bluuebunny/crossref_metadata_2025 huggingface dataset:
Does neighbourhood crime mediate the relationship between neighbourhood SES and birth outcomes?
Authors: Ochoa L Burgos , Bijlsma MJ , Steegers EAP , Been JV , Bertens LCM
Published: October 2022

Background

Previous studies have consistently found that women living in low socioeconomic status (SES) neighbourhoods are at higher risk of experiencing adverse birth outcomes compared to women from high SES areas. However, the mechanisms through which neighbourhood SES might influence health at birth remain poorly understood. One of the proposed pathways is the exposure to higher crime rates. The aim of this study is to investigate whether neighbourhood crime mediates the relationship between neighbourhood SES and birth outcomes.

Methods

A retrospective cohort study including over 1.3 million singleton births occurred in the Netherlands between 2010 and 2017. Individual-level data from the Dutch perinatal registry was linked to quintiles of neighbourhood SES scores and neighbourhood-level crime rates. Using the mediational g-formula, we estimated the total effect, natural direct effect, and natural indirect effect of neighbourhood SES on birth outcomes: small-for-gestational-age (SGA), low birth weight, and preterm birth. The neighbourhood SES intervention settings correspond with a hypothetical improvement in neighbourhood SES from the lowest to the highest quintile.

Results

The hypothetical improvement in neighbourhood SES resulted in a 6.6% (CI = 5.6%; 7.5%) relative reduction in the proportion of SGA births, an 8.9% (CI = 7.6%; 10.3%) reduction in the proportion of low birth weight, and a 5.1% (CI = 4.0%; 6.1%) decrease of preterm birth. Neighbourhood crime accounted for 29.0% (CI = 25.1%; 32.8%) of the total effect of neighbourhood SES on SGA, and for 8.6% (CI = 5.1%; 11.6%) of the total effect on low birth weight. For preterm birth, we found no evidence of mediation by neighbourhood crime.

Conclusions

Neighbourhood crime mediates the association between neighbourhood SES and key adverse birth outcomes. Interventions targeted at lowering neighbourhood crime rates could improve birth outcomes in disadvantaged areas.

Key messages
Do fathers have sufficient knowledge to administer medicine to children correctly?
Authors: Yanagi N , Satoh H , Sawada Y
Published: October 2022

Background

Recently, the father's involvement in childcare is increasing in Japan. Inappropriate use of medication for children at home has been reported worldwide, however, the most responsible person was likely to be the mother. We aimed to compare the knowledge related to administering medication to children between fathers and mothers among Japanese parents.

Methods

An online survey regarding medication administration to children was conducted in March 2022. Parents living with preschool children were recruited and categorized by four factors: sex (fathers and mothers), age of children, regular medication, and the difficulty level in giving medicine to their own children. The cross-sectional data were collected for each category. The knowledge related to administering medication to children was measured using ten statements such as “Children can be given a reduced dose of adult medicine” using a 5-point Likert scale. The answer “disagree” was defined as correct understanding and was compared between fathers and mothers (Chi-square test).

Results

The participants were 145 fathers and 128 mothers. The percentage of fathers who answered all questions correctly or all questions incorrectly was 9.0% (mothers = 13.3%) and 25.5% (mothers = 13.3%) respectively. Each statement was answered correctly by fathers 20.0-57.9% and by mothers 25.8-71.9% and fathers were less likely to have the correct knowledge than mothers (6 items, p < 0.05). The biggest difference between those two groups was the statement of “Children should be given more than the proper dose for rapid effect”. Furthermore, the fathers having some difficulties in giving medicine had lower awareness about appropriate medication use than fathers having no difficulties.

Conclusions

Fathers were more likely to have lower knowledge related to administering medication to children than mothers. Medical professionals like pharmacists will need to support fathers.

Key messages
Impact of socioeconomic position on childhood obesity in Finland based on register data from 2018
Authors: Paalanen L , Levälahti E , Mäki P , Tolonen H , Laatikainen T
Published: October 2022

Background

Obesity is a globally growing public health challenge among children. In developed countries, the risk of obesity is commonly higher among lower socioeconomic groups. Measuring socioeconomic position (SEP), especially income, is challenging in surveys as self-reported information may suffer from reporting, awareness, recall and non-response bias. Our aim is to utilize official register data on several SEP indicators and measured height and weight of children, to identify the strongest predictors of SEP of the parents on the risk of obesity among the whole 2-17-year-old child population in Finland.

Methods

Data for all children who had visited child health clinic or school health care in 2018 were extracted from the National Outpatient Register on Primary Health Care Services (n = 387623, coverage 40% in 2018). Obesity was defined according to the WHO criteria. SEP indicators were obtained from Statistics Finland for both parents living in the same household with a child. Boosted regression model was used to analyze the contribution of SEP to obesity using training dataset on 155479 non-related children.

Results

The area under the curve for the final model in training dataset was 0.736 and 0.718 in validation dataset. Mother's educational level (12.6% of the total explained variation) and household's disposable income (12.6%) were the SEP indicators that most strongly predicted childhood obesity, whereas the impact of educational level of the father was somewhat smaller (8.1%). The influence of the age of a child was even bigger (39.2%), the prevalence of obesity being highest at 11 and 9 years of age among boys and girls, respectively.

Conclusions

Our results based on official register data from Finland, a Nordic high-income country, endorse earlier findings on higher obesity risk among children with low socio-economic family background. Identification of the SEP related risk factors and support to families are essential in the prevention of childhood obesity.

Key messages
Changing epidemiology and trends in incidence of thyroid cancer in England, 1985-2019
Authors: Stonell R , Bannister P , Memon A
Published: October 2022

Background

Thyroid cancer is 2-3 times more common in females and is currently the fastest growing cancer worldwide. Exposure to ionizing radiation is the only established risk factor for thyroid cancer. Other factors include obesity, history of benign thyroid conditions, and family history. We conducted a retrospective population-based cohort study to examine whether there have been changes in the incidence of thyroid cancer in England during the past four decades.

Methods

Individual level data for patients diagnosed with thyroid cancer in England during 1985-2019 were obtained from the Office for National Statistics/Public Health England. Average annual incidence rates were calculated by two age categories (0-49, 50+ years) and all ages combined during the seven five-year time periods (1985-89 to 2015-19). The percentage change in incidence was calculated as change in the average annual incidence rate from the first (1985-89) to the last time period (2015-19).

Results

During the 35-year study period, a total of 58,710 new cases of thyroid cancer were registered in England (27.3% males, 72.7% females). In young people aged 0-49 years, the average annual incidence rates increased by 375% in males and 438% in females (from 0.4/100,000 in 1985-89 to 1.9/100,000 in 2015-19 in males and from 1.3/100,000 in 1985-89 to 7.0/100,000 in 2015-19 in females). In older people aged 50+ years, the rates increased by 146% in males and 171% in females (from 2.4/100,000 in 1985-89 to 5.9/100,000 in 2015-19 in males and from 4.1/100,000 in 1985-89 to 11.1/100,000 in 2015-19 in females).

Conclusions

There has been a steady and substantial increase in the incidence of thyroid cancer in England over the past four decades. The largest increase in incidence was observed in young people aged 0-49 years. Some of this increase is due to enhanced surveillance and sensitive diagnostic methods, but other factors (e.g., obesity and history of benign thyroid conditions) need to be considered.

Key messages
Assessing the state of Web-based communication for public health: a systematic review
Authors: Ceretti E , Covolo L , Cappellini F , Nanni A , Sorosina S , Taranto M , Gasparini A , Castro P De , Brusaferro S , Gelatti U
Published: October 2022

Background

Communicating strategically is a key issue for health organisations and, over the past decade, healthcare communication via social media and websites has generated a great deal of studies. As for systematic reviews, there is, however, fragmentary evidence on this type of communication. The aim of this research was to summarise the evidence on Web institutional health communication for public health authorities to evaluate aim-specific key points based on existing studies.

Methods

Guided by the PRISMA statement, we conducted a comprehensive review across two electronic databases (PubMed and Web of Science) from 2011 until 7 October 2021, searching for studies investigating institutional health communication. Two independent researchers reviewed the articles for inclusion, and assessment of methodological quality was based on the Kmet appraisal checklist.

Results

78 articles were selected. Most of the studies targeted health promotion/disease prevention (n = 35), followed by crisis communication (n = 24), general health (n = 13), and misinformation correction/health promotion (n = 6). Engagement and message framing were the most analysed aspects. Few studies focused on campaign effectiveness. Only 18 studies had an experimental design. Kmet evaluation was used to distinguish studies presenting a solid structure from lacking studies. In particular, considering the 0·75-point threshold, out of 74 studies, 28 were excluded (37·8% of the total). Studies above this threshold were used to identify a series of aim-specific and medium-specific suggestions, as communication strategies employed differ quite greatly.

Conclusions

Overall, findings suggest that no single strategy works best in the case of Web-based healthcare communication. The extreme variability of outcomes and the lack of a unitary measure for assessing the end-points of a specific campaign or study leads us to reconsider the tools we use to evaluate the efficacy of Web-based health communication.

Key messages
Disruptive e-prevention from 2019: dummy online drug selling sites to reach new consumers
Authors: Mau M , Bouchet-Mayer C , Bost S , Shelly M , Trauchessec D
Published: October 2022

Background

The last three decades have seen the development of chemsex, the diversification of substances through New Psychoactive Substances (NPS), and new technologies allowing people to buy online and find peers to consume on applications while remaining in private spheres (Trend, Cadet-Taillou, 2020). The latter has made it more difficult to reach users, so as to document their uses and the population, and to design public health schemes aimed at users, except through targeting metapopulations known to consume more than the general population (Léobon et al., 2018; Talley et al., 2011).

Methods

The PlaySafe association designed two dummy websites, one selling GBL, the other NPS. These websites use the same graphics and syntactic codes as the main websites of the field, except for: 1) a fake drug named “love machine”; 2) an automatic redirection to a health promotion page instead of payment finalization. The information collected is: delivery region, birth year, gender, perceived usefulness of the health promotion messages, whether people would recommend to friends, the contents and quantities of the shopping cart, the time spent on each page, and data gathered via Google Analytics.

Results

On both websites 21,459 order attempts have been placed. This pathfinder research project has allowed to reach 6,203 people on the GBL website in 30 months and 7,927 people in 12 months on the NPS website, with people spending on average 1 min 35 s on the first website's prevention page and 1 min 27 s on the second. Around 85% of people consider the content useful, among whom 75% would recommend the website to friends. This communication also aims to present the characteristics of the reached population.

Conclusions

This innovative approach has allowed to precisely target a population escaping public health research and prevention schemes. It appears interesting to explore online prevention, especially since most of the respondents consider the experience helpful and recommendable.

Key messages
Climate-sensitive health counselling: a quantitative survey on addressing climate change
Authors: Krippl N , Mezger NCS , Fischer H , Schildmann J , Mikolajczyk R , Danquah I , Kantelhardt EJ , Herrmann A
Published: October 2022

Background

Climate change and its mitigation have significant health implications. Hence, medical associations call on physicians to inform the population about health risks of climate change and possible health co-benefits of climate action. However, so far it is unclear what preferences the general public has about climate-sensitive health counselling (CSHC). Therefore, we developed a survey tool to a) characterize experiences of CSHC, b) identify preferences about communication methods and themes, and c) determine associations of socioeconomic characteristics and climate change attitudes with CSHC preferences.

Methods

The tool development for this cross-sectional online-based survey was embedded in a bigger research project on the conceptualization of CSHC, which follows an exploratory mixed-methods design. Results of preceding qualitative interviews about CSHC were integrated into the tool development. After two pilot tests, the tool was administered from April to June 2022 through the population-based HeReCa panel (Health Related Beliefs and Health Care Experiences in Germany), comprising 3200 participants from 5 federal states. Sociodemographic data is available for all participants.

Results

The final tool entails 46 items, sorted into 7 sections. Two sections serve as dependent variables for the association analysis: 13 items about the acceptability of different communicative approaches of CSHC and 18 items on preferences for themes in CSHC. Three sections serve as independent variables for the analysis: attitudes on climate change, level of engagement, and sociodemographic data. Two sections assess experiences with CSHC and preferred information channels to serve as descriptive results.

Conclusions

A rigorous methodology proved helpful for survey development within a mixed methods study. In triangulation with qualitative data, results of the survey will help physicians to deliver CSHC tailored to the preferences of different sociodemographic groups.

Key messages
CO2 production in waste management during the COVID pandemic in an Italian hospital
Authors: Di Russo M , Alizadeh A Heidar , Santoli G , Castagna C , Nurchis M , Rosano A , Cadeddu C
Published: October 2022

Background

Personal protection equipment (PPE) use in hospitals has consistently increased due to the Sars-Cov-2 outbreak, in wards repurposed for Covid-19 patients and wards that kept their usual activity. This increase influenced an environmental emergency in terms of health waste (HW) disposal. This study aims to assess the economic and environmental impact of the increase in HW generated before and during the pandemic in an Italian Hospital.

Methods

Data from 2016 to 2019 and 2020 to 2021 was retrieved from Risk Management department. Per capita and per days-of-stay waste quantity were calculated for the hospital inpatient wards and medical service areas (anatomical pathology, laboratories, radiology, nuclear medicine). Linear regression models assessed the epidemiological impact of COVID, and LOESS analysis modeled the relationship between infectious HW generation and the percentage of COVID-related inpatient days. Average weight of HW per patient was used to estimate the monetary value of CO2 produced.

Results

Preliminary results show that the inpatient days related to COVID nonlinearly influenced the infectious HW generated by wards. PPE usage increased in every context, and the proportion of COVID-related bed-days ranged from 2% to 12% in low-incidence months to 17% to 31% during acute phases. Pre-COVID CO2 production weighted 487 kg per patient and cost 1705€ per-capita, whereas during the pandemic it amounted to 768 kg per patient and cost 2688€ per capita which resulted in a significant increase of 983€ per patient.

Conclusions

In light of the results, HW disposal is an urgent issue that should be addressed by policy makers when implementing new monitoring systems for hospitals. A more adequate disposal of HW could substantially contribute in reducing air pollution and concurrently reduce the economic impact health systems due to the coronavirus pandemic.

Key messages
Untangling the influence of depression on clinical risks: role of leukocytes and somatic symptoms
Authors: Gialluisi A , Bracone F , Costanzo S , Di Castelnuovo A , Orlandi S , Curtis A De , Cerletti C , Donati MB , Gaetano G de , Iacoviello L
Published: October 2022

Background

Depression has been associated with increased hospitalization and mortality risk, especially for cardiovascular causes. We previously found a composite circulating inflammation score (INFLA-score) to explain part of this link, although the role of its component and of depressive symptoms domains in this relationship is unexplored.

Methods

In an Italian population cohort (N = 13,191; age≥35 years; 51.7 % women; 4,856 hospitalizations and 471 deaths, median follow-up 7.28/8.24 years), we estimated the proportion of association explained by C-reactive protein levels (CRP), platelet count, granulocyte-to-lymphocyte ratio (GLR) and white blood cell counts (WBC), in multivariable Cox regressions modelling first hospitalization/mortality for all and cardiovascular (CVD), ischemic heart (IHD) and cerebrovascular disease (CeVD) causes vs depression severity based on an alternative validated version of PHQ-9. We also estimated the proportion of association explained by INFLA-score in the associations of polychoric factors tagging somatic and cognitive depressive symptoms with clinical risks.

Results

In models adjusted for age, sex and education, significant proportions of the positive influence of depression on clinical risks were explained by CRP (4.8% on IHD hospitalizations), GLR (11% on all-cause mortality) and WBC (24% on IHD/CeVD hospitalizations). Stable associations of somatic but not of cognitive depressive symptoms were observed with increased hospitalization risk (+16% for all causes, +14% for CVD causes), with INFLA-score again explaining small but significant proportions of these associations (2.5% for all causes, 8.6% for IHD causes).

Conclusions

These findings suggest a prominent explanatory role of leukocytes in the link between depression and clinical (especially CVD) risks, and highlight the importance of inflammation in the influence of somatic depressive symptoms. Therefore, acting on these factors may reduce clinical risks associated with depression.

Key messages
Associations between early life transitions and depressed mood over time: A 27-year study
Authors: Jørgensen M , Smith ORF , Wold B , Haug E
Published: October 2022

Background

Few studies have looked at how life transitions influence depressed mood from adolescence to adulthood and if parental socioeconomic status (SES) moderates these effects.

Study questions

Methods

We used latent growth modelling to analyze depressed mood in a Norwegian sample (n = 1257) surveyed at age 13, 14, 15, 16, 18, 19, 21, 23, 30 and 40 (1990-2017). The effects of life transitions were modelled as time-varying predictors. At age 30 and 40, attaining employment and beginning cohabitation were used as covariates while parenthood was controlled for from age 19. Time-invariant covariates were gender and SES.

Results

Depressed mood peaked at age 15 and 18, but decreased over time - following a polynomic curve with a linear (B = -.38, 95% CI = [-.49, -.28], p < .001) and quadratic slope (B = .05, 95% CI = [.013, .086], p < .001). Leaving the parental home (B = -.166, 95% CI = [-.250, -.083], p < .001) and beginning cohabitation (B = -.130, 95% CI = [-.231, -.029], p < .05) led to decreases in depressed mood regardless of age of transition. Higher SES was associated with lower depressed mood at intercept compared to mid-SES (B = -.106, 95% CI = [-.295, -.030], p < .05) and low SES (B = -.202, 95% CI = [-.343, -.062], p < .05). Girls also reported a higher intercept level of depressed mood (B = .274, 95% CI = [.165, .383], p < .001). Life transitions were not moderated by SES.

Conclusions

The study demonstrated that leaving the parental home and beginning cohabitation were associated with depressed mood, and SES showed no moderation. Public health initiatives should therefore pay attention to life transitions when aiming to lessen depressive symptoms from adolescent years to adulthood.

Key messages
Assessment of the impact of the Belgian and French food industry on obesity and population nutrition
Authors: Van Dam I , Allais O , Vandevijvere S
Published: October 2022

Major food industry players make commitments to improve food environments, but it remains unclear how well these commitments translate into practice. This study set out to quantitatively assess the nutrition-related commitments and practices, as well as the correlation between both, of major food companies in Belgium and France. The ‘Business Impact Assessment’ (BIA-Obesity) was applied to evaluate nutrition-related commitments and practices regarding product formulation, labelling, promotion and accessibility. Publicly available commitments were collected and companies given the opportunity to complete the information (2019-2020). Practices were evaluated applying following performance metrics: the proportion of products with Nutri-Score A or B, the percentage of products not-permitted to be marketed to children (World Health Organisation) and the proportion of ultra-processed food products (NOVA). Correlations between commitments and practices were calculated applying the Spearman's rank correlation coefficient. Overall BIA-Obesity scores for commitments were lower in France (median: 28%) than in Belgium (35%). Response rates in France (39%) were lower than in Belgium (56%). Median product portfolios in France contained less ultra-processed products (63%) and contained a higher proportion of products with a Nutri-Score A or B (38%) compared to Belgium (75% and 29%, respectively). In both countries a similar proportion of products was not-permitted to be marketed to children (81% in Belgium and 84% in France). Stronger company commitments did not translate into better performance metrics. Belgian food companies obtained a higher score for their nutrition-related commitments. French companies performed slightly better according to the performance metrics. In both countries there was ample room to improve commitments and practices. To improve food environments it is crucial to ensure that commitments are strengthened and translate into improved company practices.

Key messages
An exploratory study of the level of folic acid in food staples in Ireland in 2021
Authors: McMenemy D , Sweeney MR
Published: October 2022

Background

Ireland previously had widespread voluntary fortification but there has been a major decline in the number of food staples fortified with folic acid in Irish supermarkets in the past 15 years. In this research we set out to examine the level of folic acid in food staples in supermarkets with the leading market share in the Republic of Ireland.

Methods

The food labels of food staples (breads, spreads, milk, cereals, cereal bars, yoghurt/yoghurt drinks) were photographed in supermarkets with the leading market share in the Republic of Ireland (Tesco's, Dunnes, SuperValu, Lidl, Aldi, and M&S) between 2017 and 2021.The data was extracted and collated in an excel spreadsheet. The data was analysed to examine the level of folic acid in each product. We compared the levels captured at the current times with the levels previously captured in 2017.

Results

Preliminary analysis suggests that folic acid level in food staples in Ireland continues to decline. Folic acid was not found in any breads (except a number of gluten free breads), milks, spreads but was found in several cereals marketed mainly at children.

Conclusions

This study reports on the declining levels of folic acid in the food chain in Ireland. The number of food staples fortified with folic acid continues to decline demonstrating that voluntary fortification in Ireland is no longer an effective measure for passively augmenting the folic acid levels of consumers. This is of concern due to the incidence of neural tube defects in Ireland largely preventable by folic acid.

Key messages
Assessment of maternal dietary patterns and their relationship with c-reactive protein in pregnancy
Authors: van der Pligt P , McNaughton SJ , Kuswara K , Abbott G , Islam S , Ebrahimi S , Ellery S
Published: October 2022

Background

Inflammation during pregnancy including elevated C-reactive protein (CRP) is associated with adverse pregnancy outcomes. Understanding relationships between CRP and modifiable factors such as dietary patterns is key to identifying opportunities for pregnancy intervention. This study assessed change in adherence to the Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diet (MED-diet) from early to late-pregnancy and the relationship between adherence to both dietary patterns at early-pregnancy with plasma CRP at early and late-pregnancy.

Methods

Women (n = 215) attending antenatal clinics at Monash Health, Melbourne were recruited at 10-20 weeks gestation. Medical history and blood samples were collected at 5 antenatal visits. Adapted DASH and MED-diet scores were calculated from Food Frequency Questionnaires completed at early ([mean±SD] 15±3 weeks) and late (36±1 week) pregnancy. CRP was measured in maternal plasma samples collected at early and late-pregnancy. Adjusted linear regression assessed associations of early-pregnancy DASH and MED-diet scores with early and late-pregnancy plasma CRP.

Results

DASH score at early (23.5±4.8) and late (23.5±5.2) pregnancy was not significantly different (p = 0.971). There was no statistically significant change in MED-diet score from early (3.99±1.6) to late-pregnancy (4.08±1.8) (p = 0.408), however, MED-diet adherence and plasma CRP at early pregnancy were significantly and inversely associated (β= -0.14 [95%CI= -0.27, -0.01], p = 0.039).

Conclusions

Adherence to the MED-diet in early pregnancy may be beneficial in reducing inflammatory markers and assisting optimal pregnancy outcomes. Assessment of dietary patterns is important to assist identifying modifiable factors which impact maternal and child health.

Key messages
Quality of life and social contacts in old age
Authors: Loeffler K , Weidinger L , Bohnstingl M , Pammer C , Goldgruber J
Published: October 2022

Background

Changes in lifestyle, housing and social relationships have a verifiable impact on aging. Older adults of today have different ideas about housing and residential mobility than previous generations. Consequently, the importance of innovative types of housing for senior citizens, which allow largely independent housekeeping and provide integration into preexisting social structures, is increasingly in the focus of public health debates.

Methods

Face-to-face interviews with 32 tenants of Wohnoase Robert Stolz in Graz were conducted between July 2018 and December 2020. The subjects were interviewed twice (T1: at move-in, T2: 6-12 months after moving-in). WHOQOL-BREF and WHOQOL-Old were used to assess health-related quality of life. Furthermore, the ego-centered social network map and a questionnaire to assess subjective sense of safety at home were applied.

Results

Tenants’ health-related quality of life improved by an average of 11% after 6-12 months in the area of environmental conditions for health promotion ((T1: 3.83; T2: 4.25). Residential satisfaction (T1: 3.44; T2: 4.3; +25%) as well as subjective feeling of safety in their own homes (T1: 4.19; T2: 4.81; +14.8%) rose significantly. Tenants on average had about 6 more social contacts than before moving in (52.2%). In contrast, no significant changes were evident in tenants’ self-assessment of their physical, mental, and social health.

Conclusions

Results indicate that moving into assisted living can lead to psychosocial stabilization and an increased sense of security. Over time, deteriorations in physical health can be observed, which can most likely be attributed to advanced ageing. Conducting an evaluation study with a higher number of participants and a control group is recommended.

Key messages
Caregiver burden in professionals working in different settings for persons with dementia
Authors: Katreniakova Z , Nemcikova M , Nagyova I
Published: October 2022

Introduction

Professionals caring for persons with dementia (PwD) have to meet demands from various sides. Considering today's high standards put on institutional care with respect to “person centred care” and the skills related to specific needs of PwD, caring for care staff is one of the major challenges.

Objectives

The aim of this study was to investigate the caregiver burden in professional dementia care and its work related differences.

Methods

The study was carried out from September 2021 to February 2022 among 105 professionals working in different settings for PwD in Slovakia including home care and day care centres. The Professional Care Team Burden scale (PCTB) and the Zarit Burden Interview (ZBI-12) were chosen to measure caregiver burden. Length of work in the organisation (< 3, 3 to 6, > 6 years), job position (domiciliary and other care worker), and current dementia care intensity (≤ 8, 9 to 39, > 40 hours/week) were also measured. Independent samples T-tests and ANOVA were used to analyse the differences (IBM SPSS 27).

Results

87.6% of professionals were women (mean age 48.6±9.8 years). 52.5% worked more than 6 years in the organisation, 53.3% were in the job position of domiciliary care workers, and for 52.1% the current dementia care intensity was 9 to 39 hours/week. Caregiver burden mean scores achieved were 26.7±4.0 (PCTB) and 9.7±6.2 (ZBI-12). The significant difference was found in the PCTB by job position with the higher burden in domiciliary care workers (mean score 26.0 + 4.2, p < 0.05). No significant differences were observed in the PCTB and the ZBI-12 by the length of work in the organisation and current dementia care intensity.

Conclusions

Specific scales for assessing professionals’ caregiver burden are useful to uncover areas for intervention. Structuring the interventions by taking the care staff subjective feelings of burden into account is important for future improvements in institutional care. (Grant support: VEGA no. 1/0372/20).

Key messages
A qualitative study on newly settled migrants’ perceptions of civic and health orientation in Sweden
Authors: Al-Adhami M , Hjelm K , Wångdahl J , Larsson E
Published: October 2022

Background

Migrants face structural, socio-political barriers in their resettlement processes that affect their health. Migration also impacts resources such as social capital and health literacy that are of importance for health and integration in society. Hence, there is a need for health promotion in the post-migration phase. The aim of the study was to explore participants' perceptions and experiences of civic orientation with added health communication.

Methods

Six focus group discussions were performed with 32 men and women. Two were held in Arabic, two in Farsi and two in Somali, with native speaking moderators. Participants were recruited from civic orientation classes in the county of Stockholm. An interview guide with semi-structured questions was used. The data were analysed using a method for content analysis of focus group discussions.

Results

Three main categories were identified: ‘The course gives valuable information but its delivery needs adjustments', which includes that the civic and health orientation is valuable and needed earlier, during asylum phase, and that planning and course content need adjustments. ‘The health communication inspired participants to focus on their health', includes that the health communication was useful and inspired uptake of healthier habits. ‘Participation in the course promoted independence and self-confidence', which includes that the course gave insights into society and values in Sweden and promoted independence and new social contacts.

Conclusions

This study adds knowledge of the users' perspectives on the potential of civic orientation to promote health and integration of newly settled migrants, describing ways in which civic orientation with added health communication prompted health and empowerment. However, the content and delivery of the course needs adjustment to better fit the migrants' life situations and varying pre-existing knowledge.

Key messages

The civic and health information is needed early in the resettlement phase. Participation in the course promoted health awareness, independence and self-confidence.
Trust in societal factors and vaccine hesitancy in Western Balkans
Authors: Matovic-Miljanovic S , Cvjetkovic S , Jeremic-Stojkovic V , Mandic-Rajcevic S , Bjegovic-Mikanovic V , Gross M
Published: October 2022

Background

Countries in the Western Balkans are facing vaccine hesitancy, trying to bring vaccine acceptance and ways to improve it into the focus. Trust in science and institutions, namely political trust, plays an important role and can significantly affects vaccine acceptance.

Methods

Cross-sectional research was carried out from July to September 2021 in five countries of the Western Balkans (Albania, Bosnia and Herzegovina, North Macedonia, Montenegro and Serbia) and included adult population aged 18 and older (1605 individuals). Convenience sampling was applied using anonymised online questionnaires and Likert scales, shared through online social media, and asking, among others, for trust in societal factors.

Results

In all countries people had more confidence in health authorities than in political officials. There are no gender differences found in showing trust in societal factors, except in Serbia where women compared to men showed greater trust in health authorities (50.6% vs. 34.4%), as well as in political officials (42.8% vs. 28.2%). The lowest trust in pharmaceutical companies was found in Albania where 34,9% respondents believe that vaccination against COVID-19 is largely promoted by pharmaceutical companies due to financial profits. People who put more trust in societal factors were vaccinated to a greater extent. In Serbia and Albania, the older respondents in general put more trust in societal factors. People who assessed themselves as more religious in Serbia and North Macedonia demonstrated less trust towards societal factors.

Conclusions

The study demonstrated moderate trust in societal factors in all countries, with greatest trust in health authorities. This implies that health authorities should have a pivotal role, together with physicians in primary health, in promoting vaccination and educating the general public in the Western Balkans.

Key messages
Supporting patient involvement in health service research: development of a methodological guidance
Authors: Dauvrin M , Kohn L , Cleemput I
Published: October 2022

Background

The Belgian Health Care Knowledge Centre (KCE) issued a Position Paper in 2019 regarding the Patient Involvement (PI) in its researches as stakeholders. After previously investigating the organizational culture of the KCE, a key element for a successful implementation of PI was providing methodological guidance to the researchers.

Objectives

The objective of this study was to develop a methodological guidance for implementing PI into the practices of researchers at KCE.

Methods

In order to build a practical and effective process note, reflecting the needs and points of attention of all involved participants, different methods were combined: a literature review, workshops with the umbrellas of patient associations, patients and patient representatives, Delphi survey and a pilot project involving patients as research partners.

Results

The resulting guidance identified 5 prerequisites and conditions for implementation of patient involvement at the organisational level. The guidance also focused on how to involve patients (which patients, how, when, what for) and included general recommendations to researchers during the collaboration (communication, relational aspects, animation techniques, specific needs of patients). Recommendations for the reporting and evaluation of PI were also formulated. Alongside the guidance for researchers, supports for patients were also developed and validated by the patient associations.

Conclusions

The KCE guidance for PI in research could inspire other agencies willing to implement PI in their practices. Implementation will therefore require additional human and financial resources.

Key messages
Recreational walking and the perceived local environment among socioeconomic disadvantaged adults
Authors: D'Hooghe S , Deforche B , van Dyck D , De Ridder K , Vandevijvere S , van de Weghe N , Dury S
Published: October 2022

Background

Insufficient physical activity (PA) is a risk factor for obesity and non-communicable diseases and seems more prevalent among socioeconomically disadvantaged (SED) adults. Recreational walking (RW) is an important type of leisure time PA which can be done for free and without specific equipment or facilities. Environmental factors influencing PA may be particularly important for SED adults who are more reliant on their direct environment. The objectively measured environment is not always congruent with the perception of residents, and this may differ by socioeconomic group. This study aims to identify the local environmental factors important for RW as perceived by SED adults.

Methods

This study is part of the CIVISANO project. Purposeful convenience sampling was used to recruit 38 SED adults (25-65 y/o) in two Flemish semi-urban municipalities. Individual walk-along interviews have been performed in the participants’ neighborhood. 20 participants joined the focus group discussion (n = 4) that were intended for member checking, to categorize identified environmental factors and to identify local actions to promote recreational walking. MaxQDA was used for content analysis.

Results

The way the environment is perceived by SED adults plays an important role in their RW behavior. Results demonstrate the interrelation of different environmental types (physical, sociocultural, economic, political and information) and sizes (micro, meso, macro). Improving communication and knowledge transfer, stimulation of physical, sociocultural, and economic accessibility, and promotion of physical and social safety are identified most important action points for the local government to facilitate RW.

Conclusions

Our findings indicate that the perceived local environment can play an important role in promoting RW among SED adults. Future studies should investigate if changes in these environments and in residents’ perception lead to changes in RW behavior of SED adults.

Key messages
Breast cancer screening adhesion among migrants: a matter of communication strategy?
Authors: Banzola S , Corsaro A , Capitani S , Vesco S , Dodi L , Serra O , Piazza N , Onesti S , Salvati MA , Musolino A
Published: October 2022

Background

Migrants’ engagement to cancer screening programs is a relevant issue for universalistic health systems. To increase breast cancer screening coverage among migrant women, a public-private partnership involving a multidisciplinary team of Primary Care, Public Health, Hospital and private social workers has been built up in a district in Italy. The team worked in two steps, planning health promotion (HP) meetings addressing women in refugees’ reception programs and a web-based workshop involving intercultural mediators (IMs) and community health promoters.

Objectives

The workshop, involving 10 professionals among IMs and community health promoters, realized in 3 online meetings during March ‘22, aimed at identifying communication tools to enable migrants’ participation to breast cancer screening and increasing health literacy (HL) and cultural competence (CC) among the team. A participatory approach, supported by learning methods, such as storytelling and role-play, has been adopted to identify the major barriers to access to screening and public health messages. Participants worked on critical words and concepts, highlighted during HP meetings, accounting for HL, literacy, language skills, communication techniques and different perspectives about health and prevention.

Results

Several barriers, such as lack of knowledge on preventive initiatives and different approaches to health, decrease the perception of cancer risk. Others, like family and work duties, influence the adhesion. Fear or shame about the exam and linguistic issues are further hampering factors. Participants pointed out text, audio and video messages, in Italian and native plain language, as useful tools to explain the screening procedure and give relevant and practical information supported by simple and clear illustrations to diffuse via WhatsApp.

Conclusions

The intervention enabled the team to improve HL and CC defining suitable communication strategies for cancer screening programs.

Key messages
An analysis of hospital-treated attempted hanging and drowning in Ireland, 2007-2019
Authors: White P , Corcoran P , Griffin E , Arensman E , Barrett P
Published: October 2022

Background

Highly lethal of methods of self-harm, such as attempted hanging and drowning, are a major public health concern due to their high associated risk of completed suicide. This study aims to describe hospital presentations for attempted hanging and drowning in Ireland and explore the factors associated with self-harm and repeat self-harm by these methods.

Methods

Data on all self-harm presentations to Irish hospitals (2007-2019) were obtained from the National Self-Harm Registry Ireland, a national surveillance system of hospital-treated self-harm. Multivariable logistic regression was used to explore factors associated with any presentation for attempted hanging and drowning and factors associated with repetition of attempted hanging and drowning.

Results

There were 9,719 and 4,637 attempted hanging and drowning hospital presentations, respectively, in Ireland in 2007-2019. The odds of presentations being due to hanging, rather than due to any other self-harm method, were highest for males (aOR 2.88, 95% CI: 2.76-3.02), children aged <15 (aOR 1.32, 1.17-1.48) and in summer (aOR 1.09, 1.02-1.14). The odds of presentations being due to drowning, rather than due to any other self-harm method, were highest for those aged ≥55 (aOR 1.60, 1.43-1.78), homeless individuals (aOR 2.59, 2.32-2.89) and in autumn (aOR 1.15, 1.06-1.25). Repetition of attempted hanging was positively associated with homelessness (aOR 2.47, 2.02-3.04) and acute alcohol ingestion (aOR 1.12, 1.02-1.23). Similar associations were observed for repetition of attempted drowning.

Conclusions

This study identifies key population groups for whom the risk of self-harm, or repeat self-harm, by hanging and drowning is greatest. Universal, targeted and indicated interventions are needed to address the determinants of highly lethal methods of self-harm. Biopsychosocial assessments of those presenting after attempted hanging and drowning are essential, in view of their high risk of repeat self-harm and suicide.

Key messages
The impact of the COVID-19 pandemic on tuberculosis case reporting in Kazakhstan
Authors: Kulimbet M , Yergasen A , Glushkova N , Adenov M , Davletov K
Published: October 2022

Background

The COVID-19 pandemic had a significant impact on economic development, lifestyles and health systems in all countries. Due to the lack of medical interventions, many countries adopted restrictive measures to slow the spread of the virus and reduce the burden on the healthcare system. Quarantine measures have had an impact on the transmission of SARS-CoV-2. However, the unintended consequences of such drastic measures were inevitable. In developing countries, there have been adverse effects of disruptions in health services, including the provision of timely medical services in detecting cases of tuberculosis in the population. The aim of this study was to study the influence of COVID-19 pandemic on the tuberculosis incidence in the Republic of Kazakhstan.

Methods

We analyzed national data on the reported tuberculosis cases and screening results of tuberculosis in Kazakhstan for 2019-2020. The primary data were collected from regular reporting of cases through surveillance.

Results

The number of registered patients identified during screening activities in 2020 were 2,854 cases compared to 4,288 cases in 2019 before COVID-19 era. The proportion of cases with antibiotic-resistant (poly, multi, super) forms of tuberculosis increased up to 6.7% in 2020 in comparison with 2019.

Conclusions

There is a need to conduct an analysis of the reasons for the increase in cases of multidrug-resistant and extensively drug-resistant tuberculosis. The working process should be adapted to epidemics and emergencies to ensure the availability of medical services, as well as to improve the system of preventive examinations and screening for the early detection of TB cases.

The abstract was submitted under the ‘CATINCA - Capacities and infrastructures for health policy development’ project which is coordinated/led by Robert Koch Institute and supported by the WHO Regional Office for Europe.

Key messages