccine hesitant; 22.11% - received a vaccine (18.6%-Sputnik V, 2%-Hayat-Vax, 0.9%-QazCovid and 0.6%- CoronaVac). We used logistic regression to explore factors that were associated with vaccine hesitancy, adjusting age, education, employment, type of residence, self-reported COVID-19. The odds of not being vaccine hesitant were higher among those who had a higher perception that the COVID-19 vaccine was important for health OR = 2.66 (95%CI:2.24,3.17), higher belief in vaccine safety/effectiveness OR = 3.16 (95%CI:2.57,3.89), higher trust in government/health providers OR = 3.32 (95%CI:2.72,4.05), higher trust in official sources of information OR = 1.16 (95%CI:1.12,1.21), higher adherence to preventive measures OR = 1.05 (95%CI:1.03,1.08), knew someone diagnosed with COVID-19 OR = 1.36 (95%CI:1.01,1.82), or who died of COVID-19 OR = 1.47 (95%CI:1.04,2.08), had been ever tested for COVID-19 OR = 1.75 (95%CI:1.30,2.35), had ever received flu vaccine OR = 2.16 (95%CI:1.62,2.88), among health professionals OR = 2.76 (95%CI:1.38,5.51), and who had lower vaccine conspiracy beliefs OR = 0.48 (95% CI:0.40,0.58).

Conclusions
Vaccine accepting individuals held positive beliefs about the COVID-19 vaccine, had greater trust in government/official sources of information/health care workers, had greater exposure to COVID-19. Interventions aimed at reducing vaccine hesitancy need to address sources people find credible and may need to target individuals who have had limited exposure to the risks of COVID-19.

Key messages
• Strategies to increase trust in government/ health care workers and official sources of information can be an effective approach to reduce COVID-19 vaccination hesitancy.
• Interventions to reduce COVID-19 vaccination hesitancy should target individuals who have had limited exposure to the risks of COVID-19.
A dynamic transmission model to calculate vaccination coverage needed to control COVID-19 in Germany
Authors: Waize M , Scholz S , Schmid-Küpke N , Koch J , Vygen-Bonnet S , Harder T , Wichmann O 
Published: October 2022

Abstract

Background
Control of the 2019 coronavirus disease (COVID-19) pandemic in Germany and return to pre-pandemic behaviour can only be achieved through natural or vaccine-induced immunity. Sufficient vaccine capacity promotes interest in the necessary and feasible target vaccination coverage.

Methods
An age and risk group stratified SEIR transmission model was used to assess the impact of vaccination coverage ranging 65%-95% for 12-59-year-olds and 90%-95% for ≥ 60-year-olds on COVID-19 incidence and intensive care unit (ICU) utilization between 01.07.2021-31.03.2022. Separate implementation of licensed vaccines allows to consider different efficacies, delivery rates and age-specific national vaccination recommendations. The analysis was conducted under different assumptions about contact behaviour during summer, reduction of daily contacts with increasing number of cases, daily vaccination uptake and the dominant variant. Data from the COVIMO study (N = 3004, data collection: 17.05.-09.06.2021) were used to define the population percentage willing to be vaccinated.

Results
The COVIMO study indicates an achievable vaccination compliance rate of 83.9% among 12-59-year-olds and 94.8% among those ≥ 60-year-olds. Maximum incidence or ICU utilization during observation period decreases from 385 to 61 and 6220 to 2800, respectively, with an increase in vaccination coverage from 65% to 95% of 12-59-year-olds, 90% vaccination rate among ≥ 60-year-olds, compared to pre-pandemic reduced contact behaviour in summer and reduction of contacts as case numbers increase.

Conclusions
The vaccination campaign should be continued at high intensity until at least 85% of 12-59-year-olds or 90% of ≥ 60-year-olds are fully vaccinated against COVID-19. Based on the population's willingness to be vaccinated, this goal seemed feasible.

Key messages
• Mathematical modeling was used to determine an evidence-based target vaccination coverage of ≥ 85%.
• Expertise in modeling should be further strengthened.
Case-case study on comparative vaccine effectiveness against Delta and Omicron SARS-CoV-2 infections
Authors: Kislaya I , Peralta-Santos A , Vieira L , Sousa C , Ferreira B , Pelerito A , Gomes JP , Pinto Leite P , Nunes B ,   PT COVID-19 group
Published: October 2022

Abstract

Introduction
Vaccination is the primary pharmacological measure to reduce SARS-CoV-2 transmission and its complications. Timely information on vaccines effectiveness in a context of novel variants of concern (VOC) emergence is essential for public health policies. This study aimed to provide a measure of comparative vaccine effectiveness between Omicron (BA.1) and Delta (B.1.627.2) VOC according to vaccination exposure (complete primary regimen or booster dose) for Portuguese population aged 12 or more years old using routinely collected data from electronic health records.

Methods
We used a case-case study design linking national electronic vaccination registry and surveillance data on 13,134 SARS-CoV-2 RT-PCR laboratory-confirmed cases notified in Portugal during weeks 49-51 of 2021. Notified cases were classified as Omicron or Delta based on whole-genome sequencing or S-gene Target Failure (SGTF) status using the RT-PCR TaqPath™ Covid 19 CE IVD Kit (Thermo Scientific™) assay. The odds of vaccination was compared between Omicron cases and Delta cases using logistic regression adjusted for age group, sex, region and week of diagnosis and laboratory of origin.

Results
The odds of vaccination were higher in laboratory-confirmed cases infected by Omicron (BA.1) VOC compared to Delta (B.1.627.2) VOC for both complete primary vaccination (Odds ratio (OR)=2.1; 95% Confidence Interval (95%CI): 1.8 - 2.4) and booster dose (OR = 5.2; 95%CI: 3.1 - 8.8), indicating vaccine effectiveness reduction against Omicron.

Conclusions
We found significantly higher odds of vaccination in Omicron cases compared to Delta, suggesting lower effectiveness of the primary vaccination and the booster dose in preventing infections by Omicron. Case-case study design has proven to be feasible approach to rapidly compare vaccine effectiveness between VOC in context of novel VOC emergence to timely inform public health stakeholders.

Key messages
• Reduction of vaccine-induced protection against SARS-COV-2 infection with the Omicron compared to Delta after primary and booster vaccination.
• Continuous monitoring of COVID-19 vaccine effectiveness is essential to support public health policies in context of novel VOC emergence.
The impact of conscientious objection on voluntary abortion in Italy in the last two decades
Authors: Charrier L , Bo M , Koumantakis E , Zotti CM 
Published: October 2022

Abstract

Background
Italian Law 194/1978 legalized voluntary abortion during the first 90 days of pregnancy. Healthcare professionals can claim conscientious objection (CO), but regional governments must guarantee women's rights. In recent years, international human rights authorities argued that access to safe abortion was limited in Italy due to widespread CO.

Methods
An ecological study was conducted using 1997-2019 ministerial data on the number of gynecologists registered as conscientious objectors, the proportion of abortions performed timely (within 14 days of the request), and within 8-10 weeks of pregnancy. The extra workload for non-objecting gynecologists was calculated as the ratio between the workload for non-objectors and the (theoretical) workload for each gynecologist on duty. The correlation between the extra workload for non-objectors and the proportion of abortions performed within 14 days of the request or beyond 21, as well as the correlation between waiting time and gestational age at the time of the procedure. Data were analyzed for Italy and stratified for its 21 Regions.

Results
CO among gynecologists turned out to be stable around an average of 70% (median 69%, IQR 64-71%) in the last decades, with 62% of abortions performed within 14 days and 82% of procedures performed by the 10th week of pregnancy. In 13 regions (statistically significant in 5) the increase in workload for non-objectors was inversely correlated with abortions performed within 14 days, and directly correlated with those performed later than 21 days. In all regions (statistically significant in 18) a direct correlation was found between procedures performed timely and those performed within 8 weeks of pregnancy.

Conclusions
Data from the last 20 years confirm previous findings and CO still seems to have a strong impact on women's right to access safe and timely abortion in Italy. More efforts are needed to narrow the gap between the provisions of the law and its implementation.

Key messages
• A high proportion of objecting staff makes it difficult to guarantee women’s rights to access timely and safe abortion.
• Effective organizational strategies and a proper legal framework are needed to cope with the high percentage of conscientious objectors among health professionals.