bluuebunny/crossref_metadata_2025 huggingface dataset:
Maternal dietary adherence during pregnancy to recommendations: a cross-sectional study in Modena
Authors: De Pasquale L , Palandri L , Casalucci MA , Azzalini D , Lucaccioni L , Passini E , Facchinetti F , Righi E
Published: October 2022

Background

Unbalanced nutrients intake and incorrect weight gain can lead to immediate and future adverse health consequences for both mother and child. The Italian Society of Gynaecology and Obstetrics (SIGO), has drawn up a series of nutritional recommendations with the aim of promoting a correct food intake for future mothers. The purpose of our study was to assess adherence to good dietary indications during pregnancy and to evaluate if voluptuary habits could play a role.

Methods

This cross-sectional study investigated dietary habits during the last trimester of pregnancy. We evaluated the adherence to dietary SIGO recommendations of a sample of pregnant women representative of physiologic full-term pregnancies (n = 572, mean age 33.4±5.2) living in Modena (Italy), recruited between 2016 and 2020. Maternal diet during pregnancy was assessed by a self-administered questionnaire fill in at the hospital after childbirth, evaluating lifestyle habits and usual food intake. Descriptive statistics and bivariate associations (Chi-square tests) were performed.

Results

More than 50% of women did not comply with SIGO dietary recommendations. Overall, adherence was very low, ranging between 8.4% (sweets) and 38.8% (seafood), for all food categories, excluding coffee and tea (89%), alcohol (76.2%), red wine (99.1%) and seasoning (olive oil 93.4%). Preliminary results suggest that several factors and behaviours, including BMI before pregnancy, age, smoking habits, education, are associated with levels of adherence to different food categories.

Conclusions

Poor adherence to a proper dietary regimen during pregnancy is a missed opportunity for prevention and demonstrates the importance of promoting public health interventions to improve dietary recommendations adherence. Several initiatives, such as courses, information campaigns, use of social media and counselling can be useful for a nutrition education in pregnancy, raising awareness of the related benefits for both mother and child.

Key messages

• Nowadays pregnant women’s compliance to diet recommendations is still low.

• There is still a lot to do in terms of education and awareness of future mothers.
Strengthening antenatal care providers’ role to address HIV: experiences of pregnant women in Russia
Authors: King EJ , Vetrova MV
Published: October 2022

Background

Significant gaps in HIV treatment remain in Russia. Women are often diagnosed during pregnancy, which is important for prevention of mother-to-child transmission and mothers’ longer-term treatment. We aimed to learn the needs of HIV-positive pregnant and postpartum women and to identify opportunities for antenatal care (ANC) providers to better address these needs.

Methods

We conducted in-depth interviews with Russian women who were diagnosed with HIV during pregnancy in July-November 2021. We conducted thematic analysis using team-based deductive and inductive coding of the interview transcripts.

Results

The Russian healthcare system operates in silos, which means that while pregnant women are tested in ANC services, they must visit a specialized AIDS Center for their HIV care. Our respondents mostly appreciated the specialized care, but they recognized that it presented difficulties in discussing their HIV-related needs with ANC providers. Respondents noted a lack of coordination and collaboration between the AIDS Centers and the ANC services. Respondents described how ANC providers were often ill-equipped to answer questions, offer information, or provide extensive counseling upon diagnosis. However, some respondents shared the positive impact a supportive and trustworthy ANC provider had on their engagement in HIV care. This included psychological, informational, and instrumental support. Respondents were receptive to the empathy and openness of ANC providers as long as they did not exhibit incompetence or judgement. The stigma and discrimination that many respondents encountered in the healthcare setting served as significant barriers to openly discussing HIV with ANC providers.

Conclusions

Issues of trust, knowledge, support, compassion, de-stigmatization, and coordination of services are important considerations in strengthening the role that ANC providers can have in improving HIV-positive pregnant women’s engagement in HIV treatment.

Key messages

• Pregnant women who are diagnosed with HIV require more comprehensive psychosocial support from the healthcare system. This could have a positive impact on longer-term engagement in HIV treatment.

• Antenatal care providers need better preparation and empathy to address the concerns of HIV-positive pregnant women and to support these women through the process of accessing HIV treatment and care.
Parents’ knowledge about their children’s congenital heart disease: an observational study
Authors: Martinato M , Virgis S , Cerantola E , Ocagli H , Cainelli E , Vedovelli L , Comoretto RI , Azzolina D , Monaco E , Gregori D
Published: October 2022

Introduction

Congenital heart diseases (CHD) represent abnormalities of cardiovascular structure or function present at birth. The degree of knowledge of parents of children with CHD determines the quality of care and the quality of life of their children. Several studies have shown that parents’ knowledge is still lacking.

Objectives

This study aims to translate and validate in Italian the Leuven Knowledge Questionnaire for Congenital Heart Disease (LKQCHD) and to assess the knowledge of parents of children with CHD about heart defect, treatments, preventive measures, opportunities for physical activity and reproductive problems of their children.

Methods

Translation and validation of the questionnaire were performed using a multistep method: forward translation, backward translation, and pilot testing. Five experts in CHD were included for the validation of the questionnaire. The sample consisted of fifty-four pairs of parents of children with CHD. Parents were contacted by telephone; knowledge was assessed using an electronic questionnaire.

Results

Five items were found to have an Item Content Validity Index (I-CVI) of 0.6, 2 of 0.5, and 2 of 0.2. The Scale ContentValidity Index (S-CVI) was found to be 0.80. Regarding parental knowledge, the results show that almost all parents are able to correctly state the name of the diagnosis and the description and location of the heart defect. However, parental knowledge has important gaps; in particular, parents are less informed about the most characteristic sign of endocarditis, the possibility of contracting endocarditis more than once in a lifetime, and risk factors. Parental knowledge also seems to be lacking regarding symptoms suggesting worsening health status in their children.

Conclusions

The Italian version of the LKQCHD has proved to be a valid tool to measure the level of knowledge of parents of children with CHD, allowing to identify in which areas it is necessary to improve the education addressed to parents.

Key messages

• Assessing the knowledge of parents of children with CHD allows to improve their education.

• The Italian version of the LKQCHD is a valid tool to measure the level of knowledge of parents of children with CHD.
Prospective prediction of substances use among a cohort of Tunisian adolescents
Authors: Zammit N , Amara A , Ghammam R , Ben Fredj S , Maatouk A , Ouertani M , Ben Belgacem W , Boujebha S , Maatoug J , Ghannem H
Published: October 2022

Background

The risk of substances use increases during adolescence. In Sousse (Tunisia), an upward trend of these risk behaviors has been observed during the last years among young adolescents. Among older adolescents, the trend of their use is unknown.

Objectives

To determine the incidences and the most influencing factors on substances use among high school students in Sousse between 2018 and 2019.

Methods

A prospective longitudinal study was conducted among a cohort of high school students from Sousse. The same pre-tested questionnaire served to collect data in 2018 and 2019 from the same participants in their classes and in the presence of pre-trained investigators.

Results

A total of 404 high school students have participated in the study. Their median age was of 17 (IIQ: 15.8-17.6) years. Girls represented 66.8% of participants. The incidence rates of lifetime tobacco use, alcohol consumption, lifetime inhalants use and lifetime illicit substances use between 2018 and 2019 were 13%, 3.5%, 1.8% and 2 .9% respectively. Lifetime tobacco use was the main predictor of inhalants experimentation. This latter was the main predictor of becoming a user of e-cigarettes while alcohol consumption was the most influencing factor on cannabis experimentation among high school students. On the other hand, illicit substances use among friends predicted e-cigarette use, alcohol consumption, and cannabis experimentation among participants.

Conclusions

The existing prevention programs aiming at reducing tobacco use and substances use in the schools of Tunisia should be reinforced and integrate a comprehensive and multi-sectoral prevention program. The implementation of a national observatory of substances use would ensure the continuous improvement of this program.

Key messages

• There is an upward trend on using substances among the adolescents of Sousse, Tunisia.

• Tobacco experimentation and alcohol consumption are the gateway to later substances experimentation among the adolescents of Sousse, Tunisia.
It matters what we do: Relationships between forms of media use and life satisfaction of adolescents
Authors: Schloemer T , Rocco I , Kolip P
Published: October 2022

Background

Electronic media communication is firmly anchored in the leisure time of adolescents. Adolescents use electronic devices (ED) as a means of interpersonal communication with friends, such as text messaging, for entertainment in the form of receptive communication, such as watching movies, in the form of interactive communication, such as playing computer games, and for other purposes, such as homework. We aimed to identify how these communication forms are related to and interact on life satisfaction (LS) of girls and boys.

Methods

We conducted multivariable linear regression analysis with the dataset of 5,961 adolescents aged 11, 13 and 15 years, obtained from the German Health Behaviour in School-aged Children (HBSC) survey of 2013/2014. Separate statistical analyses were performed for girls and boys, including statistical interactions. We controlled for age, family affluence and family structure.

Results

Interpersonal communication with friends has a positive relationship with LS in boys (β = 0.12, t = 3.19, p = 0.001), but no effect in girls. Whereas other communication forms have a negative main effect on life satisfaction in girls (entertainment β = -0.1, t = -3.79, p < 0.001; gaming β = -0.09, t = -4.12, p < 0.001; using the ED for other purposes β = -0.04, t = -2.26, p = 0.024), we found no association of entertainment with LS for boys. The negative effect of gaming in boys is conditional on the level of using the ED for other purposes: the results show a reinforcing statistical interaction (β = 0.02, t = 3.24, p = 0.001).

Conclusions

The results demonstrate the relevance of considering the differences in associations between single forms of communication and LS for boys and girls separately. This confirms our theoretical focus on a communication-centred approach. Moreover, it is of high relevance to identify potentially enabling and harmful media communication and to understand adolescents’ perspectives on these forms of communication.

Key messages

• When examining associations between media use and life satisfaction among adolescents, form of communication and gender should be taken into account.

• Investigating interactions of different forms of communication can help to better understand their influence on adolescents’ life satisfaction.
Gambling disorder symptoms among Slovenian gamblers
Authors: Selak Š , Žmavc M , Makivić I
Published: October 2022

Background

We are facing a growing popularity of gambling, partly due to the rapid rise of internet related technologies. This growth has been linked to a considerable increase in problem gambling and gambling disorder, which has been an established non-substance addiction. The aim of our study was to assess the prevalence rate of gambling disorder among the Slovenian population.

Methods

National Survey on the Use of Tobacco, Alcohol and Other Drugs was conducted in 2018 on a nationally representative sample (n = 16,000; age: 15-64 years), using mixed-mode data collection (CAWI and CAPI). Responses were obtained from 9,161 respondents, of those 18.4% (n = 1,686) reported to have gambled in the last 12 months (i.e. gamblers). Gambling disorder symptoms were assessed using Berlin Inventory of Gambling Behavior - Screening, consisting of 14 items with a yes/no response option, which measure 9 gambling disorder criteria (DSM-V). Participants who reported at least 5 out of 9 gambling disorder criteria were classified as disordered.

Results

Data shows that 4.3% of Slovenian gamblers met the criteria for gambling disorder. Significantly higher shares were observed among men (5.9%; compared to 1.2% of women) and among younger generations (highest shares among 15-19 year olds (19.4%) and 20-24 year olds (14.5%)). The same goes for money spent for gambling. Namely, males (4.4% of men; compared to 0.6% of women) and younger generations (highest shares among 20-24 year olds (9.2%) and 30-34 year-olds (6.9%)) were more likely to spend more than 100 EUR in a day for gambling.

Conclusions

Data obtained in the present study indicates the extent of gambling disorder symptomatology and highlights key demographic groups with risk for gambling disorder. These findings are consistent with previous comparable studies and provide a basis for tailored public health measures in Slovenia with an emphasis on early intervention.

Key messages

• 4.3% of Slovenian residents, who engaged in gambling in the last 12 months met the criteria for gambling disorder.

• Males and younger generations were more likely to report gambling disorder symptoms and spent more money on gambling. The data shows the need for tailored public health measures.
Pandemic-related determinants of depression in Czech older persons: Evidence from the HAPIEE cohort
Authors: Dalecká A , Pikhart H , Čapková N , Bobák M
Published: October 2022

Background

A number of studies reported higher levels of mental health issues during the COVID-19 pandemic but only minority of studies focused to assess changes in mental health against measurements taken before the pandemics. We investigated a change in depressive symptoms using repeated measurements and the impact of the pre-existing and COVID-19-related stressors in an ageing cohort in the Czech Republic.

Methods

We used data on 2853 subjects (mean age 73 years) from the Czech part of the prospective HAPIEE cohort that participated on postal questionnaire surveys before (2017) and during the pandemic (autumn 2020 to early 2021). Participants reported their depressive symptoms using validated CESD-10 report tool. The impact of pre-existing stressors (age, sex, education, living alone, self-rated health, employment status, depression before pandemic), as well as pandemic-related stressors on change in depressive symptoms were tested using multivariable linear regression, after adjustment for age and potential confounders.

Results

Compared with pre-pandemic period, there was a significant increase in depression score during the COVID-19 pandemic. The mean CESD-10 score increased from 4.92 to 5.37 (p < 0.001). Significantly larger increases in depressive score reported older persons (β = 0.073; p < 0.001) and those with poor self-rated health (β = 0.170; p < 0.001) in the fully adjusted model. Moreover, those who experienced social deprivation (β = 0.057; p < 0.001), death or hospitalization of a close person (β = 0.064; p < 0.001), delays in healthcare (β = 0.048; p = 0.005) and those who suffered from COVID-19 (β = 0.045; p = 0.008) also reported worsened depressive symptoms.

Conclusions

This longitudinal study confirms important increase in depressive symptoms during the COVID-19 pandemic and contributes to identify pandemic-related risk factors. Interventions and future public health policies should address vulnerable individuals and population groups.

Key messages

• Mental health worsened during the COVID-19 pandemic compared to previous years.

• Social deprivation, delays in healthcare and experiencing COVID-19 infection affected mental health of older people.
Development and evaluation of an evidence-based health information on benzodiazepines and z-drugs
Authors: Lindemann C , Heeg J , Dirmaier J , Verthein U , Haerter M
Published: October 2022

Background

With approximately 1.1-1.4 million people in Germany taking benzodiazepines (BZDs) and z-drugs in a problematic or dependent manner, this is a relevant public health problem which needs to be adressed. However, it is well known that affected individuals do not receive the counseling or treatment they need. One possible solution is preventive education of affected individuals and medical practioners using evidence-based and target-group-health information (HI).The project EDER-MIA aimed to develop and evaluate evidence-based and target-group-related HI.

Methods

With the help of three different focus groups (18-40-years; women: 40-60-years; > 60-year-olds), the information needs of affected individuals were assessed. Based on the results, we developed the HI and received feedback from health experts. The HI was implemented online (http://www.psychenet.de) and evaluated with the ‘Usefulness Scale of Patient Information’ (USE): An assessment was made on 3 subscales with a 10-point scale from ‘1=disagree at all’ to ‘10=agree completely'. By forming a sum score (range: 0-90), an overall assessment was calculated.

Results

The results of the focus group study revealed the persons taking BZDs or z-drugs were in need about informations about sleep problems, the risk of taking BZDs and z-drugs and a better orientation regarding help services. The evaluation of the health information achieved medium acceptance rates of usefulness for affected persons (N = 192, 68.2% female; mean= 54.3, sd = 15.4). A somewhat higher usefulness was recognised by the medical staff (N = 58, 69.0% female, mean=64.7, sd = 17.2).

Conclusions

The development of target group-specific HI with the participation of affected individuals and experts is suitable for topics that are associated with possible experiences of shame and stigma. In addition to providing information about the risks of taking BZDs and z-drugs, screening of problematic BZD and z-drug use is also a matter of concern.

Key messages

• BZDs and z-drug use is a relevant public health concern which needs to be adressed.

• Target-group specific health information for BZD and z-drug use accompanied by a screening-test can encourage affected individuals to seek medical advice.
A six-week parenting program for parents of children with learning disabilities in Greece
Authors: Pedioti N , Papadakaki M , Koutra K , Parlalis S
Published: October 2022

Children with learning disabilities have been shown to experience complex emotional and conduct difficulties due to late diagnosis and inappropriate parental management. Parenting support have been deemed necessary for a holistic management of learning disabilities. The current presentation reports on the methodology and initial results of a program offered to parents of children aged 8-12 years with learning difficulties at the region of Crete in Greece, during the school year 2020-2021. The program aimed at improving parenting skills and parent-child interaction, through a short training (four meetings) and a set of seven techniques offered to parents for boosting children’s positive response. All children diagnosed with a learning disability by an interdisciplinary team of experts serving a mobile unit, were approached and their parents were offered a personalised intervention plan and a package of counselling services including a six-week program, based on the “A Six Week Parenting Program For Child Compliance” (Cipani, 2005). Parents were randomly assigned to an intervention (n = 40, 6-week parenting program) and a control group (n = 29, no intervention). A pre- and post evaluation design, with self-administered questionnaires, was used to assess changes in parental skills and performance as well as the quality of parent-child interaction (Parenting Style Questionnaire; the Family Quality of Life Scale (FQOL)). Most of the participants were mothers (n = 63), of low educational level (n = 26) and low income (n = 49). Statistically significant improvements were evident in the intervention group at post-intervention level in parenting skills as compared to baseline scores. Significant differences were also observed in the parenting skills at post-intervention level, between the intervention and the control group. Findings are expected to highlight new approaches towards improving the parental role, with an impact on the quality of life of families.

Key messages

• Training on parenting skills should be included in family support services offered to children with learning disabilities.

• Professionals working with learning disabilities should be trained to assess deficits in parenting skills and offer brief counseling to parents.
Good health information for people with a migration background
Authors: Ecker S , Weigl M , Gaiswinkler S
Published: October 2022

Background

Studies show that people with a migration background are often uncertain concerning the kinds of health services that are offered and where to turn to with which health concerns. Some factors, like fears or obstacles (e.g. deductibles), lead to the health system not being used (on time). This is particularly true for those who are socioeconomically or socially disadvantaged. The aim of the project was to get an insight into the information needs of this population group as a basis for producing and disseminating good health information in the future.

Methods

In this qualitative study co-researchers conducted guided focus groups (separated by sex) or interviews in their first languages. In total, more than 100 people from 16 different countries of origin were involved in the survey.

Results

In general, a substantial need for multilingual health information prepared in easy-to-understand language was expressed. Some health topics (e.g. the Austrian health system, mental health and available support) were mentioned by many participants. Other issues were relevant for few groups only (e.g. TCM). Gender differences can be seen in some groups but not in all. Besides acquaintances/relatives, general practitioners were named as main source of information. Indications can be derived on how health information should be prepared, designed and distributed. Besides multilingual health information, translation services are needed during appointments but also for the medical reports.

Conclusions

When searching for health information, but also when trying to understand it, language barriers are a major obstacle. Multilingual and culture-sensitive explainer videos on selected topics are an appropriate medium for reaching a broad group of people. Low-threshold multilingual regional contact points could provide an important contribution to health equity, as a guide in the health system, providing information and translation services, and setting health promotion offers.

Key messages

• Language barriers represent a major obstacle for vulnerable population groups with migration background in all stages of the health care process.

• There is a substantial need for adequately prepared multilingual health information.
The influence of social support on subjective health among people with selected citizenships
Authors: Bug M , Kajikhina K , Hövener C , Koschollek C
Published: October 2022

Background

Social support as a psychosocial resource has a significant impact on health. However, data on the association between social support and subjective health among people with a migration history is scarce. The aim of this analysis was to examine this association among a sample of people with selected citizenships in consideration of socio-demographic and migration-related factors.

Methods

Data from the project “Improving Health Monitoring in Migrant Populations (IMIRA)” was used, including people with Croatian, Polish, Romanian, Syrian, and Turkish citizenship. Descriptive and logistic regression analyses were conducted to analyse the effect of socio-demographic (gender, age, socio-economic status (SES)) and migration-related factors (length of residence, residence status, German language proficiency) on the association between social support and subjective health (very good/good).

Results

A total of 60.8% of participants with a low level of social support, indicated good subjective health in comparison to 78.8% among those who reported strong support. Participants with a length of residence of over 20 years (aOR=0,29) and (very) poor German language proficiency (aOR=0,39) were less likely to report good health. A high SES had the strongest impact on good subjective health (aOR=5,42).

Conclusions

Overall, the results confirm the findings for the general population in a sample of people with selected citizenships. The fact that people with a migration history more often face structural and health related barriers and that the existence of resources is helpful in overcoming these, a differentiated consideration of the relationship between social support and subjective health seems necessary in order to establish targeted prevention measures.

Key messages

• Among people with selected citizenships, good social support has a positive impact on subjective health.

• Results remain consistent when considering socio-economic and migration-related factors.
eHealth solutions for trans* persons: a systematic literature review of research from 2000 till 2021
Authors: Gahbauer S , Haluza D
Published: October 2022

Though familiarity with trans* personś needs has increased in the new millennium, still, addressing their specific health issues is challenging. In and outside of complex interdisciplinary settings with trans* persons and health care workers, ICT solutions are used to remind trans* persons of their hormone injection or to conduct voice training. Hence, we reviewed the pertinent literature to shed light on what kind of eHealth solutions are investigated, what diagnosis and treatment are eHealth solutions related to, and how are trans* persons enacted within these eHealth solutions. We conducted a systematic literature review analyzing peer reviewed articles presenting all kind of studies except literature reviews. Using the electronic databases PubMed and Scopus, we analyzed data from 1 January 2000 to 31 December 2021. For screening purposes we used the PRISMA checklist and, data extraction followed the PICO (Population, Intervention, Control, Outcome, and Improvement) model. We also analyzed studies covering aspects of the impact on the COVID-19 pandemic. Overall, we identified 322 records, 187 from Scopus and 135 from PubMed. Removing 117 duplicated and 47 records for other reasons, 158 reports were assessed for eligibility. Our results show that trans* persons were often presented as subsamples in larger samples of non-binary populations. Also, eHealth solutions related to very different technological solutions and to a wide range of treatment models, with the vast majority relating to sexual health. Hence, we could also see that trans* women were the more interesting group in the research included in this review. We found 23 studies relating to COVID-19. eHealth solutions have great potential to contribute to a better healthcare for trans* persons but the needs of different groups during healthcare have to be taken into account in further research. During the COVID-19 pandemic, the need for research on eHealth solutions for trans* persons came into focus.

Key messages

• Our analyzes showed that research on eHealth solutions for trans* persons takes place in complex interdisciplinary settings which need to be taken into account in further research.

• The COVID-19 pandemic crisis lead to an uptake of eHealth interventions in mental, endocrinological, and sexual health care, especially in younger groups and in the frame of routine clinical care.
Health interventions for migrants and refugees in host Southeast Asian countries: a systematic review
Authors: Sappyabanphot J , Aye TT , Shreedhar P , Wasko Z , Antia K , Winkler V
Published: October 2022

Background

Understanding the different types of health interventions that have been conducted for migrants and refugees is crucial for the improvement and implementation of future health interventions for these populations. This systematic review aimed to identify and to look at the scope and outcomes of health interventions focused on migrants and refugees in the main host counties in Southeast Asia which are Thailand, Singapore, and Malaysia.

Methods

This study was conducted in line with the PRISMA guidelines and its protocol has been submitted to PROSPERO. The following databases were searched until June 2021: PubMed, Web of Science, Science Direct, Cochrane, and Google Scholar. Studies were excluded if: 1) they were conducted outside Thailand, Singapore, and Malaysia; 2) had only had qualitative results; 3) were non-peer reviewed; 4) not written in English.

Results

The search yielded 8,266 studies, out of which 33 were included in the review. The majority of the studies (79%) were conducted in Thailand of which most were focused on migrants or refugees from Myanmar (85%). Besides two randomized controlled trials (RCTs) of mental health interventions, most Thai studies were observational (81%) and focused on infectious disease-related interventions (33%) or the evaluation of health-related programs (29%). Six studies were conducted in Malaysia (18%) of which 4 assessed mental health interventions in refugees. Three of these studies were RCTs, whereas 1 was an observational study. Only 1 study was situated in Singapore and was an RCT evaluating treatments for COVID-19 in migrant workers. Even in studies with similar interventions, outcomes were too diverse to conduct a meta-analysis.

Conclusions

The low number of studies highlights the gap in literature on health interventions for migrants and refugees, especially in Malaysia and Singapore. More rigorous and cohesive intervention-related research needs to be conducted in Southeast Asia.

Key messages

• More intervention-related research for migrant and refugee populations in the main Southeast Asian host countries is needed.

• Interventions for migrant and refugee populations in host countries in Southeast Asia often do not follow the gold standard RCT study design, limiting the knowledge on their effectiveness.
National belonging and psychological strain among Finnish migrant populations
Authors: Seppänen A , Kuusio H , Mäkipää L , Lilja E , Rask S , Castaneda A
Published: October 2022

Background

National identities are socially constructed and imaginary groups with real-life consequences. Migrants are in a heightened risk to be treated as ‘others’ who do not belong to society. It remains unclear, to what extent national belonging is experienced among Finnish migrants and what consequences on health this has. We study migrants’ sense of belonging to Finns, how it’s manifested in sociodemographic groups and whether it’s associated with psychological strain.

Methods

We used nationally representative data from the cross-sectional Survey on Well-Being among Foreign-Born Population (FinMonik, n = 6836). National belonging was assessed by the item “Finns” in question “which of the following areas or groups you feel you belong to?”. Response options fully and quite a lot were coded to indicate sense of belonging. Logistic regression was used to test the association between belonging, sociodemographic factors and psychological strain (MHI-5). Weights were used to correct the sample.

Results

51% reported sense of belonging to Finns. 46% of those aged 30-44 reported sense of belonging to Finns, whereas the youngest and oldest age groups yielded highest prevalences (18-29=53% and 45-64=58%, p<.001). Married persons reported sense of belonging to Finns more than those who weren't (55% vs. 48%, p<.01). Country group accounted for the variation in Finnish identification with a p-value of less than 0.001. Only 27 percent of those born in East Asia reported sense of belonging to Finns, whereas almost 60% of those born in Middle East and North Africa sensed belonging to Finns. Those with sense of belonging to Finns were twice as likely to report lack of psychological strain than those with no sense of belonging to Finns (p<.001).

Conclusions

Achieving national belonging to the receiving society seems to be more difficult or non-appealing for some migrant populations than others. Lack of national belonging poses risk of deterioration of mental health.

Key messages

• The socially constructed boundaries of national belonging can be exclusionary and have negative consequences for the health of migrant populations.

• Experiencing a sense of national belonging to the country of residence has positive associations with mental wellbeing.
Vaccinating The Invisibles, the COVID-19 vaccination of irregular migrants in Rome
Authors: Punzo O , Ferrara C , Pierconti S
Published: October 2022

Background

The death toll of the COVID-19 pandemic has been hugely downsized by the advent of the currently available vaccines, at least in high-income countries. Nevertheless, there is a huge gap between countries and within countries with respect to vaccination access and coverage. In June 2021, several non-governmental non-profit organizations responded to a call issued by Regione Lazio to help organize and enrol for vaccination vulnerable people such as irregular migrants and migrants living in temporary or informal settlements. Through a huge effort, non-profit voluntary organizations Nonna Roma and Intersos enabled the vaccination of thousands of immigrants from different countries, age and residence status.

Methods

We obtained a dataset regarding part of the people these NGOs facilitated in accessing the vaccination booking. We had information regarding age, sex, country of origin, nationality and type of document.

Results

These populations were from different ethnic backgrounds, in majority males and below 50 years old on average. We found an association between the continent of origin and holding any document and between age and holding any document, both at a significant level (p < 0.05). Coming from Asia, as opposed to coming to any other continent, and being younger, i.e. under 25 years of age, were associated with holding any type of document.

Conclusions

We reflect on the need of rethinking the services for this population, having in mind article 25 of the Universal Declaration of Human Rights, but also, more practically, that often these people work in our elderly homes as caregivers or as cleaners in our offices. Therefore, making it easier to access health services would be in any country’s interest, especially during a pandemic. Policy efforts directed at facilitating migrant access to health services would ultimately help create a safer community for both migrants and residents, for whom migrants often work as strategic employees.

Key messages

• Irregular migrants have not been included in national vaccination plans everywhere, despite WHO and other entities recommendations.

• An integrated national plan for irregular migrants vaccination would be useful for protecting other vulnerable populations such as elderly.
Ethnic disparities in clinical severity of coronavirus disease 2019 (COVID-19) upon admission
Authors: Goldschmidt M , Norredam M , Benfield T
Published: October 2022

Background

Reports from all over the world have shown great ethnic disparities in COVID-19 morbidity and mortality. Recent European studies have found discrepancies between higher risk of admission and intensive care treatment among ethnic minorities but lower mortality rates compared to the ethnic majority. This study will elucidate the ethnic differences in disease severity upon admission as a possible factor in explaining these discrepancies.

Methods

A retrospective cohort study of 1442 patients admitted with COVID-19 at three hospitals in Copenhagen, Denmark, between 1st February 2020 and 31st May 2022. Clinical, demographic and ethnicity data were extracted from health care records and collected using REDCap. Severity upon admission (< 24 hours) was assessed as 1) oxygen need, 2) oxygen administration and 3) need for intensive care.

Results

Ethnicity was registered on 1341 patients (57,0% Danish, 34,8% non-Western). Over all, preliminary descriptive analyses show patients of non-Western origin had symptoms of COVID-19 for a longer period (8,0 vs 6,7 days, p < 0,0001) and had a higher oxygen need (7,0L vs 5,2L, p = 0,02) upon admission compared to patients of Danish origin. A higher percentage of patients of non-Western origin needed high flow oxygen administration upon admission (30,2% vs 22,9%, p = 0,006) and were transferred to the ICU within the first 24 hours (4,9% vs 2,2 %, p = 0,02) compared to patients of Danish origin. Further analysis will be done, including biochemistry and link to registers in order of obtaining more accurate info on country of birth and migration status. We will do logistic regression regarding ethnic differences in severity of COVID-19 upon admission adjusting for comorbidities, age, sex and BMI.

Conclusions

Preliminary data on disease severity of COVID-19 upon admission show some ethnic disparities. Language barriers, low health literacy or the fear of stigma might explain this. Further analyses are needed.

Key messages

• Preliminary data from this cohort study suggest that patients of non-Western origin had symptoms of COVID-19 for a longer period before being admitted compared to patients of Danish origin.

• Preliminary data on disease severity of COVID-19 upon admission show ethnic disparities with regard to oxygen need, oxygen administration and need for intensive care.
Alcohol industry’s arguments against French pregnancy warning labels: a press coverage analysis
Authors: Millot A , Serra M , Gallopel-Morvan K
Published: October 2022

Background

Alcohol drinking during pregnancy has harmful consequences. Warnings displayed on alcohol bottles are an effective measure to inform people about these risks and have been put in place in France. However, the alcohol industry (AI) resisted this measure when it was introduced in 2007 and during an expansion project in 2018. This study aims to identify arguments used by the AI against warnings targeting pregnant women.

Methods

A documentary method was used to analyse these arguments disseminated by the AI and its partners (elected representatives of wine-producing regions, etc.) in the French mainstream press (the national, regional and specialised press) from 2000 to 2020 through the Europresse documentary database. A quantitative analysis (number and evolution of press articles, mapping of the actors of AI who expressed themselves) and an inductive thematic content analysis (analytical framework of the arguments identified) using NVivo Software were carried out.

Results

Among the 85 articles included in this study, a majority of the arguments used by the AI are against this measure. It argues that this measure (1) is a questionable measure because ineffective in changing behaviours, (2) will have counterproductive effects (on women and on the economy); and (3) there are other preferred alternatives than warnings (targeted prevention programs, etc.). A minority is nevertheless in favour of this measure. Among the actors who expressed themselves, a large majority comes from the winegrowing sector.

Conclusions

The analysis of these arguments will add new insights about AI lobbying against warnings, by analyzing the arguments over a 20 years period covering a failure and a success of industry lobbying. It will also be useful for public health advocacy to better counter this lobbying influence and these arguments, which are not necessarily evidence based.

Key messages

• Warnings displayed on alcohol bottles are an effective measure which is challenged by the alcohol industry.

• Analysing the arguments disseminated by the alcohol industry is useful for public health advocacy in order to counter them.
How does better regulation shape EU health policy? A case study of unhealthy advertising regulation
Authors: Lauber K , Brooks E
Published: October 2022

Introduction

Better Regulation is a meta-regulatory tool designed to improve regulatory quality and reduce regulatory burden in the development of EU policy. Despite concerns by civil society that its operation may have a chilling effect on regulatory protections, its impact on health policy has not been researched systematically. Using provisions on high fat, sugar and salt (HFSS) food and alcohol advertising to children within the revision of the audiovisual media services directive (AVMSD) as a case study, we explore how the operation of Better Regulation affects EU health policy processes.

Methods

We employ a qualitative process tracing approach based on policy documents, Freedom of Information requests, media reporting, and expert interview data.

Results

After an evaluation in 2016, the revised AVMSD maintained a reliance on self- and co-regulation of alcohol and HFSS food advertising to children, despite significant evidence supportive of statutory measures and pressure from the public health community to strengthen provisions. This result aligns with calls from commercial actors to retain the status quo. Preliminary results indicate that pathways via which Better Regulation guidelines may have contributed to this outcome include, for instance, the structure and approach used in the impact assessment and the related scrutiny process, the design of the consultation strategy, and the evaluation criteria of the AVMSD proposal.

Conclusions

Considering how policymaking infrastructure - as a key political determinant of health - may shape the processes and dynamics underlying decision-making can support those working towards a policy environment which protects human and environmental health. In examining EU alcohol and HFSS food advertising provisions within the AVMSD revision through a focus on Better Regulation processes, we contribute a novel perspective towards explaining how measures to improve regulatory quality interact with actors’ agency to shape policy outputs.

Key messages

• The Better Regulation agenda should be understood as a key political determinant of health at the EU level.

• Understanding the ways in which governance tools such as Better Regulation can shape health policy is important for those engaged in promoting effective and evidence-informed public health action.
Categorising commercial sector practices to advance human and planetary health
Authors: Gilmore A , Fabbri A , Bondi K , Bertscher A , Lacy-Nichols J
Published: October 2022

Background

There is growing interest in the commercial determinants of health, broadly understood as the ways in which commercial actors influence health & health equity. Such actors can impact on health & health inequity, positively or negatively, through two main routes: (1) producing & driving use of/access to products or services potentially damaging or beneficial to health. (2) through diverse commercial practices which range from marketing, through lobbying, to tax & labour practices. Practices are arguably of greater importance given the growing shift to private sector employment & because all industries, not just those whose products are harmful, engage in them. Yet their contribution to physical, mental & planetary ill health is generally under-recognised with a focus hitherto on unhealth commodities. We aim to develop a practical categorisation of commercial sector practices

Methods

Narrative review & content analysis of existing categorisations (those attempting to cover all practices), & taxonomies (those focused on specific practices (e.g., marketing), related academic &grey literatures.

Results

There is dualism between the business studies & public health literatures, the latter tending to dichotomise market & non-market strategies while the former sees this as an outdated approach. While some specific practices are well documented, others remain poorly understood & theorised. A simplified categorisation is proposed which attempts to identify key commercial sector practices that can impact on health, the ways in which they overlap & reinforce each other. Evidence-based taxonomies for specific practices are identified.

Conclusions

Our categorisation provides a simple approach through which the commercial practices that can harm human & planetary health & drive health equity can be understood & addressed. It draws attention to the diverse ways through which corporations can harm health, identifies areas for action & further research.

Key messages

• The ways in which commercial sector practices influence health and health equity are diverse yet poorly understood.

• We offer a simple categorisation of commercial practices which draws attention to the diverse ways through which they can harm health, helps identify solutions and areas for PH action.
Agnogenic practices: an analysis of UK gambling industry-funded youth education programmes
Authors: van Schalkwyk MCI , Hawkins B , Petticrew M , Reeves A , McKee M
Published: October 2022

Background

The corporate political activities of harmful industries, including the use of agnogenic (ignorance or doubt producing) practices and the construction of dystopian narratives, directed at influencing policymaking are well documented. However, the use of agnogenic practices by industry-funded organisations who deliver industry-favoured education-based measures remains unexplored. This study aims to build understanding of this by analysing three UK gambling industry-funded youth education programmes that represent key policy responses to gambling harms.

Methods

Using a published typology of corporate agnogenic practices the ways that evidence is used within the programmes’ resources to legitimise their content and implementation were analysed. Programme evaluations and claims about the programmes’ evidence base and effectiveness were also analysed.

Results

Agnogenic practices, including confounding referencing, misleading summaries and evidential landscaping, that resemble those adopted by harmful industries are used within gambling industry-funded youth education programmes and by the charities that oversee their delivery. These practices serve corporate interests, distort the limited evidence in support of youth gambling education measures, and legitimise industry favoured policies.

Conclusions

This novel study demonstrates that agnogenic practices are used to construct utopian narratives that claim that gambling industry-favoured youth education programmes are evidence-based and evaluation-led. These practices misrepresent the literature and evaluation findings and may undermine effective policymaking to protect children and young people from gambling harms.

Key messages

• Gambling industry-funded education programmes warrant greater scrutiny and conflicts of interest need to be addressed.

• The methods and findings of this study are of relevance to other contexts and areas in the field of the commercial determinants of health given other harmful industries adopt similar approaches.