bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 6 years trends in hospitalization: retrospective study of Traumatic Brain Injury
Authors: Chikhladze N , Burkadze E , Pitskhelauri N , Tsiskaridze A , Peek-Asa C , Coman M 
Published: October 2022

Abstract

Introduction
Traumatic Brain Injury (TBI) is a significant public health issue globally, and the mortality and morbidity burden is particularly high in low- and middle-income counties (LMICs). The WHO predicts a disproportionately large increase of TBI burden in LMICs. The aim of this study was to identify trends in hospitalization associated with TBI in Georgia from 2015-2020.

Methods
The study was designed in the framework of the project INITIatE: International Collaboration to Increase TBI Surveillance in Europe, funded by the US National Institutes of Health (NIH/NINDS R21NS098850). The surveillance database of National Center for Disease Control and Public Health of Georgia was used for the study.

Results
During the study period a total 51 147 patients were admitted in hospitals throughout the country. In 2015-2019 the hospitalization increased and highest number of cases was in 2019 (n = 11779; 23,0%), in 2020 hospitalization decreased in comparison with the previous year (n = 9228; 18,0%). The highest number of burn injuries (n = 22963; 45,0%) occurred in the capital of Georgia (Tbilisi). Among hospitalized patients about 61,0% were males (n = 31162) and 39,0% females (n = 19985), retrospectively with ratio 1,6:1. The modal age of hospitalized patients was 25-44 and the highest hospitalization was in the age group of 15-24. 92,5% of cases were unintentional. The leading cause of Traumatic Brain Injury in all years were falls with some variations (57%-71%), followed by road traffic injuries (12%-25%). The average of LOS was 3 days, the highest LOS was 702 days. 1,6% (n = 805) of patients died. The most common mechanism of fatal injuries were falls.

Conclusions
The study provide important information about trends in hospitalization, size of the TBI problem, which is crucial for elaborating relevant policy and establishing priorities in order to reduce the burden of Traumatic Brain Injury in Georgia, as well to identify directions for further TBI related research.

Key messages
• Epidemiological data are essential for designing relevant preventive programs.
• Prevention is a key component of public health efforts to reduce TBI burden.
The association between Chorionic Villus Sampling and preterm birth: A systematic review
Authors: Giannakou K , Mastrou L 
Published: October 2022

Abstract

Background
Preterm birth is defined as a syndrome that can be initiated via various mechanisms. During the past few decades, it has been an emerging health issue worldwide and thus, several actions to benefit public health have been undertaken to reduce its rate. Chorionic Villus Sampling (CVS) is one of the methods that are performed prognostically for prenatal diagnosis. However, several complications can occur after this invasive method is performed. The aim of this review is to identify whether CVS may result in preterm birth as a complication, compared to other invasive or non-invasive methods.

Methods
A systematic literature review was conducted in PubMed and Scopus from inception until December 2021, to identify studies examining the above association. The research strategy included a combination of search and MESH terms related to CVS and preterm birth, Inclusion and exclusion criteria were set. The research was conducted by two researchers that thoroughly screened the articles and extracted the data.

Results
37 studies met the inclusion criteria. Comparisons were performed between CVS and amniocentesis or control group or between the different weeks that CVS was performed. No significant difference was observed in most of the studies when CVS was compared to amniocentesis, control groups, or between different weeks of gestation that was performed.

Conclusions
The risk of preterm birth of women undergoing CVS was relatively lower or had no difference compared to the other methods or controls investigated. Therefore, CVS is considered as a safe prenatal diagnostic procedure with minimum rates of preterm birth as a complication.

Key messages
• The risk of preterm birth of women undergoing CVS was found to be relatively lower with no significant differences compared to the other methods or controls.
• Future studies should be performed recruiting a large sample with women of different age and compare it with a control group that will not undergo any invasive method.
Associations between breastfeeding and the “10 Steps for Successful Breastfeeding”
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
The Baby-Friendly Hospital Initiative’s (BFHI) ‘‘Ten Steps for Successful Breastfeeding'’ has been the cornerstone of national and international strategies for decades; however, adherence is suboptimal. Despite successive National Strategies, breastfeeding rates remain low in Cyprus.

Methods
The overall experience of a consecutive sample of 568 mother-baby dyads (response: 70.8%) across all public (N = 5) and 29 (of 35) private maternity clinics was operationalized as the sum score of full, partial or no implementation of each WHO/UNICEF BFHI self-assessment questionnaire item, with the exclusion of Step 6 (exclusivity). Associations with initiation and continuation of any (BF) and exclusive breastfeeding (EBF) up to the 6th month were explored in logistic regression after adjusting for potential confounders, including breastfeeding self-efficacy.

Results
At mean score 5.6 (SD = 2.4), the overall 10 steps experience was low (theoretical range 0-14), even among those who breastfed exclusively (M = 6.9, SD = 2.1; p &lt; 0.001). EBF and BF initiation and continuation showed a stepwise association with self-reported experience of the 10 steps. Across quartiles of increasing scores, the prevalence of EBF was 7.1%, 15.1%, 17.0% and 35.6%. The quartile of mothers who assessed their experience more favourably were 8- (adjOR: 8.4, 95% CI 1.5-48.0; p = 0.017) and 4-times (adjOR: 4.1; 95% CI 1.7-9.8, p = 0.002) more likely to initiate BF and EBF, even though only 6.5% continued EBF by the 6th month. Step 7 (rooming-in) and step 9 (no pacifiers) were least practiced but more strongly associated with EBF initiation.

Conclusions
While breastfeed intention may determine the actual experience of the 10 steps, implementation across maternity clinics appeared fragmented, despite clear association with successful initiation and continuation of BF, at the same time that the Cyprus National Committee for Breastfeeding is embarking on the first BFHI accreditation of maternity clinics.

Key messages
• Despite successive National Strategies identifying breastfeeding as Public Health priority, adherence to the WHO/UNICEF’s 10 Steps appears fragmented across Cypriot maternity clinics.
• Despite low overall adherence, mothers reporting experiencing more of the 10 steps were more likely to initiate and continue breastfeeding.
Forced migrant women’s Mental Health in the perinatal period in Germany- A mixed-method study
Authors: Al Munjid R , Teschemacher L , Mohr E , Engelhardt M , Breckenkamp J , Borde T 
Published: October 2022

Abstract

Background
After forced migration, pregnant women and new mothers face specific challenges in the host country. Little research focuses on the impact these challenges have on forced migrant (FM) women’s mental health (MH). The study’s aim shed light on FM women’s mental wellbeing in the perinatal period.

Methods
For this mixed-method study 15 individual problem-centered interviews were carried out in Arabic with FM mothers living in Germany within the postnatal period to one year postpartum. The transcripts were analysed using the Framework Analysis. In addition, structured quantitative interviews with 3070 new mothers were conducted on 3 obstetric wards in Berlin over a period of 23 months using an adapted version of the MFMCQ and the PHQ4. FM women (n = 187) were compared with immigrant (n = 1192) and non-immigrant women (n = 1673). A Kruskal-Wallis-Test was performed to compare the three groups.

Results
In the qualitative interviews mothers stated having depression and varied emotions (e.g. unavoidable sadness, relief). Most FM mothers indicated contextual factors (e.g. bad housing conditions) and structural barriers in perinatal healthcare as negatively impacting their MH. The preliminary quantitative analysis of the interviews conducted in birth clinics directly after birth showed no significant differences in the mean scores of the PHQ-4 within the compared groups (mFMW= 2.83; mimmi=2.61; mnonimmi= 2.5; p=.72).

Conclusions
While the quantitative study part indicates that PHQ-4 scores are independent of FM experience, the qualitative part shows that FM new mothers face particular burdens in their living conditions that make them vulnerable to MH issues. Inconsistent results could be attributed to the different timing in which the structured questionnaires and qualitative interviews were conducted.

Key messages
• To promote Mental health of new mothers, we advocate for a diversity oriented, responsive healthcare system.
• Effective approaches must be provided to include FM mothers in existing Early Childhood Intervention programs.
Feeding preterm infants with breast milk – the role of maternal pressure
Authors: Schwab I , Okumu I , Ohnhäuser I , Dresbach II , Scholten I 
Published: October 2022

Abstract

Background
Motheŕs own milk (MOM) is the best nutrition for preterm infants because of its preventive effects. Nevertheless, current research shows that mothers have problems getting into continuous lactation, especially after preterm birth. Breastfeeding-related pressure after prematurity has not been measured yet. It's relevance for the lactation is thus unclear, as well as the role of the NICU staff's attitudes. The aim of this study is to gain more knowledge about breastfeeding-related pressure in order to enable mothers to have a positive breastfeeding experience and to sensitise NICU staff about this topic.

Methods
The written survey included mothers of preterm infants with a birth weight under 1500g and an age from 6 to 24 months at the time of the survey. Descriptive and bivariate testing was used for analyses.

Results
Data of 506 mothers was included (32% response rate). One third totally agreed to perceive pressure regarding breastfeeding their child with MOM (36%). A milk volume over 500ml/day 14 days post-partum was reported in 60%. That the nutrition with MOM was promoted by the physicians in the NICU was totally agreed by 44% of the mothers. To the promotion by nurses, 50% totally agreed. Pearson Chi2-Test showed a significant correlation between milk volume and breastfeeding-related pressure (p = 0.005). Spearman’s correlation test showed a significant correlation between a high promotion of MOM by physicians (Spearman’s rho: -0.1150, p = 0.0109) and nurses (Spearman’s rho: -0.0949, p = 0.0362) and lower breastfeeding-related pressure.

Conclusions
Our findings indicate that breastfeeding-related pressure seems to affect most of the mothers of preterm infants and correlates with lactation, even if no direction of effect can be stated. A more breastfeeding promoting NICU staff is related to lower breastfeeding-related pressure. Therefore, NICU staff should be sensitised to breastfeeding-related pressure with regard to communication with mothers.

Key messages
• Noticing breastfeeding-related pressure as an important factor for mothers within their lactation process may have the potential to enhance mothers to achieve their breastfeeding goals.
• NICU staff should be aware of breastfeeding-related pressure to enable more mothers to have a positive breastfeeding experience.
Designing active breaks in secondary school, results from focus group with teachers: the brave study
Authors: Longo G , Masini A , Ricci M , Marini S , Sansavini A , Scheier LM , Ceciliani A , Dallolio L 
Published: October 2022

Abstract

Background
Many adolescents are unable to accomplish the daily 60 minutes of moderate to vigorous physical activity (PA) recommended by WHO. Secondary school is a critical period for developing healthy habits and PA interventions have the potential to promote healthy development. Active Breaks (ABs) are a school-based intervention consisting of short bursts (5-15 minutes) of PA made part of the academic routine. Primary school has been ABs main setting, while secondary school interventions received less attention. The aim of the BRAVE Study is to investigate teachers’ opinion about the feasibility of ABs in Italian secondary school.

Methods
In November 2020 20 teachers from two secondary schools located in Bologna province (Italy) were enrolled in two focus groups (FGs). FGs were held online, recorded, and transcribed. Questions were asked about the role of PA in the school routine and related experiences, perceived barriers and facilitators of the intervention, suggestions regarding the intervention design. Final expectations were then discussed.

Results
Despite limited experience with PA interventions, participants felt ABs would improve psycho-physical well-being for both students and teachers. Lack of time and space and a wary attitude towards ABs were listed as barriers. Program flexibility regarding content, administration time frames and implementation mode was listed as a great facilitator: program should be adaptable to participants’ needs, favoring easy and quick exercises. Overall, expectations emphasized improving classroom behavior and promoting healthy habits.

Conclusions
Teachers felt that inclusion of ABs in secondary school was promising and could lead to many health benefits. ABs were deemed feasible given their short duration and adaptability, since the program can be implemented with current personnel resources and space configurations. Co-design is essential to overcome personal barriers and create an effective and sustainable intervention.

Key messages
• According to secondary school teachers, PA interventions have the potential to improve psycho-physical well-being and classroom environment, promoting healthy habits among students.
• ABs are deemed as a feasible and sustainable PA intervention thanks to program flexibility regarding contents, administration time frames and implementation mode.
The Brave study: promoting active breaks in secondary school from students’ point of view
Authors: Ricci M , Masini A , Longo G , Sansavini A , Scheier LM , Marini S , Ceciliani A , Dallolio L 
Published: October 2022

Abstract

Background
According to the WHO recommendations, children and adolescents should perform at least 60 minutes per day of moderate to vigorous physical activity (PA). Active Breaks (ABs) interventions, short physical activity breaks of 5-15 minutes during school hours, have been examined in primary school children as a potential strategy to counteract a sedentary lifestyle, with minimal disruption to school learning activities. The aim of the BRAVE STUDY is to investigate the feasibility of ABs in a secondary school setting from the students’ point of view.

Methods
In December 2020, 10 students (age 12-13, 6 females and 4 males) attending the second and third grade of secondary schools located in Bologna province (Italy) were involved in a focus group (FG). The FG was conducted online because of COVID-19 and the answers transcribed for a later analysis. Students’ opinions were probed on the role of PA in school and possible facilitators/barriers to implementation of ABs in the school.

Results
Students reported they wanted to be more active as a consequence of time spent in class sitting at a desk. Students also reported that an organized activity like ABs conducted in the classroom setting provides an excellent opportunity to improve social relations with classmates. Students also highlighted the possible psycho-physical well-being benefits arising from PA. Among the potentially negative aspects reported, students underlined the possible confusion that would be created in classroom and the time subtracted from academic learning activities.

Conclusions
The FG represents an ideal mean to obtain in-depth information on how people feel about a pending program or a change in their routine. The current FG reinforces positive outcomes from exposure to a PA program that can be intertwined with their daily classroom activities. ABs programs can help to reconcile the needs of students that arise during the day with the PA objectives recommended by the WHO.

Key messages
• ABs can be a zero-cost intervention strategy to achieve WHO recommendations and would create conditions for a greater psycho-physical benefits in classrooms.
• A qualitative approach, such as FGs, provides a mean to collect information not obtainable with quantitative methods, that could be useful to co-design interventions for children and adolescents.
Multisectoral approach to address Female Genital Mutilation: a case study from Portugal
Authors: Vareda R , Valente J , Alho AM , Carmona A , Chaves D , Silva L , Ribeiro S , Paixão M , Leite A 
Published: October 2022

Abstract

Issue
Female genital mutilation (FGM) comprises all procedures that injury female genital organs for non-medical reasons, with several health impacts. Due to global migration, FGM has been increasingly recognised as a healthcare issue in Europe, affecting nearly 1 million women. In Portugal it is estimated that 5483 migrant women have undergone FGM in the Lisbon region. Intervention is required to tackle this issue.

Description
Portugal launched the “Healthy Practices: End of FGM”, a multiagency project targeting Lisbon and Tagus Valley region. Project implementation started in Nov 2018 at 5 local public health units (PHU) and was scaled-up to 5 more in Feb 2020. Project comprises 3 main axes: 1) inclusion in public policy instruments; 2) professionals’ education and awareness; and 3) community intervention. We describe inclusion of FGM in public policy, professionals training and changes in FGM recording before and after intervention.

Results
Between 2018-2022, inclusion of FGM in municipalities’ migration policies doubled. Between 2019-2021, 110 training sessions (n = 1722 professionals) were promoted. During pandemic years, only 344 (2020) and 202 (2021) were trained. Raising awareness and empowerment to risk communities happened mainly through local/online open sessions, workshops, flyer distribution, video projections. These occurred in all 10 PHU, mostly through partnerships with Non-Governmental Organizations and municipalities. According to the Portuguese Health Records, until 2018 there were only 300 women registered with FGM. Between 2019-2021, 363 more were added.

Lessons
The multisectoral approach allowed PHU professionals to collaborate directly with external organizations from different society sectors. COVID-19 pandemic posed a challenge to implementation, especially in the community intervention axis. Notification numbers increased after interventions, though causality could not be established and impact evaluation is yet to be performed.

Key messages
• Multisectoral projects for FGM intervention have specific implementation challenges, including how to justify and evaluate them, that must be considered in each setting.
• Training health professionals might increase identification and notification of FGM, but the impact in preventing FGM in the Portuguese reality is still largely unknown.
Comparing perspectives on research needs from stakeholders vs. researchers in an exposome project
Authors: Benz S , Weber M , van den Hazel P , Jansen S , Arat A , White M , Riedel N , Ristovska G , van Kamp I , Schreckenberg D 
Published: October 2022

Abstract

Background
Exposome research looks into how combined exposures affect human health. The EU-funded Equal-Life project focuses on physical and social exposures in a child’s environment and its effects on children’s mental health and cognitive development in the life course. Perspectives and priorities on what to study in particular might differ between practitioners and researchers. Therefore, collaboration with external stakeholders from various fields is encouraged to integrate practical experience and link it to the researchers’ aims.

Methods
Two Delphi studies were conducted collecting and evaluating research questions to be studied in the project among a) the researchers within the project and b) among external stakeholders from various European countries. The exercise was to evaluate the research questions for group a) based on relevance and testability and for b) e.g. regarding practitioners’ work and options for policies. Involved stakeholders work in health care, and urban planning, among others. Prioritised questions are collated.

Findings
Within the researchers’ group, top-rated questions were mainly mechanism-directed in terms of how and to what extent certain factors affect children’s mental health and cognitive development, cumulative effects in different settings, among others. Stakeholders most value research questions on practical issues, e.g. effects of early experiences of discrimination, critical windows in children’s lives that are most sensitive regarding the impact of exposures on mental health and cognitive development, or impact of exposures in early stages of life.

Discussion
In comparing approaches of stakeholders and researchers, stakeholders’ input from the practical field can shape the approach of the research process. The second benefit is to derive implications for creating effective interventions and policies to prevent adverse effects of environmental exposures and to foster positive health in children and later on in life.

Key messages
• Bi-directional exchange between researchers and external stakeholders can make gaps visible.
• Engaging stakeholders into a research process can help sharpening the aim and outcome of a project.