bluuebunny/crossref_metadata_2025 huggingface dataset:
Inequalities in COVID-19’s collateral public health damage in Vienna
Authors: Oberndorfer M , Dorner TE
Published: October 2021

Background

Although lockdown measures are effective in containing the spread of COVID-19, such societal shutdowns may be accompanied by collateral public health damage. We aimed to assess potential inequalities in the distribution of adverse health-related and socioeconomic outcomes related to this pandemic for an urban Central European context.

Methods

Using a stratified random sample of 1004 participants living in Vienna, the capital of Austria with approximately 2 million inhabitants, this study analysed the distribution of 10 adverse health-related and socioeconomic outcomes attributable to the COVID-19 pandemic across socioeconomic strata. Data were collected between April, 27th and May, 17th 2020. Outcomes comprised a worsened economic situation, worsened self-reported mental and physical health, and a suspected or diagnosed infection with COVID-19 of the participant or someone close. Socioeconomic position (SEP) was indicated by income, education, and household overcrowding. We estimated differences in the incidence rates of our 10 outcomes by SEP using zero-inflated Poisson and logistic regression models adjusted for age and gender.

Results

Analysing the total number of experienced adverse outcomes, participants in the lowest and second lowest SEP category experienced a higher incidence rate (IRR=1.333[95%CI: 1.079 - 1.639] and IRR=1.447[95%CI: 1.190 - 1.760] respectively) compared to participants in the highest SEP category. Inequalities were highest for the outcomes job loss, worsened financial situation, and worse mental health. Different measurements of SEP yielded similar results, however, inequalities were most visible across income groups.

Conclusions

These results add to the rapidly accumulating evidence on the unequally distributed burden of the COVID-19 pandemic. Increased awareness about effect heterogeneity across SEP indicators will help to identify those in most urgent need of supportive policies.

Key messages

During the early phase of the COVID-19 pandemic in Vienna, its health-related and socioeconomic burden has been disproportionately carried by people in low socioeconomic positions. Inequalities in the incidence rate of adverse COVID-19-related outcomes were highest across income groups and for the outcomes job loss, worse financial situation, and worse mental health.
Lockdown constipation insidence and associated factors among adults during COVID-19 in Turkey
Authors: Yilmazel G
Published: October 2021

Background

The COVID-19 pandemic, by restricting population mobility, may exacerbate the risk factors for new constipation. This study was aimed to determine lock-down constipation incidence and associated factors among adults during COVID-19 pandemic in Çorum city from Turkey.

Methods

A descriptive, cross-sectional study was conducted on adult Turkish population (above 20 years of age), applying an electronic survey between December 2020-February 2021 to evaluate: demographic characteristics, nutrition behaviors, physical activity, weight gain, constipation incidence (according to Rome IV criteria) and coronavirus anxiety with Coronavirus Anxiety Scale Brief Form.

Results

Out of 816 participants evaluated, 301 (36.8%) developed new constipation with a significant decreased in the daily water consumption (p < 0.05) and physical activity, increased consumption of caffeinated beverages, skipped breakfast often, feeding mainly flour and cereal products, and weight gain (p < 0.05) during lock-down. Coronavirus anxiety was detected in 35% of participants and the incidence of constipation was significantly higher in those with coronavirus anxiety (p < 0.001). The multivariate analysis (logistic regression) showed that low water consumption (OR:1.67; p = 0.004), poor fiber diet (OR:1.45; p = 0.000), decreased physical activity (OR:1.34; p = 0.039), weight gain (OR:1.23; p = 0.000) and coronavirus anxiety (OR:1.17; p = 0.000) were associated with “new” constipation.

Conclusions

Lock-down constipation incidence was considerably high among adults and associated with lifestyle behaviors and coronavirus anxiety due to COVID-19 pandemic.

Key messages

Lock-downs may trigger the development of new constipation and anxiety. Risk factors related to the behavior of constipation come to the fore in lock-downs.
11.F. Workshop: Provision of strategic information during the COVID-19 pandemic through a multiple-layers model
Authors:   Organised by: Robert Koch Institute (Germany),   Chair persons: Johanna Hanefeld (Germany), Charbel El Bcheraoui (Germany)
Published: October 2021

The response to the COVID-19 pandemic has been random across the world's geographic, economic, social, and political settings, with no one unique approach identified as most successful. The fact is that to respond to a pandemic domestically, public health decision makers need timely and extensive knowledge from international settings, especially about successful practices. Within the Robert Koch Institute, different departments monitor and respond to the epidemic situation domestically. To supplement routine data from domestic settings, the Centre for International Health Protection (ZIG) deployed three additional mechanisms to feed strategic pandemic-related international information into the domestic response. The evidence provided to the appropriate decision makers was collected, evaluated, and synthesized on a daily, bi-weekly, and need-based frequency. Each of the three mechanisms will be presented with a focus on a specific analysis example. The discussion that follows will allow us to share our lessons learned on using international data in domestic epidemic control. Our objective is to inform the public health community on a variety of mechanisms to utilize information from international settings to control their domestic epidemic.

Key messages

Domestic epidemic response should comprise evidence from international settings: a systematic and structured process for data monitoring and analysis is needed to support evidence-informed policies. Departments of international health imbedded within domestic public health agencies can deploy a multiplicity of mechanisms to provide such evidence.
Ethical parameters and guidelines for the introduction of potentially discriminatory measures
Authors: Maeckelberghe Els
Published: October 2021

The last panelist will present key ethical considerations under which the DCC was introduced, determining whether extrapolating such an approach, even given extenuating circumstances sets a precedent serving solely a utilitarian perspective. Different approaches will be discussed on whether the immunised ought to be treated preferentially (granted unrestricted freedoms or a greater degree of freedom for the DCC holders) and whether there are grounds to argue the non-immunised can be justifiably discriminated against (restricted freedom). The basis upon which there can be such discrimination, i.e., healthy, innate biological characteristics, etc., will be further elaborated upon. A key aspect on whether non-contagious, but non-immunised people should experience the same freedoms will also be discussed (given freedom restrictions are normally regarded as a form of punishment). Guidelines for studying the introduction of such measures and ethical parameters to consider when planning research for such public health measures will also be discussed, incl. the assessment of of trade-offs for the individual vs. the broader societal good.
Non–Small-Cell Lung Cancer: Real-World Cost Consequence Analysis
Authors: De Polo A , Buja A , Pasello G , Bortolami A , Zorzi M , Schiavon M , Marchetti M , Baldo V , Rugge M , Conte PF
Published: October 2021

Background

The present work aimed at conducting a real-world data analysis on the management costs and survival analysis comparing data from non-small-cell lung cancer (NSCLC) cases diagnosed in the Veneto region before (2015) and after (2017) the implementation of a regional diagnostic and therapeutic pathway including all new diagnostic and therapeutic strategies.

Methods

This study considered 254 incidental cases of NSCLC in 2015 and 228 in 2017 within the territory of the Padua province (Italy), as recorded by the Veneto Cancer Registry. Tobit regression analysis was performed to verify if total and each item costs (2 years after NSCLC diagnosis) are associated with index year, adjusting by year of diagnosis, sex, age, and stage at diagnosis. Logistic regression models were run to study overall mortality at 2 years, adjusting by the same covariates.

Results

The 2017 cohort had a lower mortality odd (odds ratio, 0.93; P = .02) and a significant increase in the average overall costs (P = .009) than the 2015 cohort. The Tobit regression analysis by cost item showed a very significant increase in the average cost of drugs (coefficient = 5,953, P 5 .008) for the 2017 cohort, as well as a decrease in the average cost of hospice care (coefficient = -1,822.6, P = .022).

Conclusions

Our study showed a survival improvement for patients with NSCLC as well as an economic burden growth. Physicians should therefore be encouraged to follow new clinical care pathways, while the steadily rising related costs underscore the need for policymakers and health professionals to pursue the most rational utilization of public resources.

Key messages

Our work underscores the importance of real-world assessment of costs in oncology, especially in case of a disease like NSCLC, which has such a high impact on treatment costs and patient outcomes. New therapies prolong survival for patients with NSCLC but their sustainability reminds of the importance of prevention: the earlier the diagnosis, the longer the survival and the lower the costs.
The effects of the COVID-19 lockdown and socio-economic factors on stroke hospitalizations in France
Authors: Plat R , Vasile M , Quantin C , Arquizan C , Mercier G
Published: October 2021

Background

Worldwide, the COVID-19 pandemic has been associated with a drop in overall stroke hospitalizations. Additionally, there is a well-known association between stroke and socioeconomic status. This study aims to assess the COVID-19 effect on stroke admissions in France during the first national lockdown and investigate the factors associated with its spatial heterogeneity.

Methods

In this retrospective nationwide study, we used data from the French hospital discharge database (PMSI) to estimate rates of admission for stroke to all public and private hospitals in 2019 and 2020. We used negative binomial regression to test for a nationwide change in stroke admissions during the first lockdown, compared to the same period in 2019 (from week 12 to week 19). We conducted a multivariate analysis to explore the factors associated with the stroke admission incidence rate ratio variation (2020 incidence rate/2019 incidence rate) at the county level.

Results

We found a significant nationwide reduction in stroke admissions during the first wave of COVID-19 (incidence rate ratio 0,91 [0,86 - 0.97]), with notable geographic variations. After adjustment on hospital bed capacity, cumulative in-hospital COVID-19 incidence, standardized death rate at age 65 and unemployment rate, a higher share of labourers at the county level was associated with a higher incidence rate ratio (p < 0.01).

Conclusions

During the first national lockdown, there has been an overall decrease in stroke admission rates. Socio-economic determinants such as low-skilled jobs were independently associated with an increase in the stroke admission incidence rate ratio, while we did not find any independent effect from the local COVID 19 burden and hospital capacities.

Key messages

The first national lockdown led to an overall decrease in stroke admissions in France. This decrease varied between counties according to socio-economic determinants.
Socioeconomic determinants of traditional diet in Eastern Europe: result from the HAPIEE study
Authors: Stefler D , Yi X , Malyutina S , Kubinova R , Pajak A , Hrezova E , Pikhart H , Peasey A , Bobak M
Published: October 2021

Background

Traditional eating habits in Eastern Europe are associated with higher risk of all-cause and cardiovascular disease mortality. However, it is unclear whether this eating pattern is related to socio-economic characteristics of individuals. The aim of this analysis was to examine the socioeconomic determinants of traditional diet in Eastern European populations.

Methods

Data was available from the baseline survey of the Health, Alcohol and Psychosocial Factors in Eastern Europe study, including 21,752 eligible subjects from Russia, Poland and the Czech Republic. Dietary data was collected using food frequency questionnaires, and adherence to the traditional diet was assessed with the Eastern European Diet Score (EEDS). Information on participants` education, parental education and experience of financial difficulties in buying food were used as indicators of participants` socioeconomic position (SEP).

Results

In the multivariable adjusted logistic regression models, high EEDS, indicating higher adherence to the traditional diet, was significantly associated with lower education attainment (university vs. primary or less; OR: 0.85, 95%CI: 0.75-0.96) and lower parental education (0.82, 0.72-0.94). High EEDS was also more common in people who reported financial difficulties in buying food, but this association was weaker (often vs. never; 1.12, 1.00-1.25). Specific components of the EEDS, including intakes of lard, processed meat and preserved fruit and vegetables, were also closely linked to SEP indicators.

Conclusions

Our results suggest that individuals with lower SEP are more likely to follow the traditional eating pattern in Eastern Europe, and education seems to be a particularly important determinant. Public health nutritional interventions should focus on the more disadvantaged groups to improve diet and reduce health inequalities in this region.

Funding: This work was partly funded by the Horizon 2020 CETOCOEN Excellence project (grant no. 857560).

Key messages

This work shows that socioeconomic factors, particularly education, are important determinants of traditional eating habits in Eastern European countries. As traditional diet in this region is linked with poor health, nutritional interventions have the potential to improve population health and reduce socioeconomic inequalities in Eastern Europe.
Dimensions of fruit and vegetable access in the retail food environment; a systematic review
Authors: Turner G , Green R , Alae-Carew C , Dangour AD
Published: October 2021

The consumption of fruit and vegetable (F&V) is important for human health to protect against non-communicable disease and micronutrient deficiency. Increasing consumption of F&V may also benefit planetary health if these foods are substituted for foods with higher environmental footprints such as red meat or dairy. The retail food environment (RFE) is an influential junction between the food system and individual diets as it drives access to F&V through external (physical access) and personal (availability, affordability, acceptability) domains. We performed a systematic search of six literature databases (January 2021) for studies assessing access to F&V in the RFE and its association with F&V consumption in adults in high- and upper-middle income countries. 36 studies were identified and categorised by dimensions of food access - accessibility, affordability, acceptability, availability and accommodation. More than half of the studies (n = 20) were based in the USA. F&V accessibility was the most commonly reported dimension (n = 29); no study reported on accommodation. 6 studies were rated to be high quality. A positive association of increased availability of F&V options in the RFE with intake was identified in 9 of 15 studies. Associations in both acceptability and accessibility dimensions were inconsistent. No association was observed between F&V affordability and consumption although available data were limited. Many challenges exist to building a robust evidence base within food environment research including conceptual, definitional and methodological heterogeneity and measurement standardisation. Future food policies should consider multi-dimensional interventions to promote access to F&V in the RFE across all domains.

Key messages

First systematic review of dimensions of access in the retail food environment (RFE) and fruit and vegetable (F&V) intake suggesting importance of access to available healthy options for F&V intake. The retail food environment is complex but likely predictor of F&V consumption.
Being a parent in Finland: a culturally-tailored psychoeducative parental support programme
Authors: Skogberg N , Laajasalo T
Published: October 2021

Problem

Migrant origin children are overrepresented in child protective services and among cases of suspected maltreatment against children. Language barriers, poor understanding of the child welfare system and differences in perceptions of child rearing and disciplinary practices create additional burden during the assessment process. Authorities struggle to meet the needs of migrant origin families.

Description of the problem

A variety of universal, selective and indicative parenting support programmes are available. While these have been shown to be effective also among persons of migrant origin, cultural adaptation has also been suggested to increase the benefits. Any adaptation to a trial-tested programme may, however, impact its integrity. To avoid this, a separate culturally sensitive Being a Parent in Finland programme was developed to complement other parenting interventions and supporting services offered by the health and social welfare authorities. Intervention was developed as part of the Barnahus project coordinated by the Finnish Institute for Health and Welfare.

Results

The aim of the Being a Parent in Finland psychoeducational group programme is to increase the wellbeing and safety of children through group-based parental support. The programme consists of three two-hour meetings offered to parents of children aged 3 to 12 years. The main themes include the Finnish service system, parenting practices that support the child's development and wellbeing and wellbeing of the family as well as children's rights. Psychoeducational videos were produced as supportive material. Groups of maximum 8-10 participants are led by trained instructors, assisted by professional interpreters.

Lessons

The programme will be piloted by the city of Helsinki, with the first two groups starting in May 2021. Experiences and lessons learned from these groups will be presented. Impact assessment of the programme and will be launched in autumn 2021.

Key messages

While culturally sensitive adaptations may increase positive outcomes of parental programmes, there is a risk for compromising programme integrity, leading to minimized or even adverse consequences. Being a parent in Finland aims at supporting the wellbeing and safety of families through culturally sensitive psychoeducative groups administered as complementary support measure to other services.
Analysis of sexual and reproductive health indicators according sexual orientation young Brazilians’
Authors: Sousa M , Rocha L , Silva F , Felisbino-Mendes M
Published: October 2021

Background

Sexual and reproductive health indicators and behaviors may occur differently between sex and according to sexual orientation. In addition, there is a lack of studies that consider sexual orientation and approach young adults in Brazil.

Objective

To analyze sexual and reproductive health indicators of young Brazilian adults and their differences according to sex and sexual orientation.

Methods

Cross-sectional study with 2,063 young adults, undergraduate students from a public university who responded to the online survey. We estimated the prevalence of sexual and reproductive health indicators, desire or not to have children, report of pregnancy and feeling about the pregnancy state), according to sex (male and female) and sexual orientation (heterosexual, bisexual, homosexual). Differences between prevalence were assessed using Pearson's chi-square test.

Results

Among heterosexuals, condoms were the contraceptive method most used by men (90.6%) and women (75.5%). Women used double protection (53.5%) and had a fixed sexual partner (67.8%) in a greater proportion. Men, on the other hand, maintain the practice of casual relationships more frequently (70.5%) and 43.2% have already had unprotected casual relationships. Among bisexuals, condoms were the method most used by men (97.7%) and women (85.4%). In this group, 51% of women use double protection and have a steady partner (62.2%). Among homosexuals, 99.1% of gays and 46.1% of lesbians used condoms at the last sexual intercourse and 46.1% of lesbians used hormonal methods. Also, 28.8% of gays have already had an STI, a higher rate than among heterosexuals.

Conclusions

There are important differences in sexual and reproductive behaviors between genders and according to the sexual orientation of young people, such as greater vulnerability to STIs among gays and lesbians, and medicalization around the female body, highlighted by the permanence of questionable practices among lesbians.

Key messages

Gender issues could also explain the differences found between men and women. Differences between the sexes are also present when evaluating the use of protection against STIs or unplanned pregnancies.
A systematic review of the association between mental health and tuberculosis disease risk
Authors: Hayward SE , Deal A , Rustage K , Nellums LB , Sweetland AC , Boccia D , Hargreaves S , Friedland JS
Published: October 2021

Background

Tuberculosis (TB) and mental illnesses are highly prevalent globally and often co-exist. Whilst poor mental health is known to modulate immune function, whether mental disorders causally increase TB incidence is unknown. This systematic review examines the association between mental health and TB disease risk to inform clinical and public health measures.

Methods

We carried out a systematic review following PRISMA guidelines (PROSPERO CRD42019158071). We searched MEDLINE, PsycINFO and PsycEXTRA databases alongside reference list and citation searching. Inclusion criteria were original research studies published 01/01/1970-11/05/2020 reporting data on the relationship between mental health and risk of TB disease. CASP and AXIS checklists were used to critically appraise included studies.

Results

We screened 1546 records published over 50 years, resulting in data synthesised from 607,184 individuals. Settings include Asia, South America, and Africa, and both mood (e.g. depression) and psychotic (e.g. schizophrenia) disorders are investigated. Robust evidence from cohort studies in Asia shows that depression and schizophrenia can increase risk of TB disease, with effect estimates ranging from HR = 1.15 [95% CI 1.03-1.28] to HR = 2.63 [95% CI 1.74-3.96] for depression and HR = 1.52 [95% CI 1.29-1.79] to RR = 3.04 for schizophrenia, and a dose-response relationship reported in one study. These data are consistent with data from cross-sectional studies, such as a large survey across low- and middle-income countries (n = 242,952) reporting OR = 3.36 [95% CI 3.01-4.50] for a depressive episode in those with TB versus those without.

Conclusions

Individuals with mental illnesses including depression and schizophrenia experience increased TB incidence and represent a high-risk population to target for screening and treatment. Integrated care for mental health and TB is needed, and interventions tackling mental illnesses and underlying drivers may help reduce TB incidence globally.

Key messages

This systematic review examines data from 607,184 individuals and finds evidence that mental health is a risk factor for TB disease. Those suffering from depression and schizophrenia are an at-risk population that could be identified and targeted for TB screening and treatment.
Stressful life events in pregnancy and sleep problems in childhood: Evidence from the ELSPAC Cohort
Authors: Ksinan Jiskrova G , Stepanikova I
Published: October 2021

Background

Childhood sleep problems have been associated with adjustment difficulties; furthermore, early-onset sleep problems may persist over the life course. Exposure to stress during pregnancy may be a risk factor for developing sleep problems in childhood due to its effect on the stress reactivity in the child. In the current study, we examined the association between prenatal stressful life events (SLE) and childhood sleep problems, paying attention to their trajectory over time.

Methods

Data were obtained from the European Longitudinal Cohort Study of Pregnancy and Childhood (ELSPAC-CZ; N = 4,371 mother-child dyads). Mothers reported SLE during pregnancy using an inventory of 42 life events and the number of child sleep problems at the child's age of 18 months and 3, 5, 7, and 11 years. The association between prenatal SLE and the developmental course of sleep problems was examined using a Poisson latent growth model. The model was adjusted for maternal and family demographics, birth characteristics, and maternal depression.

Results

At 18 months, mothers reported on average 2.01 sleep problems (range 0-7, p < 0.001). The rate of sleep problems decreased linearly by 0.89 (p < 0.001) per year. A higher number of prenatal SLE was associated with a higher rate of sleep problems at 18 months (rate ratio [RR]=1.02, 95% confidence interval [CI]=1.01-1.02, p < 0.001), and significantly reduced rate of decrease in sleep problems from 18 months to 11 years (p < 0.001).

Conclusions

Exposure to prenatal SLE was associated with a higher number of sleep problems in early childhood and with their persistence over time. Thus, experiencing prenatal stress may serve as a predisposing factor for the development of sleep problems later in life.

Key messages

Children of mothers who experienced stressful life events in pregnancy had more sleep problems during childhood. Prenatal exposure to stress may predispose individuals to sleep problems later in life.
Using the Middle-Out Perspective to augment advocacy for smokefree legislation
Authors: Mindell JS , Bartington S , Janda KB , Stoll L , Barlow J , Parag Y
Published: October 2021

Issue

Complementing ‘Bottom-up' and ‘Top-down' approaches, the Middle-Out Perspective (MOP) conceptual framework focuses on how middle actors can influence action by enhancing other actors' interest and ability to act. Middle actors exert influence sideways on other middle actors, upwards on policymakers and downwards on individuals. Middle actors can be immediate targets as potential allies or communication channels.

Description of the problem

Successive governments' longstanding voluntary agreements with industry have not protected children and non-smokers from secondhand smoke. Can the MOP enhance effectiveness of small organisations whose voices are ignored?

Results

The NGO Action on Smoking and Health (ASH) built a coalition of NGOs, practitioners' organisations, and others to advocate for smokefree legislation. Aggregating these voices made them more visible and their demand more influential. Involvement of trade unions and lawyers threatened legal action by exposed employees. Local government support and threats of local legislation changed the hospitality trade's opposition to support. Middle actors' supporters and members lobbied their MPs. ASH's professional expertise and reputation made them a trustworthy actor with legitimacy. The consortium led to the national government in England passing smokefree legislation in 2006.

Lessons

Middle actors can be agents of change, promoting desirable public health goals in a middle-out manner. Formal MOP mapping at the start of work can help public health staff identify potential non-traditional ‘allies' to expand the range of who are considered potential middle actors for a particular issue, enlisting powerful additional leverage in improving the public's health. However, middle actors are not neutral. They can contribute to better public health, but they may also be exploited by commercial interests to block healthy policies or promote a health-diminishing agenda.

Key messages

The Middle-Out Perspective (MOP) provide a lens to examine how actors positioned between government (top) and individuals (bottom) act to promote changes in a middle-out manner. Using MOP as a formal approach can help public health organisations and practitioners consider potential ‘allies’ from outside traditional health-related bodies or professions.
Recreational cannabis consumption: a public health perspective
Authors: Gaspar da Rocha A , Queiroz Almeida D , Almeida MA
Published: October 2021

Introduction

The misuse of psychoactive drugs is an important public health problem. It's estimated that there are between 120-224 million users worldwide. In 2001, Portugal started the legal process to decriminalize the use of narcotic drugs and psychotropic substances.

Objectives

To analyze the recreational use of cannabis from a Public Health perspective, to summarize the adverse health effects, to describe the situation in countries where it's legal, and to assess the impacts of its legalization.

Methods

A literature review was carried out using the main databases of scientific articles. Additionally, legal documentation, institutional reports, journalistic pieces, interviews and books were also consulted.

Results

Individual possible effects of punctual used found were: Temporary feeling of euphoria and relaxation; Distortion of perception; Changes in short-term memory and concentration; Altered motor coordination; Paranoia and psychosis. Effects of regular consumption or products with a high THC content: Dependency; Changes in brain development; Cognitive impairment; Decreased life satisfaction and personal fulfilment; Depression. Population level effects described were: increased number of consumers, increased risk of dangerous driving and accidents; decreased suicide rate and death from opioid overdose, decline in black market and in criminality near trading posts. The legalization of consumption in certain countries has allowed us to realize that the price, the quantity of product and the definition of sales locations are relevant topics for the successful implementation of policies in this area.

Conclusions

As the cannabis legalization policy is changed, it is expected the consumption will increase. An investment in prevention campaigns and increase in health literacy should begin before this change focusing particularly on younger people and drivers. This way, the negative health and social effect that can arise from this change will be minimized.

Key messages

Campaigns to prevent cannabis use must begin before legalization. Campaigns to prevent cannabis use should target teenagers and young people and drivers.
COVID-19 vaccine acceptance among primary care residents in Middle-Black Sea Region of Turkey
Authors: Yilmazel G
Published: October 2021

Background

Family Health Center residents fights against infectious diseases at the forefront in primary care. This study aimed to identify COVID-19 vaccine acceptance and associated factors among FHC residents of primary care Middle-Black Sea Region of Turkey.

Methods

A-web based cross-sectional study was conducted with family health center residents in Turkey between October-November 2020. The main outcome variable was acceptance of a potential COVID-19 vaccines. Also COVID-19 Fear scale was used. The associated factors with acceptance were identified through a multiple logistic regression analysis. In evaluations p < 0.05 value were considered significant.

Results

A total of 443 family health center residents were enrolled in the study. In the study group, 65.7% were women, 44% were doctors and 56.0% were other family health staffs. Among the residents, 60.9% reported to willing and 39.1% reported to hesitant to COVID-19 vaccine. Major reasons for acceptance and hesitancy were expection of high protection of vaccines (76.4%) and lack of scientific studies (37.5%) respectively. Men (ORa=1.54), non-smokers (ORa=2.12), those with vaccinated to influenza (ORa=0.33), those with non-infected with COVID-19 (ORa=2.36), and residents who had high level of COVID-19 fear (ORa=2.69) were more likely to be accepted to vaccinate.

Conclusions

More than half of the family health center residents had COVID-19 vaccine acceptance. The way to strengthen the process of vaccination is to well informed of family health center residents with newly emerging scientific data and evidence.

Key messages

Acceptance of a potential COVID-19 vaccine was not desired level. Informing about current evidence on COVID-19 may be needed in order to achieve better vaccine coverage.
Living conditions, lifestyle habits and health among adults before and after the COVID-19 outbreak
Authors: Molarius A , Persson C
Published: October 2021

Background

Studies on the public health consequences of COVID-19 pandemic based on robust data and methods are scarce. The aim of this study was to investigate mental and physical health as well as living conditions and lifestyle habits in the general population before and after the COVID-19 outbreak in Sweden in spring 2020.

Methods

The study is based on 2,273 persons 16-84 years who responded to the national public health survey in spring 2020 in Värmland county (overall response rate 45%). The differences between early (n = 1,711) and late (n = 562) respondents were studied using multivariate logistic regression, adjusting for background characteristics age, gender, educational level, and country of birth. Similar analyses were also completed in the corresponding survey carried out in spring 2018.

Results

Statistically significant differences between the groups were obtained for economic difficulties and worry about losing onés job, which were more common among late respondents, and for sleeping difficulties, which were more common among early respondents. There were no differences in other living conditions nor in lifestyle factors. Prevalence of good self-rated health, high blood pressure, aches in shoulders or neck, anxiety or worry and stress did not differ between the groups. In 2018, the only statistically significant difference between early and late respondents concerned economic difficulties.

Conclusions

Very few differences in living conditions, lifestyle factors and health were observed in the study population before and after the COVID-19 outbreak when adjusted for background characteristics. The results suggest that, in addition to a possible decrease in sleeping difficulties, the prevalence of being worried about losing one's job increased among the employed after the outbreak.

Key messages

The results suggest that the prevalence of being worried about losing one’s job increased among the employed after the outbreak. More research on the short- and long-term public health consequences of the pandemic in the general populations and in different subgroups, using robust data and methods, is needed.
Associated factors to SARS-CoV-2 infection among dental professionals
Authors: Peres Neto J , Fini de Souza M , Martins Camargo Barbosa A , Marsico Loschiavo L , Barbieri W , da Costa Palacio D , Bonfim D , Nascimento Monteiro C , Cintra Nunes Mafra AC , Ferreira Silva Junior M
Published: October 2021

The objective of this study was to analyze associated factor to SARS-CoV-2 infection among dental professionals. This was a cross-sectional study carried out from February to September 2020 in the municipality of São Paulo, Brazil. We included all dental team working at 11 basic health units. Professionals included were from the three different categories oral surgeon-dentist, dental technician, dental assistant. The analysis included SARS-CoV-2 infection and independent variables (sociodemographic, labor and behavior) with descriptive analyses with absolute (n) and relative (%) frequencies, inferential analysis by chi-squared and Fisher exact test (p < 0.05). There was a prevalence of 20.3% of infection by SARS-CoV-2 between dental professionals. However, in the analysis by professional category the infection rate was 3.8 among oral surgeon-dentist, 30.0% among dental technician, 33.3% for dental assistant. The diagnostic of SARS-CoV-2 infection was associated with lower income (p = 0.027), lower level of formal education (p = 0.011), technical professional category (p = 0.025), and the use of public transportation (p = 0.009). The higher prevalence of COVID-19 in technical professionals than oral surgeon-dentists may suggest that infection had occurred outside the working environment, once professional had personal protective equipment available as well as the training for their professional activity. In addition, professionals reported to feel safe and prepared to perform their activities in the work environment.

Key messages

Transmission of SARS-CoV-2 in oral health in the public service. Promotion and prevention of SARS-CoV-2 transmission in oral health in the public service.
Impact of mandatory institutional quarantine on sleep quality: A cross sectional Tunisian study
Authors: Cherif I , Kharroubi G , Haj Amor S , Zribi M , Ouali U , Bettaieb J
Published: October 2021

Background

Given the COVID-19 pandemic, Tunisian authorities have imposed quarantine in dedicated centers mainly for travelers coming from countries with highest coronavirus infection rates. Such restrictive measures may have a detrimental impact on people's mental health and can thus affect sleep. We aimed in this study to assess the impact of mandatory institutional quarantine on sleep quality in Tunisia and to determine factors associated with clinical insomnia.

Methods

Data were collected through a cross sectional study conducted from April to November 2020 among individuals who were in quarantine for 14 days including at least a week in a Tunisian quarantine center. Sleep quality was assessed using the Insomnia Severity Index. Factors associated with clinical insomnia were assessed using bivariate and multivariate analysis.

Results

In the present study, 506 participants were included with a mean age of 37.6±13.6 years. Majority (66.4%) were men. Nearly one fifth (19.2%) of surveyed individuals had symptoms of clinical insomnia. In multivariate analysis, we found that being a woman, spending longer time on covid-19 news per day, having experienced stigma during the quarantine period, financial difficulties due to the coronavirus pandemic and dissatisfaction by the accommodation conditions of the quarantine facility were independently associated with clinical insomnia.

Conclusions

Nearly one fifth of participants had clinical insomnia during the quarantine period. Providing a good sleep environment, educating sleep healthy behavior and giving adequate psychological support to quarantined individuals in quarantine centers is necessary.

Key messages

Among surveyed participants, 19.2% had symptoms of clinical insomnia. Providing a good sleep environment in quarantine centers and providing mental health support to quarantined individuals is essential.
Myths of ‘good motherhood’ and the wellbeing of mothers during the Covid-19 pandemic
Authors: Batram-Zantvoort S , Wandschneider L , Razum O , Miani C
Published: October 2021

Background

Measures to contain the Covid-19 pandemic had major impacts on families, e.g., due to the unpredictable closing of childcare facilities and schools. Parents had to re-arrange their work, childcare and household obligations.

Methods

We conducted 17 email interviews with mothers having at least one child aged < =6 years. Topics included adjustments to the pandemic situation, views on motherhood and wellbeing. We analysed data through content analysis.

Results

We found differing consequences on the wellbeing of the interviewees. One group articulated a deceleration of daily life and increased satisfaction due to doing more justice to their role as mother. Another group felt highly stressed and overloaded. Some expressed having shaky hands and heart palpitations, others felt mentally exhausted. The idea of not being a ‘good mother' was expressed by many, provoking guilt and self-doubt. Most interviewees referred to ideological myths of motherhood, picturing mothers as caring and sacrificial, yet well-organized managers of the family. Norms imposed on ‘working mothers' require their full effort and an ability to manage employers' demands. These conflicting norms reveal tensions between the roles mothers find themselves in, potentially leading to adverse (mental) health outcomes.

Conclusions

Our analysis shows that myths of ‘good motherhood' act as a perpetuation mechanism of traditional gender roles and increase the social burden many mothers are expected to carry, adding to the challenges the global pandemic brought on families. Negative consequences on (mental) health require mitigation strategies, putting mothers at the centre of Covid-19 response policies.

Key messages

The Covid-19 pandemic exacerbates traditional gender roles and the multiple social burdens that mothers are expected to carry. Conflicting norms imposed on mothers reveal tensions between the different roles they find themselves in, potentially leading to adverse (mental) health outcomes.
Assessment of COVID-19 vaccine literacy among cancer patients: A cross sectional Tunisian study
Authors: Cherif I , Khiari H , M'ghirbi F , Mallekh R , Mezlini A , Hsairi M
Published: October 2021

Background

In the context of the COVID-19 pandemic, Vaccine literacy (VL) is considered as an important determinant of vaccine hesitancy and uptake. Cancer patients constitute a target group for COVID-19 vaccination. Thus, we aimed in this study to assess COVID-19 VL among cancer patients in Tunisia.

Methods

A cross sectional study was conducted, during the month of February 2021, in the Salah Azaiez institute of cancer including all inpatients aged ≥18 years. A standardized VL scale was used, composed of two dimensions: functional VL and interactive-critical VL, using a four point Likert scale. A global score was calculated for each scale (ranging from 1 to 4); A cutoff of 2.5 was defined according to the literature. The students' t and Anova tests were used for comparison of VL mean scores according to the studied characteristics. A p value <0.05 was considered as statistically significant.

Results

A total of 200 patients were enrolled in this study with a mean age of 54.4±12.7 years. A low VL score (≤ 2.5) was observed among 27.5% and 81.0% participants for functional and interactive critical scales respectively. Higher functional VL score was associated with a higher educational level (3.7±0.5 among individuals with a university degree level vs 2.5±1.2 among illiterate, p < 0.001). Interactive critical VL significantly increased with educational level (p < 0.001) and was significantly higher among healthcare workers (2.5±1.3 vs 1.7± 0.9, p < 0.001), those who accepted to get the COVID-19 vaccine (2.0±0.9 vs 1.6±0.8, p = 0.002), who did not believe that vaccines are unsafe (1.9±0.9 vs 1.4±0.7, p < 0.001) and that there is no need to be vaccinated since natural immunity exists (2.1±1.0 vs 1.7±0.8,p=0.016).

Conclusions

Vaccine literacy among cancer patients included in this study is weak. Effective communication strategies about COVID-19 vaccination should build VL and consider the level of patient's health literacy to redress vaccine hesitancy and uptake.

Key messages

This study showed a low interactive-critical vaccine literacy score. Communication strategies in vaccination campaigns should be aligned with people’s vaccine literacy.
Subjectively perceived healthcare provision during the first wave of the COVID-19 pandemic
Authors: Hannemann N , Götz NA , Schmidt L , Babitsch B
Published: October 2021

Background

An OECD benchmark (2020) shows that Germany has, in effect, an above-average healthcare infrastructure to face COVID-19. Nevertheless, at the beginning of the pandemic, there were restrictions and uncertainties in the use of health-related services. The following analysis examines the subjective perception of respondents with their healthcare provision whether there were sociodemographic differences.

Methods

Data from an online cross-sectional survey conducted between 29 April and 8 May 2020 were used (N = 1,570; 18-74 years). Bivariate test methods were used for analysis, stratified by age group, subjective social status (SSS) and chronic illness. The subjective perception was assessed via subjects' subjectively perceived worries, fears and difficulties of not receiving an adequate healthcare provision during the COVID-19 pandemic. Thus, an index was constructed with a range of values from 3 to 12 (Cronbach's α = 0.886). A higher index implies a poorer perception of the healthcare provision.

Results

Compared to the groups 50-59-year-olds and 60 years and older the 18-29-year-olds (MRank 431.1) had a significantly (p < 0.05) poorer perception of their healthcare provision during COVID-19. In addition, probands with low SSS were found to have a significantly (p < 0.05) worse perception (MRank 423.0) than subjects with medium SSS (MRank 374.1). Chronically ill subjects suffered significantly poorer perception (MRank 406.1; p < 0.05) compared to healthy subjects (MRank 366.0).

Conclusions

Vulnerable groups with poorer perceptions of their health care provision during COVID-19 can be identified. More investigation is needed to identify subjective or COVID-19 related predictors that cause this subjective perception.

Reference

OECD (2020). Beyond Containment: Health systems responses to COVID-19 in the OECD.

Available: https://read.oecd-ilibrary.org/view/?ref=119_119689-ud5comtf84&title=Beyond_Containment:Health_systems_responses_to_COVID-19_in_the_OECD (Accessed: 14.04.2021)

Key messages

It was found that respondents perceived their subjective healthcare provision during COVID-19 differently, according to sociodemographic stratification. Especially younger, chronically ill, and socioeconomically deprived respondents experienced a poorer perception of their healthcare provision during the first wave of the COVID-19 pandemic.