Vulnerable Population Groups Research Articles

A qualitative exploration to inform an oral health training for disability care workers in Burkina Faso.

To explore enablers and barriers to the creation of an oral health training for care workers at specialized centres for children with disabilities in Ouagadougou. This was a formative study informed by the Theoretical Domains Framework using qualitative methods. Qualitative observations and 14 semi-structured interviews were conducted with care workers from six specialized centres for disability. Carer workers emphasized that a successful oral health training must account for available resources and competencies in each specific centre. Part of the training must be dedicated to oral hygiene targeted for people with disabilities and provide knowledge about risk factor management. Care workers must be empowered through the training with practical skills and tools to manage regular toothbrushing and identify oral health needs of their dependents. This study gathered valuable and unique perspectives about the roles of care workers of children with disabilities in Ouagadougou and underscores the need for improving access to oral health and care services for children with disabilities in low-resourced settings. Teams planning oral health promotion activities in low resourced settings for vulnerable population groups can benefit from the methodology and results of this research for ensuring their interventions are appropriate and relevant. This is a unique field study conducted in a scarcely researched area of caregiving practices for children with disabilities in a low-income country, Burkina Faso. Results from the disability centre observations and interviews with local caregivers are of great value to any team planning health projects in similar low-resourced settings. Psychiatric and mental health nursing practices are highly context-dependent, thus using proposed qualitative methods can help to ensure that planned interventions are appropriate and relevant. There was no patient contribution in this study.

The Effectiveness of a Training Program Based on Health Education to Improve Health Empowerment Level among Refugees in Jordan

Objectives: The study aimed to assess the effectiveness of a health education-based training program in enhancing the level of health empowerment among refugees in Jordan. Health empowerment is a crucial component of health promotion, enabling individuals to take control of their health, manage their health outcomes, and improve them. Refugees are a vulnerable population group with limited access to healthcare. Methods: The study sample consisted of 38 refugees in Irbid governorate, Jordan, who were conveniently selected in coordination with some organizations working in the field of asylum in the governorate. They were randomly divided into two groups: an experimental group (n = 19) that received the health education training program, and a control group (n = 19) that did not receive any health education training. The Health Empowerment Scale (HES), a validated tool, was used to collect data from both groups in pre-tests and post-tests, and a follow-up test was conducted for members of the experimental group only. Results: The results showed a statistically significant increase in the health empowerment scores for the experimental group that received the training program compared to the control group. The mean of the pre-test for the experimental group was (1.97 ± 0.27), and for the control group, it was (1.84 ± 0.21). The post-test mean for the experimental group became (3.88 ± 0.13), while for the control group, it was (1.85 ± 0.20). The follow-up test indicated sustained enhanced levels of health empowerment in the experimental group, with little difference between the post-test and follow-up scores, indicating the effectiveness of the health education training program in enhancing health empowerment for refugees in Jordan. Conclusions: Healthcare providers and policymakers in Jordan and other countries hosting large numbers of refugees have significant responsibilities. Giving sufficient priority to health education and awareness programs is essential to enhance the health empowerment of refugees and improve their health literacy, which ultimately impacts their overall public health.

Corruption and Population Health

Population health is an approach to health with the goal of improving the health of an entire human population which includes health outcomes, patterns of health determinants, and policies and interventions. As the population of countries increases, it creates scarcity of resources that will enhance population health. In the midst of this scarce resources’ corruption heightens the unavailability of such resources. High levels of corruption impoverish populations, increase inequality, and cause health status to deteriorate, especially among the most vulnerable population groups. The main determinants of health include: Income and social status, employment and working conditions, education and literacy, childhood experiences, physical environments, Social supports and coping skills, and healthy behaviours. Access to health services, biology and genetic endowment, gender, culture and race / racism are also determinants of health. In absence of corruption there is health equity, which helps to reduce inequalities and seek to promote opportunities and conditions that is conducive to health for all. Addressing corruption complements the right to health, and promotes health equity in order to achieve population health of the people.

Assessment of the acceptability and feasibility of HIV self-testing in vulnerable population groups in Togo

Background: The aim of this study was to assess the acceptability and feasibility of HIV self-testing in vulnerable population groups. Methods: This was a quantitative and qualitative study conducted in April 2022 in thirteen pilot centers of the national AIDS program. The target populations were men who had sex with men (MSM), female sex workers (FSWs), and street adolescents. Results: During the study period, 802 people were included in this study, among whom 51.4% were male. The study population consisted mainly of FSWs (34.4%), MSM (24.4%), and people from the general population (23.2%). The median age of the participants was 23 years, ranging from 13 to 77 years. The overall acceptability of the self-test was estimated to be 97.1% (n = 779). Six participants refused to do it immediately yet suggested that they might do it later, and 17 (2.1%) outright refused to do it. Acceptability was 100% among street adolescents, transgender people, and drug users. The lowest level of acceptability (93.5%) was found among the FSWs. Self-testing was considered feasible for 99.7% (n = 777) IC95% (99.1-100.0) of the participants. Conclusion: Our study showed that self-testing is a highly acceptable and practical strategy for MSM, FSWs, and adolescents in Togo. Therefore, in order to accelerate the implementation of population screening programs in our country, it is important to bring all innovative interventions to scale if we are to achieve the UNAIDS 95-95-95 targets by 2026. Key words: Autoimmune bullous dermatoses, Pemphigus, Bullous pemphigoid, Togo

The professional functions and competences of personnel of medical public organizations

The article considers role and specifics of professional competencies of employees of medical public organizations providing vital medical and social services to vulnerable groups of population having no access to necessary care due to financial difficulties, geographical isolation, natural disasters and other causes. It is noted that employees of such organizations have unique set of professional competencies permitting them to effectively function in conditions of limited resources and unstable circumstances. The importance of interdisciplinary interaction, cultural competence, ethicality and legal awareness of employees.

Suicide in Hong Kong during the COVID-19 pandemic: an observational study

IntroductionThe COVID-19 pandemic has exacerbated suicide risk factors in Hong Kong, which faces economic shocks and strict travel restrictions due to its unique economic structure and geographical location. However, there...

Household Food Insecurity and COVID-19 Social Safety Nets in Cavite, Philippines

The COVID-19 restrictions have caused economic losses that affected food availability and accessibility, thereby compromising people’s lifestyles and putting the already existing poor households into severe food insecurity. As such, national government agencies and local government units in the Philippines provided emergency cash assistance and food aid as safety nets during the pandemic to help vulnerable households cope with the impending economic crisis and to improve food security in the country. This cross-sectional study assesses the association of social safety net programs with household food security (i.e., food secure, consistently food insecure, and newly food insecure) in Cavite province, Philippines. Findings show that being beneficiaries of the Pantawid Pamilyang Pilipino Program and the Social Amelioration Program are associated with being consistently and newly food insecure. Furthermore, households that obtained food from the community pantry, a volunteer-led movement during the height of the COVID-19 pandemic are also associated with food insecurity. On the other hand, the households that were provided with food packs, across different socioeconomic conditions, are not significantly associated with food insecurity. The study also affirms that households most vulnerable to food crises in the context of COVID-19 are those who are consistently food insecure and were already exposed to critical food and dietary deprivations before the onset of the pandemic. There is much to be done to improve the safety net programs in the country. The study results can add information and policy recommendations toward strengthening the services for vulnerable population groups to withstand short- and long-term food system disruptions and eventually build food-resilient households and communities.

Understanding current antenatal Hepatitis C testing and care in maternity services in England.

Universal opt-out antenatal screening for Hepatitis C virus (HCV) is not currently recommened and it is recommended that maternity services offer risk-based testing. We aimed to investigate antenatal HCV testing and adherence to testing guidance. A cross-sectional survey was circulated to maternity service providers between November-December 2020 which included testing policy, training for healthcare staff, and management of women found to be HCV positive. Descriptive data are presented. A total of 75 questionnaires were returned, representing 48 % of English maternity service providers. 87 % of providers reported offering antenatal HCV risk-based testing. Risk factors used to identify pregnant women for testing varied. Less than 15 % of respondents considered women that were ever homeless or with history of incarceraton or from higher HCV prevalence areas as high risk. Current antenatal HCV testing practices are inadequate and HCV infection likely goes undiagnosed in pregnancy, especially among vulnerable population groups. In the absence of universal antenatal screening, re-framing antenatal HCV risk-based testing and management as a quality improvement initiative and developing HCV specific pathway guidance for maternity units is required.

Applied Social Research in the Healthcare System: New Forms and Meanings of Interdisciplinarity

This article provides a summary of the V Anniversary Forum with International Participation “Sociology of Health: New Forms of Interdisciplinary Synergy,” which took place at the end of 2023. Based on the materials of the Forum, topical issues in the field of applying social research methodologies to healthcare organization are observed. Among them are such topics as the value and strategies for applying interdisciplinary approaches, the emergence of new trends and understanding of old ones in healthcare digitalization (neural networks, new research methods, gamification, transformation of communication), focusing on certain vulnerable population groups, e.g., the senior population and their health, increasing attention to mental health issues, etc. The Forum offered new forms of interdisciplinary dialogue, connecting standard scientific sections with novel ideas such as immersive spaces. According to survey results, the event was highly appreciated by listeners, showing how well it matched their interests.

Issues pertaining to posology in ancient Greek, Roman and Byzantine medical texts

Researching medical texts of the past reveals that the preparation of a therapeutic recipe usually involved the use of several active ingredients. There are many detailed reports on the ratio of the ingredients in a recipe, but also on the dosage administered to the patient. In this article, we recorded the use of units of weight and volume in therapeutic recipes from antiquity, the Hellenistic era, the Roman Empire, Byzantium, and also empirical medical texts of the 19th century. The changes emerging over time from the growing trade in the wider Mediterranean area, with the introduction of both new products and new units of measurement, did not affect the basic principles of the therapeutic methods. Through the centuries, the main concern of physicians was to fight the disease without burdening the patient with any unwanted effects. In this context, we observe even dosage modifications when it comes to special vulnerable population groups, such as children, the elderly and pregnant women. The period covered is very large, which means that the approach is impressionistic not aiming to the philologists. We hope that this does not pose a problem to the interested historians of medicine.

Predictors of HIV/AIDS preventive behavior among undergraduate health science university students in Northwest Ethiopia, 2022. Institution-based cross-sectional study

IntroductionHuman immunodeficiency virus (HIV) infection is a major global public health issue, affecting millions of people annually. University students are among the risk groups in the community because of their high-risk behaviors. Few studies have been conducted on HIV/AIDS preventive behaviors and associated factors among university students. Therefore, focusing on these target populations is crucial because it will help university managers and different stakeholders be informed about the burden of the problem and take different measures to halt the distribution of the infection. ObjectiveTo assess the predictors of HIV/AIDS preventive behaviors among undergraduate Health Science University students in Northwest Ethiopia in 2022. MethodsThis study used an institution-based cross-sectional design with a single-population proportion formula, and participants were selected using a simple random sampling technique. Data were entered into Epi Data version 4.6.0.2 and exported to SPSS version 26 for cleaning and analysis, and the results were presented using text, graphs, pie charts, percentages, and frequencies. Bivariate and multivariable logistic regression analyses were used, and variables with a p-value of ≤0.25 in the bivariate analysis were entered into the multivariable analysis. A p-value of less than or equal to 0.05 in the multivariable analysis was considered statistically significant. ResultOut of 287 study participants, 284 of them responded completely, with a response rate of 99.0 %. Among the total respondents, 42.3 % (95 % CI: 37.7, 47.8) of the participants had poor HIV/AIDS preventive behavior. Younger age (AOR: 3.05; 95 % CI (1.243, 7.496)), low perceived susceptibility (AOR: 2.12; 95 % CI (1.179, 3.809), low perceived severity (AOR: 3.00; 95 % CI (1.636, 5.509)), high perceived barriers (AOR: 2.78; 95 % CI (1.487, 5.202)), and having poor HIV/AIDS preventive knowledge (AOR: 3.87; 95 % CI (2.170, 6.919)) were significantly associated with poor HIV/AIDS preventive behaviors. ConclusionThe HIV/AIDS preventive behavior of participants in this study was poor. Young age, low perceived susceptibility, low perceived severity, high perceived barriers, and poor HIV/AIDS preventive knowledge were predictors of poor HIV/AIDS preventive behavior. It is better to design strategies and programs by the Ministry of Health, the Ministry of Education, university top managers, and other stakeholders to provide appropriate information and focus on behavioral changes in vulnerable population groups.

Occurrence of cancer in people with intellectual disabilities in Germany.

1595 Background: Intellectual disability (ID) affects about 1% of the general population, involving approximately 1 million people in Germany. People with ID experience shorter life expectancies and one of the most common causes of death include malignancies (20%). In addition to life-style factors, possibly genetic mutations causing ID may contribute to oncogenesis. Whether individuals with ID have a higher-than-expected risk of cancer in Germany remains unknown. Methods: A cross-sectional study was conducted using nationwide outpatient health insurance data in Germany from 2019. The data set included 438 028 people with ID and 65 762 146 people without ID (0-107 years, male/female). After matching for age, sex, and district code, data from 437 802 people with ID (4.23 % with cancer) and 4 378 020 without ID (5.06 % with cancer) aged 0-95 years were analyzed. Univariate odds ratios estimated the association between ID and cancer occurrence for various cancer diagnoses (ICD-10: C00-C97). The study was approved by the ethics committee of the Berlin Medical Association (Eth-11/23). Results: Across all cancer types, people with ID showed lower risks for a cancer diagnosis than those without ID (Odds Ratio [OR] 0.83; 95% Confidence Interval [95% CI] 0.82-0.84); p < .0001 for all data. Certain cancer types occurred more often, such as malignant neoplasms of the brain (C71; OR 2.80; 95% CI 2.58-3.03), other parts of the central nervous system (C72; OR 2.45; 95% CI 1.76-3.34), the testicles (C62; OR 1.80; 95% CI 1.68-1.93), the ovary (C56; OR 1.26; 95% CI 1.13-1.4), the corpus uteri (C54; OR 2.02; 95% CI 1.86-2.19), leukemia of unspecified cell type (C95; OR 1.86; 95% CI 1.67-2.06) and other leukemia of specified cell type (C94; OR 1.81; 95% CI 1.43-2.25). However, other entities such as malignant melanomas (C43; OR 0.55; 95% CI 0.51-0.59), prostate cancer (C61; OR 0.59; 95% CI 0.56-0.62), tumors in the respiratory system (C30-39; OR 0.69; 95% CI 0.64-0.74) and the breast (C50; OR 0.82; 95% CI 0.79-0.85) occurred less often. Conclusions: People with ID showed a decreased risk for being diagnosed with cancer. This may be caused by lower exposition to certain risk factors in some cancer types such as skin or lung cancers. Difficulties in accessing the health care system and lower cancer screening rates leading to fewer diagnoses may partly explain the results. Later recognition of cancer in a more advanced stage of the disease may be associated with premature deaths and lead to lower prevalence rates. Certain oncological diseases such as malignant neoplasms of the central nervous system, urogenital tumors and hematological neoplasms require a special focus in prevention and therapy. Medical services, screening programs and patient education for people with ID need to be established, adapted and expanded to meet the needs of people with ID and to reach this highly vulnerable population group for guideline-based oncological screening and treatment.

Features of Constipation Syndrome Management in Elderly and Senile Patients in General Medical Practice (Literature Review)

Constipation in old age ppatients is most often caused by disorders of the digestive tract (DT) and, less often, by the use of medications that affect it. One of the reasons that cause problems with bowel movements is a nutritional disorder. It is known that people in old age eat less. The amount of dietary fiber and the amount of water consumed in the diet are reduced. This leads to a decrease in liquid in the stool masses, which become harder. A significant decrease in motor activity of a person, in particular due to both somatic diseases and mental disorders, causes the development of pathology. Usually, such patients are prescribed cardiac glycosides, sleeping pills, analgesics, and antidepressants. It is necessary to take into account the peculiarities of the psyche of the elderly and senile persons. Loneliness and social isolation combined with depression or egocentrism, as well as poor memory, have a negative impact on a person at this age. It should be taken into account that often elderly and senile patients have their own system of views on treatment and this can make it difficult for them to understand each other with the doctor. Due to biological, medical and social challenges, elderly patients are one of the most vulnerable population groups. At the same time, they are the main consumers of medicines. Therefore, it is very important that the prescribed treatment for constipation is the most rational and safe, taking into account the side effects of drug therapy of the main and concomitant diseases. Compliance with the specified requirements guarantees the safe use of medicinal products, prevents the development of their side effects, and contributes to the continuation of an active and healthy lifestyle of gerontological and geriatric patients.

Hematological parameters of healthy pregnant women in three trimesters compared with parameters of non-pregnant women

Anemia is a public health problem, especially in developing countries. All over the world iron deficiency is the main cause of anemia, especially during pregnancy. Pregnant women belong to the most vulnerable population group in Iraq.The objective: to determine the impact of pregnancy on hematological parameters and to compare the hematological indicators in different periods of gestation with the indicators of non-pregnant women.Materials and methods. The study was conducted over a three-month period at Baghdad hospitals and medical centers, including Baghdad Teaching Hospital, Al-Karam Hospital, and a health center in Al-Dorrah and Al-Shaab, Baghdad province, from September 1 to December 1, 2022. 60 pregnant women, 20 persons in each trimester, and 25 non-pregnant women (control) aged 18–35 years were included in the study. All participants were examined for hematological parameters: hemoglobin, erythrocytes, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), measured of the concentration of hemoglobin in red blood cells (MCHC) and determined the level of iron in the blood (serum iron – SI, total iron binding capacity – TIBC, transferrin saturation – TS and serum ferritin – SF).Results. A significant decrease in the hematological indicators of pregnant women in the first trimester of pregnancy compared to non-pregnant women was established – hemoglobin, erythrocytes, PCV, MCH, MCHC. The dynamics of the decrease in the level of these parameters increases in the second trimester, and also progressively decreases in the third trimester, which leads to anemia.Starting from the first trimester and during the second and third trimesters, a decrease in the level of serum iron, transferrin saturation and serum ferritin was found in pregnant women compared to non-pregnant women, but the level of TIBC increased. During the second trimester, the need for iron begins to increase and continues to growth until the end of pregnancy. In addition, these research results indicate the importance of iron deficiency in the development of iron deficiency anemia.Conclusions. During pregnancy, anemia and a decrease in the level of some hematological parameters were determined, which progresses with increasing gestational age and is less compared to that in non-pregnant women. A decrease in the level of iron in the blood serum was established from the first to the third trimester of pregnancy. The severity of anemia is related to many factors, especially age, education level, low income, type of diet and parity.

Food literacy in Venezuelan adolescents: a cross-sectional study

ABSTRACT Food literacy reflects personal behaviours around healthy eating and is an important skill for individuals to make healthy dietary choices. The present cross-sectional study investigated food literacy and the ability to identify n = 43 foods of plant origin in n = 1322 Venezuelan adolescents aged 15–17 years in the city of Puerto La Cruz, Venezuela. With only n = 14 correctly identified plant food items (median; IQR: 12), the performance in this sample was alarmingly poor, suggesting that food literacy in Venezuelan adolescents warrants urgent public health attention. Substantial and significant sex-specific differences were found, with an even worse performance in male adolescents. The lacking ability to correctly identify foods of plant origin has national public health implications, and constitutes an important obstacle for national strategies and dietary guidelines, which aim at improving nutrient intake in this particularly vulnerable population group.

Trends in environmental risk and child health research: A bibliometric study, 1990–2022

BackgroundWorldwide, climate change has significantly contributed to the global burden of disease. Children are among the most vulnerable groups of population bearing the brunt of climate change. To explore the development of research on environmental risk and child health, a bibliometric analysis was conducted encompassing literature from 1990 to 2022. MethodsThe study draws upon 6816 published articles related to environmental risk and child health, sourced from the Scopus database spanning the period from 1990 to 2022. The research encompasses several key analyses: trend analysis, country and journal contribution, author contribution using the Bibliometrix R package and co-occurrence analysis was performed using VOSviewer. ResultsThe study highlights the major contributions of the USA and China. The USA leads in both Single Country Publications and Multiple Country Publications. The International Journal of Environmental Research and Public Health stands out as the primary source, with the highest number of documents in this field. Co-occurrence analysis revealed common clusters of words like children, child health, mental health, adolescence, and physical activity. The keyword network map highlighted climate change, social determinants of health, and resilience as the most emerging research topics. ConclusionsThe study highlights the crucial role of environmental factors in influencing child health. The geographical disparities in research output suggest a need for broader research engagement globally, particularly from developing countries, to better address and mitigate the adverse effects of environmental exposures on children's health worldwide.

The Food and Nutrition Policy Environment and Drivers of Changes in Key Food System Outcomes in Ethiopia

Background: There seems to be huge gap in our understanding of the changes over time in food system outcomes and their drivers in Ethiopia. The main aim of this study is to examine the food and nutrition programs and policies and their corresponding key food system outcomes in Ethiopia. Methods: The bulk of the information was generated using scooping review of relevant articles and policy documents. About 67 full text records were used for the review. In addition, data were collected using Key Informant Interview (KIIs) purposefully selected from sectoral offices from two major cities (Hawassa and Dire Dawa), of two regions. The analytical framework used in this paper was adopted from previous studies on related subjects and addressed three key components of food system: review of food and nutrition policy environment, key food system outcomes and key drivers. Results: Despite improvement in some food system outcomes (such as child nutrition and survival), food security crises in Ethiopia are still becoming more frequent and more acute, affecting the poor disproportionately. Most food and nutrition policies are constrained by lack of implementation capacities. Indicating the presence of various barriers (socioeconomic, demographic, and environmental). Poor human capital (such as knowledge and attitude), food taboos and tradition, cultural practices such as gender-based norms, poor education, poor delivery/supply chain, demographic pressure and other environmental drivers play critical role in food and nutrition security of most vulnerable population groups in Ethiopia. Conclusion and implications: Given the challenges confronting Ethiopia today, it is imperative to assume that meeting Sustainable Development Goal (SDG) 2 (i.e., attaining zero hunger by 2030) becomes challenging. This calls for continuous capacity building to help implement, learn, and adapt a systems approach; and access to education and skill training on food production and consumption and narrowing down the gender differential in food access and consumption.

The Food and Nutrition Policy Environment and Drivers of Changes in Key Food System Outcomes in Ethiopia

Background: There seems to be huge gap in our understanding of the changes over time in food system outcomes and their drivers in Ethiopia. The main aim of this study is to examine the food and nutrition programs and policies and their corresponding key food system outcomes in Ethiopia. Methods: The bulk of the information was generated using scooping review of relevant articles and policy documents. About 67 full text records were used for the review. In addition, data were collected using Key Informant Interview (KIIs) purposefully selected from sectoral offices from two major cities (Hawassa and Dire Dawa), of two regions. The analytical framework used in this paper was adopted from previous studies on related subjects and addressed three key components of food system: review of food and nutrition policy environment, key food system outcomes and key drivers. Results: Despite improvement in some food system outcomes (such as child nutrition and survival), food security crises in Ethiopia are still becoming more frequent and more acute, affecting the poor disproportionately. Most food and nutrition policies are constrained by lack of implementation capacities. Indicating the presence of various barriers (socioeconomic, demographic, and environmental). Poor human capital (such as knowledge and attitude), food taboos and tradition, cultural practices such as gender-based norms, poor education, poor delivery/supply chain, demographic pressure and other environmental drivers play critical role in food and nutrition security of most vulnerable population groups in Ethiopia. Conclusion and implications: Given the challenges confronting Ethiopia today, it is imperative to assume that meeting Sustainable Development Goal (SDG) 2 (i.e., attaining zero hunger by 2030) becomes challenging. This calls for continuous capacity building to help implement, learn, and adapt a systems approach; and access to education and skill training on food production and consumption and narrowing down the gender differential in food access and consumption.

To the question of the constitutional and legal regulation of ensuring the right to education in the conditions of modern crisis situations

In the context of an increasing number of crisis events, such as natural disasters, epidemics, terrorist attacks, armed conflicts and states of war, ensuring access to quality education becomes extremely important for maintaining the stability of society and developing civil capacity. Within the scope of this scientific work, international and national legal norms that guarantee educational rights in crisis situations are analyzed, as well as practical aspects of their implementation are considered. Special attention is paid to measures aimed at ensuring access to education for all sections of society, including vulnerable population groups. Issues of managing the educational process in crisis conditions are also studied, including the impact of crisis situations on the organization of teaching methods and educational institutions in general. It was established that, in order to ensure proper access to education in Ukraine, we consider it expedient to implement and observe the following aspects: providing comprehensive access to education, which involves not only the creation of conditions for distance learning, but also the supply of high-quality Internet services, the necessary devices and infrastructure for the implementation of the educational process in conditions of war. For full-time education, the priority is the reconstruction of schools and the construction of shelters with the possibility of continuing the educational process in conflict conditions; provision of psychological and social support to children and adults who survived war or conflict, within the framework of educational programs; development and implementation of innovations in the field of education, in particular, the introduction of cloud-based learning environments, electronic journals, as well as an emphasis on the development of skills in the field of digital technologies for preparation for future professional activities; ensuring cyber security of data to protect personal information and prevent unauthorized access; involvement of parents and relatives of children in a certain part of pedagogical duties; development of special educational programs for Ukrainian children abroad; cooperation with international organizations and partners to ensure the necessary resources and financing of educational projects; improvement of pedagogical approaches aimed at raising a tolerant and peaceful society. the implementation of «peace education», which involves the inclusion of the study of the history of conflicts and wars in the curricula, the development of conflict resolution skills and cooperation between countries and cultures, as well as the involvement of students in discussions and projects aimed at supporting peace.

‘It's not for the children's sake’: A qualitative inquiry into the barriers and facilitators underlying parents' decision-making for vaccinating children against influenza in Denmark

Recently, the Danish Health Authority began recommending vaccinating children aged 2–6 years against seasonal influenza, underscoring the pivotal role of children in its transmission dynamics within the wider population and the need to protect vulnerable population groups after COVID-19. Under a third followed the recommendation. For the routine Danish childhood vaccine program coverage is usually well above 90%.Through a qualitative in-depth study with 28 key informants during the 2022/2023 influenza season, we investigated the barriers and facilitators of parents' decision-making for vaccinating their children against influenza. We found that parents' decision-making was influenced by a range of factors that present barriers or facilitators at the individual or collective levels, depending on personal antecedents and family situations. We also gained insights on how COVID-19 mass vaccination shaped parents’ attitudes and awareness toward influenza vaccination, explaining why many parents who fully complied with the COVID-19 recommendations elected to opt out of influenza.The implications of these findings extend beyond the concrete context of parent's decision-making regarding influenza vaccination, contributing to our understanding of vaccine confidence in at least two ways. First, the limited public controversy regarding childhood influenza vaccination allows for a perspective onto low vaccine uptake that does not resort to the usual framing of a well-defined “crisis”. Second, the interaction between COVID-19 vaccination and the childhood influenza vaccination reveals how the massive pressure on parents to vaccinate themselves and their children against COVID-19 contributed to an erosion of vaccine confidence in general.