bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a mobile app on breastfeeding among cesarean deliveries: A randomized controlled trial
Authors: Duong Doan TT , Binns C , Lee A , Minh Pham N , Phuong Hoa Dinh T , Zhao Y , Ha Bui TT 
Published: October 2022

Abstract

Aim
Cesarean section has negative impacts on breastfeeding rates. This study is to evaluate the effect of a mobile application on breastfeeding outcomes among mothers who had cesarean section using a randomized control trial in Vietnam in 2020 - 2022.

Methods
A triple-blinded randomized trial of a mobile application was conducted. The mobile application was tailored to Vietnamese culture with two separate versions for the intervention and the control group. The intervention version auto-generated three messages per week and linked the information in the library content to improve breastfeeding while the control version sent messages on maternal and child health care. Pregnant mothers were recruited during their antenatal visits and randomly assigned to two groups. Outcomes of interest included early initiation of breastfeeding and exclusive breastfeeding rates.

Results
A total of 275 mothers in the control and 293 in the intervention group who had undergone a cesarean section were included in the analyses. Significant increases were observed for early initiated breastfeeding within two hours (aOR= 1.51, 95%CI: 1.01 to 2.27) and exclusive breastfeeding during hospital stay (aOR=1.59, 95%CI: 1.02 to 2.49).

Conclusions
Our results support the use of a theory-based design mobile phone application as a part of a promising intervention to improve breastfeeding outcomes.

Key messages
• A mobile phone application could be a widely accessible, acceptable, and effective intervention to improve breastfeeding outcomes.
• To improve exclusive breastfeeding rates, comprehensive interventions at different levels of sociocultural and market contexts, settings, and individuals are needed.
Assisted Reproductive Technology: Gaps in young adults’ perceptions and information from clinics
Authors: López-Toribio M , Melovska J , Dimitrievska V , Dostálová A , Novotná M , Rozée V , Hens K , March S , Güell F , Carrasco JM 
Published: October 2022

Abstract

Background
Around 186 million individuals are facing infertility worldwide, with a huge impact on their wellbeing. Fertility care is considered a key element to promote reproductive health. This study aims to explore young adults’ knowledge, perceptions and concerns about infertility and Assisted Reproductive Technology (ART), and to contrast it with the information provided by ART clinics.

Methods
A multi-country qualitative study was conducted in Albania, Belgium, Slovenia, Spain, Italy, Kosovo, North Macedonia and Switzerland within the H2020 B2-INF project (Grant Agreement 872706). In 2021, 10-15 semi-structured interviews were conducted in each country with participants aged 18-30, childless and non-ART users. Additionally, 3-5 clinics’ websites in each country were explored. Data was collected in native languages and translated into English. A thematic analysis was carried out.

Results
In total, 98 interviews were conducted and 38 clinics’ websites were explored. Three themes emerged from the analysis of the interviews: 1. Parenthood and (in)fertility; 2. Young people's perception on ART; 3. Information and publicity of ART. Parenthood was described as a relationship beyond biological ties and infertility as a social taboo. Most participants perceived ART positively and would use it if needed, although knowledge on ART was low. Participants considered information on ART as scarce and suggested that government-led information campaigns should be launched to raise awareness on it. Concerning clinics, the websites provided information on infertility and exhaustive technical descriptions of ART techniques, although it may be difficult for the general population to understand. Data offered on success rates were unclear and heterogeneous.

Conclusions
Gaps in citizens’ expectations and needs and the information provided by ART clinics were identified. Awareness campaigns are needed to diminish social taboo on infertility and ART and to promote reproductive health.

Key messages
• Assisted Reproductive Technology is positively perceived by young adults, though their knowledge of it and infertility is low. Information campaigns are thus needed to raise awareness among the young.
• ART clinics have room for improvement in aligning the information provided on their websites with young people's perceptions and needs, and to show it in a more accessible and understandable way.
Stressful life events as predictors of refugee adolescents’ subjective mental health need
Authors: Namer Y , Fretian A , Podar D , Razum O 
Published: October 2022

Abstract

Background
Asylum seeking and refugee (ASR) adolescents fleeing armed conflict have lived through stressful events. Although not all stressful life events are experienced as post-traumatic stress, they may still lead to subjective need for mental health support. In this study, we assessed which stressful events predicted subjective need.

Methods
We collected and analysed cross-sectional data (February 2019-November 2020) from ASR adolescents aged 11-18, coming from Syria, Afghanistan and Iraq (n = 216). Subjective mental health need was measured with the question “Do you think you have emotional difficulties that you need help with?” and stressful life events (SLE) by the SLE Checklist, a self-report screening tool that asks if participants experienced stressful events in three categories: separation from family, witnessing armed conflict, experiencing violence. Binary logistic regression was run to assess the relative contribution of stressful life events to subjective need.

Results
30.1% of participants reported subjective need for mental health support. Most commonly encountered events were witnessing armed conflict (53.2%) and experiencing the death of a loved one (51.9%). Only one stressful event significantly predicted subjective need for mental health support: separation from family or relatives against one's will (e.g., by police or military) [OR = 6.32, 95%CI(1.79,22.31)].

Conclusions
ASR adolescents who have been separated from their family by force report subjective need for mental health support. It is important to supplement diagnostic tools with subjective report of needing mental health care. ASR adolescents who have experienced separation from famil by force should be given spaces to talk about their need for mental health support. Public health interventions could focus on creating or utilising such spaces where mental health support is available. Crucially, bureaucratic and legal burdens that impede speedy family reunification should be reduced.

Key messages
• ASR adolescents who have been separated from their families by force are more likely to report subjective need for mental health support.
• The higher reported need highlights the importance of reducing bureaucratic and legal burdens that impede fast family reunification.
Reform of the mental health care system in the Republic of Croatia
Authors: Stimac Grbic D 
Published: October 2022

Abstract

Issue/problem
The pandemic and earthquakes that hit Croatia have increased the need to develop an effective community based mental health care system.

Description of the problem
In Croatia, the hospitalization rate for depression has doubled in the last 20 years, and the growing needs are mainly related to the mental health of children and young people. The average length of hospital stay due to mental disorders is higher than the EU average, as is the suicide rate. Due to insufficient recognition at the primary level of health care, inadequate treatment and stigma, people with mental disorders rarely seek help.

Results
Croatia is in the process of adopting the Strategic Framework for Mental Health 2022-2030. The Action Plan for community based mental health service and the Action Plan for mental health promotion, the early detection and treatment of mental disorders are being developed. Emphasis is on intersectoral cooperation, reorientation of the mental health system to community-based care, empowerment, especially of young people, through social emotional learning in school programs, peer support and involvement of young people in decision-making processes. Increasing the mental health literacy, destigmatization, empowering people with mental health disorders to participate in designing interventions, establishing multidisciplinary mobile teams to provide community services and the cooperation of all sectors in mental health care are emphasized. The national program for improvement mental health literacy of educational staff was launched. Telemedicine services have been developed, and the pilot project Providing psychosocial services by mobile multidisciplinary teams have been implemented.

Lessons
Comprehensive, multidisciplinary and multisectoral action is needed to effectively address the problems in the mental health care system.

Key messages
• Community based mental health care is client oriented care.
• People with experience of mental disorder and their families must be involved in the decision-making process.
Mental health problems, low economic capability, and social marginalization among 28,047 adults
Authors: Haugland SH , Topor A , Friesinger JG 
Published: October 2022

Abstract

Background
Mental health problems and low economic capability increase the risk of social marginalization. However, few larger studies with a broad age group have investigated how the cumulative effect of having both these difficulties may affect social life. The purpose of this study was to examine the associations between having mental health problems or having low economic capability or reporting both, and social marginalization.

Methods
The study is based on responses from 28 047 adults (&gt; 18 years old) from the general population participating in The Norwegian Counties Public Health Survey 2019. The study had a cross-sectional design and included respondents’ evaluation of own economic capability, mental health problems (HSCL-5) and social marginalization measured as lack of social support, low participation in organized social activities, low participation in other activities, missing someone to be with, feeling excluded and feeling isolated. Multivariable logistic regression was adjusted for sex and age.

Results
Findings showed that having mental health problems or low economic capability were both associated with various measures of social marginalization with odds ratio [OR] 95% confidence interval [CI] ranging from OR 1.33; CI 1.23-1.43 to OR 12.63; CI 10.90-14.64. However, the odds of social marginalization strongly increased for respondents having both mental health problems and low economic capability compared to respondents without both these difficulties, with OR ranging from OR 2.08; CI 1.90-2.27 to OR 29.46; CI 25.32-34.27. Findings are preliminary.

Conclusions
Having both mental health problems and low economic capability strongly increases the risk of social marginalization, far beyond the effect of each factor alone.

Key messages
• Having both mental health problems and low economic capability strongly increases the risk of social marginalization, far beyond the effect of each factor alone.
• Services should aim to develop multi-faceted approaches to meet multiple life-challenges to prevent social marginalization.
Trends in health reforms in the Health System and Policies Monitor network: increasing interaction of primary health care and care coordination
Authors: Polin K , Quentin W 
Published: October 2022

Abstract
Since 2018, the Health System and Policy Monitor (HSPM) network of the European Observatory on Health Systems and Policies has tracked health reform activity in its countries. Top three reforms are identified by national experts yearly and classified across 11 policy clusters. Efforts inform a standardized overview of healthcare development. 337 reforms have been assessed for 31 (mainly EU) countries over 4 years, with clear trends like the converging of PHC and care coordination. Main reform areas were primary/ambulatory care, governance, and hospital care (2018-2019); coordination, governance, and digital health (2020); and care coordination, governance, and insurance coverage/resource generation (2021). For PHC, this suggests a shift from leveraging innovations to support existing delivery mechanisms to transforming PHC. Some PHC reforms in 2018-2019 introduced elements of integrated care, but more focused narrowly on specific levers, e.g., gatekeeping. Early care coordination reforms focused on certain patient groups or care delivery across the system. Separately, PHC and care coordination have long been reform priorities. Since 2020, they are increasingly linked to one another, and to multidisciplinary care. This suggests a recognition that multidisciplinary processes/staffing are key to realizing the promises of PHC-to coordinate the care of patients and ensure comprehensive and continuous care over time for most health needs. This vision is underpinned by the UN SDGs and COVID-19, which highlighted the need for health systems to be set up for and with the resources to respond to crises while maintaining core functions. The overview of HSPM health reforms identifies reform trends and opportunities for cross-country learning. More research is needed for policymakers to benefit fully from reform experiences abroad. Case studies with in-depth analysis of reform design and implementation processes can help inspire or support future health reforms elsewhere.
Storytelling to communicate public health messages during the COVID-19 pandemic; A systematic review
Authors: Paudyal P , Ozkosar S 
Published: October 2022

Abstract

Background
Storytelling has been increasingly used in public health to disseminate health messages in a format that is more understandable and engaging. This project aims to summarize the findings from the studies that used storytelling approach for conveying health messages during the COVID-19 pandemic.

Methods
The protocol for this systematic review is registered in PROSPERO (CRD42021281957). Studies were identified via electronic databases; EMBASE, Ovid MEDLINE and EBSCO using variations of the search terms ‘COVID-19’ and ‘storytelling’. Studies that used storytelling interventions in COVID-19 and published in English after 2020 were eligible for inclusion. Data from eligible full text article was collated in a summary table. Quality of included studies were assessed using Joanna Briggs Institute Checklists.

Results
Of the 4562 studies identified in the electronic search, 11 were eligible for inclusion. Participant numbers in each study varied from 14 to 3746. Eight of the 11 studies included were set online, looking at virtual forms of storytelling. This included online surveys and social media campaigns within hospitals, and online meetings with patients at home. Overall, studies showed that storytelling intervention increased engagement in health communication and has the potential to be used as an effective public health communication tool, for changing health behaviours. Studies were small, six out of 11 were of poor quality.

Conclusions
Storytelling is a widely accepted intervention and has the potential to positively impact communication, empathy and health behaviour. As there is no standardized definition of storytelling, and studies into this area are new, it is important to continually re-evaluate data to enhance understanding and provide standardized guidelines for storytelling in the COVID-19 context.

Key messages
• Storytelling has been increasingly used in public health to disseminate health messages.
• Storytelling has the potential to positively impact communication, empathy and health behaviour.
Semi-Automatic Knowledge Extraction from COVID-19 Scientific Literature: the COKE Project
Authors: Golinelli D , Nuzzolese AG , Sanmarchi F , Bulla L , Mongiovì M , Gangemi A , Rucci P 
Published: October 2022

Abstract

Background
The COVID-19 pandemic highlighted the importance of rapidly updating scientific information. However, the guidelines’ drafting process is highly time- and resource-consuming. The COKE Project aims to accelerate and streamline the extraction and synthesis of scientific evidence. To do so, the Project used deep learning to implement a semi-automated system that enhances the systematic literature review processes. We aim to show some preliminary results on the automatic classification of abstract sentences in papers related to COVID-19.

Methods
The tool is based on Natural Language Processing algorithms to detect and classify PICO elements and medical terms and organize abstracts accordingly. We built a BERT + bi-LSTM language model. The tool was trained on a corpus of 24,668 abstracts unrelated to COVID-19. We assessed the tool performance in a specific topic related to COVID-19 that has not been covered during training. To carry out manual validation, we randomly selected 50 abstracts. Abstract sentences were classified by 2 domain experts into 7 types: Aim (A), Participants (P), Intervention (I), Outcome (O), Method (M), Results (R), and Conclusion (C). The performance of the tool was compared with that of the experts in terms of precision, recall, and F1.

Results
The classifier proved to have a 76% overall accuracy. Precision, recall, and F1 were above 75% for all types of sentences except I, M, and P.

Conclusions
The results indicate a promising ability of the semi-automated classifier to predict expert-validated labels on abstracts of different topics. Our proposed tool is expected to significantly reduce the effort for producing medical guidelines and therefore have a strong, positive impact, particularly in emergency scenarios. The COKE Project also represents a call-to-action for similar initiatives, aimed at enhancing the information extraction process in medicine.

Key messages
• A rapidly changing healthcare requires fast decisions supported by scientific evidence. This is not compatible with the human limits in cognitive skills that reduce the ability to extract information.
• The COKE Project aims to speed up the creation of healthcare guidelines, semi-automating parts of the workflow, and supporting the human-performed process of extracting and analyzing contents.
PHIRI Rapid Exchange Forum (REF): A key tool for cross-country exchange in times of crisis
Authors: Habl C , Pries C 
Published: October 2022

Abstract

The COVID-19 pandemic demanded a quick exchange between experts and institutions supporting national governments in the crisis response literally from the first day onward to provide evidence-based information. There was no such regular cross-country forum established in the field of population health in the beginning of the crisis. Thus, devoted members of the Joint Action on Health Information started already in April 2020 to meet regularly online to foster cross-country exchange. In these meetings, partners could approach each other for questions and shared views in a trusted environment. The European Commission recognized this achievement and supported this exchange as part of the Population Health Research Infrastructure (www.phiri.eu), allowing a quick exchange of data, indicators, good practices and experiences in the COVID-19 crisis response in an efficient manner. Till May 2022 34 REF meetings have taken place, involving project partners, national advisors to ministers/heads of agency, representatives of expert networks (e.g. Healthy Cloud), EU services (ECDC, JRC) and different health stakeholders (e.g. ELIXIR). The bi-weekly 1 hour online meetings cover in a moderated, structured format pre-agreed COVID-19-topics that are proposed by the participating countries and chosen via a survey ex-ante to each meeting). Responses by the countries (backed up by national reports, andguidelines that are briefly presented in the meetings) are compiled and shared immediately after the meeting via the Corona-Corner of the Health Information Portal (www.healthinformationportal.eu/rapid-exchange-forum). Topics covered reach from a discussion on suitable non-pharmaceutical interventions and their application especially prior to the availability of vaccines to child vaccination strategies and overall testing regimes to the most suitable communication tools. In average, 25 to 30 delegates from different, mainly EU member states attend each exchange.

Key messages
• The PHIRI Rapid Exchange Forum demonstrated its importance for regular decision making in the field of population health not only in times of crisis.
• The Rapid Exchange Forum is an integral part of the European Health Information Portal (www.healthinformationportal.eu) which shall be transformed into a sustainable infrastructure.
Health facilities readiness to provide primary cardiometabolic healthcare in Burkina Faso, 2012-2018
Authors: Cissé K , Kirakoya F 
Published: October 2022

Abstract

Background
Cardiovascular diseases (CVD) and diabetes, referred to as “cardiometabolic diseases” (CMD), are a growing health issue in developing countries like Burkina Faso. As the first contact point with the national health system, primary health care must play a crucial role in CMD prevention and control. This study aimed to analyse the primary health care (PHC) system readiness for CMD prevention and treatment in Burkina Faso from 2012 to 2018.

Methods
We performed repeated cross-sectional data analysis from health facility-based surveys, conducted in 2012, 2014, 2016, and 2018. These surveys were conducted using the World Health Organisation (WHO) Service Availability and Readiness Assessment (SARA) tool. The readiness of PHC for CMD was defined according to the SARA manual.

Results
A total of 586 healthcare facilities were included in 2012, 659 in 2014, 567 in 2016, and 653 in 2018. Between 2012 and 2018, the percentage of healthcare facilities providing CMD specific care significantly increased (66.2% to 92.0% for CVD and 39.4% to 46.6% for diabetes). However, the mean readiness index of the PHC system to manage CVD decreased from 26.0% to 21.6% (p for trend&lt;0.001). For diabetes, the overall readiness index increased significantly (from 34.2% to 37.5%, p = 0.005). The readiness index of PHC for CVD significantly decreased in all health regions particularly in the Sahel region (from 31.7% to 20.8%, p &lt; 0.001). While, for diabetes, it increased in all the health regions excepted the Centre-Sud region (from 37.8% to 32.2%, p &lt; 0.001).

Conclusions
There is a low level of preparedness of PHC system to provide CMD in Burkina Faso. Although improvements for diabetes, this is not enough (80% availability of affordable basic technologies and essential medicines recommended by the WHO). Strengthening of the primary healthcare system considering the geographical disparities is urgently required for early detection and management of CMD.

Key messages
• There is a low level of readiness of PHC system to provide cardiometabolic healthcare in Burkina Faso.
• Public health policy makers must pay more attention to strengthening of the primary healthcare system to address the rising burden of CMD.