Room
1er étage - D130
Theme
Aspects of child and adolescent health
Chair
Damiano Costantini
Title
Sexual health among youth: the need for a sexual health and sexual rights approach to better understand, prevent and talk about sexual violence
Name
Lorraine Chok & Dre
Yara Barrense-Dias
Affiliation
Unisanté
Abstract
The World Health Organization defines sexual health as “a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity.” Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence. Harmonious sexual development begins at an early age and gradually takes place throughout life. During adolescence, in addition to repositioning and searching for identity, and renegotiating relationships with themselves and others, young people test their limits, and learn to respect those of others. This phase of transition, learning and experimentation between childhood and adulthood (which can last until the age of 25 or even 30) can present certain challenges. Young people can be particularly vulnerable to sexual violence in the midst of a physical and psychosocial transition. This presentation will provide a state-of-the-art overview of definitions and data on four topics: (1) consent and laws, (2) unwanted sexual experiences, (3) street harassment, and (4) online sexual violence.
Title
Machine Learning powered Patient Records Analysis for Injury Monitoring in Children and Adolescents
Name
Feer
Sonja
Affiliation
Institut
of Public Health, ZHAW
Abstract
Background:Injuries to children and adolescents are common and are associated with individual suffering and costs for the healthcare system and society. The incidence of injuries among children in Switzerland has so far been insufficiently monitored. This study investigates the feasibility of utilizing machine learning (ML) methodology to automatically extract insights from electronic patient record data needed for monitoring and prevention purposes.
Method:
First, we assessed the utility of text data from electronic emergency patient records for injury monitoring and prevention. Text quality and desired information content were assessed in a sample of 100 electronic case histories. ML experts investigated data regarding ML requirements.
Second, we are developing an ML approach for accident-relevant information extraction based on 24’000 electronic case histories of children treated for injuries between 2018 and 2022 at the University Children’s Hospital Zurich emergency department. The development of the ML approach requires manual annotation based on an internationally used code-tree, followed by a design and implementation of the ML methods needed for automatic extraction of the information for injury monitoring. The methods’ performance will be evaluated on randomly selected case histories, not included in the initial method development.
Finally, generalizability of the ML approach will be tested on patient records from an emergency department of another Children’s Hospital.
Results:
Qualitative assessment of the sample showed that the desired information on injuries (i.e., type of injury, mechanism and products involved) is contained in the electronic emergency patient records and case histories. Most of the patients had minor injuries. The more severe the injury, the more detailed the information. Electronic case history data are suitable for application of ML approaches.
Lessons learned and the challenges faced during the development process of the ML approach, along with initial findings on injuries in children and adolescents, will be available by August 2024.
Conclusion and recommendations:
Extraction of injury information from electronic patient record by means of ML may provide valuable data for injury prevention, so far missing. The current study is monocentric. In future, the SwissPedHealth dataset represents a potentially promising national database for applying the ML approach and monitoring pediatric injuries.
Title
Long-term Mortality Effects of the 1918/19 Pandemic Birth Cohort
in Switzerland
Name
Katarina Matthes
Affiliation
Institute of Evolutionary Medicine, University of Zurich
Abstract
Infectious diseases, especially pandemics, can have lasting
health consequences beyond the immediate effects. Several studies have shown
that exposure to the 1918/19 pandemic or other unfavorable in-utero
conditions are associated with an increased risk of enduring adverse effects
on health, mortality, and socioeconomic status in adulthood. Moreover,
adverse post-pandemic outcomes are often not associated with the pandemic
because it may have already faded into the background decades ago. This
emphasizes the importance of post-pandemic monitoring that goes beyond those
directly affected. In Switzerland, it has already been shown, that the birth
cohort of 1918/19 (experiencing in-utero exposure during the 'Spanish flu')
exhibited a decreased life expectancy from the age of 50 when compared to
adjacent birth cohorts. However, the causes of death that contribute to the
increased mortality risk experienced by the 1918/19 birth cohort have not yet
been investigated. The factors for the increased risk of death and the
specific causes of death that are responsible for this are still unknown. It
is also unclear whether these causes of death vary depending on the trimester
of pregnancy in which the in-utero exposure took place.
This study aims to identify the causes of death among the 1918/19 birth
cohort in Switzerland and to compare their risk of dying from these causes
with that of the surrounding birth cohorts. Individual data from the cause of
death statistics from the Swiss Federal Statistical Office for the years 1969
- 2022 are used to investigate whether the causes of death in the 1918/19
birth cohort differ from adjacent birth cohorts and whether these causes are
influenced by the trimester of in-utero exposure.
The risk of dying from cancer, cardiovascular diseases, or diabetes is
increased for the 1919 birth cohort for females and males compared to
surrounding birth cohorts. Furthermore, it is expected that trimester of
exposure will play a crucial role in the later causes of death.
Prospectively, it remains speculative to predict whether the COVID-19
pandemic will influence the 2020/21 birth cohorts in the decades to come.
However, post-pandemic surveillance of neonatal health should be an important
component of public health policy, in the post-COVID-19 era and also in
future pandemics. This study aims to contribute to a deeper understanding of
the long-term consequences associated with in-utero exposure to infectious
diseases.
Title
LLTAGSHERAUSFORDERUNGEN VON ELTERN MIT TIEFEREM SOZIOÖKONOMISCHEN STATUS
Name
Paz
Castro
Raquel
Affiliation
Marie
Meierhofer Institut für das Kind (MMI)
Abstract
Ausgangslage:
Digitale Medien prägen den Alltag von Familien mit Kleinkindern. In vielen
Fällen stellen digitale Medien für die Eltern sowohl hilfreiche, berufliche Werkzeuge, wie auch
eine Ressource zur Bewältigung des stressreichen Familienalltags dar. Aktuelle Studien zeigen,
dass die Auswirkungen der kindlichen und elterlichen Mediennutzung in Bezug auf die
kindliche Entwicklung stark variieren können, je nachdem in welchem Kontext das Kind
aufwächst und welche Inhalte es nutzt. Ein kontextueller Faktor, welcher häufig diskutiert wird,
ist der sozio-ökonomische Status (SES). Tieferer SES geht mit einer höheren Bildschirmzeit
von Kleinkindern einher und mit ungünstigeren Entwicklungsoutcomes. Doch wenig ist über
die Veränderungsbereitschaft von Eltern mit tieferem SES im Hinblick auf die Mediennutzung
bekannt und über die Herausforderungen, die sie im Alltagsumgang mit digitalen Medien
erleben.
Methode:
Im März 24 wurden 107 Elternteile mit mind. einem Kleinkind (<5-jährig) in Bezug
auf die Herausforderungen rund um den Alltagsumgang mit digitalen Medien befragt. Zur
Erreichung von Personen mit tieferem SES wurde ein aufsuchender Ansatz in Familienzentren
und Kinderarztpraxen in Gebieten mit geographisch tieferen SES in der Region Zürich
umgesetzt.
Resultate:
Die Mehrheit der Befragten war weiblich (82, 76.6%) und im Schnitt 35.3 (SD: 4.7)
Jahre alt. Über Dreiviertel (82, 76.6%) hatten einen Migrationshintergrund und 56.6% (60)
wiesen max. einen Sek II Abschluss aus. Im Schnitt lag ihre subjektive Einschätzung des SES
bei 6.1 (SD: 1.5; Skala 1-10). Eltern mit tieferem SES nannten v.a. folgende
Herausforderungen: Medienexposition über Geschwisterkinder, Umsetzung von Regeln,
Ungleiche Einstellungen im Umfeld und Bewältigung der Hausarbeit ohne digitale Medien.
SES und Selbstwirksamkeitserwartung korrelierten positiv (r = .218, p = .015), während SES
und totale Bildschirmzeit pro Tag (�= -.147, p = .028) negativ korrelierten. SES korrelierte mit
der Veränderungsbereitschaft in Bezug auf die eigene (�= .256, p = .012), nicht jedoch auf die
kindliche Mediennutzung (tiefer vs. hoher SES: 25.7% vs. 21.3%).
Diskussion:
Der aufsuchende Ansatz war erfolgreich, um die Zielgruppe zu erreichen. Der SES
steht in keinem Zusammenhang zur Veränderungsbereitschaft der kindlichen Mediennutzung,
jedoch zur Selbstwirksamkeitserwartung der Eltern. Darauf und auf den relevanten
Alltagsherausforderungen, wird die Intervention Kinder und Digitale Medien (iKiDiM) des
MMI aufbauen.
Title
Facilitators and Barriers of Maternal and Infant Healthcare Access for Undocumented Migrants: A Systematic Review
Name
Montagnoli
Caterina
Affiliation
University
of Basel
Abstract
Background:Adequate access to healthcare in the first 1000 days of life is concurrent with lifelong well-being and should be guaranteed regardless of nationality, legal status, and social conditions. By exploring how migration status affects the social determinants of health, this review provides a nuanced understanding of the barriers and facilitators encountered by undocumented migrant women and their infants in the first 1000 days of life when accessing healthcare.
Methods:
Following the PRISMA guidelines for systematic reviews and the registration of the protocol on PROSPERO (registration number: CRD42022328220), a literature search in PubMed, Embase, CINAHL, PsycInfo, and Scopus from 2000 to 2022 was performed.
Results:
Of 1295 initial results, 45 studies met the inclusion criteria. Identified barriers of healthcare access in the first 1000 days include (1) legal barriers, such as the criminalization of migrants or the complexity of administrative procedures, and (2) socio-cultural barriers, such as inadequate health literacy and financial challenges. Additionally, ethical concerns as barriers of healthcare access were also mapped from the included papers. Facilitators that improved healthcare accessibility include (1) legal facilitators, like dedicated healthcare clinics, and (2) socio-cultural facilitators, such as language support and healthier lifestyle habits.
Conclusion:
Considering the health consequences on future generations, the economic implications, and the vulnerability of pregnant (migrant) women, these findings offer examples of facilitators that could be put into place to move towards universal health coverage. Achieving this requires a holistic multidisciplinary approach that shifts from exclusion and criminalization to support and compassion.