ObjectiveThis study investigates the feasibility of using an automated approach to extract injury-related information from narrative text in a paediatric emergency department to improve data basis on injuries among children and adolescents in Switzerland.MethodsThe dataset comprises paediatric injury cases treated between 2018 and 2022 at the University Children’s Hospital Zürich emergency department (N = 30,876). Model development involved (1) adapting EU-IDB, a domain-specific hierarchical coding-system; (2) manual data annotation; and (3) fine tuning and (4) evaluation of a transformer-based model for multi-label text span classification.ResultsInterrater reliability improved from moderate (κ = 0.45) to substantial (κ = 0.73) following adaptation of the coding system. Variable level classification performance was encouraging across three training variants (macro F1: ALL = 0.57, IND = 0.64, VAR = 0.63). Performance declined at lower levels, particularly at level 3 (macro F1: ALL = 0.08, IND = 0.23). Automated prevalence estimates correlated strongly with manual annotations (ρ = 0.948).ConclusionAutomated text span classification of injury-relevant information from electronic patient records shows promising first results to provide valuable information for injury surveillance and prevention, missing in Switzerland. However, more annotated data and detailed validation are needed to draw robust conclusions.
ObjectivesRapid urbanization in China has been accompanied by residential segregation, which may influence wellbeing of rural-urban migrants (RUMs). This study aims to investigate the impact of residential segregation on life satisfaction among RUMs, with particular attention to the mediating role of social capital.MethodsWe screened 1,255 participants who met the inclusion criteria from the 2016 China Labor-force Dynamics Survey to investigate the relationship between residential segregation and life satisfaction using ordinary least squares regression and instrumental variable estimation. The mediating role of social capital was evaluated by mediation analysis.ResultsResidential segregation has a significant negative impact on life satisfaction of RUMs. This effect is partially mediated by cognitive social capital, whereas no mediating effect is observed for structural social capital. Among the dimensions of cognitive social capital, neighborhood trust and reciprocity are more significant mediators than familiarity.ConclusionResidential segregation undermines life satisfaction among RUMs partly through weakening cognitive social capital. Policies aimed at reducing residential segregation and promoting trust as well as reciprocity within neighborhoods may help improve the life satisfaction of migrants.
ObjectivesTo develop a framework of policy-level domains for analyzing the sustainment and scale-up of Individual Placement and Support and, tentatively, other complex evidence-based psychosocial interventions.MethodsIntegrative review of 41 empirical studies on contextual determinants of Individual Placement and Support (IPS) sustainment and scale-up was conducted. The results were synthesized inductively and interpreted abductively using implementation science, policy implementation research, and welfare policy literature.ResultsThe LEL framework organizes recurring external-context patterns into three policy-level domains: Policy Legitimacy addresses policy legitimization and decision chains linking high-level policy decisions to implementation; Policy Embedding addresses multi-level and cross-sector implementation structure; and Policy Learning addresses implementation evidence infrastructure through which implementation experience informs practice, policy, and model refinement.ConclusionThe Legitimacy–Embedding–Learning (LEL) framework proposes policy-level domains for analyzing IPS sustainment and scale-up. It functions as an integrative analytical framework that supports cumulative evidence-building and comparative research within IPS, with testable relevance for other evidence-based complex psychosocial interventions.
ObjectivesSchool-based health promotion is critical for enhancing health literacy and academic performance. In South Africa, preventable visual impairment among school children may be exacerbated by the absence of structured eyecare promotion interventions. The objective of the study was to implement and evaluate the effectiveness of eyecare health promotion in the Thabo Mofutsanyane district, Free State province.MethodsA school-based cross-sectional interventional study was conducted. Following a simple randomised assignment, 10 schools received the intervention while the remaining 10 received no intervention. An adopted and piloted questionnaire was administered at baseline and readministered 6 months after the intervention. The McNemar’s chi-square test was used for statistical analysis.ResultsThe baseline study included 199 participants, and following attrition, stood at 136 learners, parents, and teachers. The learner experimental arm demonstrated a statistically significant change in eyecare knowledge (p < 0.05). While no statistically significant changes were noted among teachers, parents and learners had statistically significant variables.ConclusionDespite limitations, this study demonstrated that targeted eye health promotion can improve eyecare knowledge.
ObjectivesAs population needs continuously evolve new technologies have to find ways to address healthcare challenges. Inputs of key stakeholders are critical when adopting new technologies. Our objective was to map stakeholders along the Access and Delivery Partnership value chain framework (ADP) in relation to the RTS,S malaria vaccine introduction in Ghana.MethodsStakeholders engaged with the SAVING consortium were identified and an online questionnaire distributed to map stakeholders positioning in relation to the ADP framework. A workshop was also held to validate findings and to examine the decision processes in adopting new interventions.Results31 stakeholders responded the questionnaire reporting their involvement in the ADP framework, most of them identified with stages close to “service delivery”, as opposed to the preceding research and regulatory stages. A few stakeholders were seen as having the highest interest and influence on vaccine introduction.ConclusionThere is an imbalance between Ghana’s high demand for vaccines and its Research and Development (R&D) capacity, similar to other African countries. Enhancing upstream R&D capacity and fostering more inclusive stakeholder contributions could strengthen the pathway to new technologies adoption.
ObjectivesTo compare employment outcomes reported by a completed randomised controlled trial (IPS-AD: Individual Placement and Support - Alcohol and Drug Dependence) with those observed during the English national expansion of IPS services, and to identify factors associated with improved outcomes.MethodsThis was a secondary comparative analysis of five employment outcomes – employment rate, time to employment attainment, job tenure (longest single appointment duration), total time employed and job sustainment defined as ≥13 consecutive weeks employment, in two cohorts: the IPS-AD study intervention arm (n = 843) and IPS expansion participants (n = 3,182).ResultsCompared with the IPS-AD cohort, the expansion cohort showed a higher employment rate (52% versus 30%; p-value <0.001); faster employment attainment (143 versus 180 days; p-value <0.001); longer job tenure (254 versus 110 days; p-value <0.001); greater total time employed (300 versus 133 days; p-value <0.001); and higher job sustainment (76% versus 42%; p-value <0.001).ConclusionExpansion outcomes were consistently more favourable than those observed in the IPS-AD study. Factors that may have contributed to improved outcomes included implementation and delivery enhancements, broadened eligibility criteria, and favourable environmental and economic conditions.
ObjectiveThis study aims to determine accuracy of GlucoNeo Check, PPG-Based Non-Invasive Glucose Screening Device in interpreting patients’ blood glucose levels and to understand participants’ perspectives on their experiences.MethodThis study uses a mixed-methods with a cross-sectional diagnostic accuracy design to obtain a comprehensive overview through Clarke Error Grid Analysis using 660 participants with 3300 data sets, while incorporating qualitative components to assess feasibility and acceptance, using interviews and FGDs from 31 respondents, and analyzed thematically to understand user experience perspectives when using the device.ResultsGlucoNeo Check performance had a Mean Absolute Percentage Error of 3.6% ± 0.621 and classification accuracy of 89.2% ± 0.0515. Most data fell within Zone A, with a small amount in Zone B and no data in Zones C and D. Thematic analysis identified 4 themes: 1) device quality and practicality, 2) comfort of use, 3) facilitating technology, and 4) inclusive interface design.ConclusionGlucoNeo Check is accurate, innovative, and well-received tool for supporting community-based diabetes prevention but requires further validation to be adopted as a standard clinical monitoring tool.
ObjectivesTo assess infection risk perception, attitudes toward Infection Prevention and Control (IPC) measures, and knowledge related to Healthcare-Associated Infections (HAIs) among health sciences students.MethodsA cross-sectional study was conducted among students enrolled in medical, dental, pharmacy, paramedical, and other health-related programs. Data were collected using a structured self-administered questionnaire. Statistical analyses included chi-square, Mann–Whitney U, and Kruskal–Wallis tests, as appropriate. Internal consistency was assessed using Cronbach’s alpha.ResultsA total of 270 students were included in the study. Most participants had heard about HAIs (80.7%) and correctly identified their definition (94.4%). Surgical site infections were the most frequently identified HAIs (75.6%). The mean knowledge score was 4.32 ± 1.30, while attitudes toward IPC measures showed a high overall score (4.31 ± 0.55). The overall risk perception score was (3.01 ± 0.68), with university hospitals perceived as the highest-risk setting. Knowledge scores differed significantly according to field of study and prior IPC training (p < 0.05).ConclusionFavorable attitudes were observed, but variations in knowledge and risk perception highlight the need to strengthen IPC training.
Objectives:Evaluate whether circulating blood biomarker profiles identify shared and disease-specific risks of non-communicable diseases (NCDs). Methods:We considered 42,666 participants from Taizhou, China. After exclusions, discovery (n = 14,478; recruited 2011.9-2014.1) and temporal validation (n = 25,018; recruited 2018.7-2021.11) cohorts were defined. We integrated 54 blood biomarkers and 26 questionnaire/physical indicators. Predictors were selected after Cox pre-screening based on concordant inclusion across stepwise regression, regularized regression, and Boruta random forest. Results:The final score included 15 biomarkers plus age, smoking, hypertension, and vegetable intake. In the temporal validation cohort, high-risk individuals (25.0% of participants) accounted for 53.9% of incident major NCD cases, with a 6.29-fold (4.83-8.19) higher risk than the low-risk group. Similar gradients were observed for all-cause mortality. Compared with disease-specific scores, the combined score effectively stratified both composite and individual outcomes and revealed shared risks: 56.1% of disease-specific high-risk individuals were also high risk for other NCDs. Conclusion:A score integrating blood biomarkers with epidemiological and physical measures achieved clear risk stratification in the temporal validation cohort and may support priority population identification for major NCDs.
ObjectivesMany people with disabilities in Switzerland face exclusion, especially in mobility, work, and leisure. Assistive technologies can support participation and wellbeing, particularly when developed with user involvement. This study explored societal perspectives on inclusion through technology using a public engagement approach.MethodsThe study took place at the Swiss Abilities Fair 2024 in Lucerne. At an interactive booth, visitors tested assistive technologies like a robotic arm and a recumbent trike. They shared their views in semi-structured interviews conducted by physiotherapists and a wheelchair-using researcher. Interviews were recorded, transcribed, and analyzed using qualitative content analysis. The sample included people with and without disabilities.ResultsForty-one people participated. Non-disabled participants emphasized equality and acceptance, while those with mobility impairments focused on barriers and support. Assistive technologies were seen as key to independence, though gaps in innovation, access, and affordability remain.ConclusionInclusion is a shared societal responsibility that requires awareness, participation, and adaptable solutions. While assistive technologies support independence and participation, interviewees emphasized that true inclusion also depends on affordability, access, user involvement, and broader structural change.
ObjectivesThis study aimed at (i) exploring the effects of a 12-month home-based family intervention on perceived global health and 24 h movement patterns among children with overweight/obesity (OW/OB) and their family members; (ii) identifying intra-family behavioral clusters and their influence on the intervention’s effectiveness.Methods142 families (n = 223 legal guardians) with at least one child with OW/OB were included. At baseline and 12 months, perceived health, sleep, physical activity (PA) and sedentary behaviors (SB) were assessed.ResultsChildren with OW/OB showed poorer physical and mental quality of life (QoL) than normal weight (NW) ones (p < 0.001), and decreased body mass index (BMI) z-score over time (p = 0.001). Guardians with OW/OB improved physical QoL at the end of the program (p = 0.002). For all outcomes, clusters analysis suggested a distinction between NW children and those with OW/OB. Children tended to resemble their guardians of same weight status (WS). Changes in BMI z-scores among children with OW/OB might vary by QoL and behavioral profiles with greatest reductions in clusters having higher baseline global health or PA.ConclusionThis study suggests the potential of family-centered strategies addressing childhood obesity.
ObjectivesEvidence on the burden and clustering of metabolic non-communicable disease risks and on data-driven risk profiles remains limited. This study assessed trends in the clustering of metabolic risk factors in Viet Nam from 2015 to 2021 and identified behavioral–metabolic profiles in 2021.MethodsA repeated cross-sectional design was used, using national STEPS data from 2015 (n = 3,074) and 2021 (n = 3,712), both of which included participants who completed all survey components. Behavioral risk factors (smoking, alcohol use, physical inactivity, and low fruit and vegetable intake) and metabolic risk factors (elevated blood pressure, fasting glucose, body mass index (BMI), and total cholesterol) were defined using Asian-calibrated cutoffs. Clustering was defined as the co-occurrence of two or more metabolic risk factors within an individual. Weighted analyses estimated prevalence and clustering, and latent class analysis (LCA) identified behavioral–metabolic profiles.ResultsAll metabolic risks increased between 2015 and 2021, most sharply for raised fasting glucose (12.0% → 37.7%). This increase was a major contributor to intensified clustering, with the prevalence of ≥2 risk factors increasing from 27.6% to 46.6% and ≥3 risk factors increasing from 8.7% to 20.1%. LCA revealed three profiles: “Health-Conscious” (38.1%, low behavioral and metabolic risks), “Metabolic Risk-Aware” (34.6%, low behavioral but high metabolic risks, linked to older age), and “High Behavioral Risk with Moderate Metabolic Comorbidity” (27.3%, characterized by high smoking and alcohol use together with moderate metabolic abnormalities, concentrated among socioeconomically disadvantaged men).ConclusionMetabolic risks in Viet Nam increased markedly between 2015 and 2021, with elevated glucose levels playing an important role in multi-risk clustering. These distinct profiles underscore the need for integrated, multi-risk screening and management in primary care, especially targeting older adults and socioeconomically disadvantaged men.
ObjectivesStudy substance use among second-generation immigrants in France (G2) in comparison with first-generation immigrants (G1) and majority population, and particularly the variation according to practice of heritage language.Methodsin a nation-wide probability sample, we focused on the two largest groups (from Maghreb and Southern-Europe: n = 2,736), analysing their use of alcohol, tobacco and cannabis. The main factor of interest was practice of heritage language at home at age 15 (vs. exclusive use of French), and we also considered type of parentage: homogenous (two immigrant parents from the same country) vs. mixed (only one, the other being French).ResultsIn comparison with the majority population (neither G1 nor G2: n = 19,185), G1 had lower levels of substance use, followed by G2 speaking the heritage language and by G2 with homogeneous parentage. The other G2 reported higher levels of substance use, close to those of the majority population (even higher for tobacco among Maghrebins and cannabis among South-Europeans). These associations remained robust after adjusting for potential individual and contextual confounding variables.ConclusionIntegrating those specificities may help in designing culturally grounded prevention policies benefitting the population at large.
ObjectivesTo estimate the prevalence of self-reported (un)met need for mental healthcare and associated barriers among adults in Germany and to compare this information with documented mental healthcare use in order to assess the suitability of this indicator for mental health surveillance.MethodsSelf-report survey and routine data documented by healthcare providers from 6,558 randomly sampled adults insured with a major German health insurance company built the basis of bivariate and multivariate analyses, also examining influences of sociodemographic determinants and mental health literacy. Prevalence estimates were additionally replicated with representative data from two national health surveys (n = 10,676 and n = 27,102).Results57% of individuals with perceived need reported no mental healthcare use in the previous 12 months. Unmet need was associated with younger age, but not with sex or education. Most individuals with an unmet need reported internal barriers in terms of low mental health literacy. Self-report corresponds with documented mental healthcare use.ConclusionMonitoring self-reported met and unmet need can inform healthcare planning from a patient perspective and addresses the mental health treatment gap.
